scholarly journals Granulomatosis polyangitis: an otorhinolaryngological perspective

2020 ◽  
Vol 6 (9) ◽  
pp. 1729
Author(s):  
Jyotirmay Shyamsundar Hedge ◽  
Shruthi Dechamma
Keyword(s):  
Renal Involvement ◽  
Clinical Manifestations ◽  
Subglottic Stenosis ◽  
C Reactive Protein ◽  
Autoimmune Process ◽  
Reactive Protein ◽  
Progression Of Disease ◽  
Life Threatening ◽  
Histological Confirmation ◽  
Nasal Biopsy

<p>Granulomatosis with polyangitis or Wegeners granulomatosis is a rare entity, however is known to have specific otorhinolaryngological manifestations. Initial clinical manifestations could be subtle but deteriorate rapidly with an underlying active autoimmune process which can be life threatening in severe subglottic stenosis. We report a case of Granulomatosis with polyangitis in an adolescent girl initially presented with otitis media refractory to treatment and epistaxis and rhinitis and eventually with the progression of disease presented with subglottic stenosis. Diagnosis was made by anti-neutrophil cytoplasmic antibody proteinase 3 (ANCA-PR3) positive status and histological confirmation by nasal biopsy, elevated C-reactive protein (CRP) levels and renal involvement with evidence of microalbuminuria. She underwent dilatation of the subglottic stenosis twice, with resection of the stenotic mass by coblation. The diagnostic and therapeutic challenges faced are emphasized in this report.</p>

scholarly journals Serum peptidyl-prolyl cis-trans isomerase NIMA-interacting 1 in combination with C-reactive protein and white blood cell as novel predictors for infants with community-acquired pneumonia

2020 ◽  
Vol 18 ◽  
pp. 205873922094234
Author(s):  
Heng Xue ◽  
Hui Liu ◽  
Liangpu Xu ◽  
Qiaoling Liu ◽  
Bimin Zhuo ◽  
...  
Keyword(s):  
Blood Cell ◽  
White Blood Cell ◽  
Roc Curve ◽  
Predictive Value ◽  
Clinical Manifestations ◽  
Community Acquired Pneumonia ◽  
Enzyme Linked Immunosorbent Assay ◽  
C Reactive Protein ◽  
Roc Curve Analysis ◽  
Reactive Protein

The aim of this study was to investigate the predictive value of peptidyl-prolyl cis-trans isomerase NIMA-interacting 1 (Pin1) with C-reactive protein (CRP) and white blood cell (WBC) count for community-acquired pneumonia (CAP) in infants. A total of 84 hospitalized infants with CAP and 69 healthy infants were included in this study. The clinical manifestations and laboratory assay results of infants were recorded. Serum Pin1 level was estimated by enzyme-linked immunosorbent assay. The median serum Pin1 concentration in infants with CAP was significantly higher than that in controls (1.44 vs. 0.21 ng/mL, P < 0.0001). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) of the combination Pin1, CRP and WBC (Pin1 + CRP + WBC, 0.943) was higher than Pin1, CRP, WBC alone or the combination of Pin1 and CRP ( P < 0.05). The sensitivity of Pin1 + CRP + WBC (94.0%) was higher than that of Pin1, CRP, WBC alone, or any two combined ( P < 0.05). Pin1 + CRP + WBC also had a high negative predictive value (91.4%). Moreover, serum Pin1 alone had a high specificity (97.0%) and excellent positive predictive value (96.6%) for infants with CAP, which were higher than WBC, Pin1 and WBC in combination, CRP and WBC in combination, and Pin1 + CRP + WBC ( P < 0.05). Therefore, serum Pin 1 was highly expressed in infants with CAP and can singly or in combination with CRP and WBC represent promising novel predictors for infants with CAP.

Combined Imaging and Serum Bioinformatics Analysis for Neonatal Infectious Pneumonia

2020 ◽  
Vol 10 (6) ◽  
pp. 1385-1388
Author(s):  
Yalin Li
Keyword(s):  
Neonatal Jaundice ◽  
Bioinformatics Analysis ◽  
Clinical Manifestations ◽  
Control Group ◽  
Imaging Features ◽  
Imaging Analysis ◽  
C Reactive Protein ◽  
Infection Group ◽  
Reactive Protein ◽  
Combined Imaging

