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https://www.readbyqxmd.com/read/28439062/a-rare-case-of-necrotizing-myopathy-and-fibrinous-and-organizing-pneumonia-with-anti-ej-antisynthetase-syndrome-and-ssa-antibodies
#1
Muhammad Kashif, Divya Arya, Masooma Niazi, Misbahuddin Khaja
BACKGROUND Idiopathic inflammatory myopathies are autoimmune disorders that can involve the skin, joints, muscles, and lungs. The most common of these disorders are dermatomyositis, polymyositis, overlap syndrome, and inclusion body myositis. Necrotizing autoimmune myopathy is an idiopathic inflammatory myopathy that is rarely associated with Sjögren's syndrome. The most common lung findings associated with anti-EJ antisynthetase syndrome are nonspecific interstitial pneumonia and usual interstitial pneumonia; this condition is rarely associated with fibrinous and organizing pneumonia...
April 25, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28416360/primary-hepatic-angiosarcoma-and-liver-transplantation-radiological-surgical-histological-findings-and-clinical-outcome
#2
M Tran Minh, A Mazzola, F Perdigao, F Charlotte, G Rousseau, F Conti
Angiosarcoma is a rare type of soft tissue sarcoma that accounts for less than 1% of all sarcomas and only 2% of all primary hepatic tumours. Thorotrast, arsenic, and vinyl chloride monomer are frequently listed as occupational exposure risks. The estimated latency is long (10-40 years) in occupational cases and very long (60 years or more) in non-occupational cases. The symptoms and CT-scan appearance of hepatic angiosarcoma (HAS) are non-specific. We present a case of a 65-year-old Caucasian male with history of cryptogenic cirrhosis, low alpha-foetoprotein levels and a single, 4-cm nodule of potential atypical hepatocellular carcinoma (no washout at MRI and CT-scan) in segment VIII...
April 14, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28367758/bortezomib-as-a-novel-approach-to-early-recurrent-membranous-glomerulonephritis-after-kidney-transplant-refractory-to-combined-conventional-rituximab-therapy
#3
Antoine Barbari, Rima Chehadi, Hala Kfoury Assouf, Gaby Kamel, Mahassen Jaafar, Ayman Abdallah, Sylvana Rizk, Marwan Masri
We report a case of early recurrent membranous glomerulonephritis after kidney transplant from a deceased donor. The patient received induction therapy and was discharged with a serum creatinine level of 0.78 mg/dL on triple maintenance immunosuppressive therapy, which included tacrolimus, mycophenolate mofetil, and prednisone. At 7 months after transplant, a graft biopsy for new-onset isolated proteinuria (2.7 g/day) revealed stage 2 recurrent membranous glomerulonephritis. In the face of persistent proteinuria despite combined conservative rituximab therapy over several months and the total eradication of CD20-positive cells, bortezomib was introduced...
April 3, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28349124/alemtuzumab-induction-and-delayed-acute-rejection-in-steroid-free-simultaneous-pancreas-kidney-transplant-recipients
#4
Jonna R Bank, Sebastiaan Heidt, Dirk Jan A R Moes, Dave L Roelen, Marko J K Mallat, Paul J M van der Boog, Manon Vergunst, Cornelia M Jol-van der Zijde, Robbert G M Bredius, Andries E Braat, Jan Ringers, Maarten J D van Tol, Frans H J Claas, Marlies E J Reinders, Johannes W de Fijter
BACKGROUND: The optimal immunosuppressive regimen in simultaneous pancreas-kidney transplant (SPKT) recipients that prevents acute rejection episodes (AREs) and allows optimal outcome remains elusive. METHODS: This cohort study assessed incidence and time to AREs in 73 consecutive SPKT recipients receiving alemtuzumab induction and steroid-free maintenance with tacrolimus and mycophenolate mofetil. A cohort with single high-dose antithymocyte globulin (ATG; n = 85) and triple therapy served as controls...
January 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28342067/the-incidence-of-post-transplant-cancer-among-kidney-transplant-recipients-is-associated-with-the-level-of-tacrolimus-exposure-during-the-first-year-after-transplantation
#5
Shelly Lichtenberg, Ruth Rahamimov, Hefziba Green, Benjamin D Fox, Eytan Mor, Uzi Gafter, Avry Chagnac, Benaya Rozen-Zvi
PURPOSE: Immunosuppressive therapy plays a major role in the development of post-transplant cancer. In this nested case-control study of kidney transplant recipients (KTRs), we investigated whether the incidence of post-transplant cancer is associated with the level of tacrolimus exposure over time. METHODS: We screened the Rabin Medical Center database for adults who received kidney transplants between 2001 and 2014 and developed post-transplant cancer (excluding basal and squamous cell skin cancers)...
