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https://www.readbyqxmd.com/read/28644343/second-line-agents-in-pediatric-patients-with-autoimmune-hepatitis-a-systematic-review-and-meta-analysis
#1
Andréanne N Zizzo, Pamela L Valentino, Prakesh S Shah, Binita M Kamath
BACKGROUND AND AIMS: Ten percent to 20% of children with autoimmune hepatitis (AIH) require second-line therapy to achieve remission. Although current guidelines exist on first-line management, evidence for second-line therapy in treatment-refractory patients is lacking. Our aim was to perform a systematic review and meta-analysis of the efficacy and safety of second-line treatments used in this population. METHODS: Electronic and manual searches were used to identify potential studies for inclusion...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28644183/more-dose-dependent-side-effects-with-mercaptopurine-over-azathioprine-in-ibd-treatment-due-to-relatively-higher-dosing
#2
Mark M T J Broekman, Marieke J H Coenen, Corine J van Marrewijk, Geert J A Wanten, Dennis R Wong, Andre L M Verbeek, Olaf H Klungel, Piet M Hooymans, Henk-Jan Guchelaar, Hans Scheffer, Luc J J Derijks, Dirk J de Jong
BACKGROUND: There are substantial global differences in the preference for mercaptopurine (MP) or its prodrug azathioprine (AZA) as first-choice thiopurine to treat inflammatory bowel diseases. Studies comparing both agents are scarce. Our aim was to compare AZA and MP in thiopurine-naive patients with inflammatory bowel disease for the frequency of side effects and efficacy. METHODS: Post hoc analysis of the "Thiopurine response Optimization by Pharmacogenetic testing in Inflammatory bowel disease Clinics" (TOPIC) trial, in which thiopurine-naive patients with inflammatory bowel disease with an indication for a thiopurine were randomized for a genotype-based dose versus standard of care...
June 20, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28641774/membranous-nephropathy-with-neuromyelitis-optica-spectrum-disorder
#3
Xiangling Li, YanQiang Wang
Membranous nephropathy (MN) accompanying Neuromyelitis optica spectrum disorders (NMOSD) has rarely been described previously. We recently presented a 45-year-old Chinese male presenting with recurrent lower extremity pitting edema, or eyelid edema, proteinuria and hyperlipidemia. especially intractable hiccup and vomiting, painful tonic spasm (PTS) as the revealing symptom of a demyelinating disorder of central nervous system. The kindey biopsy specimen showed MN stage 2. Serological testing revealed antibodies AQP4, MRI head and spine revealed medulla oblongata and C1-C2 cervical vertebra lesions...
July 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28639592/current-status-of-lupus-nephritis
#4
REVIEW
Ajay Jaryal, Sanjay Vikrant
Systemic lupus erythematosus (SLE) is a systemic disease of unknown aetiology with variable course and prognosis. Lupus nephritis (LN) is one of the important disease manifestations of SLE with considerable influence on patient outcomes. Immunosuppression therapy has made it possible to control the disease with improved life expectancy and quality of life. In the last few decades, various studies across the globe have clarified the role, dose and duration of immunosuppression currently in use and also provided evidence for new agents such as mycophenolate mofetil, calcineurin inhibitors and rituximab...
February 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28638678/detailed-features-of-hematological-involvement-and-medication-induced-cytopenia-in-systemic-lupus-erythematosus-patients-single-center-results-of-221-patients
#5
Hava Üsküdar Teke, Döndü Üsküdar Cansu, Cengiz Korkmaz
OBJECTIVE: Systemic lupus erythematosus (SLE) may affect a number of systems, with the hematological system being one of the most common. Our aim is to determine the existence of cytopenia at diagnosis or during follow-up of our SLE patients as well as the associated factors. MATERIAL AND METHODS: A cohort of SLE patients that had been followed-up in the Department of Rheumotology from 1998 to 2015 was retrospectively assessed. Clinical and laboratory findings about the patients were recorded...
