P058 Epidemiological clinical, etiologic spectrum and follow-up results of uveitis in children: a single center experience

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
W Messadi ◽  
A Salmi ◽  
N Guemri ◽  
N Cherif
Keyword(s):  
Visual Acuity ◽  
Rheumatic Diseases ◽  
Immunosuppressive Treatment ◽  
Underlying Disease ◽  
Intermediate Uveitis ◽  
Single Center Experience ◽  
Pooled Prevalence ◽  
Tnf Α ◽  
Etiologic Diagnosis

Abstract Background Uveitis refers to the inflammation of the vascular tunic of the eye. This inflammation varies greatly in its clinical expressions and etiologies and is often a majordiagnostic challenge for physicians. These data cover symptoms, clinical examination results, complications, etiologies and treatments Methods A retro-prospective monocentric study was carried out on 22patients hospitalized in the pediatric department of the issaadhassani hospital of Algiers during the period of January 2017 to December 2021. Results The sex ratio is 1,2. Their average age was 8 years (4–15Y). Most of thepatients consulted for the three cardinal signs of uveitis: 81% for a decrease in visual acuity, 59% for redness, and 43% for ocular pain. Uveitis was bilateral in 55% of the cases. Inanatomical localization, 45,5% of patients had total uveitis, 27% had anterior uveitis, and 18% had intermediate uveitis, and 9% had anterior and intermediate uveitis. An etiologic diagnosis was made in 32% of the cases. The most frequent causes were inflammatory. Treatments consisted of local corticosteroid therapy for all thepatients, a general corticoid treatment for all of the patients, associated with an immunosuppressive treatment for 50% and biologic anti TNF α treatment (adalimumab) for23% cases. A good evolution after treatment was noted among patients with visual acuity <3/10 with a substantial decrease from 67% to 2%.77.5% are in remission, 13.5% are improving and 9% are in relapse the duration of the follow-up is 1 ½ years with intervals of 2 months and 5 years. Conclusion The results of the current study are generally compatible with the literature. however. The percentage of etiologies covered remains a point to improve, The pooled prevalence of uveitis in pediatric rheumatic diseases widely varied based on the underlying disease requiring more investigations in different subtypes of rheumatic diseases. The biologic medications, especially Adalimumab are the most effective treatments for uveitis in pediatric rheumatic diseases; however, a combination of the safe, available alternatives is preferred to achieve the most desirable treatment response.

Antinuclear Antibodies and Lupus-like Manifestations in Rheumatoid Arthritis and Ankylosing Spondylitis Patients at 4 Months' Follow-up After Treatment with Infliximab and Etanercept

2020 ◽  
Vol 16 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Mir Amir Aghdashi ◽  
Mohsen Khadir ◽  
Roshan Dinparasti-Saleh
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Treatment Regimen ◽  
Antinuclear Antibodies ◽  
Clinical Symptoms ◽  
Underlying Disease ◽  
Case Group ◽  
Tnf Α ◽  
The Relationship

Background: Up to 44% of patients treated with infliximab and 7% of patients treated with etanercept reported to have anti-drug antibodies within the first 6 months of treatment. Recently, anti-TNF-α therapies have been reported to be employed in the induction of the druginduced lupus erythematous. Objective: The aim of the present study was to investigate the relationship between anti-TNFα antibodies and various manifestations of lupus erythematous. Methods: We enrolled a total of 56 cases divided into 28 known cases of rheumatoid arthritis and 28 cases of ankylosing spondylitis patients and 56 controls. The case group was divided into 4 groups according to the underlying disease (RA or AS) and treatment regimen (infliximab or etanercept). ANA and anti-dsDNA levels and lupus criteria were assessed at the beginning of the study and 4 months after the initiation of anti-TNFα. Results: 36% and 21% of RA patients treated with infliximab, were ANA and anti-dsDNA positive after 4 months (P=0.003, P=0.025). 28% and 7% of RA patients treated with etanercept, were ANA and anti-dsDNA positive after 4 months (P=0.009, P=0.15). 21% and 7% of AS patients treated with infliximab, were ANA and anti-dsDNA positive, respectively (P=0.025, P=0.15). 14% and 7% of AS patients treated with etanercept, were ANA and anti-dsDNA positive, respectively (P=0.63, P=0.15). Three patients who were positive for auto-antibodies developed three criteria for SLE. Conclusions: Infliximab potentially may increase both ANA and anti-dsDNA levels in rheumatoid arthritis, but only ANA in ankylosing spondylitis patients. In general, clinicians should consider different clinical symptoms of ATIL, which may be present as a lupus-like syndrome similar to idiopathic SLE or classical DIL.

