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https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#1
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28451433/lenalidomide-induced-eosinophilic-pneumonia
#2
Andrew Toma, Aaron P Rapoport, Allen Burke, Ashutosh Sachdeva
Multiple myeloma is a plasma cell dyscrasia accounting for 10% of haematologic malignancies. Lenalidomide is an immunomodulatory drug analogous to thalidomide that is approved for use in patients with myelodysplastic syndrome, and in combination with dexamethasone for refractory or relapsed multiple myeloma. Lenalidomide is preferred to thalidomide because of reduced toxicity, and pulmonary side effects are considered rare. We present, to our knowledge, an unusual and first reported case of a patient with relapsed multiple myeloma who received lenalidomide after autologous stem cell transplant, then developed eosinophilic pneumonia presenting as dyspnoea, peripheral eosinophilia, and bilateral pulmonary opacities...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28449321/a-review-of-associated-controversies-surrounding-glucocorticoid-use-in-veterinary-emergency-and-critical-care
#3
Maya A Aharon, Jennifer E Prittie, Kate Buriko
OBJECTIVE: To review the literature in human and veterinary medicine regarding the indications for, efficacy of, and controversies surrounding glucocorticoid (GC) administration in the emergency and critical care (ECC) setting, and to provide an overview of the most commonly used synthetic GC formulations. MEDICATIONS: Synthetic GCs vary in GC and mineralocorticoid potency, hypothalamic pituitary axis suppression, duration of action, route of administration, and clinical indication for use...
May 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28443580/amyopathic-dermatomyositis-associated-with-histopathological-findings-of-organizing-pneumonia-and-pulmonary-vasculitis
#4
Jeong Uk Lim, Hye Seon Kang, Yong Hyun Kim, Tae Jung Kim
BACKGROUND: Clinically amyopathic dermatomyositis (CADM) is a distinct subgroup of dermatomyositis characterized by unique dermatologic manifestations without muscle involvement. CADM is frequently associated with interstitial lung disease (ILD), which usually has a rapidly progressive, fatal clinical course. Although CADM-related ILD (CADM-ILD) is well-described, data on the histopathology of CADM-ILD are limited. Organizing pneumonia and pulmonary vasculitis have rarely been reported...
April 13, 2017: Balkan Medical Journal
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
#5
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/28414687/disseminated-cryptococcal-disease-with-diffuse-pulmonary-infiltrates-in-a-non-hiv-host
#6
M Hughes, K Trivedi, M Rudrappa
INTRODUCTION: We present a case of disseminated Cryptococcus in a non-HIV host, where the primary manifestation was pulmonary with diffuse pulmonary infiltrates. This patient was on high dose corticosteroids for autoimmune hemolytic anemia. CASE: A 79 year old Caucasian man with a history of autoimmune hemolytic anemia on 100 mg of prednisone daily, coronary artery disease s/p bypass surgery, ischemic cardiomyopathy, chronic obstructive pulmonary disease, sleep apnea, chronic kidney disease, and history of bilateral pulmonary emboli presented to Hematology/Oncology clinic with symptoms of productive cough, worsening shortness of breath, hemoptysis...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28371243/infection-rates-in-tacrolimus-versus-cyclosporine-treated-pediatric-kidney-transplant-recipients-on-a-rapid-discontinuation-of-prednisone-protocol-1-year-analysis
#7
Sarah J Kizilbash, Michelle N Rheault, Ananta Bangdiwala, Arthur Matas, Srinath Chinnakotla, Blanche M Chavers
AR is lower in pKTx recipients on Tac vs CsA. Data comparing infection outcomes for children treated with these agents are limited. We retrospectively studied infection outcomes in 96 pKTx recipients on a RDP. PS, DCGS, AR, and infection-free survival were assessed using Kaplan-Meier/log-rank tests and proportional hazards models. There were no differences in 1-year PS, DCGS, or AR between Tac and CsA recipients. After adjusting for AR, the hazard of CMV viremia was 4.0 times higher (95%CI: 1.04, 15.5; P = ...
June 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28288233/-dress-syndrome-in-paediatrics-clinical-case
#8
Marcos Silva-Feistner, Elena Ortiz, María Jesús Rojas-Lechuga, Daniel Muñoz
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...
