Sa2036 Antiglycan Antibodies are Associated With Steroid Dependence in IBD

2012 ◽  
Vol 142 (5) ◽  
pp. S-386
Author(s):  
Freddy Mounsef ◽  
Stephane Paul ◽  
Leslie Rinaldi ◽  
Emilie Presles ◽  
Emilie Del Tedesco ◽  
...  
Keyword(s):  
Steroid Dependence ◽  
Antiglycan Antibodies

scholarly journals Lipoprotein (a) as a Predictor of Steroid Dependence in Paediatric Steroid Sensitive Nephrotic Syndrome

2021 ◽  
Author(s):  
Surupa Basu ◽  
Sushmita Banerjee ◽  
Pranab Roy ◽  
Apurba Ghosh
Keyword(s):  
Nephrotic Syndrome ◽  
First Episode ◽  
Urine Protein ◽  
Lipoprotein A ◽  
Steroid Dependence ◽  
Steroid Dependency ◽  
Steroid Dependent ◽  
Steroid Sensitive ◽  
One Year ◽  
Lipid Parameters

Introduction: Lipoprotein a {Lp(a)} increases in Nephrotic Syndrome (NS). Although the majority of paediatric NS are steroid sensitive, relpase and steroid dependence are commonly seen in this cases. Lp(a) is an LDL-like lipoprotein that consists of an LDL particle to which the glycoprotein apolipoprotein(a) {apo(a)} is attached. Aim: To evaluate the potential of Lp(a), measured on admission, for the prediction of relapse/steroid dependency. Materials and Methods: Children (n=36) with first episode NS were recruited in this prospective observational case-control study and followed up for one year. They were tested at presentation for Lp(a) (mg/dL) and standard tests such as haemoglobin, albumin, protein, cholesterol, triglyceride, and urine protein. Children received standard therapy for NS, and were followed for a period of one year from diagnosis to record days to initial remission, relapse episodes, steroid dependence etc. Patients were categorised as: no relapse (NR), Infrequent Relapse (IFR), frequent relapse (FR) and Steroid Dependent (SD) as per standard definitions. Fifteen healthy volunteers were also tested for lipid profile and Lp(a) levels. Results: Of 36 cases (median age 3 years, 19 males), there were 15NR, 7IFR, 2FR and 12SD. The mean Lp(a) of the NS group (165.2±120.4 mg/dL) was higher than controls (30.52±21.9 mg/dL) (p<0.0001). All the lipid parameters except HDL-cholesterol were significantly higher in the NS group. Within the NS group, Lp(a) showed significant correlation (Spearman-rho) with albumin (p=0.0062,r=0.47), but no correlation with lipid parameters or urine protein. Comparison of Lp(a)levels in the NS groups revealed that the SD patients had a high Lp(a)(222.0±115.7 mg/dL) compared to NR (129.7±120.1 mg/dL) (p=0.02). Conclusion: Concentration of plasma Lp(a) in patients with SDNS was higher compared to patients who did not suffer any relapse, and this concentration may serve as a marker for prediction of SDNS.

scholarly journals Anabolic-androgenic steroid dependence: an emerging disorder

Addiction ◽  
2009 ◽  
Vol 104 (12) ◽  
pp. 1966-1978 ◽  
Author(s):  
Gen Kanayama ◽  
Kirk J. Brower ◽  
Ruth I. Wood ◽  
James I. Hudson ◽  
Harrison G. Pope Jr
Keyword(s):  
Anabolic Androgenic Steroid ◽  
Steroid Dependence ◽  
Androgenic Steroid

The Effect of Mesalamine and Nicotine in the Treatment of Inflammatory Bowel Disease

1997 ◽  
Vol 31 (7-8) ◽  
pp. 907-913 ◽  
Author(s):  
Charles R. Bonapace ◽  
David A. Mays
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Relapse Rate ◽  
Bowel Disease ◽  
Therapeutic Agent ◽  
Active Ulcerative Colitis ◽  
Steroid Dependence ◽  
Inflammatory Bowel

