scholarly journals A study of clinical and Immunofluorescence spectrum of Immunobullous diseases

2021 ◽  
Vol 12 (7) ◽  
pp. 117-121
Author(s):  
Nitesh R. Pokharel ◽  
Anil Dev Pant ◽  
Raghavendra Rao ◽  
Surakchya Koirala
Keyword(s):  
Pemphigus Vulgaris ◽  
Final Diagnosis ◽  
Clinical Findings ◽  
Direct Immunofluorescence ◽  
Age Group ◽  
Provisional Diagnosis ◽  
Intercellular Substance ◽  
Linear Band ◽  
Male Patients ◽  
To Come

Background: Immunobullous disorders are a group of disorders involving the formation of a fluid filled cavity within or beneath the epidermis, due to the presence of autoantibodies against adhesion molecules in epidermis and dermis. Accurate diagnosis of these disorders requires clinicopathological correlation along with immunofluorescence study. Aims and Objectives: This study was undertaken to describe the clinical features of immunobullous disorders and to analyse the utility of Direct immunofluorescence (DIF) in the diagnosis of these disorders. Materials and Methods: A total of 42 Patients attending skin OPD between February 2014 and March 2017 who had a provisional diagnosis of immunobullous disease were enrolled in the study. Detailed clinical examination and DIF study were done in all cases. Results: Out of 42 cases studied, 31 were diagnosed as pemphigus vulgaris (PV) and 11 as bullous pemphigoid (BP) that was confirmed by DIF. There were 20 (46.61%) male patients and 22 (52.38%) female patients in the age group of 18 to 81 years with a mean age of 52.64 years. A slightly female preponderance was observed. Mean age of presentation of PV patients is 50.83 years with age group range was between 18 to 77 years. Majority of patients presented at 4th and 5th decade of life. Age group range for BP was between 34 to 81years with mean age of presentation being 57.72 years. Majority of our patients presented at 5th decade or later. DIF was positive in all 42 cases (100%) of immunobullous disease. DIF in all 31 cases of PV showed 100% IgG deposition in intercellular substance (ICS) and 64.51% C3 deposition in ICS. BP showed 100% C3 deposition in all 11 cases, 63.63% IgG in seven of the eleven,18.18% IgA in two and 9% IgM, fibin in one each as a linear band at basement membrane zone (BMZ). Conclusion: Both the clinical findings and the Imunofluorescence features are important in arriving at a definite diagnosis in immunobullous diseases. In all the cases DIF was absolutely essential tool to come to a final diagnosis.

scholarly journals A study of clinicopathologic spectrum of vesicobullous disorders

2017 ◽  
Vol 3 (3) ◽  
pp. 355
Author(s):  
Heena Mittal ◽  
Sukhjot Kaur ◽  
Bhavna Garg ◽  
Neena Sood ◽  
Sunil Kumar Gupta ◽  
...  
Keyword(s):  
Pemphigus Vulgaris ◽  
Clinical History ◽  
Final Diagnosis ◽  
Stevens Johnson Syndrome ◽  
Direct Immunofluorescence ◽  
Diagnostic Dilemma ◽  
Dermoepidermal Junction ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Detailed Clinical History

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Blistering diseases are alarming skin conditions. Autoimmune blistering diseases are a group of bullous disorders characterized by pathogenic antibodies directed at the target antigens in the epidermis or dermoepidermal junction.</span><span lang="EN-IN">The objectives were to study the spectrum of histopathological changes by light microscopy, to evaluate the pattern of direct immunofluorescence (DIF) and to correlate clinical, histopathological features and DIF findings of vesiculobullous lesions of the skin or/and mucosa.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The present study was carried out on 110 skin and/or mucosal biopsies with vesicobullous disorders from July 2013 to June 2016. Detailed clinical history, morphology of lesions, site of involvement and other findings were recorded as per proforma.<strong> </strong>These cases were analysed clinically, histopathologically and on immunofluorescence</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Majority of the patients presented in the age group of 41-50 years (30.9%). The male: female ratio was 1:1.15. Pemphigus vulgaris was the most common vesiculobullous disorder constituting 48.2%, followed by Bullous Pemphigoid constituting 27.3%. Dermatitis herpetiformis constituted 8.3%; Pemphigus foliaceous 3.6%, varicella and Stevens Johnson Syndrome both were observed in 2.7% each. DIF was performed in 81 cases out of which only 72 cases (92.6%) showed positivity. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">DIF is a sensitive tool for distinguishing immune mediated bullous diseases from other vesiculobullous disorders especially in cases which pose a diagnostic dilemma both clinically and histologically. The final diagnosis depends on correlation of clinical, histopathological and immunoflourescence findings.</span></p><p class="abstract"> </p>

