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  1 / 28079 MEDLINE  
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[PMID]:29191853
[Au] Autor:Stevenson DR; Hashim H; Salman M; Mouyis M
[Ad] Endereço:Northwick Park Hospital, Harrow, UK danny.r.stevenson@gmail.com.
[Ti] Título:A non-cardiac cause of bilateral leg swelling.
[So] Source:BMJ;359:j5306, 2017 11 30.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Edema/diagnóstico
Imunoglobulina G/sangue
Perna (Membro)/patologia
Fibrose Retroperitoneal/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Diagnóstico Diferencial
Edema/tratamento farmacológico
Edema/etiologia
Glucocorticoides/administração & dosagem
Glucocorticoides/uso terapêutico
Seres Humanos
Perna (Membro)/fisiopatologia
Masculino
Prednisolona/administração & dosagem
Prednisolona/uso terapêutico
Fibrose Retroperitoneal/complicações
Fibrose Retroperitoneal/tratamento farmacológico
Fibrose Retroperitoneal/imunologia
Tomografia Computadorizada por Raios X/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 0 (Immunoglobulin G); 9PHQ9Y1OLM (Prednisolone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5306


  2 / 28079 MEDLINE  
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[PMID]:29465558
[Au] Autor:Xiao J; Xu P; Li B; Hong T; Liu W; He X; Zheng C; Zhao Y
[Ad] Endereço:Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
[Ti] Título:Analysis of clinical characteristics and treatment of immunoglobulin G4-associated cholangitis: A retrospective cohort study of 39 IAC patients.
[So] Source:Medicine (Baltimore);97(8):e9767, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Immunoglobulin (Ig)G4-associated cholangitis (IAC) is one of the common organ manifestations of IgG4-related systemic disease (ISD). IAC and autoimmune pancreatitis (AIP) may mimic sclerosing cholangitis, cholangiocarcinoma, or pancreatic carcinoma. Diagnosis is based on a combination of clinical, biochemical, radiological, and histological findings.To study the clinical presentation of and treatment strategy for IAC, we reviewed clinical, serologic, and imaging characteristics, as well as treatment response, in 39 patients with IAC. The majority of patients were men (82%). Clinical features on presentation included obstructive jaundice in 26 patients (67%) and abdominal pain in 20 (51%). Positive IgG4 immunostaining was seen in 27 patients. The median serum IgG4 level before treatment was 769.4 mg/dL (range, 309.1-1229.7 mg/dL). After the steroid therapy, the median serum IgG4 level in 23 patients was 247.0 mg/dL (range, 139.0-355.0 mg/dL). Cholangiograms were available in 36 (92%) patients. Stenosis of the lower part of the common bile duct was found in 26 of 39 patients. Stenosis was diffusely distributed in the intra- and extrahepatic bile ducts in 14 of 39 patients. Additionally, strictures of the bile duct were detected in the hilar hepatic lesions in 27 of 39 patients. AIP was the most frequent comorbidity (35/39 in this study) of IAC. Other affected organs included eyes (n = 6), salivary glands (sialadenitis, n = 10), lymph nodes (mediastinal and axillary, n = 3), kidneys (n = 2), and the retroperitoneum (retroperitoneal fibrosis, n = 2).Regarding treatment, 29 patients were treated with steroids, of whom one underwent pancreatoduodenectomy, and one underwent choledochojejunostomy. Eight patients were treated with biliary stents. The remaining 19 patients took prednisolone alone. Eight patients achieved spontaneous resolution. Four patients with suspected pancreatic cancer or cholangiocarcinoma underwent surgery, including 2 patients who also received postoperative steroids. All patients were regularly followed up for 9 to 36 months. Only 2 patients in the steroids treatment group relapsed to manifest obstructive jaundice and high serum IgG4 levels. These 2 patients were treated with steroids and biliary stents, resulting in complete remission.We also review the diagnostic and therapeutic management and discuss recent pathophysiological findings, which might aid in understanding the molecular mechanisms contributing to IAC and other manifestations of IgG4-related diseases (IgG4-RD). Biomarkers that are more accurate are needed to correctly diagnose IAC and prevent misdiagnoses and unnecessary therapeutic interventions.