June 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28631133/bone-density-in-pediatric-crohn-s-disease-a-cross-sectional-observation-from-south-india
#6
Shiraz Salim Khan, Sagar S Patil
BACKGROUND: Crohn's disease (CD) frequently manifests in the second and third decades of life. Malnutrition and corticosteroid therapy may affect bone mineralization and delay bone growth. Our aim was to study bone mineral density and factors associated low bone mineral density (BMD) in pediatric CD. METHODS: A cross-sectional observational study in children with CD (aged 5 to <18 years) was done. Demographic and treatment details were noted. Vitamin D levels <20 ng/mL were considered as deficiency...
June 20, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28630623/strategies-for-preventing-endoscopic-recurrence-of-crohn-s-disease-1-year-after-surgery-a-network-meta-analysis
#7
REVIEW
Jin-Shan Feng, Jin-Yu Li, Xiu-Yan Chen, Zheng Yang, Shang-Hai Li
OBJECTIVE: To assess the benefits of different treatments that aim to prevent the endoscopic recurrence of Crohn's disease (CD) after ileal resection. METHODS: Randomized controlled trials (RCTs) were searched from MEDLINE, Embase, and the Cochrane Central Database. All the included RCTs with an endoscopic recurrence outcome which was defined as Rutgeerts' score ≥ i2 have a duration of more than 1 year. The quality of the included RCTs was assessed by the Cochrane Risk of Bias Tool...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28630341/pig-model-mimicking-chronic-hepatitis-e-virus-infection-in-immunocompromised-patients-to-assess-immune-correlates-during-chronicity
#8
Dianjun Cao, Qian M Cao, Sakthivel Subramaniam, Danielle M Yugo, C Lynn Heffron, Adam J Rogers, Scott P Kenney, Debin Tian, Shannon R Matzinger, Christopher Overend, Nicholas Catanzaro, Tanya LeRoith, Heng Wang, Pablo Piñeyro, Nicole Lindstrom, Sherrie Clark-Deener, Lijuan Yuan, Xiang-Jin Meng
Chronic hepatitis E virus (HEV) infection is a significant clinical problem in immunocompromised individuals such as organ transplant recipients, although the mechanism remains unknown because of the lack of an animal model. We successfully developed a pig model of chronic HEV infection and examined immune correlates leading to chronicity. The conditions of immunocompromised patients were mimicked by treating pigs with an immunosuppressive regimen including cyclosporine, azathioprine, and prednisolone. Immunocompromised pigs infected with HEV progressed to chronicity, because 8/10 drug-treated HEV-infected pigs continued fecal virus shedding beyond the acute phase of infection, whereas the majority (7/10) of mock-treated HEV-infected pigs cleared fecal viral shedding at 8 wk postinfection...
June 19, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28626961/comparing-polyarteritis-nodosa-in-children-and-adults-a-single-center-study
#9
Abdulsamet Erden, Ezgi D Batu, Hafize E Sönmez, Alper Sarı, Berkan Armagan, Zehra S Arıcı, Emre Bilgin, Umut Kalyoncu, Ömer Karadağ, Yelda Bilginer, Ali Ihsan Ertenli, Seza Özen
OBJECTIVE: Polyarteritis nodosa (PAN) is a necrotizing vasculitis of medium/small arteries. We aimed to examine the characteristics of adult- and childhood-onset PAN. METHODS: Fifteen pediatric (˂ 18 years) and 22 adult PAN patients who fulfilled the Ankara 2008 and American College of Rheumatology 1990 criteria, respectively, were included in the study. RESULTS: Five children had cutaneous and all the rest of the patients had systemic PAN...
