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Pediatric vasculitis

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https://www.readbyqxmd.com/read/28325522/giant-aneurysms-a-gender-specific-complication-of-kawasaki-disease
#1
Sanne M Dietz, Irene M Kuipers, Carline E A Tacke, Jeffrey C D Koole, Barbara A Hutten, Taco W Kuijpers
BACKGROUND: Kawasaki disease (KD) is a pediatric vasculitis of unknown origin. Its main complication is the development of coronary artery aneurysms (CAA) with giant CAA at the end of the spectrum. METHODS: In this cohort study, we evaluated the association between patient characteristics and the development of giant CAA based on z-scores. Multivariable, multinomial logistic regression analysis was used to identify variables associated with giant CAA. RESULTS: A total of 301 KD patients, comprising 216 patients without enlargement, 45 with small-sized, 19 with medium-sized, and 21 with giant CAA with all echocardiographies at our center were retrospectively included...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28318198/-subglottic-stenosis-as-the-initial-manifestation-of-wegener-s-granulomatosis-in-a-teenager-case-report
#2
Giselle Cuestas, Verónica Rodríguez, Flavia Doormann, Alejandra Pringe, Patricio Bellia Munzón, Gastón Bellia Munzón, Carlos Ortega, Rubén Álvarez
Wegener's granulomatosis is a necrotizing granulomatous vasculitis of autoimmune origin that primarily affects the upper and lower airways and kidneys. It is very rare in children and adolescents. When started at a young age it is often associated with subglottic stenosis. Subglottic stenosis is a potentially fatal manifestation of Wegener's granulomatosis. Its diagnosis requires a high index of suspicion since it might develop in the absence of other signs of activity. Occasionally, subglottic stenosis may present as the initial manifestation of the disease...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28316855/central-nervous-system-involvement-in-henoch-schonlein-purpura-in-children-and-adolescents
#3
Iliyana H Pacheva, Ivan S Ivanov, Krastina Stefanova, Elena Chepisheva, Lyubov Chochkova, Dafina Grozeva, Angelina Stoyanova, Stojan Milenkov, Penka Stefanova, Anna Petrova
Central nervous system (CNS) involvement in Henoch-Schonlein purpura (HSP) is rare but poses diagnostic difficulties. The aim of the study was to establish the frequency of CNS involvement in HSP, to analyze its clinical characteristics and do a literature review. Medical files of patients with HSP admitted at the Department of Pediatrics, Plovdiv, were studied retrospectively for a five-year period (2009-2013). Diagnosis was based on the American College of Rheumatology criteria. Out of 112 children with HSP 1 case (0...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28285838/incidental-findings-on-pediatric-abdominal-magnetic-resonance-angiography
#4
Nattinee Leelakanok, Matthew A Zapala, Emily A Edwards, Andrew S Phelps, John D Mackenzie, Jesse Courtier
RATIONALE AND OBJECTIVES: Abdominal magnetic resonance angiography (MRA) has gained favor in pediatric patients owing to its lack of ionizing radiation and noninvasive nature. Reports exist regarding incidental findings on body MRA in adult patients. However, the incidental findings in pediatric abdominal MRA have not been previously reported. Our study aims to determine the frequencies, characteristics, and categories of incidental findings in pediatric patients undergoing abdominal MRA...
March 9, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28261032/eosinophilic-colitis-in-children
#5
Urszula Grzybowska-Chlebowczyk, Sabina Horowska-Ziaja, Maciej Kajor, Sabina Więcek, Wojciech Chlebowczyk, Halina Woś
INTRODUCTION: Eosinophilic colitis, which is a rare form of eosinophilic gastrointestinal diseases, occurs as primary and secondary allergic eosinophilic colitis of the gastrointestinal tract infection, inflammatory bowel disease, celiac disease, and vasculitis. The diagnosis is based on a significant amount of eosinophils in the inflammatory infiltrate of the colon wall. AIM: To analyze the clinical picture taking into account comorbidities and endoscopic picture in children with eosinophilic colitis...