[Mh] Termos MeSH primário: Doenças Autoimunes/imunologia
Doenças Autoimunes/terapia
Colangite/imunologia
Colangite/terapia
Imunoglobulina G/sangue
[Mh] Termos MeSH secundário: Adulto
Anti-Inflamatórios/uso terapêutico
Doenças Autoimunes/patologia
Procedimentos Cirúrgicos do Sistema Biliar/instrumentação
Procedimentos Cirúrgicos do Sistema Biliar/métodos
Colangite/patologia
Coledocostomia
Ducto Colédoco/patologia
Constrição Patológica
Feminino
Seres Humanos
Masculino
Meia-Idade
Pancreaticoduodenectomia
Pancreatite/imunologia
Prednisolona/uso terapêutico
Estudos Retrospectivos
Stents
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Immunoglobulin G); 9PHQ9Y1OLM (Prednisolone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009767


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[PMID]:29390349
[Au] Autor:Fujimoto S; Kawabata H; Kurose N; Kawanami-Iwao H; Sakai T; Kawanami T; Fujita Y; Fukushima T; Masaki Y
[Ad] Endereço:Department of Hematology and Immunology, Kanazawa Medical University.
[Ti] Título:Sjögren's syndrome manifesting as clinicopathological features of TAFRO syndrome: A case report.
[So] Source:Medicine (Baltimore);96(50):e9220, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: TAFRO syndrome is a newly proposed disorder that manifests as thrombocytopenia, anasarca, fever, reticulin myelofibrosis, renal dysfunction, and organomegaly. In this report, we describe the development of severe TAFRO syndrome-like systemic symptoms during the clinical course of juvenile-onset Sjögren's syndrome in a 32-year-old woman. PATIENT CONCERNS: The patient was admitted due to dyspnea, fever, polyarthralgia, and generalized edema. She had been diagnosed with Sjögren's syndrome at the age of 14 years, based on histopathological examination of a biopsy of the minor salivary glands and the development of Raynaud's phenomenon, with no follow-up treatment required. On admission, she presented with anemia, elevated C-reactive protein levels, anasarca, and hepato-splenomegaly. A bone marrow examination revealed increased megakaryocytes with reticulin fibrosis, and the histopathology of an axillary lymph node was consistent with mixed-type Castleman disease. Eventually, she developed thrombocytopenia. INTERVENTIONS: Her symptoms fulfilled all of the major and minor categories of the diagnostic criteria for TAFRO syndrome. However, considering her prior diagnosis, we assumed that the clinical presentation was consistent with an acute exacerbation of Sjögren's syndrome. Unlike typical cases of TAFRO syndrome, the administration of relatively low-dose prednisolone relieved her symptoms. LESSONS: Differentiation between TAFRO syndrome and exacerbation of an autoimmune disease is clinically important, although this can be challenging. Identification of specific biomarkers for TAFRO syndrome would be clinically beneficial.
[Mh] Termos MeSH primário: Doença de Castleman/diagnóstico
Síndrome de Sjogren/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Doença de Castleman/tratamento farmacológico
Diagnóstico Diferencial
Feminino
Glucocorticoides/uso terapêutico
Seres Humanos
Prednisolona/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 9PHQ9Y1OLM (Prednisolone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009220


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[PMID]:29390345
[Au] Autor:Liu A; Zhang Q; Liu B; Xu N; Li A
[Ti] Título:A case of immunoglobulin G4-related lung disease with bilateral diffuse infiltration: A case report.
