scholarly journals Immunofluorescence in Oral Dermatological Disorders- No Shiny Matter

2017 ◽  
pp. 24
Author(s):  
Umamaheswari Kanniah ◽  
Unnimaya Varghese ◽  
V. S. Sruthi ◽  
Mathew Jacob
Keyword(s):  
Molecular Biology ◽  
Early Diagnosis ◽  
Disease Activity ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Dermatological Diseases ◽  
Biopsy Tissue ◽  
Life Threatening ◽  
Dermatological Disorders

Dermatological diseases with underlying immunological pathosis exhibiting similar clinical manifestations have challenged even the veteran dermatologists in rendering diagnosis clinically, necessitating study of the skin lesions with immunofluroscence. The technique is similar to immunochemistry where instead of enzymes antibodies are labelled with a fluorescent dye4. It probes the study of the cell and molecular biology. Immunofluorescence permit early diagnosis, treatment and subsequent monitoring of disease activity in patient with potentially life threatening disease. It is widely used in the field of vesiculo-bullous lesions and other related oral dermatological disorders by demonstrating antibodies either in biopsy tissue or in the serum separated from blood collected from the patients.

Involvement of scalp and nails in lupus erythematosus

Lupus ◽  
2010 ◽  
Vol 19 (9) ◽  
pp. 1078-1086 ◽  
Author(s):  
RM Trüeb
Keyword(s):  
Disease Activity ◽  
Lupus Erythematosus ◽  
Cell Activation ◽  
Cutaneous Lupus Erythematosus ◽  
Autoimmune Disorder ◽  
Skin Lesions ◽  
B Cell Activation ◽  
Autoantibody Production ◽  
Life Threatening ◽  
The Many

Lupus erythematosus (LE) is a systemic autoimmune disorder associated with polyclonal B-cell activation resulting in diverse patterns of autoantibody production and a heterogeneous clinical expression constituting a spectrum extending from limited cutaneous disease to life-threatening systemic manifestations. For daily clinical practice, the characteristics of cutaneous lupus erythematosus (CLE) have been well defined in terms of morphology, and clinical and laboratory criteria are available for the classification as systemic lupus erythematosus (SLE). The many different types of skin lesions encountered in patients with LE have been classified into those that are histologically specific for LE and those that are not. While LE non-specific skin lesions on their own do not enable a diagnosis of LE, they can be important reflections of underlying SLE disease activity. This also applies to the involvement of the scalp and nails. Finally, it must be kept in mind that LE patients may also develop drug-related, or other unrelated common disorders of the hair and nails that do not reflect LE disease activity. Lupus (2010) 19, 1078—1086.

scholarly journals Recent application of metabolomics in the diagnosis, pathogenesis, treatment, and prognosis of sepsis

2021 ◽  
Keyword(s):  
Early Diagnosis ◽  
Organ Dysfunction ◽  
Host Response ◽  
Clinical Manifestations ◽  
Rapid Diagnosis ◽  
Pathophysiological Mechanism ◽  
Recent Application ◽  
Biochemical Pathways ◽  
Diagnosis And Prognosis ◽  
Life Threatening

Sepsis is a life-threatening organ dysfunction caused by dysregulated host response to infections. It is a leading cause of morbidity and mortality in hospitalized patients. Patients with sepsis often require care in the intensive care unit (ICU) which is costly to the patients and their families. Sepsis has no specific clinical manifestations, and its pathophysiological mechanism is complex. The disease progresses rapidly which makes early diagnosis difficult. Severe forms of the disease, such as septic shock, may lead to organ dysfunction, organ failure, and death. As an emerging “-omics” technology, metabolomics has revolutionized the clinical and research landscape of sepsis. Metabolomics has been applied in the prognosis, diagnosis, and risk stratification in patients with sepsis. This technology provides details on the metabolites and biochemical pathways commonly associated with the pathophysiology of sepsis. At present, it is mostly used to identify metabolites in various diseases. Using this technology, metabolites in body fluids such as blood and urine are detected and analyzed in relation to disease progresssion. The technology therefore helps to understand the pathogenesis of diseases and promote early diagnosis and treatment of the disease. So far, the applicaition of metabolomics in patients with sepsis has not been well defined. This article briefly reviews the application of metabolomics technology in patients with sepsis in recent years, to generate ideas for improving rapid diagnosis and prognosis evaluation of patients with sepsis.

