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https://www.readbyqxmd.com/read/29345595/hospital-management-of-severe-hypertriglyceridemia-in-children
#1
Ambika Ashraf, Badhma Valaiyapathi
Severe hypertriglyceridemia (HTG), i.e., triglyceride levels exceeding 1000 mg/dL, is one of the established causes of acute pancreatitis and severe abdominal pain. There are no established pediatric guidelines for treatment of children and adolescents with severe HTG. Management often includes hospital admission, fasting followed by fat free diet until the triglyceride (TG) levels are below 1000 mg/dL. Insulin infusion lowers TG levels in patients, especially in those with diabetes. Plasmapheresis is a limited option due to its restricted availability and scarcity of studies on its efficacy and safety in children...
January 16, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29344912/capillary-leak-syndrome-as-a-complication-of-antibody-mediated-rejection-treatment-a-case-report
#2
Juan C Ramirez-Sandoval, Ricardo Varela-Jimenez, Luis E Morales-Buenrostro
We report a case of capillary leak that developed during treatment of antibody-mediated rejection in a kidney transplant recipient. A 53-year-old female transplant recipient experienced an increase in serum creatinine from 1.1 to 1.8 mg/dL. Antibody-mediated rejection was diagnosed by graft biopsy. She was treated with five plasmapheresis sessions (on alternate days with albumin replacement), five doses of immunoglobulin (5 g/dose at 100 mg/kg), a single dose of rituximab (500 mg), and four doses of bortezomib on days 1, 4, 7, and 10 (1...
January 17, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29341982/extensive-necrotic-skin-lesions-due-to-post-varicella-protein-s-deficiency
#3
Aymeric De Geyer, Guillaume Robert, Sylvette Marleix, Bernard Fraisse, Grégory Lucas, Pierre Tattevin, Philippe Violas
Post-varicella protein S deficiency is a rare and severe disease. We report a case of extensive necrotic skin lesions of acute onset 7 days after varicella in a 4-year old girl. Protein S antigen and activity were <10%, anti-protein S antibodies were detected. She was treated with anticoagulation, plasmapheresis, and fresh frozen plasma. She survived, but required leg amputation.
January 16, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29334853/therapeutic-plasma-exchange-use-in-pediatric-neurologic-disorders-at-a-tertiary-care-center-a-10-year-review
#4
Sonika Agarwal, Jake R Keller, Chloe E Nunneley, Eyal Muscal, Michael C Braun, Poyyapakkam Srivaths, Timothy E Lotze
Pediatric neurologic conditions requiring therapeutic plasma exchange are rare in children and literature is sparse. The study aims to determine the outcomes, safety, and feasibility of therapeutic plasma exchange treatment in pediatric neurologic disorders. This retrospective analysis looked at the outcomes and safety of therapeutic plasma exchange in children (n = 50) with neurologic conditions. Patient age ranged <1 to 19 years old with a mean of 10.35 years. Of the 50 children treated with plasmapheresis, 26 patients received inpatient rehabilitation...
February 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29332416/-autoimmune-encephalitis-possibilities-in-the-laboratory-investigation
#5
Katalin Böröcz, Zsófia Hayden, Viktória Mészáros, Zsuzsanna Csizmadia, Kornélia Farkas, Zoltán Kellermayer, Péter Balogh, Ferenc Nagy, Tímea Berki
INTRODUCTION: The role of autoimmune responses against central nervous system (CNS) antigens in encephalitis presenting with non-classified neurologic or psychiatric symptoms has been appreciated in the past decade. Paraneoplastic limbic encephalitis has a poor prognosis and is most commonly associated with lung, ovarium, and testicular neoplasms, leading to immune reactions against intracellular antigens (anti-Hu/ANNA1, anti-Ri/ANNA2, anti-CV2/CRMP5 and anti-Ma2/Ta). In contrast, the recently described autoimmune encephalitis subtypes present with a broad spectrum of symptoms, respond to autoimmune therapies well and usually associate with autoantibodies against neuronal cell surface receptors (NMDAR, GABABR, AMPAR) or synaptic proteins (LGI1, CASPR2)...
