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https://www.readbyqxmd.com/read/28690859/case-report-of-a-lupus-patient-with-a-severe-flare-and-miliary-tuberculosis-need-for-proper-guidelines-for-management
#1
Masooma Hashmat, Ramsa Suhail Rana, Tafazzul-E-Haque Mahmud, Aflak Rasheed, Ata Ur Rehman, Syed Ali Rukh Pirzada, Muhammad Ammad Asghar, Sadia Asif, Amjad Ali
Systemic lupus erythematosus (SLE) is an autoimmune disease that is frequently treated with high doses of corticosteroids and other immunosuppressive drugs. Thus patients with SLE are at increased risk for infections with several pathogens including Mycobacterium tuberculosis. There are no established guidelines available for treatment of tuberculosis in SLE patients with high disease activity due to lack of relevant studies and management based more on physician expertise. We report a case of a young SLE patient with high disease activity index (SLEDAI19) as evidenced by the presence of a vasculitic rash, non-healing ulcer on forearm and proteinuria of >1 g/d along with miliary tuberculosis...
July 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28681585/a-simple-method-for-removing-low-density-granulocytes-to-purify-t-lymphocytes-from-peripheral-blood-mononuclear-cells
#2
Si-Gong Zhang, Yu-Xin Song, Xiao-Ming Shu, Hai-Li Shen, Han-Bo Yang, Rui-Xue Duo, Guo-Chun Wang
OBJECTIVE: Low-density granulocytes (LDGs) can form neutrophil extracellular traps (NETs) spontaneously and excessively. When peripheral blood mononuclear cells (PBMCs) are used for studying T lymphocytes, LDGs contained in the PBMCs may decrease the threshold of activating T lymphocytes by forming NETs. This study focused on the profiles of LDGs in common autoimmune diseases and methods for removing LDGs from PBMCs. METHODS: The percentages of LDGs in PBMCs from 55 patients with dermatomyositis (DM), 15 with polymyositis (PM), 42 with rheumatoid arthritis (RA), 25 with systemic lupus erythematosus (SLE), and 19 healthy controls were determined by flow cytometry...
July 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28623951/progressive-respiratory-distress-in-a-42-year-old-hiv-positive-woman-with-systemic-lupus-erythematosus
#3
Katongo Mutengo, Patrice Mukomena, Nason Lambwe, Owen Ngalamika
BACKGROUND: Identifying and treating the cause of pulmonary symptoms in HIV patients with underlying systemic lupus erythematosus (SLE) can be very challenging. Delays in diagnosing active SLE in HIV patients can lead to significant morbidity and even mortality. We report the case of an HIV-positive woman with SLE who presented with severe respiratory distress. CASE PRESENTATION: A 42-year-old HIV-positive woman presented with a 7-month history of anorexia, progressive dyspnoea, and a productive cough...
June 17, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28557287/epidemiology-and-clinical-features-of-inflammatory-retinal-vascular-occlusions-pooled-data-from-two-tertiary-referral-institutions
#4
Aniruddha Agarwal, Samendra Karkhur, Kanika Aggarwal, Alessandro Invernizzi, Ramandeep Singh, Mangat R Dogra, Vishali Gupta, Amod Gupta, Diana V Do, Quan D Nguyen
IMPORTANCE: In a subset of patients with retinal vasculitis, there is occlusion of blood flow through the retinal vessels. These eyes are at high risk of sight-threatening complications. BACKGROUND: To characterize epidemiology, clinical course, treatment and outcomes of occlusive retinal vasculitis (ORV). DESIGN: Retrospective study PARTICIPANTS: Seventy-seven uveitis patients with ORV at two large tertiary-care institutions (the USA and India)...