scholarly journals Comprehensive Medical System for Early Diagnosis of Rheumatoid Arthritis Based on Autoimmune Antibodies

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Sha Liu
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Diagnosis ◽  
Autoimmune Diseases ◽  
Disease Activity ◽  
Clinical Manifestations ◽  
Therapeutic Effects ◽  
Disease Group ◽  
Autoimmune Antibodies ◽  
Joint Monitoring ◽  
New Treatment

With the development of understanding of the pathogenesis of rheumatoid arthritis, it has led to the development of new treatment targets and new treatment guidelines. In the past 10 years, the treatment effect of RA patients has improved significantly. Due to the special clinical symptoms of RA, it is very important to have a clear assessment of the overall activity of the patient’s disease and timely adjustment of treatment through joint monitoring of symptoms and laboratory indicators. Clinicians have always relied on clinical manifestations and imaging progress as the key basis for diagnosis. In addition, some markers that reflect disease activity are used to aid the diagnosis of RA, but in other autoimmune diseases, these markers are usually increased. The emergence of specific autoantibodies makes it easier for clinicians to distinguish RA from other autoimmune diseases and osteoarthritis. This study collected a large number of medical records through retrospective analysis, analyzed the epidemiological data, clinical characteristics, and laboratory indicators of RA patients, and analyzed the characteristics and laboratory indicators of patients in the stable disease group and active disease group. In order to further understand the clinical features, disease activity and related factors of RA in our country, and some new biomarkers for early rheumatoid arthritis, for example, the study found that the specificity of RF for the diagnosis of RA was 71.1%, the sensitivity was 73.3%, the combined detection of anti-CCP antibody + RF increased the specificity to 97.8%, and anti-CCP the combined diagnosis of antibody+RF + GPI antigen increases the specificity of diagnosis to 100%, which significantly reduces the sensitivity compared with all tests. These autoimmune antibodies can more effectively prevent the progression of the disease in the early diagnosis and treatment of rheumatoid arthritis, achieve long-term remission, and obtain very effective therapeutic effects.

scholarly journals Meningitis in children of early age. Criteria for early diagnostics

2019 ◽  
Vol 64 (5) ◽  
pp. 183-188
Author(s):  
S. V. Khaliullina ◽  
V. A. Anokhin ◽  
Kn. S. Khayertynov ◽  
V. E. Sagieva ◽  
G. R. Kamasheva ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Laboratory Diagnostics ◽  
Life Threatening ◽  
Viral Nature ◽  
Standard Set ◽  
Meningitis In Children ◽  
Disease Characteristic

Meningitis is characterized by the prevalence of severe forms and it is often accompanied by life-threatening syndromes.Purpose. To determine the most informative clinical manifestations of meningitis in children in their first years of life to optimize early diagnosis and treatment.Materials and methods. The authors carried out a retrospective analytical study involving 47 cases of children hospitalized to the Republican Clinical Hospital for Infectious Diseases in 2014–2016. Their diagnose was based on the acute onset of the disease, characteristic clinical symptoms and the results of lumbar puncture. The laboratory diagnostics included a standard set of examinations.Results. Meningitis was diagnosed in 34 patients (72.3%), meningoencephalitis – in 13 patients (27.7%). 30 cases (63.8%) of meningitis / meningoencephalitis had a bacterial nature, and 9 cases (19.1%; p<0.01) had a viral nature. The most common bacterial pathogens of meningitis was Pneumococcus (10 cases), hemophilus bacillus (8). Str. agalactiae (6) and meningococcus (6). 38 (80.9%) patients had high febrile fever, 1005 of patients had weakness, drowsiness, changes in consciousness of varying severity, 29 patients (61.7%) had vomiting, 16 patients ( 34%) – headache, “brain” cry, 7 patients (15%) – hyperesthesia, a symptom of “mother’s hands”, 4 patients (8.5%) – forced posture, 34 patients (72.3%) had meningeal signs.Conclusion. The most significant symptoms of early diagnosis of meningitis in children are high febrile fever combined with drowsiness and retardation, vomiting without diarrhea.

scholarly journals Vitamin D Status in Patients with Systemic Lupus Erythematosus in Serbia: Correlation with Disease Activity and Clinical Manifestations

