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polyarteritis nodosa diagnosis

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https://www.readbyqxmd.com/read/28422001/microscopic-polyangiitis-and-non-hbv-polyarteritis-nodosa-with-poor-prognosis-factors-10-year-results-of-the-prospective-chuspan-trial
#1
Maxime Samson, Xavier Puéchal, Luc Mouthon, Hervé Devilliers, Pascal Cohen, Boris Bienvenu, Kim Heang Ly, Alain Bruet, Brigitte Gilson, Marc Ruivard, Edouard Pertuiset, Mohamed Hamidou, Christian Pagnoux, Benjamin Terrier, Loïc Guillevin
OBJECTIVES: To analyse the 10-year outcomes of 64 patients with non-HBV polyarteritis nodosa (PAN) or microscopic polyangiitis (MPA) and Five-Factor Score-defined poor-prognosis factors enrolled (1994-2000) in the prospective, randomised, open-label CHUSPAN trial. METHODS: The 64 patients were randomised to receive 12 (33: 23 MPA, 10 PAN) or 6 (31: 17 MPA, 14 PAN) cyclophosphamide (CYC) pulses combined with glucocorticoids. Ten-year follow-up of these patients included times to relapse(s), failure(s) and/or deaths calculated from treatment onset...
April 18, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28406761/the-performance-of-different-classification-criteria-in-paediatric-beh%C3%A3-et-s-disease
#2
Ezgi Deniz Batu, Hafize Emine Sönmez, Betul Sözeri, Yonatan Butbul Aviel, Yelda Bilginer, Seza Özen
OBJECTIVES: Behçet's disease (BD) is a variable vessel vasculitis. The most widely used classification criteria for adults is the International Behçet's Study Group (ISG) criteria. Recently, the paediatric BD (PEDBD) classification criteria has been developed for children. For disease activity, there are mainly two severity scores; the Iranian BD dynamic activity measure (IBDDAM) and BD current activity form (BDCAF). We tested the performances of PEDBD and ISG criteria and the correlation between severity scores and physician global assessment (PGA) in children with BD...
April 5, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28386466/single-organ-vasculitis-of-the-cervix-accompanying-human-papillomavirus-infection
#3
REVIEW
Murat Gözüküçük, Aslı Yarcı Gürsoy, Duygu Kankaya, Cem Atabekoglu
Single-organ vasculitis (SOV) has rarely been reported to involve the female genital tract but mostly the uterine cervix. A 39-year-old woman was diagnosed to have a high-grade cervical intraepithelial lesion and was treated by large loop excision of the transformation zone. Histopathological evaluation of the excised specimen confirmed the diagnosis of cervical intraepithelial neoplasia grade III accompanied by human papillomavirus infection. The excised second specimen showed the evidence of vasculitis of medium-sized vessels of the cervix, which is a quite rare form of SOV...
June 1, 2016: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28379475/are-the-1990-american-college-of-rheumatology-vasculitis-classification-criteria-still-valid
#4
Benjamin Seeliger, Jan Sznajd, Joanna C Robson, Andrew Judge, Anthea Craven, Peter C Grayson, Ravi S Suppiah, Richard A Watts, Peter A Merkel, Raashid A Luqmani
Objectives.: Advances in diagnostic techniques have led to better distinction between types of vasculitis, potentially affecting the utility of the 1990 ACR classification criteria for vasculitis. This study tested the performance of these criteria in a contemporary vasculitis cohort. Methods.: The Diagnosis and Classification in Vasculitis Study provided detailed clinical, serological, pathological and radiological data from patients with primary systemic vasculitis and clinical context-specific comparator conditions...
