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[PMID]: 25233821
[Au] Autor:Krishnan R; Shah P; Thomas D
[Ad] Address:Moorfields Eye Hospital NHS Foundation Trust, London, UK.
[Ti] Title:Subacute idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) in a child and review of paediatric cases of IRVAN revealing preserved capillary perfusion as a more common feature.
[So] Source:Eye (Lond);29(1):145-7, 2015 Jan.
[Is] ISSN:1476-5454
[Cp] Country of publication:England
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150117
[Lr] Last revision date:150117
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1038/eye.2014.213

  2 / 32745 MEDLINE  
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[PMID]: 25186798
[Au] Autor:Itoh K; Yagita K; Nozaki T; Katano H; Hasegawa H; Matsuo K; Hosokawa Y; Tando S; Fushiki S
[Ad] Address:Department of Pathology & Applied Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
[Ti] Title:An autopsy case of Balamuthia mandrillaris amoebic encephalitis, a rare emerging infectious disease, with a brief review of the cases reported in Japan.
[So] Source:Neuropathology;35(1):64-9, 2015 Feb.
[Is] ISSN:1440-1789
[Cp] Country of publication:Australia
[La] Language:eng
[Ab] Abstract:Balamuthia mandrillaris is an amoeba found in fresh water and soil that causes granulomatous amoebic encephalitis. We report herein an autopsy case of B. mandrillaris amoebic encephalitis, which was definitely diagnosed by PCR. An 81-year-old man, who had Sjögren's syndrome, manifested drowsiness 2 months before his death with progressive deterioration. Neuroimaging demonstrated foci of T2- and fluid-attenuated inversion recovery high and T1 low-intensity with irregular post-contrast ring enhancement in the cerebral hemisphere, thalamus and midbrain. Pathologically, multiple hemorrhagic and necrotic lesions were found in the cerebrum, thalamus, midbrain, pons, medulla and cerebellum, which were characterized by liquefactive necrosis, marked edema, hemorrhage and necrotizing vasculitis associated with the perivascular accumulation of amoebic trophozoites, a few cysts, and the infiltration of numerous neutrophils and microglia/macrophages. The trophozoites were ovoid or round, 10-60 µm in diameter, and they showed foamy cytoplasm and a round nucleus with small karyosome in the center. The PCR and immunohistochemistry from paraffin-embedded brain specimens revealed angioinvasive encephalitis due to B. mandrillaris. Human cases of B. mandrillaris brain infection are rare in Japan, with only a few brief reports in the literature.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1111/neup.12151

  3 / 32745 MEDLINE  
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[PMID]: 25543660
[Au] Autor:Mehta RI; Mehta RI; Choi JM; Mukherjee A; Castellani RJ
[Ad] Address:University of Maryland Medical Center, Department of Pathology, Baltimore, MD, 21201. Electronic address: rmehta@som.umaryland.edu....
[Ti] Title:Hydrophilic polymer embolism and associated vasculopathy of the lung: prevalence in a retrospective autopsy study.
[So] Source:Hum Pathol;46(2):191-201, 2015 Feb.
[Is] ISSN:1532-8392
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Hydrophilic polymers are commonly applied as surface coatings on vascular devices and have been shown to dissociate during endovascular use, causing hydrophilic polymer embolism (HPE). Adverse effects related to this phenomenon have been recognized and reported. The prevalence of this complication is unknown. We conducted a retrospective study to determine the prevalence of HPE among hospital autopsies over a 29-month period. Postmortem tissue was histologically evaluated for the presence, location(s) and extent of HPE. HPE findings were correlated with documented clinical and laboratory data and patient outcome. Of 136 hospital autopsies examined, 18 (13%) showed evidence of HPE involving the lungs (n = 18), heart (n = 1) or central nervous system (n = 1). Localized pulmonary HPE was seen in 12 patients (9%). Multifocal pulmonary HPE was found in 6 patients (4%) and was associated with clinical vasculitis (33%; P < .0001), suspected pulmonary ischemia (50%; P = .008), coagulopathy (67%; P = .002), and constitutional disease (83%; P = .01). Within affected lung, associated histopathologic changes included occlusive intravascular or perivascular inflammation (89%), intravascular fibrous response (56%), microthrombus formation (44%), vasculitis (28%), and/or pulmonary microinfarction (28%). Statistically significant differences in hospital days (P = .008) and number of vascular interventions (P = .01) were noted between affected and unaffected patients. We conclude that HPE is an underdiagnosed phenomenon with primary involvement of the lungs, where secondary vascular changes are common. Additional studies may be needed to clarify risks and to identify preventative strategies for this iatrogenic complication of catheterizations and "minimally invasive" endovascular techniques.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Js] Journal subset:IM
[St] Status:In-Data-Review

