scholarly journals Delayed Manifestation of Shunt Nephritis: A Case Report and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-9
Author(s):  
Michael Babigumira ◽  
Benjamin Huang ◽  
Sherry Werner ◽  
Wajeh Qunibi
Keyword(s):  
Unusual Case ◽  
Propionibacterium Acnes ◽  
Elevated Serum ◽  
Skin Lesions ◽  
Review Of The Literature ◽  
Intravenous Antibiotic ◽  
Dense Deposits ◽  
Shunt Nephritis ◽  
New Onset

We present an unusual case of shunt nephritis in a 39-year-old male who presented 21 years after placement of a ventriculoperitoneal (VP) shunt. He complained of fevers, headaches, dizziness, and urticarial plaques on arms, trunks, and legs and was found to have anemia, low complement levels, elevated serum creatinine, proteinuria, and new onset microhematuria. Blood and urine cultures were negative. Renal biopsy showed features of acute tubulointerstitial nephritis attributed to vancomycin use. Glomeruli showed increased mesangial hypercellularity and segmental endocapillary proliferation. Immunofluorescence showed focal IgM and C3 staining. Electron microscopy revealed small subendothelial electron-dense deposits. Symptoms and renal insufficiency appeared to improve with antibiotic therapy. He was discharged and readmitted 2 months later with similar presentation. CSF grewPropionibacterium acnesand shunt hardware grew coagulase-negativeStaphylococcus. He completed an intravenous antibiotic course and was discharged. On 1-month follow-up, skin lesions persisted but he was otherwise asymptomatic. Follow-up labs showed significant improvement. We did a brief systematic review of the literature on shunt nephritis and report our findings on 79 individual cases. In this review, we comment on the presentation, lab findings, pathological features, and management of this rare, potentially fatal, but curable disease entity.

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

Unusual case of aortic valve involvement in patient with Löffler’s Endomyocarditis: management, follow-up and short review of the literature

2007 ◽  
Vol 24 (3) ◽  
pp. 309-313 ◽  
Author(s):  
Evin Bozcali ◽  
Farid Aliyev ◽  
Mustafa Tarik Agac ◽  
Hakan Erkan ◽  
Barıs Okcun ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Unusual Case ◽  
Short Review ◽  
Review Of The Literature

scholarly journals Congenital self-healing reticulohistiocytosis in a newborn: unusual oral and cutaneous manifestations

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Alessandra Rizzoli ◽  
Simona Giancristoforo ◽  
Cristina Haass ◽  
Rita De Vito ◽  
Stefania Gaspari ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Langerhans Cell Histiocytosis ◽  
Skin Lesions ◽  
Langerhans Cell ◽  
Self Healing ◽  
Review Of The Literature ◽  
Cutaneous Lesions ◽  
Cutaneous Manifestations ◽  
Case Presentation

Abstract Background Congenital self-healing reticulohistiocytosis (CSHRH), also called Hashimoto-Pritzker disease, is a rare and benign variant of Langerhans cell histiocytosis, characterized by cutaneous lesions without extracutaneous involvement. Case presentation We present a case of CSHRH with diffuse skin lesions and erosions in the oral mucosa, present since birth and lasting for 2 months, and we perform a review of the literature on Pubmed in the last 10 years. Conclusions Our case confirm that lesions on oral mucosa, actually underestimated, may be present in patients with CSHRH. Patients affected by CSHRH require a close follow-up until the first years of life, due to the unpredictable course of Langerhans cell histiocytosis, in order to avoid missing diagnosis of more aggressive types of this disorder.

