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corticosteroids therapy in tuberculosis

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https://www.readbyqxmd.com/read/28108140/steroid-treatment-in-ocular-tuberculosis-a-double-edged-sword
#1
S Souissi, T David, L Beral
INTRODUCTION: We report the case of a Caribbean patient with an atypical presentation of bilateral tuberculous chorioretinopathy. PATIENT AND METHODS: A 57-year-old woman, with hypertension and non-insulin dependent diabetes, was referred to our center for a sudden loss of vision in the right eye to hand motions. Ophthalmic examination revealed only right papilledema. Brain magnetic resonance imaging was normal. Laboratory examination revealed no signs of inflammation...
January 17, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/28058156/paradoxical-worsening-of-tubercular-serpiginous-like-choroiditis-after-initiation-of-antitubercular-therapy
#2
Ebru Esen, Selçuk Sızmaz, Zeynep Kunt, Nihal Demircan
In this study, a case with tubercular choroiditis showing severe macular edema and progression of choroidal lesions following initiation of antitubercular treatment is presented and the management of posterior uveitis associated with tuberculosis is evaluated. A 40-year-old female patient was admitted with decreased vision in her right eye and her fundoscopic examination revealed serpiginous choroiditis. It was learned from her medical history that she had taken antitubercular therapy 9 years ago. Mantoux tuberculin skin test showed an area of induration measuring 15 mm and a positive interferon-gamma release assay was documented...
August 2016: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/27965998/a-prospective-investigation-into-the-effect-of-colchicine-on-tuberculous-pericarditis
#3
Jurgens Jacobus Liebenberg, Catherine Jane Dold, Lourens Rasmus Olivier
INTRODUCTION: Tuberculous (TB) pericarditis carries significant mortality and morbidity rates, not only during the primary infection, but also as part of the granulomatous scar-forming fibrocalcific constrictive pericarditis so commonly associated with this disease. Numerous therapies have previously been investigated as adjuvant strategies in the prevention of pericardial constriction. Colchicine is well described in the treatment of various aetiologies of pericarditis. The aim of this research was to investigate the merit for the use of colchicine in the management of tuberculous pericarditis, specifically to prevent constrictive pericarditis...
November 2016: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/27933686/risk-of-incident-mycobacterium-tuberculosis-infection-in-patients-with-inflammatory-bowel-disease-a-nationwide-population-based-study-in-south-korea
#4
S N Hong, H J Kim, K H Kim, S-J Han, I M Ahn, H S Ahn
BACKGROUND: The low incidence of Mycobacterium tuberculosis infection and lack of adequate controls have prevented researchers from estimating tuberculosis (TB) risk in inflammatory bowel disease (IBD) patients. AIM: To evaluate the risk of incident TB among IBD patients. METHODS: Using the 2011-2013 data of the South Korean National Health Insurance (NHI) system, we calculated the incidence rates (IRs), standardised incidence ratio (SIR) and number needed to screen (NNS) for incident TB in IBD patients compared to the general population in terms of subtype, age, gender and IBD medications...
January 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27904945/-sarcoidosis-and-uveitis-an-update
#5
REVIEW
J G Garweg
Ocular involvement in sarcoidosis is present in up to one third of patients and is frequently manifested before the underlying systemic disease has been diagnosed. With a view to the therapeutic consequences an early diagnosis of the underlying disease is advantageous. In cases of visual loss early diagnostic measures include invasive procedures, such as ultrasound-guided bronchoalveolar lavage and transbronchial biopsy, if nodular conjunctival or cutaneous manifestations which would confirm the diagnosis are not present...
