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https://www.readbyqxmd.com/read/29669775/a-case-of-autoimmune-haemolytic-anaemia-after-39-cycles-of-nivolumab
#1
Hira Shaikh, Nour Daboul, Mary Albrethsen, Salman Fazal
With growing use of nivolumab, rare but serious side effects have surfaced in some patients. We present a case of autoimmune haemolytic anaemia that developed after 39 cycles of nivolumab. A 78-year-old man with metastatic lung adenocarcinoma, refractory to multiple lines of chemotherapy was switched to nivolumab. After around 2 years of stable course on nivolumab, he developed transfusion-dependent anaemia with haemoglobin of 8.6 g/dL. Nivolumab was held immediately. Bone marrow biopsy findings were inconclusive of myelodysplastic syndrome...
April 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29666838/a-brief-history-of-intracrine-androgen-metabolism-by-castration-recurrent-prostate-cancer
#2
REVIEW
James L Mohler
This mini-review describes the evolution of the concept of intracrine androgen metabolism by prostate cancer during androgen deprivation therapy. Persistence of androgen receptor protein in the face of castrate circulating levels of testosterone could not be explained fully by hypersensitization or mutation of the androgen receptor. The hypothesis that castration-recurrent prostate cancer produced its own testosterone was proven using radioimmunoassay and mass spectrometry methods adopted for use in prostate tissue...
2018: American Journal of Clinical and Experimental Urology
https://www.readbyqxmd.com/read/29623227/fulminant-diabetes-in-a-patient-with-advanced-melanoma-on-nivolumab
#3
Nora Chokr, Hafsa Farooq, Elizabeth Guadalupe
Background: Anti-PD-1 agents were approved for advanced melanoma after the landmark trial Checkmate-037. Anti-PD-1 agents can breach immunologic tolerance. Fulminant diabetes is an immune endocrinopathy that results from a violent immune attack leading to complete destruction of pancreatic beta cells in genetically predisposed people. We present a rare case of fulminant diabetes precipitated by anti-PD-1 immunotherapy. Case: A 61-year-old male with advanced melanoma presented with a three-day history of nausea, vomiting, and malaise...
2018: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/29555348/low-disease-activity-irrespective-of-serologic-status-at-baseline-associated-with-reduction-of-corticosteroid-dose-and-number-of-flares-in-patients-with-systemic-lupus-erythematosus-treated-with-belimumab-a-real-life-observational-study
#4
Antonis Fanouriakis, Christina Adamichou, Sofia Koutsoviti, Stylianos Panopoulos, Chrysanthi Staveri, Anastasia Klagou, Christina Tsalapaki, Lamprini Pantazi, Styliani Konsta, Clio P Mavragani, Despoina Dimopoulou, Styliani Ntali, Georgios Katsikas, Kyriaki A Boki, Dimitrios Vassilopoulos, Pinelopi Konstantopoulou, Stamatis-Nick Liossis, Antonia Elezoglou, Maria Tektonidou, Prodromos Sidiropoulos, Abdulsamet Erden, Petros P Sfikakis, George Bertsias, Dimitrios T Boumpas
BACKGROUND: Low disease activity is a validated target of current systemic lupus erythematosus (SLE) therapy. The aim of this study was to assess the ability of belimumab to achieve low disease activity states in real-life settings. METHODS: Multicentre prospective observational study of consecutive SLE patients receiving belimumab for at least 3 months, due to active disease refractory to at least one conventional immunosuppressant. Disease activity, including the recently defined lupus low disease activity state (LLDAS) and remission (clinical SLEDAI-2K = 0), accrual of organ damage, flares and side effects were documented...
February 23, 2018: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29551338/sirolimus-in-patients-with-clinically-active-systemic-lupus-erythematosus-resistant-to-or-intolerant-of-conventional-medications-a-single-arm-open-label-phase-1-2-trial
#5
Zhi-Wei Lai, Ryan Kelly, Thomas Winans, Ivan Marchena, Ashwini Shadakshari, Julie Yu, Maha Dawood, Ricardo Garcia, Hajra Tily, Lisa Francis, Stephen V Faraone, Paul E Phillips, Andras Perl
BACKGROUND: Patients with systemic lupus erythematosus have T-cell dysfunction that has been attributed to the activation of the mammalian target of rapamycin (mTOR). Rapamycin inhibits antigen-induced T-cell proliferation and has been developed as a medication under the generic designation of sirolimus. We assessed safety, tolerance, and efficacy of sirolimus in a prospective, biomarker-driven, open-label clinical trial. METHODS: We did a single-arm, open-label, phase 1/2 trial of sirolimus in patients with active systemic lupus erythematosus disease unresponsive to, or intolerant of, conventional medications at the State University of New York Upstate Medical University (Syracuse, NY, USA)...
