scholarly journals Antineutrophil Cytoplasmic Antibodies in Patients Treated With Methimazole

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A922-A922
Author(s):  
Pedro Weslley Rosario ◽  
Gabriela Costa Andrade ◽  
Flavia Coimbra Pontes Maia
Keyword(s):  
High Frequency ◽  
Clinical Manifestations ◽  
Severe Adverse Event ◽  
The Other ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Antithyroid Drugs ◽  
Anca Associated Vasculitis ◽  
Asymptomatic Patients ◽  
Antibodies Detection

Abstract Introduction: Antithyroid drugs (ATDs) are widely used for the treatment of hyperthyroidism. Most side effects of these medications are mild and emerge within the first months of treatment. In contrast, antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is a severe adverse event whose occurrence increases with increasing time of treatment. Vasculitis is more frequently associated with propylthiouracil than with methimazole, but the latter has also been related to the occurrence of ANCA and even to clinically manifest vasculitis. Many patients develop ANCA during treatment with methimazole but do not exhibit signs/symptoms of vasculitis. Objective: We previously reported a relatively high frequency (20%) of ANCA in patients exposed to methimazole but none of them exhibited clinical manifestations of vasculitis on that occasion. We continued to follow up these patients with ANCA and report here their evolution after 2 years. Methods: Seventeen patients exposed to methimazole were followed for 2 years after antibodies detection (ANCA). Results: Eight patients had ANCA but had not used methimazole for at least 6 months. During the following 24 months, continuing without ATD, none of the patients developed clinically apparent vasculitis. In the last assessment, five patients no longer had ANCA, while these antibodies persisted in three. Nine patients had ANCA and had been on methimazole for at least 6 months. The medication was not immediately discontinued in these patients when the antibodies were detected. After this detection, treatment with methimazole was continued in these patients for more 3 months (n = 1), 6 months (n = 2), 9 months (n = 1), 12 months (n = 2), 18 months (n = 2), and 24 months (n = 1). During the 2 years of follow-up after the detection of ANCA, none of the 9 patients developed signs/symptoms of vasculitis. In the last assessment, ANCA were negative in two patients who had received methimazole for more 3 and 6 months and who were therefore without receiving the drug for 21 and 18 months, respectively. The other 7 patients remained ANCA positive. Conclusion: Although vasculitis is necessarily associated with the presence of ANCA, the inverse frequency is undefined and appears to be low. Thus, measurement of ANCA would not be recommended in asymptomatic patients during methimazole treatment and immediate discontinuation of this drug, if these antibodies are detected eventually, may not be required. Reference: Antineutrophil cytoplasmic antibodies in patients treated with methimazole: a prospective Brazilian study. Andrade GC, Maia FCP, Mourão GF, Rosario PW, Calsolari MR. Braz J Otorhinolaryngol. 2019; 85:636-41.

scholarly journals AB0533 ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) IN GENERAL POPULATION WITHOUT ANCA ASSOCIATED VASCULITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1563.3-1563
Author(s):  
H. Tamaki ◽  
S. Fukui ◽  
T. Nakai ◽  
G. Kidoguchi ◽  
S. Kawaai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Autoimmune Disease ◽  
General Population ◽  
Granulomatosis With Polyangiitis ◽  
Dietary Habits ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Anca Associated Vasculitis ◽  
The Mean

