scholarly journals POS0826 SKIN LIMITED IGA VASCULITIS IN ADULTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 666.1-666
Author(s):  
A. Hočevar ◽  
J. Ostrovrsnik ◽  
K. Perdan-Pirkmajer ◽  
M. Tomsic ◽  
Z. Rotar
Keyword(s):  
Clinical Characteristics ◽  
Systemic Disease ◽  
Elevated Serum ◽  
Skin Lesions ◽  
Current Smoker ◽  
P Value ◽  
Symptom Duration ◽  
Iga Vasculitis ◽  
Reactive Protein

Background:IgA vasculitis (IgAV) could be limited to skin or evolve into a systemic disease, affecting characteristically joints, gastrointestinal tract and/or kidneys.Objectives:We aimed to look for differences between adult IgAV patients with disease limited to skin compared to systemic IgAV.Methods:Medical records of histologically proven adult IgAV cases, diagnosed between January 2010 and December 2020 at our secondary/tertiary rheumatology centre were analyzed.Results:During the 132-month observation period we identified 328 new IgAV cases (59.5% males, median (IQR) age 64.3 (45.1; 76.1) years). Ninety-four (40.2%) patients had skin limited disease, and the rest systemic IgAV.Clinical differences between skin limited and systemic adult IgAV are presented in table 1. Adults with IgAV limited to skin were significantly older, had less commonly skin lesions above the waistline and a lower level of C reactive protein compared to patients with a systemic disease. There were no differences in the frequency of skin necroses between the compared IgAV subgroups. The frequency of potential vasculitis triggers (prior infections, new medications, malignancy) was similar between the compared subgroups.Table 1.Clinical characteristics of IgA vasculitis patients with skin limited and systemic diseaseClinical characteristicsSkin limited IgAV (94)Systemic IgAV (234)P valueMale gender (%)54.361.50.263Age (years)*68.0 (55.0-80.5)61.5 (41.7-75.8)0.007Current smoker (%)13.821.80.123Antecedent infection (%)28.733.80.434New medication23.423.51.0History of cancer12.810.70.569Symptom duration (days)*7 (5-21)8 (5-14)0.756Purpura above waistline36.255.60.002Skin necroses (%)52.145.70.329ESR /mm/h) *32 (18-52)34 (17-53)0.873CRP (g/l) *13.5 (1-32)30 (11-68)<0.001Elevated serum IgA (%)50.649.10.892Legend: * median and IQR;Follow up data were available for 250 (76.2%) patients. During the follow up of median (IQR) 12.5 (6.8 – 22.4) months 35 patients relapsed (13/70 (18.6%) with skin limited IgAV and 22/180 (12.2%) with systemic IgAV, p= 0.224).Conclusion:Skin limited IgAV was associated with older age and less extensive skin puprura in adults. However, relapses of purpura were as common as in systemic IgAV.Disclosure of Interests:None declared

Orbital plasmacytoma as the presenting feature in multiple myeloma

2020 ◽  
pp. 112067212092995 ◽  
Author(s):  
Malavika Mani ◽  
Nirupama Kasturi ◽  
Rekha Sravya ◽  
Subashini Kaliaperumal ◽  
Debasis Gochhait
Keyword(s):  
Plasma Cells ◽  
Systemic Disease ◽  
Elevated Serum ◽  
Needle Aspiration ◽  
Serum Lactate ◽  
Serum Lactate Dehydrogenase ◽  
Reactive Protein ◽  
Lytic Lesions ◽  
Needle Aspiration Cytology

A 50-year-old female patient presented with protrusion of the left eye for 1 month. Examination showed abaxial proptosis, restriction of extraocular movements, and elevated intraocular pressure. Computed tomography of the orbits showed soft tissue enhancing lesion in the superolateral aspect of the left orbit with lytic lesions in calvarium. Fine needle aspiration cytology of the lesion revealed a diagnosis of plasmacytoma with positive CD138 and CD38 immunohistochemical stains. Erythrocyte sedimentation rate, C-reactive protein and serum lactate dehydrogenase were elevated. Serum protein electrophoresis revealed hypergammaglobulinemia, and bone marrow biopsy revealed 6% plasma cells. The patient was started on chemotherapy with bortezomib, dexamethasone and lenalidomide by the medical oncologist. Significant improvement in proptosis and extraocular movements noted on follow-up. Orbital myeloma may be the first manifestation of systemic disease.

