scholarly journals MO090TRANSPLANT KIDNEY BIOPSY FINDINGS IN COVID-19: A SYSTEMATIC REVIEW

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Henry Wu ◽  
Vishnu Jeyalan ◽  
Rajkumar Chinnadurai ◽  
Arvind Ponnusamy
Keyword(s):  
Renal Biopsy ◽  
Kidney Biopsy ◽  
Single Case ◽  
Wide Spectrum ◽  
Case Reports ◽  
Case Series ◽  
Antibody Mediated Rejection ◽  
Early Results ◽  
Transplant Kidney ◽  
Transplanted Kidneys

Abstract Background and Aims Patients with transplanted kidneys are more susceptible to COVID-19 infections compared to those with native kidneys because of chronic immunosuppression and co-existing co-morbidities. A wide spectrum of renal pathologies has been reported from renal biopsies taken from patients with native kidneys following COVID-19 presentation. In comparison, biopsy-proven findings in the setting of kidney transplantation and COVID-19 diagnosis are seldom described. Our study aims to review early reported histological findings of transplant kidney biopsies from patients testing positive for COVID-19. Method This is a secondary analysis of a larger study (PROSPERO registration number: CRD42020218048) which reviewed the histopathological findings of kidney biopsies in adults with concurrent COVID-19 infection. A systematic literature search was conducted independently by two authors (HW, VJ) through ‘PubMed’, ‘Web of Science’, ‘Embase’ and ‘Medline-ProQuest’ using the following keywords: “COVID-19 AND Kidney Biopsy”, “COVID-19 AND Renal Biopsy”, “SARS-CoV-2 AND Kidney Biopsy” and “SARS-CoV-2 AND Renal Biopsy”. Articles were screened by three authors (HW, VJ, RC) for relevance and duplicates were removed. The study selection process was carried out as per the PRISMA guideline. In this analysis, we included all research articles reporting biopsies in transplanted kidneys in adults over age > 18 who tested positive with COVID-19 following a PCR swab test. We only included articles published in the English language. All relevant articles published before November 1st 2020 were included in this review. Information regarding demographic data, co-morbidities, renal presentation, renal parameters at time of COVID-19 diagnosis, management, need for renal replacement therapy and outcomes were extracted from selected articles. Results Our review identified 11 cases reporting transplant kidney biopsies in patients with positive COVID-19 status. These 11 cases were reported from 7 articles, which were either single case reports or part of a case series. Mean age of the reported cases was 43.6 years ± 10.7. Transplant kidney biopsies were taken from 4 female and 7 male patients, where 7 patients were of black ethnicity. The review involved 3 live donor and 6 deceased donor transplanted kidneys, and 2 cases did not report type of kidney transplant received. All of the documented cases presented with acute kidney injury. 9 patients have essential hypertension or hypertension secondary to other co-morbidities. Biopsy findings revealed 2 cases of acute T-cell mediated and antibody mediated rejection, 2 cases of acute tubular injury, 5 cases of either FSGS or collapsing FSGS and 1 report of post-transplant kidney infarction. Acute treatment received involved different regimes. All 11 patients were eventually discharged from hospital, where 2 patients required dialysis following discharge. Table 1 describes data from the extracted cases. Conclusion There are multiple histological pathologies observed amongst transplant kidney biopsies taken from patients admitted following COVID-19 diagnosis. Early results suggest aggressive medical treatment to manage inflammation, transplant rejection and co-morbidities such as hypertension may optimize general and renal-specific outcomes. Collation of further cases is required to determine a clearer association between COVID-19 and characteristics demonstrated from transplant kidney biopsies.

scholarly journals Cryptococcosis complicating diabetes mellitus: a scoping review

2021 ◽  
Vol 8 ◽  
pp. 204993612110147
Author(s):  
Lauryn Nsenga ◽  
Jonathan Kajjimu ◽  
Ronald Olum ◽  
Sandra Ninsiima ◽  
Andrew Peter Kyazze ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Single Case ◽  
Wide Spectrum ◽  
Case Reports ◽  
Case Series ◽  
Cochrane Library ◽  
Cryptococcal Disease ◽  
Language Restriction ◽  
Antigen Tests ◽  
The Cochrane Library