Objective: The morbidity and mortality of neonatal pneumonia are high, and the clinical manifestations are often lack of specificity. The aim of this study was to analyze the combined imaging and serum bioinformatics characteristic in neonatal infectious pneumonia, in order to provided a useful early diagnosis methods. Methods: A total of 38 patients with neonatal infectious pneumonia and 20 children with neonatal jaundice (control group) was analyzed respectively. The imaging and serum bioinformatics characteristic, including the white blood cell (WBC), and C-reactive protein (CRP), was used to diagnosis disease. Results: The imaging features of neonatal infectious pneumonia are complex and variable, ranging from slight thickening of lung texture to obstructive emphysema. Compared with control group, the WBC, and CRP in pneumonia group is significantly higher. The sensitivity of WBC, and CRP in infection group was 67.4%, 80.4.4%, individually, and increased to 96.7% in combination. Conclusion: The specificity of simple imaging analysis is not enough. Combined imaging and serum bioinformatics characteristic are good indicator for differential diagnosis of neonatal infectious pneumonia.

Rationale and efficacy of interleukin-1 targeting in Erdheim–Chester disease

Blood ◽  
2010 ◽  
Vol 116 (20) ◽  
pp. 4070-4076 ◽  
Author(s):  
Achille Aouba ◽  
Sophie Georgin-Lavialle ◽  
Christian Pagnoux ◽  
Nicolas Martin Silva ◽  
Amédée Renand ◽  
...  
Keyword(s):  
Rescue Therapy ◽  
Interleukin 1 ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erdheim Chester Disease ◽  
Poor Tolerance ◽  
Life Threatening ◽  
And Control ◽  
Erdheim Chester ◽  
Chester Disease

Abstract Erdheim–Chester disease (ECD) pathophysiology remains largely unknown. Its treatment is not codified and usually disappointing. Interferon (IFN)-α therapy lacks efficacy for some life-threatening manifestations and has a poor tolerance profile. Because interleukin (IL)-1Ra synthesis is naturally induced after stimulation by IFN-α, we hypothesized that recombinant IL-1Ra (anakinra) might have some efficacy in ECD. We treated 2 patients who had poor tolerance or contraindication to IFN-α with anakinra as a rescue therapy and measured their serum C-reactive protein, IL-1β, IL-6, and monocytic membranous IL-1α (mIL-1α) levels before, under, and after therapy. Another untreated ECD patient and 5 healthy subjects were enrolled as controls. After treatment, fever and bone pains rapidly disappeared in both patients, as well as eyelid involvement in one patient. In addition, retroperitoneal fibrosis completely or partially regressed, and C-reactive protein, IL-6, and mIL-1α levels decreased to within the normal and control range. Beside injection-site reactions, no adverse event was reported. Therefore, our results support a central role of the IL-1 network, which seemed to be overstimulated in ECD. Its specific blockade using anakinra thereby opens new pathophysiology and therapeutic perspectives in ECD.

scholarly journals C-reactive protein/albumin ratio as a predictor of 28 day mortality in patients with sepsis

2020 ◽  
Vol 8 (2) ◽  
pp. 503
Author(s):  
Hamsa B. T. ◽  
Srinivasa S. V. ◽  
Raveesha A.
Keyword(s):  
Inotropic Support ◽  
Secondary Outcome ◽  
P Value ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Significant Difference ◽  
Life Threatening ◽  
Sepsis And Septic Shock ◽  
A Prospective Study

Background: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis remains a major cause of morbidity and mortality worldwide. Important biomarkers that can be used as prognostic markers in sepsis are C Reactive Protein (CRP) and serum Albumin levels. CRP levels markedly elevate in response to infection whereas albumin levels decrease in response to acute phase infection. We want to ascertain the value of CRP/albumin ratio as an independent predictor of 28-day mortality in sepsis patients.Methods: A prospective study was conducted including 150 patients satisfying the criteria for sepsis according to SOFA score of more than 2. Initial CRP/Albumin ratio was assessed to determine its significance in assessing the 28-day mortality, primary end point of our study. Secondary end points assessed were length of ICU stay, need for inotropic support, need for ventilator support and renal replacement therapy.Results: In the analysis of CRP/Albumin ratio as a predictor of 28-day mortality, patients were followed up from day of admission till 28 days to assess primary outcome. Among study subjects survivors were 92 in whom mean CRP/ALB ratio was 0.1197 and non survivors were 58 patients with mean CRP/ALB ratio was 0.0426. p-value <0.001, there was statistically significant difference found between survivor and Non-Survivor with respect to CRP/Albumin ratio. In assessing secondary outcome statistically significant association was found for need for ventilator and inotropic support, whereas it was insignificant in assessing need for dialysis and length of ICU stay.Conclusions: CRP/albumin ratio, which indicates the extent of residual inflammation, could be used as a prognostic marker in predicting mortality in patients with sepsis and septic shock.