scholarly journals POS0823 ARTHRITIS IN ADULT IGA VASCULITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 664.2-665
Author(s):  
A. Hočevar ◽  
V. Jurčić ◽  
M. Tomsic ◽  
Z. Rotar
Keyword(s):  
Gastrointestinal Tract ◽  
Clinical Characteristics ◽  
Renal Involvement ◽  
Elevated Serum ◽  
Joint Involvement ◽  
P Value ◽  
Iga Vasculitis ◽  
Upper And Lower Extremities ◽  
Tract Involvement ◽  
Metatarsophalangeal Joints

Background:Arthritis is one of the main clinical features of IgA vasculitis (IgAV). Joint involvement represents the second most common manifestation in childhood IgAV with the predilection for the knees and ankles.Objectives:We aimed to describe the characteristics of arthritis in adult IgAV cohort.Methods:We analysed medical records of histologically proven adult IgAV cases, diagnosed between January 2010 and December 2020 at our secondary/tertiary rheumatology centre. The frequency, temporal occurrence and the localization of arthritis was recorded. In addition, we searched for potential differences in other IgAV features between patients with and without arthritis.Results:During the 132-month observation period we identified 328 new IgAV cases (59.5% males, median (IQR) age 64.3 (45.1; 76.1) years). Forty-eight (14.6%) patients developed arthritis. Arthritis was the first IgAV manifestation in 16 (4.9%) patients. Arthritis was mono-, oligo- and poly- articular (involving up to 15 joints) in 13 (4.0%), 25 (7.6%) and 10 (3.0%) patients, respectively. Arthritis was most common in wrists and ankles (each in 18 (37.5%) patients); metacarpophalangeal joints and knees (each in 11 (22.9%)); proximal interphalangeal joints (9 (18.8%)); elbows (8 (16.7%)) and metatarsophalangeal joints (4 (8.3%)). Clinical differences between IgAV patients with and without arthritis are presented in table 1. Patients with arthritis were significantly younger, more commonly developed gastrointestinal tract involvement compared to those without arthritis. Arthritis remitted in all with immunomodulatory treatment (given predominantly for necrotic skin purpura or visceral involvement). Follow up (FU) data accessible for 42/48 (87.5%) patients with arthritis showed that IgAV relapsed in 10 (23.8%) patients during a median (IQR) 24.5 (12.9; 40.7) month FU. Relapses were limited to skin and/or kidneys, there were no relapses of arthritis.Table 1.Clinical characteristics of IgA vasculitis patients with and without arthritisClinical characteristicsArthritis IgAV(48)Non-arthritis IgAV(280)P valueMale gender (%)56.360.00.636Age (years)*49.9 (36.1-66.9)65.4 (48.4;77.5)<0.001Ever smoker (%)50.043.60.435Prior infection (%)43.830.40.094Generalized purpura50.050.01.0Skin necroses (%)35.449.60.085GI involvement (%)47.925.00.002Renal involvement (%)47.946.81.0Elevated serum IgA (%)33.3 (11/33)52.0 (115/221)0.061Legend: * median and IQR; GI gastrointestinal;Conclusion:Arthritis in adult IgAV was frequently oligoarticular, involved large and small joints of both upper and lower extremities, and was not prone to chronic course and recurrence. In addition, we found an association between arthritis and gastrointestinal tract involvement.Disclosure of Interests:None declared

Abstract P096: Maternal Serum C-Reactive Protein Levels During Pregnancy and Risk for High C-Reactive Protein 7-13 Years Later

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Bonny Rockette-Wagner ◽  
Claudia Holzman ◽  
Bertha L Bullen ◽  
Andrew D Althouse ◽  
Janet M Catov
Keyword(s):  
Relative Risk ◽  
Weight Change ◽  
Elevated Serum ◽  
Maternal Serum ◽  
Health Study ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Inflammatory Status