March 24, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28332959/de-novo-donor-specific-antibody-formation-in-tacrolimus-based-mycophenolate-versus-mammalian-target-of-rapamycin-immunosuppressive-regimens
#6
Zain Mithani, Jane Gralla, Oluwafisayo Adebiyi, Patrick Klem, James E Cooper, Alexander C Wiseman
OBJECTIVES: De novo donor-specific antibody formation posttransplant is associated with decreased graft survival. It is not known whether mammalian target of rapamycin inhibitors may be advantageous or detrimental compared with mycophenolate in the prevention of de novo donor-specific antibody formation. MATERIALS AND METHODS: We compared 66 kidney and kidney-pancreas transplant recipients who received tacrolimus, mammalian target of rapamycin inhibitor, and prednisone (group 1; 36 of whom received everolimus and 30 of whom received sirolimus) versus 132 patients who received tacrolimus, mycophenolate, and prednisone (group 2) matched for age, sex, race, and type/timing of transplant from 2007 to 2012...
March 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28327659/the-immunosuppressant-mycophenolic-acid-alters-nucleotide-and-lipid-metabolism-in-an-intestinal-cell-model
#7
Svenja Heischmann, Monika Dzieciatkowska, Kirk Hansen, Dieter Leibfritz, Uwe Christians
The study objective was to elucidate the molecular mechanisms underlying the negative effects of mycophenolic acid (MPA) on human intestinal cells. Effects of MPA exposure and guanosine supplementation on nucleotide concentrations in LS180 cells were assessed using liquid chromatography-mass spectrometry. Proteomics analysis was carried out using stable isotope labeling by amino acids in cell culture combined with gel-based liquid chromatography-mass spectrometry and lipidome analysis using (1)H nuclear magnetic resonance spectroscopy...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28317040/intra-individual-variability-of-mycophenolic-acid-concentration-according-to-renal-function-in-liver-transplant-recipients-receiving-mycophenolate-monotherapy
#8
Shin Hwang, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Ki-Hun Kim, Sung-Gyu Lee
BACKGROUNDS/AIMS: Mycophenolate mofetil (MMF) has wide inter- and intra-individual variability of mycophenolic acid (MPA) after liver transplantation (LT). On this study, we aimed to analyse the intra-individual variability of MPA concentration in stable adult LT recipients receiving MMF monotherapy and develop a method to determine the target level in the situation of wide intra-individual variability. METHODS: This retrospective cross-sectional study included 30 LT recipients...
February 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28314079/low-serum-testosterone-is-associated-with-impaired-graft-function-early-after-heart-transplantation
#9
Gregor Poglajen, Mojca Jensterle, Nika Kravos, Andrej Janež, Bojan Vrtovec
BACKGROUND: We sought to investigate a correlation between serum testosterone levels and graft function early after heart transplantation. METHODS: In a cross-sectional study, we measured serum testosterone levels 4 weeks after heart transplantation in 49 consecutive male recipients. Echocardiography was carried out to evaluate graft function. Low serum testosterone was defined as <11 nmol/L. RESULTS: Low serum testosterone was present in 21 (43%) recipients (Group A), and 28 (57%) had normal testosterone levels (Group B)...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28300419/dried-blood-spot-validation-of-five-immunosuppressants-without-hematocrit-correction-on-two-lc-ms-ms-systems
#10
Remco A Koster, Herman Veenhof, Rixt Botma, Alle Tjipke Hoekstra, Stefan P Berger, Stephan Jl Bakker, Jan-Willem C Alffenaar, Daan J Touw
AIM: Hematocrit (Ht) effects remain a challenge in dried blood spot (DBS) sampling. The aim was to develop an immunosuppressant DBS assay on two LC-MS/MS systems covering a clinically relevant Ht range without Ht correction. RESULTS: The method was partially validated for tacrolimus, sirolimus, everolimus, cyclosporin A and fully validated for mycophenolic acid on an Agilent and Thermo LC-MS/MS system. Bias caused by Ht effects were within 15% for all immunosuppressants between Ht levels of 0...
