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Case Reports in Rheumatology

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https://www.readbyqxmd.com/read/28607793/the-case-of-reactive-arthritis-secondary-to-echinococcus-infestation
#1
Bülent Alım, Sinan Çetinel, M Alperen Servi, Fahrettin Bostancı, Mehmet Ozan Bingöl
Reactive arthritis is an inflammatory joint disease that develops after an infection and it usually occurs following a gastrointestinal or genitourinary system infection and it belongs to the family of arthritis called "spondyloarthritis." We wanted to represent a rare case of reactive arthritis secondary to Echinococcus infestation. Cyst hydatid disease is common in endemic regions like Turkey. Internal organ involvements, especially liver and lung, are most frequent involvements. Primary bone involvement is rare complication of Echinococcus infestation...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28546881/haematological-malignancies-in-systemic-sclerosis-patients-case-reports-and-review-of-the-world-literature
#2
M Colaci, D Giuggioli, C Vacchi, C Ferri
Background. The association of systemic sclerosis (SSc) and haematological cancers was reported in a large number of case reports and cohort studies, describing SSc patients with highly heterogeneous clinical pictures. Objective. We reviewed the literature to better describe SSc patients with haematological malignancies. Methods. SSc cases complicated by haematological malignancies described in the world literature were collected; other 2 cases referred to our centre were reported. Results. One hundred-thirty SSc subjects were collected from 1954 up to date...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28523201/sarcoidosis-is-it-a-possible-trigger-of-inclusion-body-myositis
#3
Ali Zakaria, Issam Turk, Kenneth Leung, Ana Capatina-Rata, Waseem Farra
Sarcoidosis is a multisystem disorder of unknown etiology, characterized pathologically by the presence of nonnecrotizing granulomatous inflammation in affected organs. Although skeletal muscle is involved in 50-80 percent of individuals with sarcoidosis, symptomatic myopathy has been shown to be a rare manifestation of the disease. Inclusion body myositis (IBM) is a rare acquired idiopathic inflammatory myopathy with the insidious onset of asymmetric and distal muscle weakness that characteristically involves the quadriceps, tibialis anterior, and forearm flexors...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28428903/sle-and-non-hodgkin-s-lymphoma-a-case-series-and-review-of-the-literature
#4
Prajwal Boddu, Abdul S Mohammed, Chandrahasa Annem, Winston Sequeira
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder punctuated by varied multiorgan complications all along the course of its natural history. Lymphoma represents a relatively well-recognized malignant phenomenon associated with lupus. The cause and effect relationships of lymphoma in SLE have been subject to extensive scrutiny with several studies reporting on clinic-pathologic characteristics and risk factors predicting lymphoma development in SLE. However, the pathogenic role of immunosuppressives in SLE-related lymphoma still remains unclear, and indices to help guide diagnosis, prognostication, therapy, and posttreatment monitoring are yet to be established...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28386506/an-unusual-presentation-of-limited-granulomatosis-with-polyangiitis-involving-vagina-and-urethra
#5
Sandra Soro Marín, Enrique Júdez Navarro, Manuela Sianes Fernández, Ginés Sánchez Nievas, Juan Gabriel Lorenzo Romero
Granulomatosis with polyangiitis (GPA) is a systemic necrotizing granulomatosis vasculitis characterized by predilection to affect small- and medium-sized blood vessels and commonly affects the upper and lower respiratory tract and kidneys in most cases. Genital involvement is reported in <1% of cases in large cohorts and nearly all cases have been in the setting of multisystemic disease or during the course of the disease in patients already diagnosed as GPA. A case is presented of uncommon limited urogenital GPA in a 66-year-old woman with an irregular mass occupying urethra and vagina...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28386505/the-child-as-a-surrogate-for-diagnosis-of-lupus-in-the-mother
#6
Olufemi O Adelowo, Kenneth A Ohagwu, Ejiehi E Aigbokhan, Richard O Akintayo
Introduction. Neonatal lupus erythematosus (NLE) is an acquired disease of the newborn caused by transplacental transfer of maternal anti-Ro/SSA, anti-La/SSB, and infrequently anti-U1 RNP antibodies. Methodology. This is a case report of a male infant delivered via Caesarean section at 36-week gestation following detection of fetal bradycardia during routine antenatal clinic visit. Results. The mother was seropositive for antinuclear antibody (ANA) and anti-Ro/SSA and had elevated erythrocyte sedimentation rate...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28373922/a-64-year-old-woman-with-chest-pain-limb-weakness-and-endometrial-cancer
#7
Simon Ponthus, Omar Kherad, Nicole Petriccioli, Johannes Alexander Lobrinus, Pierre-André A Guerne
