Serum cytokines in ANCA-associated vasculitis: Correlation with disease-related clinical and laboratory findings

A rare case of a patient with an unusual skin rash after using cocaine is presented. A clinical diagnosis of levamisole-induced vasculitis was made based on initial presentation of purpuric skin lesions involving the ears and positive cocaine on urine toxicology screening. The diagnosis was confirmed after laboratory findings of neutropenia, positive serum levamisole, and a histopathologic test of the skin lesions. The pathophysiology of this condition is discussed. Treatment with methylprednisolone and prednisone led to the resolution of the neutropenia and complete recovery of the skin lesions. With the growing use of levamisole-tainted cocaine, clinicians should be aware of the symptoms of vasculitis and neutropenia induced by this combination of drugs to avoid unnecessary tests and delayed diagnosis.

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Interleukin-8 is elevated in severe hand, foot, and mouth disease

The Journal of Infection in Developing Countries ◽

10.3855/jidc.3542 ◽

2014 ◽

Vol 8 (01) ◽

pp. 094-100 ◽

Cited By ~ 13

Author(s):

Wen Wang ◽

Wei Li ◽

Xue Yang ◽

Tong Zhang ◽

Yuxuan Wang ◽

...

Keyword(s):

Disease Severity ◽

Enterovirus 71 ◽

Foot And Mouth Disease ◽

Length Of Hospital Stay ◽

Mouth Disease ◽

Brainstem Encephalitis ◽

Laboratory Findings ◽

Serum Cytokines ◽

Foot And Mouth ◽

Isolated Brainstem

Introduction: Enterovirus 71 (EV71) infections can cause hand, foot, and mouth disease (HFMD), which is a potentially fatal illness in children. Epidemics of HFMD are seen every year globally and present an increasing threat to public health worldwide. Methodology: To identify potential severity markers for severe HFMD, laboratory findings and levels of eight serum cytokines in 143 EV71-infected patients in Beijing You’an Hospital were analyzed. Patients were grouped by disease severity: Mild (no severe complications) (n = 59), isolated isolated brainstem encephalitis (BE) (n = 47), isolated pulmonary edema (PE) (n = 12), and BE+PE (n = 25). Results: IL-8 levels peaked at day one after admission and were found to be correlated to disease severity, maximal body temperature, and length of hospital stay. Among all tested cytokines, IL-8 was correlated to only IL-6 (p = 0.010). IL-6 and IL-10 were elevated in most patients (98.6% and 70.6%), but not correlated to disease severity (both p > 0.05). IFNg was only negatively correlated to mild cases (p = 0.025). Conclusions: IL-8 was correlated to disease severity of HFMD. IL-6 and IL-10, although elevated in most HFMD patients, were not correlated to disease severity.

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Systematic Histological Scoring Reveals More Prominent Interstitial Inflammation in Myeloperoxidase-ANCA Compared to Proteinase 3-ANCA Glomerulonephritis

Journal of Clinical Medicine ◽

10.3390/jcm10061231 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1231

Author(s):

Samy Hakroush ◽

Ingmar Alexander Kluge ◽

Philipp Ströbel ◽

Peter Korsten ◽

Désirée Tampe ◽

...

Keyword(s):

Granulomatosis With Polyangiitis ◽

Clinical Presentation ◽

Systemic Vasculitis ◽

Antineutrophil Cytoplasmic Antibody ◽

Laboratory Findings ◽

Treatment Regimens ◽

Anca Associated Vasculitis ◽

Kidney Involvement ◽

Tubulointerstitial Lesions ◽

Severe Deterioration

Background: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic vasculitis, most frequently presenting as microscopic polyangiitis (MPA) or granulomatosis with polyangiitis (GPA). Kidney involvement is a common and severe complication of ANCA AAV which is observed in a considerable subset of patients, mainly affecting glomeruli. However, tubulointerstitial lesions have also been described in ANCA glomerulonephritis (GN). Therefore, we aim to describe active and chronic tubulointerstitial lesions in ANCA GN subtypes by systematic scoring analogous to the Banff scoring system while also utilizing clinical and laboratory findings. Methods: A total of 49 kidney biopsies with ANCA GN were retrospectively included in a single-center cohort study between 2015–2020. Results: We report that MPO-ANCA GN is associated with more severe deterioration of kidney function independent of systemic markers of AAV disease activity, and is also associated with increased proteinuria in MPO-ANCA GN and a decreased fraction of normal glomeruli. Finally, MPO-ANCA GN showed distinct, active, and chronic tubulointerstitial lesions. Conclusion: New insights into the pathophysiology of both entities, as well as differences in the clinical presentation of MPO- versus PR3-ANCA GN, could potentially pave the way for more precise treatment regimens. Therefore, it is important to understand the differences in histopathological presentation, especially in yet underestimated active tubulointerstitial lesions of ANCA GN subtypes. This research could further improve our understanding of distinct pathophysiological mechanisms.