February 2017: Postȩpy Dermatologii i Alergologii
https://www.readbyqxmd.com/read/28251502/avoiding-rash-conclusions-challenge-of-iga-vasculitis-in-adults
#6
S Hu, A Birg, M Hovaida, M W Gavin, D McCarthy
IgA vasculitis is primarily a pediatric disease that is rarely encountered in adults. With adults, gastrointestinal manifestations are quite common, yet are nonspecific and may overlap with other diseases, particularly Crohn's disease, which can make the diagnosis a challenging task. Treatment is controversial given the disease course is usually self-limited with few serious complications. We present a case of IgA vasculitis in an adult patient with limited extraintestinal findings illustrating the complexity of arriving at the correct diagnosis...
March 1, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28238636/-kawasaki-disease-is-more-prevalent-in-rural-areas-of-catalonia-spain
#7
Judith Sánchez-Manubens, Jordi Antón, Rosa Bou, Estibaliz Iglesias, Joan Calzada-Hernandez, Xavier Rodó, Josep-Antón Morguí
INTRODUCTION: Kawasaki disease (KD) is an acute self-limited systemic vasculitis relatively common in childhood. The etiology of KD is still unknown, although clinical, laboratory and epidemiological features suggest an infectious origin or trigger. Differences on incidence between countries have been related to specific genetic factors, ethnicity, country of birth and some other sociocultural and environmental factors. We present a population-based study on incidence of KD in Catalonia (Spain), focusing on differences between patients in rural and non-rural areas of the region...
February 23, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28238458/increased-levels-of-anti-phosphatidylcholine-and-anti-phosphatidylethanolamine-antibodies-in-pediatric-patients-with-cerebral-infarction
#8
Seigo Korematsu, Hiroshi Yamada, Hiroaki Miyahara, Kenji Ihara
Cerebral infarction in children is rare and often occurs secondary to moyamoya disease, hereditary coagulopathies, vasculitis, antiphospholipid antibody syndrome, heart disease, mitochondrial disease. However, in some cases, the causes of cerebral infarction is unknown. In this study, we detected increased levels of serum anti-phosphatidylcholine and anti-phosphatidylethanolamine IgG antibodies in three pediatric patients with cerebral infarction whose primary disorders are unknown by routine examination. For the five disease control patients of cerebral infarction due to other primary disorders, there was no such increase in these antibodies levels...
February 23, 2017: Brain & Development
https://www.readbyqxmd.com/read/28237004/nuclear-medicine-in-pediatric-cardiology
#9
REVIEW
Ornella Milanesi, Giovanni Stellin, Pietro Zucchetta
Accurate cardiovascular imaging is essential for the successful management of patients with congenital heart disease (CHD). Echocardiography and angiography have been for long time the most important imaging modalities in pediatric cardiology, but nuclear medicine has contributed in many situations to the comprehension of physiological consequences of CHD, quantifying pulmonary blood flow symmetry or right-to-left shunting. In recent times, remarkable improvements in imaging equipments, particularly in multidetector computed tomography and magnetic resonance imaging, have led to the progressive integration of high resolution modalities in the clinical workup of children affected by CHD, reducing the role of diagnostic angiography...
March 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/28236162/regression-and-complications-of-z-score-based-giant-aneurysms-in-a-dutch-cohort-of-kawasaki-disease-patients
#10
S M Dietz, I M Kuipers, J C D Koole, J M P J Breur, Z Fejzic, S Frerich, M Dalinghaus, A A W Roest, B A Hutten, T W Kuijpers
Kawasaki disease (KD) is a pediatric vasculitis. Its main complication is the development of coronary artery aneurysms (CAA), with giant CAA at the end of the spectrum. We evaluated regression and event-free rates in a non-Asian cohort of patients with giant CAA using the current z-scores adjusted for body surface area instead of absolute diameters. KD patients with giant CAA (z-score ≥10) visiting our outpatient clinic between January 1999 and September 2015 were included. Patient characteristics and clinical details were extracted from medical records...