Necrotizing autoimmune myopathy (NAM) is a rare subgroup of idiopathic inflammatory myopathies (IIM). This pathology usually affects proximal limb muscles and in some cases the myocardium. Patients usually display proximal limb weakness. Muscular biopsy is required to confirm the diagnosis. We report the case of a 64-year-old woman with an atypical first presentation of NAM, manifested by chest pain in the context of metastatic endometrial cancer. The diagnosis of NAM was however made when she returned a second time with proximal limb weakness...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28348913/a-rare-case-of-digital-ischemia-and-gangrene-in-anca-associated-vasculitis-with-review-of-the-literature
#8
Richard A Lau, Ramandeep Bains, Duminda Suraweera, Jane Ma, Emil R Heinze, Andrew L Wong, Philip J Clements
This paper describes one patient with Antineutrophil Cytoplasmic Antibody- (ANCA-) associated vasculitis who initially presented with multiple ischemic fingers and toes. On further evaluation, the patient was also found to have pulmonary-renal involvement and episcleritis. The diagnosis was supported with a positive cANCA (anti-proteinase 3) and a bronchoscopy consistent with diffuse alveolar hemorrhage. Although the patient refused a tissue biopsy, clinical presentation including nasal ulceration, sinus congestion, and epistaxis and anti-proteinase 3 antibody were more consistent with Granulomatosis with Polyangiitis (GPA) rather than Microscopic Polyangiitis (MPA) or Eosinophilic Granulomatosis with Polyangiitis (EGPA) based on the recently presented ACR/EULAR Provisional 2017 Classification Criteria for GPA (Luqmani et al...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28316857/progressive-pseudorheumatoid-dysplasia-or-jia
#9
Geetha Wickrematilake
Progressive pseudorheumatoid dysplasia (PPD) or spondyloepiphyseal dysplasia tarda with progressive arthropathy (SEDT-PA) is a rare arthropathy of childhood involving the axial skeleton as well as small peripheral joints. A 10-year-old boy was referred by a general practitioner with pain and deformity in the fingers of hands and limping gait. There was no joint synovitis although the finger joints were bulky on examination with mild flexion deformity. Patient had exaggerated kyphosis and lumbar lordosis with pigeon chest and restricted hip joint movements...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28251013/antiproteinase-3-positive-eosinophilic-granulomatosis-with-polyangiitis-presenting-with-heart-failure-and-intraventricular-thrombosis
#10
Dan Zhu, Yiming Luo, Xiangyuan Liu, Lingyun Zu
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis commonly with cardiac complications. We describe a case of anti-PR3 ANCA-positive EGPA complicated by congestive heart failure and intraventricular thrombosis. Interestingly, the thrombus was resolved rapidly with steroid and cyclophosphamide in the setting of interrupted anticoagulation. To the best of our knowledge, we report the first case of anti-PR3 positive EGPA with extensive cardiac involvement. Our patient had overlapping features with previously studied ANCA-positive and ANCA-negative EGPA cases...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28194293/hydralazine-induced-lupus-syndrome-presenting-with-recurrent-pericardial-effusion-and-a-negative-antinuclear-antibody
#11
Praneet Iyer, Ahmed Dirweesh, Ritika Zijoo
Drug induced lupus erythematosus (DIL or DILE) is an autoimmune disorder caused by chronic use of certain drugs. We report a unique case of hydralazine induced lupus syndrome (HILS) with a negative antinuclear antibody in a female patient who was on hydralazine for a period of 1.5-2 years and developed recurrent pericardial effusion as a result of it. Initially her condition was managed with a pericardial window. The recurrence of a massive pericardial effusion necessitated a right hemipericardiectomy. After hydralazine was stopped, she never had any further episodes of pericardial effusion or tamponade...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28116207/primary-idiopathic-osteoarthropathy-could-it-be-related-to-alcoholism
#12
Yanal Alnimer, Suresh Subedi, Thair Dawood, Ghassan Bachuwa
Background. Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by abnormal proliferation of the skin and bony structures at the distal extremities resulting in digital clubbing, periosteal bony reaction, and joint effusion. It can be primary (idiopathic) without any clear identifiable etiology as well as secondary to variety of systemic diseases most notably lung pathology. Case Presentation. We describe a rare case of primary idiopathic osteoarthropathy in a male patient who presented with severe pain and tenderness in his legs...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28127489/a-unique-case-of-systemic-lupus-erythematosus-pelvic-vasculitis
#13
Pamela Traisak, Shristi Basnyat, Hala Eid, Patrick Cronin, Halyna Kuzyshyn, David Feinstein
The clinical presentation of Systemic Lupus Erythematosus (SLE) is diverse and vasculitis can be a potential manifestation. Cutaneous lesions involving small vessels are the most frequent presentation. However, medium and large vessel vasculitis may present with life-threatening visceral manifestations. We present a unique case of pelvic vasculitis mimicking a pelvic mass as an initial presentation of SLE. There are case reports of systemic vasculitis involving the female genital tract with giant cell arteritis (GCA), polyarteritis nodosa (PAN), and granulomatous with polyangiitis and microscopic polyangiitis (GPA/MPA), among others, but only a few cases attributed to SLE...
