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corticosteroids therapy in tuberculosis

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https://www.readbyqxmd.com/read/29740727/the-first-case-of-bacillus-calmette-gu%C3%A3-rin-induced-small-vessel-central-nervous-system-vasculitis
#1
REVIEW
Marc-Etienne Parent, Maxime Richer, Patrick Liang
To present an unrecognized vascular complication of bacillus Calmette-Guérin (BCG) therapy administered for superficial bladder carcinoma. We also review the potential mimickers for primary angiitis of the central nervous system (PACNS) as well as complications of intravesical BCG therapy. An 89-year-old Caucasian man with a history of relapsing high-grade bladder carcinoma treated with intravesical BCG presented with recurring episodes of right upper limb paresthesia with clumsiness and dysarthria. Magnetic resonance imaging of the head revealed multiple predominantly left-sided frontotemporal micronodular peri-vascular lesions...
May 9, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29692453/controversies-in-the-management-of-cutaneous-adverse-drug-reactions
#2
Yashpal Manchanda, Sudip Das, Aarti Sarda, Projna Biswas
Some cutaneous adverse drug reactions (CADRs) are severe life-threatening conditions due to multisystem involvements with a high morbidity and mortality rates ranging from 25 - 70% and require immediate medical care. But there are huge controversies regarding the management because large clinical trials are lacking. Most frequent discussion and division occur regarding the use of systemic corticosteroid as early intervention with corticosteroids controls inflammation. Corticosteroids are potent agents that target several intracellular processes to modify almost all components of inflammatory and immune responses but their impact on the long term disease course is not known...
March 2018: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/29661467/paradoxical-reaction-of-tuberculosis-in-a-heart-transplant-recipient-during-antituberculosis-therapy-a-case-report
#3
A Wakamiya, O Seguchi, A Shionoiri, Y Kumai, K Kuroda, S Nakajima, M Yanase, S Matsuda, K Wada, Y Matsumoto, S Fukushima, T Fujita, J Kobayashi, N Fukushima
INTRODUCTION: Tuberculous paradoxical reactions (PRs) are excessive immune reactions occurring after antituberculosis (TB) treatment and are commonly observed in immunocompromised hosts such as patients infected with the human immunodeficiency virus. CASE REPORT: We recently encountered a 63-year-old male heart transplant recipient who developed tuberculous PR after treatment for miliary TB. The patient had been receiving immunosuppressive therapy with cyclosporine and mycophenolate mofetil for over 15 years...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29580651/-ocular-tuberculosis-a-case-series
#4
M Koubaa, F Smaoui, S Gargouri, H Ben Ayed, K Rekik, I Abid, I Maaloul, J Feki, C Marrakchi, M Ben Jemaa
OBJECTIVES: Ocular tuberculosis is a rare form of extra pulmonary tuberculosis. It represents 1-2% of all clinical forms. The aim of this work was to focus on diagnostic and therapeutic characteristics of ocular tuberculosis. METHODS: We report a case series of 14 patients with ocular tuberculosis seen in an infectious diseases department between 2006 and 2015. The diagnosis was retained on clinical data and a positive tuberculin skin test or interferon-gamma release assay...
March 23, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29466690/safety-and-efficacy-of-etanercept-methotrexate-combination-therapy-in-patients-with-rhupus-an-observational-study-of-non-glucocorticoid-treatment-for-rheumatic-diseases
#5
Bei-Bei Yang, Hua Xiao, Xiao-Jie Li, Min Zheng
OBJECTIVES: To evaluate the safety and efficacy of etanercept (ETN) plus methotrexate (MTX) in patients with rhupus without using corticosteroids. METHODS: Twenty rhupus patients [meeting the criteria for both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE)] who had never been treated with corticosteroids, DMARDs, or biological agents with a 28-joint Disease Activity Score (DAS28) >3.2 and lupus nephritis determined from histopathological specimens were enrolled...