Background:Currently it is hypothesized that many systemic autoimmune diseases occur due to environmental risk factors in addition to genetic risk factors. Anti-Neutrophil Cytoplasmic Antibody (ANCA) is mainly associated with three systemic autoimmune disease including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA). It is known that ANCA can be positive before clinical symptoms in patients with known diagnosis of GPA and ANCA titers rise before clinical manifestations appear. However, prevalence of ANCA among general population is not well known. It has not been described as well how many of people with positive ANCA eventually develop clinical manifestations of ANCA associated Vasculitis.Objectives:This study aims to estimate prevalence of ANCA in general population without ANCA associated Vasculitis. It also describes natural disease course of people with positive ANCA without ANCA associated Vasculitis. Risk factors for positive ANCA are also analyzed.Methods:This is a single center retrospective study at Center for Preventive Medicine of St. Luke’s International Hospital in Tokyo. ANCA was checked among the patients who wished to between 2018 and 2019. St. Luke’s Health Check-up Database (SLHCD) was utilized to collect the data. The patients whose serum was measured for ANCA were identified. The data for basic demographics, social habits, dietary habits and laboratory data were extracted. The charts of the patients with positive ANCA were reviewed.Results:Sera of total 1204 people were checked for ANCA. Of these 1204 people, 587 (48.8%) are male and the mean age was 55.8 years (32.6 to 79). There were total 11 patients with positive ANCA. Myeloperoxidase ANCA (MPO-ANCA) was positive for 3 patients and proteinase 3 ANCA (PR3-ANCA) was positive for 8 patients. Of these 11 patients, 5 were male (45.5%) and the mean age was 54.6 years. Two patients had history of autoimmune disease (primary biliary cirrhosis and ulcerative colitis). Five patients were evaluated by rheumatologists with the median follow-up period of 274 days. None of them developed clinical signs and symptoms of ANCA associated Vasculitis. Four out of five patients had ANCA checked later, two of which turned negative. The prevalence of ANCA in this cohort was 0.9% (95% confidence interval [95% CI]: 0.5% to 1.6%). Univariate analysis was performed to identify risk factors of positive ANCA. The variables analyzed include age, gender, body mass index (BMI), smoking habits, alcohol intake, dietary habits (fruits, fish, red meat), hypertension, dyslipidemia, and laboratory data. None of these variables demonstrated statistically significant differences except for positive rheumatoid factor (ANCA positive group: 33 % vs ANCA negative group: 9.1%, p value = 0.044).Conclusion:The prevalence of ANCA in this cohort was 0.9% (95% CI: 0.5% to 1.6%). None of them who had a follow-up developed ANCA associated Vasculitis during the follow-up period. Longer follow-up and more patients are necessary to determine natural course of people with positive ANCA.Disclosure of Interests:None declared

scholarly journals Acute Megakaryocytic Leukemia with or Without Acquired Trisomy 21 in 15 Pediatric Patients

2020 ◽  
Author(s):  
Wenzhi ZHANG ◽  
Hui LI ◽  
Jingzhen LIU ◽  
Jiawei XU ◽  
Jinjin HAO ◽  
...  
Keyword(s):  
Trisomy 21 ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
The Other ◽  
Hematopoietic Stem ◽  
Acute Megakaryocytic Leukemia

Abstract The knowledge of clinical characteristics and prognosis of pediatric acute megakaryocytic leukemia (AMKL) with or without acquired +21 was limited. We reported 15 AMKL pediatric patients without Down Syndrome (four cases with acquired +21 and 11 cases without acquired +21) with the clinical manifestations, laboratory data, and prognosis. The clinical features and laboratory data between patients with acquired +21 and patients without acquired +21 are similar. As for prognosis, three of the 11 cases without acquired +21 obtained complete remission (CR) after 1st induction. The median follow-up time of the 11 cases was 9 months. Among four cases with acquired +21, one case gave up treatment during 1st induction, one obtained CR after 1st induction and was still alive after 49 months of follow-up. One case obtained CR after 2nd induction and was still alive for 15 months of follow-up after bone marrow transplantation, the other patient was planning for allogeneic hematopoietic stem cell transplantation (HSCT) without CR. The median follow-up time of the four cases was 12 months. None relapsed in our study. In conclusion, acquired trisomy 21 may not be an indicator for poor prognosis. Cytogenetics analysis can help us for diagnosis stratification, prognostic judgment and individualized treatment of AMKL.

