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https://www.readbyqxmd.com/read/29457989/propylthiouracil-induced-anti-neutrophil-cytoplasmic-antibody-associated-vasculitis-mimicking-kawasaki-disease
#1
Yoshihiro Aoki, Katsuhiko Kitazawa, Hironobu Kobayashi
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is rare in children and is characterised as necrotising vasculitis predominantly affecting small and medium-sized vessels. Propylthiouracil (PTU), an antithyroid drug, has been implicated in drug-induced AAV. In contrast, Kawasaki disease (KD) is a common systemic vasculitis, typically observed in children, which affects the medium-sized vessels, including the coronary arteries. An 11-year-old girl who developed AAV while receiving PTU therapy for Graves' disease is described...
February 19, 2018: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/29456929/controversies-in-diagnosis-and-management-of-kawasaki-disease
#2
REVIEW
Rakesh Kumar Pilania, Dharmagat Bhattarai, Surjit Singh
Kawasaki disease (KD) is a common medium vessel systemic vasculitis that usually occurs in small children. It has a predilection for the coronary arteries, but other medium sized arteries can also be involved. The etiology of this disorder remains a mystery. Though typical presentation of KD is quite characteristic, it may also present as incomplete or atypical disease in which case the diagnosis can be very challenging. As both incomplete and atypical forms of KD can be associated with serious coronary artery complications, the pediatrician can ill afford to miss these diagnoses...
February 8, 2018: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/29447930/linked-help-from-bacterial-proteins-drives-autoantibody-production-in-small-vessel-vasculitis
#3
David B G Oliveira
The small vessel vasculitides granulomatosis with polyangiitis (GPA) and microscopic polyangiitis are associated with autoantibodies to neutrophil cytoplasm antigens (ANCA), principally proteinase-3 (PR3) and myeloperoxidase (MPO). There is an association between GPA and nasal carriage of Staphylococcus aureus. The recent finding that S. aureus produces proteins that bind tightly to and block the function of both PR3 and MPO suggests a mechanism for ANCA formation. The bacterial protein-autoantigen conjugate is recognised by B cells with ANCA specificity, internalised, and the bacterial protein processed and presented to T cells with specificity for bacterial peptides...
March 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29447643/a-case-of-leukocytoclastic-vasculitis-caused-by-novel-anticoagulant-rivaroxaban
#4
Riley Dean, Alison M Messer, Melanie Pickett, Richard Jahan-Tigh
Cutaneous leukocytoclastic vasculitis (LCV) is type of small vessel vasculitis that commonly presents as palpable purpura involving the lower extremities and buttocks. Approximately half of cases are idiopathic, but the disease may be triggered by infection, drug reaction, inflammatory disease, or other causes. We report a case of leukocytoclastic vasculitis secondary to the novel anticoagulant rivaroxaban (Xarelto®).
November 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29441165/propylthiouracil-induced-anca-negative-cutaneous-small-vessel-vasculitis
#5
Aliaksandr Trusau, Michael L Brit
Propylthiouracil (PTU) is a commonly used medication for the treatment of hyperthyroidism. PTU is known to cause different adverse reactions including autoimmune syndromes. PTU-induced autoimmune syndromes can be classified into drug-induced lupus or drug-induced vasculitis. Differential diagnoses could be very challenging. PTU-induced vasculitis is more common than PTU-induced lupus, and has a higher risk of morbidity and mortality. Usually it is limited to the skin in a form of cutaneous leukocytoclastic vasculitis, but may also affect organs including kidneys and lungs...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29438165/histologic-features-of-gastrointestinal-tract-biopsies-in-iga-vasculitis-henoch-sch%C3%A3-nlein-purpura
#6
Christine Y Louie, Adam J Gomez, Richard K Sibley, Dorsey Bass, Teri A Longacre
Immunoglobulin A (IgA) vasculitis or Henoch-Schönlein purpura (HSP) typically occurs in the pediatric population, although rare cases also occur in adults. Gastrointestinal (GI) involvement is common. The "classic" histologic finding in IgA vasculitis (HSP) is leukocytoclastic vasculitis (LCV); other histologic features in biopsies of IgA vasculitis (HSP) have only been rarely described. The pathology archival files at our institution were searched for GI biopsies from patients with IgA vasculitis (HSP)...