Introduction: Elevated serum C-reactive protein (CRP) can be a marker of disease activity involving inflammation, such as pregnancy complications and cardiovascular disease (CVD). Systemically high levels of CRP in women, including during pregnancy, may indicate higher risk for CVD. It is unknown if CRP measured during the pro-inflammatory state of pregnancy correlates with concentrations assessed 7-13 years after delivery. Hypothesis: Concentrations of CRP assessed during pregnancy will be related to CRP measured several years after pregnancy, independent of weight gain. Methods: We studied the first 252 women enrolled in the follow-up of the Pregnancy Outcomes and Community Health Study (POUCHmoms 2011-2013) with complete CRP data for the pregnancy (mean gestational age: 22.36 [2.22] weeks) and POUCHmoms visits (mean follow-up: 10.76 [1.38] years). The relative risk for high hsCRP (≥ 3.39 μg/ml) at the follow-up visit, related to quartiles of CRP during pregnancy, was examined using stepwise regression models. Results: Median (IQR) levels of pregnancy CRP and hsCRP at the follow-up visit were 5.68 [3.08, 9.76] and 3.39 [0.69, 9.73] μg/ml, respectively. Although absolute values of hsCRP at follow-up were generally lower than pregnancy CRP, 56% of women in the top and bottom quartiles of pregnancy CRP (71 of 126) were in the same quartile for hsCRP at follow-up (figure). The relative risk of having high hsCRP (≥ 3.39 μg/ml) at follow-up ranged from 2.7-5.2 for the 2 nd - 4 th quartiles of pregnancy CRP (vs. the 1st quartile). Controlling for pre-pregnancy BMI and follow-up weight change, the relative risk of having high hsCRP at follow-up was significantly higher for the 2 nd (1.15 [1.02-1.30]),3 rd (1.19 [1.05-1.35), and 4 th (1.22 [1.05-1.41]) quartiles of pregnancy CRP. Conclusions: Pregnancy CRP levels are related to hsCRP levels several years later in this cohort of women, even after adjusting for pre-pregnancy BMI and follow-up weight change. CRP assessed in pregnancy may reflect inflammatory status later in life.

scholarly journals Neonatal Outcomes in Pregnant Women Infected with COVID-19 in Babol, North of Iran: A Retrospective Study with Short-Term Follow-Up

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Zahra Akbarian-Rad ◽  
Mohsen Haghshenas Mojaveri ◽  
Zinatossadat Bouzari ◽  
Farzin Sadeghi ◽  
Yousef Yahyapour ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Characteristics ◽  
Neonatal Outcomes ◽  
Long Term Outcomes ◽  
Short Term ◽  
Reactive Protein ◽  
Clinical Presentations ◽  
North Of Iran

During the coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks postdischarge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were 37 ± 3.19 weeks (30₊6-40) and 3077.50 ± 697.64 gr (1720-3900), respectively. Apgar score of the first and fifth minutes in all neonates was ≥8 and ≥9 out of 10, respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP) in three infants are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results similar to those described for nonpregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study.

scholarly journals Neonatal outcomes in pregnant women infected with COVID-19 in Babol, North of Iran: retrospective study with short-term follow-up

2021 ◽  
Author(s):  
Zahra Akbarian-Rad ◽  
Mohsen Haghshenas Mojaveri ◽  
Zinatossadat Bouzari ◽  
Farzin Sadeghi ◽  
Yousef Yahyapour ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Characteristics ◽  
Neonatal Outcomes ◽  
Short Term ◽  
Post Discharge ◽  
Reactive Protein ◽  
Clinical Presentations ◽  
North Of Iran

Abstract During the Coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks post-discharge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 who were admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were 37 ± 3.19 weeks (30₊6 − 40) and 3077.50 ± 697.64 gr (1720–3900) respectively. Apgar score of the first and fifth minutes in all neonates was ≥ 8 and ≥ 9 out of 10 respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP), in three infants, are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results almost similar to those described for non-pregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study.

scholarly journals Changes in the Clinical Characteristics of 62 Patients Who Died from Coronavirus Disease 2019

