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https://www.readbyqxmd.com/read/28971575/disseminated-tuberculosis-masquerading-as-a-presentation-of-systemic-lupus-erythematosus
#1
Justin C-H Li, Warren Fong, Limin Wijaya, Ying Y Leung
Tuberculosis (TB) infection is the endemic in Asia-Pacific region. Miliary TB is a disseminated form which may present similarly as autoimmune conditions. Here we describe a 17-year-old girl who had miliary TB with manifestations mimicking new-onset systemic lupus erythematosus (SLE) including oral ulcers, serositis, cytopenia, proteinuria and raised autoantibody titers. Complex associations between SLE and TB are highlighted. High index of clinical suspicion for TB infection is needed upon presentations resembling immune diseases like SLE...
October 2, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28937580/diagnosis-of-systemic-inflammatory-diseases-among-patients-admitted-for-acute-pericarditis-with-pericardial-effusion
#2
Maureen Assayag, Rachid Abbas, Noémie Chanson, Anne Perozziello, Gregory Ducrocq, Jean-François Alexandra, Antoine Dossier, Thomas Papo, Karim Sacre
AIMS: Acute pericarditis may be the heralding manifestation of various systemic inflammatory diseases (SIDs). The aim of this study was to identify clinical indicators for SIDs in patients admitted for acute pericarditis with pericardial effusion. METHODS: All consecutive adult patients hospitalized in a Department of Internal Medicine over a 10-year period for acute pericarditis with pericardial effusion were retrospectively reviewed. Patients with cancer and tuberculosis were excluded...
September 20, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28920417/effects-of-deoxynivalenol-and-zearalenone-contaminated-feed-on-the-gene-expression-profiles-in-the-kidneys-of-piglets
#3
Kondreddy Eswar Reddy, Woong Lee, Jin Young Jeong, Yookyung Lee, Hyun-Jeong Lee, Min Seok Kim, Dong-Woon Kim, Dongjo Yu, Ara Cho, Young Kyoon Oh, Sung Dae Lee
Objective: Fusarium mycotoxins deoxynivalenol (DON) and zearalenone (ZEN), common contaminants in the feed of farm animals, cause immune function impairment and organ inflammation. Consequently, the main objective of this study was to elucidate DON and ZEN effects on the mRNA expression of pro-inflammatory cytokines and other immune related genes in the kidneys of piglets. Methods: Fifteen 6-week-old piglets were randomly assigned to three dietary treatments for 4 weeks: control diet, and diets contaminated with either 8 mg DON/kg feed or 0...
September 18, 2017: Asian-Australasian Journal of Animal Sciences
https://www.readbyqxmd.com/read/28841837/decreased-ex-vivo-production-of-interferon-gamma-is-associated-with-severity-and-poor-prognosis-in-patients-with-lupus
#4
Sung Soo Ahn, Eun Seong Park, Joo Sung Shim, Sang-Jun Ha, Beom Seok Kim, Seung Min Jung, Sang-Won Lee, Yong-Beom Park, Jason Jungsik Song
BACKGROUND: Lupus pathogenesis is closely associated with interferon gamma (IFN-γ), which plays a central role in innate and adaptive immunity. The aim of this study was to evaluate the ex vivo production of IFN-γ after stimulation of peripheral blood mononuclear cells with phytohemagglutinin (PHA) in patients with lupus, according to disease activity. METHODS: This study included 118 patients with lupus who had undergone IFN-γ-releasing assays (IGRAs) to screen for tuberculosis...
August 25, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28764615/cerebral-tuberculosis-in-a-patient-with-systemic-lupus-erythematosus-following-cyclophosphamide-treatment-a-case-report
#5
S Cooray, H Zhang, R Breen, G Carr-White, R Howard, M Cuadrado, D D'Cruz, G Sanna
Central nervous system (CNS) tuberculosis (TB) is a rare but catastrophic event in patients with systemic lupus erythematosus (SLE). Here we report a case of cerebral TB in a patient with lupus myocarditis and nephritis, following cyclophosphamide immunosuppression. To our knowledge this is the first reported case of cerebral TB in SLE in a non-endemic country. A 31-year-old female with SLE and a history of regular travel to Kenya presented to our centre with clinical features of acute heart failure. She was diagnosed with severe lupus myocarditis, and a renal biopsy also confirmed lupus nephritis...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28754137/tuberculous-monoarthritis-of-the-wrist-in-a-patient-with-systemic-lupus-erythematosus-a-case-report
#6
W A N V Luke, M P M L Gunathilake, Duminda Munidasa, Dilshan Munidasa, S T De Silva
BACKGROUND: Unusual forms of tuberculosis are common among immune-suppressed patients, leading to challenges in diagnosis and management. We present a Sri Lankan patient with systemic lupus erythematosis, investigated for chronic wrist pain with low inflammatory markers and without systemic symptoms, who was subsequently diagnosed to have tuberculosis of the joint. CASE PRESENTATION: A 31-year-old woman with systemic lupus erythematosis in remission was evaluated for chronic left wrist pain without significant examination findings on presentation...
July 28, 2017: BMC Research Notes
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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