scholarly journals P082 Appendicular syndrome revealing Kawasaki-like syndrome: a case report

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Hanane Hajaj ◽  
Aziza El Ouali ◽  
Ayad Ghanam ◽  
Maria Rkain ◽  
Noufissa Benajiba ◽  
...  
Keyword(s):  
Heart Failure ◽  
White Blood Cells ◽  
Cervical Lymphadenopathy ◽  
Abdominal Ultrasound ◽  
Number Of Children ◽  
Bilious Vomiting ◽  
Erythematous Skin ◽  
Anti Inflammatory ◽  
Atypical Presentations ◽  
Inflammatory Syndrome

Abstract Background With the wide spread of the current SARS-CoV-2, It was found that about 2% of children was affected according to several studies, However, a small number of children with Covid-19 develop a significant systemic inflammatory response similar to Kawasaki disease, a new disease entity called multisystem inflammatory syndrome. Methods A 12-year-old child, without a notable pathological history, who presented to the emergency, during the SARS-CoV-2 pandemic, for management of a pseudo-appendicular syndrome. Our patient was initially assessed by the surgical team due to his query acute abdomen. The pain had been evolving for 3 days associated with several episodes of bilious vomiting in a context of fever at 38.5°. Abdominal examination noted abdominal tenderness and defence. Extradigestive signs were not reported, The Lab Testing objectified a CRP at 235, elevated white blood cells at 18 180, an abdominal ultrasound was requested returning without particularities. Faced with the persistence of bilious vomiting, surgical exploration was indicated objectifying a catarrhal appendix. A pediatric opinion was requested, the clinical examination shows conscious child who presents infra cervical lymphadenopathy with a fever at 38 associated with an erythematous skin rash on the back and aseptic conjunctivitis. The Lab Testing objectified an important inflammatory syndrome, a acute kidney and heart failure a Covid 19 serology was requested with positive IGG, négative IGM, PCR covid test was negative, given the unavailability of In immunoglobulins, the treatment was based on corticosteroid bolus then relay by oral corticosteroid associated with an anti-inflammatory treatment, gastric protection by proton pump inhibitors, treatment of heart and acute kidney failure. The evolution was marked by clinical and biological improvement Discussion Coronavirus 2 (SARS-CoV-2) infection among children and adolescents, is mainly responsible for mild respiratory symptoms, in contrast to the severe forms reported in adults [7]. A systemic inflammatory syndrome mimicking kDa, temporally associated with infection with SARS-CoV-2 (Kawa-COVID-19) has recently been described as a serious illness sometimes requiring intensive care (44%). The median age is older (> 5 years), the frequency and severity of myocarditis are very different from classic kDa, abdominal pain and/or diarrhea were more frequently (81%) reported than in classic kDa, heart failure, pneumonia, neurological and renal impairment, associated with elevated CRP, hyperferritinemia are more common in Kawasaki-Like syndrome [10]. Some investigations must be systematically realized urgently to diagnose potentially fatal complications. These include testing for myocarditis, patients should benefit from careful monitoring and treatment with IV Ig 2 g/kg should be administered rapidly and seems to be effective in the majority of cases, associated anti-inflammatory therapy, such as steroids is necessary Conclusion Pediatricians should be aware of these atypical presentations of COVID-19 infection for early diagnosis.

scholarly journals COVID-19 Pandemic in the Disguise of Multi System Inflammatory Syndrome in Children: A Case Series

2021 ◽  
Author(s):  
Anahita Sanaei Dashti ◽  
Kamyar Ebrahimi ◽  
Reza Shahriarirad ◽  
Shabnam Hajiani Ghotbabadi ◽  
Shiva Aminnia
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Organ Damage ◽  
The Novel ◽  
Number Of Children ◽  
Public Crisis ◽  
Novel Coronavirus ◽  
Atypical Presentations ◽  
Inflammatory Syndrome

