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https://www.readbyqxmd.com/read/29879029/no-obvious-sympathetic-excitation-after-massive-levothyroxine-overdose-a-case-report
#1
Jianxin Xue, Lei Zhang, Zhiqiang Qin, Ran Li, Yi Wang, Kai Zhu, Xiao Li, Xian Gao, Jianzhong Zhang
RATIONALE: Thyrotoxicosis from an overdose of medicinal thyroid hormone is a condition that may be associated with a significant delay in onset of toxicity. However, limited literature is available regarding thyrotoxicosis attributed to excessive ingestion of exogenous thyroid hormone and most cases described were pediatric clinical researches. Herein, we presented the course of a patient who ingested a massive amount of levothyroxine with no obvious sympathetic excited symptoms exhibited and reviewed feasible treatment options for such overdoses...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29868033/aberrant-t-cell-signaling-and-subsets-in-systemic-lupus-erythematosus
#2
REVIEW
Takayuki Katsuyama, George C Tsokos, Vaishali R Moulton
Systemic lupus erythematosus (SLE) is a chronic multi-organ debilitating autoimmune disease, which mainly afflicts women in the reproductive years. A complex interaction of genetics, environmental factors and hormones result in the breakdown of immune tolerance to "self" leading to damage and destruction of multiple organs, such as the skin, joints, kidneys, heart and brain. Both innate and adaptive immune systems are critically involved in the misguided immune response against self-antigens. Dendritic cells, neutrophils, and innate lymphoid cells are important in initiating antigen presentation and propagating inflammation at lymphoid and peripheral tissue sites...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29858401/baff-neutralization-aggravates-atherosclerosis
#3
Dimitrios Tsiantoulas, Andrew P Sage, Laura Göderle, Maria Ozsvar-Kozma, Deirdre Murphy, Florentina Porsch, Gerard Pasterkamp, Jörg Menche, Pascal Schneider, Ziad Mallat, Christoph J Binder
Background -Atherosclerotic cardiovascular disease (heart attacks and strokes) is the major cause of death globally and is caused by the buildup of a plaque in the arterial wall. Genomic data showed that the B cell activating factor receptor (BAFFR) pathway, which is specifically essential for the survival of conventional B lymphocytes (B-2 cells), is a key driver of coronary heart disease. Deletion or antibody-mediated blockade of BAFFR ablates B-2 cells and decreases experimental atherosclerosis. Anti-BAFF immunotherapy is approved for treatment of autoimmune systemic lupus erythematosus and can therefore be expected to limit their associated cardiovascular risk...
June 1, 2018: Circulation
https://www.readbyqxmd.com/read/29798687/thrombotic-storm-in-a-4-year-old-boy-with-a-thrombus-in-the-right-atrium
#4
Jing-Yao Ma, Xin Zhang, Xiao-Feng Li, Le-Jian He, Ning Ma, Yun-Yun Wei, Run-Hui Wu, Fang-Yun Wang
Thrombotic storm (TS) is a rare disease, especially with thrombus in the heart of pediatric patient. We present a case of a 4-year-old boy, who was diagnosed with TS during his first hospitalization due to lower extremity deep venous thrombosis, pulmonary embolism, and thrombosis of the inferior vena cava, cerebral, left internal jugular, portal, renal, and iliac veins. He was eventually prescribed with rivaroxaban to control thrombosis after 30 days of successive use of low-molecular-weight heparin, unfractionated heparin, and warfarin, which were demonstrating little effect on preventing thrombosis, and the patient was intolerant to argatroban...
