scholarly journals Clinical case of lupus erythematosus panniculitis

2020 ◽  
Vol 23 (5) ◽  
pp. 334-340
Author(s):  
N. P. Teplyuk ◽  
O. V. Grabovskaya ◽  
Polina A. Razhev
Keyword(s):  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Observation ◽  
Combined Treatment ◽  
Dynamic Monitoring ◽  
Systemic Steroid ◽  
Lupus Panniculitis ◽  
Systemic Steroid Therapy ◽  
Systemic Glucocorticoids ◽  
Lupus Erythematosus Panniculitis

BACKGROUND: This clinical case is interesting because of extreme rarity of lupus panniculitis in the population, as well as the possible risk of developing systemic lupus erythematosus. CASE REPORT: The article presents a clinical observation of a rare skin disorder lupus erythematosus panniculitis and the results of a successful combined treatment of the disease with systemic glucocorticoids (prednisolone), and an antimalarial agent (hydroxychloroquine). A review of the literature on the etiology, pathogenesis, and diagnosis of lupus panniculitis has been conducted. CONCLUSION. Early detection of lupus erythematosus panniculitis (LEP) makes systemic steroid therapy and quinoline drugs more effective in achieving remission. That is why dynamic monitoring of patients with LEP is important to identify new or progressive symptoms.

scholarly journals Palisaded Neutrophilic and Granulomatous Dermatitis in a Patient with Granulomatosis with Polyangiitis

2020 ◽  
Vol 12 (1) ◽  
pp. 52-56
Author(s):  
Mai Akagawa ◽  
Yuki Hattori ◽  
Yoko Mizutani ◽  
En Shu ◽  
Tatsuhiko Miyazaki ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Granulomatosis With Polyangiitis ◽  
Microscopic Polyangiitis ◽  
Elevated Serum ◽  
Systemic Steroid ◽  
M2 Macrophages ◽  
Normal Range ◽  
Systemic Steroid Therapy ◽  
Scd163 Level ◽  
Granulomatous Dermatitis

Palisaded neutrophilic and granulomatous dermatitis (PNGD) shows various clinical features and is histologically characterized by palisaded granulomas surrounding degenerated collagen. PNGD is known to be associated with a variety of systemic conditions such as rheumatoid arthritis and systemic lupus erythematosus. Furthermore, PNGD has been reported to be associated with antineutrophilic cytoplasmic antibody-associated vasculitis, including granulomatosis with polyangiitis (GPA) and microscopic polyangiitis. Here, we report a case of PNGD associated with GPA, which showed the infiltration of CD163-positive M2 macrophages in the skin lesion with elevated serum level of soluble CD163 (sCD163). The serum sCD163 level was reduced to normal range after systemic steroid therapy. Thus, M2 macrophages may play a role in the pathomechanisms of PNGD associated with GPA.

scholarly journals Loeys–Dietz syndrome (literature review and case description)

2020 ◽  
Vol 8 (1) ◽  
pp. 83-94
Author(s):  
Olga E. Agranovich ◽  
Sergey Yu. Semenov ◽  
Eugeniya F. Mikiashvili ◽  
Svetlana V. Sarantseva
Keyword(s):  
Differential Diagnosis ◽  
Connective Tissue ◽  
Literature Review ◽  
Clinical Case ◽  
Multidisciplinary Approach ◽  
Clinical Observation ◽  
Autosomal Dominant ◽  
Connective Tissue Disorder ◽  
Dynamic Monitoring ◽  
Case Description

Background. The LoeysDietz syndrome is a rare autosomal dominant connective tissue disorder characterized by the pathology of the cardiovascular system in combination with various anomalies of the musculoskeletal system. In modern literature, there is neither any information about the frequency of pathology nor any algorithm of examination and treatment for patients with this syndrome. Clinical case. The article presents a clinical observation of a 7-year-old patient with LoeysDietz syndrome with a genetically confirmed diagnosis. Discussion. This article provided a literature review, examined diagnosis issues and differential diagnosis, and presented the clinical picture of the syndrome. The main symptoms of LoeysDietz syndrome are artery aneurysms (most often in the aortic root), arterial tortuosity (mainly the vessels of the neck), hypertelorism, and bifid (split) or broad uvula. However, the combination of these symptoms is not found in all patients with this disease. Conclusions. The article emphasized the importance of a genetic verification of the disease, as well as a multidisciplinary approach to treatment with mandatory dynamic monitoring by specialists such as a cardiologist, neurologist, orthopedist, and pediatrician, which help prevent the development of complications and increase the life expectancy of this group of patients.

Simple dose-escalation regimen for hydroxychloroquine-induced hypersensitivity reaction in patients with systemic lupus erythematosus enabled treatment resumption

Lupus ◽  
2019 ◽  
Vol 28 (12) ◽  
pp. 1473-1476 ◽  
Author(s):  
E Takamasu ◽  
N Yokogawa ◽  
K Shimada ◽  
S Sugii
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Dose Escalation ◽  
Lupus Erythematosus ◽  
Odds Ratio ◽  
Maculopapular Rash ◽  
Systemic Steroid ◽  
Systemic Lupus ◽  
Confidential Interval ◽  
Systemic Steroid Therapy ◽  
The Mean

