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Case Reports in Immunology

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https://www.readbyqxmd.com/read/27872771/tranexamic-acid-an-exceedingly-rare-cause-of-anaphylaxis-during-anaesthesia
#1
R A Bansal, A Nicholas, A S Bansal
Tranexamic acid (TXA) allergy is extremely rare. An 80-year-old woman without prior exposure to TXA underwent elective knee replacement. Shortly after induction of anaesthesia and intravenous TXA, she developed hypotension, tachycardia, and facial erythema accompanied by a raised serum tryptase. Later, skin prick and intradermal testing confirmed positive responses to TXA in high dilution and with negative results to the other drugs used. While neuromuscular blocking agents, opiates, and antibiotics remain the most frequent cause of anaphylaxis during anaesthesia, allergy to TXA should always be borne in mind and requires skin testing for confirmation as there are presently no blood tests available...
2016: Case Reports in Immunology
https://www.readbyqxmd.com/read/27843658/giant-condyloma-acuminata-in-indonesian-females-with-sle-under-immunosuppressant-and-steroid-therapy
#2
Andhika Rachman, Nabila Hasan
Introduction. Immunosuppressant and steroid therapy in systemic lupus erythematosus (SLE) increases the risk of human papillomavirus (HPV) infections, one of which is giant condyloma acuminata (GCA). To our knowledge, there is no report evaluating the correlation between immunosuppressive and steroid therapy in patients with SLE and the prevalence of GCA. Case Report. A 42-year-old female was diagnosed with SLE a year ago and has been treated with steroids and immunosuppressive drugs. In the last few months she presented GCA involving the genital area recurring almost every two months...
2016: Case Reports in Immunology
https://www.readbyqxmd.com/read/27818807/successful-use-of-tocilizumab-in-a-patient-with-coexisting-rheumatoid-arthritis-and-ulcerative-colitis
#3
Matthew Chak Hin Szeto, Metin Devrim Yalçın, Abdul Khan, Andrzej Piotrowicz
Tocilizumab is an interleukin-6 receptor inhibitor licensed for moderate to severe rheumatoid arthritis (RA). We report a case of Tocilizumab monotherapy for severe active RA in a patient with coexisting ulcerative colitis (UC). The patient was intolerant to multiple disease-modifying drugs, so Tocilizumab monotherapy was commenced. We found clinical improvement in both RA and UC. There was no major adverse event after 2 years. Manufacturer advised caution in using Tocilizumab in patient with gastrointestinal ulceration due to an increased risk of bowel perforation...
2016: Case Reports in Immunology
https://www.readbyqxmd.com/read/27699073/early-diagnosis-and-hematopoietic-stem-cell-transplantation-for-il10r-deficiency-leading-to-very-early-onset-inflammatory-bowel-disease-are-essential-in-familial-cases
#4
Neslihan Edeer Karaca, Guzide Aksu, Ezgi Ulusoy, Serap Aksoylar, Salih Gozmen, Ferah Genel, Sanem Akarcan, Nesrin Gulez, Tatjana Hirschmugl, Savas Kansoy, Kaan Boztug, Necil Kutukculer
Alterations of immune homeostasis in the gut may result in development of inflammatory bowel disease. A five-month-old girl was referred for recurrent respiratory and genitourinary tract infections, sepsis in neonatal period, chronic diarrhea, perianal abscess, rectovaginal fistula, and hyperemic skin lesions. She was born to second-degree consanguineous, healthy parents. Her elder siblings were lost at 4 months of age due to sepsis and 1 year of age due to inflammatory bowel disease, respectively. Absolute neutrophil and lymphocyte counts, immunoglobulin levels, and lymphocyte subsets were normal ruling out severe congenital neutropenia and classic severe combined immunodeficiencies...
2016: Case Reports in Immunology
https://www.readbyqxmd.com/read/27579193/autoimmune-lymphoproliferative-syndrome-a-rare-cause-of-disappearing-hdl-syndrome
#5
Swetha Sriram, Avni Y Joshi, Vilmarie Rodriguez, Seema Kumar
The term disappearing HDL syndrome refers to development of severe high density lipoprotein cholesterol (HDL-C) deficiency in noncritically ill patients with previously normal HDL-C and triglyceride levels. Autoimmune lymphoproliferative syndrome (ALPS) is a disorder of the immune system due to an inability to regulate lymphocyte homeostasis resulting in lymphadenopathy and hepatosplenomegaly. We describe a 17-year-old boy who was evaluated in the lipid clinic for history of undetectable or low HDL-C and low density lipoprotein cholesterol (LDL-C) levels...