March 31, 2017: Rheumatology
https://www.readbyqxmd.com/read/28352011/biopsy-of-small-kidneys-a-safe-and-a-useful-guide-to-potentially-treatable-kidney-disease
#5
Kamel El-Reshaid, Wael El-Reshaid, Dalal Al-Bader, Jozsef Varro, John Madda, Hosameldin Tawfik Sallam
Over the past four years, all patients with unexplained rapid progression of their renal disease were subjected to kidney biopsy, despite their small size (<9 cm), to define its etiology. Children, pregnant women, morbidly obese patients, and those with an unstable cardiovascular state, septicemia, bleeding diathesis as well as those kidney size with size <6 cm were excluded from the study. Doppler ultrasound was used to exclude renovascular/ischemic nephropathy. The procedure was performed by an interventional radiologist using a biopsy gun technique and under ultrasound guidance...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28345423/systemic-lupus-erythematosus-and-hearing-disorders-literature-review-and-meta-analysis-of-clinical-and-temporal-bone-findings
#6
Arianna Di Stadio, Massimo Ralli
Objective This literature review and meta-analysis was performed to evaluate the correlations among hearing and vestibular clinical symptoms, temporal bone findings, and pathological mechanisms in patients with systemic lupus erythematosus (SLE). Study design Relevant papers in the literature were retrospectively reviewed. Clinical hearing aspects in patients with SLE and relevant temporal bone studies in the same field were analyzed. Methods PubMed and Google Scholar searches were performed using the following keywords: "auto-immune disease," "systemic lupus erythematosus (SLE)," "hearing loss," "temporal bone study," "vertigo," "dizziness," "tinnitus," "ear symptoms," "treatment," "diagnosis," "symptoms," "etiopathogenesis," "Wegener granulomatosis," "Sjogren," "polyarteritis nodosa," "Cogan syndrome," and "granulomatosis...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28341881/birmingham-vasculitis-activity-score-at-diagnosis-is-a-significant-predictor-of-relapse-of-polyarteritis-nodosa
#7
Yoon-Jeong Oh, Sung Soo Ahn, Eun Seong Park, Seung Min Jung, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee
The objective of this study was to investigate whether clinical and laboratory data, Birmingham vasculitis activity score (BVAS) and five factor scores (FFS) at diagnosis could predict relapse in 30 patients with polyarteritis nodosa (PAN) having the follow-up duration for over 12 months. We reviewed the medical charts of 30 patients with PAN. We obtained clinical and laboratory data at diagnosis, and we compared them between the two groups based on relapse. The optimal cut-off values of BVAS and FFS (1996) at diagnosis to predict relapse were extrapolated...
May 2017: Rheumatology International
https://www.readbyqxmd.com/read/28293454/can-rheumatoid-vasculitis-predate-a-diagnosis-of-rheumatoid-arthritis
#8
Sarah Sacks, Alan Steuer
We report regarding a male patient who presented with a systemic vasculitis that was consistent with a diagnosis of polyarteritis nodosa. At presentation, he had no features of inflammatory arthritis but had a high rheumatoid factor titer and low C4 level. Withdrawal of immunosuppression after 6 years resulted in the development of classical rheumatoid arthritis (RA). This case supports previous reports that revealed that vasculitis may predate the development or occur very early in the course of articular RA...
March 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28228431/right-upper-quadrant-abdominal-pain-as-the-initial-presentation-of-polyarteritis-nodosa
#9
Ricardo Gago, Lee Ming Shum, Luis M Vilá
Polyarteritis nodosa (PAN) is a necrotising vasculitis that involves medium and small vessels. PAN generally presents with constitutional, cutaneous, neurological, renal and gastrointestinal manifestations. However, PAN initially involving a single organ/system is uncommon. Here, we present a 42-year-old man who was hospitalised because of severe right upper quadrant abdominal pain that started 2 months before. Physical examination was remarkable for right upper quadrant abdominal tenderness. Abdominopelvic CT showed lymphadenopathy but no hepatic, gallbladder, pancreatic, intestinal or renal abnormalities...
