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https://www.readbyqxmd.com/read/27847518/adult-onset-still-s-disease-associated-with-mycoplasma-pneumoniae-infection-and-hemophagocytic-lymphohistiocytosis
#1
Abhishek Agnihotri, Allison Ruff, Lauren Gotterer, Addie Walker, Amy H McKenney, Andrei Brateanu
Adult Onset Still's Disease (AOSD) is a systemic inflammatory disorder that can be associated with hemophagocytic lymphohistiocytosis (HLH), a rare but potentially fatal disease of overactive histiocytes and lymphocytes. We present a unique case of AOSD complicated by Mycoplasma pneumonia infection and HLH. A 28-year-old female developed joint pains followed by a diffuse, erythematous, pruritic skin rash that quickly spread throughout the body. The patient deteriorated and developed fever, chills, cough, and dyspnea and had to be intubated...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27843429/paraneoplastic-necrotizing-autoimmune-myopathy-in-a-patient-undergoing-laparoscopic-pancreatoduodenectomy-for-distal-cholangiocarcinoma
#2
Stefan van Dijk, Anneke J van der Kooi, Eleonora Aronica, Thomas M van Gulik, Olivier R Busch, Marc G Besselink
A 73-year-old male presented with jaundice and severe muscle weakness. He was diagnosed with distal cholangiocarcinoma and paraneoplastic necrotizing autoimmune myopathy (NAM). Treatment of NAM consisted of dexamethasone pulse therapy, prednisone, and single-dose intravenous immunoglobulin. The distal cholangiocarcinoma was resected through a total laparoscopic pancreatoduodenectomy. After hospital discharge, muscle strength initially increased postoperatively; however, pneumonia resulted in the deterioration of his general condition and death 5 months after the diagnosis of paraneoplastic NAM...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27835759/zika-virus-epidemic-in-brazil-i-fatal-disease-in-adults-clinical-and-laboratorial-aspects
#3
Raimunda S S Azevedo, Marialva T Araujo, Arnaldo J Martins Filho, Consuelo S Oliveira, Bruno T D Nunes, Ana C R Cruz, Ana G P A C Nascimento, Rita C Medeiros, Cezar A M Caldas, Fernando C Araujo, Juarez A S Quaresma, Barbara C B Vasconcelos, Maria G L Queiroz, Elizabeth S Travassos da Rosa, Daniele F Henriques, Eliana V P Silva, Jannifer O Chiang, Lívia C Martins, Daniele B A Medeiros, Juliana A Lima, Márcio R T Nunes, Jedson F Cardoso, Sandro P Silva, Pei-Yong Shi, Robert B Tesh, Sueli G Rodrigues, Pedro F C Vasconcelos
BACKGROUND: Zika virus (ZIKV) was first detected in Brazil in May 2015 and the country experienced an explosive epidemic. However, recent studies indicate that the introduction of ZIKV occurred in late 2013. Cases of microcephaly and deaths associated with ZIKV infection were identified in Brazil in November, 2015. OBJECTIVES: To determine the etiology of three fatal adult cases. STUDY DESIGN: Here we report three fatal adult cases of ZIKV disease...
December 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/27773995/amiodarone-induced-pulmonary-toxicity-a-frequently-missed-complication
#4
Alexander J Sweidan, Navneet K Singh, Natasha Dang, Vinh Lam, Jyoti Datta
INTRODUCTION: Amiodarone is often used in the suppression of tachyarrhythmias. One of the more serious adverse effects includes amiodarone pulmonary toxicity (APT). Several pulmonary diseases can manifest including interstitial pneumonitis, organizing pneumonia, acute respiratory distress syndrome, diffuse alveolar hemorrhage, pulmonary nodules or masses, and pleural effusion. Incidence of APT varies from 5-15% and is correlated to dosage, age of the patient, and preexisting lung disease...
2016: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/27722084/shortness-of-breath-patient-history-not-always-indicative-of-the-cause
#5
Tony S Brar, Neeka Akhavan
This is a 78 year old male with a past medical history of coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), hypertension (HTN), and gastroesophageal reflux disorder (GERD) who presented to the emergency room with worsening shortness of breath (SOB) and low-grade fevers for one week prior to admission. He was originally diagnosed with healthcare associated pneumonia (HCAP) and an acute on chronic COPD exacerbation and treated with prednisone, inhalers, ipratropium/albuterol, and broad-spectrum antibiotics...