scholarly journals The impact of COVID-19 pandemic on pediatric rheumatology patients under immunosuppressive therapy: A single-center experience

2020 ◽  
Author(s):  
Oya Koker ◽  
Fatma Gul Demirkan ◽  
Gulsah Kayaalp ◽  
Figen Cakmak ◽  
Ayse Tanatar ◽  
...  
Keyword(s):  
Current Knowledge ◽  
Demographic Data ◽  
Immunosuppressive Treatment ◽  
Connective Tissue Diseases ◽  
Additional Risk ◽  
Entire Cohort ◽  
Single Center Experience ◽  
Policy Transmission ◽  
The Impact

Abstract Objective: The aim of the research was to further broaden current knowledge of whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease 2019 (COVID-19) entails a risk for children with rheumatic diseases regarding immunosuppressive treatment.Methods: Telephone-survey was administered by conducting interviews with the parents. A message containing a link to the actual questionnaire was sent to their phones simultaneously. The medical records of the patients were reviewed for gathering information about demographic data, clinical follow-up, and treatments.Results: Patients who were followed up with immunosuppressive treatment (n=439) were attempted to be contacted between 1 May 2020 and 15 May 2020. The diagnostic distribution of patients who were accessible and eligible for the study was as follows; juvenile idiopathic arthritis (JIA) (n=243, 58.7%), autoinflammatory diseases (n=109, 26.3%), autoimmune connective tissue diseases (n=51, 12.3%) and vasculitis (n=11, 2.7%). In the entire cohort, the mean age was 12 ± 4.7 years, and 54.1% (n=224) of the patients were female. One patient with seronegative polyarticular JIA, previously prescribed methotrexate and receiving leflunomide during pandemic has been identified to be diagnosed with COVID-19. None of the patients, including the patient diagnosed with COVID-19, had any severe symptoms. More than half of the patients with household contacts required hospitalization as they were asymptomatic.Conclusion: Although circumstances such as compliance in social distancing policy, transmission patterns, attitude following contact may influence the results, immunosuppressive treatment does not seem to pose additional risk in terms of COVID-19.

scholarly journals Erythroderma: analysis of 247 cases

1995 ◽  
Vol 29 (3) ◽  
pp. 177-182 ◽  
Author(s):  
Cidia Vasconcellos ◽  
Paula P. Domingues ◽  
Valéria Aoki ◽  
Ricardo K. Miyake ◽  
Naim Sauaia ◽  
...  
Keyword(s):  
Sex Differences ◽  
Underlying Disease ◽  
Clinical Findings ◽  
Significance Level ◽  
Diffuse Erythema ◽  
Skin Biopsies ◽  
Underlying Diseases ◽  
Environmental Antigens ◽  
Etiologic Diagnosis

The profile of 247 patients with erythroderma during a 23 year period from January, 1962 through March, 1985, with a follow-up period ranging from 1 to 26 years were analysed. The patients presented with diffuse erythema, scaling and pruritus of more than 2 months' duration, and the age ranged from 16 to 60 years. Psoriasis was the most frequent underlying disease with an estimated frequency of 44.9%, the reaction to the use of drugs appeared in 7.3% of total cases and association with reticulosis showed a frequency of 4.1%. The cause of the erythroderma could not be determined in 29.2% of the cases. Sex differences in terms of underlying diseases were not observed. One or more skin biopsies along with the clinical findings were diagnostic or suggestive of the underlying disease in 63.6% of the cases. Repeated skin biopsies are recommended as the best method for etiologic diagnosis of erythroderma. At P=0.05 significance level, masculine/feminine ratio of 2 : 1 was found. The question arises wether causal agent of erythroderma may not be somehow related to different exposure by sex to environmental antigens.