2016: Case Reports in Immunology
https://www.readbyqxmd.com/read/27403355/abnormal-trec-based-newborn-screening-test-in-a-premature-neonate-with-massive-perivillous-fibrin-deposition-of-the-placenta
#6
Stefan Kostadinov, Karen A Robbins, Anthony Hayward
Severe combined immunodeficiency (SCID), a primary immunodeficiency arising from variable defects in lymphocyte development and survival, is characterized by significant deficiency of thymus derived (T-) lymphocytes and variable defects in the B-lymphocyte population. Newborn screening for SCID is based on detection of low numbers of T-cell receptor excision circles (TRECs) by real time quantitative PCR (RT-qPCR). This screening allows for early identification of individuals with SCID and other disorders characterized by T-lymphopenia...
2016: Case Reports in Immunology
https://www.readbyqxmd.com/read/27022493/mycetoma-caused-by-acremonium-species-in-a-patient-with-chronic-granulomatous-disease
#7
Richard Antrobus, Gabriel Wong, Julie Jones, Aarnoud Huissoon
Patients with chronic granulomatous disease are predisposed to fungal infections and are therefore routinely prescribed antifungal prophylaxis. We report a case where acremonium was responsible for causing a cutaneous infection (mycetoma) despite antifungal prophylaxis. Treatment with voriconazole was initiated and the infection gradually resolved. This case highlights the need for careful clinical follow-up and thorough investigation of patients who have a neutrophil immunodeficiency.
2016: Case Reports in Immunology
https://www.readbyqxmd.com/read/26989530/successful-use-of-plasma-exchange-in-the-treatment-of-corticosteroid-refractory-eosinophilic-granulomatosis-with-polyangiitis-associated-with-gastrointestinal-manifestations
#8
Kohei Tsujimoto, Masato Yagita, Masashi Taniguchi, Masaaki Fujita
We describe the case of a 33-year-old woman having corticosteroid-refractory eosinophilic granulomatosis with polyangiitis (EGPA) who presented with abdominal pain and responded dramatically to plasma exchange. Eosinophilia, asthma history, neuropathy, pulmonary infiltrates, and paranasal sinus abnormalities confirmed the diagnosis of EGPA. Treatment was initiated with 1 g/day of methylprednisolone pulse therapy for 3 days followed by 60 mg/day of intravenous prednisolone without relieving abdominal pain...
2016: Case Reports in Immunology
https://www.readbyqxmd.com/read/26798527/refractory-immunological-thrombocytopenia-purpura-and-splenectomy-in-pregnancy
#9
Santiago Bernal-Macías, Laura-Marcela Fino-Velásquez, Felipe E Vargas-Barato, Lucio Guerra-Galue, Benjamín Reyes-Beltrán, Adriana Rojas-Villarraga
Thrombocytopenia is defined as a platelet count of less than 100,000 platelets per microlitre (mcL). Thrombocytopenia develops in approximately 6-7% of women during pregnancy and at least 3% of these cases are caused by immunological platelet destruction. Herein, we present a pregnant woman who develops at the first trimester autoimmune thrombocytopenia purpura associated with positive antiphospholipid antibodies. The disease was refractory to pharmacological treatments but had a favourable response to splenectomy...
2015: Case Reports in Immunology
https://www.readbyqxmd.com/read/26491579/systemic-sarcoidosis-presenting-with-headache-and-stroke-like-episodes
#10
J Campbell, R Kee, D Bhattacharya, P Flynn, M McCarron, A Fulton
Sarcoidosis is a multisystem granulomatous disorder. Neurological manifestations as a presenting symptom are relatively rare. A 26-year-old male presented with a five-week history of headache suggestive of raised intracranial pressure. He subsequently developed transient episodes of mild right-sided hemiparesis and numbness. Magnetic resonance imaging (MRI) of brain revealed widespread inflammatory white matter lesions, an ischaemic focus in the left corona radiata, and widespread microhaemorrhages consistent with a more diffuse vasculopathy...