scholarly journals Epidemiological and Clinical Characteristics of Patients with COVID-19 in Arak, Iran

2020 ◽  
Vol 13 (1) ◽  
pp. 712-717
Author(s):  
Morteza Mousavi-Hasanzadeh ◽  
Hossein Sarmadian ◽  
Fatemeh Safi ◽  
Mohammad Jamalian ◽  
Amir Almasi-Hashiani
Keyword(s):  
Clinical Characteristics ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The Mean ◽  
Mixed Ground ◽  
Taste And Smell ◽  
Muscle Ache

Background: The number of confirmed cases of COVID-19 is increasing. Here we present the clinical characteristics and outcomes of COVID-19 in Arak, Iran. Methods: In this study, 139 COVID-19 confirmed cases from 15 February to 15 March 2020 in Arak, Iran, were investigated. The clinical signs, symptoms, laboratory and radiological findings and outcomes were analyzed. Results: The mean age of the patients was 55.41 years (S.D.: 17.11) and 55.40% of them were males. 26.81% of patients had recently traveled to other epidemic cities. The most common clinical manifestations were fever (71.64%), cough (67.16%), shortness of breath (55.22%), muscle ache (50.00%) and the most prevalent complications were taste and smell disruption (29.5%), weakness (22.3%), anorexia (20.1%) and acute respiratory distress syndrome (ARDS) (15.8%). Almost half of the patients had lymphopenia, an elevated level of erythrocyte sedimentation rate (ESR) and C - reactive protein (CRP). In terms of outcome, 9.3% of patients needed an ICU admission as a result of ARDS in which 15.32% were directly admitted to the ICU. 43.2% of patients have been discharged and the case fatality rate (CFR) was estimated as 11.5%. Conclusion: COVID-19 pneumonia usually occurred at an age older than 50 years and in the male gender. The most common initial clinical laboratories and radiological presentations are fever, cough, lymphopenia with elevated CRP and ESR and Bilateral mixed ground-glass opacities with consolidation.

scholarly journals Immune-Mediated Inflammation in Vulnerable Atherosclerotic Plaques

Molecules ◽  
2019 ◽  
Vol 24 (17) ◽  
pp. 3072 ◽  
Author(s):  
Harald Mangge ◽  
Gunter Almer
Keyword(s):  
Blood Lipids ◽  
Atherosclerotic Plaques ◽  
Conventional Imaging ◽  
C Reactive Protein ◽  
Blood Biomarkers ◽  
Clinical Endpoints ◽  
Reactive Protein ◽  
Immune Mediated ◽  
Life Threatening ◽  
Per Se

Atherosclerosis is a chronic long-lasting vascular disease leading to myocardial infarction and stroke. Vulnerable atherosclerotic (AS) plaques are responsible for these life-threatening clinical endpoints. To more successfully work against atherosclerosis, improvements in early diagnosis and treatment of AS plaque lesions are required. Vulnerable AS plaques are frequently undetectable by conventional imaging because they are non-stenotic. Although blood biomarkers like lipids, C-reactive protein, interleukin-6, troponins, and natriuretic peptides are in pathological ranges, these markers are insufficient in detecting the critical perpetuation of AS anteceding endpoints. Thus, chances to treat the patient in a preventive way are wasted. It is now time to solve this dilemma because clear results indicate a benefit of anti-inflammatory therapy per se without modification of blood lipids (CANTOS Trial, NCT01327846). This fact identifies modulation of immune-mediated inflammation as a new promising point of action for the eradication of fatal atherosclerotic endpoints.

RECURRENT POLYSEROSITIS ("PERIODIC DISEASE," "FAMILIAL MEDITERRANEAN FEVER") IN CHILDREN

PEDIATRICS ◽  
1962 ◽  
Vol 30 (3) ◽  
pp. 443-449
Author(s):  
Tehila R. Shapiro ◽  
Ernest N. Ehrenfeld
Keyword(s):  
Familial Mediterranean Fever ◽  
Acute Rheumatic Fever ◽  
Age Of Onset ◽  
Clinical Manifestations ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Periodic Disease ◽  
Mediterranean Fever ◽  
The Difference

A series of 19 cases of recurrent polyserositis is presented. All but one child were of Oriental Jewish parentage, and the disease sometimes showed a familial occurrence. The average age of onset was 4 years. The symptoms consisted of fever; abdominal, chest, and joint pains; and skin eruptions. The clinical manifestations often simulated those of acute rheumatic fever, particularly since cardiac murmurs occurred in more than half of the patients. The laboratory findings were those accompanying nonspecific inflammations such as leukocytosis, accelerated enythrocyte sedimentation rate, elevated antistreptolysin titer, and positive C-reactive protein. Though some patients showed transitional albuminunia, no cases of amyloidosis were found. The difference in the clinical manifestations in children as compared with adults, and possible etiological factors are discussed.

