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[PMID]: 25709064
[Au] Autor:Karampelas M; Sim DA; Chu C; Carreno E; Keane PA; Zarranz-Ventura J; Westcott M; Lee RW; Pavesio CE
[Ad] Address:NationaI Institute for Health Research, Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital National Health Service Foundation Trust, London, United Kingdom; West Hertfordshire National Health Service Foundation Trust, London, United Kingdom. Electronic address: mikekarampelas@hotm...
[Ti] Title:Quantitative analysis of peripheral vasculitis, ischemia, and vascular leakage in uveitis using ultra-widefield fluorescein angiography.
[So] Source:Am J Ophthalmol;159(6):1161-1168.e1, 2015 Jun.
[Is] ISSN:1879-1891
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To investigate the relationships between peripheral vasculitis, ischemia, and vascular leakage in uveitis using ultra-widefield fluorescein angiography (FA). DESIGN: Cross-sectional, consecutive case series. METHODS: Consecutive ultra-widefield FA images were collected from 82 uveitis patients (82 eyes) in a single center. The extent of peripheral vasculitis, capillary nonperfusion, and vessel leakage were quantified. Parameters included: (1) foveal avascular zone area and macular leakage, (2) peripheral diffuse capillary leakage and ischemia, (3) peripheral vasculitis, and (4) leakage from neovascularization. Central macular thickness measurements were derived with optical coherence tomography. Main outcome measures were correlations between central and peripheral fluorangiographic changes as well as associations between visual function, ultra-widefield FA-derived metrics, and central macular thickness. RESULTS: Although central leakage was associated with peripheral leakage (r = 0.553, P = .001), there was no association between foveal avascular zone size and peripheral ischemia (r = 0.114, P = .324), regardless of the underlying uveitic diagnosis. Peripheral ischemia was, however, correlated to neovascularization-related leakage (r = 0.462, P = .001) and focal vasculitis (r = 0.441, P = .001). Stepwise multiple regression analysis revealed that a poor visual acuity was independently associated with foveal avascular zone size and central macular thickness (R(2)-adjusted = 0.45, P = .001). CONCLUSIONS: We present a large cohort of patients with uveitis imaged with ultra-widefield FA and further describe novel methods for quantification of peripheral vascular pathology, in an attempt to identify visually significant parameters. Although we observed that relationships exist between peripheral vessel leakage, vasculitis, and ischemia, it was only macular ischemia and increased macular thickness that were independently associated with a reduced visual acuity.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Cu] Class update date: 150509
[Lr] Last revision date:150509
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review

  2 / 33248 MEDLINE  
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[PMID]: 25949841
[Au] Autor:Masuda T; Izumi Y; Takeshita H; Kawahara C; Tsuji Y; Kurohama H; Iwanaga N; Inamoto M; Kase K; Ito M; Kawakami A; Migita K
[Ad] Address:Departments of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki 856-8562, Japan....
[Ti] Title:Granulomatosis with polyangiitis presenting as a choroidal tumor.
[So] Source:Case Rep Rheumatol;2015:271823, 2015.
[Is] ISSN:2090-6889
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Granulomatosis with polyangiitis (GPA) sometimes involves the eye orbit; however, choroidal involvements in GPA had been rarely reported. We report a rare case presenting with a choroidal mass in an 83-year-old Japanese woman who presented with left eye pain. Diagnostic biopsy revealed necrotizing vasculitis with infiltrates of inflammatory cells. Diagnosis was localized granulomatosis with polyangiitis. Combined treatments with corticosteroid plus azathioprine resolved the choroidal mass region. Although treatment with corticosteroid and immunosuppressive agents improves the prognosis of the disease, ocular morbidity is still well recognized. Clinicians should consider a differential diagnosis of GPA in patients with inflammatory choroidal tumors.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Cu] Class update date: 150509
[Lr] Last revision date:150509
[Da] Date of entry for processing:150507
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1155/2015/271823

  3 / 33248 MEDLINE  
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[PMID]: 25956318
[Au] Autor:Choo E; Ledford D
[Ad] Address:Allergy & Asthma Associates, Houston, Tex; Past-Assistant Professor of Medicine, Division of Allergy/Immunology, National Jewish Health, Denver, Colo. Electronic address: emchoo@texallergy.com.
[Ti] Title:Eosinophilic granulomatosis with polyangiitis (churg-strauss vasculitis).
[So] Source:J Allergy Clin Immunol Pract;3(3):466-7, 2015 May-Jun.
[Is] ISSN:2213-2201
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Js] Journal subset:IM
[St] Status:In-Data-Review