June 19, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28625907/long-standing-isolated-autoimmune-hypothalamitis-diagnosed-with-endoscopic-transventricular-biopsy-a-case-report
#10
Lorenzo Bertulli, Giulio Andrea Bertani, Umberto Gianelli, Giovanna Mantovani, Paolo Maria Rampini, Marco Locatelli
BACKGROUND: Autoimmune hypothalamitis, which is among the causes of acquired central diabetes insipidus, has been described very rarely in the literature. This condition is probably provoked by the production of anti-vasopressin secreting cells antibodies and anti-hypothalamus antibodies, and is often associated with pituitary or polyendocrine autoimmunity. Correct diagnosis and immediate treatment are essential in order to avoid the progression of the pathological process. CASE DESCRIPTION: A woman diagnosed with central diabetes insipidus 12 year ago, suffering from panhypopituitarism and mild memory deficit came to our attention...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28625079/retrospective-analysis-of-nephritis-response-and-renal-outcome-in-a-cohort-of-928-egyptian-lupus-nephritis-patients-a-university-hospital-experience
#11
M Momtaz, A Fayed, M Wadie, S M Gamal, S A Ghoniem, N Sobhy, N M Kamal Elden, W M Hamza
Aim We aim to describe the pattern of response to treatment in a cohort of Egyptian lupus nephritis (LN) patients and to define variable prognostic factors. Methods We retrospectively analyzed records of 928 systemic lupus erythematosus (SLE) patients (898 females, 30 males) with biopsy-confirmed LN seen between 2006 and 2012 at Cairo University hospitals. Results Our study involved 928 SLE patients with a mean age of 26.25 ± 6.487 years, mean LN duration at time of renal biopsy 6.48 ± 4.27 months, mean SLEDAI 28...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28622464/the-impact-of-drugs-on-male-fertility-a-review
#12
REVIEW
M Semet, M Paci, J Saïas-Magnan, C Metzler-Guillemain, R Boissier, H Lejeune, J Perrin
Beside cytotoxic drugs, other drugs can impact men's fertility through various mechanisms. Via the modification of the hypothalamic-pituitary-gonadal axis hormones or by non-hormonal mechanisms, drugs may directly and indirectly induce sexual dysfunction and spermatogenesis impairment and alteration of epididymal maturation. This systematic literature review summarizes existing data about the negative impact and associations of pharmacological treatments on male fertility (excluding cytotoxic drugs), with a view to making these data more readily available for medical staff...
June 16, 2017: Andrology
https://www.readbyqxmd.com/read/28619978/rheumatoid-arthritis-causing-diffuse-alveolar-haemorrhage-a-novel-therapeutic-approach
#13
Afaf Osman, Panagis Galiatsatos, Sonali Bose, Sonye Danoff
Pulmonary vascular involvement due to rheumatoid arthritis, presenting as diffuse alveolar haemorrhage (DAH), is a rare phenomenon, especially if there are no signs of systemic vasculitides. Furthermore, how to proceed with the management of these patients is challenging, as in the case of our patient, who had recurrent DAH. We present a case of a patient with known rheumatoid arthritis who had recurrence of DAH that spanned over several years, often presenting with life-threatening respiratory failure. While her DAH presentation improved with high-dose glucocorticoids, to resolve her recurrence, we opted to initiate treatment with rituximab, with a short course of azathioprine...
June 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28617756/optimizing-thiopurine-therapy-in-inflammatory-bowel-disease-among-2-real-life-intercept-cohorts-effect-of-allopurinol-comedication
#14
Berrie Meijer, Margien L Seinen, Remco van Egmond, Gerd Bouma, Chris J J Mulder, Adriaan A van Bodegraven, Nanne K H de Boer
BACKGROUND: Thiopurines (azathioprine and mercaptopurine) are frequently used immunosuppressive drugs to maintain remission in patients with inflammatory bowel disease. Half of the conventional thiopurine-derivative users have to discontinue treatment within 5 years, mainly because of intolerable adverse events. Over recent years, different strategies to optimize thiopurine treatment were suggested, yet, studies describing the clinical effectiveness of these strategies remain scarce. The aims of this study were to compare tolerability and sustained clinical benefit of conventional thiopurine derivatives therapy among two 5-year real-life intercept cohorts and to assess the clinical value of specifically allopurinol cotherapy...
