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vasculitis in the elderly

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https://www.readbyqxmd.com/read/29738576/distinct-characteristics-and-outcomes-in-elderly-onset-iga-vasculitis-henoch-sch%C3%A3-nlein-purpura-with-nephritis-nationwide-cohort-study-of-data-from-the-japan-renal-biopsy-registry-j-rbr
#1
Hiroyuki Komatsu, Shouichi Fujimoto, Shoichi Maruyama, Masashi Mukoyama, Hitoshi Sugiyama, Kazuhiko Tsuruya, Hiroshi Sato, Jun Soma, Junko Yano, Seiji Itano, Tomoya Nishino, Toshinobu Sato, Ichiei Narita, Hitoshi Yokoyama
BACKGROUND: The clinical presentation and prognosis of adult and elderly patients with IgA vasculitis (Henoch-Schönlein purpura) accompanied by nephritis (IgAV-N) have not been investigated in detail. We therefore surveyed the features and outcomes of IgAV-N based on nationwide data derived from the Japan Renal Biopsy Registry (J-RBR). METHODS: This multi-center cohort study compared the clinicopathological parameters at diagnosis, initial therapies and outcomes between 106 adult (age 19-64 years) and 46 elderly (≥65 years) patients with IgAV-N who were registered in the J-RBR between 2007 and 2012...
2018: PloS One
https://www.readbyqxmd.com/read/29546609/igg4-related-disease-beyond-glucocorticoids
#2
REVIEW
Mitsuhiro Akiyama, Tsutomu Takeuchi
IgG4-related disease is a heterogeneous immune-mediated fibroinflammatory condition that can affect every single organ. This disease is more prevalent in the elderly (the mean age of patients is above 60 years) and the prevalence rate is estimated to be over 4.6 per 100,000 population. Before making a diagnosis, the exclusion of malignancies, lymphoma, anti-neutrophil cytoplasmic antibody-associated vasculitis, multicentric Castleman disease, and other mimickers is crucial for appropriate treatment. Broad management guidelines have been published emphasizing the need for prompt treatment and the use of glucocorticoids as first-line drug therapy for induction of remission...
April 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29478046/management-of-elderly-patients-with-rapidly-progressive-glomerulonephritis
#3
Zdenka Hruskova, Vladimir Tesar
BACKGROUND: Rapidly progressive glomerulonephritis (RPGN) is characterized by a rapid deterioration of renal function and by extracapillary proliferation in >50% of glomeruli. The most common type of RPGN is "pauci-immune" glomerulonephritis caused by anti-neutrophil cytoplasmic antibodies-associated vasculitis (AAV). SUMMARY: The incidence of AAV increases with age and pauci-immune glomerulonephritis is the most common diagnosis found in renal biopsies in the elderly population...
2018: Blood Purification
https://www.readbyqxmd.com/read/29391771/does-herpes-zoster-predispose-to-giant-cell-arteritis-a-geo-epidemiologic-study
#4
Edsel B Ing, Royce Ing, Xinyang Liu, Angela Zhang, Nurhan Torun, Michael Sey, Christian Pagnoux
Purpose: Giant cell arteritis (GCA) is the most common systemic vasculitis in the elderly and can cause irreversible blindness and aortitis. Varicella zoster (VZ), which is potentially preventable by vaccination, has been proposed as a possible immune trigger for GCA, but this is controversial. The incidence of GCA varies widely by country. If VZ virus contributes to the immunopathogenesis of GCA we hypothesized that nations with increased incidence of GCA would also have increased incidence of herpes zoster (HZ)...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29332573/torsades-de-pointes-in-patients-with-polymyalgia-rheumatica
#5
Pietro Enea Lazzerini, Iacopo Bertolozzi, Maurizio Acampa, Rosella Fulceri, Franco Laghi-Pasini, Pier Leopoldo Capecchi
Polymyalgia rheumatica (PMR) represents the most common inflammatory rheumatic disease of the elderly. It is characterized by synovitis of proximal joints and extra-articular synovial structures, along with chronic high-grade systemic inflammation. PMR is closely related to giant cell arteritis (GCA), a large-vessel vasculitis that involves the major branches of the aorta, particularly the extracranial branches of carotid artery including temporal arteries. It is currently believed that PMR and GCA may represent different manifestations of the same disease process...
January 10, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29285157/serum-creatinine-level-and-esr-values-associated-to-clinical-pathology-types-and-prognosis-of-patients-with-renal-injury-caused-by-anca-associated-vasculitis
#6
Hongda Liang, Miaomiao Xin, Lei Zhao, Liqin Wang, Mingshu Sun, Jibo Wang
The correlation between serum creatinine and erythrocyte sedimentation rate (ESR) values and clinical pathology and prognosis in patients with renal injury caused by anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis were analyzed. Eighty-six patients with ANCA-associated vasculitis (AAV) treated in the Affiliated Hospital of Qingdao University were enrolled in the study. Patients were assigned into an elderly group (n=45) or a non-elderly group (n=41) according to age. The serum creatinine (Scr) level was measured via the sarcosine oxidase method, and the erythrocyte sedimentation rate (ESR) was measured using the full-automatic ESR analyzer; the relationship between Scr and ESR values and the pathology type of patients was statistically analyzed...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29145680/-a-rare-differential-diagnosis-of-chronic-cough
#7
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
#8
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
#9
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
#10
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
#11
Hajime Kaga, Atsushi Komatsuda, Masaya Saito, 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 (granulomatosis 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...
January 1, 2018: Internal Medicine
https://www.readbyqxmd.com/read/28956128/anti-neutrophil-cytoplasmic-antibody-associated-vasculitis-prevalence-treatment-and-outcomes
#12
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
#13
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
#14
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
#15
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
#16
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 Englishlanguage literature by combining the term influenza vaccination with each term for a specific form of vasculitis from January 1966 through April 2016...
2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28499411/paraneoplastic-acral-vascular-syndrome-in-a-patient-with-metastatic-melanoma-under-immune-checkpoint-blockade
#17
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
#18
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
#19
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
#20
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
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