  4 / 32745 MEDLINE  
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[PMID]: 25587470
[Au] Autor:Ma WL; Li CC; Yu SC; Tien HF
[Ad] Address:Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin 64041, Taiwan ; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan....
[Ti] Title:Adult T-cell lymphoma/leukemia presenting as isolated central nervous system T-cell lymphoma.
[So] Source:Case Rep Hematol;2014:917369, 2014.
[Is] ISSN:2090-6560
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Adult T-cell leukemia/lymphoma (ATLL) is a T-cell neoplasm, associated with infection by the retrovirus human T-lymphotropic virus type 1 (HTLV-1). Central nervous system (CNS) involved by ATLL is often occurred in advanced disease, such as acute and lymphomatous variants. On the other hand, isolated CNS lymphoma is rare. We repot a 50-year-old woman who presented with multiple infiltrative brain lesions on the magnetic resonance (MR) imaging. Results of initial biopsy of brain tumor indicated CNS vasculitis. The patient received one course of high-dose methotrexate and MR imaging of brain revealed remission of infiltrative lesions. Two years later, new brain lesions were detected. Histopathologic examination of specimens via craniotomy revealed T-cell lymphoma. The patient responded poorly to subsequent chemotherapy, and salvage whole-brain irradiation was performed. Six months later, the patient had hepatosplenomegaly, hypercalcemia, and multiple lymphocytes with a cloverleaf appearance in circulation. Results of flow cytometry analysis of peripheral blood indicated ATLL and antibodies to human T-lymphotropic virus type 1 (HTLV-1) were detected. Clinicians should screen HTLV-1 infection when patients are diagnosed with peripheral T-cell lymphoma. Combined antiviral therapy and intensive chemotherapy may improve the outcomes of ATLL.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150116
[Lr] Last revision date:150116
[Da] Date of entry for processing:150114
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1155/2014/917369

