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  1 / 11895 MEDLINE  
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[PMID]:29523340
[Au] Autor:Rodríguez Prida J; Trapiella Martínez L; Astudillo González A
[Ad] Dirección:Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario de Cabueñes, Gijón, Asturias, España. Electronic address: xurdeprida@gmail.com.
[Ti] Título:Giant cell myositis associated with myasthenia gravis and thymoma.
[Ti] Título:Miositis de células gigantes asociada a miastenia gravis y timoma..
[So] Fuente:Med Clin (Barc);, 2018 Mar 06.
[Is] ISSN:1578-8989
[Cp] País de publicación:Spain
[La] Idioma:eng; spa
[Pt] Tipo de publicación:LETTER
[Em] Mes de ingreso:1803
[Cu] Fecha actualización por clase:180310
[Lr] Fecha última revisión:180310
[St] Status:Publisher


  2 / 11895 MEDLINE  
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[PMID]:29289272
[Au] Autor:Shuker O; Khamaisi M
[Ad] Dirección:Internal Medicine Department, Institute of Endocrinology, Diabetes & Metabolism, Rambam Health Care Campus, Haifa, Israel; Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
[Ti] Título:When Patient/Family Expectations and Hospital Protocol Conflict.
[So] Fuente:Am J Med Sci;355(1):99-100, 2018 Jan.
[Is] ISSN:1538-2990
[Cp] País de publicación:United States
[La] Idioma:eng
[Mh] Términos MeSH primario: Conflicto (Psicología)
Familia/psicología
Transferencia de Pacientes
Polimiositis
[Mh] Términos MeSH secundario: Femenino
Seres Humanos
Masculino
Mediana Edad
Polimiositis/psicología
Polimiositis/terapia
[Pt] Tipo de publicación:CASE REPORTS; EDITORIAL
[Em] Mes de ingreso:1803
[Cu] Fecha actualización por clase:180301
[Lr] Fecha última revisión:180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:180101
[St] Status:MEDLINE


  3 / 11895 MEDLINE  
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[PMID]:29289262
[Au] Autor:Chen F; Li S; Wang T; Shi J; Wang G
[Ad] Dirección:Department of Rheumatology, China-Japan Friendship Hospital, Yinghua East Road, Chaoyang District, Beijing, China.
[Ti] Título:Clinical Heterogeneity of Interstitial Lung Disease in Polymyositis and Dermatomyositis Patients With or Without Specific Autoantibodies.
[So] Fuente:Am J Med Sci;355(1):48-53, 2018 01.
[Is] ISSN:1538-2990
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: The aim of this study was to compare the heterogeneity of interstitial lung disease (ILD) in patients with polymyositis and dermatomyositis (PM/DM) according to serological type. METHODS: A total of 182 patients with PM/DM-ILD were observed retrospectively. Antiaminoacyl-tRNA synthetase (ARS) and antimelanoma differentiation-associated gene5 (MDA5) antibodies were screened using immunoblotting approach. The patients with ILD were divided into 3 groups: MDA5 (with anti-MDA5 antibody), ARS (with anti-ARS antibody) and MSN (without anti-MDA5 or anti-ARS antibody) group. Pulmonary features, treatment responses and prognoses were compared among the groups. RESULTS: A higher percentage of rapidly progressive ILD (RP-ILD) occurrences (55.8% versus 25% versus 16.9%, P < 0.001) was observed in the MDA5 group compared to ARS and MSN groups. The MSN group experienced lower dyspnea (48.2% versus 79% versus 71.4%, P = 0.001) and fever (18.1% versus 39.5% versus 37.5%, P = 0.01) frequencies compared to MDA5 and ARS groups. Response to 6-month treatment among 95 patients showed highest deterioration ratio (70%, P = 0.001) of ILD in the MDA5 group. Additionally, the highest frequency of ILD improvement (60%, P = 0.04) was observed in the ARS group. During the observation period, 24 patients died of respiratory failure. The 5-year survival rates were significantly lower in MDA5 group (50.2%) compared to ARS group (97.7%) or the MSN group (91.4%) (P < 0.001). CONCLUSIONS: MDA5-ILD was associated with severe pulmonary manifestations, poor response to treatment and aggravated prognosis. The ARS-ILD group had favorable treatment response and prognosis. MSN-ILD patients had relatively worse treatment response and prognosis compared to the ARS group, even though they expressed milder pulmonary manifestation.