November 30, 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/27895668/oral-tuberculosis-a-rare-manifestation-of-disseminated-disease-in-a-patient-with-dermatomyositis-on-chronic-corticosteroids
#6
Dina Khateeb, Mohleen Kang, Eugenio Capitle, Mirela Feurdean
Tuberculosis remains one of the leading causes of death around the world despite advancements in diagnostic testing and medical therapies. It commonly affects the lungs, but isolated extra pulmonary clinical manifestations have been reported. Tuberculosis of the oral cavity is exceedingly rare. We present a case of a patient with dermatomyositis on chronic steroid therapy, who presented with tuberculosis involving the tongue as the only clinical manifestation of disseminated disease. Physicians must be aware of extra pulmonary manifestations of tuberculosis in patients at risk, in order to avoid delays in diagnosis and treatment and to prevent further contagion...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27888495/an-unusual-presentation-of-intraocular-tuberculosis-in-a-monocular-patient-clinicopathological-correlation
#7
Kanika Aggarwal, Aniruddha Agarwal, Shobha Sehgal, Suryaprakash Sharma, Nirbhai Singh, Kusum Sharma, Ramanuj Samanta, Alessandro Invernizzi, Aman Sharma, Vishali Gupta
BACKGROUND: Lack of uniform diagnostic criteria often poses a challenge in the diagnosis and management of tubercular uveitis. The index case describes an unusual presentation of tubercular panuveitis initially misdiagnosed as sympathetic ophthalmia, where the appropriate diagnosis was made using various imaging and laboratory investigations. RESULTS: A 52-year-old Indian woman underwent multimodal imaging, extensive clinical and laboratory work-up, and analysis of microbiological and histopathological specimens...
December 2016: Journal of Ophthalmic Inflammation and Infection
https://www.readbyqxmd.com/read/27861333/isolated-neurosarcoidosis-mimicking-multifocal-meningiomas-a-diagnosis-pitfall-a-case-report
#8
Kun Wang, Xiaoying He, Wei Wang, Huanjiang Niu, Yirong Wang, Xiujun Cai, Shuxu Yang
INTRODUCTION: Neurosarcoidosis accounts for approximately 5% of the sarcoidosis, which develops exclusively in the nervous system and is always difficult to diagnose. We describe a rare case of isolated neurosarcoidosis mimicking as multifocal meningiomas. A 27-year-old male was admitted to our hospital with a history of unconsciousness and convulsion 1 month ago, which was suspected as a seizure. The results showed no abnormalities in complete blood count; serum electrolytes; erythrocyte sedimentation rate and ultrasonography of the liver, pancreas, spleen, kidney and parotid gland, and so on...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27815270/controversies-in-ocular-tuberculosis
#9
REVIEW
Marcus Ang, Soon-Phaik Chee
Ocular tuberculosis still remains a presumptive, clinical diagnosis in the presence of supportive clinical signs and investigations, while in the absence of other possible causes of uveitis. The purpose of this review is to discuss three controversies of ocular tuberculosis today. First, it is unclear from many reports on how the diagnosis of ocular tuberculosis was defined, and if they included 'probable' or 'possible' diagnoses. Thus, there is a need to standardise the terminology used for ocular tuberculosis to allow for comparisons among studies...
January 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/27809952/tuberculosis-and-transplantation
#10
José M Aguado, José Tiago Silva, Palash Samanta, Nina Singh
Mycobacterium tuberculosis is a major opportunistic pathogen in transplant recipients. Compared to that in the general population, the frequency of tuberculosis (TB) is 10 to 40 times higher in hematopoietic stem cell transplant (HSCT) recipients and 20 to 74 times higher in solid-organ transplant (SOT) recipients. Transplant recipients with TB are also more likely to develop disseminated disease, have longer time to definitive diagnosis, require more invasive diagnostic procedures, and experience greater anti-TB treatment-related toxicity than the general population...
November 2016: Microbiology Spectrum
https://www.readbyqxmd.com/read/27721903/combination-leflunomide-and-methotrexate-in-refractory-rheumatoid-arthritis-a-biologic-sparing-approach
#11
Bridget Hodkinson, Kingsley Ross Magomero, Mohammed Tikly
BACKGROUND: In resource-constrained settings where biologic agents are not widely available, there are limited therapeutic options for patients with rheumatoid arthritis (RA) refractory to other synthetic disease modifying antirheumatic (DMARD) therapies. The aim of this study is to evaluate the effectiveness and safety of leflunomide (LEF) with methotrexate (MTX) in refractory RA. METHODS: A retrospective record review of adult RA patients treated with LEF/MTX...
