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Kenzo J Koike, Jeffrey P Blice, Jan A Kylstra, Jonathan S Ralston, Sally E Self, Natasha M Ruth, Lucian V Del Priore
PURPOSE: To describe an unusual case of frosted branch angiitis that developed in a patient with acute onset systemic vasculitis possibly triggered by the antithyroid medication methimazole. METHODS: We conducted a thorough review of the medical records of a 16-year-old female patient who presented with frosted branch angiitis. During the initial hospital admission, the patient underwent an extensive systemic workup to determine the etiology of her disease and ophthalmologic testing including fundus photographs and fluorescein angiography...
October 5, 2016: Retinal Cases & Brief Reports
Eline Houben, Willem A Bax, Bastiaan van Dam, Walentina A T Slieker, Gideon Verhave, Fenneke C P Frerichs, Izhar C van Eijk, Wim G Boersma, Guido T M de Kuyper, Erik L Penne
Currently no validated diagnostic system for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is available. Therefore, diagnosing AAV is often challenging. We aimed to identify factors that lead to a clinical diagnosis AAV in ANCA positive patients in a teaching hospital in The Netherlands.In this study, all patients that tested positive for ANCA proteinase 3 (PR3) and/or myeloperoxidase (MPO) between 2005 and 2015 were analysed. Patients with a clinical diagnosis of AAV were compared with patients without a clinical diagnosis of AAV...
October 2016: Medicine (Baltimore)
Xiao-Yan Yi, Yao Wang, Qi-Fu Li, Rong Li, Shu-Min Yang, Guo-Qing Zhou, Zhi-Hong Wang
BACKGROUND: Propylthiouracil is the most common drug used to treat hyperthyroidism. However, this drug could cause a severe disease, antineutrophilic cytoplasmic antibody-associated vasculitis (AAV), which was usually misdiagnosed. METHODS: We reported a 60-year-old woman of propylthiouracil-induced AAV manifested as blood coagulation disorders. The patient was admitted because of hyperthyroidism and leukopenia. At the time of hospitalization, she suffered from dry cough, erythema and knee joints ache, and gradually became febrile...
October 2016: Medicine (Baltimore)
Laurențiu Pirtea, Dorin Grigoraş, Petru Matusz, Marilena Pirtea, Lavinia Moleriu, Anca Tudor, Răzvan Ilina, Cristina Secoşan, Florin Horhat, Octavian Mazilu
BACKGROUND: Persistent infections with high risk human papillomaviruses (HR-HPV) cause virtually all cervical cancers. METHODS: An observational study was conducted aiming to estimate the rate of HPV infection persistence after LEEP in patients with high grade squamous intraepithelial lesions (HSIL). Moreover, the study investigated if persistence is age related. For this reason a total of 110 patients were included between January 2010 and June 2015. RESULTS: At 6 months after LEEP the overall HPV infection persistence rate was 40...
October 6, 2016: BMC Surgery
Eric Yuk Fai Wan, Colman Siu Cheung Fung, Carlos King Ho Wong, Edmond Pui Hang Choi, Fang Fang Jiao, Anca Ka Chun Chan, Karina Hiu Yen Chan, Cindy Lo Kuen Lam
Little is known about how the patient-reported outcomes is influenced by multidisciplinary-risk-assessment-and-management-programme for patients with diabetes mellitus (RAMP-DM). This paper aims to evaluate the effectiveness of RAMP-DM on patient-reported outcomes. This was a prospective longitudinal study on 1039 diabetes mellitus patients (714/325 RAMP-DM/non-RAMP-DM) managed in primary care setting. 536 and 402 RAMP-DM participants, and 237 and 187 non-RAMP-DM participants were followed up at 12 and 24 months with completed survey, respectively...
October 3, 2016: Endocrine
M P M Graham-Brown, R Aljayyousi, R J Baines, J O Burton, N J Brunskill, P Furness, P Topham
We report the case of a 40-year-old female transplant patient with undiagnosed ANCA-associated vasculitis (AAV) and renal allograft dysfunction who achieved disease remission with restoration of transplant function following induction therapy with rituximab. There are currently no trial data looking at the use of rituximab for induction of remission of renal transplant patients with AAV. Although recurrence of AAV following renal transplantation is rare, such patients have invariably had multiple previous exposures to induction and maintenance immunosuppressive regimens, often limiting treatment options post-transplantation...
