345. Dermatological Manifestations in Patients with COVID-19 Pneumonia in Veracruz, Mexico

Abstract Background A large number of viral infections are characterized by the presence of cutaneous manifestations. Multiple dermatological manifestations have been observed in patients with COVID-19. Dermatological lesions in patients infected by SARS-CoV-2 such as livedo reticularis, rash and vascular lesions may represent manifestations of secondary phenomena such as paraviral rashes or by participation of the innate or adaptive immune system that cause vasodilation, vascular leakage or procoagulant effects Methods Descriptive and observational study, adult patients with COVID-19 pneumonia were selected, confirmed by RT-PCR and chest CT. General symptoms, hematic cytometry results, pneumonia severity, prognosis as well as dermatological manifestations are characterized. Results 100 patients were entered into the study, with an average age of 49.4 years, 54% male. The general symptoms with the highest incidence were: fever, cough and dyspnea characteristic of SARS-CoV-2 infection, followed by chest pain, headache, anosmia and dysgeusia. The main alteration of the hemogram was lymphopenia, no leukopenia or plaquetopenia was demonstrated. 54% of those affected had mild pneumonia, the rest severe pneumonia. 75% progressed towards improvement and 25% died. Among the dermatological manifestations identified, all occurred in cases with severe pneumonia, the one with the highest incidence was the morbilliform viral exanthema in 18%, the presence of diffuse partial alopecia in 7% as well as manifestations of lividity and maceration in 1%. Regarding alopecia, in 6% it was reversible androgenetic alopecia, having manifested during the acute stage of pneumonia (all men), in 1% it presented alopecia areata (male) that has been persistent beyond the acute phase and in frank recovery Demographic and clinical variables Clinical manifestations Conclusion The incidence of dermatological manifestations is low in this study population, the most frequent being the morbilliform viral exanthema expected in a virus, however they present manifestations of low incidence such as reversible androgenetic alopecia associated with severity of the disease, a finding that has been documented recently as a manifestation associated with COVID-19 Disclosures All Authors: No reported disclosures

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Effectiveness of protected aminopenicillins in treatment of non-social pneumonia in children

Лечащий врач ◽

10.51793/os.2021.24.10.003 ◽

2021 ◽

Author(s):

Е.Е. Краснова ◽

В.В. Чемоданов ◽

Е.Г. Кузнецова

Keyword(s):