Abstract Although nearly a year has passed since the emerge of the SARS-CoV-2 virus, with it, a serious and novel pediatric condition called children's multisystem inflammatory syndrome (MIS-C) has subsequently emerged. In order to achieve a better understanding and management of the disease, documentation and reporting of atypical cases is justified, particularly with the growing number of children with inflammatory syndrome with clinical features simulating MIS during the ongoing COVID-19 pandemic. Based on similar reports from numerous countries with temporal relation to COVID-19 infection in the community, it is essential for general pediatricians to be on alert for such atypical presentations and early referral to tertiary care should be considered as appropriate. Here we four cases of Multisystem Inflammatory Syndrome (MIS) during the COVID-19 pandemic. Early diagnosis and treatment of patients meeting full or partial criteria for MIS are critical to preventing end-organ damage and other long-term complications, especially during times of public crisis and global health emergencies, such as the novel coronavirus pandemic.

scholarly journals Association of Nonsteroidal Anti-inflammatory Drugs With First Occurrence of Heart Failure and With Relapsing Heart Failure

2002 ◽  
Vol 162 (3) ◽  
pp. 265 ◽  
Author(s):  
Johan Feenstra ◽  
Eibert R. Heerdink ◽  
Diederick E. Grobbee ◽  
Bruno H. Ch. Stricker
Keyword(s):  
Heart Failure ◽  
First Occurrence ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Shared inflammatory pathways and therapeutic strategies in COVID-19 and cancer immunotherapy

2021 ◽  
Vol 9 (5) ◽  
pp. e002392
Author(s):  
Lorenzo Iovino ◽  
Laurel A Thur ◽  
Sacha Gnjatic ◽  
Aude Chapuis ◽  
Filippo Milano ◽  
...  
Keyword(s):  
Preliminary Evidence ◽  
Severe Form ◽  
Cell Transplant ◽  
T Cell Therapy ◽  
Cell Therapies ◽  
Novel Drugs ◽  
Prospective Trials ◽  
Systemic Manifestations ◽  
Anti Inflammatory ◽  
Inflammatory Syndrome

COVID-19, the syndrome caused by the infection with SARS-CoV-2 coronavirus, is characterized, in its severe form, by interstitial diffuse pneumonitis and acute respiratory distress syndrome (ARDS). ARDS and systemic manifestations of COVID-19 are mainly due to an exaggerated immune response triggered by the viral infection. Cytokine release syndrome (CRS), an inflammatory syndrome characterized by elevated levels of circulating cytokines, and endothelial dysfunction are systemic manifestations of COVID-19. CRS is also an adverse event of immunotherapy (IMTX), the treatment of diseases using drugs, cells, and antibodies to stimulate or suppress the immune system. Graft-versus-host disease complications after an allogeneic stem cell transplant, toxicity after the infusion of chimeric antigen receptor-T cell therapy and monoclonal antibodies can all lead to CRS. It is hypothesized that anti-inflammatory drugs used for treatment of CRS in IMTX may be useful in reducing the mortality in COVID-19, whereas IMTX itself may help in ameliorating effects of SARS-CoV-2 infection. In this paper, we focused on the potential shared mechanisms and differences between COVID-19 and IMTX-related toxicities. We performed a systematic review of the clinical trials testing anti-inflammatory therapies and of the data published from prospective trials. Preliminary evidence suggests there might be a benefit in targeting the cytokines involved in the pathogenesis of COVID-19, especially by inhibiting the interleukin-6 pathway. Many other approaches based on novel drugs and cell therapies are currently under investigation and may lead to a reduction in hospitalization and mortality due to COVID-19.

scholarly journals Novel multi-strain probiotics reduces Pasteurella multocida induced fowl cholera mortality in broilers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rine Christopher Reuben ◽  
Shovon Lal Sarkar ◽  
Habiba Ibnat ◽  
Md. Ali Ahasan Setu ◽  
Pravas Chandra Roy ◽  
...  
Keyword(s):  
Growth Performance ◽  
Feed Efficiency ◽  
Biochemical Parameters ◽  
Pasteurella Multocida ◽  
White Blood Cells ◽  
Clinical Signs ◽  
Basal Diet ◽  
Prostaglandin E ◽  
Fowl Cholera ◽  
Anti Inflammatory

