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Acta Clinica Belgica

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https://www.readbyqxmd.com/read/28521652/case-report-patient-with-unexplained-high-fever-and-pancytopenia
#1
Kelly De Schuyter, Tom Lodewyck
OBJECTIVE AND IMPORTANCE: We present a case of hemophagocytic lymphohistiocytosis (HLH), giving insight in how to establish diagnosis and start appropiate treatment. CLINICAL PRESENTATION: A 45-year-old male presented at the emergency ward with high fever and pancytopenia. Repeat bone marrow aspirates showed hemophagocytosis. Extensive work-up with exclusion of other infectious and malignant diseases, eventually lead us to the diagnosis of hemophagocytic lymphohistiocytosis...
May 19, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28508721/acute-renal-failure-with-need-for-renal-replacement-therapy-as-a-complication-of-zoonotic-s-zooepidemicus-infection-case-report-and-review-of-the-literature
#2
Laurens Veldeman, Katrien De Wilde, Dirk Vogelaers, Evelyne Lerut, An Vonck, Dien Mertens, Annelies Koch, Jan Beckers
Streptococcus zooepidemicus is an animal commensal with the potential of zoonotic transmission through ingestion of contaminated dairy products, leading to outbreaks of Post-Streptococcal Glomerulonephritis (PSGN). We report for the first time acute renal failure with need for renal replacement therapy, as a complication of S. zooepidemicus bacteremia resulting from direct horse to human transmission in a young adult. Both clinical disease course and immunohistochemical staining patterns on renal biopsy had some atypical features of PSGN suggesting persistent activation of the alternative complement pathway but no known complement factor dysregulations could be identified...
May 16, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28441913/the-masquerading-presentation-of-a-systemic-anaplastic-large-cell-lymphoma-alk-positive-a-case-report-and-review-of-the-literature
#3
Selma Al-Ahmad, Vincent Maertens, Christophe Libeer, Vera Schelfhout, Filip Vanhoenacker, Nancy Boeckx, Marleen Vandevenne
We report an unusual case of systemic anaplastic large cell lymphoma (ALCL), ALK positive with leukemic involvement in a 57-year-old woman. The patient presented with a fulminant respiratory infection unresponsive to treatment requiring intensive care and ventilatory support. The CT scan demonstrated mediastinal and bilateral lymphadenopathy. On peripheral smear a few atypical lymphocytes were visualized. Based on the increasing number of atypical lymphocytes in the daily peripheral bloodsmears, the diagnosis ALCL was suggested...
April 25, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28431485/efficacy-of-golimumab-in-belgian-patients-with-active-rheumatoid-arthritis-despite-treatment-with-non-biologic-disease-modifying-anti-rheumatic-drugs-sub-analysis-of-the-go-more-study
#4
Patrick Durez, Marie Vanthuyne, Muhammad S Soyfoo, Ilse Hoffman, Michel Malaise, Piet Geusens
OBJECTIVES: The GO-MORE trial (NCT00975130) was a phase 3 study in 40 countries evaluating the efficacy and safety of golimumab as add-on therapy in biologic-naïve adults with active rheumatoid arthritis despite stable treatment with disease-modifying anti-rheumatic drugs. To inform local practice in Belgium and examine the role of baseline disease activity in treatment response, we compared the efficacy of golimumab in the Belgian subpopulation and the rest of the world. METHODS: Baseline disease activity and six-month efficacy rates in the GO-MORE trial were compared for the Belgian subpopulation and the rest of the world by t-tests and chi-squared tests...
April 21, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28420292/neuroendocrine-tumor-of-cecum-in-patient-treated-with-imatinib-mesylate-for-blastic-phase-of-chronic-myeloid-leukemia
#5
Sabina Novaković, Anamarija Kovač Peić, Hrvoje Holik, Božena Coha
Imatinib mesylate (IM), a tyrosine kinase inhibitor, is the treatment of choice in patients with chronic myeloid leukemia (CML). It is considered a very safe drug, with mostly mild and reversible side effects. Lately, it has been suggested that adverse events may occur after a long term. We report a case of a 72-year-old woman diagnosed with blastic phase of Philadelphia chromosome positive CML treated with IM for 28 months. The patient presented first with ascites as a side effect of the drug. When the ascites re-occurred, it was caused by neuroendocrine tumor (NET) with peritoneal carcinomatosis...