2015: Case Reports in Immunology
https://www.readbyqxmd.com/read/26448886/nocardia-brain-abscess-and-cd4-lymphocytopenia-in-a-previously-healthy-individual
#11
Norair Adjamian, Adeline Kikam, Kathryn Ruda Wessell, Jason Casselman, Erin Toller-Artis, Olapeju Olasokan, Robert W Hostoffer
Nocardia brain abscesses are a known occurrence in patients with immunocompromised conditions. Nocardial infection is commonly an unfortunate sequela to other complications which these patients are being followed up and treated for. The incidence of nocardial brain abscess in an otherwise healthy patient is extremely rare. We present a case of Nocardia brain abscess in a previously healthy individual, who, upon workup for vision and gait abnormalities, was shown to have multiple brain abscesses and a decreased absolute CD4(+) lymphocyte count...
2015: Case Reports in Immunology
https://www.readbyqxmd.com/read/26425377/behcet-s-disease-with-intracardiac-thrombus-presenting-with-fever-of-unknown-etiology
#12
Sajal Ajmani, Durga Prasanna Misra, Deep Chandh Raja, Namita Mohindra, Vikas Agarwal
A young male was referred to us for evaluation of fever of unknown origin (FUO). He had history of recurrent painful oral ulcers for one year and moderate to high grade fever, pustulopapular rash, and recurrent genital ulcers for 6 months and hemoptysis for 3 days. He was detected to have intracardiac thrombi and pulmonary arterial thrombosis along with underlying Behcet's disease (BD). Patient responded to high dose prednisolone (1 mg/Kg/day) along with monthly parenteral cyclophosphamide therapy. This case highlights the fact that BD is an important cause for pulmonary artery vasculitis with intracardiac thrombus formation, and such patients can present with FUO...
2015: Case Reports in Immunology
https://www.readbyqxmd.com/read/26413359/does-the-maternal-serum-igg-level-during-pregnancy-in-primary-antibody-deficiency-influence-the-igg-level-in-the-newborn
#13
Vasantha Nagendran, Noel Emmanuel, Amolak S Bansal
Purpose. To find out if the serum IgG level in the newborn baby was affected by low maternal serum IgG during pregnancy in two newly diagnosed primary antibody deficient patients. Method. Infant cord blood IgG level was compared with maternal IgG level in 2 mothers with newly diagnosed primary antibody deficiency, who declined replacement IgG treatment during pregnancy. Results. Both mothers delivered healthy babies with normal IgG levels at birth. Conclusions. The normal IgG levels and sound health in these 2 babies in spite of low maternal IgG throughout pregnancy raise interesting discussion points about maternofoetal immunoglobulin transport mechanisms in primary antibody deficiency...
2015: Case Reports in Immunology
https://www.readbyqxmd.com/read/26347280/a-case-report-of-allergic-contact-dermatitis-due-to-mandragora-radix
#14
Sevim Baysak, Müzeyyen Gönül, Damla Atacan, Can Ergin
An 82-year-old male presented with rash, burning, and itching on his knees that had started 4 days after the local application of Mandragora Radix sap for 3 consecutive days. A dermatological examination revealed erythematous, edematous, and scaly plaque lesions on the patient's knees. An open application test with M. Radix was performed, and the patient was diagnosed with allergic contact dermatitis due to M. Radix. Mandragora species, which belong to the Solanaceae family, have sedative, aphrodisiac, emetic, analgesic, and anesthetic properties...
2015: Case Reports in Immunology
https://www.readbyqxmd.com/read/26346511/cvid-associated-with-systemic-amyloidosis
#15
Saliha Esenboga, Deniz Çagdas Ayvaz, Arzu Saglam Ayhan, Banu Peynircioglu, Ozden Sanal, Ilhan Tezcan
Common variable immunodeficiency (CVID) is a frequent primary immune deficiency (PID), which consists of a heterogeneous group of disorders and can present with recurrent infections, chronic diarrhea, autoimmunity, chronic pulmonary and gastrointestinal diseases, and malignancy. Secondary amyloidosis is an uncommon complication of CVID. We report an unusual case of a 27-year-old male patient who presented with recurrent sinopulmonary infections, chronic diarrhea, and hypogammaglobulinemia and was diagnosed with CVID...