Viral Infections ◽

Respiratory Infections ◽

Acquired Resistance ◽

Age Groups ◽

Clinical Manifestations ◽

Severe Pneumonia ◽

Physical Symptoms ◽

Community Acquired Pneumonia ◽

Natural Activity ◽

Respiratory Viral Infections

Пневмония – острое инфекционно-воспалительное заболевание легких преимущественно бактериальной этиологии, характеризующееся выраженной в разной степени дыхательной недостаточностью, токсическими и респираторными нарушениями, локальными физикальными симптомами, а также инфильтративными изменениями на рентгенограмме. Заболеваемость внебольничными пневмониями повышается в октябре-декабре, достигая максимума в январе-апреле, коррелируя с сезонным повышением уровня острых респираторных вирусных инфекций. Схожесть симптомов дебюта пневмонии с проявлениями острых респираторных вирусных инфекций может привести к несвоевременной ее диагностике и, как следствие, к отсроченному началу лечения. Поэтому в период сезонной заболеваемости респираторными инфекциями должна повышаться настороженность врачей-педиатров в отношении внебольничной пневмонии. Антибактериальная терапия оказывает решающее влияние на прогноз пневмонии, поэтому при достоверном диагнозе или у больного в тяжелом состоянии с вероятным диагнозом ее следует начать незамедлительно. Выбор антибиотика в каждом случае внебольничной пневмонии проводят индивидуально с учетом природной активности препаратов в отношении предполагаемого возбудителя и их возможной приобретенной резистентности, тяжести и течения заболевания, наличия у пациента противопоказаний к использованию тех или иных антибиотиков. В статье приводятся сведения о диагностических критериях внебольничных пневмоний. Рассмотрены вопросы антибактериального лечения типичной нетяжелой пневмонии у детей разных возрастных групп амоксициллином с клавулановой кислотой и показана его эффективность. Результаты проведенного исследования позволяют заключить, что пероральное использование одного курса защищенного аминопенициллина эффективно при лечении типичной внебольничной нетяжелой пневмонии у детей разного возраста, о чем свидетельствует ликвидация основных клинических проявлений болезни в короткие сроки. Pneumonia is an acute infectious and inflammatory lung disease of predominantly bacterial etiology, characterized by respiratory failure, toxic and respiratory disorders, local physical symptoms, and infiltrative changes on the roentgenogram. The incidence of community-acquired pneumonia increases in October-December, reaching a maximum in January-April, correlating with the seasonal increase in the level of acute respiratory viral infections. The similarity of the symptoms of the onset of pneumonia with the manifestations of acute respiratory viral infections can lead to its untimely diagnosis and, as a consequence, to a delayed start of treatment. Therefore, during the period of seasonal morbidity with respiratory infections, the alertness of pediatricians in relation to community-acquired pneumonia should increase. Antibiotic therapy has a decisive influence on the prognosis of pneumonia, therefore, with a reliable diagnosis or in a patient in serious condition with a probable diagnosis, it should be started immediately. The choice of antibiotic in each case of community-acquired pneumonia is carried out individually, taking into account the natural activity of the drugs in relation to the alleged pathogen and their possible acquired resistance, the severity and course of the disease, the patient's contraindications to the use of certain antibiotics. The article provides information on the diagnostic criteria for community-acquired pneumonia. The issues of antibacterial treatment of typical non-severe pneumonia in children of different age groups with amoxicillin with clavulanic acid are considered and its effectiveness is shown. The results of the study allow us to conclude that the oral use of one course of protected aminopenicillin is effective in the treatment of typical community-acquired non-severe pneumonia in children of different ages, as evidenced by the elimination of the main clinical manifestations of the disease in a short time.

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The Possible Role of Herpesviruses in the Pathogenesis of Coronary Atherosclerosis

International Journal of Biomedicine ◽

10.21103/article11(4)_ra1 ◽

2021 ◽

Vol 11 (4) ◽

pp. 391-396

Author(s):

Julia Kotova

Keyword(s):

Cause Of Death ◽

Coronary Atherosclerosis ◽

Viral Infections ◽

Clinical Manifestations ◽

Vascular Lesions ◽

Rapid Progression ◽

Coronary Syndrome ◽

Lipid Metabolism Disorders ◽

Hereditary Disorders ◽

Atherosclerotic Process

Cardiovascular diseases are still the dominant cause of death worldwide. Coronary artery disease (CAD) is the most common type of heart disease and the leading cause of death for both men and women. Coronary atherosclerosis underlies multiple clinical manifestations ranging from asymptomatic to stable angina, acute coronary syndrome, MI, heart failure, and sudden cardiac death. The prerequisites for a closer study of the pathogenesis of the atherosclerotic process were the development of atherosclerotic vascular lesions at a younger age and the rapid progression of the process. Currently, it is generally accepted that CAD is a multifactorial disease. Attention is drawn to hereditary disorders of the receptor apparatus, endothelial dysfunction, and lipid metabolism disorders. In addition, latent viral infections are one of the etiopathogenetic factors in the development of atherosclerosis. A number of scientific studies have confirmed the relationship between infectious agents and the development of atherosclerotic vascular lesions. The viral etiology of the development and progression of atherosclerosis is the subject of debate among scientists around the world.

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Clinical and Histopathological Features and Potential Pathological Mechanisms of Skin Lesions in COVID-19: Review of the Literature

Dermatopathology ◽

10.3390/dermatopathology7010002 ◽

2020 ◽

Vol 7 (1) ◽

pp. 3-16 ◽

Cited By ~ 9

Author(s):

Gürkan Kaya ◽

Aysin Kaya ◽

Jean-Hilaire Saurat

Keyword(s):