April 19, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28412856/investigating-the-role-of-il-33-in-the-pathogenesis-of-beh%C3%A3-et-s-disease
#6
Pamir Çerçi, Seda Altıner, Ali İnal, Kenan Köse, Göksal Keskin, Ümit Ölmez
OBJECTIVES: Behçet's disease (BD) is an inflammatory disease, characterized by oral aphthous lesions, recurrent uveitis, skin lesions, and genital ulcerations. Increased release of several cytokines may play a role in the inflammatory stages of BD. IL-33, a member of the IL-1 cytokine superfamily, plays an important role in inflammation. We analyzed serum IL-33 concentration in BD patients to assess its possible role in the pathophysiology of this disease. METHODS: The study included 54 BD patients, 31 with active BD and 23 with inactive BD as well as 18 matched healthy controls...
April 17, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28406385/retrospective-chart-review-of-hospitalizations-and-costs-associated-with-the-treatment-of-adults-with-philadelphia-negative-b-cell-relapsed-or-refractory-acute-lymphoblastic-leukemia-in-belgium
#7
Johan Maertens, Carlos Graux, Dimitri Breems, Violaine Havelange, Sebastian Wittnebel, Daniëlle Strens, Caroline Hoefkens
OBJECTIVES: To quantify hospitalizations and costs among adults with Philadelphia-negative relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (ALL) who received current salvage chemotherapies in Belgium. METHODS: A retrospective chart review identified patients aged ≥18 years and hospitalized between 2005 and 2015 for Ph-negative R/R B-cell ALL. Data were collected from the index date (first diagnosis of R/R ALL) until death or loss to follow-up...
April 13, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28398157/effects-of-continuous-positive-airway-pressure-on-fatigue-in-two-patients-with-obstructive-sleep-apnea-presenting-with-chronic-fatigue-case-report-and-lessons-learned-from-a-failed-trial
#8
Els Tobback, Liesbeth Delesie, Ignace Hanoulle, Dirk Vogelaers, Dirk Pevernagie, An Mariman
INTRODUCTION: Patients referred to tertiary care for multidisciplinary investigation of unexplained chronic fatigue are not seldom diagnosed with obstructive sleep apnoea (OSA). As standard treatment for OSA, continuous positive airway pressure (CPAP) has been shown to decrease daytime sleepiness in OSA patients. However, the effect on fatigue as major complaint in chronic fatigue patients without excessive daytime sleepiness, is not fully understood nor explored. CASE REPORT: A prospective cross-over trial using effective and sham CPAP treatment periods in patients with unexplained chronic fatigue and OSA was interrupted because of poor recruitment and retainment due to complex design issues...
April 11, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28372481/staphylococcal-versus-streptococcal-infective-endocarditis-in-a-tertiary-hospital-in-belgium-epidemiology-clinical-characteristics-and-outcome
#9
Jean Cyr Yombi, Sandra Nyota Yuma, Agnes Pasquet, Parla Astarci, Annie Robert, Hector Villalobos Rodriguez
Infective endocarditis (IE) is a rare but serious illness associated with a high mortality. Staphylococcus spp and Streptococcus spp are the most frequent causative pathogens. In this study, we compared the epidemiology, clinical characteristics and outcomes of patients with Staphylococcal and Streptococcal IE in a tertiary hospital. Using our institutional database 'Medical Explorer', we collected all cases of IE retrospectively between January 2005 and December 2010 at the Cliniques Universitaires Saint Luc and then focused on Staphylococcal and Streptococcal IE...