Background: A better understanding of the epidemiology of cryptococcal infection in HIV-negative individuals is an international research interest. Immune dysfunction in diabetes mellitus (DM) significantly increases the risk of acquiring and reactivation of infection due to Cryptococcus neoformans. Risk factors and outcomes of cryptococcosis in DM are not well documented. Objective: The objective of this study was to determine the clinical characteristics and outcomes of cryptococcal infections in persons living with DM. Methods: MEDLINE (via PubMed), EMBASE, and the Cochrane Library databases were searched in November 2020. The searches covered the period between 1980 and 2020.We included studies that reported confirmed cryptococcosis in patients with DM. Reference lists of included articles were also searched, and additional studies were included if appropriate. No language restriction was applied. Single case reports, case series and original articles were included whereas review articles were excluded. Results: A total of 28 studies (24 single case reports, 4 retrospectives) were included involving 47 unique patients from Asia (17 cases), North America (six cases), South America (three cases) and Africa (two cases). Men constituted 75% ( n = 18) of the cases. Median age was 60.5 (range: 27–79) years. The majority of the patients had cryptococcal meningitis (68.1%, n = 32) followed by disseminated cryptococcosis (6.4%, n = 7), and others (isolated cutaneous disease one, peritonitis one, pleural one, thyroid one, adrenal one). Diagnosis was achieved through either culture and microscopy (38/47), cryptococcal antigen tests (9/47) or histopathology (9/47) singly or in a combination. All-cause mortality was 38.3% ( n = 18). Among those with meningitis mortality was 36.2%. Conclusion: A wide spectrum of cryptococcal infections with varying severity occurs in DM. Mortality remains unacceptably high. There is a need for more studies to characterize better cryptococcal disease in DM.

scholarly journals Post-Infectious Guillain–Barré Syndrome Related to SARS-CoV-2 Infection: A Systematic Review

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 167
Author(s):  
Pasquale Sansone ◽  
Luca Gregorio Giaccari ◽  
Caterina Aurilio ◽  
Francesco Coppolino ◽  
Valentina Esposito ◽  
...  
Keyword(s):  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Guillain Barre Syndrome ◽  
Response To Treatment ◽  
Comprehensive Overview ◽  
Fisher Syndrome ◽  
Immunomodulating Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Background. Guillain-Barré syndrome (GBS) is the most common cause of flaccid paralysis, with about 100,000 people developing the disorder every year worldwide. Recently, the incidence of GBS has increased during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemics. We reviewed the literature to give a comprehensive overview of the demographic characteristics, clinical features, diagnostic investigations, and outcome of SARS-CoV-2-related GBS patients. Methods. Embase, MEDLINE, Google Scholar, and Cochrane Central Trials Register were systematically searched on 24 September 2020 for studies reporting on GBS secondary to COVID-19. Results. We identified 63 articles; we included 32 studies in our review. A total of 41 GBS cases with a confirmed or probable COVID-19 infection were reported: 26 of them were single case reports and 6 case series. Published studies on SARS-CoV-2-related GBS typically report a classic sensorimotor type of GBS often with a demyelinating electrophysiological subtype. Miller Fisher syndrome was reported in a quarter of the cases. In 78.1% of the cases, the response to immunomodulating therapy is favourable. The disease course is frequently severe and about one-third of the patients with SARS-CoV-2-associated GBS requires mechanical ventilation and Intensive Care Unit (ICU) admission. Rarely the outcome is poor or even fatal (10.8% of the cases). Conclusion. Clinical presentation, course, response to treatment, and outcome are similar in SARS-CoV-2-associated GBS and GBS due to other triggers.