Clinical Symptoms ◽

Case Reports ◽

Clinical Manifestations ◽

Skin Lesions ◽

Vascular Lesions ◽

Cutaneous Lesions ◽

Cutaneous Manifestations ◽

Histopathological Features ◽

Pubmed Database ◽

The Mean

In recent weeks, several reports have emerged of skin lesions with different clinical presentations in COVID-19 cases. All dermatologists should be aware of these cutaneous lesions, which may be early clinical symptoms of infection. We reviewed the literature on cutaneous manifestations in the PubMed database from December 2019 and June 2020. From the cases described as case reports or series in 57 recent articles, it appears that skin lesions (i) are highly varied, (ii) may not be related to the severity of the condition and (iii) resolve spontaneously in a few days. The frequency of these lesions in COVID-19 patients varies between 1.8% and 20.4%. The major clinical forms described were maculopapular eruptions, acral areas of erythema with vesicles or pustules (pseudochilblain), urticarial lesions, other vesicular eruptions and livedo or necrosis. The lesions were mainly localized in the trunk and extremities. The majority of patients were male, aged between 4.5 and 89 years. A minority of the patients were children presenting with acral, chilblain-like lesions, papulo-vesicular eruptions or Kawasaki disease-like pediatric inflammatory multisystem syndrome. The mean duration of the lesions was a few days, but some lasting as little as 20 min and others as long as four weeks have been reported. The mean latency time in the majority of cases was between 1 and 14 days; however, in some patients, lesions appeared 2 to 5 days before the onset of COVID-19 symptoms. The histopathological features of these lesions also vary, corresponding to the diversity of clinical manifestations. These features underline the nature of epidermal and dermal vascular lesions—and in severe cases, microvascular injury and thrombosis—associated with COVID-19, and provide important clues to their pathological mechanisms.

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Coronaviruses and the cardiovascular system

ESC CardioMed ◽

10.1093/med/9780198784906.003.0800 ◽

2018 ◽

pp. 1208-1208

Author(s):

Juan M Pericàs ◽

Marta Farrero ◽

Marta Hernández-Meneses ◽

Timothy P Sheahan ◽

Carlos Falces ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Cardiovascular System ◽

Viral Infections ◽

Cardiac Injury ◽

Clinical Manifestations ◽

Cardiovascular Complications ◽

Current Evidence ◽

System P ◽

Human Coronaviruses ◽

The One

The three human coronaviruses that emerged (E-CoVs) in the last two decades, i.e. severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), pose a serious threat to global health. They share some characteristics, including the fact that although the most affected organ is the lung, human E-CoVs often cause a hyperinflammatory multiorgan disease. As in the case of many other viruses, coronaviruses cause cardiovascular disease. The cardiovascular system is predominantly affected in the case of SARS-CoV and SARS-CoV-2, with angiotensin-converting enzyme 2 (ACE2) as their primary receptor. Yet, available evidence indicates that SARS-CoV-2 is the one with higher avidity for the cardiovascular system and greater capacity to cause cardiac injury and thromboembolic events, along with a plethora of cardiovascular manifestations. This chapter provides a clinically oriented summary of the most relevant features of viral infections in relation to the cardiovascular system and the virology and pathophysiological characteristics of E-CoVs, as well as the risk factors, associated clinical manifestations, and current evidence for the management of cardiovascular complications caused by COVID-19.

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Angiodysplasia Combined with Thymic Aplasia in an Infant: A Rare Clinical Case

Вопросы современной педиатрии ◽

10.15690/vsp.v17i4.1928 ◽

2018 ◽

Vol 17 (4) ◽

pp. 333-340

Author(s):

Svetlana A. Hmilevskaya ◽

Galina N. Masljakowa ◽

Nikolai I. Zryachkin ◽

Olga A. Makarowa ◽

Mikhail M. Bazalitsky ◽

...

Keyword(s):

Clinical Case ◽

Vascular System ◽

Vascular Malformations ◽

Clinical Manifestations ◽

Severe Pneumonia ◽

Vascular Lesions ◽

Pathological Study ◽

Progressive Heart Failure ◽

Convulsive Seizures ◽

The Brain

Background. The prevalence of congenital malformations of the vessels or angiodysplasia ranges from 1:50,000 to 1:5,000,000. Congenital angiodysplasia is a consequence of impaired formation and development of the vascular system in embryogenesis. The aetiology of angiodysplasia remains poorly studied, and the diagnosis involves significant difficulties in some cases. Clinical Case Description. The observation of a rare case of a combined malformation of vessels and thymic aplasia in a female infant is presented. Angiodysplasia included the syndrome of congenital generalised phlebectasia (synonym: congenital telangiectatic marbled skin) combined with multiple vascular malformations with predominant vascular lesions of the brain, lungs, heart, kidneys, and mesentery. Clinically, the disease was characterised by a generalised change in the skin in the form of livedo reticularis accompanied by the development of severe pneumonia, persistent urinary syndrome, neurological symptoms (convulsive seizures, motor disorders), and progressive heart failure. The diagnosis was confirmed in the course of a pathological study. Conclusion. The presented case allows expanding the notion of the variety of clinical manifestations of congenital angiodysplasia, as well as its possible combinations with other malformations.