2016: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27696756/anti-il6-r-tocilizumab-for-severe-juvenile-idiopathic-arthritis-associated-uveitis-refractory-to-anti-tnf-therapy-a-multicenter-study-of-25-patients
#6
Vanesa Calvo-Río, Montserrat Santos-Gómez, Inmaculada Calvo, Ma Isabel González-Fernández, Berta López Montesinos, Marina Mesquida, Alfredo Adán, María Victoria Hernández, Olga Maíz, Antonio Atanes, Beatriz Bravo, Consuelo Modesto, Gisela Díaz-Cordovés, Natalia Palmou-Fontana, Javier Loricera, M C González-Vela, Rosalía Demetrio-Pablo, J L Hernández, Miguel A González-Gay, Ricardo Blanco
OBJECTIVE: To assess the efficacy of Tocilizumab (TCZ) for Juvenile Idiopathic Arthritis (JIA)-associated uveitis. METHODS: Multicenter study of patients with JIA-associated uveitis refractory to conventional immunosuppressive drugs and anti-TNFα agents. RESULTS: We assessed 25 (21 women) patients (47 affected eyes); mean age 18.5±8.3 years. Uveitis was bilateral in 22. Cystoid macular edema (CME) was present in 9 patients. Ocular sequelae found at TCZ onset included: cataracts (13), glaucoma (7), synechiae (10), band keratopathy (12), maculopathy (9), and amblyopia (5)...
October 1, 2016: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/27692137/clinical-features-and-natural-history-of-interstitial-pneumonia-with-autoimmune-features-a-single-center-experience
#7
Sandra Chartrand, Jeffrey J Swigris, Lina Stanchev, Joyce S Lee, Kevin K Brown, Aryeh Fischer
OBJECTIVE: To describe the clinical phenotype and natural history of a cohort of patients with interstitial pneumonia with autoimmune features (IPAF). METHODS: A retrospective, single center study of 56 patients with IPAF evaluated between February 2008 and August 2014. All clinical data were extracted from the electronic medical record and longitudinal changes in forced vital capacity (FVC) were analyzed with mixed-effects, piecewise linear regression models that considered time as a continuous factor...
October 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27683823/invasive-pulmonary-fungal-infections-in-patients-with-connective-tissue-disease-a-retrospective-study-from-northern-china
#8
H F Ge, X Q Liu, Y Q Zhu, H Q Chen, G Z Chen
Invasive pulmonary fungal infection (IPFI) is a potentially fatal complication in patients with connective tissue disease (CTD). The current study aimed to uncover the clinical characteristics and risk factors of patients with IPFI-CTD. The files of 2186 CTD patients admitted to a single center in northern China between January 2011 and December 2013 were retrospectively reviewed. A total of 47 CTD patients with IPFI were enrolled into this study and assigned to the CTD-IPFI group, while 47 uninfected CTD patients were assigned to the control group...
September 22, 2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/27677766/steroid-induced-hyperglycaemia-in-hospitalised-patients-does-it-matter
#9
N Wah Cheung
Steroid-induced hyperglycaemia is a common problem faced by endocrinologists in hospital wards. In this issue of Diabetologia, Popovic and colleagues (DOI 10.1007/s00125-016-4091-4 ) have conducted a subanalysis within a randomised controlled trial of prednisone therapy for community-acquired pneumonia. The authors found that the presence of diabetes or hyperglycaemia related to steroid therapy did not attenuate the clinical benefits of steroid therapy. The relevance and possible implications of these findings are discussed...
September 27, 2016: Diabetologia
https://www.readbyqxmd.com/read/27614658/benefit-of-adjunct-corticosteroids-for-community-acquired-pneumonia-in-diabetic-patients
#10
Milica Popovic, Claudine A Blum, Nicole Nigro, Beat Mueller, Philipp Schuetz, Mirjam Christ-Crain
AIMS/HYPOTHESIS: We have recently shown that adjunct prednisone shortens the time taken to reach clinical stability (time to clinical stability, TTCS) in patients with community-acquired pneumonia (CAP). Considering the hyperglycaemic effects of prednisone, there are concerns about the efficacy and safety of this therapy for diabetic patients with CAP. Our objective was to evaluate whether diabetes and/or hyperglycaemia on admission to hospital has an influence on the effect of corticosteroids on outcome in a well-defined cohort of patients with CAP...