Analysis of Clinical, Imaging, and Pathologic Features of 36 Patients with Primary Intraspinal Primitive Neuroectodermal Tumors: A Case Series and Literature Review

2021 ◽  
Author(s):  
Xuefeng Wei ◽  
Xu Zhang ◽  
Zimu Song ◽  
Feng Wang
Keyword(s):  
Literature Review ◽  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Subtotal Resection ◽  
Study Cohort ◽  
Primitive Neuroectodermal Tumors ◽  
Pathologic Features ◽  
Neuroectodermal Tumors ◽  
The Mean

Abstract Background and Study Aims Primary intraspinal primitive neuroectodermal tumors (PNETs) account for ∼0.4% of all intraspinal tumors, but information about these tumors in the medical literature is limited to single case reports. We report four cases of primary intraspinal PNETs and present a systematic literature review of the reported cases. Materials and Methods We retrospectively reviewed and analyzed the clinical data of 4 patients with primary intraspinal PNETs who underwent neurosurgical treatment at our clinic between January 2013 and January 2020, and of 32 cases reported in the literature. Results The female-to-male ratio was 2.6:1. The mean patient age was 21.42 ± 15.76 years (range: 1–60 years), and patients <36 years of age accounted for 83.30% of the study cohort. Progressive limb weakness and numbness were the chief symptoms (accounting for ∼55.6%). The mean complaint duration was 0.89 ± 0.66 months for males and 2.72 ± 3.82 months for females (p = 0.028). Epidural (41.7%) was the most common site, and thoracic (47.3%) was the most frequent location. Most PNETs were peripheral, and magnetic resonance imaging (MRI) appearance was isointense or mildly hypointense on T1-weighted images and hyperintense on T2-weighted images. Homogeneous contrast enhancement was observed. The 1-year survival rate of patients who underwent chemoradiation after total or subtotal lesion resection was better compared with patients who did not undergo chemotherapy, radiotherapy, or total or subtotal resection. The modality of treatment was associated with survival time (p = 0.007). Conclusion Primary intraspinal PNETs mainly occur in young people with a female preponderance. In patients with a rapid loss of lower limb muscle strength and large intraspinal lesions on MRI, PNETs should be considered. Surgical resection and adjuvant radio chemotherapy are key prognostic factors.

The Neuropathology of 1p36 Deletion Syndrome: An Autopsy Case Series

2021 ◽  
Author(s):  
Kyle S Conway ◽  
Fozia Ghafoor ◽  
Amy C Gottschalk ◽  
Joseph Laakman ◽  
Renee L Eigsti ◽  
...  
Keyword(s):  
Neuronal Migration ◽  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Deletion Syndrome ◽  
Cerebellar Hypoplasia ◽  
Autopsy Case ◽  
Single Case Report ◽  
Renal Abnormalities

Abstract 1p36 deletion syndrome is the most common terminal deletion syndrome, manifesting clinically as abnormal facies and developmental delay with frequent cardiac, skeletal, urogenital, and renal abnormalities. Limited autopsy case reports describe the neuropathology of 1p36 deletion syndrome. The most extensive single case report described a spectrum of abnormalities, mostly related to abnormal neuronal migration. We report the largest published series of 1p36 autopsy cases, with an emphasis on neuropathologic findings. Our series consists of 3 patients: 2 infants (5-hours old and 23-days old) and 1 older child (11 years). Our patients showed abnormal cortical gyration together with a spectrum of neuronal migration abnormalities, including heterotopias and hippocampal abnormalities, as well as cerebellar hypoplasia. Our findings thus support the role of neuronal migration defects in the pathogenesis of cognitive defects in 1p36 deletion syndrome and broaden the reported neuropathologic spectrum of this common syndrome.

scholarly journals Leprosy in Refugees and Migrants in Italy and a Literature Review of Cases Reported in Europe between 2009 and 2018

2020 ◽  
Vol 8 (8) ◽  
pp. 1113
Author(s):  
Anna Beltrame ◽  
Gianfranco Barabino ◽  
Yiran Wei ◽  
Andrea Clapasson ◽  
Pierantonio Orza ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Wide Spectrum ◽  
Case Reports ◽  
Case Series ◽  
Skin Lesions ◽  
Clinical Suspicion ◽  
High Risk Population ◽  
European Guidelines ◽  
Eye Involvement ◽  
Multibacillary Leprosy