February 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28134084/pneumocystis-jiroveci-pneumonia-in-rheumatic-disease-a-20-year-single-centre-experience
#9
Christopher A Mecoli, Deanna Saylor, Allan C Gelber, Lisa Christopher-Stine
OBJECTIVES: Pneumocystis jiroveci pneumonia (PJP) is an opportunistic infection with high mortality among patients with underlying rheumatologic conditions. Given the paucity of prospective data to guide treatment, clinical guidelines to initiate PJP prophylaxis are based on expert opinion and identify patients on ≥20 mg daily prednisone for ≥4 weeks duration for treatment. Herein we describe the PJP experience in rheumatic disease over a 20-year period at a single academic medical centre to investigate this 20 mg threshold and risk associated with lymphocyte counts, co-existing lung disease and immunosuppressive medications...
January 27, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28105129/acute-fibrinous-and-organizing-pneumonia-a-case-report-and-literature-review
#10
Xiao-Yong Xu, Fei Chen, Chen Chen, Hui-Ming Sun, Bei-Lei Zhao
Acute fibrinous and organizing pneumonia (AFOP) is a rare lung disease with distinct histological characteristics that include the diffuse presence of intra-alveolar fibrin, and the absence of eosinophils and hyaline membrane. In the present study, a case of AFOP that was diagnosed by lung biopsy is described. The patient presented with high fever and a cough with expectoration. Computed tomography of the lung showed the presence of bilateral patchy infiltrates, predominantly in the lower lobes. Histopathological examination of lung biopsy from the lower pulmonary lobe confirmed the pathological diagnosis...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28088967/-a-phase-%C3%A2-dose-escalating-trial-of-pegylated-liposomal-doxorubicin-in-combination-with-cyclophosphamide-vincristine-and-prednisone-for-aggressive-non-hodgkin-lymphoma
#11
W N Shen, D M Ji, K Xue, Q L Zhang, F F Lyu, X N Hong, J N Cao, Y Guo
Objective: To explore the maximum tolerated dose of pegylated liposomal doxorubicin (PLD) in combination with cyclophosphamide, vincristine and prednisone as a modified CHOP regimen for aggressive non-Hodgkin lymphoma. Methods: Patients with newly diagnosed aggressive non-Hodgkin lymphoma were eligible for this trial. PLD was administered in cycle 1 and categorized into 4 dose level (30 mg/m(2), 35 mg/m(2), 40 mg/m(2), 45 mg/m(2) D1) according to a 3 + 3 approach for dose-escalation. Doxorubin was used in cycles 2-6...
December 14, 2016: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/27998874/-analysis-of-pregnancy-outcomes-in-66-patients-with-systemic-lupus-erythematosus
#12
Xiu-Zhen Song, Jia-Mian Chen, Qiu-Gen Zhou
OBJECTIVE: To analyze the outcomes of pregnancies in women with systemic lupus erythematosus (SLE) and the risk factors affecting the outcomes. METHODS: The data of SLE patients with pregnancy admitted from October, 2006 and September, 2015 were analyzed for assessing the maternal and fetal outcomes and complications. Their risk factors affecting the outcomes of the pregnancies were analyzed. RESULTS: The 66 SLE patients (69 pregnancies) had a mean age at SLE diagnosis of 22...
December 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27921149/a-case-of-urticarial-vasculitis-in-a-female-patient-with-lupus-mycoplasma-pneumoniae-infection-or-lupus-reactivation
#13
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...
May 2017: Rheumatology International
https://www.readbyqxmd.com/read/27847518/adult-onset-still-s-disease-associated-with-mycoplasma-pneumoniae-infection-and-hemophagocytic-lymphohistiocytosis
#14
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
#15
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
#16
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
#17
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
#18
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-interleukin-6-receptor-tocilizumab-for-severe-juvenile-idiopathic-arthritis-associated-uveitis-refractory-to-anti-tumor-necrosis-factor-therapy-a-multicenter-study-of-twenty-five-patients
#19
Vanesa Calvo-Río, Montserrat Santos-Gómez, Inmaculada Calvo, M 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 the treatment of juvenile idiopathic arthritis (JIA)-associated uveitis. METHODS: We conducted a multicenter study of patients with JIA-associated uveitis that was refractory to conventional immunosuppressive drugs and anti-tumor necrosis factor (anti-TNF) agents. RESULTS: We assessed 25 patients (21 female; 47 affected eyes) with a mean ± SD age of 18.5 ± 8.3 years. Uveitis was bilateral in 22 patients...
March 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/27692137/clinical-features-and-natural-history-of-interstitial-pneumonia-with-autoimmune-features-a-single-center-experience
#20
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
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