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Hepatic involvement by systemic vasculitis

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https://www.readbyqxmd.com/read/27842627/polyarteritis-nodosa-presenting-as-a-bladder-outlet-obstruction
#1
M Borkum, H Y Abdelrahman, R Roberts, A A Kalla, I G Okpechi
Polyarteritis nodosa (PAN) of the urinary tract is rare. An unusual case of systemic PAN involving the bladder neck is described. A 27-year-old man, with known diastolic hypertension diagnosed 2 years earlier, was admitted with chronic urinary obstruction complicated by hydronephrosis. He had symptoms of myalgia and weight loss, was afebrile but had an elevated erythrocyte sedimentation rate and acute-on-chronic renal impairment. All virological and serological tests including hepatitis B and anti-neutrophil cytoplasmic antibody were negative...
November 2, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27686032/-beware-polyarteritis-nodosa-still-exists-in-nephrology
#2
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...
September 24, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27544391/kaleidoscope-of-autoimmune-diseases-in-hiv-infection
#3
Justyna Roszkiewicz, Elzbieta Smolewska
Within the last 30 years, the human immunodeficiency virus (HIV) infection has changed its status from inevitably fatal to chronic disorder with limited impact on life span. However, this breakthrough was mainly the effect of introduction of the aggressive antiviral treatment, which has led to the clinically significant increase in CD4+ cell count, resulting in fewer cases of the acquired immunodeficiency syndrome (AIDS) and improved management of opportunistic infections occurring in the course of the disease...
November 2016: Rheumatology International
https://www.readbyqxmd.com/read/27267327/the-correlation-between-antiphospholipid-syndrome-and-cryoglobulinemia-case-series-of-4-patients-and-review-of-the-literature
#4
Shiber Shachaf, Molad Yair
BACKGROUND: Cryoglobulinemia is an immune-complex-mediated small vessel vasculitis that classically involves the skin, kidneys and peripheral nerves. Antiphospholipid syndrome (APS) is an autoimmune hypercoagulable disorder which causes blood vessel thrombosis. It can present as a multi-organ microthrombotic disorder which is called catastrophic APS. OBJECTIVE: In this case series we aim to describe the diagnostic and management challenges that arise when these two severe disorders simultaneously present in the same patient...
January 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/26989675/hypertension-in-the-liver-clinic-polyarteritis-nodosa-in-a-patient-with-hepatitis-b
#5
Shalini Thapar Laroia, Suman Lata
Chronic hepatitis caused by hepatitis B virus (HBV) is an endemic disease in India. It is associated with extrahepatic manifestations like polyarteritis nodosa (PAN) which is a vasculitis like disorder, presenting in subacute or chronic phase; involving visceral and systemic vessels. It should always be considered as a possible etiology of hypertension in an underlying setting of hepatitis B. We describe a 56-year-male patient with a history of chronic HBV who presented to the outpatient clinic with history of recent onset hypertension and suspected liver disease...
March 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/26630685/histopathology-of-the-exanthema-in-dress-is-not-specific-but-may-indicate-severity-of-systemic-involvement
#6
Margarida M Gonçalo, José C Cardoso, Miguel P Gouveia, Inês Coutinho, Ana R Gameiro, Maria M Brites, Óscar E Tellechea
OBJECTIVE: Exanthema in drug reaction with eosinophilia and systemic symptoms (DRESS) has no specific clinical diagnostic hallmark and there are few histopathologic studies. The aim of this study was to describe dermal-epidermal histopathologic features in DRESS and correlate them with the culprit drug, viral reactivation, or systemic organ involvement. METHODS: Skin biopsies were independently evaluated by 2 dermatopathologists who characterized the main histological patterns and scored dermal and epidermal changes, which were further correlated with clinical and laboratorial data...
June 2016: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/26474537/treatment-of-hepatitis-c-virus-associated-mixed-cryoglobulinemia-with-direct-acting-antiviral-agents
#7
Meghan E Sise, Allyson K Bloom, Jessica Wisocky, Ming V Lin, Jenna L Gustafson, Andrew L Lundquist, David Steele, Michael Thiim, Winfred W Williams, Nikroo Hashemi, Arthur Y Kim, Ravi Thadhani, Raymond T Chung
UNLABELLED: Hepatitis C virus (HCV) is the most common cause of mixed cryoglobulinemia syndrome (MCS). The efficacy and safety of all-oral direct-acting antiviral (DAA) therapy in HCV-associated MCS (HCV-MCS) is largely unknown. The authors studied case series of patients with HCV-MCS who were treated with sofosbuvir-based regimens and historical controls treated with pegylated interferon and ribavirin in a single health care network. HCV-MCS was defined by circulating cryoglobulin associated with systemic vasculitis symptoms...
February 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/26357639/dermatologic-extrahepatic-manifestations-of-hepatitis-c
#8
REVIEW
Bhavtosh Dedania, George Y Wu
Hepatitis C virus (HCV) affects millions of people worldwide, and an estimated 3.2 million people in the United States. HCV is a hepatotropic and lymphotropic virus that causes not only liver disease, but also a significant number of extrahepatic manifestations (EHMs). Up to 74% of patients affected by HCV will have HCV-related EHMs of some severity in their lifetime. The EHMs vary from simple cutaneous palpable purpura to complex lymphoproliferative disorders, including lymphomas and immune-complex deposit diseases causing local and/or systemic complications...