February 24, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28233293/pediatric-pyoderma-gangrenosum-a-systematic-review-and-update
#11
REVIEW
Elio Kechichian, Roger Haber, Nadim Mourad, Rana El Khoury, Samer Jabbour, Roland Tomb
Pyoderma gangrenosum (PG) is a sterile neutrophilic disorder that rarely affects children. Clinical, epidemiological, and therapeutic data on pediatric PG is poor as there are many newly reported associated diseases and drugs. This paper aims to review all recent available data on pediatric PG. A systematic review of the literature was conducted using Embase, Medline, and Cochrane databases. A total of 132 articles were included in the review. The most commonly reported underlying diseases in pediatric PG are inflammatory bowel diseases followed by hematologic disorders, vasculitis, immune deficiencies and Pyogenic Arthritis, Pyoderma gangrenosum and Acne (PAPA) syndrome...
February 23, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28204946/clinical-outcomes-in-children-with-henoch-sch%C3%A3-nlein-purpura-nephritis-without-crescents
#12
Jean Daniel Delbet, Julien Hogan, Bilal Aoun, Iulia Stoica, Rémi Salomon, Stéphane Decramer, Isabelle Brocheriou, Georges Deschênes, Tim Ulinski
BACKGROUND: Henoch-Schönlein purpura is the most common vasculitis in children. Its long-term prognosis depends on renal involvement. The management of Henoch-Schönlein purpura nephritis (HSPN) remains controversial. This study reports the prognosis of children with HSPN presenting with class 2 International Study of Kidney Disease in Children (ISKDC) nephritis. METHODS: All children with HSPN class 2 diagnosed between 1995 and 2015 in four pediatric nephrology centers were included, and clinical and biological data were collected from the medical files...
February 15, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28133935/post-transplant-immune-complex-nephritis-in-a-patient-with-systemic-lupus-erythematosus-associated-with-anca-vasculitis
#13
Carlos Sanchez, Alejandra Rebolledo, Junior Gahona, Mauricio Rojas, Raquel Jiménez, Aurora Bojórquez
Nearly 20% of SLE corresponds to the pediatric population, and 75% of them have kidney involvement representing an important etiology of chronic kidney disease. A correlation between SLE and ANCA-associated vasculitis has been identified as an overlapping syndrome. Kidney allograft recurrence is rare in SLE when disease control is achieved and with nowadays immunosuppression treatment. Histologic transformation is unusual, especially when there are negative serologic markers and no immune complex deposition reported in native kidneys...
January 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28123335/posterior-reversible-encephalopathy-syndrome-in-children-a-case-series
#14
Serhat Emeksiz, Nurettin Onur Kutlu, Hüseyin Çaksen, Gülsüm Alkan, Hülya Şeker Yıkmaz, Hüseyin Tokgöz
Posterior reversible encephalopathy syndrome is characterized by hypertension, seizure, headache, clouding of consciousness, and visual disturbance, and is diagnosed in the presence of typical lesions on magnetic resonance imaging. We retrospectively evaluated five patients who were diagnosed as having posterior reversible encephalopathy syndrome and followed up in Meram Medical Faculty, Pediatric Intensive Care and Hematology wards, between January 2010 and January 2014. We reviewed the demographic and clinical data, and neuroimaging findings...
December 2016: Türk Pediatri Arşivi
https://www.readbyqxmd.com/read/28118527/from-childhood-to-adulthood-the-trajectory-of-damage-in-patients-with-childhood-onset-systemic-lupus-erythematosus
#15
Lily Sh Lim, Eleanor Pullenayegum, Lillian Lim, Dafna Gladman, Brian Feldman, Earl Silverman
Objectives 1) To determine the longitudinal damage trajectory of patients with childhood-onset SLE (cSLE). 2) To identify baseline and disease course predictors of damage trajectory. Methods This is a retrospective inception cohort. Longitudinal pediatric-age data was obtained from a cSLE research database while adult-age data was obtained from either a research database or patients' charts. Baseline factors were tested as predictors. Time-varying factors were lagged 6 to 24 months before a visit for testing their predictive effects...
January 24, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28102623/ischemic-stroke-in-kawasaki-disease
#16
Wasana Prangwatanagul, Alisa Limsuwan
Pediatric stroke is considered to be rare. Stroke resulting from cerebral vasculitis is also uncommon in young children. With the increasing prevalence of Kawasaki disease (KD) diagnosis, this acquired vasculitis has been reported with various clinical presentations including neurological symptoms. Herein we describe the case of a KD patient presenting with stroke. A 15-month-old boy was referred due to stroke that occurred on the fifth day of febrile illness. He was initially admitted to another hospital due to fever and diarrhea...
