COVID-19 as a potential trigger of complement-mediated atypical HUS.

Supersensitivity psychosis is a subdiagnosed clinical reality. This entity, however, is insufficiently elucidated from the point of view of the neurobiochemical mechanisms involved in the pathogenesis. The combination of an antipsychotic with a high D2 receptor blocking capacity and a neuroleptic-like substance such as cinnarizine trigger the dopaminergic hypersensitivity mechanisms. This stimulates the sensitivity for dopamine in the prefrontal cortex, ameliorating the negative and cognitive symptoms at the thalamic level, remodeling sensory integration and decreasing tinnitus, as well as in the cerebral tonsil, consequently decreasing the risk of antisocial behavior.

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Risk of Atypical HUS Among Family Members of Patients Carrying Complement Regulatory Gene Abnormality

Kidney International Reports ◽

10.1016/j.ekir.2021.03.885 ◽

2021 ◽

Author(s):

Gianluigi Ardissino ◽

Selena Longhi ◽

Luigi Porcaro ◽

Giulia Pintarelli ◽

Bice Strumbo ◽

...

Keyword(s):

Regulatory Gene ◽

Family Members ◽

Atypical Hus

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New onset diabetes with diabetic ketoacidosis in a child with multisystem inflammatory syndrome due to COVID-19

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0426 ◽

2020 ◽

Vol 0 (0) ◽

Cited By ~ 1

Author(s):

Monica N. Naguib ◽

Jennifer K. Raymond ◽

Alaina P. Vidmar

Keyword(s):

Metabolic Acidosis ◽

Diabetic Ketoacidosis ◽

Pediatric Patients ◽

Systolic Function ◽

Hemodynamic Instability ◽

Case Presentation ◽

Onset Diabetes ◽

Potential Trigger ◽

Inflammatory Syndrome ◽

New Onset

AbstractIntroductionMultisystem inflammatory syndrome in children (MIS-C) is a unique clinical complication of SARS-CoV-2 infection observed in pediatric patients. COVID-19 is emerging as a potential trigger for the development of diabetes in children. Here, we report a patient presenting with MIS-C and new onset diabetes, and discuss the implication and clinical management of these concomitant conditions.Case presentationAn eight-year-old female presented with hyperglycemia, ketosis and metabolic acidosis consistent with diabetic ketoacidosis (DKA) in the setting of fever, rash, respiratory distress, hemodynamic instability, reduced systolic function with dilation of the left anterior descending artery, and positive SARS-CoV-2 antibodies suggestive of MIS-C.

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Guillain-Barré syndrome triggered by surgery in a Chinese population: a multicenter retrospective study

BMC Neurology ◽

10.1186/s12883-021-02067-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Qiaoyu Gong ◽

Shuping Liu ◽

Yin Liu ◽

Jiajia Yao ◽

Xiujuan Fu ◽

...

Keyword(s):

Clinical Features ◽

Orthopedic Surgery ◽

Southern China ◽

Axonal Neuropathy ◽

Trigger Factor ◽

Guillain Barre Syndrome ◽

Initial Symptoms ◽

Guillain Barré Syndrome ◽

Potential Trigger ◽

Guillain Barré

Abstract Background Surgery is a potential trigger of Guillain-Barré syndrome (GBS), a disorder which leads to an autoimmune-mediated attack of peripheral nerves. The present study was designed to explore clinical features of post-surgical GBS compared with those of general GBS in order to provide better clinical advice to patients undergoing surgery. Methods The medical records of GBS patients who were seen at 31 tertiary hospitals in southern China between January 1, 2013 and September 30, 2016 were retrospectively analyzed. Post-surgical GBS was defined as symptoms of GBS within 6 weeks after surgery. Clinical features of post-surgical GBS are described and are compared with general GBS. Results Among the 1001 GBS patient cases examined in this study, 45 (4.5%) patient cases exhibited symptoms of GBS within 6 weeks of undergoing surgery. Within this group, 36 (80.0%) patients developed initial symptoms of limb weakness. The average interval between surgery and symptom onset was 13.31 days. The most common type of surgery which triggered GBS was orthopedic surgery, followed by neurological surgery. Compared to general GBS, post-surgical GBS was characterized by a higher proportion of severe patients (Hughes functional grading scale (HFGS) score ≥ 3) upon admission and at nadir, higher HFGS scores at discharge, and longer hospital stays. Post-surgical GBS patients also had a significantly higher frequency of the acute motor axonal neuropathy subtype (37.9 vs. 14.2, respectively; P = 0.001). Conclusion Surgery is probably a potential trigger factor for GBS, especially orthopedic surgery. Infections secondary to surgery may play a role. The possibility of preceding (post-operative) infections was not excluded in this study. Clinical presentation of post-surgical GBS is characterized by a more severe course and poorer prognosis, and should be closely monitored. Trial registration chicTR-RRc-17,014,152.

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Secukinumab as a potential trigger of inflammatory bowel disease in ankylosing spondylitis or psoriatic arthritis patients

Rheumatology ◽

10.1093/rheumatology/keab193 ◽

2021 ◽

Cited By ~ 1

Author(s):

Ioana A Onac ◽

Benjamin D Clarke ◽

Cristina Tacu ◽

Mark Lloyd ◽

Vijay Hajela ◽

...

Keyword(s):

Alternative Explanation ◽

Drug Withdrawal ◽

De Novo ◽

Gastrointestinal Symptoms ◽

Temporal Association ◽

Objective Evidence ◽

Baseline Evaluation ◽

Biopsy Confirmation ◽

Potential Trigger ◽

Inflammatory Bowel

Abstract Objective Real-world secukinumab gastrointestinal-related adverse events (GIRAE) data during treatment for AS and PsA are lacking. We aimed to obtain this through baseline evaluation of pre-existing IBD rates and predictors of GIRAE. Methods Patient electronic and paper records commencing secukinumab from 10 UK hospitals between 2016 and 2019 were reviewed. GIRAE after initiation were defined as: definite [objective evidence of IBD (biopsy proven), clear temporal association, resolution of symptoms on drug withdrawal, no alternative explanation felt more likely], probable (as per definite, but without biopsy confirmation) or possible (gastrointestinal symptoms not fulfilling definite or probable criteria). Results Data for all 306 patients started on secukinumab were analysed: 124 (40.5%) AS and 182 (59.5%) PsA. Twenty-four of 306 (7.8%) experienced GIRAE after starting secukinumab. Amongst patients who developed GIRAE, four (1.3%) had definite, seven (2.3%) probable and 13 (4.2%) possible IBD. All definite cases were patients with AS and stopped secukinumab; two had pre-existing IBD and two (0.7%) were de novo cases of which one required surgical intervention. Seven patients (2.3%) had pre-existing diagnoses of IBD prior to initiation, of which five patients experienced GIRAE. Conclusion Absolute rates of new IBD in patients starting secukinumab are low. The majority of patients developing new GIRAE did not develop objective evidence of IBD or stop therapy. For patients with pre-existing IBD and AS the risk of GIRAE is much higher, and prescribing alternatives should be considered.

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