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Prevalence and Risk Factors for Major Infections in Patients with Antineutrophil Cytoplasmic Antibody–associated Vasculitis: Influence on the Disease Outcome

The Journal of Rheumatology ◽

10.3899/jrheum.190065 ◽

2019 ◽

Vol 47 (3) ◽

pp. 407-414 ◽

Cited By ~ 5

Author(s):

Eloi Garcia-Vives ◽

Alfons Segarra-Medrano ◽

Ferran Martinez-Valle ◽

Irene Agraz ◽

Roser Solans-Laque

Keyword(s):

Bacterial Infections ◽

Granulomatosis With Polyangiitis ◽

Opportunistic Infections ◽

Disease Onset ◽

Antineutrophil Cytoplasmic Antibody ◽

First Year ◽

Laboratory Findings ◽

Anca Associated Vasculitis ◽

Tertiary Center ◽

Tract Infections

Objective.To analyze the role that infections play on the antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) outcome.Methods.A retrospective study of adult patients with AAV diagnosed in a tertiary center. Clinical features, laboratory findings, treatment, relapses, major infections, and outcome were evaluated.Results.Included were 132 patients [51 microscopic polyangiitis (MPA), 52 granulomatosis with polyangiitis (GPA), 29 eosinophilic GPA (EGPA)] with a mean followup of 140 (96–228) months. ANCA were positive in 85% of cases. A total of 300 major infections, mainly bacterial (85%), occurred in 60% patients during the followup. Lower respiratory tract (64%) and urinary tract infections (11%) were the most frequent, followed by bacteremia (10%). A total of 7.3% opportunistic infections were observed, most due to systemic mycosis. Up to 46% of all opportunistic infections took place in the first year of diagnosis, and 55% of them under cyclophosphamide (CYC) treatment. Bacterial infections were associated with Birmingham Vasculitis Activity Score (version 3) > 15 at the disease onset, a total cumulative CYC dose > 8.65 g, dialysis, and development of leukopenia during the followup. Leukopenia was the only factor independently related to opportunistic infections. Forty-four patients died, half from infection. Patients who had major infections had an increased mortality from any cause.Conclusion.Our results confirm that major infections are the main cause of death in patients with AAV.

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Cytokine levels are associated with the severity of varicella infections

The Journal of Infection in Developing Countries ◽

10.3855/jidc.5255 ◽

2015 ◽

Vol 9 (02) ◽

pp. 190-196 ◽

Cited By ~ 4

Author(s):

Meijun Hao ◽

Xiaojun Wang ◽

Jingpei Du ◽

Lifeng Liu ◽

Yanmei Jiao ◽

...

Keyword(s):

Skin Infection ◽

Serum Markers ◽

Skin Infections ◽

Laboratory Findings ◽

Serum Cytokines ◽

The Past ◽

Cytokine Levels ◽

Patients At Risk ◽

Membrane Extract ◽

Disease Epidemics

Introduction: Varicella is a highly contagious disease. Epidemics of varicella are seen every year globally and present a threat to public health, especially in China and other developing countries. Methodology: Clinical and laboratory findings of 865 varicella patients admitted to Beijing You’an Hospital, China, between January 2011 and December 2013 were collected and analyzed. Patients with isolated complication were grouped as SI (skin infection, n = 132) and LD (liver damage, n = 89). Two hundred and one patients without complications were grouped as control (mild group). Levels of T-cell subtypes and eight serum cytokines and were also tested. Levels of IFNg and IL-6 were monitored prospectively in another 12 grouped patients. Results: SI was complicated in 21.7% (188/865) of varicella cases, and LD was complicated in 16.8% (145/865). The rates of SI and LD in varicella patients increased rapidly in the past three years. No laboratory findings were associated with SI or LD (all p > 0.05). IL-6 and IFNg levels were correlated with amniotic membrane extract (AME) (p = 0.044 and p = 0.038). Their levels peaked at day 1 of admission, and then started to decline. Conclusions: The incidence of serious complications has become more common in recent years. IL-6 and IFNg may possibly be used as early serum markers for identifying patients at risk of developing complications such as skin infections in varicella.

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IL-6 and IFNγ are elevated in severe mumps cases: a study of 960 mumps patients in China

The Journal of Infection in Developing Countries ◽

10.3855/jidc.3557 ◽

2014 ◽

Vol 8 (02) ◽

pp. 208-214 ◽

Cited By ~ 13

Author(s):

Wen Wang ◽

Yueke Zhu ◽

Hao Wu ◽

Yanmei Jiao ◽

Nicholas Van Halm-Lutterodt ◽

...

Keyword(s):

Public Health ◽

Infectious Disease ◽

Developing Countries ◽

T Cell ◽

Serum Markers ◽

Laboratory Findings ◽

Serum Cytokines ◽

Common Infectious Disease ◽

Almost All ◽

Disease Epidemics

Introduction: Mumps is a common infectious disease. Epidemics of mumps are reported globally every year and represent a threat to public health, especially in China and other developing countries. Methodology: Clinical and laboratory findings of 960 mumps patients admitted to Beijing You’an Hospital, China, between January 2010 and December 2012 were collected and analyzed. Patients with isolated complication were selected and grouped as aseptic meningitis/encephalitis (AME) patients (n = 156) and Orchitis patients (n = 72). One hundred and fifty patients without complication were grouped as control. Levels of T cell subtypes and 8 serum cytokines were also tested. Results: Majority of mumps patients were male (76.3%) and younger than 17 years old (76.2%). AME was complicated in 41.6% of mumps cases, and orchitis was in 21.3% (64.7% were left-sided). Unvacinated patients had more chance to have AME or orchitis (p = 0.034 and 0.027). The rates of AME and orchitis in mumps patients rapidly increased during the last three years. No laboratory findings were associated with AME or orchitis (all p > 0.05). Serum IL-10 level was elevated in almost all patients. IL-6 and IFNγ levels were correlated with AME (p = 0.025 and p = 0.018). Their levels peaked at day one after admission, and started to decline thereafter. Conclusions: This study suggests that the incidence of serious complications has become more common in recent years, moreover IL-6 and IFNγ may possibly be used as early serum markers for identifying patients with risk of developing complications in mumps.

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