January 2018: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/29781188/a-novel-anti-malarial-drug-derivative-inhibits-cyclic-gmp-amp-synthase-in-trex1-deficient-mice
#5
Jie An, Joshua J Woodward, Weinan Lai, Mark Minie, Xizhang Sun, Lena Tanaka, Jessica M Snyder, Tomikazu Sasaki, Keith B Elkon
OBJECTIVE: Type I interferon (IFN-I) is strongly implicated in the pathogenesis of Systemic Lupus Erythematosus (SLE) as well as rare monogenic 'interferonopathies' such as Aicardi-Goutieres Syndrome (AGS) caused by mutations in the DNA exonuclease, TREX1. The DNA-activated IFN-I pathway, cyclic GMP-AMP (cGAMP) synthase (cGAS), is linked to subsets of AGS and lupus. We identified inhibitors of DNA-cGAS interaction and tested lead candidate, X6, in a mouse model of AGS. METHODS: Trex1-/- mice were treated orally from birth with either X6 or HCQ for 8 weeks...
May 21, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29779928/the-diagnosis-and-clinical-management-of-the-catastrophic-antiphospholipid-syndrome-a-comprehensive-review
#6
REVIEW
Ricard Cervera, Ignasi Rodríguez-Pintó, Gerard Espinosa
The catastrophic antiphospholipid syndrome (CAPS) is a life-threating variant of the antiphospholipid syndrome characterized by the development of multiple thrombosis in a short period of time, usually ending up in the failure of function of several vital organs. Most CAPS episodes are related to a prothrombotic situation or precipitating factor such as infections, surgical procedures or malignant diseases. In patients with CAPS, the development of multiple thrombosis leads to an important cytokine release that worsens the already critical patient's situation...
May 17, 2018: Journal of Autoimmunity
https://www.readbyqxmd.com/read/29739666/metabolism-as-a-target-for-modulation-in-autoimmune-diseases
#7
REVIEW
Nick Huang, Andras Perl
Metabolic pathways are now well recognized as important regulators of immune differentiation and activation, and thus influence the development of autoimmune diseases such as systemic lupus erythematosus (SLE). The mechanistic target of rapamycin (mTOR) has emerged as a key sensor of metabolic stress and an important mediator of proinflammatory lineage specification. Metabolic pathways control the production of mitochondrial reactive oxygen species (ROS), which promote mTOR activation and also modulate the antigenicity of proteins, lipids, and DNA, thus placing ROS at the heart of metabolic disturbances during pathogenesis of SLE...
May 5, 2018: Trends in Immunology
https://www.readbyqxmd.com/read/29720035/clinical-application-of-protein-biomarkers-in-lupus-erythematosus-and-lupus-nephritis
#8
S Qi, Q Chen, D Xu, N Xie, Y Dai
Systemic lupus erythematosus (SLE) is a type of autoimmune disease that damages multiple organs, including the heart, joints, liver and kidneys. The main characteristics of SLE are the deposition of circulating autoantibodies; autoantigen complexes in the renal system; and abnormal expression of complements, cytokines and chemokines. Lupus nephritis (LN) is the most serious manifestation of SLE and is characterized by inflammation of the kidney. This review summarizes recent clinical applications of protein biomarkers including autoantibodies, complements, cytokines and chemokines and some new protein biomarkers in SLE and LN...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29718009/pulmonary-vasoreactivity-and-phenotypes-in-pulmonary-arterial-hypertension-associated-to-connective-tissue-diseases
#9
José Luis Hernández-Oropeza, Tatiana Sofía Rodríguez-Reyna, Diego Luis Carrillo-Pérez, José de Jesús Rodríguez-Andoney, René Narváez-David, Yesenia Salado-Morales, Eduardo Rivero-Sigarroa, Guillermo Domínguez-Cherit, Tomás Pulido-Zamudio
Background: Pulmonary arterial hypertension (PAH) is a fatal complication in patients with connective tissue disease (CTD). Objective: The objective of the study was to study the prognostic value of the acute pulmonary vasoreactivity test with inhaled iloprost and its association with clinical deterioration in a tertiary care academic medical center. Methods: We conducted a prospective study of patients with CTD and the diagnosis of PAH established by right heart catheterization...