2015 ◽  
Vol 3 (2) ◽  
pp. 256-261 ◽  
Author(s):  
Rada Miskovic ◽  
Aleksandra Plavsic ◽  
Sanvila Raskovic ◽  
Zikica Jovicic ◽  
Jasna Bolpacic
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Vitamin D ◽  
Disease Activity ◽  
Vitamin D Deficiency ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Vitamin D Status ◽  
Systemic Lupus ◽  
The Impact

BACKGROUND: Numerous studies indicate potential role of vitamin D as an important factor in the development of many autoimmune diseases including systemic lupus erythematosus (SLE). Patients with SLE are especially prone to the development of vitamin D deficiency due to the nature of their illness.AIM: The aims of our study were to determine the prevalence of vitamin D insufficiency and deficiency in patients with SLE in Serbia, to identify clinical variables associated with vitamin D status and to examine the impact of vitamin D status on disease activity and presence of specific lupus autoantibodies.MATERIAL AND METHODS: The study included 46 patients with SLE. Serum 25(OH)D concentration was measured by electrohemiluminiscent immunoassay.RESULTS: The mean serum concentration of 25(OH)D was 11.9 ± 7.3 ng/ml. The prevalence of insufficiency was 32.6%, while the prevalence of deficiency was 67.4%. There was no association between vitamin D status and photosensitivity, skin lesions, arthritis and lupus nephritis. Vitamin D status was not associated with the presence of specific autoantibodies. There was no correlation between disease activity assessed by SLEDAI scale with the concentration of 25(OH)D. Patients who used vitamin D supplements and calcium did not have a significantly higher concentration of 25(OH)D.CONCLUSION: In conclusion, vitamin D deficiency is common in patients with SLE.

scholarly journals Simultaneous Oral and Umbilical Locations as a First Sign of Pemphigus Vulgaris

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Eya Moussaoui ◽  
Yassine Oueslati ◽  
Lamia Oualha ◽  
Mohamed Denguezli ◽  
Badreddine Sriha ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Early Treatment ◽  
Clinical Manifestations ◽  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Oral Lesions ◽  
Cutaneous Lesions ◽  
Autoimmune Bullous Diseases ◽  
Bullous Diseases ◽  
Pemphigus Vegetans

The place of pemphigus vulgaris (PV) among autoimmune bullous diseases (AIBD) is well established. It is an acquired chronic, autoimmune, vesiculobullous disease in which IgG antibodies target desmosomal proteins to produce intraepithelial mucocutaneous blistering. The diagnosis is often challenging for the clinicians. It requires a combination of three major features: clinical, histopathological, and immunological. Clinically, oral lesions are the first manifestations of the disease in 50-90% of the patients with widespread blisters affecting the oral mucosa. On the skin, lesions are characterized by flaccid blisters that rapidly progress into erosions and crust formation. Umbilical lesions as a clinical manifestation of PV are peculiar and have rarely been reported, and they are not yet completely elucidated. Umbilical region involvement in patients with pemphigus was assessed in a limited study totalling just 10 patients. This localisation may be a valuable hint easing the diagnosis at the clinical level for patients with oral mucosal blisters. Dentists must be familiar with the clinical manifestations of PV to make an early diagnosis and start an early treatment which determines the prognosis of the disease. To the best of the authors’ knowledge, the coexistence of these lesions with the oral lesions as a first sign of PV in the absence of skin involvement was reported in only one case of pemphigus vegetans (PVe). In this paper, we describe an observation of a female patient that was diagnosed with PV that begun with simultaneous oral and umbilical locations which coexisted for a period of 4 months before the appearance of other cutaneous lesions. We highlight the role of dentists, by being familiar with the clinical manifestations of PV, to make an early diagnosis to start an early treatment which determines the prognosis of the disease and to follow closely the evolution of lesions to change treatment if required. We also discuss the clinical, histological, and immunological features of the disease that enabled the differential diagnosis as well as the appropriate therapeutic management.

scholarly journals VASCULAR ANOMALIES IN NEWBORNS: CLINICAL PRESENTATION, COMPLICATIONS, AND PECULIARITIES OF THERAPY

2020 ◽  
Vol 73 (9) ◽  
pp. 1934-1939
Author(s):  
Iryna M. Benzar ◽  
Anatolii F. Levytskyi ◽  
Daria S. Diehtiarova ◽  
Larysa Ya. Fedoniuk ◽  
Yaroslav S. Stravskyy ◽  
...  
Keyword(s):  
Liver Failure ◽  
Cardiac Failure ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Vascular Anomalies ◽  
Urgent Surgery ◽  
Radiological Data ◽  
Life Threatening ◽  
Short Courses