October 2016: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/27699578/re-initiation-of-biologics-after-the-development-of-tuberculosis-under-anti-tnf-therapy
#12
Yesim Ozguler, Gulen Hatemi, Serdal Ugurlu, Emire Seyahi, Melike Melikoglu, Sermin Borekci, Ersan Atahan, Gul Ongen, Vedat Hamuryudan
The use of anti-TNF agents is associated with an increased risk of tuberculosis (TB) and anti-TNF agents are stopped when active TB develops. However, discontinuation of treatment can result in flare of the underlying disease. The charts of 22 patients who developed active TB among a cohort of 2754 patients using anti-TNF agents between 2001 and 2013 were reviewed retrospectively. Patients restarting biologics during further follow-up were identified. One patient with miliary TB died within 1 month. A biologic agent was restarted in 16 of the remaining 21 patients (76 %)...
December 2016: Rheumatology International
https://www.readbyqxmd.com/read/27643598/role-of-lta4h-polymorphism-in-tuberculosis-associated-immune-reconstitution-inflammatory-syndrome-occurrence-and-clinical-severity-in-patients-infected-with-hiv
#13
Gopalan Narendran, Dhanasekaran Kavitha, Ramesh Karunaianantham, Leonardo Gil-Santana, Jilson L Almeida-Junior, Sirasanambatti Devarajulu Reddy, Marimuthu Makesh Kumar, Haribabu Hemalatha, Nagesh Nalini Jayanthi, Narayanan Ravichandran, Raja Krishnaraja, Angamuthu Prabhakar, Tamizhselvan Manoharan, Lokeswaran Nithyananthan, Gunasundari Arjunan, Mohan Natrajan, Soumya Swaminathan, Bruno B Andrade
BACKGROUND: Paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is an inflammatory phenomenon complicating HIV management in coincidental tuberculosis (TB) infection, upon immune reconstitution driven by antiretroviral therapy (ART). Leukotriene A4 hydroxylase (LTA4H), an enzyme which converts LTA4 to LTB4, regulates the balance between the anti-inflammatory lipoxins and pro-inflammatory LTB4, with direct implications in TB-driven inflammation. In humans, a single nucleotide polymorphism (SNP) in the LTA4H promoter which regulates its transcriptional activity (rs17525495) has been identified and described to impact clinical severity of TB presentation and response to corticosteroid therapy...
2016: PloS One
https://www.readbyqxmd.com/read/27576870/dexamethasone-intravitreal-implants-in-the-management-of-tubercular-multifocal-serpiginoid-choroiditis
#14
Alex Fonollosa, Sonia Valsero, Joseba Artaraz, Ioana Ruiz-Arruza
BACKGROUND: Continuous progression of lesions despite an adequate treatment has been described in tubercular multifocal serpiginoid choroiditis. Reported treatments for this paradoxical response include systemic steroids, immunosuppressive drugs, and intravitreal methotrexate. We describe the use of dexamethasone intravitreal implants in a patient presenting with this condition. FINDINGS: A 46-year-old woman sought medical attention for scotomas in her left eye...
December 2016: Journal of Ophthalmic Inflammation and Infection
https://www.readbyqxmd.com/read/27571786/preventing-paradoxical-tuberculosis-associated-immune-reconstitution-inflammatory-syndrome-in-high-risk-patients-protocol-of-a-randomized-placebo-controlled-trial-of-prednisone-predart-trial
#15
Cari Stek, Charlotte Schutz, Lisette Blumenthal, Friedrich Thienemann, Jozefien Buyze, Christiana Nöstlinger, Raffaella Ravinetto, Edwin Wouters, Robert Colebunders, Gary Maartens, Robert J Wilkinson, Lutgarde Lynen, Graeme Meintjes
BACKGROUND: Early antiretroviral therapy (ART) initiation in patients diagnosed with HIV-associated tuberculosis (TB) reduces mortality among those with the lowest CD4 counts. At the same time, both early ART and a low CD4 count heighten the risk of paradoxical TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). TB is common in patients starting ART in sub-Saharan Africa. Safe interventions that reduce the incidence or severity of TB-IRIS are needed. Prednisone has been shown to reduce symptoms and markers of inflammation when used to treat TB-IRIS...