January 2018: Discovery Medicine
https://www.readbyqxmd.com/read/29374638/fluctuating-hypercalcaemia-caused-by-cavitary-mycobacterium-bovis-pulmonary-infection
#6
Darren Patrick Moloney, Liam Chawke, Mairead Therese Crowley, Terence M O'Connor
Hypercalcaemia occurs in many granulomatous diseases. Among them, sarcoidosis and tuberculosis are the most common causes. Other causes include berylliosis, coccidioidomycosis, histoplasmosis, Crohn's disease, silicone-induced granulomas, cat-scratch disease, Wegener's granulomatosis and Pneumocystis carinii pneumonia. Hypercalcaemia in granulomatous disease occurs as a consequence of dysregulated production of 1,25-(OH)2 D3 (calcitriol) by activated macrophages in granulomas. Hypercalcaemia in patients with Mycobacterium tuberculosis infection has been reported in 0%-28% of cases...
January 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29318438/presumed-tuberculous-uveitis-in-a-university-based-tertiary-referral-center-in-saudi-arabia
#7
Awad Al-Qarni, Marwan A Abouammoh, Abdullah N Almousa, Ahmed Mousa, Ahmed M Abu El-Asrar
PURPOSE: To describe clinical characteristics and outcomes of treatment in patients with presumed tuberculous uveitis (PTU). METHODS: All patients diagnosed with PTU between January 1996 and March 2013 were reviewed. The diagnosis was made when clinical findings were consistent with possible intraocular tuberculosis, strongly positive purified protein derivative (PPD) skin test result, and response to anti-tuberculous therapy with no other cause of uveitis as suggested by history, symptoms, or ancillary testing...
January 9, 2018: International Ophthalmology
https://www.readbyqxmd.com/read/29216851/what-does-igra-testing-add-to-the-diagnosis-of-ocular-tuberculosis-a-bayesian-latent-class-analysis
#8
Rupesh Agrawal, Robert Grant, Bhaskar Gupta, Dinesh Visva Gunasekeran, Julio J Gonzalez-Lopez, Peter K F Addison, Mark Westcott, Carlos E Pavesio
BACKGROUND: To evaluate the contribution made to the diagnostic work-up for patients with suspected ocular tuberculosis (TB) by QuantiFERON-TB Gold In-Tube (QFT) tests using latent class analysis model. METHODS: A single centre retrospective cohort study. A Bayesian latent class model was constructed on the basis of demographics, phenotypes and test results from patients attending a tertiary referral center in the UK. This estimated the probability of ocular TB for each patient in two versions, first with and then without QFT...
December 8, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/29201630/avoidance-of-harm-from-treatment-for-anca-associated-vasculitis
#9
REVIEW
Catherine King, Lorraine Harper
Purpose of review With established immunosuppressant treatment regimens for anti-neutrophil cytoplasm antibody-associated vasculitides (AAV), prognosis has significantly improved. The mainstay of treatment still comprises high-dose corticosteroids and cyclophosphamide for severe forms, although rituximab is being increasingly utilised instead of cyclophosphamide as induction therapy. AAV patients experience an excess of infections, malignancies and cardiovascular events as compared to the general population, which is a combination of the systemic inflammatory process associated with vasculitis and the adverse events from treatment...
2017: Current Treatment Options in Rheumatology
https://www.readbyqxmd.com/read/29175527/factors-that-contribute-to-indeterminate-results-from-the-quantiferon-tb-gold-in-tube-test-in-patients-with-inflammatory-bowel-disease
#10
Manreet Kaur, Prianka Singapura, Neeharika Kalakota, Guillermina Cruz, Richa Shukla, Sidra Ahsan, Aylin Tansel, Aaron P Thrift, Hashem B El-Serag
BACKGROUND & AIMS: The QuantiFERON-Tuberculosis Gold In-Tube (QTF-GIT) (Cellestis Limited, Carnegie, Australia) test is widely used to screen for latent Mycobacterium tuberculosis infection in patients with inflammatory bowel diseases (IBD) before treatment with a tumor necrosis factor antagonist. The test frequently produces indeterminate results, prompting additional testing. We evaluated factors associated with indeterminate results from the QTF-GIT test among patients with IBD...
