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[PMID]: 29359719
[Au] Autor:Munasipova SE; Zalyalova ZA
[Ad] Address:Kazan State Medical University, Kazan, Russia.
[Ti] Title:Kliniko-laboratornaia kharakteristika pediatricheskogo ostro voznikshego neiropsikhiatricheskogo sindroma. [Pediatric acute-onset neuropsychiatric syndrome: clinical/laboratory characteristics].
[So] Source:Zh Nevrol Psikhiatr Im S S Korsakova;117(11. Vyp. 2):47-53, 2017.
[Is] ISSN:1997-7298
[Cp] Country of publication:Russia (Federation)
[La] Language:rus
[Ab] Abstract:AIM: Based on the current conceptions on the genesis of hyperkinetic syndromes in children and adolescents, to single out a group of patients with suggestive PANS, compare clinical and laboratory results and determine clinical/laboratory characteristics of this syndrome. MATERIAL AND METHODS: Sixty-nine patients with tics were studied using neurological examination, questionnaires and international scales for assessment of tics, obsessive-compulsive disorders and attention deficit hyperactivity disorder (ADHD). Laboratory tests included general blood tests, antistreptolysin O test, determination of rheumatoid factor, C-reactive protein, circulating immune complexes, nasopharyngeal wash for ß-hemolytic streptococcus, antineuronal antibodies and immunoglobulins A, M, G, E, CD4, CD8-lymphocytes. The same tests were performed in the control group. RESULTS AND CONCLUSION: Clinical symptoms were different by the severity and phenomenology of tic hyperkineses in patients with PANS compared to the patients with tics without immune disorders. Most of the patients were diagnosed with Tourette syndrome. ADHD was the most common diagnosis in the PANS group. Its frequency was 2.5 higher in the male patients. A chronic focus of infection did no predict the development of PANS. Based on the laboratory results, one can assume that ß-hemolytic streptococcus A infection, lower JgM levels and an elevated CD8+ lymphocytes predict the development of autoimmune mental and neurological disorders in the group of PANS patients.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180123
[Lr] Last revision date:180123
[St] Status:In-Data-Review
[do] DOI:10.17116/jnevro201711711247-53

  2 / 1358 MEDLINE  
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[PMID]: 29271002
[Au] Autor:Salam A; Papalexopoulou N; White JM; Martin B; Coakley G; McGibbon DH
[Ad] Address:St John's Institute of Dermatology, Guys and St Thomas' NHS Foundation Trust, London, UK.
[Ti] Title:Neutrophilic urticarial dermatosis: a novel association with poststreptococcal rheumatic disease.
[So] Source:Clin Exp Dermatol;, 2017 Dec 22.
[Is] ISSN:1365-2230
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Neutrophilic urticarial dermatosis (NUD), a particular clinical and histological entity, can provide a strong pointer to underlying systemic disease, most frequently rheumatological diseases. We report the first case of NUD in association with a post-streptococcal rheumatic disease, with symptoms including recurrent sore throat, raised antistreptolysin O titre, persistent transient urticaria, polyarthralgia, rheumatic mitral valve disease and Jaccoud arthropathy. Histologically, NUD is characterized by an intense superficial and deep neutrophilic interstitial and perivascular infiltrate, without significant oedema or blood vessel damage. These neutrophils may have a tendency to concentrate along the basement membrane and extend into the epidermis, hair follicles, sebaceous glands and sweat glands (a feature termed 'neutrophilic epitheliotropism'). Clinicians should remain cognizant of NUD, and in particular its frequent association with an underlying inflammatory disorder.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171222
[Lr] Last revision date:171222
[St] Status:Publisher
[do] DOI:10.1111/ced.13344