February 12, 2018: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29433584/ipilimumab-induced-digital-vasculitis
#7
Amrita Padda, Elena Schiopu, Justin Sovich, Vincent Ma, Ajjai Alva, Leslie Fecher
BACKGROUND: Immune check point inhibitors (ICIs) have emerged as a new therapeutic paradigm for a variety of malignancies including metastatic melanoma. As the use of ICIs expand, immune-mediated adverse events are becoming a common occurrence. CASE PRESENTATION: We describe the first reported patient with small vessel vasculitis, manifested by digital ischemia, following treatment with high dose Ipilimumab for resected stage IIIB/C melanoma. This patient received high dose steroids, five-day intravenous (IV) Epoprostenol protocol, botulinum toxin injections, and Rituximab 375 mg/m2 weekly for four cycles...
February 12, 2018: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/29433114/-hepatitis-c-virus-induced-cryoglobulinemic-vasculitis
#8
Yasunori Minami, Masatoshi Kudo
Cryoglobulins are produced by the over-stimulated immune system of patients with hepatitis C virus (HCV). HCV-induced cryoglobulinemic vasculitis primarily affects small-sized vessels of systemic organs. The most common symptoms are purpura, joint pain, and peripheral neuropathy or Raynaud phenomenon. The blood tests of patients with HCV may exhibit raised erythrocyte sedimentation rate and C-reactive protein levels, positive rheumatoid factor and cryoglobulins, and decreased complement levels. Therapeutic options for HCV-induced cryoglobulinemic vasculitis, include anti-virals, Rituximab, steroids, immunosuppressant drugs, and plasma exchange...
February 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/29425799/vancomycin-associated-hemorrhagic-occlusive-retinal-vasculitis-a-clinical-pathophysiological-analysis
#9
Bozho Todorich, Lisa J Faia, Aristomenis Thanos, Mitual Amin, Robert Folberg, Jeremy D Wolfe, Krista M Todorich, Efthemios Raphtis, Alan J Ruby, George A Williams, Tarek S Hassan
PURPOSE: To derive novel insights into the pathophysiology of vancomycin-related hemorrhagic occlusive retinal vasculopathy (HORV) through a careful clinicopathologic correlation. METHODS: and study design: We retrospectively reviewed the clinical and pathologic course of two consecutive patients who developed HORV. The clinical history, multimodal imaging, ultrasound biomicroscopy (UBM), intraoperative and histological findings are reported. RESULTS: Both patients presented with decreased vision and eye pain within 1 week following otherwise uncomplicated cataract extraction and were diagnosed with HORV after endophthalmitis was ruled out...
February 6, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29404659/the-phenomenon-of-neutrophil-extracellular-traps-in-vascular-diseases
#10
REVIEW
Dorota Dąbrowska, Ewa Jabłońska, Marzena Garley, Jolanta Sawicka-Powierza, Karolina Nowak
Vascular diseases constitute a global health issue due to the increasing number of cases of patients with these diseases. The pathogenesis of the majority of these diseases, including atherosclerosis and thrombosis, is complex and not yet fully understood. One of the major causes for their occurrence can be immune disorders resulting in the development of a chronic inflammation within the vessels. In recent years, studies have placed emphasis on the role of neutrophils in the development of these diseases, i...
February 5, 2018: Archivum Immunologiae et Therapiae Experimentalis
https://www.readbyqxmd.com/read/29395165/anti-neutrophil-cytoplasm-antibodies-anca-recent-methodological-advances-lead-to-new-consensus-recommendations-for-anca-detection
#11
REVIEW
Elena Csernok, Juliane Mahrhold, Bernhard Hellmich
The current practice for detection of anti-neutrophil cytoplasm antibodies (ANCA) directed against proteinase 3 (PR3) and myeloperoxidase (MPO) has been screening by indirect immunofluorescence (IIF) followed by an antigen specific tests for PR3- and MPO-ANCA. However, ANCA diagnostics have undergone many technical developments that have affected the 1999 international consensus recommendations, and lead to a revision of the existing ANCA detection strategy. Recent European multicentre studies have compared the diagnostic performance of various ANCA detection methods and demonstrated that PR3- and MPO-ANCA immunoassays yielded the highest diagnostic accuracy...