October 2016: Oxford Medical Case Reports
Zachary S Wallace, Eli M Miloslavsky, Matthew Cascino, Sebastian H Unizony, Na Lu, Gary S Hoffman, Cees G M Kallenberg, Carol A Langford, Peter A Merkel, Paul A Monach, Philip Seo, Robert Spiera, E William St Clair, Ulrich Specks, Paul Brunetta, Hyon K Choi, John H Stone
INTRODUCTION: We investigated the relationships between glucocorticoid (GC) use, disease activity, and changes in body mass index (BMI) in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS: We analyzed AAV patients enrolled in the Rituximab in ANCA-Associated Vasculitis (RAVE) trial. GC use, BMI, and disease activity were measured regularly during the trial period. We performed mixed effects regressions to examine the associations of time-dependent cumulative average GC use and disease activity with changes in body mass index (BMI) over time, while adjusting for potential confounders...
October 1, 2016: Arthritis Care & Research
Anca Simioniuc, Erberto Carluccio, Stefano Ghio, Andrea Rossi, Paolo Biagioli, Gianpaolo Reboldi, Gian Giacomo Galeotti, Fei Lu, Cornelia Zara, Gillian Whalley, Pier Luigi Temporelli, Frank Lloyd Dini
BACKGROUND: B-type natriuretic peptide (BNP) and echocardiography are potentially useful adjunct to guide management of patients with chronic heart failure (HF).Thus, the aim of this retrospective, multicenter study was to compare outcomes and renal function in outpatients with chronic HF with reduced ejection fraction (HFrEF) who underwent an echo and BNP guided or a clinically driven protocol for follow-up. METHODS AND RESULTS: In 1137 consecutive outpatients, management was guided according to echo-Doppler signs of elevated left ventricular filling pressure and BNP levels conforming to the protocol of the Network Labs Ultrasound (NEBULA) in HF Study Group in 570 (mean EF=30%), while management was clinically driven based on the institutional protocol of the HF Unit of the Cardiovascular and Thoracic Department in 567 (mean EF=33%)...
September 18, 2016: International Journal of Cardiology
Daniela Gradinaru, Denisa Margina, Claudia Borsa, Cristina Ionescu, Mihaela Ilie, Marieta Costache, Anca Dinischiotu, Gabriel-Ioan Prada
OBJECTIVE: The aim of this study was to evaluate the relationships between the serum levels of adiponectin and systemic oxidative stress exerted on lipids, proteins, as well as endothelial function and cardiovascular diseases (CVD) risk markers, in elderly subjects with metabolic syndrome (MS). METHODS: The serum advanced glycation and oxidation protein products, low-density lipoprotein susceptibility to oxidation (oxLDL), nitric oxide metabolic pathway products (NOx), serum lipid peroxidation, as well as total antioxidant/oxidative capacity (TAC/TOC), were analyzed in elderly subjects with MS (n = 44), compared to aged-matched control (n = 39)...
September 29, 2016: Aging Clinical and Experimental Research
Anne M Kouri, Sharon P Andreoli
BACKGROUND: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a small- and medium-sized vasculitis classically seen in adult patients, with peak onset near the fifth to seventh decade of life. There is little data on ANCA-associated vasculitis in pediatric patients, and most studies have limited follow-up. METHODS: This is a retrospective chart review of 22 patients with ANCA-positive glomerulonephritis in a single institution from 1991 to 2013...