April 4, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28361645/an-unusual-cause-of-epidemic-thyrotoxicosis
#10
Lucie Wartique, Lucie Pothen, Nathalie Pirson, Michel P Hermans, Michel Lambert, Halil Yildiz
We describe the case of four patients consulting for headache and tachycardia of brutal onset. Their biological data were compatible with primary hyperthyroidism with low TSH and high T4 serum levels. Serum thyroglobulin level was low and Tc-scintigraphy showed decreased uptake with a homogenous pattern. These results allowed to conclude a thyrotoxicosis caused by thyroid hormones intake. History taking revealed consumption of beef neck meat containing all or parts of the bovine thyroid gland. Evolution was favourable with beta-blockers...
March 31, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28346081/pneumocystis-jiroveci-pneumonia-pjp-in-non-hiv-immunocompromised-individuals
#11
Kathleen Schoovaerts, Luc Dirix, Annemie Rutten, Jef Van Schaeren, Bruno Van Herendael, Sofie Van Grieken, Luc Heytens
OBJECTIVES: PJP is a major cause of morbidity and mortality in immunocompromised individuals. Diagnosing PJP is often difficult because respiratory signs might be minimal or absent and the sensitivity of a chest X-ray (CXR) is low. We studied the clinical risk factors in order to increase awareness and facilitate the diagnosis. METHODS: We studied a prospective case series over a one year period (from 1 January 2015 to 1 January 2016) and did a retrospective analysis (from 2013 to 2016) of all PJP positive bronchoalveolar lavage (BAL) analysis...
March 27, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28335691/cases-of-drug-induced-torsade-de-pointes-a-review-of-belgian-cases-in-the-eudravigilance-database
#12
Eline Vandael, Bert Vandenberk, Joris Vandenberghe, Rik Willems, Veerle Foulon
OBJECTIVES: Post-marketing surveillance is very important, especially for rare adverse drug reactions like QTc-prolongation and Torsade de Pointes (TdP). The objective of this study was to investigate the characteristics of Belgian cases of drug-related TdP reported in the EudraVigilance database. METHODS: The EudraVigilance database was searched for Belgian post-marketing cases of TdP reported between December 2001-April 2015. These cases were identified with MedDRA preferred terms...
March 24, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28327055/the-evaluation-of-the-anti-cancer-activity-of-ixazomib-on-caco2-colon-solid-tumor-cells-comparison-with-bortezomib
#13
Selin Engür, Miriş Dikmen
Proteasome inhibition has recently emerged as a clinically effective anticancer therapeutic approach. The first proteasome inhibitor, bortezomib (Velcade, PS-341), and new proteasome inhibitors including ixazomib have become more important in the development of targeted cancer therapies. Under physiological conditions, MLN9708 (ixazomib citrate), the stable citrate ester drug substance, hydrolyzes rapidly to MLN2238 (ixazomib), the biologically active boronic acid. It is a second-generation proteasome inhibitor, similar to the well-known proteasome inhibitor bortezomib, which is currently being investigated in phase 3 trials as a treatment for multiple Myeloma...
March 22, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28317474/young-general-practitioners-professional-activities-a-survey-in-the-french-speaking-part-of-belgium
#14
Anne-Laure Lenoir, Lou Richelle, Frédéric Ketterer, Bénédicte Fraipont, Marion Cayn, Christiane Duchesnes, Sophie Leconte
INTRODUCTION: This study described the professional activities of graduates of the Advanced Master of General Practice of the Belgian French-speaking universities from 1999 to 2013 and identified factors influencing their situation. METHODS: Between November 2014 and June 2015, all graduates were asked to complete a questionnaire concerning their professional activities. The first part of the analysis described the respondent's socio-demographic and professional characteristics...
March 20, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28303771/epidemiology-and-outcome-of-acute-kidney-injury-in-children-a-single-center-study
#15
Werner Keenswijk, Jill Vanmassenhove, Ann Raes, Evelyn Dhont, Johan VandeWalle
BACKGROUND: Information on the epidemiology of Acute Kidney Injury (AKI) in children is scarce. We performed a single center retrospective cohort study to analyze the incidence of AKI, the male/female ratio, the underlying etiology, and age at presentation. We also aimed to assess outcome measured by mortality, duration of PICU stay, and development of Chronic Kidney Disease (CKD). METHODS: Records were searched for children presenting with or developing AKI between 1st January 2008 and 1st January 2015...