Immune Recovery Uveitis in a iatrogenically Immunosuppressed Patient

2005 ◽  
Vol 15 (4) ◽  
pp. 510-512 ◽  
Author(s):  
E. Miserocchi ◽  
G. Modorati ◽  
R. Brancato
Keyword(s):  
Visual Acuity ◽  
T Lymphocyte ◽  
Immunosuppressive Treatment ◽  
Steroid Treatment ◽  
Immunosuppressed Patient ◽  
Immune Recovery ◽  
Immune Recovery Uveitis ◽  
Immunodeficiency Virus ◽  
Hiv Negative

Purpose To report a case of immune recovery uveitis (IRU) in an iatrogenically immunosuppressed human immunodeficiency virus (HIV)-negative patient. Methods Interventional case report. One patient was diagnosed with cytomegalovirus retinitis in the left eye while receiving immunosuppressive treatment following renal transplantation. The retinitis resolved completely with systemic ganciclovir. Further reduction of immunosuppressive treatment, causing a rapid increase in CD4–T lymphocyte count, was associated in the same eye with the occurrence of IRU consisting of anterior uveitis, vitritis, and macular edema. Results Visual acuity at IRU presentation onset was 20/200 in the left eye. After 6 weeks of follow-up, the uveitis resolved with topical and periocular steroid treatment. Visual acuity restored to 20/40. Conclusions IRU can occur in iatrogenically immunosuppressed HIV-negative patients.

Long-term results of pars plana vitrectomy as an anti-inflammatory therapy of pediatric intermediate uveitis resistant to standard medical treatment

2018 ◽  
Vol 28 (1) ◽  
pp. 98-102 ◽  
Author(s):  
Denisa Darsová ◽  
Pavel Pochop ◽  
Jana Štěpánková ◽  
Dagmar Dotřelová
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Immunosuppressive Treatment ◽  
Functional Results ◽  
Long Term Results ◽  
Intermediate Uveitis ◽  
Pars Plana ◽  
Anti Inflammatory ◽  
Standard Medical Treatment

Purpose: To evaluate the efficacy of pars plana vitrectomy (PPV) as an anti-inflammatory therapy in pediatric recurrent intermediate uveitis. Methods: A retrospective study evaluated the long-term results of PPV indicated for intermediate uveitis with a mean observation period of 10.3 years (range 7-15.6 years) in 6 children (mean age 8 years, range 6-12 years). Pars plana vitrectomy was performed on 10 eyes in the standard manner and was initiated by vitreous sampling for laboratory examination. Data recorded were perioperative or postoperative vitrectomy complications, anatomic and functional results of PPV, and preoperative and postoperative best-corrected Snellen visual acuity. Results: No perioperative or postoperative complications were observed. Bacteriologic, virologic, mycotic, and cytologic analysis of the vitreous was negative in all tested children. Five eyes were subsequently operated on for posterior subcapsular cataracts. An average preoperative visual acuity of 0.32 improved to an average postoperative visual acuity of 0.8. Conclusions: In the case of systemic immunosuppressive treatment failure in pediatric uveitis, particularly in eyes with cystoid macular edema, we recommend PPV relatively early.

scholarly journals Clinical Characteristics of 107 Patients with COVID-19 in Ningbo, China: Single Center Experience Outside Hubei

2020 ◽  
Author(s):  
Boming Wu ◽  
Junjie Li ◽  
Hongping Xuan ◽  
Nanhong Zheng ◽  
Honghua Ye ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Ground Glass Opacity ◽  
Underlying Disease ◽  
Good Prognosis ◽  
Radiological Findings ◽  
Single Center Experience ◽  
Radiological Data ◽  
History Of

Abstract Background Since December 2019, there has be an outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China. Nowadays, it rapidly spread across the country and then the worldwide. We aimed to investigate the clinical characteristics of patients with COVID-19.Methods The patients with confirmed COVID-19 admitted between January 25 and February 10, 2020, were enrolled. Epidemiological, demographic, clinical, laboratory, radiological data, and antivirus therapies, were retrospectively collected and analyzed. The 90-day follow-up of these patients was also performed.Results A total of 107 patients were included. The median age was 55.0 years (range from 18.0 to 85.0 years), and 72 (67.3%) were female. Ninety-three (86.9%) of the patients had a history of contacting with residents from Wuhan (n=31), or contacting with confirmed COVID-19 patients (n=62) within 2 weeks. Fifty-eight (54.2%) had a family cluster onset. Fever and cough were the most common symptoms. Only two patients had diarrhea. The most common underlying disease was hypertension. Lymphopenia was observed in 26 patients. Fifty-two patients with an elevated level of IL-6. On admission, bilateral patchy shadowing and ground-glass opacity were the typical radiological findings on chest computed tomography. Six patients had an intensive care unit (ICU) stay. Antivirus therapy was performed to all patients. 105 patients discharged with an improved condition, and no death was occurred during our 90-day follow-up for these patients.Conclusions Patients with COVID-19 in our hospital had relatively mild symptoms, and good prognosis. This study also highlights the importance of human-to-human transmission in COVID-19.

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