The aim: To analyze cases of vascular anomalies in newborns retrospectively to study their main clinical signs and to determine indications for urgent treatment. Materials and methods: A retrospective review of 281 pediatric vascular anomalies diagnosed between 2011 and 2019 was performed. The results of clinical examination, prenatal history, laboratory, sonography, and radiological data were evaluated. Results: Clinical manifestations in the newborn period documented in 170 (60.5%) patients, anomalies were visualized prenatally in 8.9% cases. Five newborns with head and neck LMs required urgent treatment, which amounted 7.9% of all newborns with LMs. The indication for urgent surgery was acute respiratory failure. Partial malformation resection with tracheostomy was performed to those patients, along with intraoperative injection of sclerotherapeutic agents and argon coagulation of residual malformation tissues. EXIT procedure was performed in one case. No correlation (p=0.2) was found between the number of skin lesions and the severity of liver lesions in children with multifocal hepatic hemangiomas, congestive cardiac failure suddenly occurs in one patient in the third week of life. Two newborns with diffuse hepatic hamangioma were manifested right after the birth with clinical signs of liver failure, hypothyreosis, and cardiac failure. Short courses of corticosteroids performed in 7 patients with KHE and Kasabach-Merritte fenomemn for thrombocytopenia correction. Conclusions: Clinical signs of vascular anomalies in neonatal period were seen in 57.5% children with vascular anomalies, and only 2.9% of them required treatment. Treatment itself is advantageous only in cases when life-threatening complications develop, such as airways obstruction, cardiac and/or liver failure, thrombocytopenia.

Apresentação e Evolução Atípicas da Granulomatose de Wegener: Relato de Caso/Atypical Presentation and Evolution of Wegener's Granulomatosis: Case Report

1970 ◽  
Vol 5 (3) ◽  
pp. 53-67
Author(s):  
Aline Dos Santos ◽  
Ana Caroline Balducci Scafi ◽  
Luciene Azevedo Morais ◽  
Pablo Girardelli Mendonça Mesquita
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Case Report ◽  
Chronic Renal Failure ◽  
Early Diagnosis ◽  
Wegener’S Granulomatosis ◽  
Immunosuppressive Treatment ◽  
Clinical Manifestations ◽  
Wegener's Granulomatosis ◽  
Creatinine Concentration

RESUMOIntrodução: A Granulomatose de Wegener (GW) é uma vasculite rara e idiopática associada à presença do anticorpo Anticitoplasma de Neutrófilo (ANCA) que acomete, preferencialmente, os pequenos vasos. As manifestações clínicas são diversas, ocorrendo em mais de 90% dos casos, sintomas do trato respiratório. O comprometimento renal é tardio e preditor de mau prognóstico.  Sua morbidade a médio e longo prazo inclui insuficiência renal crônica. A probabilidade de sucesso de manutenção da função renal depende da concentração sérica de creatinina ao início do tratamento, o que indica a importância do diagnóstico e terapêutica adequada precoces. Casuística: Relata-se o caso de uma paciente do sexo feminino, 61 anos, portadora de GW com comprometimento renal avançado à apresentação não precedido por sintomas pulmonares esperados. O tratamento imunossupressor associado a plasmaferese permitiu a melhora da função renal da paciente poupando-a de tornar-se dialítica- dependente. Discussão: A paciente iniciou a doença através de insuficiência renal assintomática, com valores de função renal compatíveis com o estágio mais avançado de doença renal crônica, ultrassonografia dos rins sem alterações compatíveis e sem os sintomas respiratórios esperados. Segundo a literatura, a combinação de imunossupressores e plasmaferese associa-se à recuperação renal em três meses com sobrevivência sem necessidade de diálise por 12 meses, no caso relatado, obteve-se tal resultado em 22 dias sem a necessidade de diálise após um ano. Conclusão: Devido ao diagnóstico precoce, o tratamento adequado foi instalado rapidamente proporcionando à paciente um aumento da expectativa e da qualidade de vida, evitando dependência de terapia renal substitutiva.Palavras-Chave: Granulomatose de Wegener, Plasmaferese, Doença renal crônica.  ABSTRACTIntroduction: The Wegener's Granulomatosis (WG) is a rare and idiopathic vasculitis associated with the presence of Antineutrophil Cytoplasmic Antibody (ANCA), that affects, preferentially, the small vessels. The clinical manifestations are diverse, occurring in over 90% of cases, symptoms in the respiratory tract. Kidney damage is a late and bad prognostic predictor. Morbidity in the medium and long term includes chronic renal failure. The probability of renal function maintenance success depends on serum creatinine concentration at the beginning of treatment that indicates the importance of early diagnosis and deployment of an appropriate therapy. Case Report: We present a case of a 61-year-old female patient, carrier of GW with advanced renal impairment presentation, not preceded by expected pulmonary symptoms. The immunosuppressive treatment associated with plasmapheresis allowed the improvement of the patient’s renal function, saving her from becoming dialysis-dependent Discussion: The patient developed the disease through asymptomatic renal failure, renal function with values that are compatible with the most advanced stage of chronic kidney disease, ultrasound of the kidneys without compatible changes and without the expected respiratory symptoms. According to the literature, the combination of immunosuppressive drugs and plasmapheresis is associated with renal recovery in three months with survival without dialysis for 12 months. In this case, a result was obtained in 22 days without the need for dialysis after one year. Conclusion: Due to the early diagnosis, appropriate treatment was quickly installed giving the patient increased life expectancy and quality, preventing dependence on renal replacement therapy.Keywords: Wegener’s granulomatosis, Plasmapheresis, Chronic renal failure.