February 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28177278/does-spontaneous-remission-occur-in-polyarteritis-nodosa-%C3%A2
#10
Simon Beyaert, Menno Pruijm, Salah Dine Qanadli, Peter Vollenweider, Matthieu Halfon
BACKGROUND: Polyarteritis nodosa (PAN) is a systemic vasculitis involving mainly medium-sized arteries and, rarely, small-sized arteries. The diagnosis is principally based on clinical exams, biopsy of an affected organ, and/or arteriography of renal or mesenteric arteries. Once diagnosed, immunosuppressive agents, such as glucocorticoids and cyclophosphamide, are generally introduced as soon as possible. Whether spontaneous remission of PAN occurs is therefore largely unknown. PRESENTATION: We describe the case of a 51-year-old woman who presented with a 4-day-history of intense pain in her left flank, hypertension, fever, microscopic hematuria, and acute renal failure...
February 8, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28129926/panniculitis-a-summary
#11
Mark R Wick
The diagnosis of panniculitis is felt to be a confusing topic by some pathologists. This summarical article presents inflammatory diseases of the subcutis in a systematic fashion, based on whether they are centered on fibrovascular septa or the adipose lobules, and whether morphologic vasculitis is present or not. Septocentric, non-vasculitis disorders include erythema nodosum, panniculitis that follows the use of "biological" therapeutic agents, lipodermatosclerosis, post-irradiation panniculitis, morphea profunda, and necrobiosis lipodica profunda...
December 27, 2016: Seminars in Diagnostic Pathology
https://www.readbyqxmd.com/read/27938815/acrally-distributed-dermatoses-vascular-dermatoses-purpura-and-vasculitis
#12
Jana Kazandjieva, Dimitar Antonov, Jivko Kamarashev, Nikolai Tsankov
Purpuric lesions appear in acral distribution in a variety of conditions and often provide clues to the clinical diagnosis. Purpuric means "hemorrhagic"-that is, the lesions do not blanch from pressure. This review focuses on dermatoses that produce hemorrhagic lesions in acral distribution from the large groups of the vasculitic diseases and their mimics. Cutaneous small vessel vasculitis is confined to the skin, involves mainly postcapillary venules, and has the hallmark manifestation of palpable purpura...
January 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/27917267/spontaneous-liver-rupture-as-first-sign-of-polyarteritis-nodosa
#13
Irene Gómez-Luque, Felipe Alconchel, Rubén Ciria, M Dolores Ayllón, Antonio Luque, Marina Sánchez, Pedro López-Cillero, Javier Briceño
Polyarteritis nodosa (PAN) is one of the systemic vasculitis that affects the media wall of arteries of small and medium diameter. Diagnosis proves difficult due to the unspecific symptoms that dominate the clinical profile. Liver involvement is very diverse, ranging from the development of cirrhotic liver disease to acute abdomen presentation that requires surgery because of liver rupture. The management of these patients requires an expert multidisciplinary team. There are several cases in the literature that describe a sudden liver rupture as the first manifestation of a PAN...
November 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27876769/gastrointestinal-aspects-of-vasculitides
#14
REVIEW
Medha Soowamber, Adam V Weizman, Christian Pagnoux
Systemic vasculitides are caused by inflammation of blood vessels and can affect any organ and any part of the gastrointestinal tract, hepatic and biliary system, as well as the pancreas. These disorders can cause a wide array of gastrointestinal manifestations, from asymptomatic elevated transaminase levels and mild abdominal pain to potentially life-threatening bowel perforations and peritonitis. A diagnosis based solely on gastrointestinal symptoms is challenging as these manifestations are not specific...
March 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27812074/cytomegalovirus-pneumonia-and-pulmonary-haemorrhage-in-a-patient-with-polyarteritis-nodosa
#15
Aysel Sunnetcioglu, Mahmut Sunnetcioglu, Habib Emre, Lokman Soyoral, Ugur Goktas
Cytomegaloviruses are opportunistic pathogens that cause lung infection in immunocompromised individuals. A 24-year-old male was admitted to the hospital with complaints of cough, fever and dyspnoea. He was receiving immunosuppressive therapy for polyarteritis nodosa. A chest X-ray showed heterogeneous right-sided opacity in the middle and lower lung zones. The diagnosis of cytomegalovirus pneumonia was confirmed by positive testfor serum cytomegalovirus IgM antibodies.Oneday after admission, haemoptysis developed and patient with hemoptysis who had shortness of breath was intubated...