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Jingli Chen ◽  
Jishi Ye ◽  
Hui Li ◽  
Zhongyuan Xia ◽  
Hong Yan
Keyword(s):  
Disease Progression ◽  
Median Time ◽  
Symptom Onset ◽  
Clinical Characteristics ◽  
Multiple Organ ◽  
Rapid Progression ◽  
Cytokine Storm ◽  
Reactive Protein ◽  
Clinical Changes

Background. Since the first reports of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in December 2019 in Wuhan, China, the virus has spread to other parts of China and across the world. Although a few studies have assessed the clinical course of coronavirus disease 2019 (COVID-19), the changes in clinical characteristics during disease progression remain unclear. Methods. We retrospectively analyzed the clinical characteristics of 62 patients who died from COVID-19 at the Central Hospital of Wuhan between January 26 and February 17, 2020. We compared the clinical features on admission and at the last follow-up before death. Results. Of the 62 patients with COVID-19, 41 (66%) patients were male, and 21 (34%) were female. The median age was 72 years (interquartile range (IQR), 54-88), and 45 (72.5%) patients had preexisting conditions. The median time from symptom onset to the first visit at the clinic was three days, while the median time from symptom onset to death was 18.5 days. During disease progression, the amounts of arterial gases worsened, and liver, renal, and heart dysfunction was observed. Due to the cytokine storm, infection-related biomarkers, including lactic acid, C-reactive protein, and interleukine-6, gradually worsened during hospitalization. Conclusion. Our findings suggest that during hospitalization, many COVID-19 patients experienced multiple organ dysfunction and cytokine storm. The time from symptom onset to death was only 18.5 days, highlighting the disease’s rapid progression. The better understanding of the clinical changes during disease progression might provide further insight into the COVID-19 pathophysiology.

scholarly journals Clinical Characteristics and Survival Analysis in Frequent Alcohol Consumers With COVID-19

2021 ◽  
Vol 8 ◽  
Author(s):  
Ricardo Wesley Alberca ◽  
Paula Ordonhez Rigato ◽  
Yasmim Álefe Leuzzi Ramos ◽  
Franciane Mouradian Emidio Teixeira ◽  
Anna Cláudia Calvielli Branco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Immune Responses ◽  
Social Practice ◽  
Death Rate ◽  
Clinical Characteristics ◽  
Systemic Disease ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Excessive Consumption

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can generate a systemic disease named coronavirus disease–2019 (COVID-19). Currently, the COVID-19 pandemic has killed millions worldwide, presenting huge health and economic challenges worldwide. Several risk factors, such as age, co-infections, metabolic syndrome, and smoking have been associated with poor disease progression and outcomes. Alcohol drinking is a common social practice among adults, but frequent and/or excessive consumption can mitigate the anti-viral and anti-bacterial immune responses. Therefore, we investigated if patients with self-reported daily alcohol consumption (DAC) presented alteration in the immune response to SARS-CoV-2. We investigated 122 patients with COVID-19 (101 male and 46 females), in which 23 were patients with DAC (18 men and 5 women) and 99 were non-DAC patients (58 men and 41 women), without other infections, neoplasia, or immunodeficiencies. Although with no difference in age, patients with DAC presented an increase in severity-associated COVID-19 markers such as C-reactive protein (CRP), neutrophil count, and neutrophil-to-lymphocyte ratio. In addition, patients with DAC presented a reduction in the lymphocytes and monocytes counts. Importantly, the DAC group presented an increase in death rate in comparison with the non-DAC group. Our results demonstrated that, in our cohort, DAC enhanced COVID-19-associated inflammation, and increased the number of deaths due to COVID-19.

scholarly journals The First Retrospective Commercial Claims-Based Analysis of CAR T Treated Patients with Relapsed or Refractory Large B-Cell Lymphoma (R/R LBCL)

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 31-31
Author(s):  
Anna Purdum ◽  
Jonathan Johnson ◽  
Anthony Bonagura ◽  
Liliosa Nyamutswa ◽  
Caitlin Elliott ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Characteristics ◽  
B Cell Lymphoma ◽  
P Value ◽  
Publicly Traded ◽  
Index Event ◽  
Car T ◽  
Ed Visits ◽  
The Mean