September 27, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Vincent Cottin, Elisabeth Bel, Paolo Bottero, Klaus Dalhoff, Marc Humbert, Romain Lazor, Renato A Sinico, Pasupathy Sivasothy, Michael E Wechsler, Matthieu Groh, Sylvain Marchand-Adam, Chahéra Khouatra, Benoit Wallaert, Camille Taillé, Philippe Delaval, Jacques Cadranel, Philippe Bonniaud, Grégoire Prévot, Sandrine Hirschi, Anne Gondouin, Bertrand Dunogué, Gérard Chatté, Christophe Briault, Christian Pagnoux, David Jayne, Loïc Guillevin, Jean-François Cordier
OBJECTIVE: To guide nosology and classification of patients with eosinophilic granulomatosis with polyangiitis (EGPA) based on phenotype and presence or absence of ANCA. METHODS: Organ manifestations and ANCA status were retrospectively analyzed based on the presence or not of predefined definite vasculitis features or surrogates of vasculitis in patients asthma, eosinophilia, and at least one systemic organ manifestation attributable to systemic disease. RESULTS: The study population included 157 patients (mean age 49...
September 23, 2016: Autoimmunity Reviews
Adina Elena Stanciu, Anca Elena Hurduc, Marcel Marian Stanciu
OBJECTIVE: We aimed to investigate the effects of thyroid hormone withdrawal on N-terminal prohormone forms of atrial natriuretic peptide (NT-proANP) and brain natriuretic peptide (NT-proBNP) during radioiodine therapy in female patients with differentiated thyroid cancer (DTC). METHODS: Serum concentrations of thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), NT-proANP and NT-proBNP were measured in 51 female patients with DTC (48.7 ± 4.2 years) at three time-points: day of radioiodine therapy (t1 - under acute hypothyroidism), 5 days after radioiodine (t2 - under acute hypothyroidism) and 3 months after radioiodine (t3 - under TSH suppression)...
September 26, 2016: Scandinavian Journal of Clinical and Laboratory Investigation
Frank Lloyd Dini, Erberto Carluccio, Anca Simioniuc, Paolo Biagioli, Gianpaolo Reboldi, Gian Giacomo Galeotti, Claudia Raineri, Luna Gargani, Laura Scelsi, Giulia Elena Mandoli, Antonia Cannito, Andrea Rossi, Pier Luigi Temporelli, Stefano Ghio
AIMS: A compromised tricuspid annular plane systolic excursion (TAPSE) is associated with worse survival in patients with chronic heart failure with reduced ejection fraction (HFrEF). However, it is not known whether a reversible abnormal TAPSE at follow-up predicts survival. Our aim was to evaluate whether a reversible abnormal TAPSE is associated with a better survival in patients with chronic HFrEF. METHODS AND RESULTS: A complete echocardiography was performed in 706 patients with chronic HFrEF (LVEF ≤45%) at baseline and after 6 ± 3 months...
September 20, 2016: European Journal of Heart Failure
Jia Wang, Jian-Nan Li, Zhao Cui, Ming-Hui Zhao
BACKGROUND: Myeloperoxidase (MPO) is pathogenic in ANCA associated vasculitis. It also acts as bactericidal agent. MPO has five N-linked glycosylation sites on its heavy chains. The effect of glycosylation pattern to the functions of MPO is barely known. METHODS: We used eight glycosidases to remove different glycans on MPO separately. The chlorination activity of MPO, the binding between ceruloplasmin and MPO, and the reversing effect of MPO-ANCA to this binding were measured...
September 19, 2016: Nephrology
Shoichi Fukui, Naoki Iwamoto, Masataka Umeda, Ayako Nishino, Yoshikazu Nakashima, Tomohiro Koga, Shin-Ya Kawashiri, Kunihiro Ichinose, Yasuko Hirai, Mami Tamai, Hideki Nakamura, Tomoki Origuchi, Shuntaro Sato, Atsushi Kawakami
A relationship between antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and complement has been shown, and complement has an important role in the pathogenesis of AAV. The clinical characteristics of AAV with hypocomplementemia still remain unclear.We conducted an observational study of 81 patients with AAV (median onset age 71 years; 58% female). Using medical records, we analyzed the patients' baseline variables, laboratory data, clinical symptoms, and therapeutic outcomes after treatments including episodes of relapses, initiation of dialysis, and death...