[So] Source:Medicine (Baltimore);96(50):e9211, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Immunoglobulin (Ig) G4-related disease (IgG4-RD) is a rare and chronic progressive autoimmune disease. It is a novel clinical entity characterized by elevated serum IgG4 concentration and tissue infiltration by IgG4 plasma cells. IgG4-related lung disease (IgG4-RLD) has been described as interstitial pneumonia and inflammatory pseudotumor, with various abnormal radiographic patterns. We report a case of IgG4-related lung disease with bilateral diffuse infiltration. PATIENT CONCERNS: A 65-year-old woman was admitted to our hospital because of cough, sputum, and fever. Chest computed tomography (CT) revealed multifocal areas of consolidations, nodules, and ground glass opacities in both lungs. She still had fever after anti-infective therapy. DIAGNOSES: Bronchial bronchoscopy and percutaneous lung biopsy were performed, resulted in a pathological diagnosis of IgG4-RLD. INTERVENTIONS: The patient was started on oral prednisolone 30 mg/day for 28 days, and then was gradually tapered. OUTCOMES: After one week treatment, the temperature was stable, CT showed significant improvement in the areas of consolidations and nodules. LESSONS: It is a typical case of IgG4-RLD. This case indicated that suggestive evidence, radiological appearances, serum tests, pathological characteristics, and classic therapy IgG4-RLD. It is a rare disease that needs our more attention in future.
[Mh] Termos MeSH primário: Doenças Autoimunes/diagnóstico
Imunoglobulina G/imunologia
Pneumopatias/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Doenças Autoimunes/tratamento farmacológico
Biópsia
Broncoscopia
Diagnóstico Diferencial
Feminino
Glucocorticoides/uso terapêutico
Seres Humanos
Pneumopatias/tratamento farmacológico
Prednisolona/uso terapêutico
Doenças Raras
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 0 (Immunoglobulin G); 9PHQ9Y1OLM (Prednisolone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009211


  5 / 28079 MEDLINE  
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[PMID]:29390437
[Au] Autor:Yoshiji S; Shibue K; Fujii T; Usui T; Hirota K; Taura D; Inoue M; Sone M; Yasoda A; Inagaki N
[Ad] Endereço:Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto.
[Ti] Título:Chronic primary adrenal insufficiency after unilateral adrenonephrectomy: A case report.
[So] Source:Medicine (Baltimore);96(51):e9091, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Unilateral adrenalectomy as part of surgical resection of renal cell carcinoma (RCC) is not thought to increase the risk of chronic adrenal insufficiency, as the contralateral adrenal gland is assumed to be capable of compensating for the lost function of the resected gland. However, recent studies have indicated that adrenalectomy might cause irreversible impairment of the adrenocortical reserve. We describe a case of chronic primary adrenal insufficiency in a 68-year-old man who previously underwent unilateral adrenonephrectomy, which was complicated by severe postoperative adrenal stress that involved cardiopulmonary disturbance and systemic infection. PATIENT CONCERNS: A 68-year-old Japanese man presented with weight loss of 6 kg over a 4-month period, and renal biopsy confirmed a diagnosis of RCC. He underwent adrenonephrectomy for the RCC, but developed postoperative septic shock because of a retroperitoneal cystic infection and ventricular fibrillation that was induced by vasospastic angina. The patient was successfully treated using antibiotics and percutaneous coronary intervention, and was subsequently discharged with no apparent complications except decreased appetite and general fatigue. However, his appetite and fatigue did not improve over time and he was readmitted for an examination. DIAGNOSES: The workup revealed a markedly elevated adrenocorticotropic hormone (ACTH) level (151.4 pg/mL, normal: 7-50 pg/mL) and a mildly decreased morning serum cortisol level (6.4 mg/mL, normal: 7-28 mg/mL). In addition to the patient's clinical symptoms and laboratory results, the results from ACTH and corticotropin-releasing hormone stimulation tests were used to make a diagnosis of primary adrenal insufficiency. INTERVENTIONS: Treatment was initiated using oral prednisolone (20 mg), which rapidly resolved his symptoms. At the 1-year follow-up, the patient had a markedly decreased serum cortisol level (2.0 mg/mL) with an ACTH level that was within the normal range (44.1 pg/mL) before his morning dose of prednisolone, which confirmed the diagnosis of chronic primary adrenal insufficiency. LESSONS: Clinicians must be aware of chronic adrenal insufficiency as a possible complication of unilateral adrenalectomy, especially when patients who underwent unilateral adrenalectomy experience severe adrenal stress.
