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https://www.readbyqxmd.com/read/28922662/treatment-of-autoimmune-glial-fibrillary-acidic-protein-astrocytopathy-follow-up-in-7-cases
#1
Xinguang Yang, Junyan Liang, Qingmei Huang, Huiming Xu, Cong Gao, Youming Long, Xiaoyu Xiao
OBJECTIVE: The aim of this work was to report an autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy with long-term follow-up in 7 patients. METHODS: Antibodies were detected by indirect immunofluorescence assay and patient data were analyzed retrospectively. RESULTS: Seven patients (4 female, 3 male) with ≥1 year follow-up were included. All patients had positive GFAP antibodies in their cerebral spinal fluid (CSF). Their median age at disease onset was 56 years (range 27-69) and the median disease duration was 1 year (range 1-4)...
September 19, 2017: Neuroimmunomodulation
https://www.readbyqxmd.com/read/28918421/macrophage-activation-syndrome-at-the-onset-of-glucocorticoid-resistant-systemic-lupus-erythematosus-a-case-report
#2
Delia Tulbă, Marius Balea, Cristian Băicuș
INTRODUCTION: Macrophage activation syndrome (MAS) is a life-threatening hyperinflammatory state mediated by uncontrolled cytokine storm and haemophagocytosis. Although rarely reported, MAS might occur in systemic lupus erythematosus (SLE), notably as an inaugural manifestation. Glucocorticoids (GCs) are the cornerstone of SLE therapy. However, in some cases high doses of GCs are required to achieve remission (i.e. glucocorticoid-resistance), leading to significant side effects. CASE REPORT: A 28-year-old Romani male was admitted to our hospital for polyarthralgia, polyserositis and fatigability...
September 16, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28914852/-efficiency-of-immunosuppressive-therapy-in-virus-negative-and-virus-positive-patients-with-morphologically-verified-lymphocytic-myocarditis
#3
O V Blagova, A V Nedostup, E A Kogan, V A Sulimov
AIM: To evaluate the efficiency of immunosuppressive therapy (IST) in virus-negative (V-) and virus-positive (V+) patients with lymphocytic myocarditis (LM). SUBJECTS AND METHODS: 60 patients (45 males) (mean age 46.7±11.8 years) with dilated cardiomyopathy (mean left ventricular (LV) end diastolic size (EDS) 6.7±0.7 cm; ejection fraction (EF) 26.2±9.1%) were examined. The diagnosis of active/borderline LM was verified by right ventricular endomyocardial biopsy in 38 patients, by intraoperative LV biopsy in 10, in the study of explanted hearts from 3 patients and at autopsy in 9...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28912075/ventricular-repolarization-disturbances-after-high-dose-intravenous-methylprednisolone-theraphy
#4
Gokhan Altunbas, Murat Sucu, Orhan Zengin
OBJECTIVE: There are no randomized trials evaluating the effects of pulse steroid treatment on cardiac electrophysiologic functions. The data are limited only to case series. In this study, we sought to evaluate the effects of high dose intravenous methylprednisolone therapy on indices of ventricular repolarization. METHODS: Fifty patients with various autoimmune and inflammatory disorders were enrolled to the study. Electrocardiography (ECG) was obtained 4h before and 12h after the pulse steroid treatment...