March 16, 2017: Bioanalysis
https://www.readbyqxmd.com/read/28279567/optimizing-everolimus-exposure-when-combined-with-calcineurin-inhibitors-in-solid-organ-transplantation
#11
REVIEW
Teun van Gelder, Lutz Fischer, Fuad Shihab, Maria Shipkova
The mammalian target of rapamycin (mTOR) inhibitor everolimus is a narrow therapeutic index drug for which optimal exposure levels are essential. The consistent pharmacokinetic profile of everolimus allows trough concentration (C0) measurement to be an appropriate and reliable index for therapeutic drug monitoring (TDM). Exposure-response analyses of data from early fixed-dose trials demonstrated that rates of biopsy-proven acute rejection (BPAR) are significantly higher if everolimus C0 declines below 3 ng/mL, an observation confirmed in subsequent concentration-controlled trials...
February 27, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28276509/suppression-of-autophagy-by-mycophenolic-acid-contributes-to-inhibition-of-hcv-replication-in-human-hepatoma-cells
#12
Shoucai Fang, Jinming Su, Bingyu Liang, Xu Li, Yu Li, Junjun Jiang, Jiegang Huang, Bo Zhou, Chuanyi Ning, Jieliang Li, Wenzhe Ho, Yiping Li, Hui Chen, Hao Liang, Li Ye
Previous studies have shown that mycophenolic acid (MPA) has an anti-HCV activity. However, the mechanism of MPA-mediated inhibition of HCV replication remains to be determined. This study investigated whether MPA has an effect on autophagy, a cellular machinery required for HCV replication, thereby, inhibits HCV replication in Huh7 cells. MPA treatment of Huh7 cells could suppress autophagy, evidenced by decreased LC3B-II level and conversion of LC3B-I to LC3B-II, decreased autophagosome formation, and increased p62 level compared to MPA-untreated cells...
March 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28260426/borderline-changes-on-dysfunctional-renal-allograft-biopsies-clinical-relevance-in-a-living-related-renal-transplant-setting
#13
Muhammed Mubarak, Shaheera Shakeel, Khawar Abbas, Tahir Aziz, Mirza Naqi Zafar, Syed Anwer Naqvi, Syed Adibul Hasan Rizvi
OBJECTIVES: Our aim was to determine the clinical significance of borderline lymphocytic infiltrates on indicated renal allograft biopsies in a living related renal transplant setting. MATERIALS AND METHODS: The study was conducted at the histopathology department of Sindh Institute of Urology and Transplantation. A retrospective review of 421 renal transplant patients was conducted from October 2007 to September 2008 to identify patients in whom a histologic diagnosis of borderline changes was made on dysfunctional renal allograft biopsies...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28257599/immunosuppressive-drugs-affect-ifn%C3%AE-and-pd1-kinetics-in-patients-with-newly-diagnosed-autoimmune-hepatitis
#14
Charlotte R Grant, Beth S Holder, Rodrigo Liberal, Michael A Heneghan, Yun Ma, Giorgina Mieli-Vergani, Diego Vergani, Maria Serena Longhi
Autoimmune hepatitis (AIH) is characterized by overwhelming effector immune responses associated with defective regulatory T cells (Tregs). Several lines of evidence indicate CD4 as the main effectors involved in the autoimmune liver damage. Herein we investigate the in vitro effects of prednisolone, 6-mercaptopurine, cyclosporine, tacrolimus, mycophenolic acid (MPA) and rapamycin, immunosuppressive drugs (ISDs) used in AIH treatment, on the expression of pro-inflammatory cytokines, co-inhibitory molecules and ability to proliferate of CD4(+) CD25(-) cells, isolated from the peripheral blood of treatment-naïve patients with AIH...
March 3, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28248797/metachronous-involvement-diagnostic-imprecision-of-serum-immunoglobulin-g4-levels-and-discordance-between-clinical-and-radiological-findings-in-immunoglobulin-g4-related-pachymeningitis-a-longitudinal-case-report
#15
Waqar Waheed, Philip Michael Skidd, Neil M Borden, Pamela C Gibson, Mohamed Ali Babi, Rup Tandan
Immunoglobulin G4-related disease is an increasingly recognized, idiopathic systemic disorder that might be associated with elevated serum IgG4 level and tissue infiltration by IgG4-positive plasma cells. We describe the clinical features and biopsy findings in a patient who presented with features suggestive of pachymeningitis and multiple cranial neuropathies. Meningeal biopsy and other laboratory studies established the diagnosis of IgG4-related hypertrophic pachymeningitis. Despite treatment with corticosteroids and mycophenolate mofetil, the patient exhibited a fluctuating progressive course, which stabilized with rituximab, although the radiological findings persisted over 2½ years of follow-up...