scholarly journals Ultrasonological evaluation of acute scrotum

2018 ◽  
Vol 6 (1-2) ◽  
pp. 11-14
Author(s):  
Prakash Sharma ◽  
Merina Gyawali ◽  
Sristi Singh
Keyword(s):  
Statistical Analysis ◽  
Color Doppler ◽  
Descriptive Analysis ◽  
Power Doppler ◽  
Rank Correlation ◽  
Final Diagnosis ◽  
Acute Scrotum ◽  
Age Group ◽  
Scrotal Pain ◽  
Kendall Rank Correlation

Introduction: Acute scrotum is a common surgical condition. Ultrasound along with Doppler plays an important role in differentiating the various causes. Purpose of this study was to evaluate the role of ultrasound in identifying the various causes of acute scrotum.Methods: All patients with history of acute scrotum presenting to the Department of Radiology were included in the study. Scrotal ultrasound was performed with a linear 7.5 to 12-MHz transducer with abundant acoustic gel. Imaging was done in longitudinal and transverse planes with Power Doppler and Color Doppler. The testes, epididymis, spermatic cord, scrotal wall and inguinal region were evaluated. Kidney, Ureter and Bladder region was evaluated for possibility of calculus. Final diagnosis was made based on clinical outcome, follow up, intraoperative findings and histopathology when available. Statistical analysis was done using SPSS version 18 for windows. Descriptive analysis was done. Non parametric correlation between side and torsion was done using Kendall Rank Correlation Coefficient.Results: There were altogether 50 patients available for statistical analysis. Age of the patients ranged from 14 to 65 years with mean age of 34.7±14.7 years. Most common age group was 21 to 40 years. Inflammatory pathology was the most common pathology of actual scrotal pain. There was no significant correlation between side of pain and testicular torsion.Conclusion: Inflammatory pathology was the most common cause for actual scrotal pain. The most common age group was 21 to 40 years.

scholarly journals A correlation of hysterolaparoscopic findings and BACTEC culture in infertility

2017 ◽  
Vol 6 (4) ◽  
pp. 1430 ◽  
Author(s):  
Mahesweta Guru ◽  
Prasad Yeshwant Deshmukh
Keyword(s):  
Health Problem ◽  
Gold Standard ◽  
Semen Analysis ◽  
Age Group ◽  
Genital Tuberculosis ◽  
Infertile Women ◽  
Dilatation And Curettage ◽  
Important Health ◽  
To Come ◽  
Sensitive Method

Background: Infertility is agonising condition. Tuberculosis is an important health problem worldwide. One third of the world’s population is currently affected with tuberculosis. Hysterolaparoscopy is a well-recognized procedure for the diagnosis of infertility. Culture for TB bacilli is the gold standard for diagnosis of genital TB.Methods: Infertile women undergoing dilatation and curettage with hysterolaparoscopy with normal husband semen analysis as a part of their infertility workup at M. G. M. Medical Hospital, Kalamboli. Sample size: 30.Results: Incidence of GTB=22.85%, 25-29 year followed by 35-40 years’ age group was the most common age group was observed. In our study, 74.3% infertility pattern was primary, 25.7% were secondary only 2.85 % (n =1) of the cases of GTB were diagnosed by using TB BACTEC. Laparoscopic findings su0ggested that 18 cases had normal findings and 8 cases had laparoscopic features suggestive of GTB. On chromo pertubation, delayed and absent spillage of the dye was seen in 2 cases. On Hysteroscopy, 29 cases (82.9%) of the patients had normal findings and 3 cases had Hysteroscopic features suggestive of GTB.Conclusions: Genital tuberculosis remains an important under diagnosed cause of infertility. Though culture is considered as gold standard for diagnosis of genital tuberculosis, since GTB is paucibacillary there is an urgent need for more research to come to conclusion whether culture is still gold standard. Further research is required to detect the most sensitive method for diagnosis.