January 27, 2018: Journal of Immunological Methods
https://www.readbyqxmd.com/read/29393242/focus-on-the-involvement-of-the-nose-and-paranasal-sinuses-in-eosinophilic-granulomatosis-with-polyangiitis-churg-strauss-syndrome-nasal-cytology-reveals-infiltration-of-eosinophils-as-a-very-common-feature
#12
Veronica Seccia, Chiara Baldini, Manuela Latorre, Matteo Gelardi, Iacopo Dallan, Lodovica Cristofani-Mencacci, Stefano Sellari-Franceschini, Maria Laura Bartoli, Elena Bacci, Pierluigi Paggiaro
BACKGROUND: Eosinophilic granulomatosis with polyangiitis (EGPA) is a necrotizing vasculitis that predominantly affects small- to medium-sized vessels. It is characterized by a wide spectrum of extrapulmonary symptoms, including sinonasal and paranasal sinus abnormalities. These are the most common features of this disease, constituting diagnostic criteria for EGPA. However, the actual clinical features, cellular mechanisms and impact on patients' quality of life (QoL) are still a matter of study...
January 23, 2018: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/29392845/recurrence-of-eosinophilic-granulomatosis-with-polyangitis-after-orthotopic-heart-transplant
#13
Ujjwal Rastogi, Ziad Sergie, Sean Pinney, Noah Moss
Eosinophilic granulomatosis with polyangitis (EGPA), previously referred to as Churg-Strauss syndrome, is a necrotizing small vessel vasculitis associated with eosinophilic infiltrates and extravascular granulomas. We report a case of a Caucasian woman successfully bridged to heart transplantation with a continuous flow left ventricular assist device (LVAD) who survived recurrence of EGPA in the allograft. This article is protected by copyright. All rights reserved.
February 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29379322/health-related-quality-of-life-in-anca-associated-vasculitis-and-item-generation-for-a-disease-specific-patient-reported-outcome-measure
#14
Joanna C Robson, Jill Dawson, Peter F Cronholm, Nataliya Milman, Katherine S Kellom, Susan Ashdown, Ebony Easley, John T Farrar, Don Gebhart, Georgia Lanier, Carol A McAlear, Jacqueline Peck, Raashid A Luqmani, Judy A Shea, Gunnar Tomasson, Peter A Merkel
Objective: The antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are multisystem diseases of the small blood vessels. Patients experience irreversible damage and psychological effects from AAV and its treatment. An international collaboration was created to investigate the impact of AAV on health-related quality of life (HRQoL), and develop a disease-specific patient-reported outcome measure to assess outcomes of importance to patients. Methods: Patients with AAV from the UK, USA, and Canada were interviewed to identify salient aspects of HRQoL affected by AAV...
2018: Patient related Outcome Measures
https://www.readbyqxmd.com/read/29366363/orbital-granulomatosis-with-polyangiitis-mimicking-igg4-related-disease-in-a-12-year-old-male
#15
Anastasia Drobysheva, Julie Fuller, Cory M Pfeifer, Dinesh Rakheja
Granulomatosis with polyangiitis is rare in children. We report a case of a 12-year-old male who presented with new symptoms of left eyelid swelling and ptosis. Magnetic resonance imaging showed an enhancing orbital mass suspicious for a neoplasm. Excisional biopsy was performed. Microscopic examination revealed fibrovascular tissue with dense collagenous fibrosis and mixed inflammatory infiltrate that included many plasma cells. Many small and medium-sized blood vessels showed granulomatous and necrotizing vasculitis with disruption of the vessel walls and fibrinoid necrosis...