June 28, 2015: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/26308313/gallbladder-and-pancreas-in-henoch-sch%C3%A3-nlein-purpura-review-of-the-literature
#9
Rossana Helbling, Sebastiano A G Lava, Giacomo D Simonetti, Pietro Camozzi, Mario G Bianchetti, Gregorio P Milani
OBJECTIVE: Involvement of the pancreato-biliary system has been occasionally noted in Henoch-Schönlein purpura. Furthermore, cases of this vasculitis syndrome sometimes develop in the context of a viral hepatitis or after hepatitis vaccination. METHODS: We completed a review of the literature. RESULTS: Fifty reports published between 1977 and 2015 were retained for the analysis. A pancreato-biliary involvement was recognized in 34 individually well-described patients (♂:♀ = 19:15) with severe abdominal pain: pancreatitis (N = 20), acalculous cholecystitis (N = 11), both pancreatitis and cholecystitis (N = 3)...
March 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/26302805/treatment-of-hcv-related-mixed-cryoglobulinemia
#10
Dilia Giuggioli, Marco Sebastiani, Michele Colaci, Poupak Fallahi, Laura Gragnani, Anna Linda Zignego, Alessandro Antonelli, Clodoveo Ferri
Mixed cryoglobulinemia syndrome (MCs) is a systemic vasculitis, involving skin, joints, peripheral nerves, and several internal organs. Hepatitis C virus (HCV) is recognized as the etiologic agent for the majority of MCs patients, as well as of number of autoimmune, lymphoproliferative, and neoplastic disorders. In this context, HCV-related MCs represents an important model autoimmune/neoplastic disease triggered by a virus in humans. With regard the therapeutic strategies of MCs, we can treat these patients at different steps by means of etiological (antivirals), pathogenetic, symptomatic drugs (mainly immunosuppressors, corticosteroids, plasmapheresis)...
August 25, 2015: Current Drug Targets
https://www.readbyqxmd.com/read/26297208/ll37-inhibits-the-inflammatory-endothelial-response-induced-by-viral-or-endogenous-dna
#11
Monika Merkle, Joachim Pircher, Hanna Mannell, Florian Krötz, Philipp Blüm, Thomas Czermak, Erik Gaitzsch, Christine Schneider, Simone Köppel, Andrea Ribeiro, Markus Wörnle
In viral infection, morbidity and mortality often result from extrahepatic disease manifestations such as vasculitis. We hereby show that human microvascular endothelial cells express viral receptors of the innate immune system which are induced upon ligand engagement. Furthermore, stimulation of endothelial cells with the synthetic analog of viral DNA, poly (dA:dT), human DNA and hepatitis B virus-containing immunoprecipitates from a patient with polyarteritis nodosa induces an inflammatory response including the upregulation of adhesion molecules, which is mediated exclusively by TLR9 and involves an IRF3-dependent pathway...
December 2015: Journal of Autoimmunity
https://www.readbyqxmd.com/read/26267002/pain-management-in-cryoglobulinaemic-syndrome
#12
REVIEW
Salvatore Scarpato, Fabiola Atzeni, Piercarlo Sarzi-Puttini, Antonio Brucato, Luca Quartuccio, Maurizio Pietrogrande, Giuseppe Monti, Massimo Galli
Cryoglobulinaemic syndrome (CS) includes clinical signs and symptoms that range from the classic triad of Meltzer and Franklin (purpura, weakness and arthralgias) to multiple organ involvement, and it may be characterised by nociceptive or neuropathic pain. Both types of pain use the same pathways and neurotransmitters, but nociceptive pain has an adaptive system and biological function whereas neuropathic pain does not. Managing CS means dealing with often very different clinical patterns, activity and severity with the aim of preventing irreversible organ damage, reducing pain, improving the patients' quality of life and reducing social costs...
February 2015: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/26161511/treatment-of-hepatitis-c-related-kidney-disease
#13
REVIEW
Fabrizio Fabrizi, Paul Martin, Patrice Cacoub, Piergiorgio Messa, Francesca M Donato
INTRODUCTION: Hepatitis C virus (HCV) infection has been associated with a large spectrum of glomerular lesions in both native and transplanted kidneys. The most common HCV-associated renal disease is type I membranoproliferative glomerulonephritis usually, but not invariably, in the context of type II mixed cryoglobulinemia (MC). HCV infection is also the major cause of MC, a systemic vasculitis characterized by involvement of small and, less frequently, medium-sized vessels. Conflicting data exist on the treatment of HCV-associated glomerular disease...
