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cotrimoxazole and vasculitis

Christian Pagnoux, Muriel Stubbe, François Lifermann, Olivier Decaux, Michel Pavic, Alice Bérezné, Isabelle Delacroix-Szmania, Nadine Méaux-Ruault, Boris Bienvenu, Jean Cabane, Loïc Guillevin
OBJECTIVE: To study the frequency and characteristics of patients with Wegener's granulomatosis (WG) strictly and persistently localized to one organ. METHODS: Retrospective analysis of the French Vasculitis Study Group (FVSG) WG cohort. RESULTS: Sixteen patients (3.2% of the cohort) were identified who had isolated lung nodules, ear-nose-throat, or ocular involvement that did not progress to systemic disease (median followup, 58 mo) over the period of observation...
March 2011: Journal of Rheumatology
Giles Walters, Narelle S Willis, Jonathan C Craig
BACKGROUND: Renal vasculitis presents as rapidly progressive glomerulonephritis (RPGN) which comprises of a group of conditions characterised by acute kidney failure (AKF), haematuria and proteinuria. Treatment of these conditions comprises steroid and non-steroid agents in combination with plasma exchange in several situations. Although immunosuppression overall has been very successful in treatment of these conditions, many questions remain unanswered in terms of dose and duration of therapy and the use of plasma exchange...
July 16, 2008: Cochrane Database of Systematic Reviews
Xavier Bosch, Antonio Guilabert, Gerard Espinosa, Eduard Mirapeix
CONTEXT: Immunosuppressive therapies for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis have greatly advanced patient survival but have turned ANCA-associated vasculitis (AAV) into chronic, relapsing disorders. Long-term treatment and disease-related morbidity are major threats. The last decade has seen a collaborative international effort to determine effective treatment. OBJECTIVE: To analyze the reported evidence on AAV therapy in order to provide physicians with a rational approach for dealing with various clinical scenarios...
August 8, 2007: JAMA: the Journal of the American Medical Association
Christian Pagnoux, Luis Teixeira
Wegener's granulomatosis is described by the Chapel Hill nomenclature (1994) as a systemic necrotizing vasculitis affecting small to medium-sized vessels. Cytoplasm-labeling antineutrophil cytoplasmic autoantibodies (cANCA) directed against proteinase 3 (PR3) are detected in the sera of approximately 90% of patients. Reported incidence varies from 2 to 12 cases/million inhabitants/year and prevalence from 24 to 157 cases/million inhabitants, depending on the series. While still rare, incidence seems to have increased slightly over the past few decades...
May 2007: La Presse Médicale
Imed Ben Ghorbel, Asma Sioud Dhrif, Mohamed Miled, Med Habib Houman
INTRODUCTION: Wegener's granulomatosis is a rare systemic vasculitis, characterized by involvement of the upper airways, lungs and kidneys; other organs may also be affected. Cutaneous lesions occur frequently during the disease course but seldom as its initial presentation. Digital necrosis and splinter hemorrhages of fingernails are described, but very rarely. CASE: We report the case of a 55-year-old man presenting multisystemic Wegener's granulomatosis with mucosal and cutaneous involvement at initial presentation: tongue and labial ulcers, digital necrosis, splinter hemorrhages of fingernails, and purpura...
April 2007: La Presse Médicale
Eric S White, Joseph P Lynch
Wegener's granulomatosis (WG) is the most common pulmonary granulomatous vasculitis and was a uniformly fatal disease prior to the identification of efficacious pharmacological regimens. The pathogenesis of WG remains elusive but proteinase 3-specific anti-neutrophil cytoplasmic antibodies may be involved. Histologically, WG is defined by the triad of small vessel necrotising vasculitis, 'geographic' necrosis and granulomatous inflammation. Organ involvement characteristically includes the upper and lower respiratory tracts and kidney, but virtually any organ can be involved...
2006: Drugs
Sonia Malik, J C Samantaray, Arvind Bagga, Anupam Das
The authors describe a case of severe debilitating diarrhea due to isosporiasis in a two year old child, a known case of systemic vasculitis receiving prolonged corticosteroids therapy, an association rarely reported previously. It was refractory to treatment with dihydrofolate reductase inhibitor combined with sulfonamide such as cotrimoxazole to which isosporiasis usually responds well and is being described here for clinical interest and uniqueness of its presentation and laboratory findings.
May 2005: Indian Journal of Pediatrics
J Tornero Saltó, M A Izquierdo González, F Cruellas Taischik, J Aragón Casas, G Viscasillas Pallàs, M Dicenta Sousa
Wegener granulomatose is an granulomatous necrotisant vasculitis of unknown ethiology that can affect in a classical form the superior and inferior respiratory tract and kidney. The possibility that the illness is limited to the ENT sphere together to a good accessibility for the biopsy of the nasal fossae and sinus usually convert the ENT in the first specialist for the diagnosis of the illness. It is a systemic illness with a frequent and important ENT expression. We have he possibility to establish an earlier diagnosis with prognostic implications in those patients with ENT clinic...
2004: Anales Otorrinolaringológicos Ibero-americanos
S Tănăseanu, V Pompilian, Cristina Tănăseanu, Camelia Badea, Florica Stăniceanu, S Zurac, C Popescu, A Bacalbaşa
Wegener's disease (WD) which is mostly a systemic illness rarely presents as isolated, monoorganic, limited disease. Limited pharyngolaryngeal WD is thus a very rare occurrence. We report the case of a 29 years old man who developed a pharyngolaryngeal tumor with clinically benign evolution, histologically showing granulomatous inflammation and small vessel vasculitis, with no signs of: tuberculosis, sarcoidosis, fungal disease, Hodgkin's disease or foreign body aspiration. p-ANCA's were positive. He was considered a limited form of WD and treated with moderate doses of corticoids and cotrimoxazole...
2003: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
J Tekavec, Z Trkanjec, S Seiwerth
A female patient suffering from Wegener's vasculitis of upper respiratory tract, lungs, kidney and skin, is presented. The diagnosis has been established on the basis of clinical course, histopathologic examination of lung tissue obtained by transbronchial lung biopsy and positive serum antineutrophil cytoplasmatic antibodies (ANCA). The patient was successfully treated with trimethoprim-sulfamethoxasole (daily dose 320 + 1600 mg) leading to complete clinical remission. The course of disease and the effects of treatment were strongly drug-dose-related...
November 1996: Lijec̆nic̆ki Vjesnik
R I Holt, J T Kwan, A M Sefton, J Cunningham
A case is reported of rapid onset concomitant pulmonary infection with Nocardia and Aspergillus fumigatus in a patient six weeks after the institution of immunosuppressive therapy for renal vasculitis. Pulmonary lesions completely resolved on treatment with a combination of imipenem, cotrimoxazole and a prolonged course of itraconazole.
February 1993: European Journal of Clinical Microbiology & Infectious Diseases
W Gibb, A Williams
A 45-year-old man presented with persistent nasal discharge and later developed arthropathy, cutaneous vasculitis, a macular rash and radiographic lung opacities. Early relapse after starting immunosuppressive therapy consisted of new cavitating lung opacities, as seen in Wegener's granulomatosis, and subcutaneous nodules. Lymph node biopsy showed Nocardia asteroides. One month after high dose cotrimoxazole the chest X-ray was normal.
1986: Scandinavian Journal of Infectious Diseases
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