  5 / 32745 MEDLINE  
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[PMID]: 24928069
[Au] Autor:Taormina G; Andolina G; Banco MA; Costanza-Gaglio EJ; Bonura A; Buscemi S
[Ti] Title:An uncommon presentation of eosinophilic granulomatosis with polyangiitis: a case report.
[So] Source:J Med Case Rep;8:190, 2014.
[Is] ISSN:1752-1947
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Eosinophilic granulomatosis with polyangiitis is a rare and potentially fatal disease if not readily diagnosed. Cerebral involvement is extremely rare and clinical presentation as hemorrhagic stroke is even rarer. CASE PRESENTATION: A 58-year-old Caucasian man was admitted to our medical unit because of a computed tomography-diagnosed hemorrhagic stroke with right-sided hemiparesis and fever. A chest computed tomography scan also revealed multiple bilateral pulmonary infiltrates; coronary artery, and carotid and left vertebral artery calcifications were also observed. Empiric antimicrobial therapy with cephalosporins was promptly undertaken; low-molecular-weight heparin was introduced as prophylaxis for venous thromboembolism. Over the following days, magnetic resonance imaging scans showed a regression of the hemorrhagic framework, also revealing hypoxic areas consistent with acute ischemic lesions. With a computed tomography scan showing a worsening of his pulmonary framework, antimicrobial therapy was modified and corticosteroids were introduced. A new blood cell count revealed further increased leukocytosis (17.49 × 10(3) µL), characterized by a surprising rise of eosinophilic cells (32.8%). Angiography of the coronary arteries found diffuse dilatations with severe signs of endothelial damage. Such an unexpected framework induced a strong suspicion that the stroke was the expression of a systemic vasculitis, which had triggered his cerebral, coronary, and pulmonary frameworks. The search for antineutrophil cytoplasmic antibody was positive for perinuclear antineutrophil cytoplasmic antibody, and eosinophilic granulomatosis with polyangiitis was diagnosed. Explaining to the patient the rarity of his disease, and what the most typical presentations of eosinophilic granulomatosis with polyangiitis were, he revealed that before admission he had had scalp injuries, in the nuchal region, and had taken corticosteroids as self-medication, with subsequent disappearance of the lesions. Therefore, high-dose corticosteroid treatment was started, and at discharge he was in good clinical condition with a slight right-sided hyposthenia. CONCLUSIONS: A diagnosis of eosinophilic granulomatosis with polyangiitis is often difficult, but we are convinced that intake of corticosteroids on a self-prescribed basis may have obscured the clinical presentation. Therefore, this case also suggests how the growing phenomenon of self-medication can be harmful, and that a careful investigation of clinical history is still an act of paramount importance.
[Mh] MeSH terms primary: Cerebral Infarction/diagnosis
Churg-Strauss Syndrome/diagnosis
Lung/radiography
Self Medication
Subarachnoid Hemorrhage/diagnosis
[Mh] MeSH terms secundary: Adrenal Cortex Hormones/therapeutic use
Cerebral Infarction/etiology
Churg-Strauss Syndrome/complications
Churg-Strauss Syndrome/drug therapy
Coronary Angiography
Humans
Immunosuppressive Agents/therapeutic use
Male
Middle Aged
Stroke/diagnosis
Stroke/etiology
Subarachnoid Hemorrhage/etiology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Adrenal Cortex Hormones); 0 (Immunosuppressive Agents)
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:140709
[St] Status:MEDLINE
[do] DOI:10.1186/1752-1947-8-190

  6 / 32745 MEDLINE  
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[PMID]: 24885926
[Au] Autor:Panagopoulos P; Terzi I; Karanikas M; Galanopoulos N; Maltezos E
[Ad] Address:2nd University Department of Internal Medicine, University General Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece. ppanago@med.duth.gr.
[Ti] Title:Myocarditis, pancreatitis, polyarthritis, mononeuritis multiplex and vasculitis with symmetrical peripheral gangrene of the lower extremities as a rare presentation of leptospirosis: a case report and review of the literature.
[So] Source:J Med Case Rep;8:150, 2014.
[Is] ISSN:1752-1947
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Leptospirosis is a zoonosis caused by the spirochete, Leptospira interrogans. While most cases of leptospirosis are mild to moderate, the course may be complicated by multiorgan dysfunction. We present a rare case of leptospirosis with acute myocarditis, pancreatitis, polyarthritis, mononeuritis multiplex and severe vasculitis with necrosis of the extremities. CASE PRESENTATION: A 32-year-old man from Congo presented with high-grade fever, confusion and headache. He developed tachycardia and hypotension followed by electrocardiogram changes and elevation of troponin I levels suggesting myocarditis. A physical examination revealed conjunctival suffusion, polyarthritis of his lower extremities and cutaneous necrosis of his feet due to vasculitis. Laboratory findings included amylase levels 10-fold the upper normal serum levels and thrombocytopenia. The diagnosis was confirmed by a positive leptospira immunoglobulin M, negative immunoglobulin G and a positive rapid agglutination test. Our patient recovered progressively with antimicrobials and supportive care. CONCLUSIONS: Because the clinical features and diagnostic findings of leptospirosis are not specific, a high index of suspicion must be maintained for the diagnosis. Serology is the most important tool for accurate and quick diagnosis in order to administer the appropriate therapy.
[Mh] MeSH terms primary: Arthritis/diagnosis
Leptospirosis/diagnosis
Lower Extremity/pathology
Mononeuropathies/diagnosis
Myocarditis/diagnosis
Pancreatitis/diagnosis
Vasculitis/diagnosis
[Mh] MeSH terms secundary: Adult
Anti-Bacterial Agents/therapeutic use
Arthritis/etiology
Gangrene/diagnosis
Gangrene/etiology
Humans
Leptospirosis/complications
Leptospirosis/drug therapy
Male
Mononeuropathies/etiology
Myocarditis/etiology
Pancreatitis/etiology
Penicillins/therapeutic use
Vasculitis/etiology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Anti-Bacterial Agents); 0 (Penicillins)
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:140604
[St] Status:MEDLINE
[do] DOI:10.1186/1752-1947-8-150