scholarly journals Treatment and follow-up of fetuses that developed congenital heart block due to autoantibody in two cases

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092559
Author(s):  
Min Hou ◽  
Ying Zhao ◽  
Xiao-Wei Liu ◽  
Yi-Hua He
Keyword(s):  
Autoimmune Disease ◽  
Heart Block ◽  
Congenital Heart ◽  
Clinical Manifestations ◽  
In Utero ◽  
Congenital Heart Block ◽  
The Other ◽  
Early Screening ◽  
Prenatal Intervention

Objective Autoantibody-related congenital heart block (ACHB) is a passively acquired autoimmune disease. This study aimed to examine the pathogenesis, clinical manifestations, and treatment of ACHB. Method The clinical data of two fetuses with first-degree ACHB were retrospectively analyzed. Results Two pregnant women were strongly positive for anti-Sjögren’s syndrome-related antigen A (SSA) antibody. Among these two cases, one had a prolonged atrioventricular (AV) interval at 28+3 weeks in utero, while the other had a prolonged AV interval at 24+6 weeks in utero. After prenatal intervention, one patient recovered to normal, while one fetus continued to have ACHB after treatment with dexamethasone and intravenous immunoglobulin. Furthermore, the two neonates were positive for anti-SSA antibody and were diagnosed with ACHB. Conclusion The pathogenesis of ACHB is closely correlated with anti-SSA/Ro antibody and anti-SSB/La antibody from the mother, and is affected by fetal susceptibility. Early screening and early intervention for ACHB are important.

scholarly journals Urine nucleic acid test positive in an asymptomatic patient with novel coronavirus 2019 infection: a case report

2020 ◽  
Author(s):  
Yaoyong Wang ◽  
Xinjian Chang ◽  
Jianguo Ren ◽  
Dongyan Li ◽  
Changfei Wang ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Throat Swab ◽  
Asymptomatic Patient ◽  
Clinical Manifestations ◽  
Nucleic Acid Test ◽  
Asymptomatic Patients ◽  
Sources Of Infection ◽  
Novel Coronavirus ◽  
Acid Test

Abstract Background: With the emergence of coronavirus disease 2019 in many places around the world, the main medical resources currently focus on the treatment of confirmed patients and the screening of suspected cases. Asymptomatic patients are difficult to detect, but they may be contagious, which makes epidemic control more difficult. We found a case of asymptomatic patient with positive urine coronavirus nucleic acid test, and we hope to attract attention of all circles.Case presentation: An asymptomatic patient with novel coronavirus infection was found in an epidemiological investigation of patients with confirmed coronavirus disease 2019. The patient was admitted to the hospital on February 24, 2020. She had no clinical manifestations such as fever, dry cough, and fatigue, and no abnormal signs. The examination showed that her throat swab was negative for nucleic acid but the urine was positive for nucleic acid. She was given antiviral and symptomatic supportive treatment. On February 26, her throat swab was checked for nucleic acid positive. On March 3 and 5, her throat swab and urine nucleic acid were negative. On March 9 and 12, her throat swab nucleic acid were negative. The patient was discharged from the hospital on March 13 and continued to be isolated and observed outside the hospital. Follow-up was conducted on March 26, the patient did not have any discomfort, the throat swab nucleic acid test was negative, and the isolation was lifted.Conclusion: There are asymptomatic patients with coronavirus disease 2019, and their urine may be one of the sources of infection.

scholarly journals Comparison of the Characteristics of Asymptomatic and Presymptomatic Patients with Coronavirus Disease 2019 in the Republic of Korea

2021 ◽  
Vol 11 (4) ◽  
pp. 354-363
Author(s):  
Miri Hyun ◽  
Ji Yeon Lee ◽  
Jae Seok Park ◽  
Jin Young Kim ◽  
Hyun Ah Kim
Keyword(s):  
Clinical Manifestations ◽  
Tertiary Hospital ◽  
Chest Radiographs ◽  
Reactive Protein ◽  
Asymptomatic Patients ◽  
Group A ◽  
The Republic ◽  
Group B ◽  
Time Of Admission