September 10, 2016: Diabetologia
https://www.readbyqxmd.com/read/27602099/tacrolimus-combined-with-low-dose-corticosteroids-is-an-effective-and-safe-therapeutic-option-for-refractory-iga-nephropathy
#11
Qi-Jun Wan, Hao-Fei Hu, Yong-Cheng He, Shao-Dong Luan, Hong-Tao Chen, Tong Li, Yi Xu, Hui-Li Xu, Ying Liao
Tacrolimus (TAC) has been shown to improve remission from proteinuria in patients with refractory IgA nephropathy (IgAN); however, the efficacy and safety of TAC in such patients have not been fully explored. Therefore, the present study was conducted to evaluate the tolerance to and efficacy of TAC combined with low-dose corticosteroids in patients with refractory IgAN. This was a single-center retrospective study. A total of 28 patients with refractory IgAN were randomly included and received TAC plus corticosteroid; 26 patients received TAC and prednisone, and 2 patients received TAC and methylprednisolone...
September 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27564782/differential-risks-for-adverse-outcomes-3-years-after-kidney-transplantation-based-on-initial-immunosuppression-regimen-a-national-study
#12
Vikas R Dharnidharka, Mark A Schnitzler, Jiajing Chen, Daniel C Brennan, David Axelrod, Dorry L Segev, Kenneth B Schechtman, Jie Zheng, Krista L Lentine
We examined integrated national transplant registry, pharmacy fill, and medical claims data for Medicare-insured kidney transplant recipients in 2000-2011 (n = 45 164) from the United States Renal Data System to assess the efficacy and safety endpoints associated with seven early (first 90 days) immunosuppression (ISx) regimens. Risks of clinical complications over 3 years according to IS regimens were assessed with multivariate regression analysis, including the adjustment for covariates and propensity for receipt of a nonreference ISx regimen...
November 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27472910/low-incidence-of-pneumocystis-pneumonia-utilizing-pcr-based-diagnosis-in-patients-with-b-cell-lymphoma-receiving-rituximab-containing-combination-chemotherapy
#13
Jason N Barreto, Lauren L Ice, Carrie A Thompson, Pritish K Tosh, Douglas R Osmon, Ross A Dierkhising, Matthew F Plevak, Andrew H Limper
Recent literature has demonstrated concern over the risk of Pneumocystis jirovecii pneumonia (PJP) when administering rituximab with combination chemotherapy such as in R-CHOP; however, the exact risk and potential need for prophylaxis is unknown. We sought to determine the incidence of PJP infection following R-CHOP administration in patients with B-cell lymphoma. Consecutive patients diagnosed with B-cell lymphoma receiving R-CHOP were evaluated from chemotherapy initiation until 180 days after the last administration...
July 29, 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27471201/pathogen-and-antibiotic-specific-effects-of-prednisone-in-community-acquired-pneumonia
#14
Sebastian A Wirz, Claudine A Blum, Philipp Schuetz, Werner C Albrich, Christoph Noppen, Beat Mueller, Mirjam Christ-Crain, Philip E Tarr
In a double-blind, randomised, placebo-controlled trial of hospitalised patients with community-acquired pneumonia (CAP), we demonstrated shorter time to clinical stability (TTCS) with adjunct corticosteroid therapy compared with placebo.We did a pre-planned, exploratory analysis of any association between microbiological diagnosis, antibiotic treatment and procalcitonin level and effect of prednisone on TTCS, mortality, and CAP complications (n=726 participants, enrolled between December 2009 and May 2014)...
October 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27448151/risk-of-serious-infection-in-patients-with-rheumatoid-arthritis-associated-interstitial-lung-disease
#15
Jorge A Zamora-Legoff, Megan L Krause, Cynthia S Crowson, Jay H Ryu, Eric L Matteson
The objective of this study is to assess the occurrence of and risk factors for serious infections in rheumatoid arthritis (RA)-associated interstitial lung disease (ILD). All patients with RA-ILD (ACR 1987 criteria for RA) seen at a single center from 1998 to 2014 were identified and manually screened for study inclusion. Follow-up data were abstracted until death or December 31, 2015. Serious infection was defined as requiring antimicrobial therapy and hospitalization. Risk of infection was analyzed by person-year (py) methods using time-dependent covariates started when the medication was first used and stopped 30 days after the medication was discontinued...