2015: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/25889007/thymic-stromal-lymphopoietin-in-hepatitis-c-virus-related-cryoglobulinemic-vasculitis-gene-expression-level-and-protein-distribution
#14
Domenico Sansonno, Sabino Russi, Silvia Sansonno, Fabio Pavone, Franco Dammacco
INTRODUCTION: Hepatitis C virus (HCV) infection can be detected in virtually all patients with cryoglobulinemic vasculitis (CV). Among its many effects, the virus is able to stimulate the production of thymic stromal lymphopoietin (TSLP) by infected hepatocytes. In this study, we assessed the systemic levels and tissue distribution of TSLP in 60 chronically HCV-infected patients, 36 with and 24 without CV. METHODS: Serum TSLP levels were measured by an enzyme-linked immunosorbent assay (ELISA) method...
2015: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/25776653/thymic-stromal-lymphopoietin-in-hepatitis-c-virus-related-cryoglobulinemic-vasculitis-gene-expression-level-and-protein-distribution
#15
Domenico Sansonno, Sabino Russi, Silvia Sansonno, Fabio Pavone, Franco Dammacco
INTRODUCTION: Hepatitis C virus (HCV) infection can be detected in virtually all patients with cryoglobulinemic vasculitis (CV). Among its many effects, the virus is able to stimulate the production of thymic stromal lymphopoietin (TSLP) by infected hepatocytes. In this study, we assessed the systemic levels and tissue distribution of TSLP in 60 chronically HCV-infected patients, 36 with and 24 without CV. METHODS: Serum TSLP levels were measured by an enzyme-linked immunosorbent assay (ELISA) method...
December 2015: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/25547031/cryoglobulinemic-vasculitis-and-skin-ulcers-our-therapeutic-strategy-and-review-of-the-literature
#16
Dilia Giuggioli, Andreina Manfredi, Federica Lumetti, Marco Sebastiani, Clodoveo Ferri
OBJECTIVE: Cryoglobulinemic vasculitis (CV) involving small- and medium-sized vessels is very frequently associated with hepatitis C virus and may be responsible for multiple organ involvement and skin ulcers (SU). Skin ulcers are often non-healing cutaneous lesions, possibly complicated by local infection and gangrene; they may severely affect the patients׳ quality of life and the overall prognosis. Therefore, the treatment of cryoglobulinemic SU is particularly challenging in the clinical practice...
April 2015: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/25440702/the-correlation-between-antiphospholipid-syndrome-and-cryoglobulinemia-case-series-of-4-patients-and-review-of-the-literature
#17
Shiber Shachaf, Molad Yair
BACKGROUND: Cryoglobulinemia is an immune-complex-mediated small vessel vasculitis that classically involves the skin, kidneys and peripheral nerves. Antiphospholipid syndrome (APS) is an autoimmune hypercoagulable disorder which causes blood vessel thrombosis. It can present as a multi-organ microthrombotic disorder which is called catastrophic APS. OBJECTIVE: In this case series we aim to describe the diagnostic and management challenges that arise when these two severe disorders simultaneously present in the same patient...
January 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/25376297/clinical-features-of-vascular-disorders-associated-with-chronic-hepatitis-virus-infection
#18
REVIEW
Naoshi Nishida, Masatoshi Kudo
Hepatitis virus infections can be accompanied by extrahepatic manifestations that may be caused by the host's immune reaction to the viral infection. Vascular involvement is one of these manifestations and is occasionally associated with life-threatening conditions due to systemic organ failure. The unique profile of hepatitis-related vascular involvement is associated with infection by different types of hepatitis viruses. For example, polyarteritis nodosa is more frequently reported in patients with chronic hepatitis B than those with chronic hepatitis C...
2014: Digestive Diseases
https://www.readbyqxmd.com/read/25198366/complement-system-in-sle-as-a-target-for-antibodies
#19
Pavel Horak, Martina Skacelova, Josef Zadrazil, Andrea Smrzova, Karel Krejcí, Hana Ciferska, Zuzana Hermanova
SLE is characterized by overproduction of various types of autoantibodies. Under certain circumstances, antibodies targeting some of the neoepitopes of the complement system can be seen. The most studied among antibodies directed against a component of the complement system is anti-C1q. Anti-C1q antibodies are present in approximately one third of the patients with lupus, who often have high clinical disease activity and in particular renal involvement. In the presence of high titers of anti-C1q antibodies also the levels of C1q and C3 and C4 components of the complement system are also usually low...
2013: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/25068833/a-rare-but-serious-manifestation-of-beh%C3%A3-et-s-disease-intracardiac-thrombus-in-22-patients
#20
Hakan Emmungil, N Şule Yaşar Bilge, Orhan Küçükşahin, Levent Kılıç, Sercan Okutucu, Sercan Gücenmez, Umut Kalyoncu, Timuçin Kaşifoğlu, Murat Turgay, Kenan Aksu
OBJECTIVES: Behçet's disease (BD) is a chronic, multisystemic disorder characterised by recurrent oral aphtous ulcers, genital ulcers and ocular inflammation. Vasculitis and thrombotic events are the most important causes of mortality. Vena cava thrombosis, pulmonary artery aneurysms, Budd-Chiari syndrome, peripheral artery aneurysms, dural sinus thrombosis and abdominal aorta aneurysms are the other less common vascular manifestations of BD. Cardiac involvement in BD is a rare and life-threatening complication...
July 2014: Clinical and Experimental Rheumatology
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