Alpha 1 Antitrypsin, C Reactive Protein, and Hemolysis Markers: Association With Cytokines Profile In Sickle Cell Disease Patients In Steady-State and Crisis-State

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4701-4701
Author(s):  
Magda Carvalho ◽  
Wendell Vilas Boas ◽  
Bruno Antônio Veloso Cerqueira ◽  
Joao Oliveira Reis ◽  
Theo Araujo ◽  
...  
Keyword(s):  
Steady State ◽  
Sickle Cell Disease ◽  
Significant Positive Correlation ◽  
Clinical Manifestations ◽  
Cell Disease ◽  
C Reactive Protein ◽  
Positive Correlation ◽  
Reactive Protein ◽  
Alpha 1 Antitrypsin

Introduction Sickle cell disease (SCD) has a heterogeneous clinical picture, characterized by hemolysis, chronic inflammation and vaso-occlusive events and painful crisis. Aims Investigate the levels of Alpha 1 antitrypsin (A1AT), C reactive protein (CRP), hemolysis markers and its association with cytokines profile in SCD patients in steady-state and crisis-state. Methods It was developed a cross sectional study in a total of 72 SCD patients in steady-state (SP) and 23 SCD patients in crisis (CP) age-and-sex-matched. Hematological analysis was performed by automatic cell counter, hemoglobin profile by HPLC, and biochemistry analyses of inflammation and infection markers and lipid, hepatic, and kidney metabolism markers were investigated by immunochemistry assays. Plasma levels of TNFα, IFNγ, IL-10, IL-1β, IL-6 and IL-8 were measured using Cytometric Bead Array - CBA (BD Biosciences Pharmingen, USA) according to the manufacturer’s protocol. Results Statistical analysis showed that SCD steady-state patients group had the highest IL-12 concentration (p<0.0001) and there were a decrease in TNFα, IL-10, IL-1β, and IL-6 levels (p< 0.0001) when compared to CP group (figure 1). However, significant differences in IL-8 levels were not finding in the comparison between SCD in steady-state and crisis patients groups. Biomarkers analyses of SCD steady-state patients showed significant negative correlation between IL-8 with A1AT (r= -0.25; p= 0.03) and CRP (r= -0.24; p= 0.04) and significant positive correlation with lactate dehydrogenase (LDH) (r= 0.25; p= 0.03). The IL-6 showed significant positive correlation with white blood cell count (WBC) (r= 0.52; p< 0.0001), ferritin (r= 0.30; p= 0.001) and CRP (r= 0.42; p= 0.0002). TNFα showed a significant positive correlation with leukocyte count (r= 0.28; p= 0.02) and A1AT (r= 0.29; p= 0.01) and IL-10 showed a significant positive correlation with platelets count (r= 0.30; p= 0.01) and A1AT (r= 0.29; p= 0.01). Conclusions Immunological aspects of SCD patients have been increasingly studied. The high levels of Th2 cytokines (IL-6 and IL-10) and proinflammatory cytokines (TNFα and IL-1β) in SCD patients in crisis-state, possibly is related to severe clinical manifestations, despite the fundamental role of these cytokines in the pathophysiology is not yet completely clear. The correlation between these cytokines and biomarkers associated with important clinical manifestations in SCD, such as WBC, platelet count, A1AT and CRP, highlights the important role of inflammatory mediators in SCD and its possible association with an expression or activation of adhesion molecules in neutrophils and vascular endothelium. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Differences and similarities in clinical manifestations of Listeria monocytogenes and Mycobacterium tuberculous meningitis

2020 ◽  
pp. 326-335
Author(s):  
Marcin Paciorek ◽  
Carlo Bieńkowski ◽  
Dominika Krogulec
Keyword(s):  
Listeria Monocytogenes ◽  
Tuberculous Meningitis ◽  
Blood Cells ◽  
Immunosuppressive Treatment ◽  
White Blood Cells ◽  
Clinical Manifestations ◽  
C Reactive Protein ◽  
Duration Of Symptoms ◽  
Treatment Regimens ◽  
Reactive Protein