  7 / 32745 MEDLINE  
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[PMID]: 24661403
[Au] Autor:Chang T; de Alwis JS; Samarasekara N; Rajapakse S
[Ad] Address:Department of Clinical Medicine, Faculty of Medicine, University of Colombo, 25, Kynsey Road, Colombo, Sri Lanka. thashichang@gmail.com.
[Ti] Title:Cerebral infarction 3 weeks after intravenous immunoglobulin for Miller Fisher syndrome: a case report.
[So] Source:J Med Case Rep;8:100, 2014.
[Is] ISSN:1752-1947
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Intravenous immunoglobulin is considered generally safe and is used widely as proven, and sometimes empiric, treatment for an expanding list of autoimmune diseases. Thromboembolic complications following intravenous immunoglobulin therapy are rare and there have been only five previous reports of stroke occurring within 2 to 10 days of infusion. This is the first report of cerebral infarction occurring after a longer latency of 3 weeks following intravenous immunoglobulin therapy in a patient presenting with Miller Fisher syndrome. CASE PRESENTATION: A previously well, 44-year-old Sri Lankan man progressively developed ophthalmoplegia, facial paralysis, ataxia and areflexia with neurophysiological and cerebrospinal fluid evidence consistent with the Miller Fisher syndrome. He made an unremarkable recovery with intravenous immunoglobulin therapy (0.4 g/kg/day for 5 days, total 180 g), but developed a cerebral infarct with haemorrhagic transformation 25 days later. He was noted to have a low blood pressure. Extensive investigations ruled out vasculopathic, embolic, thrombophilic and inflammatory aetiologies. Circulating intravenous immunoglobulins combined with a low blood pressure was considered the most probable cause of his stroke. CONCLUSIONS: Cerebral infarction following intravenous immunoglobulin is thought to be secondary to hyperviscosity, thromboemboli, vasculitis, or cerebral vasospasm and reported to occur after a short latency when the immunoglobulin load is highest. Even though the immunoglobulin load is halved by 3 weeks, our case suggests that that the predisposition to thromboembolism persists over a longer period and may result in vascular complications if synergised with other vascular risk factors. It is recommended that intravenous immunoglobulin be infused at a rate of not less than 8 hours per day and that factors predisposing to thromboembolism such as dehydration, immobilisation and low blood pressure be avoided for the duration of at least two half-lives of immunoglobulin (6 weeks).
[Mh] MeSH terms primary: Cerebral Infarction/etiology
Hypotension/complications
Immunoglobulins, Intravenous/adverse effects
Immunologic Factors/adverse effects
Intracranial Hemorrhages/etiology
Miller Fisher Syndrome/therapy
[Mh] MeSH terms secundary: Adult
Humans
Male
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Immunoglobulins, Intravenous); 0 (Immunologic Factors)
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:140603
[St] Status:MEDLINE
[do] DOI:10.1186/1752-1947-8-100