AbstractPasteurella multocida causes fowl cholera, a highly contagious poultry disease of global concern, causing significant ecological and economic challenges to the poultry industry each year. This study evaluated the effects of novel multi-strain probiotics consisting of Lactobacillus plantarum, L. fermentum, Pediococcus acidilactici, Enterococcus faecium and Saccharomyces cerevisiae on growth performance, intestinal microbiota, haemato-biochemical parameters and anti-inflammatory properties on broilers experimentally challenged with P. multocida. A total of 120 birds were fed with a basal diet supplemented with probiotics (108 CFU/kg) and then orally challenged with 108 CFU/mL of P. multocida. Probiotics supplementation significantly (P < 0.05) improved growth performance and feed efficiency as well as reducing (P < 0.05) the population of intestinal P. multocida, enterobacteria, and mortality. Haemato-biochemical parameters including total cholesterol, white blood cells (WBC), proteins, glucose, packed cell volume (PCV) and lymphocytes improved (P < 0.05) among probiotic fed birds when compared with the controls. Transcriptional profiles of anti-inflammatory genes including hypoxia inducible factor 1 alpha (HIF1A), tumor necrosis factor- (TNF) stimulated gene-6 (TSG-6) and prostaglandin E receptor 2 (PTGER2) in the intestinal mucosa were upregulated (P < 0.05) in probiotics fed birds. The dietary inclusion of the novel multi-strain probiotics improves growth performance, feed efficiency and intestinal health while attenuating inflammatory reaction, clinical signs and mortality associated with P. multocida infection in broilers.

Abstract 285: Cardiac Inflammation and Fibrosis Induced by Heart Failure Are Reversed by Short-Duration Estrogen Therapy

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Andrea Iorga ◽  
Rangarajan Nadadur ◽  
Salil Sharma ◽  
Jingyuan Li ◽  
Mansoureh Eghbali
Keyword(s):  
Heart Failure ◽  
Estrogen Therapy ◽  
Pressure Overload ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Neonatal Rat ◽  
In Vivo Model ◽  
Anti Inflammatory

Heart failure is generally characterized by increased fibrosis and inflammation, which leads to functional and contractile defects. We have previously shown that short-term estrogen (E2) treatment can rescue pressure overload-induced decompensated heart failure (HF) in mice. Here, we investigate the anti-inflammatory and anti-fibrotic effects of E2 on reversing the adverse remodeling of the left ventricle which occurs during the progression to heart failure. Trans-aortic constriction procedure was used to induce HF. Once the ejection fraction reached ∼30%, one group of mice was sacrificed and the other group was treated with E2 (30 αg/kg/day) for 10 days. In vitro, co-cultured neonatal rat ventricular myocytes and fibroblasts were treated with Angiotensin II (AngII) to simulate cardiac stress, both in the presence or absence of E2. In vivo RT-PCR showed that the transcript levels of the pro-fibrotic markers Collagen I, TGFβ, Fibrosin 1 (FBRS) and Lysil Oxidase (LOX) were significantly upregulated in HF (from 1.00±0.16 to 1.83±0.11 for Collagen 1, 1±0.86 to 4.33±0.59 for TGFβ, 1±0.52 to 3.61±0.22 for FBRS and 1.00±0.33 to 2.88±0.32 for LOX) and were reduced with E2 treatment to levels similar to CTRL. E2 also restored in vitro AngII-induced upregulation of LOX, TGFβ and Collagen 1 (LOX:1±0.23 in CTRL, 6.87±0.26 in AngII and 2.80±1.5 in AngII+E2; TGFβ: 1±0.08 in CTRL, 3.30±0.25 in AngII and 1.59±0.21 in AngII+E2; Collagen 1: 1±0.05 in CTRL.2±0.01 in AngII and 0.65±0.02 (p<0.05, values normalized to CTRL)). Furthermore, the pro-inflammatory interleukins IL-1β and IL-6 were upregulated from 1±0.19 to 1.90±0.09 and 1±0.30 to 5.29±0.77 in the in vivo model of HF, respectively, and reversed to CTRL levels with E2 therapy. In vitro, IL-1β was also significantly increased ∼ 4 fold from 1±0.63 in CTRL to 3.86±0.14 with AngII treatment and restored to 1.29±0.77 with Ang+E2 treatment. Lastly, the anti-inflammatory interleukin IL-10 was downregulated from 1.00±0.17 to 0.49±0.03 in HF and reversed to 0.67±0.09 in vivo with E2 therapy (all values normalized to CTRL). This data strongly suggests that one of the mechanisms for the beneficial action of estrogen on left ventricular heart failure is through reversal of inflammation and fibrosis.

