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vasculitis in the elderly

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https://www.readbyqxmd.com/read/29145680/-a-rare-differential-diagnosis-of-chronic-cough
#1
Michael Dicker, Tino Schneider, Johannes von Kempis, Markus Diethelm
History and admission findings We report on a 62-year-old male patient with dry cough for 3 months, constitutional symptoms and elevated inflammatory markers. Investigations Despite extensive diagnostics no infectious, malignant or rheumatologic disease could be found. Bronchoscopy with bronchoalveolar lavage showed lymphocytosis. 18-FDG-PET/CT demonstrated increased metabolic activity of the aorta and its primary branches. Diagnosis, treatment and course We diagnosed large vessel vasculitis consistent to a subtype of giant cell arteritis (GCA) without cranial manifestation...
November 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29037464/-ocular-sarcoidosis-what-the-internist-should-know
#2
P Sève, L Kodjikian, Y Jamilloux
Sarcoidosis is one of the leading causes of inflammatory eye disease. Any part of the eye and its adnexal tissues can be involved. Uveitis and optic neuropathy are the main manifestations, which the internists face. This review reports the state of knowledge for these two ocular involvements and proposes an assessment-algorithm for sarcoidosis in patients with suspected sarcoid uveitis. Two groups of patients with sarcoid uveitis can be distinguished: one young and multiethnic group in which ophthalmological findings are various and another group of elderly Caucasian women with mostly chronic posterior uveitis...
October 13, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29033822/facial-edema-in-an-elderly-man-an-unusual-presentation-of-nonepisodic-angioedema-with-eosinophilia
#3
Takashi Hashimoto, Kanako Muneta, Ken Watanabe
Nonepisodic angioedema with eosinophilia (NEAE) is a rare allergic disease with a young Japanese and East Asian female predominance. NEAE features transient, nonrecurrent angioedema and peripheral blood eosinophilia without visceral organ involvement. Angioedema in NEAE occurs on the extremities, while the trunk and face are rarely involved. Here, we report a case of NEAE affecting only the face in an 80-year-old Japanese man. He was otherwise healthy and took no medication until the sudden development of angioedema on the face...
September 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/29026760/etiological-and-clinicopathological-study-of-secondary-small-vessel-vasculitis-in-elderly-a-case-series-of-12-patients
#4
Ajay Kumar Mishra, Ramya Iyadurai, Anu Anna George, Ebenezer Rajdurai, V Surekha
BACKGROUND: Inflammation involving the postcapillary venular wall is defined as small vessel vasculitis. Small vessel vasculitis has various clinical manifestations. Etiologically, it can be primary or secondary. Literature regarding secondary vasculitis in elderly is scanty. AIM AND OBJECTIVES: In this case series, we aimed to assess the clinical features and etiologies of biopsy-proven secondary small vessel vasculitis in the elderly. METHODOLOGY: Twelve elderly patients with biopsy-proven small vessel vasculitis were included in this study...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29021484/anti-neutrophil-cytoplasmic-antibody-associated-vasculitis-complicated-by-periaortitis-and-cranial-hypertrophic-pachymeningitis-a-report-of-an-autopsy-case
#5
Hajime Kaga, Atsushi Komatsuda, Masaya Saitoh, Mizuho Nara, Ayumi Omokawa, Masaru Togashi, Shin Okuyama, Hideki Wakui, Naoto Takahashi
Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a systemic inflammatory disorder categorized as small-vessel vasculitis. We herein report an elderly Japanese man with AAV (granulomatous with polyangiitis affecting the eyes, nose, lungs, and kidneys) who also showed periaortitis at the diagnosis and developed cranial hypertrophic pachymeningitis (HP) during steroid maintenance therapy. His consciousness disturbance caused by HP improved after steroid pulse therapy, but he died of aspiration pneumonia...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28956128/anti-neutrophil-cytoplasmic-antibody-associated-vasculitis-prevalence-treatment-and-outcomes
#6
REVIEW
Lei Shi
Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a primary small-vessel vasculitis group with three distinct clinical entities, including GPA, MPA, and EGPA. The incidence of AAV has increased since the 1980s and remained stable since the early 2000s. Distinct phenotypes of AAV may also differ in various geographical regions. Elderly people are susceptible to developing AAV, and AAV is used to be a fatal disease before the introduction of glucocorticoids and immunosuppressants. Different treatment protocols should be employed for patients with different disease severity levels...