[Mh] Términos MeSH primario: Autoanticuerpos/sangre
Dermatomiositis/sangre
Enfermedades Pulmonares Intersticiales/sangre
Polimiositis/sangre
[Mh] Términos MeSH secundario: Adulto
Anciano
China/epidemiología
Dermatomiositis/diagnóstico
Dermatomiositis/mortalidad
Femenino
Seres Humanos
Enfermedades Pulmonares Intersticiales/diagnóstico
Enfermedades Pulmonares Intersticiales/epidemiología
Masculino
Mediana Edad
Polimiositis/diagnóstico
Polimiositis/mortalidad
Estudios Retrospectivos
Tasa de Supervivencia/tendencias
[Pt] Tipo de publicación:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nombre de substancia:
0 (Autoantibodies)
[Em] Mes de ingreso:1803
[Cu] Fecha actualización por clase:180301
[Lr] Fecha última revisión:180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:180101
[St] Status:MEDLINE


  4 / 11895 MEDLINE  
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[PMID]:29185960
[Au] Autor:Barsotti S; Bruni C; Cometi L; Valentini V; Cioffi E; Neri R; Cavagna L
[Ad] Dirección:Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa; and Department of Medical Biotechnologies, University of Siena, Italy.
[Ti] Título:One year in review 2017: idiopathic inflammatory myopathies.
[So] Fuente:Clin Exp Rheumatol;35(6):875-884, 2017 Nov-Dec.
[Is] ISSN:0392-856X
[Cp] País de publicación:Italy
[La] Idioma:eng
[Ab] Resumen:Every year new concepts about pathogenesis, serology, diagnosis and treatment in inflammatory myopathies (IIMs) have been provided. The purpose of this manuscript is to summarise the most relevant literature contributions published over the last year about these complex and rare diseases.
[Mh] Términos MeSH primario: Miositis/terapia
[Mh] Términos MeSH secundario: Ensayos Clínicos como Asunto
Seres Humanos
Miositis/complicaciones
Miositis/diagnóstico
Miositis/etiología
[Pt] Tipo de publicación:JOURNAL ARTICLE; REVIEW
[Em] Mes de ingreso:1803
[Cu] Fecha actualización por clase:180301
[Lr] Fecha última revisión:180301
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:171130
[St] Status:MEDLINE


  5 / 11895 MEDLINE  
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[PMID]:29390370
[Au] Autor:Chen JH; Lee KY; Hu CJ; Chung CC
[Ad] Dirección:Department of Neurology.
[Ti] Título:Coexisting myasthenia gravis, myositis, and polyneuropathy induced by ipilimumab and nivolumab in a patient with non-small-cell lung cancer: A case report and literature review.
[So] Fuente:Medicine (Baltimore);96(50):e9262, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:RATIONALE: Immune checkpoint inhibitors have led to the development of new approaches for cancer treatment with positive outcomes. However, checkpoint blockade is associated with a unique spectrum of immune-related adverse events (irAEs), which may cause irreversible neurological deficits and even death. PATIENT CONCERNS: We presented a case of a 57-year-old man with non-small-cell lung cancer.who developed ptosis, dyspnea, and muscle weakness as initial symptoms with progression after the treatment with ipilimumab and nivolumab. DIAGNOSES: Myasthenia gravis was confirmed by serum acetylcholine receptor antibody and single fiber electromyography. Myositis was identified by high level of serum creatine phosphokinase and electromyography. Polyneuropathy was identified by nerve conduction study. INTERVENTIONS: The patient underwent treatment with steroid and pyridostigmine. Respiratory rehabilitation was also performed. OUTCOMES: Dyspnea and muscle weakness improved gradually. Ipilimumab and nivolumab were permanently discontinued. LESSONS: This case has increased the clinical awareness by indicating that the checkpoint inhibitors-related neurological irAEs could be complicated and simultaneously involve multiple neurological systems. Early recognition and complete evaluation are critical in clinical practice.