March 17, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28287344/ewing-s-sarcoma%C3%A2-of-the-cranial-vault-a-case-report
#16
Jihene Feki, Zeineb Guermazi, Brahim Kammoun, Afef Khanfir, Nabil Toumi, Tahiya Boudawara, Zaher Boudawara, Jamel Daoud, Mounir Frikha
Ewing's sarcoma is a malignant tumor that mainly affects young patients. It represents 10% of primary malignant tumors of the bone and 3% of malignant tumors of the child. Cranial localization is extremely rare representing less than 1% of all the localizations. We report a case of a 10-year-old girl who presented with an intracranial hypertension syndrome with left parietal mass of progressive installation. The X-ray skull showed a lytic lesion with irregular margins involving the left parietal bone. Brain magnetic resonance imaging revealed extensive parietal bone destruction involving both the inner and outer tables...
March 13, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28271744/an-exceptional-evolution-of-primary-peritoneal-serous-carcinoma
#17
Wala Ben Kridis, Syrine Sghaier, Nabil Toumi, Afef Khanfir, Jamel Daoud, Mounir Frikha
Primary peritoneal serous carcinoma (PPSC) is a rare malignancy of the peritoneum. Clinically and histopathologically, PPSC is similar to serous ovarian papillary carcinoma. Brain metastases (BM) from PPSC are exceedingly rare. We report here a new case of BM two years after complete remission from a PPSC, to make aware physicians about this entity. This case is exceptional; firstly given the rarity of this entity and secondly due to the good response after radiotherapy then systemic chemotherapy with Carboplatin and Paclitaxel...
March 8, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28262030/highly-sensitive-assays-are-mandatory-for-the-differential-diagnosis-of-patients-presenting-with-symptoms-of-mast-cell-activation-diagnostic-work-up-of-38-patients
#18
Bea Van den Poel, Anne-Marie Kochuyt, Elke Del Biondo, Barbara Dewaele, Els Lierman, Thomas Tousseyn, Gert de Hertogh, Peter Vandenberghe, Nancy Boeckx
Mastocytosis is a heterogeneous disease caused by excessive mast cell (MC) proliferation. Diagnosis of systemic mastocytosis (SM) is based on the presence of major and minor criteria defined by the World Health Organization. Symptoms of MC activation can also occur in patients without SM or without allergic or inflammatory disease. These MC activation syndromes (MCAS) can be divided into primary (monoclonal) MCAS (MMAS) vs. secondary and idiopathic MCAS. In this single center study, the diagnostic work-up of 38 patients with a clinical suspicion of SM and/or with elevated basic tryptase levels is presented...
March 6, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28251862/ingestion-of-white-spirit-resulting-in-perineal-skin-burns-a-case-report-and-review-of-the-literature
#19
Joke Vanhoucke, Walter Buylaert, Kirsten Colpaert, Peter De Paepe
In the literature, possible systemic effects on health of inhalation or ingestion of white spirit are well described. Only a few case reports discuss the toxic skin effects that can occur following massive ingestion. Ingestion of large amounts of white spirit produces a watery diarrhoea with a high concentration of white spirit, resulting in perineal skin burns when there is prolonged contact. We describe a patient who developed partial thickness perineal skin burns after ingestion of white spirit and review the literature...
March 2, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28245723/asthma-exacerbations-factors-related-to-longer-hospital-stay
#20
Francisco-Javier Gonzalez-Barcala, Uxio Calvo-Alvarez, Francisco-Javier Salgado-Castro, David Facal, Maria-Teresa Garcia-Sanz, Xavier Muñoz, Nuria Garcia-Couceiro, Olalla Paz-Neira, Esther San-Jose, Luis Valdes-Cuadrado, Jose-Martin Carreira
BACKGROUND: Hospital admissions account for a significant part of asthma cost, but with significant differences between geographic areas. AIMS: The aim of our study is to analyse hospital admissions due to asthma, as well as the factors associated with longer hospital stays. METHODS: A review was retrospectively carried out on all admissions of patients over 18 years old due to exacerbation of asthma occurring in our hospital between the years 2000 and 2010...
March 1, 2017: Acta Clinica Belgica
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