May 29, 2017: Clinical & Experimental Ophthalmology
https://www.readbyqxmd.com/read/28486537/association-between-a-history-of-mycobacterial-infection-and-the-risk-of-newly-diagnosed-sj%C3%A3-gren-s-syndrome-a-nationwide-population-based-case-control-study
#5
Wen-Cheng Chao, Ching-Heng Lin, Tsai-Ling Liao, Yi-Ming Chen, Der-Yuan Chen, Hsin-Hua Chen
OBJECTIVE: To address the association between a history of tuberculosis (TB) or nontuberculous mycobacterial (NTM) infection and the risk of newly diagnosed Sjögren's syndrome (SS). METHODS: Using a nationwide, population-based, claims dataset, and after excluding those who had rheumatoid arthritis or systemic lupus erythematosus, we identified 5,751 newly diagnosed SS cases during 2007-2012, and compared them to 86,265 non-SS controls matched (1:15) for age, sex, and the year of first SS diagnosis date...
2017: PloS One
https://www.readbyqxmd.com/read/28384925/sle-and-tuberculosis-a-case-series-and-review-of-literature
#6
Prasanta Kumar Bhattacharya, Md Jamil, Aakash Roy, Kishore Kumar Talukdar
Systemic Lupus Erythematosus (SLE) and Tuberculosis (TB) are intricately related with an increase in the risk of TB in SLE. Primary mechanisms pertaining to the increased susceptibility for TB are the inherent immunodeficient state of SLE and use of immunosuppressant agents in the treatment of SLE. We report a case series of five female patients of SLE with TB who presented between January 2015 and December 2015 in a tertiary care teaching hospital in North Eastern India. All the patients were young to middle aged females having SLE with or without lupus nephritis who were on immunosuppressive therapy with corticosteroids, mycophenolate mofetil or cyclophosphamide...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28355724/-a-clinical-analysis-on-fever-of-unknown-origin-in-in-patients-with-systemic-lupus-erythematosus
#7
C F Zhang, R Xu, M T Li, X F Zeng
To investigate the etiology and differential diagnoses of patients with systemic lupus erythematosus (SLE) and fever of unknown origin (FUO). From January 2012 to December 2014, a total of 928 SLE patients were admitted to Peking Union Medical College Hospital.Only 50 patients were combined with FUO (5.4%). The most common reason of fever was caused by infections(33 cases, 66.0%), including bacterial infection in 17 cases with 5 tuberculosis, viral infection in 11 cases, and fungal infection in 5 cases.The second reason offever was due to poor disease control or recurrence in 17 patients (34...
April 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28293057/kikuchi-fujimoto-disease-a-rare-presentation-with-localized-iliac-lymphadenitis
#8
Shrihari Anil Anikhindi, Anil Arora, Shashi Dhawan, Naresh Bansal, Praveen Sharma, Vikas Singla, Ashish Kumar
Kikuchi-Fujimoto disease (KFD) is a benign, self-limiting disease characterized by histiocytic necrotising lymphadenitis. Though several viral agents or an autoimmune etiology has been proposed as causative, the exact cause remains unknown. It has a female predilection and most commonly seen among young Asian people. Patients usually present with a febrile illness and the presence of lymphadenopathy may provide a clue to diagnosis. The most common site of lymphadenopathy is cervical lymph nodes while intra-abdominal involvement is uncommon...
January 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28286903/the-risk-of-tuberculosis-in-sle-patients-from-an-asian-tertiary-hospital
#9
Yong Yang, Julian Thumboo, Ban Hock Tan, Thuan Tong Tan, Chern Hui Jeffrey Fong, Han Seong Ng, Kok Yong Fong
Systemic lupus erythematosus (SLE) has been associated with increased risk of tuberculosis (TB). However, little is known about the extent and risk factors for TB among Asian patient with SLE. We aimed to assess the rate of TB in patients with SLE, and investigate the risk of SLE on TB development using hospital administrative database. This is an historical cohort study of hospital discharge database from 2004 to 2011 to identify cases with SLE and TB using International Statistical Classification of Diseases and Related Health Problems, 9th Revision, Australian Modification (ICD-9-AM) codes...
June 2017: Rheumatology International
https://www.readbyqxmd.com/read/28178208/effector-mechanisms-of-neutrophils-within-the-innate-immune-system-in-response-to-mycobacterium-tuberculosis-infection
#10
REVIEW
Eric Warren, Garrett Teskey, Vishwanath Venketaraman
Neutrophils have a significant yet controversial role in the innate immune response to Mycobacterium tuberculosis (M. tb) infection, which is not yet fully understood. In addition to neutrophils' well-known effector mechanisms, they may also help control infection of M. tb through the formation of neutrophil extracellular traps (NETs), which are thought to further promote the killing of M. tb by resident alveolar macrophages. Cytokines such as IFN-γ have now been shown to serve an immunomodulatory role in neutrophil functioning in conjunction to its pro-inflammatory function...