  4 / 33248 MEDLINE  
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[PMID]: 25739829
[Au] Autor:Jones RB; Furuta S; Tervaert JW; Hauser T; Luqmani R; Morgan MD; Peh CA; Savage CO; Segelmark M; Tesar V; van Paassen P; Walsh M; Westman K; Jayne DR; European Vasculitis Society (EUVAS)
[Ad] Address:Renal Unit, Addenbrooke's Hospital, Cambridge, UK....
[Ti] Title:Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis: 2-year results of a randomised trial.
[So] Source:Ann Rheum Dis;74(6):1178-82, 2015 Jun.
[Is] ISSN:1468-2060
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: The RITUXVAS trial reported similar remission induction rates and safety between rituximab and cyclophosphamide based regimens for antineutrophil cytoplasm antibody (ANCA)-associated vasculitis at 12 months; however, immunosuppression maintenance requirements and longer-term outcomes after rituximab in ANCA-associated renal vasculitis are unknown. METHODS: Forty-four patients with newly diagnosed ANCA-associated vasculitis and renal involvement were randomised, 3:1, to glucocorticoids plus either rituximab (375 mg/m(2)/week×4) with two intravenous cyclophosphamide pulses (n=33, rituximab group), or intravenous cyclophosphamide for 3-6 months followed by azathioprine (n=11, control group). RESULTS: The primary end point at 24 months was a composite of death, end-stage renal disease and relapse, which occurred in 14/33 in the rituximab group (42%) and 4/11 in the control group (36%) (p=1.00). After remission induction treatment all patients in the rituximab group achieved complete B cell depletion and during subsequent follow-up, 23/33 (70%) had B cell return. Relapses occurred in seven in the rituximab group (21%) and two in the control group (18%) (p=1.00). All relapses in the rituximab group occurred after B cell return. CONCLUSIONS: At 24 months, rates of the composite outcome of death, end-stage renal disease and relapse did not differ between groups. In the rituximab group, B cell return was associated with relapse. TRIAL REGISTRATION NUMBER: ISRCTN28528813.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1136/annrheumdis-2014-206404

  5 / 33248 MEDLINE  
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[PMID]: 25943359
[Au] Autor:Nolan AL; Jen KY
[Ad] Address:Department of Pathology, University of California San Francisco, 513 Parnassus Avenue, Box 0102, San Francisco, CA, 94143, USA. Amber.Nolan2@ucsf.edu.
[Ti] Title:Pathologic manifestations of levamisole-adulterated cocaine exposure.
[So] Source:Diagn Pathol;10(1):48, 2015.
[Is] ISSN:1746-1596
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:UNLABELLED: á…Ÿ: Rheumatic manifestations of cocaine have been well described, but more recently, a dramatic increase in the levamisole-adulterated cocaine supply in the United States has disclosed unique pathologic consequences that are distinct from pure cocaine use. Most notably, patients show skin lesions and renal dysfunction in the setting of extremely high perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA). Unexpectedly, antibodies to myeloperoxidase, the typical target of p-ANCA, are relatively low if at all present. This discrepancy is due to the fact that p-ANCA seen in association with levamisole-adulterated cocaine exposure is often directed against atypical p-ANCA-associated antigens within the neutrophil granules such as human neutrophil elastase, lactoferrin, and cathepsin G. Biopsies of the skin lesions reveal leukocytoclastic vasculitis often involving both superficial and deep dermal vessels. Renal injury most typically manifests as crescentic and necrotizing pauci-immune glomerulonephritis. In this review, the manifestations of levamisole-adulterated cocaine-induced vasculitis are discussed with an emphasis on the typical histomorphologic findings seen on biopsy. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1764738711370019 .
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Cu] Class update date: 150508
[Lr] Last revision date:150508
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1186/s13000-015-0279-z