March 15, 2018: Lancet
https://www.readbyqxmd.com/read/29549463/pharmacology-and-pharmacogenetics-of-prednisone-and-prednisolone-in-patients-with-nephrotic-syndrome
#6
Anne M Schijvens, Rob Ter Heine, Saskia N de Wildt, Michiel F Schreuder
Nephrotic syndrome is one of the most common glomerular disorders in childhood. Glucocorticoids have been the cornerstone of the treatment of childhood nephrotic syndrome for several decades, as the majority of children achieves complete remission after prednisone or prednisolone treatment. Currently, treatment guidelines for the first manifestation and relapse of nephrotic syndrome are mostly standardized, while large inter-individual variation is present in the clinical course of disease and side effects of glucocorticoid treatment...
March 16, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29538200/loeffler-endocarditis-as-a-rare-cause-of-heart-failure-with-preserved-ejection-fraction-a-case-report-and-review-of-literature
#7
Ming Gao, Weihua Zhang, Waiou Zhao, Ling Qin, Fei Pei, Yang Zheng
RATIONALE: Hypereosinophilic syndrome (HES) is a rare disease characterized by hypereosinophilia and its ensuing organ damage. Cardiac involvement is divided into 3 chronological stages: an acute necrotic stage; a thrombus formation stage; and a fibrotic stage. Infiltration of the myocardium by eosinophilic cells followed by endomyocardial fibrosis is known as "Loeffler endocarditis." PATIENT CONCERNS: We report a case of a 60-year-old man diagnosed with left-sided restrictive cardiomyopathy...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29535672/clinical-characteristics-of-juvenile-myasthenia-gravis-in-southern-china
#8
Xin Huang, Yingkai Li, Huiyu Feng, Pei Chen, Weibin Liu
Objectives: To describe the clinical profile, clinical outcomes and factors that may affect the outcome of juvenile myasthenia gravis (JMG) patients in southern China. Methods: We reviewed information relating to JMG patients treated and evaluated at the First Affiliated Hospital, Sun Yat-sen University, between 1998 and 2015. The study involved 327 JMG patients who had been followed up for ≥1 year. Results: Overall, 77.4% patients showed initial symptoms in the prepubertal period (<12 years)...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29527848/corticosteroid-therapy-in-combination-with-antibiotics-for-erysipelas
#9
Michal Solomon, Aviv Barzilai, Hila Elphasy, Henri Trau, Sharon Baum
BACKGROUND: Erysipelas, an acute infection of the dermal and subcutaneous tissue, is normally treated with antibiotics. Previous data indicated that treatment with prednisone in combination with antibiotics results in significant acceleration of the healing phase. OBJECTIVES: To investigate the effectiveness of corticosteroids combined with antibiotics for the treatment of erysipelas. METHODS: A retrospective study was conducted on hospitalized patients diagnosed with erysipelas between 2004 and 2011 at the Department of Dermatology at Sheba Medical Center, Israel...
March 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29525810/glucocorticoid-induced-myopathy-in-a-patient-with-systemic-lupus-erythematosus-sle-a-case-report-and-review-of-the-literature
#10
Elliot M Silver, William Ochoa
BACKGROUND Chronic intake of high-dose corticosteroids is associated with multiple adverse clinical effects, including hypertension, insulin resistance, impaired wound healing, immunosuppression, myopathy, and osteoporosis. In cases of autoimmune disease, use of steroid-sparing treatment modalities is preferred over chronic steroid therapy to limit these side effects. Glucocorticoid-induced myopathy is a less common side effect of chronic steroid use in patients treated with <10 mg/day of prednisone. However, doses exceeding 40-60 mg/day can induce clinically significant myopathy and weakness...