[Mh] Términos MeSH primario: Anticuerpos Monoclonales/efectos adversos
Antineoplásicos Inmunológicos/efectos adversos
Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico
Ipilimumab/efectos adversos
Neoplasias Pulmonares/tratamiento farmacológico
Miastenia Gravis/inducido químicamente
Miositis/inducido químicamente
Polineuropatías/inducido químicamente
[Mh] Términos MeSH secundario: Seres Humanos
Masculino
Mediana Edad
[Pt] Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nombre de substancia:
0 (Antibodies, Monoclonal); 0 (Antineoplastic Agents, Immunological); 0 (Ipilimumab); 31YO63LBSN (nivolumab)
[Em] Mes de ingreso:1802
[Cu] Fecha actualización por clase:180301
[Lr] Fecha última revisión:180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009262


  6 / 11895 MEDLINE  
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[PMID]:29367529
[Au] Autor:Tamura M; Kitano M; Azuma K; Tsuboi K; Abe T; Ogita C; Yokoyama Y; Furukawa T; Yoshikawa T; Saito A; Nishioka A; Sekiguchi M; Azuma N; Tsunoda S; Hosono Y; Nakashima R; Ohmura K; Matsui K; Mimori T; Sano H
[Ad] Dirección:Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine.
[Ti] Título:[A case of anti-PL-7 antibody positive polymyositis with thrombotic microangiopathy].
[So] Fuente:Nihon Rinsho Meneki Gakkai Kaishi;40(6):450-455, 2017.
[Is] ISSN:1349-7413
[Cp] País de publicación:Japan
[La] Idioma:jpn
[Ab] Resumen:  A 65-year-old woman with a 17-year history of polymyositis and 8-year history of rheumatoid arthritis who was treated with a low dose of prednisolone and tacrolimus (Tac) was admitted to our hospital because of general malaise and hypertension. Blood tests showed thrombocytopenia, hemolytic anemia with fragmented erythrocytes, and hypercreatinemia. Based on these clinical features, she was diagnosed with thrombotic micro-angiopathy (TMA). Thrombocytopenia and hemolytic anemia with fragmented erythrocytes improved with the discontinuation of Tac and plasma exchange; however, hypertension and renal dysfunction persisted. TMA due to calcineurin inhibitor (CNI) nephropathy was suspected based on the histopathological findings of renal biopsy. However, the condition was atypical of a CNI nephropathy because the trough level of Tac was lower than that reported previously and renal dysfunction persisted after drug discontinuation. She had mild sclerodactylia and Raynaud's symptoms, although the diagnostic criteria for systemic sclerosis (SSc) were not satisfied. Moreover, the patient tested positive for anti PL-7 antibody. The relationship between anti PL-7 antibody and pathogenesis of SSc has been reported. In this case, it was suspected that CNI nephropathy worsened because of the potential basic factors of SSc. These findings indicate that TMA may occur in patients testing positive for anti PL-7 antibody who are treated with Tac.
[Mh] Términos MeSH primario: Aminoacil-ARNt Sintetasas/inmunología
Autoanticuerpos/sangre
Polimiositis/complicaciones
Microangiopatías Trombóticas/etiología
[Mh] Términos MeSH secundario: Anciano
Artritis Reumatoide/complicaciones
Artritis Reumatoide/terapia
Biomarcadores/sangre
Inhibidores de la Calcineurina/administración & dosificación
Inhibidores de la Calcineurina/efectos adversos
Femenino
Seres Humanos
Intercambio Plasmático
Polimiositis/diagnóstico
Polimiositis/terapia
Tacrolimus/administración & dosificación
Tacrolimus/efectos adversos
Microangiopatías Trombóticas/diagnóstico
Privación de Tratamiento
[Pt] Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nombre de substancia:
0 (Autoantibodies); 0 (Biomarkers); 0 (Calcineurin Inhibitors); EC 6.1.1.- (Amino Acyl-tRNA Synthetases); WM0HAQ4WNM (Tacrolimus)
[Em] Mes de ingreso:1802
[Cu] Fecha actualización por clase:180227
[Lr] Fecha última revisión:180227
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:180126
[St] Status:MEDLINE
[do] DOI:10.2177/jsci.40.450


  7 / 11895 MEDLINE  
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[PMID]:28461123
[Au] Autor:Tanizawa K; Handa T; Nakashima R; Kubo T; Hosono Y; Watanabe K; Aihara K; Ikezoe K; Sokai A; Nakatsuka Y; Taguchi Y; Hatta K; Noma S; Kobashi Y; Yoshizawa A; Oga T; Hirai T; Chin K; Nagai S; Izumi T; Mimori T; Mishima M
[Ad] Dirección:Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
[Ti] Título:The long-term outcome of interstitial lung disease with anti-aminoacyl-tRNA synthetase antibodies.