January 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29331505/successful-treatment-of-anti-angiotensin-ii-type-1-receptor-antibody-associated-rejection-in-kidney-transplantation-a-case-report
#6
P Wiwattanathum, A Ingsathit, D Thammanichanond, S Worawichawong
Angiotensin II type 1 receptor (AT1R) antibody, a non-HLA antibody, has been found to have a detrimental effect on kidney allografts. Similarly to HLA antibodies, recipients who have AT1R antibodies are at risk for allograft rejection and poor long-term graft outcome. Besides mediating allograft rejections via direct effects on endothelial and vascular smooth muscle without complement activation, AT1R antibodies may lead to accelerated hypertension via the renin-angiotensin pathway. There has been no definite level of AT1R antibody that predicts allograft rejection...
January 10, 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29329518/the-use-of-eculizumab-in-gemcitabine-induced-thrombotic-microangiopathy
#7
Vinod Krishnappa, Mohit Gupta, Haikoo Shah, Abhijit Das, Natthavat Tanphaichitr, Robert Novak, Rupesh Raina
BACKGROUND: Thrombotic microangiopathy (TMA) secondary to gemcitabine therapy (GiTMA) is a very rare pathology that carries a poor prognosis, with nearly half of the cases progressing to end stage renal disease. GiTMA is most commonly associated with adenocarcinomas, most notably pancreatic cancers. The mainstay of management is withdrawal of the offending drug and supportive care. Plasmapheresis has a limited role and hemodialysis may help in the management of fluid overload secondary to renal failure...
January 12, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29326853/purtscher-like-retinopathy-associated-with-atypical-hemolytic-uremic-syndrome
#8
Melih Ustaoğlu, Feyza Önder, Nilgün Solmaz, Savaş Öztürk, Mesut Ayer
A 25-year-old woman presented with acute bilateral blurred vision and history of headache, dizziness, and syncope for three days. Her visual acuity was 20/60 in both eyes. Fundoscopy revealed multiple bilateral peripapillary yellow-white patches like cotton wool spots, intraretinal hemorrhages and macular edema. The patient was diagnosed with Purtscher-like retinopathy based on the retinal findings and lack of trauma history. She was urgently admitted to the nephrology clinic due to thrombotic microangiopathy findings (hemoglobinemia, thrombocytopenia, and acute renal failure)...
December 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/29325970/the-role-of-adjuvant-immunomodulatory-agents-for-treatment-of-severe-influenza
#9
REVIEW
David S Hui, Nelson Lee, Paul K Chan, John H Beigel
A severe inflammatory immune response with hypercytokinemia occurs in patients hospitalized with severe influenza, such as avian influenza A(H5N1), A(H7N9), and seasonal A(H1N1)pdm09 virus infections. The role of immunomodulatory therapy is unclear as there have been limited published data based on randomized controlled trials (RCTs). Passive immunotherapy such as convalescent plasma and hyperimmune globulin have some studies demonstrating benefit when administered as an adjunctive therapy for severe influenza...
January 8, 2018: Antiviral Research
https://www.readbyqxmd.com/read/29322703/impact-of-electrophysiological-and-clinical-variants-and-timing-of-plasmapheresis-on-outcome-of-guillain-barr%C3%A3-syndrome
#10
Bipin Amin, Himanshu Meghnathi, M D Gajjar, Tarak Patel, Jignesh Vanani, Nidhi Gupta, Anil Chauhan
Introduction: Guillain-Barré syndrome (GBS) is an autoimmune polyneuropathy causing acute flaccid paralysis and it is known to improve with plasmapheresis. Objective: To study effects of electrophysiological type of GBS, clinical variant of GBS and time taken for initiation of plasmapheresis on outcome of disease. Methods: 50 consecutive patients of GBS attending tertiary care hospital underwent clinical examination and electrophysiological studies...