[Mh] Termos MeSH primário: Doença de Addison/etiologia
Adrenalectomia/efeitos adversos
Nefrectomia/efeitos adversos
[Mh] Termos MeSH secundário: Doença de Addison/diagnóstico
Doença de Addison/tratamento farmacológico
Idoso
Carcinoma de Células Renais/cirurgia
Glucocorticoides/uso terapêutico
Seres Humanos
Hidrocortisona/sangue
Neoplasias Renais/cirurgia
Masculino
Prednisolona/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 9PHQ9Y1OLM (Prednisolone); WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009091


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[PMID]:29402251
[Au] Autor:Kim JY; Lee JH; Lee CS; Lee SC
[Ad] Endereço:Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, South Korea.
[Ti] Título:Varicella zoster virus-associated Chorioretinitis: a case report.
[So] Source:BMC Ophthalmol;18(1):28, 2018 Feb 05.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Chorioretinitis is an unusual form of varicella zoster virus (VZV)-associated uveitis, and no report has described VZV-associated chorioretinitis using serial optical coherence tomography (OCT) images obtained during the course of resolution. CASE PRESENTATION: A 61-year-old woman presented with acute, unilateral vision loss in her right eye. Her visual acuity was count fingers in the right eye and 16/20 in the left eye, and she exhibited skin vesicles on her right forehead. Slit lamp biomicroscopy, funduscopy, OCT, and intraocular fluid analysis were performed. The right eye exhibited multiple inflammatory lesions at the posterior pole, macular edema, and disc swelling on the fundus examination. OCT revealed predominant involvement of the choroid and the retinal pigment epithelium (RPE). Intraocular fluid analysis showed positivity for VZV. The patient was admitted and treated with intravenous acyclovir. Additional oral prednisolone was used to reduce the inflammatory reaction. After 2 weeks of treatment with acyclovir, the lesion resolved, with undulation of the RPE. Her final visual acuity was 20/20. CONCLUSIONS: VZV-associated posterior uveitis may present as multifocal chorioretinitis. Intraocular fluid analysis is important to detect an infectious origin.
[Mh] Termos MeSH primário: Coriorretinite/virologia
Infecções Oculares Virais/virologia
Herpesvirus Humano 3/isolamento & purificação
Uveíte Posterior/virologia
Infecção pelo Vírus da Varicela-Zoster/virologia
[Mh] Termos MeSH secundário: Aciclovir/uso terapêutico
Administração Oral
Antivirais/uso terapêutico
Coriorretinite/diagnóstico
Coriorretinite/tratamento farmacológico
Terapia Combinada
Infecções Oculares Virais/diagnóstico
Infecções Oculares Virais/tratamento farmacológico
Feminino
Angiofluoresceinografia
Glucocorticoides/uso terapêutico
Seres Humanos
Meia-Idade
Prednisolona/uso terapêutico
Tomografia de Coerência Óptica
Uveíte Posterior/diagnóstico
Uveíte Posterior/tratamento farmacológico
Infecção pelo Vírus da Varicela-Zoster/diagnóstico
Infecção pelo Vírus da Varicela-Zoster/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiviral Agents); 0 (Glucocorticoids); 9PHQ9Y1OLM (Prednisolone); X4HES1O11F (Acyclovir)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0696-3


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[PMID]:29390558
[Au] Autor:Thodou V; Buechter M; Manka P; Gerken G; Kahraman A
[Ad] Endereço:Department of Gastroenterology and Hepatology, University Clinic Essen, Germany.