INTRODUCTION. Tuberculous meningitis (TbM) and meningitis caused by Listeria monocytogenes (LM) require different treatment regimens and have grave prognosis if therapy is delayed . THE AIM OF THE STUDY. Comparison of clinical manifestations, laboratory features and outcome of TbM and LM. MATERIAL AND METHODS. We retrospectively analyzed records of 402 patients with community acquired bacterial meningitis (BM) who were hospitalized between January 2010 and September 2019. RESULTS. LM and TbM were diagnosed in 28 (7.0%) and 23 (5.7%) patients, respectively. Patients with TbM were more likely to present with hydrocephalus (p<0.001), scored lower on the Thwaites Index (TI) (p<0.001) and had longer duration of symptoms prior to hospitalization (p=0.001). Furthermore, TbM patients had lower concentration of c-reactive protein (CRP) (p<0.001) and lower white blood cells count (WBC) (p=0.035). When compared to BM patients with etiology other than LM and TbM (nLnTbM), TbM patients presented with lower concentration of CRP (p<0.001), and procalcitonin (PCT) (p<0.001), lower WBC (p<0.001), and lower granulocyte percentage of CSF cytosis (p<0.001), but were more likely to present with hydrocephalus (p<0.001), aphasia (p=0.003) and hemiparesis (p=0.008). In comparison with the nLnTbM group, LM patients had lower concentration of CRP (p=0.01), lower WBC (p<0.001), and lower granulocyte percentage of CSF cytosis (p<0.016). LM patients were also more likely to have concomitant cancer (p=0.008), receive immunosuppressive treatment (p<0.001) or be immunocompromised (p=0.015). CONCLUSIONS. TbM patients had less pronounced inflammation but more severe central nervous system complications compared to patients with LM and other etiologies. Furthermore, LM patients, but not TbM patients, were often immunocompromised.

scholarly journals Treatment of Covid-19 Patients With High Dose of Ulinastatin

2020 ◽  
Author(s):  
Hai Huang ◽  
Ping-Fang Hu ◽  
Liang-Liang Sun ◽  
Yi-Bin Guo ◽  
Qiong Wang ◽  
...  
Keyword(s):  
Standard Care ◽  
Oxygen Therapy ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Therapeutic Agents ◽  
High Dose ◽  
C Reactive Protein ◽  
Peripheral Oxygen Saturation ◽  
Reactive Protein ◽  
Laboratory Examinations

Abstract Background No specific therapeutic agents or vaccines are available for the treatment of Coronavirus disease 2019 (Covid-19) yet. In this study, we aimed to assess the efficacy of high dose ulinastatin for patients with Covid-19.Methods Twelve patients hospitalized with confirmed SARS-CoV-2 infection were treated with high dose of ulinastatin beyond standard care. The changes of clinical manifestations, laboratory examinations and chest images were retrospectively analyzed. Results A total of 10 patients with severe Covid-19 and 2 patients with moderate Covid-19 received ulinastatin treatment. The average age of the patients was 68.0 ± 11.9 years, ranging from 48 to 87 years. Nine of 12 patients (75.0%) had one or more comorbidities. The most common symptoms on admission were fever (8/12, 66.7%), cough (5/12, 41.7%) and dyspnea (5/12, 41.7%). The percentage of lymphocytes was decreased in 41.7% of patients (5/12), and 58.3% of patients (7/12) had elevated hypersensitive C-reactive protein (CRP) levels (mean, 49.70 ± 77.70 mg/L). The white blood cell levels and the percentage of lymphocytes returned to normal in all of the patients, and CRP decreased significantly and returned to normal in 83.3% of patients (10/12; mean, 6.87 ± 6.63 mg/L) on the seventh day after ulinastatin treatment. Clinical symptoms were relieved synchronously. The peripheral oxygen saturation improved and 66.7% of the patients (8/12) did not need further oxygen therapy seven days after ulinastatin treatment. No patients required intensive care unit admission or mechanical ventilation. All patients revealed different degrees of absorption of pulmonary lesions after treatment. No obvious adverse events were observed.Conclusions Our preliminary data revealed that high dose of ulinastatin treatment was safe and showed a potential beneficial effect for patients with Covid-19.

Sign in / Sign up

Export Citation Format

Share Document