March 11, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29524454/phase-1-trial-of-vamorolone-a-first-in-class-steroid-shows-improvements-in-side-effects-via-biomarkers-bridged-to-clinical-outcomes
#11
Eric P Hoffman, Valerie Riddle, Maxime A Siegler, Daniel Dickerson, Miroslav Backonja, William G Kramer, Kanneboyina Nagaraju, Heather Gordish-Dressman, Jesse M Damsker, John M McCall
BACKGROUND: Glucocorticoid drugs are highly effective anti-inflammatory agents, but chronic use is associated with extensive pharmacodynamic safety concerns that have a considerable negative impact on patient quality of life. PURPOSE: Vamorolone (VBP15) is a first-in-class steroidal multi-functional drug that shows potent inhibition of pro-inflammatory NFkB pathways via high-affinity binding to the glucocorticoid receptor, high affinity antagonism for the mineralocorticoid receptor, and membrane stabilization properties...
March 7, 2018: Steroids
https://www.readbyqxmd.com/read/29511745/combination-nivolumab-and-cabiralizumab-associated-acute-bilateral-anterior-and-posterior-scleritis-and-anterior-uveitis
#12
John A Gonzales, Jessica Shantha, Nisha R Acharya
Purpose: To report on a case of uveitis and scleritis resulting as an immune-mediated side effect of cancer immunotherapy with nivolumab and cabiralizumab. Observations: Bilateral anterior nongranulomatous anterior uveitis and bilateral diffuse anterior and posterior scleritis occurred following the use of combination cancer immunotherapy. The uveitis and scleritis resolved following temporary discontinuation of nivolumab and cabiralizumab as well as systemic prednisone...
June 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29510685/case-report-8-years-after-liver-transplantation-de-novo-hepatocellular-carcinoma-8-months-after-hcv-clearance-through-ifn-free-antiviral-therapy
#13
Giuliano Ramadori, Patrizia Bosio, Federico Moriconi, Ihtzaz A Malik
BACKGROUND: After orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC), recurrent HCC mostly develops within 2 years. All cases of de novo HCC described so far occurred later than 2 years after OLT. Prevention of post-transplantation HCC has usually been tried to achieve by curing or controlling recurrent liver disease. This has been rationale for treatment with interferon (IFN)/ribavirin of HCV-recurrence in patients after OLT, transplanted for advanced HCV-induced liver disease and/or HCC...
March 6, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29495541/dosimetry-based-consideration-on-remission-and-relapse-after-therapy-with-223-ra-dichloride-in-castration-resistant-prostate-cancer-crpc-with-bone-metastases-a-case-report
#14
Anna Maria Mangano, Massimiliano Pacilio, Pasquale Ialongo, Alessandro Semprebene, Guido Ventroni, Lucio Mango
Here, we present the case of a 64-year-old male patient diagnosed with castration-resistant prostate cancer (CRPC) with bone metastasis, treated with abiraterone prednisone/prednisolone in combination with223 Ra-dichloride therapy, who had remission and a subsequent relapse of bone metastasis on repeated bone scans after therapy. We also discuss the possibility of continuing the223 Ra-dichloride therapy over the six planned administrations by administering other cycles at the same dose or at higher doses, if shown to be devoid of a significant increase in side effects, based on dosimetry considerations...
February 27, 2018: Diagnostics
https://www.readbyqxmd.com/read/29476421/immunosuppression-in-pregnant-women-with-renal-disease-review-of-the-latest-evidence-in-the-biologics-era
#15
REVIEW
Loredana Colla, Davide Diena, Maura Rossetti, Ana Maria Manzione, Luca Marozio, Chiara Benedetto, Luigi Biancone
Care of pregnant woman, including fertility and procreation counseling, has become a significant part of the nephrological practice in the last years. In this context, the management of immunosuppression assumes a primary role both for autoimmune diseases and for post-transplant follow up. The present review analyzes the latest evidence on immunosuppressive drugs of current use in nephrology and kidney transplantation. Although the placenta inactivates prednisone and prednisolone, it is advisable to limit the dose to the minimal effective one, to prevent side effects...