[Ti] Título:Course of hepatitis E infection in a patient with rheumatoid arthritis and autoimmune hepatitis: A case report.
[So] Source:Medicine (Baltimore);96(51):e9407, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: A 62-year-old male patient was admitted to our clinic in February 2016 with persistently elevated liver enzymes. PATIENT CONCERNS: Clinical history involved a long time of poly-autoimmunity with a rheumatoid arthritis (in remission under tocilizumab therapy), an autoimmune thyroiditis, an eosinophilia as well as a hyper-immunoglobulin (IgG) 4-syndrome. DIAGNOSES: Laboratory studies revealed a significant increase in liver enzymes with an alanine aminotransferase (ALT) level of 574 U/L and an aspartate aminotransferase (AST) level of 864 U/L (normal <50 U/L). Furthermore, the patient was positive for anti-nuclear autoantibodies (ANA) with a titer of 1:320 (normal upper limit: 1:80). INTERVENTIONS: Liver histology, obtained via mini-laparoscopy, demonstrated lobular hepatitis with markedly increased hepatocyte apoptosis, lymphoplasmatic cell infiltration, and 20% microvascular fat without significant fibrosis, which strengthened the diagnosis of autoimmune hepatitis (AIH). Pulse steroid treatment with 100 mg prednisolone for 3 days followed by a tapering down was initiated. Follow-up laboratory analysis demonstrated a decrease in liver enzymes and also of the ANA-titer. OUTCOMES: At that point, hepatitis E virus (HEV) infection was diagnosed with a positive anti-HEV immunoglobulin M (IgM) antibody and HEV-ribonucleotide acid (RNA) of 6280 copies/mL. LESSONS: Despite the HEV infection and due to the strength of autoimmunity, we decided to continue immunosuppressive therapy and monitored HEV-PCR regularly. However, HEV-RNA became negative after 2 months and HEV-IgM turned negative after 13 months.
[Mh] Termos MeSH primário: Artrite Reumatoide/complicações
Hepatite E/complicações
Hepatite Autoimune/complicações
[Mh] Termos MeSH secundário: Artrite Reumatoide/patologia
Artrite Reumatoide/virologia
Hepatite E/patologia
Hepatite Autoimune/patologia
Hepatite Autoimune/virologia
Seres Humanos
Imunossupressores/uso terapêutico
Fígado/patologia
Testes de Função Hepática
Masculino
Meia-Idade
Prednisolona/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunosuppressive Agents); 9PHQ9Y1OLM (Prednisolone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009407


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[PMID]:29381940
[Au] Autor:Moraes BRM; Nascimento MVDD; Neto EDDS; Santo RM
[Ti] Título:Topical steroids eye drops in conjunctival reactive lymphoid hyperplasia: Case report.
[So] Source:Medicine (Baltimore);96(47):e8656, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Conjunctival lymphoproliferative lesions constitute a significant diagnostic challenge and it is essential to exclude neoplastic lesions. Histopathological and immunohistochemical tests are very useful in establishing the correct diagnosis. Reactive lymphoid hyperplasia (RLH) is part of a spectrum of lymphocytic infiltrative disorders. Evidence is scarce regarding appropriate treatment of conjunctival RLH. We report a case treated with topical corticosteroid. PATIENT CONCERNS: A 40 year-old female presented with a 7-month history of a slow growth tumor in the superior conjunctiva of the right eye. Slit-lamp examination demonstrated salmon colored lesion in the upper conjunctiva, with little conjunctival injection, but no significant neovascularization. There was no eyelid involvement. DIAGNOSES: Ultrasound biomicroscopy showed lesion depth (1.53 mm) and larger diameter (10.73 mm). Pathological examination revealed a chronic inflammatory process with conjunctival folicular hyperplasia. The immunohistochemistry examination showed predominance of CD20, CD23, and CD 3 e CD 5. INTERVENTION: We started topic prednisolone 1% 6 times daily. OUTCOMES: Six months after starting treatment, the lesion completely resolved, without any side-effects or recurrence during three-year follow-up period. LESSONS: Conjunctival RLH can be managed in various ways, depending on patient symptonm, comorbities, and disease distribution. Surgical resection with cryotherapy, radiotherapy, systemic corticosteroids, subconjunctival triamcinolone, and rituximab are some options. There is no strong evidence in the literature of conjunctival RLH successfully treated with topical eye drops corticosteroid. In this report, we obtained completely resolution of conjunctival RLH with topical corticosteroid. CONCLUSION: Topical eye drops corticosteroids are an alternative treatment for selected cases of conjuncitval RLH with no orbital or eyelid involvement.