October 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27378664/-dress-syndrome-in-paediatrics-clinical-case
#16
Marcos Silva-Feistner, Elena Ortiz, María Jesús Rojas-Lechuga, Daniel Muñoz
INTRODUCTION: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, potentially life-threatening, drug-induced hypersensitivity reaction that includes skin eruption, haematological abnormalities, lymphadenopathy, and internal organ involvement. OBJECTIVE: Presenting a rare condition in children, to facilitate a rapid diagnostic suspicion and recognition by doctors CASE REPORT: An 9 months old infant admitted due to a severe viral pneumonia, managed with non-invasive ventilation and ceftriaxone...
July 1, 2016: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/27266681/-effectiveness-and-safety-of-conversion-therapy-with-the-combination-of-sirolimus-with-low-dose-cyclosporine-in-renal-transplantation-recipients-a-five-year-clinical-observation
#17
L Zhu, T Ding, X X Wang, Z B Lin, G Chen
OBJECTIVE: To assess the effectiveness and safety of the conversion therapy from traditional cyclosporine (CsA) triple immunosuppression therapy to sirolimus (SRL) combined with low dose CsA and prednisone (Pred) in renal transplantation recipients in a five-year follow-up period. METHODS: A prospective, open-label non-randomized study was performed with 46 renal allograft recipients who visited Tongji Hospital regularly for follow-up visits between January 2007 and May 2011 and were taking CsA+ mycophenolate mofetil (MMF)+ Pred...
May 31, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27264915/medication-palatability-affects-physician-prescribing-preferences-for-common-pediatric-conditions
#18
Hans Bradshaw, Michael J Mitchell, Christopher J Edwards, Uwe Stolz, Oday Naser, Amanda Peck, Asad E Patanwala
OBJECTIVES: The objective of this study was to determine if physicians would alter their prescribing preferences after sampling liquid formulations of medications for common pediatric diagnoses. METHODS: This was a prospective interventional before/after study conducted at an academic medical center in the United States. The participants of interest included emergency, family medicine, and pediatric physicians. Participants initially completed a brief survey for their primary oral liquid medication of choice for the treatment of selected disease states...
November 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27190360/the-effect-of-rituximab-dose-on-infectious-complications-in-abo-incompatible-kidney-transplantation
#19
Juhan Lee, Jae Geun Lee, Sinyoung Kim, Seung Hwan Song, Beom Seok Kim, Hyun Ok Kim, Myoung Soo Kim, Soon Il Kim, Yu Seun Kim, Kyu Ha Huh
BACKGROUND: Rituximab (RIT) improves the outcomes of ABO-incompatible (ABOi) kidney transplantation (KT), but it has been associated with infectious complications. The aim of this study was to investigate infectious complications according to the dose of RIT in ABOi KT. METHODS: We analyzed 213 recipients [118 ABO-compatible (ABOc) KT and 95 ABOi KT] who underwent living donor KT between 2010 and 2014. ABOi KT patients were categorized by RIT dose: standard RIT (375 mg/m(2), n = 76) versus reduced RIT (200 mg, n = 19)...
June 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27178351/single-agent-mor208-salvage-and-maintenance-therapy-in-a-patient-with-refractory-relapsing-diffuse-large-b-cell-lymphoma-a-case-report
#20
Wojciech Jurczak, Agata Hanna Bryk, Patrycja Mensah, Krystyna Gałązka, Małgorzata Trofimiuk-Müldner, Łukasz Wyrobek, Anna Sawiec, Aleksander B Skotnicki
BACKGROUND: Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin's lymphoma. Standard first-line treatment for this aggressive subtype comprises the anti-CD20 antibody rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone. If patients receiving such treatment have an early relapse, or their disease is initially refractory to such treatment, standard salvage regimens may not be effective. There is therefore a high unmet clinical need for new targeted agents that might improve the outcome for such patients...
2016: Journal of Medical Case Reports
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