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Henoch-Schönlein Purpura: Management and Complication

Biomolecular and Health Science Journal ◽

10.20473/bhsj.v3i2.22207 ◽

2020 ◽

Vol 3 (2) ◽

pp. 113

Author(s):

Radhitya Farizky Deta Juniawan ◽

Awalia Awalia

Keyword(s):

Plasma Cells ◽

Clinical Manifestations ◽

Supportive Therapy ◽

Henoch Schonlein Purpura ◽

Cutaneous Manifestations ◽

Male Patients ◽

Low Incidence ◽

Almost All ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

Henoch-Schönlein Purpura (HSP) is a disease that mainly affects children, while the incidence in adults is rarely reported. Low incidence in adults caused by undiagnosed or misdiagnosed. Course of the disease in adults is more complex, including high incidence of renal insufficiency. Renal manifestations need special attention because it can worsen the prognosis, so patients must be detected and treated as quickly as possible. Poor prognosis depends on the presence of renal clinical manifestations accompanied by an increase in the severity of renal histological grading, abdominal manifestations, and persistent purpura. We describe male patients with HSP, presenting with gastrointestinal, renal, and cutaneous manifestations. Gastroscopy showed superficial gastritis (reddish patches on almost all gastric mucosa. Skin biopsy showed lymphocytic vasculitis. Gastric biopsy shows infiltration of lymphocyte inflammation cells, histiocytes, plasma cells in the corpus and gastric antrum. Patients have received supportive therapy, steroid, and showed clinical improvement.

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Polymyalgia Rheumatica - a Disease of the Elderly

Revista de Chimie ◽

10.37358/rc.18.1.6063 ◽

2018 ◽

Vol 69 (1) ◽

pp. 152-154

Author(s):

Vasilica Cristescu ◽

Aurelia Romila ◽

Luana Andreea Macovei

Keyword(s):

Giant Cell Arteritis ◽

Giant Cell ◽

Polymyalgia Rheumatica ◽

Temporal Arteritis ◽

Viral Infections ◽

Clinical Manifestations ◽

The Elderly ◽

Clinical Aspects ◽

Immune Disorder ◽

Markers Of Inflammation

Polymyalgia rheumatica is a disease that occurs mostly in the elderly and is rarely seen in patients less than 50 years of age. Polymyalgia rheumatica is a vasculitis, which manifests itself as an inflammatory disease of the vascular wall that can affect any type of blood vessel, regardless of its size. It has been considered a form of giant cell arteritis, involving primarily large and medium arteries and to a lesser extent the arterioles. Clinical manifestations are caused by the generic pathogenic process and depend on the characteristics of the damaged organ. PMR is a senescence-related immune disorder. It has been defined as a stand-alone condition and a syndrome referred to as rheumatic polyarteritis with manifestations of giant cell arteritis (especially in cases of Horton�s disease and temporal arteritis) which are commonly associated with polymyalgia. The clinical presentation is clearly dominated by the painful girdle syndrome, with a feeling of general discomfort. Polymyalgia and temporal arteritis may coexist or be consecutive to each other in the same patient, as in most of our patients. The present study describes 3 cases of polymyalgia rheumatica, admitted to the Clinic of Rheumatology of Sf. Apostol Andrei Hospital, Galati. The cases were compared with the literature. Two clinical aspects (polymyalgia rheumatica and/or Horton�s disease) and the relationship between them were also considered. Polymyalgia rheumatica is currently thought to have a multifactorial etiology, in which the following factors play a role: genetic factors or hereditary predisposition (some individuals are more prone to this disease), immune factors and viral infections (triggers of the disease). Other risk factors of polymyalgia rheumatica include age over 50 years and the association with giant cell arteritis. The characteristic feature of the disease is girdle pain, with intense stiffness of at least one hour�s duration. Markers of inflammation, erythrocyte sedimentation rate and C-reactive protein are almost always increased at the onset of the disease. Diseases that can mimic the clinical picture of polymyalgia rheumatica are neoplasia, infections, metabolic disorders of the bone and endocrine diseases.