November 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27803418/an-autopsy-case-of-aortic-intimal-sarcoma-initially-diagnosed-as-polyarteritis-nodosa
#16
Yuko Toyoda, Ryohiko Ozaki, Jun Kishi, Masaki Hanibuchi, Katsuhiro Kinoshita, Toshifumi Tezuka, Hisatsugu Goto, Hiroyuki Ono, Kojiro Nagai, Yoshimi Bando, Toshio Doi, Yasuhiko Nishioka
A 61-year-old man had hypertension with stenosis in the left renal artery. When his fever, abdominal pain, and renal dysfunction progressed, he was admitted to our hospital. He was diagnosed with polyarthritis nodosa. His renal function rapidly deteriorated despite immunosuppressive therapy. His digestive tract perforated twice, and he subsequently died. An autopsy revealed that aortic intimal sarcoma caused stenosis in multiple arteries. Both polyarteritis nodosa and aortic intimal sarcoma are very rare diseases and the diagnoses are very difficult...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27787337/approach-to-cutaneous-vasculitides-with-special-emphasis-on-small-vessel-vasculitis-histopathology-and-direct-immunofluorescence
#17
Cuyan Demirkesen
PURPOSE OF REVIEW: The present review will focus on recent publications in cutaneous vasculitides. RECENT FINDINGS: Some histopathological and clinical features, such as papillary dermal edema, perivascular C3 deposition, clinically evident edema, and lesions above the waist, may point out renal or gastrointestinal involvement in Henoch-Schönlein purpura (HSP). HSP associated with familial Mediterranean fever differs from typical isolated HSP by showing no deposits of IgA, much younger age, and location of the lesions on the face or the trunk...
January 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/27721981/polyarteritis-nodosa-with-a-chronic-relapsing-course
#18
Ashok Kumar, Anshul Goel, Mehul Lapsiwala
Polyarteritis nodosa is a medium artery vasculitis that can cause fatal complications. It commonly follows an acute monophasic course that may remit after treatment or cause serious morbidity or death. A 24-year-old patient described here had many vasculitic episodes in the past 16 years causing infarction of different organs. The last episode was most serious which caused mononeuritis multiplex, digital gangrene, bowel gangrene and subsequent perforations. There was strong clinical suspicion of this disease right from the beginning...
October 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27709445/childhood-polyarteritis-nodosa-diagnosis-with-non-invasive-imaging-techniques
#19
Z Birsin Özçakar, Suat Fitöz, Adalet Elçin Yıldız, Fatoş Yalçınkaya
There is limited number of publications about the use of non-invasive imaging modalities in the diagnosis of childhood polyarteritis nodosa (cPAN). The aim of this study was to present the clinical and imaging findings of the patients with cPAN who were diagnosed with non-invasive imaging techniques. Files of patients who had been diagnosed as cPAN in our department from 2005 to 2015 were reviewed, retrospectively. Demographic, clinical, laboratory, and imaging findings of the patients were evaluated. Nine patients (8M, 1F; age at disease onset: 12...
January 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/27686032/-beware-polyarteritis-nodosa-still-exists-in-nephrology
#20
Justine Perrin, Julien Carvelli, Bertrand Gondouin, Laurent Daniel, Megan Fraisse, Céline Gaudon, Fouad Bouzana, Henri Vacher-Coponat, Julie Moussi-Francès, Bertrand Dussol, Noémie Jourde-Chiche
Renal involvement of systemic vasculitides is an emergency in nephrology. Although it has become very rare, the diagnosis of polyarteritis nodosa must be considered in some patients. A 70-year-old patient, previously healthy, presented with acute renal failure and malignant hypertension and abundant albuminuria. Subcutaneous nodule, orchitis and mononeuritis appeared subsequently. The search for auto-immunity or viral infection was negative. Markers of thrombotic microangiopathy, present initially, resolved after blood pressure control...
November 2016: Néphrologie & Thérapeutique
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