  3 / 1358 MEDLINE  
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[PMID]: 29067978
[Au] Autor:Sarkar S; Rastogi M; Chaudhary P; Kumar R; Arora P; Sagar V; Sahni IS; Shethi S; Thakur K; Ailawadhi S; Toor D; Chakraborti A
[Ad] Address:Department of Experimental Medicine & Biotechnology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
[Ti] Title:Association of rheumatic fever & rheumatic heart disease with plausible early & late-stage disease markers.
[So] Source:Indian J Med Res;145(6):758-766, 2017 Jun.
[Is] ISSN:0971-5916
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:BACKGROUND & OBJECTIVES: Rheumatic fever (RF) and rheumatic heart disease (RHD) are the autoimmune sequelae caused by Group A Streptococcus. RHD still remains a major concern in the developing countries due to its poor diagnosis, lack of vaccines and social awareness among population. This study was aimed to identify the plausible early- and late-stage disease markers associated with RF/RHD. METHODS: A total of 84 patients with confirmed pharyngitis (n=18), RF (n=23) and RHD (n=43) were included in the comparative analysis of different factors involved in host-pathogen interaction during RF/RHD pathogenesis. RESULTS: This study revealed high titre of serum antistreptolysin O (ASO) antibody in pharyngitis compared to RF and RHD patients, whereas procollagen type 1 C-peptide (PICP) level was elevated in RHD which showed an inverse correlation with serum ASO titre. The significant elevation of serum anti-peptide associated with RF (PARF) antibody in RF patients was correlated as a probable stage-specific determinant. In addition, pro-inflammatory cytokine profile revealed high levels of interleukin-12 (IL-12)/IL-23p40, IL-17A in RF, whereas IL-6 concentration was higher in RHD compared to healthy controls. INTERPRETATION & CONCLUSIONS: The overall assessment of the factors/ disease markers involved in host-pathogen interaction in RF/RHD may be suggestive of plausible disease marker in different groups of patients. Further studies with larger sample need to be done to better understand RF/RHD pathogenesis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171119
[Lr] Last revision date:171119
[St] Status:In-Process
[do] DOI:10.4103/ijmr.IJMR_1554_14

  4 / 1358 MEDLINE  
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[PMID]: 29036258
[Au] Autor:Totoraitis K; Magro CM; Friedman A
[Ti] Title:Serpiginous Purpuric Eruption of the Leg.
[So] Source:J Drugs Dermatol;16(10):1036-1038, 2017 Oct 01.
[Is] ISSN:1545-9616
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:A previously healthy 68-year-old male presented with a rash on his right lower leg. The lesions had spread along the leg since onset 9 days prior, and the patient reported localized soreness and pruritus. He denied systemic symptoms including fever, fatigue, myalgia, joint pain, and recent illness. Physical examination revealed a serpiginous, purpuric eruption on the anterior and posterior right thigh and lower leg. A 4mm punch biopsy from the right lower leg revealed a Th2 dominant process reflective of a type IV delayed hypersensitivity reaction. Superficial and deep angiocentric and eccrinotropic lymphocytic infiltrate and tissue eosinophilia were noted. Degranulated eosinophils forming 'flame figures' were also identified with accompanying mural edema and red blood cell extravasation. Further evaluation revealed an elevated antistreptolysin O antibody, though the remainder of the work up was unremarkable. Clinicohistopathologic correlation supported the diagnosis of Blaschkolinear purpuric Wells' Syndrome. This case highlights a unique presentation of a rare inflammatory dermatosis, and serves as a reminder that given Wells' can be associated with underlying malignancy, an age appropriate work up, based on patient history and presentation, may be warranted.

J Drugs Dermatol. 2017;16(10):1036-1038.

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[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171016
[Lr] Last revision date:171016
[St] Status:In-Process