February 7, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28068928/newly-recognized-cerebral-infarctions-on-postmortem-imaging-a-report-of-three-cases-with-systemic-infectious-disease
#11
Sakon Noriki, Kazuyuki Kinoshita, Kunihiro Inai, Toyohiko Sakai, Hirohiko Kimura, Takahiro Yamauchi, Masayuki Iwano, Hironobu Naiki
BACKGROUND: Postmortem imaging (PMI) refers to the imaging of cadavers by computed tomography (CT) and/or magnetic resonance imaging (MRI). Three cases of cerebral infarctions that were not found during life but were newly recognized on PMI and were associated with severe systemic infections are presented. CASE PRESENTATIONS: An 81-year-old woman with a pacemaker and slightly impaired liver function presented with fever. Imaging suggested interstitial pneumonia and an iliopsoas abscess, and blood tests showed liver dysfunction and disseminated intravascular coagulation (DIC)...
January 10, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28036316/post-delivery-mycobacterium-tuberculosis-infection-misdiagnosed-as-systemic-lupus-erythematosus
#12
Li Yu Ting, Bikash Shrestha, Yi Lu Lu, Fu Ping
Tuberculosis is a common infectious mycobacterial disease having a wide range of clinical and serological manifestations that are similar to rheumatic disease. Differential diagnosis is a crucial aspect in any rheumatic disease as many other infectious diseases portray clinical similarities and autoantibody positivity. Our case report illustrates of a young woman just after the delivery of a child presented an unusual case of extrapulmonary tuberculosis infection initially misdiagnosed as systemic lupus erythematosus (SLE)...
December 30, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/27891378/isoniazid-induced-lupus-presenting-as-oral-mucosal-ulcers-with-pancytopenia
#13
Ria Shah, Padmaraj Ankale, Kanishk Sinha, Aparna Iyer, T K Jayalakshmi
Drug Induced Lupus Erythematous (DILE) is a rare adverse reaction to a large variety of drugs including Isoniazid (INH), with features resembling idiopathic Systemic Lupus Erythematosus (SLE). Diagnosis require identification of a temporal relationship between drug administered and symptom. It is an idiosyncratic reaction, with no pre-existing lupus. Our case highlights a rare presentation of isoniazid induced lupus with profound pancytopenia and mucosal ulcers, thus posing a diagnostic challenge. The patient was on multidrug treatment for pulmonary and knee joint tuberculosis...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27730777/ovarian-insufficiency-is-major-short-term-toxicity-in-systemic-lupus-erythematosus-patients-treated-with-cyclophosphamide
#14
Gurmeet Singh, Ramnath Misra, Amita Aggarwal
OBJECTIVE: To study the toxicities associated with pulse cyclophosphamide therapy and to compare them with patients without cyclophosphamide exposure. METHODS: In this retrospective cross-sectional observational study Systemic Lupus Erythematosus (SLE) patients who had received immunosuppressive agents in the past were interviewed in the Out Patient Department for drug related toxicities. Patients were asked about the any history of tuberculosis, herpes zoster, hemorrhagic cystitis or ovarian toxicity in the past...
February 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27708968/a-case-of-systemic-lupus-erythematosus-with-multiple-nodules-in-the-bilateral-lungs-and-vertebrae
#15
Takuma Tsuzuki Wada, Kojiro Sato, Toshihide Mimura
We encountered a case of a middle-aged woman with systemic lupus erythematosus. As the patient had progressive peripheral neuropathy including foot drop, we intended to treat her with intensive immunosuppressive therapy as soon as possible. Pretreatment assessment, however, revealed multiple nodular lesions in the lungs and bones, suggesting disseminated tumor metastasis or miliary tuberculosis. To our surprise, gallium and bone scintigraphy as well as cytodiagnosis revealed no sign of malignancy or infection, leading us to suspect the presence of another multisystem disorder...