[Mh] Termos MeSH primário: Túnica Conjuntiva/patologia
Neoplasias da Túnica Conjuntiva/diagnóstico
Prednisolona/administração & dosagem
Pseudolinfoma
[Mh] Termos MeSH secundário: Administração Tópica
Adulto
Diagnóstico Diferencial
Feminino
Glucocorticoides/administração & dosagem
Seres Humanos
Imuno-Histoquímica
Microscopia Acústica/métodos
Soluções Oftálmicas
Pseudolinfoma/diagnóstico
Pseudolinfoma/tratamento farmacológico
Pseudolinfoma/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 0 (Ophthalmic Solutions); 9PHQ9Y1OLM (Prednisolone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008656


  9 / 28079 MEDLINE  
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[PMID]:29253897
[Au] Autor:Negera E; Walker SL; Bekele Y; Dockrell HM; Lockwood DN
[Ad] Endereço:London School of Hygiene and Tropical Medicine (LSHTM), Faculty of Infectious Tropical Diseases, London, United Kingdom.
[Ti] Título:Increased activated memory B-cells in the peripheral blood of patients with erythema nodosum leprosum reactions.
[So] Source:PLoS Negl Trop Dis;11(12):e0006121, 2017 12.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:B-cells, in addition to antibody secretion, have emerged increasingly as effector and immunoregulatory cells in several chronic inflammatory diseases. Although Erythema Nodosum Leprosum (ENL) is an inflammatory complication of leprosy, the role of B- cell subsets has never been studied in this patient group. Therefore, it would be interesting to examine the contribution of B-cells in the pathogenesis of ENL. A case-control study design was used to recruit 30 untreated patients with ENL and 30 non-reactional lepromatous leprosy (LL) patient controls at ALERT Hospital, Ethiopia. Peripheral blood samples were obtained before, during and after treatment from each patient. Peripheral blood mononuclear cells (PBMCs) were isolated and used for immunophenotyping of B- cell subsets by flow cytometry. The kinetics of B-cells in patients with ENL before, during and after Prednisolone treatment of ENL was compared with LL patient controls as well as within ENL group. Total B-cells, mature B-cells and resting memory B-cells were not significantly different between patients with ENL reactions and LL controls before treatment. Interestingly, while the percentage of naive B-cells was significantly lower in untreated ENL patients than in LL patient controls, the percentage of activated memory B-cells was significantly higher in these untreated ENL patients than in LL controls. On the other hand, the percentage of tissue-like memory B-cells was considerably low in untreated ENL patients compared to LL controls. It appears that the lower frequency of tissue-like memory B-cells in untreated ENL could promote the B-cell/T-cell interaction in these patients through downregulation of inhibitory molecules unlike in LL patients. Conversely, the increased production of activated memory B-cells in ENL patients could imply the scale up of immune activation through antigen presentation to T-cells. However, the generation and differential function of these memory B-cells need further investigation. The finding of increased percentage of activated memory B-cells in untreated patients with ENL reactions suggests the association of these cells with the ENL pathology. The mechanism by which inflammatory reactions like ENL affecting these memory cells and contributing to the disease pathology is an interesting area to be explored for and could lead to the development of novel and highly efficacious drug for ENL treatment.