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A systematic review of historical and current trends in Chagas disease

Therapeutic Advances in Infectious Disease ◽

10.1177/20499361211033715 ◽

2021 ◽

Vol 8 ◽

pp. 204993612110337

Author(s):

Diego-Abelardo Álvarez-Hernández ◽

Rodolfo García-Rodríguez-Arana ◽

Alejandro Ortiz-Hernández ◽

Mariana Álvarez-Sánchez ◽

Meng Wu ◽

...

Keyword(s):

Systematic Review ◽

Chagas Disease ◽

Case Reports ◽

Clinical Manifestations ◽

Human Case ◽

Acute Stage ◽

Diagnostic Tools ◽

Chronic Stage ◽

Pubmed Database ◽

Trypanocidal Drugs

Introduction: Chagas disease (CD) is caused by Trypanosoma cruzi. When acquired, the disease develops in stages. For diagnosis, laboratory confirmation is required, and an extensive assessment of the patient’s health should be performed. Treatment consists of the administration of trypanocidal drugs, which may cause severe adverse effects. The objective of our systematic review was to analyze data contained in the CD published case reports to understand the challenges that patients and clinicians face worldwide. Materials and methods: We performed a systematic review following the PRISMA guidance. PubMed database was explored using the terms ‘American trypanosomiasis’ or ‘Chagas disease’. Results were limited to human case reports written in English or Spanish. A total of 258 reports (322 patients) were included in the analysis. Metadata was obtained from each article. Following this, it was analyzed to obtain descriptive measures. Results: From the sample, 56.2% were males and 43.8% were females. Most cases were from endemic countries (85.4%). The most common clinical manifestations were fever during the acute stage (70.0%), dyspnea during the chronic stage in its cardiac form (53.7%), and constipation during the chronic stage in its digestive form (73.7%). Most patients were diagnosed in the chronic stage (72.0%). Treatment was administered in 56.2% of cases. The mortality rate for the acute stage cases was 24.4%, while for the chronic stage this was 28.4%. Discussion: CD is a parasitic disease endemic to Latin America, with increasing importance due to human and vector migration. In this review, we report reasons for delays in diagnosis and treatment, and trends in medical practices. Community awareness must be increased to improve CD’s diagnoses; health professionals should be appropriately trained to detect and treat infected individuals. Furthermore, public health policies are needed to increase the availability of screening and diagnostic tools, trypanocidal drugs, and, eventually, vaccines.

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POS0083 USEFUL EXPERIENCE OF RHEUMATOLOGISTS FOR UNDERSTANDING OF THE DISEASE ORIGIN AND APPROACHES TO THERAPY IN FIBRODYSPLASIA OSSIFICANS PROGRESSIVA

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4307 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 249.2-250

Author(s):

I. Nikishina ◽

S. Arsenyeva ◽

V. Matkava ◽

A. Arefieva ◽

M. Kaleda ◽

...

Keyword(s):