Introduction: Approximately 74,000 Americans are diagnosed with Non-Hodgkin Lymphoma (NHL) each year, of whom 30% are identified as having LBCL. In recent years, two autologous anti-CD19 chimeric antigen receptor T-Cell (CAR T) therapies were approved for the treatment of patients with R/R LBCL with ≥ 2 prior systemic therapies. Objectives: To describe the demographic and clinical characteristics of the CAR T patients and to compare healthcare resource utilization (HCRU) and costs pre- and post-CAR T therapy. Methods: This pre/post-index comparison evaluated in the Optum Research Database included adult (age ≥ 18 years) commercial and Medicare Advantage (MA) enrollees, with medical benefits and evidence of medical/procedure codes indicative of CAR T therapy between 01/01/2017 and 03/31/2019. Patients must have been continuously enrolled in their commercial healthcare plan for at least 3 months prior to and 6 months after the infusion (index) unless death occurred. Patients with evidence of pre-index leukemia were excluded. Baseline demographic and clinical characteristics included age, gender, insurance type, geographic region, and comorbidities. Measures of pre/post HCRU and standardized cost (scaled as per patient per month (PPPM) values to account for variable follow-up durations) included ambulatory visits, emergency department (ED) visits, and inpatient admissions (both Intensive Care Unit (ICU) and non-ICU visits). Information on the CAR T administration index visit and length of stay (LOS) for inpatient admissions were also captured. Data analysis (descriptive statistics) was conducted using Statistical Analysis System (SAS) Version 9.4. Results: 109 patients met all inclusion criteria. The patient mean age was 59.31 (SD = 12.60), 59% were male, 70% were commercially insured, 30% MA, and the mean Quan-Charlson Comorbidity score was 3.60.Thirty patients received CAR T administration through clinical trials. Seventeen percent received CAR T therapy in a Prospective Payment System (PPS) Exempt Cancer Hospital and 83% received treatment in Inpatient PPS hospitals. The CAR T therapy index event was administered inpatient for 82% of patients and twenty patients (18%) received CAR T in the outpatient setting. The median LOS during CAR T administration was 16 days which included 52% ICU admissions. During the pre-index period, all patients experienced an ambulatory visit with an average of 15.09 visits PPPM, whereas 41% had an ED encounter for an average rate of 0.39 visits PPPM, and 44% had an inpatient stay with 0.28 PPPM. The total medical and pharmacy costs were $128K PPPM. With a median follow-up of 8.4 months, patients experienced 46% fewer ambulatory visits (average 8.14 PPPM, p-value &lt; 0.001), 49% fewer ED visits (average 0.20 PPPM, p-value &lt; 0.037), and 18% fewer inpatient visit rates (average 0.23 PPPM, p-value = 0.415) in the post index period (excluding the index event) than pre-index period. The mean total medical and pharmacy costs were also 49% lower at $66K PPPM (p-value &lt; 0.008). Conclusions:Post-CAR T care was associated with lower health care utilization including fewer ambulatory visits, and ED visits and lower overall total health care costs compared to pre-CAR T care. Disclosures Purdum: Kite: Current Employment, Current equity holder in publicly-traded company. Johnson:Optum: Current Employment, Current equity holder in publicly-traded company. Bonagura:Optum: Current Employment, Current equity holder in publicly-traded company. Nyamutswa:Kite: Current Employment, Current equity holder in publicly-traded company. Elliott:Optum: Current Employment. Lal:Optum: Current Employment.

Abstract TP71: Delayed Lesion on Diffusion-Weighted Image is Not Uncommon in Elderly and Severe Stroke-Suspected Patients

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Hiroyuki Kida ◽  
Kenichiro Sakai ◽  
Hiroki Takatsu ◽  
Takeo Sato ◽  
Teppei Komatsu ◽  
...  
Keyword(s):  
Elevated Serum ◽  
Multivariate Logistic Regression Analysis ◽  
Favorable Outcome ◽  
Neurological Deficits ◽  
Symptom Duration ◽  
Ischemic Lesion ◽  
Nihss Score ◽  
Suspected Stroke