  5 / 1358 MEDLINE  
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[PMID]: 28892995
[Au] Autor:Yadav S; Garg D; Vaswani ND; Kaushik JS; Rohilla S
[Ad] Address:Resident, Department of Pediatrics, Pt B D Sharma PGIMS, Rohtak, Haryana, India.
[Ti] Title:Concurrent Acute Glomerulonephritis and Retropharyngeal Abscess in 10 Year Boy: A Case Report.
[So] Source:J Clin Diagn Res;11(7):SD13-SD14, 2017 Jul.
[Is] ISSN:2249-782X
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Postinfectious Glomerulonephritis (PIGN) usually follows 1-2 weeks after respiratory tract infection and 4-6 weeks after skin infection. Acute Glomerulonephritis (AGN) is uncommon with simultaneous severe throat infections. We describe a 10-year-old boy who was presented with high grade fever, dysphagia and tender swelling over left side of neck. Examination also revealed enlarged multiple cervical lymph nodes on the same side of neck. Magnetic Resonance Imaging (MRI) of soft tissue of neck revealed evidence of retropharyngeal abscess. The next day, he subsequently developed haematuria and oliguria with borderline raised blood pressure. His corresponding blood urea and serum antistreptolysin O (ASO) levels were raised with low C3 levels. He had a remarkable improvement on injectable broad spectrum antibiotics with complete resolution of fever and neck symptoms. At eight weeks follow up, complete resolution of microscopic haematuria with normal C3 levels was observed. The present case highlights a 10-year-old young boy with retropharyngeal abscess presenting with clinical and laboratory evidence of Poststreptococcal Glomerulonephritis (PSGN).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 170914
[Lr] Last revision date:170914
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.7860/JCDR/2017/26421.10299

  6 / 1358 MEDLINE  
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[PMID]: 28732547
[Au] Autor:Balendran K; Senarathne LDSU; Lanerolle RD
[Ad] Address:University Medical Unit, National Hospital of Sri Lanka, Colombo 10, Colombo, Sri Lanka. karthihabalendran@gmail.com.
[Ti] Title:Crescentic glomerular nephritis associated with rheumatoid arthritis: a case report.
[So] Source:J Med Case Rep;11(1):197, 2017 Jul 21.
[Is] ISSN:1752-1947
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Rheumatoid arthritis is a systemic disorder where clinically significant renal involvement is relatively common. However, crescentic glomerular nephritis is a rarely described entity among the rheumatoid nephropathies. We report a case of a patient with rheumatoid arthritis presenting with antineutrophil cytoplasmic antibody-negative crescentic glomerular nephritis. CASE PRESENTATION: A 54-year-old Sri Lankan woman who had recently been diagnosed with rheumatoid arthritis was being treated with methotrexate 10 mg weekly and infrequent nonsteroidal anti-inflammatory drugs. She presented to our hospital with worsening generalized body swelling and oliguria of 1 month's duration. Her physical examination revealed that she had bilateral pitting leg edema and periorbital edema. She was not pale or icteric. She had evidence of mild synovitis of the small joints of the hand bilaterally with no deformities. No evidence of systemic vasculitis was seen. Her blood pressure was 170/100 mmHg, and her jugular venous pressure was elevated to 7 cm with an undisplaced cardiac apex. Her urine full report revealed 2+ proteinuria with active sediment (dysmorphic red blood cells [17%] and granular casts). Her 24-hour urinary protein excretion was 2 g. Her serum creatinine level was 388 µmol/L. Abdominal ultrasound revealed normal-sized kidneys with acute parenchymal changes and mild ascites. Her renal biopsy showed renal parenchyma containing 20 glomeruli showing diffuse proliferative glomerular nephritis, with 14 of 20 glomeruli showing cellular crescents, and the result of Congo red staining was negative. Her rheumatoid factor was positive with a high titer (120 IU/ml), but results for antinuclear antibody, double-stranded deoxyribonucleic acid, and antineutrophil cytoplasmic antibody (perinuclear and cytoplasmic) were negative. Antistreptolysin O titer <200 U/ml and cryoglobulins were not detected. The results of her hepatitis serology, retroviral screening, and malignancy screening were negative. Her erythrocyte sedimentation rate was 110 mm in the first hour, and her C-reactive protein level was 45 mg/dl. Her liver profile showed hypoalbuminemia of 28 g/dl. She was treated with immunomodulators and had a good recovery of her renal function. CONCLUSIONS: This case illustrates a rare presentation of antineutrophil cytoplasmic antibody-negative crescentic glomerular nephritis in a patient with rheumatoid arthritis, awareness of which would facilitate early appropriate investigations and treatment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170725
[Lr] Last revision date:170725
[St] Status:In-Process
[do] DOI:10.1186/s13256-017-1346-8