Abstract Purpose This retrospective study aimed to evaluate the baseline characteristics of asymptomatic patients with coronavirus disease 2019 at admission and to follow-up their clinical manifestations and radiological findings during hospitalization. Methods Patients with coronavirus disease 2019 who were asymptomatic at admission were divided into two groups—those with no symptoms until discharge (group A) and those who developed symptoms after admission (group B). Patients who could not express their own symptoms were excluded. Results Overall, 127 patients were enrolled in the study, of whom 19 and 108 were assigned to groups A and B, respectively. The mean age and median C-reactive protein level were higher in group B than in group A. All patients in group A and one-third of patients in group B had normal initial chest radiographs; 15.8% and 48.1% of patients in groups A and B, respectively, had pneumonia during hospitalization. One patient in group B, whose condition was not severe at the time of admission, deteriorated due to aggravated pneumonia and was transferred to a tertiary hospital. Conclusion We summarize the clinical characteristics during hospitalization of patients with coronavirus disease 2019 who were purely asymptomatic at the time of admission. The majority of asymptomatic patients with coronavirus disease 2019 were discharged without significant events during hospitalization. However, it may be difficult to predict subsequent events from initial chest radiographs or oxygen saturation at admission.

scholarly journals Familial pineal tumours in two siblings

2015 ◽  
Vol 42 (S1) ◽  
pp. S45-S45
Author(s):  
FB Maroun ◽  
R Avery ◽  
E Walsh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brain Tumours ◽  
Clinical Manifestations ◽  
The Other ◽  
Resonance Imaging ◽  
Von Hippel Lindau ◽  
Endocrine Neoplasia ◽  
Close Relationship

Background: The occurrence of familial brain tumours, particularly gliomas, hemangioblastomas in Von Hippel Lindau and other endocrine neoplasia, is well documented in the literature. On the other hand, familial pineal tumours are extremely rare and only a handful of cases have been reported. Methods and Results: Two female siblings presented at ages 12 and 15 with histories of progressive headaches. Neurological examination in each was completely normal. Magnetic Resonance Imaging confirmed the presence of cystic and solid lobulated pineal lesions with mild enhancement, consistent with pineocytoma, in both girls. Follow-up for 15 years in the first sibling and 4 years in the second showed no evolution in radiological or clinical manifestations. No active treatments have been carried out. Conclusion: The occurrence of familial pineal lesions raises the possibility of a close relationship between heredity and oncogenicity, and should be further explored.

scholarly journals ANCA-ASSOCIATED VASCULITIS: HETEROGENEITY OF CLINICAL MANIFESTATIONS, PROGNOSIS, CURRENT OPPORTUNITIES OF PHARMACOTHERAPY

2017 ◽  
Vol 13 (1-2) ◽  
pp. 98-105
Author(s):  
O.B. Yaremenko ◽  
L.B.
Keyword(s):  
Nervous System ◽  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Joint Involvement ◽  
Upper Respiratory Tract ◽  
Diagnosis And Prognosis ◽  
Anca Associated Vasculitis