[So] Fuente:Respir Med;127:57-64, 2017 Jun.
[Is] ISSN:1532-3064
[Cp] País de publicación:England
[La] Idioma:eng
[Ab] Resumen:RATIONALE: Anti-aminoacyl transfer RNA synthetase antibodies (anti-ARS) are a group of myositis-specific autoantibodies that are detected in the sera of patients with polymyositis and dermatomyositis (PM/DM) and also in those of patients with idiopathic interstitial pneumonias without any connective tissue disease (CTD), including PM/DM. Although we reported the clinical characteristics of interstitial lung disease with anti-ARS antibodies (ARS-ILD) with and without PM/DM, the long-term prognosis of ARS-ILD remains undetermined. As our previous studies revealed that ARS-ILD without PM/DM was similar to CTD-associated ILD, and that ARS-ILD with PM/DM was radiologically suggestive of a nonspecific interstitial pneumonia (NSIP) pathological pattern, we hypothesized that the prognosis of ARS-ILD might be distinct from that of idiopathic pulmonary fibrosis (IPF) without anti-ARS. OBJECTIVES: To elucidate the long-term outcome of ARS-ILD with and without PM/DM and compare it to that of IPF. METHODS: A two-center retrospective study was conducted. The study population comprised 36 patients with ARS-ILD (8 with PM, 12 with DM, and 16 without myositis throughout the course), 100 patients with IPF without anti-ARS, and 7 patients with NSIP without anti-ARS. The presence of anti-ARS was determined by RNA immunoprecipitation using the sera obtained at the time of diagnosis before specific treatment. MEASUREMENTS AND MAIN RESULTS: During the observational period (median 49 months; range, 1-114 months), 7 patients with ARS-ILD (19%; 3 with PM, 1 with DM, and 3 without PM/DM) and 51 patients with IPF (51%) died. Patients with ARS-ILD had better overall survival than those with IPF (log-rank test, P < 0.001) and similar survival compared to those with NSIP (log-rank test, P = 0.59). The prognosis for patients with ARS-ILD was similar between those with and without myositis (log-rank test, P = 0.91). At the median follow-up time of 76.5 months, 14 of the 36 patients with ARS-ILD had deteriorated. Both a decline in forced vital capacity or an initiation of long-term oxygen therapy during the course (odds ratio [OR], 5.34) and acute exacerbation (OR, 28.4) significantly increased the mortality risk. CONCLUSIONS: The long-term outcome of ARS-ILD was significantly better than that of IPF regardless of the presence or absence of myositis.
[Mh] Términos MeSH primario: Aminoacil-ARNt Sintetasas/inmunología
Autoanticuerpos/sangre
Dermatomiositis/complicaciones
Fibrosis Pulmonar Idiopática/inmunología
Enfermedades Pulmonares Intersticiales/inmunología
Miositis/inmunología
[Mh] Términos MeSH secundario: Adulto
Anciano
Autoanticuerpos/inmunología
Enfermedades del Tejido Conjuntivo/complicaciones
Enfermedades del Tejido Conjuntivo/diagnóstico
Enfermedades del Tejido Conjuntivo/inmunología
Enfermedades del Tejido Conjuntivo/mortalidad
Dermatomiositis/inmunología
Dermatomiositis/mortalidad
Femenino
Seres Humanos
Oxigenación Hiperbárica/métodos
Fibrosis Pulmonar Idiopática/complicaciones
Fibrosis Pulmonar Idiopática/diagnóstico por imagen
Enfermedades Pulmonares Intersticiales/diagnóstico por imagen
Enfermedades Pulmonares Intersticiales/mortalidad
Masculino
Mediana Edad
Mortalidad
Miositis/mortalidad
Estudios Observacionales como Asunto
Evaluación de Resultado (Atención de Salud)
Pronóstico
ARN/inmunología
Estudios Retrospectivos
Análisis de Supervivencia
Capacidad Vital/fisiología
[Pt] Tipo de publicación:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nombre de substancia:
0 (Autoantibodies); 63231-63-0 (RNA); EC 6.1.1.- (Amino Acyl-tRNA Synthetases)
[Em] Mes de ingreso:1802
[Cu] Fecha actualización por clase:180226
[Lr] Fecha última revisión:180226
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:170503
[St] Status:MEDLINE


  8 / 11895 MEDLINE  
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[PMID]:29293605
[Au] Autor:Ha YJ; Hur J; Go DJ; Kang EH; Park JK; Lee EY; Shin K; Lee EB; Song YW; Lee YJ
[Ad] Dirección:Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
[Ti] Título:Baseline peripheral blood neutrophil-to-lymphocyte ratio could predict survival in patients with adult polymyositis and dermatomyositis: A retrospective observational study.