September 2016: Medicine (Baltimore)
Lazaros I Sakkas, Dimitrios P Bogdanos
Exogenous and endogenous environmental exposures and particularly infections may participate in the breakage of tolerance and the induction of autoimmunity in rheumatic diseases. Response to infections apparently occurs years before clinical manifestations and features of autoimmunity, such as autoantibodies, are detected years before clinical manifestations in autoimmune rheumatic diseases. In this review, we summarize the current evidence for a potential causal link between infectious agents and rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjogren's syndrome and ANCA-associated vasculitis...
December 2016: Auto- Immunity Highlights
Carlos K H Wong, Cindy L K Lam, Eric Y F Wan, Anca K C Chan, C H Pak, Frank W K Chan, William C W Wong
To examine the effects of a structured group-based education programme, patient empowerment programme (PEP), compared with usual care on 2-year changes in patient-reported outcomes (PRO) in patients with diabetes mellitus (DM). A prospective observational study of 715 patients (PEP/non-PEP: 390/325) was conducted to complete the baseline PRO survey and followed up for 2 years. Health-related quality of life (HRQOL) was measured using the short-form 12 at baseline and annually at two follow-up assessments, which yielded physical and mental component summary and SF-6D preference-based scores...
September 13, 2016: Endocrine
Martin-Immanuel Bittner, Nicole Wiedenmann, Sabine Bucher, Michael Hentschel, Michael Mix, Gerta Rücker, Wolfgang A Weber, Philipp T Meyer, Martin Werner, Anca-Ligia Grosu, Gian Kayser
BACKGROUND: Tumor hypoxia is associated with poor prognosis and outcome and can be visualized using 18F-MISO-positron emission tomography (PET) imaging. The goal of this study was to evaluate the correlation between biological markers and biological imaging in a group of patients in whom a correlation between biological imaging and outcome has previously been demonstrated. MATERIAL AND METHODS: In a prospective pilot project, 16 patients with locally advanced cancer of the head and neck underwent 18F-MISO-PET scans before and during primary radiochemotherapy in addition to 18F-FDG-PET and computed tomography (CT)...
November 2016: Acta Oncologica
Koji Tamai, Harukazu Yoshimatsu, Toshiharu Saito, Hirofumi Matsuoka, Nobuhiko Okada, Yasuko Koma, Akiko Otsuka, Nao Oda, Sayaka Inoue, Sachie Kume, Yujiro Suzuki
BACKGROUND: Autoimmune involvement in the pathogenesis of asthma and chronic obstructive pulmonary disease (COPD) has been proposed, and autoantibodies are a hallmark of autoimmunity. This study aimed to compare the autoantibody profiles of asthma and COPD, and the relationship between autoantibodies and features of these diseases. METHODS: We recruited 110 asthma patients and 92 COPD patients for a prospective study. Six autoantibody types were evaluated: antinuclear antibody, anti-cytoplasmic antibodies, rheumatoid factor, anti-cyclic citrullinated peptide antibody, myeloperoxidase-anti-neutrophil cytoplasmic autoantibody (MPO-ANCA) and proteinase 3-ANCA...
August 31, 2016: Allergology International: Official Journal of the Japanese Society of Allergology
Ahmed M Bata, Katarzyna J Witkowska, Piotr A Wozniak, Klemens Fondi, Gerald Schmidinger, Niklas Pircher, Stephan Szegedi, Valentin Aranha Dos Santos, Anca Pantalon, René M Werkmeister, Gerhard Garhofer, Leopold Schmetterer, Doreen Schmidl
Importance: Corneal abrasions are frequent after standard (epithelium-off [epi-off]) corneal collagen cross-linking (CXL) in patients with progressive keratoconus. A new matrix therapy agent (ReGeneraTing Agent [RGTA]) has been developed to promote corneal wound healing. Objective: To assess the effect of the new type of matrix therapy agent on corneal wound healing after epi-off CXL in patients with keratoconus. Design, Setting, and Participants: This double-masked randomized clinical trial enrolled 40 patients with keratoconus undergoing epi-off CXL from July 18, 2014, to October 21, 2015, when the last follow-up was completed...
October 1, 2016: JAMA Ophthalmology
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