August 1, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28906408/eosinophilic-gastroenteritis-presenting-as-upper-gastrointestinal-hematoma-and-ulcers-after-endoscopic-biopsy-a-case-report-and-literature-review
#5
Biqin Chen, Zhao Yang, Heng Lu, Cheng Wei, Fangyu Wang, Chang Liu
RATIONALE: Eosinphilic gastroenteritis (EG) is a gastrointestinal disorder characterized by eosinophilic infiltration with various manifestations. The diagnosis is usually confirmed by an endoscopic biopsy, which is considered a safe and routine procedure for the majority. PATIENT CONCERNS: We report a 54-year-old male who was presented with intermittent periumbilical pain and melena, and only revealed verrucous gastritis by endoscopy. DIAGNOSES: The patient's condition worsened two days after the endoscopic biopsy, and another endoscopy found hematoma and ulcers in upper gastrointestinal tract...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28904454/rituximab-in-neuromyelitis-optica-spectrum-disorders-our-experience
#6
Jui Dilip Jade, Srishti Bansi, Bhim Singhal
BACKGROUND: Neuromyelitis optica (NMO) is an inflammatory demyelinating central nervous system disease, with recurrent attacks of severe bilateral optic neuritis and longitudinally extensive transverse myelitis. Aggressive immunosuppression is essential to prevent clinical relapses and permanent disability. Rituximab, a monoclonal antibody to CD20, has been found effective in several reports and small uncontrolled studies. There is a paucity of data regarding its use in Indian patients...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28903582/methylprednisolone-for-prevention-of-ovarian-hyperstimulation-syndrome-in-patients-with-polycystic-ovarian-syndrome-undergoing-in-vitro-fertilisation-a-randomised-controlled-trial
#7
Ladan Mohammadi Yeganeh, Ashraf Moini, Marzieh Shiva, Naimeh Mirghavam, Narges Bagheri Lankarani
This study aimed to evaluate the effect of methylprednisolone on prevention of ovarian hyperstimulation syndrome (OHSS) in polycystic ovarian syndrome (PCOS) patients undergoing in-vitro fertilisation (IVF). This randomised controlled trial was carried out between November 2009 and December 2013. A total of 219 eligible patients were randomly allocated for treatment (n = 108) or control groups (n = 111). The treatment group received oral methylprednisolone starting from the first day of stimulation...
September 14, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28888561/delayed-presentation-and-prolonged-survival-of-a-child-with-surfactant-protein-b-deficiency
#8
Juan A López-Andreu, Antonio D Hidalgo-Santos, Miguel A Fuentes-Castelló, Nuria Mancheño-Franch, Juan A Cerón-Pérez, Maria J Esteban-Ricós, Laia Pedrola-Vidal, Lawrence M Nogee
Surfactant protein B encoding gene mutations have been related to early onset fatal respiratory distress in full-term neonates. We report a school-aged male child homozygous for a surfactant protein B encoding gene missense mutation who presented after the neonatal period. His respiratory insufficiency responded to high dose intravenous methylprednisolone and hydroxychloroquine.
September 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28886955/successful-combined-targeting-of-b-and-plasma-cells-in-treatment-refractory-anti-nmdar-encephalitis
#9
Olafur Sveinsson, Mathias Granqvist, Yngve Forslin, Kaj Blennow, Henrik Zetterberg, Fredrik Piehl
We describe an extremely severe case of therapy refractory NMDA receptor encephalitis (NMDAe) in a 26-year-old woman. After rituximab, bilateral oophorectomy, repeated cycles of high dose methylprednisolone and plasma exchange, she received repeated cyclophosphamide, tocilizumab (interleukin-6 inhibitor) and finally bortezomib (plasma cell depleting drug) leading to remission after 204days in intensive care. Two years after disease onset her cognitive functions are still affected, but slowly improving and the cerebral atrophy has been partly reversed...
August 25, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28880456/urinary-mir-155-5p-and-cxcl10-as-prognostic-and-predictive-biomarkers-of-rejection-graft-outcome-and-treatment-response-in-kidney-transplantation
#10
Olga Millán, Klemens Budde, Claudia Sommerer, Irene Aliart, Olesja Rissling, Beatriz Bardaji, Maaren Matz, Martin Zeier, Irene Silva, Lluis Guirado, Mercè Brunet
BACKGROUND AND PURPOSE: MicroRNAs (miRNAs) may be useful biomarkers of rejection and allograft outcome in kidney transplantation. Elevated urinary CXCL10 levels have been associated with acute rejection (AR) and may predict allograft failure. We examined the correlation of miRNA, CXCL10 levels and immunosuppressive drug exposure with AR and graft function in kidney transplant recipients. EXPERIMENTAL APPROACH: Eighty de novo kidney transplant recipients were recruited from four European centres...
September 7, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28879452/methylprednisolone-plus-diazepam-i-v-as-bridge-therapy-for-medication-overuse-headache
#11
Matteo Paolucci, Claudia Altamura, Nicoletta Brunelli, Angelo Cascio Rizzo, Federica Assenza, Patrizio Pasqualetti, Fabrizio Vernieri
Management of medication overuse headache (MOH) requires abrupt suspension of overused drugs either alone or in association with a detoxification protocol to prevent withdrawal. However, there is no consensus about which suspension strategy is the most effective. Moreover, reliable data about the possible mid-term effect of detoxification are not available. The objective of this study was to evaluate whether a bridge therapy consisting of a 5-day i.v. infusion of methylprednisolone and diazepam determines a significant reduction in headache frequency and drug assumption during the detoxification protocol (day 5) and in the first 3 months in patients with MOH...