[So] Fuente:PLoS One;13(1):e0190411, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:Recent studies have suggested that neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein-to-albumin ratio (CAR) are emerging markers of disease activity and prognosis in patients with chronic inflammatory diseases, cardiovascular diseases, or malignancies. Therefore, we investigated the clinical significance and prognostic value of the NLR and CAR in adult patients with polymyositis and dermatomyositis. The medical records of 197 patients with newly diagnosed polymyositis/dermatomyositis between August 2003 and November 2016 were retrospectively reviewed. Survival and causes of death were recorded during an average 33-month observational period. Clinical and laboratory findings were compared between survivors and non-survivors. Using receiver operating characteristic curves, the NLR and CAR cut-off values for predicting survival were calculated. Univariate and multivariate analyses using Cox proportional hazard models were performed to identify factors associated with survival. Twenty-six patients (13.2%) died during the study period, and the 5-year survival-rate was estimated to be 82%. The non-survivor group exhibited older age and a higher prevalence of interstitial lung disease (ILD), acute interstitial pneumonia, and acute exacerbation of ILD compared to that in the survivor group. NLR and CAR values were significantly higher in the non-survivors and in patients with polymyositis/dermatomyositis-associated ILD, and the death rates increased across NLR and CAR quartiles. Furthermore, when stratified according to the NLR or CAR optimal cut-off values, patients with a high NLR (>4.775) or high CAR (>0.0735) had a significantly lower survival rate than patients with low NLR or CAR, respectively. In addition, old age (>50 years), the presence of acute interstitial pneumonia, hypoproteinemia (serum protein <5.5 g/dL), and high NLR (but not high CAR) were independent predictors for mortality. The results indicate that a high NLR is independently associated with worse overall survival. Thus, the baseline NLR level may be a simple, cost-effective prognostic marker in patients with polymyositis/dermatomyositis.
[Mh] Términos MeSH primario: Dermatomiositis/sangre
Linfocitos/patología
Neutrófilos/patología
Polimiositis/sangre
[Mh] Términos MeSH secundario: Adulto
Dermatomiositis/patología
Femenino
Seres Humanos
Masculino
Polimiositis/patología
Estudios Retrospectivos
Análisis de Supervivencia
[Pt] Tipo de publicación:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mes de ingreso:1802
[Cu] Fecha actualización por clase:180221
[Lr] Fecha última revisión:180221
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:180103
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190411


  9 / 11895 MEDLINE  
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[PMID]:29241348
[Au] Autor:Kim M; Sadoughi B
[Ad] Dirección:1 Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, New York, USA.
[Ti] Título:The Voice of Autoimmunity: Antisynthetase Syndrome Manifesting as Vocal Fold Bamboo Nodes.
[So] Fuente:Ann Otol Rhinol Laryngol;127(2):128-130, 2018 Feb.
[Is] ISSN:1943-572X
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:OBJECTIVES: To describe a case of vocal fold bamboo nodes leading to the diagnosis of antisynthetase syndrome, a rare autoimmune disorder. To highlight the link between these laryngeal lesions and autoimmunity. METHODS: A case of vocal fold bamboo nodes in a patient with long-standing interstitial lung disease is presented. The presence of these characteristic lesions prompted a rheumatologic workup that led to the diagnosis of a rare autoimmune disorder. RESULTS: The patient was ultimately diagnosed with antisynthetase syndrome, a rare condition characterized by inflammatory myositis and interstitial lung disease. She was treated with steroids and immunosuppressive agents with improvement in her symptoms and clinical findings. CONCLUSIONS: Vocal fold bamboo nodes are pathognomonic signs of autoimmunity. Management consists primarily of medical treatment of the underlying systemic disorder. Intralesional steroid injection or phonomicrosurgical excision may be considered for refractory cases.