scholarly journals COVID-19 in Children

2021 ◽  
Vol 41 (1) ◽  
pp. 15-21
Author(s):  
Diana Didović ◽  
Srđan Roglić ◽  
Lorna Stemberger-Marić ◽  
Ivana Valenčak-Ignjatić ◽  
Andrea Nikčević
Keyword(s):  
Clinical Presentation ◽  
Viral Infections ◽  
Rare Complication ◽  
Older Children ◽  
Symptomatic Infection ◽  
Number Of Children ◽  
Multisystem Involvement ◽  
Laboratory Results ◽  
Inflammatory Syndrome

COVID-19 in children accounts for up to 8% of all the cases and is less severe than in adults. This could be an underestimation. A significant number of children are asymptomatic. Symptomatic infection is hard to distinguish from other respiratory tract viral infections based on symptoms and laboratory results. Anosmia is the only symptom in children that is highly suggestive of COVID-19. Infected children mostly have a positive household member. However, the role of children in SARS-CoV-2 transmission is still controversial. Data suggest that schoolchildren have a greater impact in SARS-CoV-2 transmission compared to younger children. Multisystem inflammatory syndrome in children is a new entity reported since April 2020 and is considered a rare complication of SARS-CoV-2 infection. It occurs in previously healthy older children and adolescents presenting with multisystem involvement and elevated inflammatory markers. Most children respond well to immune-modifying therapy. Treatment of COVID-19 in children is based solely on data received from adults and consists of supportive treatment and, in rare occasions, antiviral therapy (remdesivir), corticosteroids (dexamethasone) and monoclonal antibodies (tocilizumab). Further studies in children are needed in order to better understand this disease. This article discusses clinical presentation and therapeutic options for COVID-19 in children.

Leflunomide counterakts cardiac hypertrophy

2018 ◽  
Vol 132 (10) ◽  
pp. 1069-1073 ◽  
Author(s):  
Luciana A. Pescatore ◽  
Francisco R.M. Laurindo
Keyword(s):  
Heart Failure ◽  
Cardiac Hypertrophy ◽  
Independent Risk Factor ◽  
Cultured Cells ◽  
Protein Kinase B ◽  
Therapeutic Interventions ◽  
Recent Issue ◽  
Aortic Banding ◽  
Akt Activation ◽  
Anti Inflammatory

Cardiac hypertrophy (CH) is a major independent risk factor for heart failure and mortality. However, therapeutic interventions that target hypertrophy signaling in a load-independent way are unavailable. In a recent issue of Clinical Science (vol. 132, issue 6, 685-699), Ma et al. describe that the anti-inflammatory drug leflunomide markedly antagonized CH, dysfunction, and fibrosis induced by aortic banding or angiotensin-II in mice or by agonists in cultured cells. Unexpectedly, this occurred not via anti-inflammatory mechanisms but rather via inhibtion of Akt (protein kinase B, PKB) signaling. We further discuss the mechanisms underlying Akt activation and its effects on CH and review possible mechanisms of leflunomide effects. Despite some caveats, the availability of such a newly repurposed compound to treat CH can be a relevant advance.

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