September 6, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28878663/subacute-cerebellar-degeneration-due-to-a-paraneoplastic-phenomenon-associated-with-metastatic-merkel-cell-carcinoma-a-case-report
#12
Angelos Sharobeam, Jason Ray, Juliana Dong, Victor Chong
PURPOSE: The aim of this article is to illustrate the diagnostic challenges and management of paraneoplastic neurological syndromes in Merkel cell carcinoma. MATERIALS AND METHODS: We describe a previously functionally independent 85-year-old woman who presented with subacute onset of dizziness and gait ataxia in the setting of metastatic Merkel cell carcinoma. RESULTS: Diagnosis was made on biopsy after positron emission tomography imaging revealed increased metabolic activity in 2 left inguinofemoral lymph nodes...
May 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28877949/feasibility-randomised-multicentre-double-blind-double-dummy-controlled-trial-of-anakinra-an-interleukin-1-receptor-antagonist-versus-intramuscular-methylprednisolone-for-acute-gout-attacks-in-patients-with-chronic-kidney-disease-asgard-protocol-study
#13
Gowrie Balasubramaniam, Trisha Parker, David Turner, Mike Parker, Jonathan Scales, Patrick Harnett, Michael Harrison, Khalid Ahmed, Sweta Bhagat, Thiraupathy Marianayagam, Costantino Pitzalis, Christian Mallen, Edward Roddy, Mike Almond, Bhaskar Dasgupta
INTRODUCTION: Acute gout occurs in people with chronic kidney disease, who are commonly older people with comorbidities such as hypertension, heart disease and diabetes. Potentially harmful treatments are administered to these vulnerable patients due to a lack of clear evidence. Newly available treatment that targets a key inflammatory pathway in acute gout attacks provides an opportunity to undertake the first-ever trial specifically looking treating people with kidney disease. This paper describes the protocol for a feasibility randomised controlled trial (RCT) comparing anakinra, a novel interleukin-1 antagonist versus steroids in people with chronic kidney disease (ASGARD)...
September 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28870016/clinical-features-and-treatment-outcomes-of-blastic-plasmacytoid-dendritic-cell-neoplasm-a-single-center-experience-in-korea
#14
Hae Su Kim, Hee-Jin Kim, Sun-Hee Kim, Joon Young Choi, Young Hyeh Ko, Won Seog Kim, Chul Won Jung, Seok Jin Kim
BACKGROUND/AIMS: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy that typically presents in the form of skin manifestations with or without lymph node and bone marrow involvement. Given its rarity and recent recognition as a distinct pathological entity, no standard of treatment exists for this aggressive disease and its prognosis is particularly dismal. METHODS: We retrospectively analyzed clinical features and treatment outcomes of patients who were diagnosed with BPDCN between 2000 and 2014...
September 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28869958/management-of-nephrotic-syndrome-a-case-report-from-lao-pdr
#15
Phanekham Souvannamethy
We report the case of a 23-year-old woman with a 2-week history of swelling around the eyes and both legs, and generalized body swelling. She had a history of chronic constipation and poor diet but no fever, recent illnesses, or hematuria. Examination revealed bilateral pedal edema and mild ascites. Laboratory investigations showed low hemoglobin 79 g/L, low mean corpuscular volume 53 fL, thrombocytosis 973 × 109/L, and marked hypochromia and microcytosis, with low iron and ferritin. She had hypoalbuminemia and reduced serum protein (albumin 1...
2017: Blood Purification
https://www.readbyqxmd.com/read/28866833/voriconazole-induced-periostitis-deformans-serial-imaging-in-a-patient-with-anca-vasculitis
#16
S Cormican, N Adams, P O'Connell, A McErlean, D de Freitas
OBJECTIVES: A 61-year-old with acute granulomatosis and polyangiitis developed Aspergillus fumigatus pneumonia after admission to the intensive care unit with a small bowel perforation. This occurred after immunosuppression (intravenous methylprednisolone, intravenous cyclophosphamide, and plasmapheresis) for his initial presentation with stage 3 acute kidney injury. MATERIALS AND METHODS: The mycologist recommended long-term treatment with voriconazole after initial recovery...