  7 / 1358 MEDLINE  
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[PMID]: 28554544
[Au] Autor:Joseph J; Kent N; Bowen A; Hart J; Sheel M; Wardrop R; Abbs S; Bazely S; Rybak M
[Ad] Address:PathWest Laboratory Medicine, QE2 Medical Centre Redevelopment, Australia. Electronic address: john.joseph@health.wa.gov.au.
[Ti] Title:Immuno-nephelometric determination of group streptococcal anti-streptolysin O titres (ASOT) from dried blood spots: Method for validating a new assay.
[So] Source:J Immunol Methods;448:59-65, 2017 Sep.
[Is] ISSN:1872-7905
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:This study was designed to determine the sensitivity and reproducibility of recovering anti-streptolysin O titres (ASOT) from dried blood spot (DBS) samples, a methodologic subcomponent of the penicillin pharmacokinetic studies in children receiving secondary prophylaxis with intramuscular benzathine penicillin for acute rheumatic fever.
[Mh] MeSH terms primary: Antistreptolysin/blood
Dried Blood Spot Testing
Immunologic Tests/methods
Rheumatic Fever/diagnosis
Streptolysins/immunology
[Mh] MeSH terms secundary: Anti-Bacterial Agents/administration & dosage
Anti-Bacterial Agents/pharmacokinetics
Bacterial Proteins/immunology
Biomarkers/blood
Calibration
Equipment Design
Feasibility Studies
Humans
Immunologic Tests/instrumentation
Immunologic Tests/standards
Injections, Intramuscular
Nephelometry and Turbidimetry
Penicillin G Benzathine/administration & dosage
Penicillin G Benzathine/pharmacokinetics
Predictive Value of Tests
Reference Standards
Reproducibility of Results
Rheumatic Fever/blood
Rheumatic Fever/drug therapy
Rheumatic Fever/microbiology
[Pt] Publication type:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Name of substance:0 (Anti-Bacterial Agents); 0 (Bacterial Proteins); 0 (Biomarkers); 0 (Streptolysins); 0 (streptolysin O); 9006-92-2 (Antistreptolysin); RIT82F58GK (Penicillin G Benzathine)
[Em] Entry month:1709
[Cu] Class update date: 170918
[Lr] Last revision date:170918
[Js] Journal subset:IM
[Da] Date of entry for processing:170531
[St] Status:MEDLINE

  8 / 1358 MEDLINE  
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[PMID]: 28358593
[Au] Autor:McDonald KA; Pierscianowski TA
[Ad] Address:1 University of Ottawa, Ottawa, Ontario, Canada.
[Ti] Title:A Case of Amoxicillin-Induced Acute Generalized Exanthematous Pustulosis Presenting as Septic Shock.
[So] Source:J Cutan Med Surg;21(4):351-355, 2017 Jul/Aug.
[Is] ISSN:1615-7109
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:This case report demonstrates the challenges of diagnosing and managing acute generalized exanthematous pustulosis (AGEP) presenting as septic shock. The disseminated, erythematous, pustular rash is a common feature. However, extensive organ involvement and life-threatening hypotension are unusual. The constellation of signs has not previously been documented following amoxicillin therapy. Toxic epidermal necrolysis (TEN) and toxic shock syndrome (TSS) were considered in addition to AGEP because of the systemic presentation. AGEP was diagnosed following histopathology (TEN was ruled out based on limited necrotic keratinocytes and lack of epidermal necrosis) and a negative antistreptolysin O titer (eliminated TSS). Antibiotic therapy for septic shock was provided before the diagnosis was confirmed as AGEP. Upon confirmation of the AGEP diagnosis, antibiotics were discontinued and a 5-day course of oral prednisone (40 mg/d) was initiated in addition to topical half-strength (0.05%) betamethasone valerate. The patient rapidly improved and was discharged. Outpatient patch testing confirmed amoxicillin as the culprit drug. In conclusion, it is critical to realize that AGEP cannot be ruled out with a septic shock presentation. Recent drug history is critical in recognizing an adverse drug reaction, and patch testing is useful for determining the culpable drug when the diagnosis is AGEP.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1703
[Cu] Class update date: 170914
[Lr] Last revision date:170914
[St] Status:In-Process
[do] DOI:10.1177/1203475417701421