Leprosy is a chronic neglected infectious disease that affects over 200,000 people each year and causes disabilities in more than four million people in Asia, Africa, and Latin America. The disease can appear with a wide spectrum of clinical forms, and therefore the clinical suspicion is often difficult. Refugees and migrants from endemic countries affected by leprosy can remain undiagnosed in Europe due to the unpreparedness of clinicians. We retrospectively describe the characteristics of 55 refugees/migrants with a diagnosis of leprosy established in Italy from 2009 to 2018. Continents of origin were Africa (42%), Asia (40%), and South and Central America (18%). The symptoms reported were skin lesions (91%), neuropathy (71%), edema (7%), eye involvement (6%), fever (6%), arthritis (4%), and lymphadenopathy (4%). Seven patients (13%) had irreversible complications. Overall, 35% were relapses and 66% multibacillary leprosy. Furthermore, we conducted a review of 17 case reports or case series and five nationwide reports, published in the same decade, describing 280 migrant patients with leprosy in Europe. In Europe, leprosy is a rare chronic infectious disease, but it has not completely disappeared. Diagnosis and treatment of leprosy in refugees and migrants from endemic countries are a challenge. European guidelines for this neglected disease in this high-risk population would be beneficial.

Propranolol for treating emotional, behavioural, autonomic dysregulation in children and adolescents with autism spectrum disorders

2018 ◽  
Vol 32 (6) ◽  
pp. 641-653 ◽  
Author(s):  
Ilyas Sagar-Ouriaghli ◽  
Kate Lievesley ◽  
Paramala J Santosh
Keyword(s):  
Clinical Trials ◽  
Cognitive Performance ◽  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Semantic Networks ◽  
Neural Correlates ◽  
Autism Spectrum ◽  
Autonomic Dysregulation ◽  
Randomised Controlled

Objectives: To date, there is no single medication prescribed to alleviate all the core symptoms of Autism Spectrum Disorder (ASD; National Institute of Health and Care Excellence, 2016). Both serotonin reuptake inhibitors and drugs for psychosis possess therapeutic drawbacks when managing anxiety and aggression in ASD. This review sought to appraise the use of propranolol as a pharmacological alternative when managing emotional, behavioural and autonomic dysregulation (EBAD) and other symptoms. Materials and methods: Sixteen reports examined the administration of propranolol in the context of ASD. Results: Sixteen reports broadly covered cognitive domains, neural correlates, and behavioural domains. From the eight single-dose clinical trials, propranolol led to significant improvements in cognitive performance – verbal problem solving, social skills, mouth fixation, and conversation reciprocity; and changes in neural correlates – improvement in semantic networks and functional connectivity. The remaining eight case series and single case reports showed improvements in EBAD, anxiety, aggressive, self-injurious and hypersexual behaviours. Additionally, propranolol significantly improved similar behavioural domains (aggression and self-injury) for those with acquired brain injury. Conclusion: This review indicates that propranolol holds promise for EBAD and cognitive performance in ASD. Given the lack of good quality clinical trials, randomised controlled trials are warranted to explore the efficacy of propranolol in managing EBAD in ASD.

scholarly journals Gastric Emphysema a Spectrum of Pneumatosis Intestinalis: A Case Report and Literature Review

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Guillermo López-Medina ◽  
Roxana Castillo Díaz de León ◽  
Alberto Carlos Heredia-Salazar ◽  
Daniel Ramón Hernández-Salcedo
Keyword(s):  
Single Case ◽  
Case Reports ◽  
Gastric Wall ◽  
Case Series ◽  
Pneumatosis Intestinalis ◽  
Assessment Method ◽  
Emphysematous Gastritis ◽  
Prognostic Implications ◽  
High Doses ◽  
Gastric Emphysema

The finding of gas within the gastric wall is not a disease by itself, rather than a sign of an underlying condition which could be systemic or gastric. We present the case of a woman identified with gastric emphysema secondary to the administration of high doses of steroids, with the purpose of differentiating emphysematous gastritis versus gastric emphysema due to the divergent prognostic implications. Gastric emphysema entails a more benign course, opposed to emphysematous gastritis which often presents as an acute abdomen and carries a worse prognosis. Owing to the lack of established diagnostic criteria, computed tomography is the assessment method of choice. Currently no guidelines are available for the management of this entity, since the evidence is limited to a few case series and a considerable number of single case reports.