February 23, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29392482/ixazomib-induced-cutaneous-necrotizing-vasculitis
#16
A Alloo, H Khosravi, S R Granter, S M Jadeja, P G Richardson, J J Castillo, N R LeBoeuf
Ixazomib is a second-generation proteasome inhibitor that has been approved in the combination treatment of multiple myeloma and is currently under clinical investigation for the management of Waldenstrom's macroglobulinemia. While cutaneous adverse events secondary to proteasome inhibitors have been reported, the side effect profile of ixazomib remains to be documented. We report two patients, one with multiple myeloma and one with Waldenstrom's macroglobulinemia, who developed cutaneous necrotizing vasculitis after the initiation of ixazomib...
February 1, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29323755/direct-acting-antiviral-regimens-are-safe-and-effective-in-the-treatment-of-hepatitis-c-in-simultaneous-liver-kidney-transplant-recipients
#17
Anupama U Nookala, James Crismale, Thomas Schiano, Helen Te, Joseph Ahn, Suzanne Robertazzi, Colleen Rodigas, Rohit Satoskar, Mandip Kc, Mohamed Hassan, Coleman Smith
Hepatitis C (HCV) remains the single most common etiology of end-stage liver disease leading to simultaneous liver/kidney transplant (SLKT) and has worse post-transplant survival compared to non-HCV patients. We aim to assess the effectiveness and tolerance of the all-oral direct-acting antiviral (DAA) agents with or without ribavirin (RBV) in the treatment of HCV recurrence post-SLKT. Thirty-four patients were studied retrospectively, composed predominantly of treatment-naïve (73.5%) non-Caucasian (61.8%) males (82...
March 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29320598/eruptive-sebaceous-hyperplasia-a-rare-consequence-of-systemic-corticosteroids
#18
Geraldine Cheyana Ranasinghe, Adam J Friedman
BACKGROUND: Eruptive sebaceous hyperplasia is a rare and poorly understood consequence of immunosuppression, most commonly with cyclosporine, following organ transplantation. To date, there have been no reports documenting eruptive sebaceous hyperplasia associated with the utilization of immunosuppression outside of this clinical scenario. OBSERVATION: A 43-year-old Caucasian male with a significant history for Crohn's disease presented with the sudden appearance of multiple asymptomatic growths now present for several weeks...
January 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29296854/cyclosporine-or-steroids-as-an-adjunct-to-plasma-exchange-in-the-treatment-of-immune-mediated-thrombotic-thrombocytopenic-purpura
#19
Spero R Cataland, Peter J Kourlas, Shangbin Yang, Susan Geyer, Leslie Witkoff, Haiwa Wu, Camila Masias, James N George, Haifeng M Wu
Although steroids are routinely used as an adjunct to plasma exchange (PEX) therapy in the treatment of immune-mediated thrombotic thrombocytopenic purpura (iTTP), limited data regarding their efficacy or effect on ADAMTS13 biomarkers are available. We report the results of a prospective, randomized study that compared the effectiveness of prednisone or cyclosporine (CSA) as adjuncts to PEX in the treatment of iTTP. A total of 26 of the planned 72 subjects were enrolled and treated from November 2007 until February 2014 before the study was halted after a planned interim analysis...
October 24, 2017: Blood Advances
https://www.readbyqxmd.com/read/29285775/systemic-immune-inflammation-index-predicts-the-combined-clinical-outcome-after-sequential-therapy-with-abiraterone-and-docetaxel-for-metastatic-castration-resistant-prostate-cancer-patients
#20
Liancheng Fan, Rui Wang, Chenfei Chi, Wen Cai, Yong Zhang, Hongyang Qian, Xiaoguang Shao, Yanqing Wang, Fan Xu, Jiahua Pan, Yinjie Zhu, Xun Shangguan, Lixin Zhou, Baijun Dong, Wei Xue
OBJECTIVE: To compare the antitumor effect of abiraterone (AA) followed by docetaxel-prednisone (DP) or vice versa in metastatic castration-resistant prostate cancer (mCRPC) patients, and explored factors that might predict combined PSA-PFS, combined rPFS and OS. PATIENTS AND METHODS: We retrospectively analyzed mCRPC patients treated with sequential therapy using DP followed by AA or vice versa. Patients who had received enzalutamide or cabazitaxel were excluded...
March 2018: Prostate
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