The article highlights the new views on classification and nomenclature of systemic vasculitis, the meaning of detection of antineutrophil cytoplasmic antibodies (ANCA) in the diagnosis and prognosis of the disease. The literature data and own research regarding clinical manifestations of ANCA-associated vasculitis are presented.  Analyzing the first clinical manifestations in 41 patients with granulomatosis with polyangiitis, we identified four variants of the debut: with involvement of ENT organs (n ​=21), with lung lesions without involvement of the upper respiratory tract (n=8), with skin lesions, joint involvement and fever (n=7) and other variants (n=5). Fever (76%), involvement of ENT organs (51%), skin (41%), nervous system (39%) and arthritis/arthralgia (37%) were the most frequent first manifestations of granulomatosis with polyangiitis. In comparison with the presenting features there were more often lesions of the skin (66% vs. 41%), nervous system (51% vs. 39%), kidneys (41% vs. 10%), lungs (63% vs. 30%), eyes (32% vs. 10%) and myalgia (34% vs. 12%) throughout course of disease.  Among the lesions of the ENT organs, sinusitis (n=19), rhinitis (n=8) and otitis (n=6) were predominate, laryngotracheitis, sublottic stenosis, saddle-shaped deformation of the nose, destruction of the walls of the paranasal sinuses and mastoiditis were diagnosed less frequently. The latest clinical recommendations for treating patients with ANCA-associated vasculitis, including the use of immunobiological therapy are presented, as well as describing of the results of our own experience in the using of immunobiological therapy in patients with granulomatosis with polyangiitis.

scholarly journals Olfactory and Gustatory Dysfunctions In 100 Patients Hospitalized For Covid-19: Sex Differences and Recovery Time In Real-Life

2020 ◽  
Author(s):  
Simone Meini ◽  
Lorenzo Roberto Suardi ◽  
Michele Busoni ◽  
Anna Teresa Roberts ◽  
Alberto Fortini
Keyword(s):  
Recovery Time ◽  
Real Life ◽  
Clinical Manifestations ◽  
Female Ratio ◽  
Phone Interview ◽  
Asymptomatic Patients ◽  
Male Female Ratio ◽  
Males And Females ◽  
The Mean

Abstract Purpose. COVID-19 displays a variety of clinical manifestations; in pauci-symptomatic patients olfactory (OD) and gustatory dysfunctions (GD) may represent the first or only symptom. To date, literature addressing these disorders is scarce. Aim of this study is to investigate the timing of recovery from OD and GD in a real-life COVID-19 population.Methods. We followed up by a phone interview the first 100 patients discharged a month earlier from three Italian non-intensive care wards.Results. All patients were Caucasian, mean age was 65 years, 60% were males. OD and GD were early symptoms reported by 29% and 41% of patients, respectively. Among the 42 symptomatic patients, the male/female ratio was 2:1; 83% reported an almost resolved dysfunction at follow-up. The recovery rate was not significantly different between males and females. The mean duration of OD and GD was 18 and 16 days, respectively. The mean recovery time from OD or GD resulted significantly longer for females than for males (26 vs 14 days, p=0.009). Among the 42 symptomatic, the mean age of males was significantly higher than that of females (66 vs 57 years, p=0.04), while the opposite was observed in the 58 asymptomatic patients (60 vs 73 years, p=0.0018).Conclusions. Recovery from OD or GD was rapid, occurring within 4 weeks in most patients. Chemosensory dysfunctions in women was less frequent, but longer lasting. The value of our study is its focus on a significantly older population than those previously described, and to add further data on gender differences.

Surgical Treatment of Coronary Artery Fistula

2000 ◽  
Vol 8 (1) ◽  
pp. 24-26
Author(s):  
Chun Jiu Gu ◽  
Zhi Wei Zhang ◽  
De Min Yan ◽  
Tian Xiang Gu ◽  
Yi Hua Yuan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Surgical Treatment ◽  
Ventricular Fibrillation ◽  
Surgical Techniques ◽  
Clinical Manifestations ◽  
Coronary Artery Fistula ◽  
The Other ◽  
Heart Murmurs ◽  
Indications For Operation

Six patients with coronary artery fistula were treated surgically between October 1977 and November 1998. The clinical manifestations, diagnostic criteria, indications for operation, and surgical techniques were evaluated. One patient died from ventricular fibrillation on the 2nd postoperative day. The outcome for the other 5 patients was good; symptoms and heart murmurs disappeared and all are alive and well after 10 to 21 years of follow-up. It was concluded that analysis of clinical data can confirm the diagnosis and this condition can be treated satisfactorily by suitable surgery.

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