November 2017: Rheumatology International
https://www.readbyqxmd.com/read/28954579/an-exceptional-cause-of-hemoptysis-in-the-elderly-patient-iga-vasculitis
#7
Aline Pourcelet, Marine Georgery, Frederic Vandergheynst, Jean-Michel Hougardy, Sandra De Breucker
We describe here the case of a 73-year-old woman who presented a recurrent macular rash, acute respiratory distress, and hemoptysis. Chest CT scan showed diffuse ground-glass opacities that were suggestive of alveolar hemorrhage. With the development of severe acute kidney injury and nephrotic-range proteinuria (creatininemia 2.6 from 1.9 mg/dL with overt proteinuria 34 from 2.1 g/g creat), a kidney-lung syndrome was evoked. Skin biopsy revealed leukocytoclastic vasculitis with IgA deposits. Blood tests showed an increased IgA level...
September 28, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28712642/febrile-abdominal-pain-revealing-horton-s-disease
#8
Arnaud Chaudet, Jean-Michel Goujon, Aiham Daniel Ghazali
BACKGROUND: Horton's disease is a systemic inflammatory vasculitis, usually found in persons over 50years old. It affects medium and large-sized arteries stemming from the external carotid, especially the superficial temporal arteries. It can affect extracranial large vessels but only rarely the aorta. Diagnosis of aortitis is difficult and its incidence is probably underestimated. CASE PRESENTATION: A 68-year-old Caucasian woman consulted in an emergency department for febrile abdominal pain with inflammatory syndrome...
October 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28710188/leucocytoclastic-vasculitis-following-influenza-vaccination
#9
Sissi Cao, Dongmei Sun
BACKGROUND: Influenza vaccinations are commonly administered and effectively prevent influenza. Most vaccine reactions are mild and self-limiting with few reported cases of vasculitis. We present a case of vasculitis post-vaccination unique for its dramatic visual presentation and rapid response to treatment with the aim to emphasise possible causation and timely treatment. CASE PRESENTATION: This is a case of a 60-year-old man with chronic idiopathic pulmonary fibrosis, with fever, arthralgias and rash characterised by extensive erythematous plaques on his limbs and trunk 5 days after influenza vaccination...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28521688/vasculitis-following-influenza-vaccination-a-review-of-the-literature
#10
Toru Watanabe
BACKGROUND: Influenza vaccine is safe and effective for the general population as well as for patients with autoimmune diseases. However, although rare, vasculitis has been reported as an adverse event following influenza vaccination. OBJECT: The aims of this literature review were to identify patients who developed vasculitis following influenza vaccination and to clarify the clinical manifestations of vasculitis in these patients. METHODS: Using the PubMed database and search engine, we performed a search of the English-language literature by combining the term influenza vaccination with each term for a specific form of vasculitis from January 1966 through April 2016...
May 17, 2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28499411/paraneoplastic-acral-vascular-syndrome-in-a-patient-with-metastatic-melanoma-under-immune-checkpoint-blockade
#11
Thilo Gambichler, Stefanie Strutzmann, Andrea Tannapfel, Laura Susok
BACKGROUND: Paraneoplastic acral vascular syndrome (PAVS) is a rare phenomenon which is observed in patients with adenocarcinomas and other malignancies. Various potential pathogenic mechanisms such as tumour invasion of sympathetic nerves, hyperviscosity, hypercoagulability, vasoactive tumour-secreted substances, and immunological mechanisms have been suggested. CASE PRESENTATION: We report a 60-year-old Caucasian male attended our hospital with a bulky lymph node mass in the right axilla...