November 23, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29152599/a-novel-clinical-sign-in-intraocular-tuberculosis-active-chorioretinitis-within-chorioretinal-atrophy
#11
Avinash Pathengay, Bhavik Panchal, Himadri Choudhury, Soumyava Basu, Nidhi Relhan, Harry W Flynn
Purpose: To report a novel clinical sign in patients with intraocular tuberculosis. The current study is an observational consecutive case series of patients diagnosed with intraocular tuberculosis managed at a tertiary eye care centre from June 1, 2012 to December 31, 2015. Observations: The diagnosis of intraocular tuberculosis was made in 6 patients based on ocular features suggestive of tuberculosis along with a positive tuberculin skin testing and chest X-ray consistent with tuberculosis...
September 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29117661/a-rare-case-of-infectious-multifocal-serpiginoid-choroiditis
#12
Miloš Mitrašević, Svetlana Jovanović, Filip Radotić, Snežana Pešić, Zorica Jovanović
Multifocal serpiginoid choroiditis is an infectious variety of serpiginous choroiditis. The disease is characterized by infectious etiology and overlapping clinical features in an intermediary form of acute posterior multifocal placoid pigment epitheliopathy and serpiginous choroiditis. In a 33-year-old patient, bilateral multiple placoid partially confluent chorioretinal lesions were diagnosed after a febrile flu-like episode. On the right eye, there was a progressive decrease in visual acuity. Later, the lesions had a prolonged progressive devastating clinical course and widespread distribution of placoid lesions, and took the form of serpiginoid choroiditis...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29075752/clinical-features-and-outcomes-of-patients-with-tubercular-uveitis-treated-with-antitubercular-therapy-in-the-collaborative-ocular-tuberculosis-study-cots-1
#13
Rupesh Agrawal, Dinesh Visva Gunasekeran, Robert Grant, Aniruddha Agarwal, Onn Min Kon, Quan Dong Nguyen, Carlos Pavesio, Vishali Gupta
Importance: Eradication of systemic tuberculosis (TB) has been limited by neglected populations and the HIV pandemic. Whereas ocular TB often presents as uveitis without any prior evidence of systemic TB, the existing uncertainty in the diagnosis of TB uveitis may perpetuate missed opportunities to address systemic TB. Objective: To examine the clinical features of TB uveitis and the associations with response to antitubercular therapy (ATT). Design, Setting, and Participants: This retrospective multinational cohort study included patients from 25 ophthalmology referral centers diagnosed with TB uveitis and treated with ATT from January 1, 2004, through December 31, 2014, with a minimum follow-up of 1 year...
December 1, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29027603/review-of-people-with-retinal-vasculitis-and-positive-quantiferon-%C3%A2-tb-gold-test-in-an-area-nonendemic-for-tuberculosis
#14
David R Brunner, Sandrine A Zweifel, Daniel Barthelmes, Fabio Meier, Christian Böni
PURPOSE: To assess the frequency of a positive QuantiFERON(®)-TB Gold test (quantiferon) among patients with retinal vasculitis in an area nonendemic for tuberculosis (TB); to review clinical characteristics and management of affected individuals. METHODS: Consecutive patients with retinal vasculitis and a positive quantiferon were retrospectively analyzed. Demographics, clinical data, laboratory, imaging findings, and therapy were evaluated. RESULTS: Among 49 patients with retinal vasculitis, 12 (24%) had a positive quantiferon...
October 13, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/29020496/clinical-outcomes-of-adjunctive-sustained-release-intravitreal-dexamethasone-implants-in-tuberculosis-associated-multifocal-serpigenoid-choroiditis
#15
Lubhani Jain, Krushna Gopal Panda, Soumyava Basu
PURPOSE: To analyze the safety and efficacy of sustained-release intravitreal dexamethasone implant (Ozurdex) in management of TB-associated multifocal serpiginoid choroiditis (MSC). METHODS: Retrospective review of TB-associated MSC patients, treated with anti-TB therapy (ATT) and adjunctive intravitreal Ozurdex. RESULTS: Nine eyes of six patients were included. Four patients required Ozurdex implant for progressive or new lesions following ATT and two for additional systemic contraindications to corticosteroids - hyperglycemia and uncontrolled hypertension, respectively...