[Mh] Términos MeSH primario: Enfermedades Autoinmunes/diagnóstico
Disfonía/diagnóstico
Enfermedades de la Laringe/diagnóstico
Enfermedades Pulmonares Intersticiales/diagnóstico
Enfermedad Mixta del Tejido Conjuntivo/diagnóstico
Miositis/diagnóstico
Nódulo Reumatoide/diagnóstico
Pliegues Vocales/patología
[Mh] Términos MeSH secundario: Enfermedades Autoinmunes/tratamiento farmacológico
Diagnóstico Diferencial
Disfonía/tratamiento farmacológico
Disfonía/patología
Femenino
Seres Humanos
Enfermedades de la Laringe/tratamiento farmacológico
Enfermedades de la Laringe/patología
Laringoscopía
Enfermedades Pulmonares Intersticiales/tratamiento farmacológico
Enfermedades Pulmonares Intersticiales/patología
Mediana Edad
Enfermedad Mixta del Tejido Conjuntivo/tratamiento farmacológico
Miositis/tratamiento farmacológico
Prednisona/uso terapéutico
Nódulo Reumatoide/tratamiento farmacológico
Nódulo Reumatoide/patología
Grabación en Video
[Pt] Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nombre de substancia:
VB0R961HZT (Prednisone)
[Em] Mes de ingreso:1801
[Cu] Fecha actualización por clase:180123
[Lr] Fecha última revisión:180123
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:171216
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417748331


  10 / 11895 MEDLINE  
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[PMID]:29310344
[Au] Autor:Anan R; Akiyama M; Kaneko Y; Kikuchi J; Suzuki K; Matsubara S; Takeuchi T
[Ad] Dirección:Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine.
[Ti] Título:Polymyositis with elevated serum IgG4 levels and abundant IgG4+ plasma cell infiltration: A case report and literature review.
[So] Fuente:Medicine (Baltimore);96(48):e8710, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:INTRODUCTION: Polymyositis (PM) is a type of autoimmune, inflammatory myopathy. IgG4-related disease (IgG4-RD) is a recently recognized disease entity characterized by elevated serum IgG4 levels and IgG4 plasma-cell infiltration of various organs. However, several reports have described cases of other diseases that present with those features, suggesting the importance of careful differential diagnosis. Herein, we report the first case of PM with elevated serum IgG4 levels and IgG4 plasma cells in the muscles, mimicking IgG4-RD.A 73-year-old woman visited our hospital because of proximal muscle weakness of both thighs. Her blood test showed high levels of serum creatinine kinase, aldolase, and IgG4. Magnetic resonance imaging of the thighs showed muscle edema. Needle electromyography showed findings typical of myositis. Histological analysis of her left quadriceps revealed infiltration of IgG4 plasma cells as well as CD8 T cells. Scattered necrotic and regenerating muscle fibers with no specific findings for IgG4-RD (storiform fibrosis and obliterative phlebitis) were typical for PM. We diagnosed her condition as PM and treated her with 40 mg/day of prednisolone that decreased levels of muscle enzymes and improved muscle weakness. CONCLUSION: Our case indicated that PM could present with high serum IgG4 levels and IgG4 plasma-cell infiltration, mimicking IgG4-RD. Although the mechanism of IgG4 elevation in such PM is unclear, our case highlights the necessity to recognize that high serum IgG4 levels and IgG4 plasma-cell infiltration in organs are not specific for IgG4-RD.
[Mh] Términos MeSH primario: Glucocorticoides/uso terapéutico
Inmunoglobulina G/sangre
Células Plasmáticas/patología
Polimiositis/diagnóstico
Polimiositis/tratamiento farmacológico
Prednisolona/uso terapéutico
[Mh] Términos MeSH secundario: Anciano
Biomarcadores/sangre
Diagnóstico Diferencial
Electromiografía
Femenino
Seres Humanos
Pierna
Imagen por Resonancia Magnética
[Pt] Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nombre de substancia:
0 (Biomarkers); 0 (Glucocorticoids); 0 (Immunoglobulin G); 9PHQ9Y1OLM (Prednisolone)
[Em] Mes de ingreso:1801
[Cu] Fecha actualización por clase:180115
[Lr] Fecha última revisión:180115
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008710



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