May 12, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28485026/giant-cell-arteritis-beyond-temporal-artery-biopsy-and-steroids
#12
REVIEW
Jem V Ninan, Susan Lester, Catherine L Hill
Giant cell arteritis is the most common primary vasculitis of the elderly. The acute complications of untreated giant cell arteritis, such as vision loss or occasionally stroke, can be devastating. The diagnosis is, however, not altogether straightforward due to variable sensitivities of the temporal artery biopsy as a reference diagnostic test. In this review, we discuss the increasing role of imaging in the diagnosis of giant cell arteritis. Glucocorticoid treatment is the backbone of therapy, but it is associated with significant adverse effects...
November 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28400903/neurosarcoidosis-presenting-with-recurrent-strokes-a-case-report-and-literature-review
#13
Naheed Raza, Karisa C Schreck
Neurosarcoidosis is a rare but important cause of stroke as it is treatable. Cases reported thus far have primarily been in young people who are relatively healthy. Here we report the case of a 73-year-old woman presenting with recurrent strokes and high-grade intracranial stenosis caused by probable neurosarcoidosis. This is unique as neurosarcoidosis is not usually considered as an etiology for recurrent strokes in our patient's age-group. We review and categorize published cases of neurosarcoidosis causing stroke and describe a classification scheme for certainty of diagnosis...
April 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28371513/early-outcomes-in-children-with-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#14
Kimberly A Morishita, Lakshmi N Moorthy, Joanna M Lubieniecka, Marinka Twilt, Rae S M Yeung, Mary B Toth, Susan Shenoi, Goran Ristic, Susan M Nielsen, Raashid A Luqmani, Suzanne C Li, Tzielan Lee, Erica F Lawson, Mikhail M Kostik, Marisa Klein-Gitelman, Adam M Huber, Aimee O Hersh, Dirk Foell, Melissa E Elder, Barbara A Eberhard, Paul Dancey, Sirirat Charuvanij, Susanne M Benseler, David A Cabral
OBJECTIVE: To characterize the early disease course in childhood-onset antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and the 12-month outcomes in children with AAV. METHODS: Eligible subjects were children entered into the Pediatric Vasculitis Initiative study who were diagnosed before their eighteenth birthday as having granulomatosis with polyangiitis (Wegener's), microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis (Churg-Strauss), or ANCA-positive pauci-immune glomerulonephritis...
July 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28174414/a-case-of-henoch-schonlein-purpura-associated-with-rotavirus-infection-in-an-elderly-asian-male-and-review-of-the-literature
#15
REVIEW
Chen Tang, Daphne Scaramangas-Plumley, Cynthia C Nast, Zab Mosenifar, Marc A Edelstein, Michael Weisman
BACKGROUND Henoch-Schönlein purpura (HSP), a small vessel vasculitis mediated by deposition of immune-complexes containing IgA in the skin, gut, and glomeruli, often presents with abdominal pain, purpuric rash in the lower extremities and buttocks, joint pain, and hematuria. The disease most commonly targets children but can affect adults who tend to have a worse prognosis. CASE REPORT We discuss a case of HSP in an elderly Chinese male who presented with severe proximal bowel inflammation, vasculitic rash, and proteinuria; he was found to have positive stool rotavirus and giardia...