  6 / 33248 MEDLINE  
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[PMID]: 25555818
[Au] Autor:Østensen M; Andreoli L; Brucato A; Cetin I; Chambers C; Clowse ME; Costedoat-Chalumeau N; Cutolo M; Dolhain R; Fenstad MH; Förger F; Wahren-Herlenius M; Ruiz-Irastorza G; Koksvik H; Nelson-Piercy C; Shoenfeld Y; Tincani A; Villiger PM; Wallenius M; von Wolff M
[Ad] Address:National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, St. Olavs Hospital, University Hospital of Trondheim, Norway. Electronic address: monika.ostensen@gmail.com....
[Ti] Title:State of the art: Reproduction and pregnancy in rheumatic diseases.
[So] Source:Autoimmun Rev;14(5):376-86, 2015 May.
[Is] ISSN:1873-0183
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Throughout the last decade, increasing awareness has been raised on issues related to reproduction in rheumatic diseases including basic research to clarify the important role of estrogens in the etiology and pathophysiology of immune/inflammatory diseases. Sub- or infertility is a heterogeneous condition that can be related to immunological mechanisms, to pregnancy loss, to disease burden, to therapy, and to choices in regard to family size. Progress in reproductive medicine has made it possible for more patients with rheumatic disease to have children. Active disease in women with rheumatoid arthritis (RA) affects their children's birth weight and may have long-term effects on their future health status. Pregnancy complications as preeclampsia and intrauterine growth restriction are still increased in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), however, biomarkers can monitor adverse events, and several new therapies may improve outcomes. Pregnancies in women with APS remain a challenge, and better therapies for the obstetric APS are needed. New prospective studies indicate improved outcomes for pregnancies in women with rare diseases like systemic sclerosis and vasculitis. TNF inhibitors hold promise for maintaining remission in rheumatological patients and may be continued at least in the first half of pregnancy. Pre-conceptional counseling and interdisciplinary management of pregnancies are essential for ensuring optimal pregnancy outcomes.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1503
[Js] Journal subset:IM
[St] Status:In-Process

  7 / 33248 MEDLINE  
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[PMID]: 25950695
[Au] Autor:Shi YY; Li ZY; Zhao MH; Chen M
[Ad] Address:From the Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education.
[Ti] Title:The CD4 Lymphocyte Count is a Better Predictor of Overall Infection Than the Total Lymphocyte Count in ANCA-Associated Vasculitis Under a Corticosteroid and Cyclophosphamide Regimen: A Retrospective Cohort.
[So] Source:Medicine (Baltimore);94(18):e843, 2015 May.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Patients with antineutrophil cytoplasmic autoantibody associated vasculitis (AAV) have a high prevalence of infection during immunosuppressive therapy, and the total lymphocyte count (TLC) has been demonstrated to be an independent predictor of infection. The current study investigated the value of the TLC and its subsets, particularly the CD4 count, for predicting infections of AAV in a single Chinese cohort.A total of 124 AAV patients were retrospectively recruited in our department from December 1997 to October 2013. Multivariate Cox models with the CD4 count or TLC measured at three typical time points, that is, at baseline, at the beginning of immunosuppressant dose reduction, and at the last visit before infection or censoring, or with the measurements included as time-varying covariates, were compared to select the most predictive time point for infection. A time-dependent area under the receiver operating characteristic curve (AUC(t)) for the TLC (AUC(t)TLC) and the CD4 count (AUC(t)CD4count) measured at the most predictive time point were calculated and compared.During an average follow-up of 11.5 (range 0.5-142) months, 55 of the 124 patients (44.3%) experienced a microbiologically confirmed infection. Independent predictors of overall infection were initial creatinine clearance (P = 0.02 and 0.04), pulmonary interstitial fibrosis (P = .04 and .05), pulmonary nodule or cavity (P = 0.002 and .002), CD4 count (P < 0.001) or TLC (P = 0.05) from the last visit. The comparison of Cox models fitted at different time points confirmed the last visit to be the most predictive one for overall infection. The predictive value of the CD4 count or TLC from the last visit measured by AUC showed that the AUC(t)CD4count (62.8-70.2%) was almost always higher than AUC(t)TLC (55.2-58.1%) during the first 2 years of immunosuppressive therapy (P = 0.01-0.2). In terms of different pathogens, both the CD4 count and TLC performed well for non-bacterial infection (AUC(t) 69.2-82.7%), and the difference between them was not significant (P > 0.1).The TLC and CD4 count were both independent risk factors of overall infection and non-bacterial infection in AAV patients. The CD4 count had a higher predictive value than the TLC for overall infections, particularly during the first 2 years of immunosuppressive therapy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.1097/MD.0000000000000843

  8 / 33248 MEDLINE  
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[PMID]: 25954277
[Au] Autor:Silva de Souza AW
[Ad] Address:Rheumatology Division, Department of Internal Medicine, Universidade Federal de São Paulo-Escola Paulista de Medicina , São Paulo , Brazil.
[Ti] Title:Autoantibodies in systemic vasculitis.
[So] Source:Front Immunol;6:184, 2015.
[Is] ISSN:1664-3224
[Cp] Country of publication:Switzerland
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1505
[Da] Date of entry for processing:150508
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.3389/fimmu.2015.00184