Could a low-cost audio-visual link be useful in rheumatology?

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 35-37 ◽  
Author(s):  
L E Graham ◽  
S Mcgimpsey ◽  
S Wright ◽  
G Mcclean ◽  
J Carser ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Junior Doctor ◽  
Low Cost ◽  
Clinical Signs ◽  
Final Diagnosis ◽  
Provisional Diagnosis ◽  
Face To Face ◽  
Significant Difference ◽  
Small Joint

We have investigated prospectively the diagnostic accuracy, specialist satisfaction and patient–specialist rapport of a low-cost audio-visual link between a junior doctor with a patient and a consultant rheumatologist. Using a telephone link and subsequently a video-phone link, 20 patients, with various rheumatological problems, were presented by a junior doctor to the consultant rheumatologist for provisional diagnosis. All patients were then seen face to face by the consultant, when a final diagnosis was made. An independent consultant rheumatologist made a ‘gold standard’ diagnosis. Thirty-five per cent of diagnoses were made correctly over the telephone and 40% over the video-phone – there was no significant difference in the diagnostic accuracy between these two methods of communication. Rapport over the video-phone was universally poor. Where it was important, clinical signs could not be visualized over the video-phone and in more than 85% of cases small joint swellings could not be seen clearly.

scholarly journals Epidemiological aspects of human and canine visceral leishmaniasis in Montes Claros, State of Minas Gerais, Brazil, between 2007 and 2009

2011 ◽  
Vol 44 (5) ◽  
pp. 561-566 ◽  
Author(s):  
Patrícia Fernandes do Prado ◽  
Marília Fonseca Rocha ◽  
Joel Fontes de Sousa ◽  
Dênio Iuri Caldeira ◽  
Gustavo Fontes Paz ◽  
...  
Keyword(s):  
At Risk ◽  
Visceral Leishmaniasis ◽  
Minas Gerais ◽  
Age Group ◽  
Canine Visceral Leishmaniasis ◽  
Disease Notification ◽  
Epidemiological Features ◽  
Male Patients ◽  
And Control ◽  
The City

INTRODUCTION: Visceral leishmaniasis (VL) is an expanding zoonosis in Brazil and is becoming urbanized in several Brazilian regions. This study aims to describe the epidemiological features of human and canine VL in the municipality of Montes Claros, State of Minas Gerais, by focusing on their spatial distribution. METHODS: Data concerning human cases and reactive dogs for VL from 2007 to 2009 were obtained from the Information System for Disease Notification (SINAN) and from reports of the local Centro de Controle de Zoonoses (CCZ), respectively. The addresses of human and canine cases have been georeferenced and localized in thematic maps, allowing their spatial visualization as well as the identification of areas at risk of VL transmission. RESULTS: Ninety-five cases of human VL were reported in the period. The 0-9-year-old age group (48.4%) was the most affected, within which the majority consisted of male patients (64%). Of the samples collected for the canine serological survey, 2,919 (6.3%) were reactive to VL. The spatial localization of these cases shows that the disease was scattered in the urban area of the municipality. Areas showing a higher dissemination risk were concentrated in the central, northwestern, and southern regions of the city. CONCLUSIONS: Identifying the areas most at risk in urban Montes Claros may help guide actions toward local epidemiological vigilance and control.

scholarly journals Ewing sarcoma: Analysis of epidemiological parameters and their relation to clinical characteristics

2006 ◽  
Vol 134 (7-8) ◽  
pp. 310-314
Author(s):  
Vladan Stevanovic ◽  
Zoran Vukasinovic ◽  
Dusko Spasovski
Keyword(s):  
Ewing Sarcoma ◽  
Orthopedic Surgery ◽  
Clinical Characteristics ◽  
Clinical Findings ◽  
Tumor Localization ◽  
Age Group ◽  
Serious Illness ◽  
Success Of Treatment ◽  
Epidemiologic Features ◽  
Epidemiological Parameters