OBJECTIVE: To characterize the usefulness of mesalamine and nicotine in the treatment of active ulcerative colitis and inactive Crohn's disease. DATA SOURCES: Citations were selected from the MEDLINE database. Only those involving human subjects, inflammatory bowel disease, and available in English were selected. STUDY SELECTION: Selection criteria consisted of clinical trials and review articles assessing the effects of mesalamine and nicotine in active ulcerative colitis or inactive Crohn's disease and the utility of reducing steroid dependence or relapse rate. Less than 20% of the articles identified met the selection criteria. DATA SYNTHESIS: In patients with inactive Crohn's disease, mesalamine 2 g/d significantly reduced the risk of relapse in high-relapse-risk patients compared with placebo, reducing the relapse rate from 71% to 55%, but was ineffective in preventing recurrence of inactive Crohn's disease following surgical resection. Mesalamine 4 g/d was effective in decreasing weaning failure due to steroid dependence by 67%, although the relapse rate was not significant compared with placebo at the end of 12 months. Following surgical resection, mesalamine was unable to significantly reduce the incidence of recurrence compared with placebo at the end of 1 year. In patients with active ulcerative colitis, oral mesalamine 2 and 4 g/d was superior to placebo in inducing remission compared with placebo. Among patients with prior steroid or sulfasalazine treatment, rectal mesalamine 4 g hs achieved a remission rate of 78% in more than 12 weeks of therapy. Other studies have not found a dose—response relationship with lower dosages of mesalamine. Whereas nicotine 15–25 mg/d administered as a transdermal patch produced greater symptomatic improvement in active ulcerative colitis compared with placebo, nicotine 15 mg/16 h produced results no different from those with placebo in maintaining remission in inactive ulcerative colitis. Nicotine appears to have an adverse effect on the course of Crohn's disease and is not recommended. CONCLUSIONS: Mesalamine has demonstrated clinical effectiveness as a therapeutic agent in the treatment of active ulcerative colitis and inactive Crohn's disease. Although its relationship to inflammatory bowel disease has been known for many years, the usefulness of nicotine for the treatment of active ulcerative colitis requires further exploration before it can be recommended as a therapeutic agent.

Case Report: Rapid Response to Low-Dose Thalidomide in a Case of Severe Steroid Recalcitrant Erythema Nodosum Leprosum

2021 ◽  
Author(s):  
B. Savitha ◽  
Kabir Sardana ◽  
Ritu Kumari ◽  
Ananta Khurana ◽  
Surabhi Sinha ◽  
...  
Keyword(s):  
Low Dose ◽  
Erythema Nodosum ◽  
Lepromatous Leprosy ◽  
High Dose ◽  
Effective Treatment Option ◽  
Steroid Dependence ◽  
Erythema Nodosum Leprosum ◽  
Organ Specific ◽  
Inflammatory Drugs

Erythema nodosum leprosum (ENL), or type 2 lepra reaction, presents with crops of evanescent, tender erythematous nodules accompanied by fever, arthralgia, weight loss, malaise, and organ-specific manifestations, and is seen in borderline and lepromatous leprosy. The drugs approved for ENL include nonsteroidal anti-inflammatory drugs, systemic steroids, thalidomide, and clofazimine. The management of ENL is challenging because long-term steroid use leads to steroid dependence. Our patient had severe steroid recalcitrant ENL with vesicular and pustular lesions mimicking Sweet’s syndrome, and was treated effectively with a low-dose thalidomide regimen (100 mg/d) as opposed to the high dose (400 mg/d) recommended in the literature. We discuss the patho-mechanics and clinical utility of a low-dose thalidomide regimen as an effective treatment option for ENL.

scholarly journals Immunoglobulin m (IGM) Nephropathy in children - report of two cases

2015 ◽  
Vol 23 (1) ◽  
pp. 131-133
Author(s):  
Shireen Afroz ◽  
Maliha Alam Simi ◽  
Shanjida Sharmin ◽  
Laila Yeasmin ◽  
LC Kundu
Keyword(s):  
Complete Remission ◽  
Immunoglobulin M ◽  
Oral Steroid ◽  
Membrane Thickness ◽  
Variable Degree ◽  
Basement Membrane Thickness ◽  
Igm Nephropathy ◽  
Steroid Dependence ◽  
First Case ◽  
Refractory Nephrotic Syndrome

Immunoglobulin M nephropathy (IgMN) is an idiopathic glomerulonephritis characterized by a variable degree of mesangialhypercellularity and diffuse IgM deposits.Patients usually presents with refractory nephrotic syndrome (NS) and hematuria. We present two patients with IgM nephropathy one with frequently relapsing NS with steroid dependence, treated with oral steroid and cyclophosphamide subsequently with tacrolimus. The patient showed complete remission but breakthrough relapses occurredduring the course of steroid treatment.The second case presented with persistentgross hematuria and nephroticrange proteinuria for 6 months. The patient showed complete remission of proteinuria and hematuria with oral steroid andremained on remission for9 months. Then again developed hematuria & proteinuria and subsequently showed response to oral steroid and cyclphosphamide . Renal histopathology & immunofluorescence study of first case revealed normal mesangial cellularity and basement membrane thickness with mesangial deposits of IgM. Second case showed global mesangial proliferation with increasing mesangial matrix with moderate mesangial deposits of IgM. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22709 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 131-133