[Mh] Termos MeSH primário: Anticorpos Antibacterianos/imunologia
Linfócitos B/imunologia
Eritema Nodoso/imunologia
Eritema Nodoso/patologia
Hanseníase/patologia
Mycobacterium leprae/imunologia
[Mh] Termos MeSH secundário: Anti-Inflamatórios/uso terapêutico
Estudos de Casos e Controles
Eritema Nodoso/tratamento farmacológico
Etiópia
Seres Humanos
Memória Imunológica/imunologia
Hanseníase/imunologia
Hanseníase/microbiologia
Contagem de Linfócitos
Prednisolona/uso terapêutico
Linfócitos T/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Antibodies, Bacterial); 9PHQ9Y1OLM (Prednisolone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0006121


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[PMID]:27774990
[Au] Autor:Schlenk RF; Stegelmann F; Reiter A; Jost E; Gattermann N; Hebart H; Waller C; Hochhaus A; Platzbecker U; Schafhausen P; Blau IW; Verbeek W; Heidel FH; Werner M; Kreipe H; Teleanu V; Benner A; Döhner H; Grießhammer M; Döhner K
[Ad] Endereço:Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany.
[Ti] Título:Pomalidomide in myeloproliferative neoplasm-associated myelofibrosis.
[So] Source:Leukemia;31(4):889-895, 2017 Apr.
[Is] ISSN:1476-5551
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Myeloproliferative neoplasm (MPN)-associated myelofibrosis is a MPN characterized by bone marrow fibrosis, cytopenias, splenomegaly and constitutional symptoms. Pomalidomide, an immune-modifying drug, is reported to improve anaemia and thrombocytopenia in some patients with MPN-associated myelofibrosis. We designed a phase 2 study of pomalidomide in patients with MPN-associated myelofibrosis and anaemia and/or thrombocytopenia and/or neutropenia. Subjects received pomalidomide 2.0 mg/day in cohort 1 (n=38) or 0.5 mg/day in cohort 2 (n=58). Prednisolone was added if there was no response after 3 months in cohort 1 and based on up-front randomization in cohort 2 if there was no response at 3 or 6 months. Response rates were 39% (95% confidence interval (CI), 26-55%) in cohort 1 and 24% (95% CI, 15-37%) in cohort 2. In a multivariable logistic regression model pomalidomide at 2.0 mg/day (odds ratio (OR), 2.62; 95% CI, 1.00-6.87; P=0.05) and mutated TET2 (OR, 5.07; 95% CI, 1.16-22.17; P=0.03) were significantly associated with responses. Median duration of responses was 13.0 months (range 0.9-52.7). There was no significant difference in response rates or duration in subjects receiving or not receiving prednisolone. Clinical trial MPNSG 01-09 is registered at ClinicalTrials.gov (NCT00949364) and clinicaltrialsregister.eu (EudraCT Number: 2009-010738-23).
[Mh] Termos MeSH primário: Fatores Imunológicos/uso terapêutico
Transtornos Mieloproliferativos/complicações
Mielofibrose Primária/tratamento farmacológico
Mielofibrose Primária/etiologia
Talidomida/análogos & derivados
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Alelos
Biomarcadores
Bandeamento Cromossômico
Feminino
Seres Humanos
Fatores Imunológicos/administração & dosagem
Fatores Imunológicos/efeitos adversos
Masculino
Meia-Idade
Mutação
Transtornos Mieloproliferativos/diagnóstico
Transtornos Mieloproliferativos/genética
Fenótipo
Prednisolona/administração & dosagem
Prednisolona/efeitos adversos
Prednisolona/uso terapêutico
Mielofibrose Primária/diagnóstico
Talidomida/administração & dosagem
Talidomida/efeitos adversos
Talidomida/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Biomarkers); 0 (Immunologic Factors); 4Z8R6ORS6L (Thalidomide); 9PHQ9Y1OLM (Prednisolone); D2UX06XLB5 (pomalidomide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180120
[Lr] Data última revisão:
180120
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1038/leu.2016.299



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