Scabies: A Neglected Global Disease

2020 ◽  
Vol 16 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Alexander K.C. Leung ◽  
Joseph M. Lam ◽  
Kin F. Leong
Keyword(s):  
English Language ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Sarcoptes Scabiei ◽  
Clinical Findings ◽  
Effective Control ◽  
Search Term ◽  
Skin Contact ◽  
Intense Pruritus ◽  
Meta Analyses

Background: Scabies is a skin disease caused by an obligate human parasite mite Sarcoptes scabiei var. hominis. Children under the age of two and elderly individuals are at the greatest risk. Knowledge of this condition is important for an early diagnosis to be made and treatment to be initiated. Objective: The review aimed to familiarize physicians with the clinical manifestations, diagnosis, evaluation, and management of scabies. Methods: A search was conducted using Pubmed with the built-in "Clinical Queries" tool. The search term "Scabies" was used. The categories of "epidemiology", "diagnosis", "therapy", "prevention" and "prognosis" had a limited scope for primary clinical studies. Meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews were included. Only papers published in the English language were included. A descriptive, narrative synthesis was provided of the retrieved articles. Results: Worldwide, scabies affects 200 to 300 million individuals annually. The average prevalence is estimated to be 5 to 10% in children of developing countries. Transmission usually occurs after close prolonged skin-to-skin contact. Classic scabies is characterized by an erythematous papular eruption, serpiginous burrows, and intense pruritus. Sites of predilection include the webs of the fingers, volar wrists, lateral aspects of fingers, extensor surfaces of elbows and knees, waist, navel, abdomen, buttocks, groins, and, genitals. A clinical diagnosis of classic scabies can be made on the basis of the history and clinical findings. Other clinical variants include crusted scabies, nodular scabies, and bullous scabies. Finding the mite, ova, or fecal pellets on microscopic examination of scrapings taken from skin lesions confirms the diagnosis of scabies infestation. For eradication of scabies mites, the drugs of choice are topical permethrin and oral ivermectin. Conclusion: Scabies is a highly contagious parasitic cutaneous disease that is stigmatising and debilitating. Increased awareness, accurate diagnosis, and prompt treatment are essential for the effective control of scabies and for the prevention of the spread of the disease.

scholarly journals Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 271
Author(s):  
Saverio Capodiferro ◽  
Luisa Limongelli ◽  
Gianfranco Favia
Keyword(s):  
Early Diagnosis ◽  
Oral Cavity ◽  
Head And Neck ◽  
Clinical Outcomes ◽  
Systemic Disease ◽  
Clinical Manifestations ◽  
Systemic Diseases ◽  
Special Issue ◽  
Hard Tissues ◽  
Current Special Issue

Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors present an overview on the most frequent clinical manifestations at the oral and maxillo-facial district of systemic disease.

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