2016: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28116206/postchikungunya-chronic-inflammatory-rheumatism
#14
Keith A Sacco, Razvan M Chirila
A 65-year-old male resident of Guatemala presented with a 5-month history of distal symmetric arthritis and generalized fatigue. This was associated with night sweats, chills, and weight loss. Symptoms were refractory to oral prednisone and hydroxychloroquine.
2016: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28074166/can-cell-bound-complement-activation-products-predict-inherited-complement-deficiency-in-systemic-lupus-erythematosus
#15
Naveen Raj, Barry Waters
Activation of the classical pathway complement system has long been implicated in stimulating immune complex mediated tissue destruction in systemic lupus erythematosus (SLE). C3 and C4 complement levels are utilized as part of SLE diagnosis and monitoring criteria. Recently, cell bound complement activation products (CBCAPs) have shown increased sensitivity in diagnosing and monitoring lupus activity, compared to traditional markers. CBCAPs are increasingly utilized in rheumatology practice as additional serological markers in evaluating SLE patients...
2016: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28050304/chronic-and-asymptomatic-diffuse-alveolar-haemorrhage-with-microscopic-polyangiitis-a-case-report-and-review-of-the-literature
#16
Hiroki Tashiro, Koichiro Takahashi, Hironori Sadamatsu, Masaru Uchida, Shinya Kimura, Naoko Sueoka-Aragane
Diffuse alveolar haemorrhage (DAH) is one of the major causes of death in microscopic polyangiitis (MPA) patients, because of acute respiratory failure with various respiratory symptoms. We, herein, present a case of chronic and asymptomatic DAH in a patient with MPA who was diagnosed by fibreoptic bronchoscopy. The patient showed localized reticular shadows, without any respiratory symptoms, and absence of inflammatory reactions, such as fever and CRP elevation, which is atypical for DAH. Three months after appearance of the lung abnormalities, DAH with MPA was diagnosed by fibreoptic bronchoscopy...
2016: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28018698/combination-immunosuppressive-therapy-including-rituximab-for-epstein-barr-virus-associated-hemophagocytic-lymphohistiocytosis-in-adult-onset-still-s-disease
#17
Eva Johanna Schäfer, Wolfram Jung, Peter Korsten
Hemophagocytic lymphopcytosis (HLH) is a life-threatening condition. It can occur either as primary form with genetic defects or secondary to other conditions, such as hematological or autoimmune diseases. Certain triggering factors can predispose individuals to the development of HLH. We report the case of a 25-year-old male patient who was diagnosed with HLH in the context of adult-onset Still's disease (AOSD) during a primary infection with Epstein-Barr virus (EBV). During therapy with anakinra and dexamethasone, he was still symptomatic with high-spiking fevers, arthralgia, and sore throat...
2016: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/27994906/swift-and-complete-healing-of-digital-ulcers-after-macitentan-treatment
#18
Emilio Giner Serret
Digital ulcers are a burdensome and painful condition with sparse options of treatment. We report the case of a 78-year-old female patient with limited cutaneous systemic sclerosis that sequentially developed digital ulcers. After the appearance of digital ulcers in the soles of her feet she was successfully treated with bosentan. The report of two new digital ulcers in her hands 9 months later alongside with elevated transaminase levels led to a switch to macitentan treatment. A swift and complete healing of both digital ulcers was observed after 3 months, with the restoration of normal biochemical values...
2016: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/27885350/a-case-of-dermatomyositis-and-anti-ej-autoantibody-with-chronic-intestinal-pseudoobstruction-successfully-treated-with-octreotide
#19
Chiho Yamada, Shinji Sato, Noriko Sasaki, Takayoshi Kurabayashi, Sho Sasaki, Yasushi Koyama, Naofumi Chinen, Takayuki Wakabayashi, Yasuo Suzuki
Chronic intestinal pseudoobstruction (CIPO) is a serious complication in patients with connective tissue disease (CTD) and is sometimes life-threatening or fatal despite intensive medical treatment. Here, we report a patient with dermatomyositis (DM) and anti-EJ autoantibody who developed CIPO that was improved by octreotide. Because her abdominal pain and bloatedness were so severe and persistent, we introduced octreotide to relieve symptoms. In this case, continuous intravenous administration as well as long-acting subcutaneous injection of octreotide was effective for treating CIPO...
2016: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/27843668/rituximab-not-effective-for-hearing-loss-in-cogan-s-syndrome
#20
Daniel R Bunker, Leslie Dubin Kerr
Importance. Rituximab was not effective in ameliorating the hearing loss in a patient with atypical Cogan's syndrome. Observations. We report the case of a patient who developed acute bilateral uveitis and sensorineural hearing loss. A diagnosis of atypical Cogan's syndrome was made. The patient's hearing loss did not improve despite high dose steroids and azathioprine. Rituximab was administered given a recent report of its efficacy in a patient with refractory disease; however, our patient's hearing loss did not improve...
2016: Case Reports in Rheumatology
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