February 8, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28050000/the-effects-of-plasma-exchange-on-severe-vasculitis-with-diffuse-alveolar-hemorrhage
#16
Kimihiko Goto, Kentaro Nakai, Hideki Fujii, Shinichi Nishi
Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis is a life-threatening disease characterized by rapidly progressive glomerulonephritis (RPGN) and diffuse alveolar hemorrhage (DAH). Glucocorticoids and immunosuppressants are commonly used to treat this disease but may induce irreversible side effects, particularly in elderly patients. We herein report the case of a 76-year-old woman with RPGN. After methylprednisolone pulse therapy, DAH occurred, and she required ventilatory support. After plasma exchange, her serum creatinine level improved, and she was discharged with home oxygen therapy...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28029757/identification-of-functional-and-expression-polymorphisms-associated-with-risk-for-antineutrophil-cytoplasmic-autoantibody-associated-vasculitis
#17
Peter A Merkel, Gang Xie, Paul A Monach, Xuemei Ji, Dominic J Ciavatta, Jinyoung Byun, Benjamin D Pinder, Ai Zhao, Jinyi Zhang, Yohannes Tadesse, David Qian, Matthew Weirauch, Rajan Nair, Alex Tsoi, Christian Pagnoux, Simon Carette, Sharon Chung, David Cuthbertson, John C Davis, Paul F Dellaripa, Lindsy Forbess, Ora Gewurz-Singer, Gary S Hoffman, Nader Khalidi, Curry Koening, Carol A Langford, Alfred D Mahr, Carol McAlear, Larry Moreland, E Philip Seo, Ulrich Specks, Robert F Spiera, Antoine Sreih, E William St Clair, John H Stone, Steven R Ytterberg, James T Elder, Jia Qu, Toshiki Ochi, Naoto Hirano, Jeffrey C Edberg, Ronald J Falk, Christopher I Amos, Katherine A Siminovitch
OBJECTIVE: To identify risk alleles relevant to the causal and biologic mechanisms of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS: A genome-wide association study and subsequent replication study were conducted in a total cohort of 1,986 cases of AAV (patients with granulomatosis with polyangiitis [Wegener's] [GPA] or microscopic polyangiitis [MPA]) and 4,723 healthy controls. Meta-analysis of these data sets and functional annotation of identified risk loci were performed, and candidate disease variants with unknown functional effects were investigated for their impact on gene expression and/or protein function...
May 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28004435/biopsy-proven-case-of-epstein-barr-virus-ebv-associated-vasculitis-of-the-central-nervous-system
#18
Kohei Kano, Takayuki Katayama, Shiori Takeguchi, Asuka Asanome, Kae Takahashi, Tsukasa Saito, Jun Sawada, Masato Saito, Ryogo Anei, Kyousuke Kamada, Naoyuki Miyokawa, Hiroshi Nishihara, Naoyuki Hasebe
A 75-year-old woman was admitted to our hospital with rapidly deteriorating consciousness disturbance. She had a 7-year history of rheumatoid arthritis (RA), which had been treated with methotrexate (MTX) and prednisolone. Brain T2-weighted MRI showed diffuse high-intensity lesions in the cerebral subcortical and deep white matter, bilateral basal ganglia and thalamus. A cerebrospinal fluid examination revealed elevated protein levels and positive Epstein-Barr virus (EBV) DNA. Human immunodeficiency virus was negative...
December 22, 2016: Neuropathology: Official Journal of the Japanese Society of Neuropathology
https://www.readbyqxmd.com/read/27994267/widespread-headache-as-the-first-clinical-manifestation-of-giant-cell-arteritis-in-patients-affected-by-polymyalgia-rheumatica
#19
Ciro Manzo
INTRODUCTION: In giant cell arteritis (GCA) headache of new onset due to inflammatory involvement of the temporal artery (TA) represents a diagnostic criterion. A widespread headache (WH) with scalp tenderness due to cranial arteritis can represent another manifestation of GCA. MATERIAL AND METHODS: In 225 elderly patients with polymyalgia rheumatica (PMR) followed in our rheumatologic outpatient clinic from 2004 until June 2016, the frequency of WH as the first clinical manifestation of GCA was evaluated...
2016: Reumatologia
https://www.readbyqxmd.com/read/27681233/vancomycin-associated-henoch-sch%C3%A3-nlein-purpura
#20
Zaw Min, Raquel R Garcia, Monika Murillo, Jeffrey M Uchin, Nitin Bhanot
Intravenous vancomycin is a widely used antibiotics, but it causes different types of cutaneous hypersensitivity reactions, ranging from maculopapular rash, red-man syndrome, drug rash with eosinophilia and systemic symptoms, IgA bullous dermatosis, leukocytoclastic vasculitis, Stevens-Johnsons syndrome, to IgE-mediated anaphylaxis. We report an elderly patient with the end-stage renal disease presented with diffuse palpable purpura while receiving IV vancomycin therapy for methicillin-resistant Staphylococcus aureus septicemia...
March 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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