January 1, 2018: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29354215/the-role-of-biopsies-and-autopsies-in-the-diagnosis-of-cognitive-impairment-with-emphasis-on-small-vessel-diseases-a-critical-appraisal-enriched-by-personal-experience
#16
Leila Chimelli
Acquired and hereditary microangiopathies cause cerebral small vessel diseases (CSVD) that impair cognition. The most frequent is primary angiitis of the CNS (PACNS), whose diagnosis remains challenging, requiring a multidisciplinary approach. Secondary vasculitis, CADASIL, miscellaneous microangiopathies and lymphomas, also cause cognitive impairment. Despite the fact that the need for biopsy has decreased in the era of new neuroimaging methods, biopsies that include small leptomeningeal and parenchymal arterial vessels still remain the gold standard to diagnose PACNS and other CSVD, and to exclude mimics such as infections and malignancies...
October 2017: Dementia & Neuropsychologia
https://www.readbyqxmd.com/read/29353097/genetics-of-immunoglobulin-a-vasculitis-henoch-sch%C3%A3-nlein-purpura-an-updated-review
#17
REVIEW
Raquel López-Mejías, Santos Castañeda, Fernanda Genre, Sara Remuzgo-Martínez, F David Carmona, Javier Llorca, Ricardo Blanco, Javier Martín, Miguel A González-Gay
Immunoglobulin-A vasculitis (IgAV) is classically a childhood small-sized blood vessel vasculitis with predominant involvement of the skin. Gastrointestinal and joint manifestations are common in patients diagnosed with this condition. Nephritis, which is more severe in adults, constitutes the most feared complication of this vasculitis. The molecular bases underlying the origin of IgAV have not been completely elucidated. Nevertheless, several pieces of evidence support the claim that genes play a crucial role in the pathogenesis of this disease...
January 15, 2018: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29320975/systemic-lupus-erythematosus-with-inflammatory-bowel-disease-ulcerative-colitis-case-report
#18
H Elsayed Mansour, S Gamal Arafa, W Abdelfatah Shehata
A 30-year-old female presented to the rheumatology outpatient clinic of the Internal Medicine Department, Ain Shams University Hospital, Cairo, Egypt, complaining of a large right leg ulcer consistent with pyoderma gangrenosum. There was history of recurrent attacks of bleeding per rectum of one-year duration. During hospitalization she noticed blurring of vision in the left eye with diffuse blackish discoloration of the feet and toes, consistent with small-vessel vasculitis. Colonoscopy with biopsy and histopathology confirmed the diagnosis of inflammatory bowel disease-ulcerative colitis (IBD-UC)...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29319773/anca-positive-pauci-immune-crescentic-glomerulonephritis-in-a-patient-with-systemic-lupus-erythematosus
#19
Percy Herrera-Añazco, Percy Velásquez-Castillo, Josmel Pacheco-Mendoza, Germán Valenzuela-Rodriguez, Carmen Asato-Higa
The pauci-immune crescentic glomerulonephritis (PICGN) is generally associated with small-vessel vasculitis with a few reported cases associated with other autoimmune diseases such as Systemic Lupus Erythematosus (SLE). We present the case of a female 34-year-old patient with acute kidney injury symptoms with indication for renal replacement therapy in the context of clinical SLE diagnosis. A kidney biopsy was conducted and it was found that most glomeruli showed some segmental sclerosis with synechia to the Bowman's capsule...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29305361/blue-toe-syndrome-as-a-first-sign-of-systemic-sclerosis
#20
Rugina Neuman, Marike Wabbijn, Samara Guillen, Adriaan Dees
We describe an unusual case of blue toe syndrome as the primary and solitary manifestation of systemic sclerosis. The possible cause was long-term occupational exposure in construction work. Blue toe syndrome is a small vessel disease, characterised by the sudden development of painful, blue discolouration in one or more toes. The most common aetiology is atheroembolic disease; however, it can also appear in several conditions ranging from hypercoagulability disorders to underlying systemic diseases such as vasculitis or autoimmune diseases...
January 5, 2018: BMJ Case Reports
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