June 14, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28614220/rituximab-was-used-to-treat-recurrent-igg4-related-hypophysitis-with-ophthalmopathy-as-the-initial-presentation-a-case-report-and-literature-review
#15
Wei-Jun Gu, Qian Zhang, Jian Zhu, Jie Li, Shi-Hui Wei, Yi-Ming Mu
RATIONALE: Immunoglobulin G4 (IgG4)-related hypophysitis is a type of IgG4-related disease (IgG4-RD), which is characterized by plasma cells infiltration in the pituitary causing functional changes and (or) space-occupying effect in the pituitary. IgG4-related hypophysitis is sensitive to hormone therapy in most patients, but recurrence is very likely. PATIENT CONCERNS: Here, we report a 57-year-old male patient with bilateral eye redness as the initial presentation...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28611998/recurrent-paronychia-as-a-presenting-manifestation-of-pemphigus-vulgaris-a-case-report
#16
Vijay Zawar, Manoj Pawar, Shrikant Kumavat
Nail involvement in pemphigus vulgaris (PV) is an unusual clinical finding. The most common clinical manifestations include chronic paronychia and onychomadesis. We report an adult female patient with PV who initially presented with chronic paronychia of multiple fingernails and toenails before the onset of vesiculobullous eruptions. Later on, after complete resolution, there was recurrence of pemphigus presenting as hemorrhagic paronychia of the left index finger. Systemic treatment with corticosteroids and azathioprine led to complete resolution of mucocutaneous lesions as well as nail manifestations...
March 2017: Skin Appendage Disorders
https://www.readbyqxmd.com/read/28611966/periprostetic-joint-infection-caused-by-salmonella-case-reports-of-two-azathioprine-and-prednisolone-induced-immunocompromised-patients
#17
Mehmet Ekinci, Serkan Bayram, Turgut Akgül, Mehmet Ersin, Önder Yazicioğlu
Periprosthetic joint infection (PJI) due to Salmonella is rare. It frequently occurs patients receiving immunosuppressive medicine. We describe two periprosthetic Salmonella infection of two immunocompromised patients. Both of patients were receiving azathioprine and prednisolone therapy. First patient presented six years after total hip arthroplasty with a huge abscess on her right thigh that was reached to femoral component through the lytic area of lateral femur. Second patient presented with drainage from his hip and he had undergone two-step revision surgery for PJI 3 months ago...
June 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28611161/follicular-dendritic-sarcoma-masquerading-as-fibrosing-mediastinitis
#18
Shashank Reddy Cingam, Majd Al Shaarani, Amol Takalkar, Prakash Peddi
Fibrosing mediastinitis (FM) is a rare disorder resulting from abnormal immunological-mediated fibro-proliferative reaction in the mediastinum. Here, we describe a case of a 46-year-old female with an incidentally found 11×9 cm posterior mediastinal mass. Multiple biopsies of this unresectable, 18-fluorodeoxyglucose avid mass revealed marked fibrosis without any evidence of malignancy, suggesting idiopathic fibrosing mediastinitis as our initial diagnosis. Multiple interventions including a trial of steroids, fluconazole, and azathioprine to target fibrosing mediastinitis were not successful...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28609764/hemodialysis-and-kidney-transplantation-as-predisposing-conditions-to-onychomycosis
#19
Antonio M S Filho, Carlucci G Ventura, Paulo R Criado, Gilda B Del Negro, Roseli S Freitas, Olinda C Luiz, Mauro C Giudice, Elias D Neto, Gil Benard
BACKGROUND/AIM: Onychomycosis (OM) is one of the commonest superficial fungal infections. Patients undergoing hemodialysis (HD) treatment and kidney transplant recipients (KTR) are considered at risk of contracting fungal infections, but the few published data do not reach the conclusion of whether they are predisposed to OM. This study aimed to determine the prevalence and etiology of OM in these patients and to determine the antifungal susceptibility profile of the isolated fungal species...
June 14, 2017: Nephron
https://www.readbyqxmd.com/read/28608315/effectiveness-of-low-dose-of-rituximab-compared-with-azathioprine-in-chinese-patients-with-neuromyelitis-optica-an-over-2-year-follow-up-study
#20
Meini Zhang, Chuntao Zhang, Peng Bai, Huiru Xue, Guilian Wang
Neuromyelitis optical (NMO) and neuromyelitis optical spectrum disorder (NMOSD) are inflammatory autoimmune demyelination diseases affecting the central nervous system. We investigated the efficiency of low-dose rituximab treatment in 31 Chinese patients with NMO/NMOSD across a median period of 2.29 ± 0.97 years and azathioprine combined with corticosteroid treatment in 34 Chinese patients with NMO/NMOSD across a median period of 2.61 ± 0.94 years. Among the rituximab-treated patients, the mean Expanded Disability Status Scale (EDSS) was 5...
June 12, 2017: Acta Neurologica Belgica
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