January 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27997528/losartan-attenuates-the-coronary-perivasculitis-through-its-local-and-systemic-anti-inflammatory-properties-in-a-murine-model-of-kawasaki-disease
#17
Eisuke Suganuma, Fumio Niimura, Shin-Ichi Matsuda, Toshiko Ukawa, Hideaki Nakamura, Kaori Sekine, Masahiko Kato, Yuji Aiba, Yasuhiro Koga, Kuniyoshi Hayashi, Osamu Takahashi, Hiroyuki Mochizuki
BACKGROUND: Kawasaki disease (KD) is a common systemic vasculitis that leads to coronary artery lesions (CALs). Besides its antihypertensive effects, losartan can modulate inflammation in cardiovascular disease. We examined whether losartan can attenuate coronary inflammation in a murine model of KD. METHODS AND RESULTS: Five-week-old C57/BL6J male mice were intraperitoneally injected with Lactobacillus casei cell wall extract (LCWE) to induce coronary inflammation and divided into 4 groups: placebo, IVIG, losartan, and IVIG+losartan...
December 20, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27988434/anti-ro-ssa-and-anti-la-ssb-antibodies-association-with-mild-lupus-manifestations-in-645-childhood-onset-systemic-lupus-erythematosus
#18
REVIEW
Glaucia V Novak, Mariana Marques, Verena Balbi, Natali W S Gormezano, Kátia Kozu, Ana P Sakamoto, Rosa M R Pereira, Maria T Terreri, Claudia S Magalhães, Andressa Guariento, Adriana M E Sallum, Roberto Marini, Virginia Paes Leme Ferriani, Cássia Maria Barbosa, Tânia Caroline Monteiro de Castro, Valéria C Ramos, Eloisa Bonfá, Clovis A Silva
BACKGROUND: To our knowledge there are no studies assessing anti-Ro/SSA and anti-La/SSB autoantibodies in a large population of childhood-systemic lupus erythematosus (cSLE) patients. METHODS: This was a retrospective multicenter cohort study performed in 10 Pediatric Rheumatology services, São Paulo state, Brazil. Anti-Ro/SSA and anti-La/SSB antibodies were measured by enzyme linked immunosorbent assay (ELISA) in 645 cSLE patients. RESULTS: Anti-Ro/SSA and anti-La/SSB antibodies were evidenced in 209/645 (32%) and 102/645 (16%) of cSLE patients, respectively...
February 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/27921149/a-case-of-urticarial-vasculitis-in-a-female-patient-with-lupus-mycoplasma-pneumoniae-infection-or-lupus-reactivation
#19
Mario Diplomatico, Maria Francesca Gicchino, Orsola Ametrano, Pierluigi Marzuillo, Alma Nunzia Olivieri
A 17-year-old female patient affected by systemic lupus erythematosus (SLE) (who had been taking 300 mg/die of hydroxychloroquine for 3 years), Graves' disease (treated with 10 mg/die of tapazole), and celiac disease came to our attention for urticarial vasculitis. She had been taking prednisone (25 mg/die) for 3 days, and her blood tests showed high levels of Mycoplasma pneumoniae IgM and IgG antibodies. The association between urticaria and M. pneumoniae infections can be present in up to 7% of the cases and, to the best of our knowledge, only two reports of urticarial vasculitis and M...
December 5, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27895519/portal-hypertension-an-uncommon-clinical-manifestation-of-takayasu-arteritis-in-a-9-year-old-child
#20
Cristina N Herrera, Javier E Tomala-Haz
Takayasu arteritis (TA) is the third most common childhood vasculitis and its clinical manifestations depend on the arteries involved. We report a case of a 9-year-old boy with multiple aneurysms in carotid and iliac arteries, subclavian and coronary arteries, and abdominal aorta. At the age of 7 years, he presented with recurrent fever and hepatosplenomegaly. An angio-computed tomography scan showed aneurysms in the left subclavian artery, abdominal aorta, and both proximal iliac arteries. He was diagnosed with TA and was treated with corticosteroids, aspirin, and enalapril...
2016: Open Access Rheumatology: Research and Reviews
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