2018: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
https://www.readbyqxmd.com/read/29702718/a-critical-review-on-obstetric-follow-up-of-women-affected-by-systemic-lupus-erythematosus
#10
Danilo Eduardo Abib Pastore, Maria Laura Costa, Mary Angela Parpinelli, Fernanda Garanhani Surita
OBJECTIVE:  To review the existing recommendations on the prenatal care of women with systemic lupus erythematosus (SLE), based on currently available scientific evidence. METHODS:  An integrative review was performed by two independent researchers, based on the literature available in the MEDLINE (via PubMed), EMBASE and The Cochrane Library databases, using the medical subject headings (MeSH) terms "systemic lupus erythematosus" AND "high-risk pregnancy" OR "prenatal care...
April 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29697012/heart-rate-variability-in-patients-with-systemic-lupus-erythematosus-a-systematic-review-and-methodological-considerations
#11
P S Matusik, P T Matusik, P K Stein
Aim The aim of this review was to summarize current knowledge about the scientific findings and potential clinical utility of heart rate variability measures in patients with systemic lupus erythematosus. Methods PubMed, Embase and Scopus databases were searched for the terms associated with systemic lupus erythematosus and heart rate variability, including controlled vocabulary, when appropriate. Articles published in English and available in full text were considered. Finally, 11 publications were selected, according to the systematic review protocol and were analyzed...
July 2018: Lupus
https://www.readbyqxmd.com/read/29682736/medical-comorbidities-in-patients-with-lichen-planopilaris-a-retrospective-case-control-study
#12
Raymond M Fertig, Shasa Hu, Austin J Maddy, Alexandra Balaban, Nouf Aleid, Adam Aldahan, Antonella Tosti
BACKGROUND: Lichen planopilaris (LPP) is a rare inflammatory lymphocyte-mediated disease of the scalp considered to have an autoimmune pathogenesis. OBJECTIVES: To identify the prevalence of medical comorbidities in patients with classic LPP (CLPP) and frontal fibrosing alopecia (FFA). METHODS: The medical records of 206 LPP patients and 323 control patients were retrospectively reviewed for existing comorbidities. The control group consisted of 257 patients with androgenetic alopecia (ICD 9 = 704...
July 2018: International Journal of Dermatology
https://www.readbyqxmd.com/read/29665757/severe-brady-arrhythmias-in-systemic-lupus-erythematosus-prevalence-etiology-and-associated-factors
#13
K Tselios, D D Gladman, P Harvey, J Su, M B Urowitz
Background Severe brady-arrhythmias, requiring a permanent pacemaker (PPM), have been sparsely reported in systemic lupus erythematosus (SLE). The aim of this study was to describe the characteristics of such arrhythmias in a defined lupus cohort. Patients and methods The database of the Toronto Lupus Clinic ( n = 1366) was searched for patients who received a PPM. Demographic, clinical, immunological and therapeutic variables along with electrocardiographic (ECG) and echocardiographic findings (based on the last available test prior to PPM) were analyzed...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29652832/sympathetic-nerve-hyperactivity-in-the-spleen-causal-for-nonpathogenic-driven-chronic-immune-mediated-inflammatory-diseases-imids
#14
REVIEW
Denise L Bellinger, Dianne Lorton
Immune-Mediated Inflammatory Diseases (IMIDs) is a descriptive term coined for an eclectic group of diseases or conditions that share common inflammatory pathways, and for which there is no definitive etiology. IMIDs affect the elderly most severely, with many older individuals having two or more IMIDs. These diseases include, but are not limited to, type-1 diabetes, obesity, hypertension, chronic pulmonary disease, coronary heart disease, inflammatory bowel disease, and autoimmunity, such as rheumatoid arthritis (RA), Sjőgren's syndrome, systemic lupus erythematosus, psoriasis, psoriatic arthritis, and multiple sclerosis...