Case of acute, resistant fulminant Wegener's granulomatosis successfully treated by rituximab

2013 ◽  
Vol 127 (4) ◽  
pp. 411-414
Author(s):  
A K Ebrahim ◽  
J W Loock
Keyword(s):  
Wegener’S Granulomatosis ◽  
Conventional Treatment ◽  
Unusual Case ◽  
Disease Recurrence ◽  
Wegener's Granulomatosis ◽  
Inflammatory Condition ◽  
Review Of The Literature ◽  
Delay In Diagnosis ◽  
New Form

AbstractBackground:Wegener's granulomatosis is generally a chronic, indolent, inflammatory condition, treated with cytotoxics (cyclophosphamide) and corticosteroids.Objective:This paper reports an unusual case of acute fulminant Wegener's granulomatosis that failed to respond to conventional treatment, but showed a dramatic response to rituximab, which is a relatively new form of treatment for resistant cases.Method:As well as describing the case (with photographic illustrations), the current paper provides a review of the literature, focusing on acute Wegener's granulomatosis and frequency of resistance to ‘conventional’ forms of treatment. There is also an evaluation of the evidence for the effectiveness of rituximab in resistant Wegener's granulomatosis.Results:The patient responded remarkably well to rituximab and had no disease recurrence at 24 months' follow up.Conclusion:Clinicians should be aware of the acute fulminant form of Wegener's granulomatosis, as a delay in diagnosis and treatment may have fatal consequences. The paper also highlights the dramatic response to rituximab experienced by the patient.

scholarly journals Multiple Second Primary Oral Squamous Cell Carcinomas in a Nonsmoker and Nondrinker Woman: Case Report and Review of the Literature

2015 ◽  
Vol 16 (4) ◽  
pp. 322-328 ◽  
Author(s):  
Maria Luiza Diniz de Sousa Lopes ◽  
Ana Rafaela Luz de Aquino ◽  
Maria de Lourdes Silva de Arruda Morais ◽  
Lélia Bristo de Medeiros ◽  
Éricka Janine Dantas da Silveira
Keyword(s):  
Case Report ◽  
Oral Mucosa ◽  
Squamous Cell ◽  
Unusual Case ◽  
Squamous Cell Carcinomas ◽  
Second Primary ◽  
Review Of The Literature ◽  
Oral Squamous Cell Carcinomas ◽  
Diagnosis And Management

ABSTRACT Aim This manuscript aims to describe an unusual case of multiple second primary squamous cell carcinomas (SCCs) in several sites of the oral mucosa in a nonsmoker and nondrinker woman and to discuss the diagnostic criteria, clinicopathological aspects and outcome of second primary tumor (SPT). Background Patients treated for SCC of the head and neck are at high risk for developing SPT arising from the same dysplastic mucosal field. Currently, there is no reliable method to predict which of the patients will develop SPT. Case description A 64-year-old nonsmoker and nondrinker woman developed several second primary oral SCCs in 7 years of follow-up, most of them being synchronic, treated by surgery without and with chemotherapy and radiotherapy. Conclusion Patients treated for SCC require a long-term and careful follow-up as the development of SPT contributes with significantly negative impact on the prognosis. Clinical significance This report describes the diagnosis and management of a very unusual case of several SPTs affecting different sites of the oral mucosa in the same patient. Moreover, the patient had no apparent risk factors associated with the development of the oral cancer. Therefore, a brief update concerning SPT and its diagnosis and management is also provided. How to cite this article de Sousa Lopes MLD, de Aquino ARL, de Arruda Morais MLS, de Medeiros LB, da Silveira EJD. Multiple Second Primary Oral Squamous Cell Carcinomas in a Nonsmoker and Nondrinker Woman: Case Report and Review of the Literature. J Contemp Dent Pract 2015;16(4):322-328.

scholarly journals The Skin as an Early Expression of Malignancies in the Neonatal Age: A Review of the Literature and a Case Series

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Vito Mondì ◽  
Fiammetta Piersigilli ◽  
Guglielmo Salvatori ◽  
Cinzia Auriti
Keyword(s):  
Neonatal Intensive Care ◽  
Case Series ◽  
Skin Lesions ◽  
Review Of The Literature ◽  
Paper Briefly ◽  
Extensive Evaluation ◽  
Frequent Finding ◽  
Early Expression ◽  
Tumor Types