September 2, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28866048/subcutaneous-lipoatrophy-and-skin-depigmentation-secondary-to-tmj-intra-articular-corticosteroid-injection
#17
Nicolás Patricio Skármeta, Fernando Ariel Hormazábal, Juan Alvarado, Ana Maria Rodriguez
Chronic orofacial pain is a complex multidimensional experience that produces disability and impairment of normal mandibular function. Overall estimations of chronic orofacial pain prevalence are 7 to 11% of the general population. Temporomandibular disorders (TMDs) are one of the most prevalent chronic orofacial pain conditions, with temporomandibular joint (TMJ) arthralgia accounted for 30.1% of TMD patients. Interventional procedures are often used in pain and palliative medicine to achieve reasonable and cost-effective pain relief...
August 5, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28866045/corticosteroid-inhibits-chemokines-production-in-systemic-sclerosis-patients
#18
Andréa Tavares Dantas, Anderson Rodrigues de Almeida, Maria Clara Pinheiro Duarte Sampaio, Marina Ferraz Cordeiro, Laurindo Ferreira da Rocha, Priscilla Stela Santana de Oliveira, Michelly Cristiny Pereira, Moacyr Jesus Barreto de Melo Rego, Claudia Diniz Lopes Marques, Ivan da Rocha Pitta, Angela Luzia Branco Pinto Duarte, Maira Galdino da Rocha Pitta
In this study, we evaluated glucocorticoids (GC) effects on cytokine/chemokine levels in serum samples and peripheral blood mononuclear cell (PBMC) production from systemic sclerosis (SSc) patients. We evaluated cytokine and chemokine levels in serum samples from SSc patients taking or not taking systemic glucocorticoids. PBMCs response to methylprednisolone (MP) was examined from 15 SSc patients and 8 healthy control subjects following PBMC stimulation with anti-CD3/CD28. Cytokine (IFN-γ, TNF, IL-2, IL-4, IL-6, IL-10, and IL-17A) and chemokine (CXCL8/IL-8, CCL5/RANTES, CXCL9/MIG, CCL2/MCP-1, and CXCL10/IP-10) levels were quantified in serum and in PBMC culture supernatants by CBA or ELISA...
September 1, 2017: Steroids
https://www.readbyqxmd.com/read/28863961/cerebellopathy-secondary-to-anti-peroxidase-antibody-mediated-toxicity-a-special-case-of-hashimoto-encephalopathy
#19
Gary Álvarez Bravo, Antonio Yusta Izquierdo, Guilherme Carvalho Monteiro, Irene Sánchez
OBJECTIVE: The aim of this case report is to highlight the importance of recognizing uncommon causes of cerebellar involvement. CASE PRESENTATION: A 45-year-old woman with no medical history who presented gait instability that appears suddenly and evolves rapidly in two weeks, causing frequent falls. Neurological examination revealed an inability to walk due to severe ataxia, accompanied by global hypotonia, appendicular dysmetria, opsoclonus and dysarthria. We studied this patient with cerebellar syndrome, obtaining as relevant findings global cerebellar atrophy in MRI (magnetic resonance imaging) and especially, considerably elevated levels of antibodies against thyroid peroxidase (TPO)...
August 19, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28858632/widely-spread-corticospinal-tracts-lesions-in-a-case-of-neuromyelitis-optica
#20
Ruixia Zhu, Xu Liu, Zhiyi He
Brain abnormalities have frequently been reported in neuromyelitis optica (NMO) patients, but corticospinal tract involvement has rarely been described. Here we review the case of a 56-year-old woman who presented with unusual MRI features involving the whole corticospinal tract, and summarize the clinical features, neuroimaging, and prognosis of the case. The patient presented with bilateral visual loss and developed progressive weakness in both lower limbs, and urinary incontinence 12days later. Brain MRI revealed T2-hyperintensities in the bilateral corticospinal tract (posterior limb of the internal capsule and cerebral peduncle), callosal lesions, and subcortical white matter lesions...
October 2017: Clinical Neurology and Neurosurgery
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