October 11, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/28986117/screening-prophylaxis-and-counselling-before-the-start-of-biological-therapies-a-practical-approach-focused-on-ibd-patients
#16
REVIEW
Cândida Abreu, António Sarmento, Fernando Magro
The standard of care in the management of immune-mediated inflammatory conditions relies on immunomodulators, glucocorticoids, and biologicals (including anti-tumour necrosis factor -α and other monoclonal antibodies). These agents have an overall favourable benefit/risk ratio; however, they modulate the immune response as part of their mechanisms of action, and therefore they may increase the risk of developing infections, particularly in older patients or in patients with concomitant corticosteroids. Some of these infections may be preventable by immunization, chemoprophylaxis or counselling...
December 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28980216/tuberculous-uveitis-association-between-anti-tuberculous-therapy-and-clinical-response-in-a-non-endemic-country
#17
Kristina L Bajema, Kaivon Pakzad-Vaezi, Thomas Hawn, Kathryn L Pepple
BACKGROUND: The study aims to report the association between successful uveitis control following anti-tuberculous therapy (ATT) for uveitis associated with a positive tuberculosis (TB) screening test in a low endemic setting. A retrospective chart review of cases between 2010 and 2017 at a tertiary uveitis referral center in the United States of America was conducted. Subjects with any form of uveitis, a positive TB interferon-gamma release assay or tuberculin skin test, and negative evaluation for other causes of uveitis were included...
October 4, 2017: Journal of Ophthalmic Inflammation and Infection
https://www.readbyqxmd.com/read/28932979/tuberculous-meningitis-in-children-and-adults-new-insights-for-an-ancient-foe
#18
REVIEW
Alyssa Mezochow, Kiran Thakur, Christopher Vinnard
PURPOSE OF REVIEW: Tuberculous meningitis is the most devastating manifestation of infection with Mycobacterium tuberculosis and represents a medical emergency. Approximately one half of tuberculous meningitis patients die or suffer severe neurologic disability. The goal of this review will be to review the pathogenic, clinical, and radiologic features of tuberculous meningitis and to highlight recent advancements in translational and clinical science. RECENT FINDINGS: Pharmacologic therapy includes combination anti-tuberculosis drug regimens and adjunctive corticosteroids...
September 20, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28884751/tuberculous-meningitis
#19
REVIEW
Robert J Wilkinson, Ursula Rohlwink, Usha Kant Misra, Reinout van Crevel, Nguyen Thi Hoang Mai, Kelly E Dooley, Maxine Caws, Anthony Figaji, Rada Savic, Regan Solomons, Guy E Thwaites
Tuberculosis remains a global health problem, with an estimated 10.4 million cases and 1.8 million deaths resulting from the disease in 2015. The most lethal and disabling form of tuberculosis is tuberculous meningitis (TBM), for which more than 100,000 new cases are estimated to occur per year. In patients who are co-infected with HIV-1, TBM has a mortality approaching 50%. Study of TBM pathogenesis is hampered by a lack of experimental models that recapitulate all the features of the human disease. Diagnosis of TBM is often delayed by the insensitive and lengthy culture technique required for disease confirmation...
October 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28883243/an-hiv-positive-case-of-obstructive-jaundice-caused-by-immune-reconstitution-inflammatory-syndrome-of-tuberculous-lymphadenitis-successfully-treated-with-corticosteroids
#20
Naoaki Watanabe, Ryota Sato, Hideaki Nagai, Hirotoshi Matsui, Akira Yamane, Masahiro Kawashima, Junko Suzuki, Hiroyuki Tashimo, Nobuharu Ohshima, Kimihiko Masuda, Atsuhisa Tamura, Shinobu Akagawa, Akira Hebisawa, Ken Ohta
A 60-year-old man was admitted to our hospital because of a persistent fever with enlargement of multiple lymph nodes in the mediastinum and around the pancreatic head. He was diagnosed with tuberculosis and human immunodeficiency virus infection. We started antiretroviral therapy three weeks after the initiation of anti-tuberculous therapy. Two weeks later, jaundice appeared with dilatation of the biliary tract due to further enlargement of the lymph nodes, which seemed to be immune reconstitution inflammatory syndrome (IRIS)...
October 1, 2017: Internal Medicine
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