Skin lesions are a frequent finding in childhood, from infancy throughout adolescence. They can arise from many conditions, including infections and inflammation. Most neonatal rashes are benign and self-limiting and require no treatment. Other conditions may be an expression of malignancy or may be a marker for other abnormalities, such as neural tube defects. Therefore, skin lesions require an extensive evaluation and close follow-up to ensure the best possible outcome. This paper briefly reviews the main tumor types presenting with cutaneous involvement in neonates, followed by the description of some patients admitted to our Neonatal Intensive Care Unit with an early skin expression of malignancies.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

Premalignant and Malignant Lesions of the Heterotopic Pancreas in the Esophagus: a Case Report and Review of the Literature

2015 ◽  
Vol 24 (2) ◽  
pp. 235-239 ◽  
Author(s):  
Jan Ulrych ◽  
Vladimir Fryba ◽  
Helena Skalova ◽  
Zdenek Krska ◽  
Tomas Krechler ◽  
...  
Keyword(s):  
Case Report ◽  
Gastrointestinal Tract ◽  
Unusual Case ◽  
Accurate Diagnosis ◽  
Heterotopic Pancreas ◽  
Premalignant Lesions ◽  
Resected Specimen ◽  
Review Of The Literature ◽  
Severe Dysphagia ◽  
Malignant Lesions

Heterotopic pancreas is a congenital pathology of the gastrointestinal tract, particularly rare in the esophagus. Both symptomatology and findings during preoperative examinations are non-specific and therefore do not often lead to an accurate diagnosis, which is usually revealed only by histopathological assessment of a resected specimen. We report an unusual case of a patient suffering from severe dysphagia caused by heterotopic pancreas in the distal esophagus with chronic inflammation and foci of premalignant changes. This article also reviews 14 adult cases of heterotopic pancreas in the esophagus previously reported in the literature, with the aim of determining the clinical features of this disease and possible complications including rare premalignant lesions and malignant transformation. Especially with regard to those complications, we suggest that both symptomatic and incidentally found asymptomatic lesions should be resected.

Serum Thyroid Peroxidase Antibody Level and Incident Hypertension in Iranian Men: A Suggestion for the Role of Thyroid Autoimmunity

2020 ◽  
Vol 20 (10) ◽  
pp. 1711-1718
Author(s):  
Maryam Tohidi ◽  
Aidin Baghbani-Oskouei ◽  
Atieh Amouzegar ◽  
Ladan Mehran ◽  
Fereidoun Azizi ◽  
...  
Keyword(s):  
Total Population ◽  
Thyroid Autoimmunity ◽  
Elevated Serum ◽  
Thyroid Peroxidase ◽  
Incident Hypertension ◽  
Natural Logarithm ◽  
Hazard Ratios ◽  
Thyroid Peroxidase Antibody ◽  
Unit Increase

Background: Dysfunction of the thyroid gland has profound effects on the cardiovascular system. Objective: We aimed to explore the relation of serum thyroid peroxidase antibody (TPO-Ab), as a marker of thyroid autoimmunity with incident hypertension among a euthyroid population. Methods: A total of 3681 participants (1647 men) entered the study. Multivariate Cox proportional hazard models were conducted to estimate the association between TPO-Ab and incident hypertension. Results: The mean age (standard deviation) of the participants was 37.5 (12.8) years. During a median follow-up of 12.2 years, 511 men and 519 women developed hypertension. The multivariable hazard ratios (HRs) and related 95% confidence intervals (CIs) of 1-unit increase in natural logarithm (ln) of TPO-Ab for incident hypertension were 1.09 (1.00-1.19), 1.03 (0.97-1.10), and 1.05 (1.00-1.11) for men, women, and total population, respectively. Moreover, considering the TPO-Ab status as a categorical variable (i.e. TPO-Ab positive or TPO-Ab negative), the multivariate-adjusted HRs (95% CIs) of TPO-Ab positivity for incident hypertension, were 1.33 (0.95-1.85), 1.12 (0.86-1.45) and 1.19 (0.97- 1.46) for men, women, and total population, respectively. Conclusion: Elevated serum TPO-Ab level can contribute to the development of hypertension among euthyroid men during a long follow-up; suggesting a role for thyroid autoimmunity.

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