February 28, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28174010/a-case-of-t-cell-lymphoproliferative-disorder-associated-with-hypereosinophilia-with-excellent-response-to-mycophenolate-mofetil
#16
Amr Hanbali, Marwan Shaheen, Feras Alfraih, Wafa Al-Otaibi, Riad El Fakih, Tarek Owaidah, Syed Ahmed
Hypereosinophilic syndrome (HES) is a group of rare blood disorders characterized by a persistent elevation of blood eosinophil count ⩾1.5×10(9)/L and clinical manifestations attributable to eosinophilia or tissue hypereosinophilia. Lymphocytic variant of HES (HES-L) is a known subtype according to World Health Organization classification. It is well documented in the literature that patients with HES-L are predisposed to develop T-cell lymphoma. We report a case of T-cell lymphoproliferation associated with hypereosinophilia, which has been successfully treated with mycophenolate mofetil, with resolution of skin lesions and normalization of eosinophil count and immunoglobulin E level...
February 1, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28148558/risk-factors-for-renal-survival-in-chinese-patients-with-myeloperoxidase-anca-associated-gn
#17
Yinghua Chen, Hao Bao, Zhengzhao Liu, Xia Liu, Erzhi Gao, Caihong Zeng, Haitao Zhang, Zhihong Liu, Weixin Hu
BACKGROUND AND OBJECTIVES: Our study explored the association of histopathologic classification of ANCA-associated GN with renal survival in Chinese patients with myeloperoxidase-ANCA-associated GN. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Two hundred fifteen patients with biopsy-proven myeloperoxidase-ANCA-associated GN were included from January of 1996 to December of 2014. The biopsies included focal (n=27), mixed (n=82), crescentic (n=47), and sclerotic (n=59) classes...
March 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28145625/pediatric-renal-transplant-practices-in-india
#18
Sidharth Kumar Sethi, Rajiv Sinha, Smriti Rohatgi, Vijay Kher, Arpana Iyengar, Arvind Bagga
Limited access to tertiary-level health care, limited trained pediatric nephrologists and transplant physicians, lack of facilities for dialysis, lack of an effective deceased donor program, non-affordability, and non-adherence to immunosuppressant drugs poses a major challenge to universal availability of pediatric transplantation in developing countries. We present the results of a survey which, to the best of our knowledge, is the first such published attempt at understanding the current state of pediatric renal transplantation in India...
May 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28133906/efficacy-and-safety-of-everolimus-and-mycophenolic-acid-with-early-tacrolimus-withdrawal-after-liver-transplantation-a-multicenter-randomized-trial
#19
F Saliba, C Duvoux, J Gugenheim, N Kamar, S Dharancy, E Salamé, M Neau-Cransac, F Durand, P Houssel-Debry, C Vanlemmens, G Pageaux, J Hardwigsen, D Eyraud, Y Calmus, F Di Giambattista, J Dumortier, F Conti
SIMCER was a 6-mo, multicenter, open-label trial. Selected de novo liver transplant recipients were randomized (week 4) to everolimus with low-exposure tacrolimus discontinued by month 4 (n = 93) or to tacrolimus-based therapy (n = 95), both with basiliximab induction and enteric-coated mycophenolate sodium with or without steroids. The primary end point, change in estimated GFR (eGFR; MDRD formula) from randomization to week 24 after transplant, was superior with everolimus (mean eGFR change +1.1 vs...
January 30, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28130037/assessing-interactions-of-binary-mixtures-of-penicillium-mycotoxins-pms-by-using-a-bovine-macrophage-cell-line-bomacs
#20
Se-Young Oh, Nina Cedergreen, Alexandros Yiannikouris, H V L N Swamy, Niel A Karrow
Penicillium mycotoxins (PMs) are toxic contaminants commonly found as mixtures in animal feed. Therefore, it is important to investigate potential joint toxicity of PM mixtures. In the present study, we assessed the joint effect of binary combinations of the following PMs: citrinin (CIT), ochratoxin A (OTA), patulin (PAT), mycophenolic acid (MPA) and penicillic acid (PA) using independent action (IA) and concentration addition (CA) concepts. Previously published toxicity data (i.e. IC25; PM concentration that inhibited bovine macrophage (BoMacs) proliferation by 25%) were initially analyzed, and both concepts agreed that OTA+PA demonstrated synergism (p<0...
March 1, 2017: Toxicology and Applied Pharmacology
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