  8 / 32745 MEDLINE  
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[PMID]: 23789598
[Au] Autor:Low LC; Kinderlerer A; Walker MM; Setterfield J
[Ad] Address:Department of Dermatology, St Mary's Hospital, Imperial College Hospital NHS trust, London, UK. lynettelow@doctors.org.uk
[Ti] Title:A woman with asthma and hemorrhagic bullae.
[So] Source:Int J Dermatol;52(7):793-4, 2013 Jul.
[Is] ISSN:1365-4632
[Cp] Country of publication:England
[La] Language:eng
[Mh] MeSH terms primary: Asthma/complications
Blister/etiology
Churg-Strauss Syndrome/complications
Hemorrhage/etiology
[Mh] MeSH terms secundary: Aged
Churg-Strauss Syndrome/diagnosis
Female
Humans
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:130624
[St] Status:MEDLINE
[do] DOI:10.1111/j.1365-4632.2012.05837.x

  9 / 32745 MEDLINE  
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[PMID]: 25591148
[Au] Autor:Poletti V; Gurioli C; Piciucchi S; Rossi A; Ravaglia C; Dubini A; Asioli S; Casoni GL
[Ad] Address:Department of Diseases of the Thorax Ospedale GB Morgagni, Forlì (I). venerino.poletti@gmail.com.
[Ti] Title:Intravascular large B cell lymphoma presenting in the lung: the diagnostic value of transbronchial cryobiopsy.
[So] Source:Sarcoidosis Vasc Diffuse Lung Dis;31(4):354-8, 2015.
[Is] ISSN:1124-0490
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:BACKGROUND AND OBJECTIVE: intravascular large B-cell lymphoma is a distinct subtype of mature B-cell neoplasms, with uncommon primary presentation in the lungs. Diagnosis could be very difficult due to the lack of detectable tumor masses and it is usually made by surgical lung biopsy or autopsy examination. METHODS: two patients occurred primarily with interstitial lung disease and underwent a pulmonary biopsy using cryoprobes. RESULTS: the pathological analysis of the lung biopsies revealed in both cases a conclusive diagnosis of intravascular large B-cell lymphoma with primary lung involvement and patients have been safely diagnosed using transbronchial cryobiopsy for the first time in the literature. CONCLUSIONS: transbronchial cryobiopsy could be used as valid surrogate for surgical lung biopsy in lymphoprolipherative lung disorders (including intravascular lymphomas), as allows larger samples of tissue, greater  diagnostic yield, no crush artifacts and much less complications than surgical biopsy. 
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Js] Journal subset:IM
[St] Status:In-Data-Review

  10 / 32745 MEDLINE  
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[PMID]: 25591147
[Au] Autor:Overbeek M; Van de Loosdrecht A; Vonk-Noordegraaf A
[Ad] Address:Medical Center Haaglanden The Hague. m.overbeek@mchaaglanden.nl.
[Ti] Title:Granulomatous lung disease in a patient with a family history of hematological disorders.
[So] Source:Sarcoidosis Vasc Diffuse Lung Dis;31(4):350-3, 2015.
[Is] ISSN:1124-0490
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:A 29-year old patient presented with granulomatous lung disease and a family history of myelodysplastic syndrome/acute myeloid leukemia. She appeared to be a carrier of a mutation in the transcription factor GATA2. The case adds to the recent described heterogeneous clinical manifestations and syndromes in which, against a background of hematologic disorders, GATA2 mutations have been demonstrated, such as the Monomac and Emberger syndromes. In patients with a granulomatous disease and a history of (familial) hematologic disorders, the occurence of GATA2 mutations should be considered, as to gain further insight in the occurrence of granulomatous disease in a possible distinct phenotype among GATA2 mutation carriers.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Js] Journal subset:IM
[St] Status:In-Data-Review


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