  9 / 1358 MEDLINE  
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[PMID]: 28007653
[Au] Autor:Hilkert SM; Koreishi AF; Pyatetsky D
[Ad] Address:Department of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois.
[Ti] Title:Poststreptococcal syndrome presenting as posterior scleritis in a child.
[So] Source:J AAPOS;21(2):163-165, 2017 Apr.
[Is] ISSN:1528-3933
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Posterior scleritis in children is very rare. In contrast to the adult form, pediatric posterior scleritis has not previously been associated with any systemic disorder. We describe a case of an 11-year-old girl who presented with left eye pain and redness and was found to have posterior scleritis on ultrasonography. Her laboratory work-up revealed a highly elevated antistreptolysin O titer; the rest of her serologic and radiologic evaluation was unremarkable. She was diagnosed with presumed poststreptococcal posterior scleritis and improved with a slow taper of oral steroids.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1612
[Cu] Class update date: 170424
[Lr] Last revision date:170424
[St] Status:In-Process

  10 / 1358 MEDLINE  
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[PMID]: 27848011
[Au] Autor:Trushin V; Englender M
[Ad] Address:Department of Otolaryngology, Barzilai Medical Center, Ashkelon, Israel. vovick2005@gmail.com.
[Ti] Title:Clinical value of antistreptolysin O levels in adult patients with tonsillitis: report I.
[So] Source:Eur Arch Otorhinolaryngol;274(4):2035-2039, 2017 Apr.
[Is] ISSN:1434-4726
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:To assess the clinical value of antistreptolysin O (ASO) level in adult patients with acute tonsillitis of group A beta-hemolytic streptococcus (GABHS) etiology and its interaction with the Centor score and throat cultures data. ASO antibody titers and throat cultures were obtained from 260 adult patients with acute tonsillitis of GABHS etiology initially proven by the Centor score. The results were compared with the group of 100 adult patients with recurrent tonsillitis who underwent tonsillectomy and with the group of 100 healthy adults. Throat cultures revealed GABHS-positive results in 69 acute cases (26.5%) and in 24 recurrent cases (24%), i.e., with no significant differences between the groups (p = 0.845). There was no significant difference between cases with GABHS-positive and with GABHS-negative throat culture in ASO titers results (mean 250 and 280, respectively, p = 0.44) but these titers were significantly higher than established normative data (p < 0.01). For the group of recurrent tonsillitis cases, the mean ASO titer was 363 being significantly higher in comparison with acute cases (p = 0.015). The ASO antibody titers are significantly higher than normative ranges in cases of acute tonsillitis in adults. The detection of the elevated titers may lead to early antibiotherapy to tonsillitis. The Centor score is supported by the ASO data and less supported by throat cultures data. Further research should reveal if these titers might have predictive value for possible further recurrence or serve as an indicator for tonsillectomy in cases of recurrent tonsillitis.
[Mh] MeSH terms primary: Antistreptolysin
Bacteriological Techniques
Streptococcal Infections
Streptococcus pyogenes
Tonsillitis
[Mh] MeSH terms secundary: Adolescent
Adult
Antistreptolysin/analysis
Antistreptolysin/blood
Bacteriological Techniques/methods
Bacteriological Techniques/statistics & numerical data
Female
Humans
Israel
Male
Middle Aged
Pharynx/microbiology
Predictive Value of Tests
Recurrence
Reproducibility of Results
Streptococcal Infections/diagnosis
Streptococcal Infections/drug therapy
Streptococcal Infections/immunology
Streptococcal Infections/surgery
Streptococcus pyogenes/immunology
Streptococcus pyogenes/isolation & purification
Tonsillectomy/adverse effects
Tonsillectomy/methods
Tonsillitis/drug therapy
Tonsillitis/immunology
Tonsillitis/microbiology
Tonsillitis/surgery
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:9006-92-2 (Antistreptolysin)
[Em] Entry month:1705
[Cu] Class update date: 170928
[Lr] Last revision date:170928
[Js] Journal subset:IM
[Da] Date of entry for processing:161117
[St] Status:MEDLINE
[do] DOI:10.1007/s00405-016-4393-7


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