Heterotopic Ossification ◽

Kinase Inhibitor ◽

Inflammatory Diseases ◽

Clinical Manifestations ◽

Fibrodysplasia Ossificans Progressiva ◽

Rapid Progression ◽

Time Duration ◽

Long Term Follow Up ◽

Vertebral Bodies ◽

The One

Background:Many monogenic genetic conditions, such as auto-inflammatory diseases (AIDs), have similar clinical manifestations and immunopathogenesis to “classic” rheumatic diseases (RD). Such cases may include Fibrodysplasia ossificans progressiva (FOP), an extremely rare genetic disease, which, according to our previous study and data from other authors1, may represent an example of AID with catastrophic heterotopic ossification due to a mutation in the ACVR1 gene. it seems that the experience of rheumatologists, especially children’s ones, will be useful in the treatment of FOP.Objectives:To analyzed the dynamics of clinical manifestations and to therapy approaches including target anti-inflammatory drug Tofacitinib (TOFA) in the one of the world’s largest groups of patients (pts) with FOP.Methods:The study was based on the analysis retrospective and prospective observation of the 35 pts (17 males and 18 females) with a verified diagnosis of FOP for the period from 1998 to 2020. In 9 pts with severe course of FOP TOFA administration were evaluated.Results:In all 35 pts the diagnosis was verified by “classic” FOP phenotype: malformed great toes in 33 pts (94,3%); short malformed thumbs-8 (22.8%); peripheral osteochondromas-20 (57.1%); abnormalities of the cervical spine-32 (91.4%), multiple heterotopic ossifications-32 (91,4%). Genetic tests were done in 26, it confirmed mutation in the ACVR1 gene in 100%. Long term follow-up detected a lot of spondyloarthritis-like signs similar to the manifestation of RD: ankylosis of the facet joints and vertebral bodies (by the type of syndesmophytes) in most pts, sacroiliitis, confirmed by radiological methods (X-ray, CT, MRI), gradual ankylosis in the peripheral joints in 18 (56.4%), synovitis in large joints in 8 (25%) pts (knee and hip mostly). In 9 pts with the most difficult course with rapid progression of ossification due to continuous flares despite the NSAIDs and steroids intake, we tried to use TOFA after the approval of the local Ethic Committee. We use the similar dose to randomized trial for JIA (up to 5 mg twice a day). The first patient was 16 y.o. at the time of TOFA administration in December 2019, the age of the other pts was from 2 to 12 y.o. By present time duration of TOFA therapy is from 6 to 15 mo. For the previous 6 months before TOFA initiation the number of flares was in average 8 per patient. After 6 months of TOFA treatment the number of new flares decreased to 0-1, except youngest patient of 2 y.o. in whom the number of flares decreased from 10 to 4 per the same period. In all 9 pts we minimize the dose or completely stop the steroids. New nodes formation stopped immediately in most pts and also the significant motion improvement of large (shoulder) joints were established. Drug tolerance was good in all pts, no AE were registered. But despite the good clinical effect without new heterotopic ossification in our first patient, we found continuous intraskeletal ossification between vertebral bodies, facet and sacroiliac joints in MRI.Conclusion:We are confident that the processes of heterotopic ossification in FOP are very similar to new born formation phenomenon in spondyloarthritis and reliable suppression of inflammation can interrupt the progression of the disease. We used similar justifications to our colleagues for the use of anti-cytokine drugs, but used a JAK-kinase inhibitor, it was extremely important the oral rout of drug administration and possibility to escape any injections in FOP. TOFA demonstrated positive effect and safety in children with severe course of FOP. It showed their advantages over the use of steroids and possibility to inhibit the rate of progression.References:[1]R.Haviv et al. Is fibrodysplasia ossificans progressiva aninterleukin-1 driven auto-inflammatory syndrome? Pediatric Rheumatology (2019) 17:84 //doi.org/10.1186/s12969-019-0386-6Disclosure of Interests:None declared.

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Structural Characterization of Complex Bacterial Glycolipids by Fourier Transform Mass Spectrometry

European Journal of Mass Spectrometry ◽

10.1255/ejms.721 ◽

2005 ◽

Vol 11 (5) ◽

pp. 535-546 ◽

Cited By ~ 39

Author(s):

Anna Kondakov ◽

Buko Lindner

Keyword(s):

Mass Spectrometry ◽

Fourier Transform ◽

Structural Information ◽

Adaptive Immune System ◽

Ion Cyclotron Resonance ◽

Bacterial Membranes ◽

Multiphoton Dissociation ◽

The One ◽

And Function

Bacterial glycolipids are complex amphiphilic molecules which are, on the one hand, of utmost importance for the organization and function of bacterial membranes and which, on the other hand, play a major role in the activation of cells of the innate and adaptive immune system of the host. Already small alterations to their chemical structure may influence the biological activity tremendously. Due to their intrinsic biological heterogeneity [number and type of fatty acids, saccharide structures and substitution with for example, phosphate ( P), 2-aminoethyl-(pyro)phosphate groups ( P-Etn) or 4-amino-4-deoxyarabinose (Ara4N)], separation of the different components are a prerequisite for unequivocal chemical and nuclear magnetic resonance structural analyses. In this contribution, the structural information which can be obtained from heterogenous samples of glycolipids by Fourier transform (FT) ion cyclotron resonance mass spectrometric methods is described. By means of recently analysed complex biological samples, the possibilities of high-resolution electrospray ionization FT-MS are demonstrated. Capillary skimmer dissociation, as well as tandem mass spectrometry (MS/MS) analysis utilizing collision-induced dissociation and infrared multiphoton dissociation, are compared and their advantages in providing structural information of diagnostic importance are discussed.

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