Objective This study aimed to investigate the risk factors of hydroxychloroquine (HCQ)-induced hypersensitivity in patients with systemic lupus erythematosus (SLE) and to propose a simple dose-escalation regimen in cases of mild HCQ-induced hypersensitivity. Methods We identified patients with SLE who started HCQ between 2009 and 2018 and cases of HCQ-induced hypersensitivity by reviewing the electronic medical charts. A simple dose-escalation regimen, starting at 40 mg/day with weekly increments of 40 mg/day to 200 mg/day, was used in patients with HCQ-induced hypersensitivity who did not require hospitalization or systemic steroid therapy. We then compared the clinical parameters of patients with and without HCQ-induced hypersensitivity and evaluated the success of our dose-escalation regimen. Results We enrolled 302 patients with SLE and identified 25 cases of HCQ-induced eruption (8.3%). The mean Naranjo score of these patients was 5.1 ± 1.4 (min 3, max 8), and all 25 patients received a ‘possible’ (9) or ‘probable’ (16) score. A mild, generalized, maculopapular rash occurred in 24 patients, and urticaria occurred in one patient at 24 days (interquartile range 15–40 days) after the start of treatment. The proportion of cyclophosphamide use, glucocorticoid consisting of prednisolone 20 mg/day or more, and initiation of SMX-TMP within 28 days were higher in patients with skin eruptions. On multivariate analysis, only cyclophosphamide use was identified as a risk factor of HCQ-induced hypersensitivity (odds ratio = 12.3 (95% confidential interval 1.4–14.3)). Thirteen of the 14 patients on the dose-escalation regimen (92.9%) tolerated continued HCQ treatment. One patient re-experienced eruptions on day 10 day after starting HCQ. Conclusions Mild late reactions are common in HCQ-induced hypersensitivity. A simpler dose-escalation regimen enables safe and easier reintroduction of HCQ but should not be applied to patients with immediate reactions or moderate late reactions.

Iatrogenic chronic adrenal insufficiency (clinical case)

2021 ◽  
Vol 19 (2) ◽  
pp. 77-79
Author(s):  
F. V. VALEEVA ◽  
◽  
T. S. YYLMAZ ◽  
T. A. KISELEVA ◽  
L. T. BAREEVA ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
General Condition ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Underlying Disease ◽  
Glucocorticoid Therapy ◽  
Dynamic Monitoring ◽  
Positive Trend ◽  
Laboratory Results ◽  
Systemic Glucocorticoids

The article presents a clinical case of a patient with chronic adrenal insufficiency, developed during many years of using glucocorticoid-containing ointments for the treatment of psoriasis. The anamnesis, laboratory results, diagnostic justification, treatment and dynamic monitoring are presented. It was noted that a change in treatment and prescription of systemic glucocorticoids led to a positive trend in clinical symptoms, confirmed by laboratory results and the general condition of the patient. The lack of alertness of patients and doctors when using local glucocorticoid therapy may be one of the causes of the development of chronic adrenal insufficiency. At the same time, correctly selected glucocorticosteroid therapy helps to stabilize the course of the underlying disease and reduce the risk of unwanted effects.

Clinical case of periostitis in pregnant women complicated by sepsis

2020 ◽  
pp. 61-63
Author(s):  
S. Sh. Kakvaeva ◽  
M. A. Magomedova ◽  
A. N. Dzhalilova
Keyword(s):  
Pregnant Woman ◽  
Multiple Organ Failure ◽  
Pregnant Women ◽  
Organ Failure ◽  
Clinical Case ◽  
Clinical Observation ◽  
Infectious Agent ◽  
Modern Medicine ◽  
Multiple Organ ◽  
Number Of Patients

One of the most serious problems of modern medicine is sepsis. The number of patients undergoing this complication is 20–30 million (WHO) annually and has no tendency to decrease. Sepsis is characterized by severe multiple organ failure due to a violation of the response of the macroorganism to an infectious agent. Moreover, it is dangerous with high mortality. Sepsis often develops in patients with immunodeficiency conditions, which primarily include pregnant women. The article presents a clinical observation of a case of periostitis in a pregnant woman complicated by a septic state.

Clinical case of lung lesions in patient with newly diagnosed systemic lupus erythematosus

2019 ◽  
Vol 1 (9) ◽  
pp. 53-57
Author(s):  
T. N. Gavva ◽  
L. V. Kuzmenkova ◽  
Yu. N. Fedulaev ◽  
T. V. Pinchuk ◽  
D. D. Kaminer ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Lung Damage ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Lung Lesions ◽  
Laboratory Parameters ◽  
Clinical Interest

A case of lung damage in systemic lupus erythematosus (SLE) in a 33-year-old woman is described. This case is of clinical interest due to the complexity of diagnosis due to the fact that SLE is a disease with diverse clinical manifestations involving many organs and systems, which often makes it difficult to timely recognize the onset of the disease. SLE still remains a challenge and requires special attention to the patient s history, clinical and laboratory parameters of the patient, as well as specific immunological examinations.

Detergent properties as the basis of the dimexide therapeutic effect in AA-amyloidosis infectious nature (clinical case analysis)

2020 ◽  
Vol 24 (2) ◽  
pp. 60-71
Author(s):  
V. Rameev ◽  
L. Kozlovskaya ◽  
A. Rameeva ◽  
P. Tao
Keyword(s):  
Therapeutic Effect ◽  
Medical Practice ◽  
Clinical Case ◽  
Clinical Observation ◽  
Case Analysis ◽  
Systemic Amyloidosis ◽  
Aa Amyloidosis ◽  
Functional Amyloid ◽  
History Of

The article discusses the current possibilities of postinfectious AA-amyloidosis treatment with dimexide on the example of clinical observation, discribes in detail the problem of functional amyloid and debates the prospects of the principle of amyloid resorption in the treatment of systemic amyloidosis. The history of the use of dimexide in medical practice is given, thenecessary dataon the pharmacology of dimexide are presented.

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