April 13, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29642752/lupus-myocarditis-a-single-center-experience-and-a-comparative-analysis-of-observational-cohort-studies
#15
J Tanwani, K Tselios, D D Gladman, J Su, M B Urowitz
Background Lupus myocarditis (LM) is reported in 3-9% of patients with systemic lupus erythematosus (SLE) but limited evidence exists regarding optimal treatment and prognosis. This study aims to describe LM in a defined lupus cohort as compared with the existing literature. Patients and methods Patients with LM were identified from the University of Toronto Lupus Clinic database. Diagnosis was based on clinical manifestations and electrocardiographic, imaging, and biochemical criteria. Demographic, clinical, diagnostic and therapeutic variables and outcomes were collected in a standardized data retrieval form...
July 2018: Lupus
https://www.readbyqxmd.com/read/29617782/epicardial-permanent-pacemaker-implantation-in-the-retrosternal-space-of-a-2-3-kg-infant
#16
Bongyeon Sohn, Jae Gun Kwak, Jae Hong Lim, Woong-Han Kim
Permanent pacemaker implantation in small infants can be challenging because of patient size and expected somatic growth. In our case, we used the retrosternal space as a generator pocket for an extremely low-birth-weight premature baby with autoantibody-associated congenital heart block born to a systemic lupus erythematosus mother.
March 29, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29610603/myasthenia-gravis-and-associated-diseases
#17
Nikolina Tanovska, Gabriela Novotni, Slobodanka Sazdova-Burneska, Igor Kuzmanovski, Bojan Boshkovski, Goran Kondov, Marija Jovanovski-Srceva, Anita Kokareva, Rozalinda Isjanovska
BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease caused by the action of specific antibodies to the postsynaptic membrane of the neuromuscular junction, leading to impaired neuromuscular transmission. Patients with MG have an increased incidence of other autoimmune diseases. AIM: to determine the presence of other associated diseases in patients with MG. METHOD: A group of 127 patients with MG followed in 10 years period, in which the presence of other associated diseases has been analysed...
March 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29609225/social-determinants-of-mortality-in-u-s-lupus-patients
#18
Nitasha Khullar, Johnson Ukken, Mary Froehlich, A Jeff Caseja, Takashi Yamashita, Xibei Liu, Ji Won Yoo
We read with interest the study by Yelin et al.1 that poverty results in higher mortality in lupus patients by increasing disease damage accumulation. We suggest some alternative mechanisms for the contribution of poverty to higher mortality. First, cardiovascular disease (CVD) is the leading cause of death in lupus patients, and lupus itself is an independent CVD risk factor.2 Risk of CVD-specific death has declined and is projected to continue declining due to better control of risk factors such as hypertension and diabetes...
April 2, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29600108/hydroxychloroquine-induced-cardiomyopathy-and-heart-failure-in-twins
#19
Hang Zhao, Joyce Wald, Michael Palmer, Yuchi Han
Hydroxychloroquine (HCQ)-induced cardiomyopathy is one of the rare but severe complications following prolonged HCQ use. However, the exact mechanism of HCQ cardiotoxicity remains unclear and it is difficult to identify risk factors. We present a case of twin sisters who both suffered from systemic lupus erythematosus (SLE) and HCQ-induced cardiomyopathy presenting with decompensated heart failure (HF), suggesting that genetic predisposition might be a factor in HCQ-induced cardiomyopathy.
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29571422/atherosclerotic-heart-disease-in-women-with-autoimmune-rheumatologic-inflammatory-conditions
#20
REVIEW
Reto D Kurmann, Rekha Mankad
Women have a higher prevalence of several inflammatory rheumatologic conditions. These include systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and systemic sclerosis (SSc) to name a few. These conditions are all associated with higher rates of cardiovascular (CV) morbidity and mortality, which is driven primarily by atherosclerotic heart disease. Traditional risk factors are important considerations in the assessment of CV risk in the rheumatologic patient; however, these factors do not appear to impart a similar weight of risk in women with inflammatory autoimmune rheumatologic conditions...
April 2018: Canadian Journal of Cardiology
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