  9 / 33248 MEDLINE  
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[PMID]: 25876704
[Au] Autor:Einspieler I; Thürmel K; Pyka T; Eiber M; Wolfram S; Moog P; Reeps C; Essler M
[Ad] Address:Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany, ingo.einspieler@tum.de.
[Ti] Title:Imaging large vessel vasculitis with fully integrated PET/MRI: a pilot study.
[So] Source:Eur J Nucl Med Mol Imaging;42(7):1012-24, 2015 Jun.
[Is] ISSN:1619-7089
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: The aim of this study was to evaluate the feasibility of hybrid [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/MRI in patients with large vessel vasculitis (LVV) by comparing visual and quantitative parameters to that of PET/CT. Furthermore, the value of PET/MRI in disease activity and extent of LVV was assessed. METHODS: A total of 16 [(18)F]FDG PET/MRI and 12 [(18)F]-FDG PET/CT examinations were performed in 12 patients with LVV. MRI of the vessel wall by T1-weighted and T2-weighted sequences was used for anatomical localization of FDG uptake and identification of morphological changes associated with LVV. In addition, contrast-enhanced (CE) magnetic resonance angiography (MRA) was performed. The vascular FDG uptake in the vasculitis group was compared to a reference group of 16 patients using a four-point visual score. Visual scores and quantitative parameters [maximum standardized uptake value (SUVmax) and target to background ratio (TBR)] were compared between PET/MRI and PET/CT. Furthermore, correlations between C-reactive protein (CRP) and quantitative PET results, as well the extent of vasculitis in PET, MRI/CE-MRA and combined PET/MRI, were analysed. RESULTS: TBRs, SUVmax values and visual scores correlated well between PET/MRI and PET/CT (r = 0.92, r = 0.91; r = 0.84, p < 0.05). There was no significant difference between both modalities concerning SUVmax measurements and visual scores. In PET/MRI, PET alone revealed abnormal FDG uptake in 86 vascular regions. MRI/CE-MRA indicated 49 vessel segments with morphological changes related to vasculitis, leading to a total number of 95 vasculitis regions in combination with PET. Strong and significant correlations between CRP and disease extent in PET alone (r = 0.75, p = 0.0067) and PET/MRI (r = 0.92, p < 0.0001) in contrast to MRI/CE-MRA only were observed. Regarding disease activity, no significant correlations were seen between quantitative PET results and CRP, although there was a trend towards significance (r = 0.55, p = 0.0651). PET/MRI also showed active LVV in 15/16 examinations. CONCLUSION: Hybrid PET/MRI is feasible in LVV and holds promise for precisely determining disease extent and disease activity.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00259-015-3007-8

  10 / 33248 MEDLINE  
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[PMID]: 25777754
[Au] Autor:Gan PY; Ooi JD; Kitching AR; Holdsworth SR
[Ti] Title:Mouse models of anti-neutrophil cytoplasmic antibody-associated vasculitis.
[So] Source:Curr Pharm Des;21(18):2380-90, 2015.
[Is] ISSN:1873-4286
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Inflammation of blood vessels (vasculitis) results from many pathological processes and is found in many different diseases. However, in most situations, the pathological processes inducing vasculitis are unknown. The discovery of anti-neutrophil cytoplasmic autoantibodies (ANCAs) in the 1980s opened the door for studies that eventually led to the description of a new previously undescribed disease, ANCA-associated vasculitis (AAV). Unravelling the immunopathogenesis of this new disease resulted largely from the development of animal models. The major breakthroughs were the description of ANCA, its association with small vessel vasculitis and the discovery of its target autoantigens (myeloperoxidase and Proteinase 3). Three major disease syndromes comprise the AAVs, microscopic polyangiitis, granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis (EGPA). Recent human studies suggest that proteinase 3 and myeloperoxidase associated vasculitis are two separate but related diseases. The ability to induce murine autoimmunity to myeloperoxidase including ANCA (with the same immune staining patterns as human ANCA) and the capacity of this anti-myeloperoxidase autoimmunity to induce disease with many of the characteristic features of human AAV are well developed. However, the development of animal models of anti-proteinase 3 ANCA and EGPA is much less well developed. Animal models are important in understanding the human disease and in particular in defining potential therapeutic targets and in early stage therapeutic testing of potential drugs. Clearly the relevance of animal models depends on how closely they mimic human diseases. The current status of animal models of vasculitis will be described in detail with reference to these criteria.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Js] Journal subset:IM
[St] Status:In-Data-Review


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