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29322702/factors-affecting-outcome-and-the-role-of-plasmapheresis-in-guillain-barr%C3%A3-syndrome
#11
Satish Khadilkar, Bhagyadhan Patel
No abstract text is available yet for this article.
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29321424/a-case-of-anti-musk-antibody-positive-myasthenia-gravis-successfully-treated-with-outpatient-periodic-weekly-blood-purification-therapy
#12
Kentaro Deguchi, Kosuke Matsuzono, Yumiko Nakano, Syoichiro Kono, Kota Sato, Shoko Deguchi, Katsuyuki Tanabe, Nozomi Hishikawa, Yasuyuki Ota, Toru Yamashita, Kiyoe Ohta, Masakatsu Motomura, Koji Abe
A 37-year-old man with anti-muscle-specific tyrosine kinase (MuSK) antibody-positive myasthenia gravis (MG) presented with subacute progressive dysphagia and muscle weakness of the neck and bilateral upper extremities. Conventional immune-suppressive treatments and high-dose intravenous immunoglobulin were ineffective. He then displayed repeated exacerbations and remissions over the course of two years, despite two to four sessions of plasma exchange (PE) every two months. The patient was successfully treated with outpatient periodic weekly blood purification therapy with alternative PE and double-filtration plasmapheresis using an internal shunt...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29315141/the-treatment-of-antibody-mediated-rejection-in-kidney-transplantation-an-updated-systematic-review-and-meta-analysis
#13
Susan S Wan, Tracey D Ying, Kate Wyburn, Darren M Roberts, Melanie Wyld, Steven J Chadban
BACKGROUND: Current treatments for antibody-mediated rejection (AMR) in kidney transplantation are based on low-quality data from a small number of controlled trials. Novel agents targeting B-cells, plasma-cells and the complement system have featured in recent studies of AMR. METHODS: We conducted a systematic review and meta-analysis of controlled trials in kidney transplant recipients using Medline, EMBASE and CENTRAL from inception to February 2017. RESULTS: Of 14,380 citations we identified 21 studies, including 10 randomized controlled trials, involving 751 participants...
January 8, 2018: Transplantation
https://www.readbyqxmd.com/read/29313573/p-vivax-malaria-presenting-as-thrombotic-microangiopathy
#14
Dharmendra Bhadauria, Harsh Vardhan, Anupma Kaul, Raj Kumar Sharma, Amit Gupta, Narayan Prasad, Manoj Jain
Introduction: Acute kidney injury (AKI) is reported to occur in patients with falciparum malaria but not uncommon with vivax malaria. AKI, anemia, thrombocytopenia and jaundice is a recurrent finding in severe malaria and can mimic as thrombotic microangiopathy (TMA). Relationship of malaria with TMA is unclear till date however evidences suggest their association. Methods & Material: We reviewed our electronic database to evaluate relationship of malaria with TMA, of cases of malaria, jaundice and AKI...
September 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29313271/mri-assessment-of-erosion-repair-in-patients-with-long-standing-rheumatoid-arthritis-receiving-double-filtration-plasmapheresis-in-addition-to-leflunomide-and-methotrexate-a-randomized-controlled-trial
#15
Xiaoxia Yu, Lei Zhang, Lixin Wang, Weiwei Lu, Fengyan Sun, Ping Xu, Guobin Lan
The objective of this study is to investigate whether the addition of double-filtration plasmapheresis (DFPP) to leflunomide and methotrexate repairs MRI bone erosion in patients with long-standing rheumatoid arthritis (RA). Seventy-two patients with highly active RA of > 3 years' duration were randomized to receive DFPP in addition to DMARDs (leflunomide and methotrexate) or DMARDs. Contrast-enhanced MRI of the right wrist was performed at months 0, 6, and 12. MRI bone erosion, synovitis, and bone edema were scored with validated methods...