Introduction: No lesion on admission DWI but delayed appearance in the follow-up DWI are not uncommon in acute stroke. Our aim is to investigate clinical features of patients with delayed-high intensity area (DHIA) on follow-up DWI. Methods: We enrolled 1) TIA patients and 2) clinically suspected stroke patients sustaining a neurological deficit over 24 hours without ischemic lesion on initial DWI. Follow-up DWI was performed in 7 days after admission. We divided into two groups as follows; DHIA group and no hyper-intense lesion on initial and second DWI (NHIA group). Univariate and multivariate logistic regression analysis were conducted on backgrounds, clinical courses including time from onset to MRI, symptom duration, and favorable outcome (mRS 0-1) in 3 months in both groups. Results: One hundred seventy-two cases were identified (male 68%, median age 66 yo, median NIHSS score 1, delayed-HIA group; 48 patients) between October 2012 and March 2019. DHIA group was older (72 yo vs 64 yo, p<0.001), higher NIHSS score on admission (1 vs 0, p=0.001), elevated serum BNP (42.5 pg/dL vs 15.6 pg/dL, p<0.001), D-Dimer (0.8 μg/mL vs 0.6 μg/mL, p=0.023). Then, favorable outcome was frequently observed in NHIA group (72% vs 88%, p=0.019). Time from onset to initial DWI of DHIA group was similar with those of NHIA group (130 min vs 148 min, p=0.142). Age and NIHSS score on admission were independent factors for DHIA (Age: OR 1.03, 95%CI 1.01-1.06, p=0.021, NIHSS on admission: OR 1.21, 95%CI 1.04-1.40, p=0.011). Conclusion: Follow-up DWI may play an important role of outcome biomarker in TIA and initially suspected stroke. Repeated MRI should be performed for elder and severe neurological deficits.

scholarly journals Clinical Characteristics of Pregnancy-Associated Central Serous Chorioretinopathy in the Chinese Population

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jia Yu ◽  
Lei Li ◽  
Chunhui Jiang ◽  
Qing Chang ◽  
Gezhi Xu
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Chinese Population ◽  
Clinical Characteristics ◽  
Subretinal Fluid ◽  
Symptom Duration ◽  
Initial Visit ◽  
Half Dose ◽  
The Mean

Purpose. To investigate the clinical characteristics of pregnancy-associated central serous chorioretinopathy (CSC) in the Chinese population. Methods. The medical records of patients diagnosed with pregnancy-associated CSC from February 2012 to October 2019 were retrospectively reviewed. Best-corrected visual acuity (BCVA), symptom duration, pregnancy-related medical information, and optical coherence tomography (OCT) images were collected. Results. Nine patients (11 eyes) were included. Five women were in their first pregnancy and four were in their second pregnancy, two of whom experienced CSC in their first pregnancy as well. The mean age was 35.00 ± 3.97 years. The mean symptom duration at the initial visit was 19.73 ± 13.65 days. The mean gestational age at the time of development of CSC was 27.11 ± 2.09 weeks. The mean BCVA (logarithm of the minimum angle of resolution (logMAR)) at the initial visit was 0.36 ± 0.18 (Snellen 20/45, range 20/100–20/25). All eyes showed subretinal hyperreflective fibrin on OCT images at the initial visit. Four patients (4 eyes) were lost to follow-up before fluid resolution. The mean BCVA at the final visit was logMAR 0.10 ± 0.15 (Snellen 20/25, range 20/50–20/20)). One eye in the oldest patient had persistent subretinal fluid at 26 months postpartum. The subretinal fluid resolved completely after half-dose photodynamic therapy (PDT); however, the ellipsoid zone at the fovea remained discontinuous at 30 months after half-dose PDT. The remaining six eyes all showed spontaneous resolution of subretinal fluid around delivery and regained intact ellipsoid zone. Conclusions. Pregnancy-associated CSC in Chinese developed mostly in the third trimester and usually recovered spontaneously around delivery with good final visual acuity. However, patients might require long-term follow-up until complete resolution of subretinal fluid and to detect recurrences. Half-dose PDT can be administered early if there is little reduction in the amount of subretinal fluid after delivery.

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