March 2016: European Journal of Rheumatology
https://www.readbyqxmd.com/read/27437280/acute-bilateral-tuberculous-pneumonia-in-a-patient-with-systemic-lupus-erythematosus
#16
Raghavendra Rao, Rama Bhat, Nitin Bhat, Savio D'Souza, Venkata Chenchaiah
Pulmonary tuberculosis is a common infection associated with immunocompromised state. It usually presents with fibrosis or fibrocavitary lesions in the lung. We report a case of bilateral tuberculous pneumonia of acute presentation in a young lady who was being treated for systemic lupus erythematosus.
May 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27432810/genetic-selection-pressure-in-tlr9-gene-may-enforce-risk-for-sle-in-indian-tamils
#17
J H Yusuf, D Kaliyaperumal, M Jayaraman, G Ramanathan, P Devaraju
Objectives Lupus is a classical systemic autoimmune disease with genetics as one of the well known causative factors for the disease pathogenesis. Toll-like receptors are the major pattern recognition receptors associated with innate immunity and also act as an interface with the adaptive immunity. Genetic polymorphisms in genes encoding TLRs were implicated in the development of infections, malignancies and autoimmune diseases. TLR9 is a member of TLR family, and recognizes the CpG DNA motifs of pathogens...
March 2017: Lupus
https://www.readbyqxmd.com/read/27408688/case-report-kikuchi-fujimoto-disease-a-diagnostic-and-therapeutic-dilemma-following-pretransplant-nephrectomy-for-a-2-35-kg-kidney
#18
Arvind P Ganpule, Jaspreet Singh Chabra, Abhishek G Singh, Gopal R Tak, Shailesh Soni, Ravindra Sabnis, Mahesh Desai
Kikuchi-Fujimoto disease (KFD) is an extremely rare disease with a worldwide distribution and higher prevalence in Asians. It is a benign and self-limiting disorder, characterized by regional cervical lymphadenopathy accompanied with mild fever and night sweats. Lymph node histopathology is diagnostic and treating physicians should be aware of this entity as it may mimic other systemic diseases like systemic lupus erythematosus, tuberculosis, malignant lymphoma, and more rarely adenocarcinoma. Key features on lymph node biopsy are fragmentation, necrosis and karyorrhexis...
2016: F1000Research
https://www.readbyqxmd.com/read/27267647/miliary-tuberculosis-a-severe-opportunistic-infection-in-juvenile-systemic-lupus-erythematosus-patients
#19
Priscilla S Freire, João D Montoni, Aline S M Ribeiro, Heloísa H Marques, Thais Mauad, Clovis A Silva
INTRODUCTION: One of the main issues in juvenile systemic lupus erythematosus (JSLE) patients is infection, such as tuberculosis (TB). Of note, SLE patients are susceptible to pulmonary and extrapulmonary TB. However, to our knowledge, this contagious disease was rarely reported in pediatric lupus population, particularly diffuse or miliary TB. Therefore, from January 1983 to December 2011, 5,635 patients were followed-up at our Pediatric Rheumatology Unit and 285 (5%) of them met the American College of Rheumatology classification criteria for SLE...
May 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/27149470/a-rare-case-of-disseminated-tuberculosis-of-the-bone-marrow-in-systemic-lupus-erythematosus-case-report
#20
Dongying Chen, Zheng Yang, Ying Yang, Zhongping Zhan, Xiuyan Yang
Patients with systemic lupus erythematosus (SLE) are susceptible to tuberculosis (TB), especially in endemic areas such as China. The variable and nonspecific clinical features of disseminated TB often leads to an erroneous or misdiagnosis. When a patient presents with TB of the bone marrow, the clinical condition is more perplexing and the prognosis is typically poor. Till now, there is no case report after apatinib came in the market.Here, we report a case of TB of the bone marrow accompanied with SLE. The patient exhibited remarkable features, including widespread lesions in the lungs, spinal vertebrae, sacrum, and ilium that were found to be consistent with TB of the bone marrow after histopathological examination...
May 2016: Medicine (Baltimore)
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