January 8, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29308761/-correlation-between-model-for-end-stage-liver-disease-score-and-prognosis-in-mushroom-poisoning-patients-a-multicenter-clinical-study
#16
Quan Cai, Ziyi Jia, Tianming Liu, Chunwu Zhang, Zhigang Hui, Xuesong Dong, Zhi Liu
OBJECTIVE: To find out the clinical indicators related to prognosis in patients with acute mushroom poisoning, and approach its correlation with prognosis. METHODS: Clinical data of patients with mushroom poisoning admitted to the First Hospital of China Medical University, the Ninth People's Hospital of Shenyang, Xiuyan Central People's Hospital, and Fushun Central Hospital from August 2015 to August 2017 were retrospectively analyzed. The biochemical indicators within 24 hours after admission, sequential organ failure assessment (SOFA) score, model for end-stage liver disease (MELD) score, whether plasmapheresis (PE) was carried out or not and 28-day prognosis of patients were collected...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29308213/case-series-of-3-patients-diagnosed-with-atypical-hemolytic-uremic-syndrome-successfully-treated-with-steroids-plasmapheresis-and-rituximab
#17
Jeffery M Patterson, Lauren Bolster, Loree Larratt
Rationale: Atypical hemolytic uremic syndrome, which has a high probability of chronic kidney disease, morbidity, and mortality, needs to be promptly recognized when patients present with microangiopathic hemolysis. Presenting Concerns of the Patient: Three patients present with laboratory parameters consistent with a thrombotic microangiopathy. With a suspected diagnosis of thrombotic thrombocytopenic purpura, steroids with plasmapheresis were initiated. Diagnoses: With ADAMTS13 levels reported normal, the suspected diagnoses were reevaluated...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29307968/plasmapheresis-a-retrospective-audit-of-procedures-from-a-tertiary-care-center-in-southern-india
#18
O T Ahammed Nizar, Pratheeksha Rai, Shobhana Nayak Rao, M Pradeep Shenoy
Introduction: The term plasmapheresis/plasma exchange refers to the removal of the plasma component of blood and its replacement with various fluids. Plasma Exchange (PE) has been used to treat a variety of conditions that are associated with an aberrant immune response. We undertook this retrospective study aiming to look at plasmapheresis procedures conducted in the nephrology department over a fixed time period. Materials and Methods: Retrospective analysis of PE procedures from January 2013 to October 2016 was conducted in the nephrology and Intensive Care Unit of a tertiary care teaching hospital...
December 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29306308/use-of-plasma-exchange-as-therapeutic-tool-in-clinical-practice
#19
Isabel Laura Campano-Pérez, Rosario Olivera-Fernández, Lara González-Freire, Carlos Crespo-Diz
OBJECTIVE: To descrive the use of therapeutic plasma exchange in several pathologies and its adjustment to international reference guides. METHOD: Observational, descriptive, retrospective study, of all the patients that  received plasmapheresis between January 2014-December 2015. We analized  the appropriate indication according to the bibliography consulted, and the  therapeutic outcome. Indication, replaced volume of plasma, number of sessions  and periodicity were established by the Hematology Service depending  on the disease and its clinical course...
January 1, 2018: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/29284208/double-filtration-plasmapheresis-in-the-treatment-of-hyperproteinemia-in-dogs-affected-by-leishmania-infantum
#20
Francesca Perondi, Claudio Brovida, Gianila Ceccherini, Grazia Guidi, Ilaria Lippi
Three dogs were evaluated for severe hyperproteinemia and hyperglobulinemia secondary to Leishmania infantum. Double filtration plasmapheresis (DFPP) was performed in two dogs at day 1, 2 and 6 after presentation (T0). The third dog received two treatments of DFPP at day 1 and 3, and eleven hemodialysis treatments to support renal function. A significant reduction in serum total protein (p〈0.0001), alpha-1 (p〈0.023), alpha-2 (p〈0.018), gamma globulins (p=0.0105), and a significant increase in albumin/globulin ratio (p=0...
December 28, 2017: Journal of Veterinary Science
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