August 29, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27544714/paradoxical-reaction-in-immunocompetent-children-with-tuberculosis
#16
Begoña Carazo Gallego, David Moreno-Pérez, Esmeralda Nuñez Cuadros, Alba Mesa Fernandez, María Martin Cantero, Pablo Obando Pacheco, Antonio Urda Cardona
BACKGROUND: A paradoxical reaction (PR) during anti-tuberculosis treatment is a phenomenon that is poorly studied in immunocompetent children. It is defined as a clinical or radiological worsening of pre-existing tuberculosis (TB) disease. METHODS: A retrospective descriptive study of children younger than 14 years of age was performed; these children developed PR during the years 2009 to 2014, following a diagnosis of TB. Demographic characteristics, microbiological results, treatment and outcome data were collected...
October 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27491042/peripheral-retinal-vasculitis-analysis-of-110-consecutive-cases-and-a-contemporary-reappraisal-of-tubercular-etiology
#17
Rupesh Agrawal, Dinesh V Gunasekeran, Julio J Gonzalez-Lopez, Joao Cardoso, Bhaskar Gupta, Peter K F Addison, Mark Westcott, Carlos E Pavesio
PURPOSE: Describe the clinical features and outcomes of patients with peripheral retinal vasculitis (RV) and describe clinical characteristics of presumed tubercular RV in a nonendemic setting. METHODS: Retrospective cohort study of 110 consecutive patients with peripheral RV at a tertiary referral eye care center in the United Kingdom. Retinal vasculitis was defined as RV with vitritis associated with peripheral retinal ischemia. Patients who also had positive Quantiferon Gold in Tube test, positive tuberculin skin test, and/or other evidence of systemic tuberculosis such as biopsy were labeled with presumed tubercular RV...
January 2017: Retina
https://www.readbyqxmd.com/read/27451593/immune-reconstitution-inflammatory-syndrome-in-central-nervous-system-tuberculosis
#18
Eliza Manea, Daniela Munteanu, Raluca Jipa, Ruxandra Moroti, Victoria Arama, Ioan-Alexandru Diaconu, Adriana Hristea
BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) related to tuberculosis (TB) is an exacerbation of an inflammatory response that most often occurs in HIV-infected patients but it has also been observed in non-HIV immunocompromised hosts. We describe two cases of TB associated IRIS with CNS involvement, one in a patient diagnosed with HIV infection and the other in a patient with immunosuppression due to anti tumor necrosis factor treatment. CASE REPORT; The first case was a 40-year-old man, newly diagnosed with HIV infection, who developed right hemiplegia and expressive aphasia...
October 2015: Pneumologia: Revista Societății Române de Pneumologie
https://www.readbyqxmd.com/read/27433170/korean-asthma-guideline-2014-summary-of-major-updates-to-the-korean-asthma-guideline-2014
#19
REVIEW
Deog Kyeom Kim, Yong Bum Park, Yeon-Mok Oh, Ki-Suck Jung, Ji Hong Yoo, Kwang-Ha Yoo, Kwan Hyung Kim
Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012)...
July 2016: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27432853/infectious-complications-with-the-use-of-biologic-response-modifiers-in-infants-and-children
#20
H Dele Davies
Biologic response modifiers (BRMs) are substances that interact with and modify the host immune system. BRMs that dampen the immune system are used to treat conditions such as juvenile idiopathic arthritis, psoriatic arthritis, or inflammatory bowel disease and often in combination with other immunosuppressive agents, such as methotrexate and corticosteroids. Cytokines that are targeted include tumor necrosis factor α; interleukins (ILs) 6, 12, and 23; and the receptors for IL-1α (IL-1A) and IL-1β (IL-1B) as well as other molecules...
August 2016: Pediatrics
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