scholarly journals Two-Year Outcome of Aflibercept for the Treatment of Choroidal Neovascularization in Punctate Inner Choroidopathy

2019 ◽  
Vol 10 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Luis Arrevola ◽  
María Almudena Acero ◽  
María Jesús Peral
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Choroidal Neovascularization ◽  
Single Case ◽  
Case Reports ◽  
Oral Prednisone ◽  
Case Series ◽  
Punctate Inner Choroidopathy ◽  
Single Case Report ◽  
The Right

Punctate inner choroidopathy (PIC) is a rare inflammatory chorioretinopathy that predominantly affects young myopic women. Visual prognosis is generally good, but occurrence of choroidal neovascularization (CNV) is common and may be vision threatening. Case reports and short case series support the effectiveness of intravitreal anti-vascular endothelial growth factor (VEGF) agents (ranibizumab and bevacizumab) for CNV associated with PIC given their anti-angiogenic and anti-inflammatory effects. Evidence concerning aflibercept, a more recent intravitreal anti-VEGF, is limited to a single case report. In this case report, we illustrate the case of a 43-year-old myopic woman presenting with visual acuity loss and distortion in the right eye over the last 5 days in whom CNV associated with PIC was diagnosed. Treatment with 1 injection per month of intravitreal aflibercept for 2 months and full-dose oral prednisone for 1 week, being tapered afterwards, improved visual acuity and resolved CNV, with benefits lasting up to 24 months.

scholarly journals Wound myiasis in Western Europe: prevalence and risk factors in a changing climate scenario

2021 ◽  
Author(s):  
Erika Andreatta ◽  
Luigi Bonavina
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Western Europe ◽  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Climate Scenario ◽  
Cutaneous Myiasis ◽  
Artery Disease ◽  
Wound Myiasis

Summary Background Myiasis is an infestation of neglected open wounds by fly larvae. Global warming, related climate changes, and increased traveling in tropical countries may contribute to the worldwide diffusion of new fly species. Common risk factors for myiasis are advanced age, poor hygiene, malnourishment, social isolation, diabetes, cancer, and peripheral artery disease. The aim of this study was to review the characteristics of cases of myiasis reported in Europe. Methods A narrative review of cutaneous myiasis was performed using PubMed, EMBASE, Web of Science database, and the search terms “human,” “myiasis,” “cutaneous myiasis,” “maggot,” “Europe,” “wound,” with the combination of “AND” and “OR.” In addition, hospital charts were reviewed to add personal experience to the literature review. Results Overall, 52 articles, both single case reports and case series reporting cutaneous myiasis, were found in the medical literature of the past two decades. A total of 64 patients living in Europe were identified, of whom 36% had wound myiasis. In addition to the literature review, we report the case of a male patient who presented with myiasis within a deep scalp ulcer occurring after radiotherapy for basal cell carcinoma. Conclusion Myasis is rare and possibly under-reported in Europe. The epidemiology of this infestation may be changing in the future due to climate variability, a rise in travel to tropical areas, and the migration of fly species.

scholarly journals Highlights of this issue

2019 ◽  
Vol 2 (1) ◽  
pp. i-ii
Author(s):  
Jayakumar Menon ◽  
Keyword(s):  
Clinical Skills ◽  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Antenatal Depression ◽  
First Episode Psychosis ◽  
First Episode ◽  
The Core ◽  
Episode Psychosis

Clinical psychiatry has always been more accommodative of the divergent methods of scientific enquiry and focus is back on enhancing the core clinical skills in Psychiatry. We are re-discovering the values of single case reports, case series as much as we look forward to systematic reviews. The standardisation of reporting with the acceptance of guidelines (eg.Equator Network) has helped immensely in ensuring transparency and quality of health research. In this issue of the journal, we have articles that cover diverse areas like First Episode Psychosis, Sleep Disorders, Interface of SLE and Psychiatry, medication adherence in depression, antenatal depression, and epigenetics.

Sign in / Sign up

Export Citation Format

Share Document