2015: Case Reports in Immunology
https://www.readbyqxmd.com/read/26339513/hereditary-angioedema-and-gastrointestinal-complications-an-extensive-review-of-the-literature
#16
Napoleon Patel, Lisbet D Suarez, Sakshi Kapur, Leonard Bielory
Hereditary Angioedema (HAE) is a rare autosomal dominant (AD) disease characterized by deficient (type 1) or nonfunctional (type 2) C1 inhibitor protein. The disorder is associated with episodes of angioedema of the face, larynx, lips, abdomen, or extremities. The angioedema is caused by the activation of the kallikrein-kinin system that leads to the release of vasoactive peptides, followed by edema, which in severe cases can be life threatening. The disease is usually not diagnosed until late adolescence and patients tend to have frequent episodes that can be severely impairing and have a high incidence of morbidity...
2015: Case Reports in Immunology
https://www.readbyqxmd.com/read/26257969/life-threatening-idiopathic-recurrent-angioedema-responding-to-cannabis
#17
Amit Frenkel, Aviel Roy-Shapira, Brotfain Evgeni, Koyfman Leonid, Abraham Borer, Moti Klein
We present a case of a 27-year-old man with recurrent episodes of angioedema since he was 19, who responded well to treatment with medical grade cannabis. Initially, he responded to steroids and antihistamines, but several attempts to withdraw treatment resulted in recurrence. In the last few months before prescribing cannabis, the frequency and severity of the attacks worsened and included several presyncope events, associated with scrotal and neck swelling. No predisposing factors were identified, and extensive workup was negative...
2015: Case Reports in Immunology
https://www.readbyqxmd.com/read/26064716/immunodeficiency-in-a-child-with-rapadilino-syndrome-a-case-report-and-review-of-the-literature
#18
M M G Vollebregt, A Malfroot, M De Raedemaecker, M van der Burg, J E van der Werff Ten Bosch
Rapadilino syndrome is a genetic disease characterized by a characteristic clinical tableau. It is caused by mutations in RECQL4 gene. Immunodeficiency is not described as a classical feature of the disease. We present a 2-year-old girl with Rapadilino syndrome with important lymphadenopathies and pneumonia due to disseminated Mycobacterium lentiflavum infection. An immunological work-up showed several unexpected abnormalities. Repeated blood samples showed severe lymphopenia. Immunophenotyping showed low T, B, and NK cells...
2015: Case Reports in Immunology
https://www.readbyqxmd.com/read/26060590/brain-abscess-and-keratoacanthoma-suggestive-of-hyper-ige-syndrome
#19
Soheyla Alyasin, Reza Amin, Alireza Teymoori, Hamidreza Houshmand, Gholamreza Houshmand, Mohammad Bahadoram
Hyper immunoglobulin-E (IgE) syndrome is an autosomal immune deficiency disease. It is characterized by an increase in IgE and eosinophil count with both T-cell and B-cell malfunction. Here, we report an 8-year-old boy whose disease started with an unusual skin manifestation. When 6 months old he developed generalized red, nontender nodules and pathologic report of the skin lesion was unremarkable (inflammatory). Then he developed a painless, cold abscess. At the age of 4 years, he developed a seronegative polyarticular arthritis...
2015: Case Reports in Immunology
https://www.readbyqxmd.com/read/25954557/allergen-immunotherapy-in-an-hiv-patient-with-allergic-fungal-rhinosinusitis
#20
Ian A Myles, Satyen Gada
Patients with HIV/AIDS can present with multiple types of fungal rhinosinusitis, fungal balls, granulomatous invasive fungal rhinosinusitis, acute or chronic invasive fungal rhinosinusitis, or allergic fungal rhinosinusitis (AFRS). Given the variable spectrum of immune status and susceptibility to severe infection from opportunistic pathogens it is extremely important that clinicians distinguish aggressive fungal invasive fungal disease from the much milder forms such as AFRS. Here we describe a patient with HIV and AFRS to both remind providers of the importance of ruling out invasive fungal disease and outline the other unique features of fungal sinusitis treatment in the HIV-positive population...
2015: Case Reports in Immunology
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