Prolonged Steroid Dependence in Adult Patients With Glioma

2020 ◽  
Vol 40 (4) ◽  
pp. 2059-2064 ◽  
Author(s):  
EMMANUEL C. MANTILLA ◽  
JESSICA ABRAMOWITZ ◽  
TU DAN ◽  
EDWARD PAN
Keyword(s):  
Adult Patients ◽  
Steroid Dependence

Atypical IgM on T cells predict relapse and steroid dependence in idiopathic nephrotic syndrome

2019 ◽  
Vol 96 (4) ◽  
pp. 971-982 ◽  
Author(s):  
Manuela Colucci ◽  
Rita Carsetti ◽  
Maria Manuela Rosado ◽  
Simona Cascioli ◽  
Maurizio Bruschi ◽  
...  
Keyword(s):  
T Cells ◽  
Nephrotic Syndrome ◽  
Idiopathic Nephrotic Syndrome ◽  
Steroid Dependence

Association between Vasculitides and Myelodysplastic Syndrome (MDS): A Report on 21 Cases.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4714-4714 ◽  
Author(s):  
O. Fain ◽  
M. Hamidou ◽  
P. Cacoub ◽  
B. Godeau ◽  
J. Stirnemann ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Renal Involvement ◽  
Relapsing Polychondritis ◽  
Hematologic Malignancies ◽  
Skin Lesions ◽  
Drug Induced ◽  
Steroid Dependence ◽  
Granulomatous Vasculitis ◽  
Cancer Remission ◽  
Median Interval

Abstract Vasculitis rarely complicates solid tumors but is more common in hematologic malignancies, particularly MDS,. We report characteristics and outcome of 21 patients with both MDS and vasculitis. Patients: We retrospectively collected data of patients with at least 1 malignancy (including MDS) and vasculitis diagnosed between 1992 and 2002 in 6 French centers. Vasculitides occurring during cancer remission were excluded, as were giant-cell arteritis, relapsing polychondritis (a well known association with MDS), cryoglobulinemia, infection- or drug-induced vasculitis. Results: 60 patients, with median follow-up of 45 months were analyzed. Vasculitides diagnosed were: cutaneous leukocytoclastic (LV,45%), polyarteritis nodosa (PAN,36.7%), Wegener’s granulomatosis (WG,6.7%), microscopic polyangiitis (MPA,5%), Henoch-Schonlein purpura( HSP,5%). Cancers were hematological (66.7%) (including 21 MDS (35%) and (23%) lymphoid malignancies) and solid tumors (41.7%). Five patients had 2 cancers. 21 patients had vasculitis associated with MDS (median age 66 yr; M/F ratio 4.25). FAB classification was: RAEB (n=11), RA (n=3) and CMML (n=7). Vasculitides were LV (n=9), PAN (n=9), MPA(n=1), WG (n=1), cutaneous granulomatous vasculitis (n=1).CMML were only associated with necrotizing vasculitis ( 6PAN, 1WG). Vasculitis and MDS were diagnosed simultaneously in 12(57%) cases, vasculitis was diagnosed after MDS in 8 (38%) cases (median interval: 11 months, range 1–45) and 6 months before MDS in 1 case.9 MDS progressed to AML. Vasculitides developed before or at the time of leukemic progression in 6 of them (median interval 3 months, range 0–12). Main vasculitis symptoms were: fever (47%), skin lesions(81%), arthralgias (62%), peripheral neuropathy (14%), renal involvement (43%)[microaneurysms 29%, renal failure 9.5%, glomerulonephritis 9.5%], inflammatory syndrome (81%), ANCA (20%). Vasculitis therapy was steroids (90%) +/− immune suppressors (33%). MDS treatment was: AraC( n:2), VP16 (n:3), hydroxyurea (n:2),allogeneic BMT (n:2), symptomatic (n:12). Vasculitis was cured in 10 (47%) cases. 17 (81%) patients died; only 1 death was linked to vasculitis. Regardless of the type, vasculitides associated with MDS had significantly more frequent renal involvement (p=0.02),steroid dependence (p=0.04), and less recovery (p=0.04) than vasculitides without MDS Conclusion: Vasculitides associated to MDS appear to have distinctive features and more severe evolution.In addition, occurrence of vasculitides during the course of MDS may be associated with a high risk of rapid leukemic progression.

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