The purpose of this investigation was to evaluate epidemiologic features of Ewing sarcoma in children treated in the Institute for Orthopedic Surgery "Banjica", as well as to establish relation of these features to clinical findings. Study involved 78 patients treated over 20-year period (1980-2000). Analysis included standard epidemiologic data (age, sex, tumor localization) and diagnostic clinical features on presentation (major symptoms, time elapsed between presentation and diagnosis, presence of metastases). Most of the patients were in the age group of 15-18 years (50.0%), predominantly males. In general, the results of our study were consistent with data reported in literature. Nevertheless, this investigation revealed slightly higher incidence in patients younger than four years of age (5.1%); localization on the upper extremity was found to be more frequent (upper to lower extremity ratio was nearly 3:1 in our study), and the time lost between presentation and diagnosis was markedly reduced (average time elapsed between presentation and diagnosis was 2.5 months). The results of our study may improve efficiency and success of treatment, thus providing the basis of better prognosis in management of such a serious illness.

scholarly journals A relapse of pemphigus vulgaris in pemphigus herpetiformis or a phenotypic “switch”

2022 ◽  
Vol 13 (1) ◽  
pp. 107-108
Author(s):  
Siham Belmourida ◽  
Meriame Meziane ◽  
Nadia Ismaili ◽  
Laila Benzekri ◽  
Badreddine Hassam ◽  
...  
Keyword(s):  
Corticosteroid Therapy ◽  
Transition Period ◽  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Exceptional Case ◽  
The Body ◽  
Direct Immunofluorescence ◽  
Phenotypic Switch ◽  
Dermatological Examination ◽  
Phenotypic Transition

Sir, Pemphigus herpetiformis (PH) was originally described by Jablonska et al. in 1975. Clinically, PH presents itself as a herpetiform dermatitis with immunopathological characteristics of pemphigus [1,2]. We report an exceptional case of typical pemphigus vulgaris (PV) relapsing after 36 years in PH. A 65-year-old patient, followed for PV for 36 years and treated with corticosteroid therapy with a remission for more than thirty years, consulted for pruriginous lesions evolving for the previous eight months. A dermatological examination revealed urticariform pruriginous ring lesions surmounted by small peripheral vesicles spread throughout the body (Fig. 1), sparing the mucous membranes, and without Nikolsky’s sign. After two non-specific skin biopsies, the histological examination revealed an intraepidermal bubble with acantholytic cells and eosinophilic spongiosis (Figs. 2a and 2b). Direct immunofluorescence confirmed the diagnosis of pemphigus and indirect immunofluorescence was at the upper limit. The diagnosis of a PV relapse in PH was retained and a dapsone-based treatment was initiated at a dose of 150 mg/day and stopped seven days later when met with hemolytic anemia. Oral corticosteroid therapy involving prednisone at a dose of 1 mg/kg/day was initiated but, given the persistence of the pruritus, the decision was to combine methotrexate at a dose of 12.5 mg/week. A good evolution and a decline within eight months were observed. An improved pruritus and the disappearance of the skin lesions were achieved after one month of treatment. PV and PH are two different anatomical and clinical entities of the autoimmune disease pemphigus, with distinct clinical, histopathological, and immunopathological characteristics [1,2]. Our observation documents a complete phenotypic “switch” of pemphigus with a transition from PV to PH both clinically, histologically, and immunologically. Several rare cases of PV switching to superficial pemphigus (SP) (“phenotypic switch”) have, since 1991, been reported, with a higher frequency this direction than otherwise; the transition period varies from six months to twenty years [3]. To the best of our knowledge, no case has been described of a progression from PV to PH. Having observed one firsthand, we are first to describe the case of a complete phenotypic switch from PV to PH. The mechanism of such a transition remains poorly understood and is often observed during a relapse. Some authors suggest that the effect of immunosuppressants on the desmoglein DSG3 more marked than on DSG1 could explain the relapse of PS in PH [3,4]. Future studies on the immunological factors and predictors of PV relapses after the discontinuation of treatment would be useful to better understand the mechanisms of a relapse in pemphigus, with or without a phenotypic transition.

scholarly journals The Prevalence of Alprazolam Uses in Geriatric Patients at Dr. Mohammad Hoesin Hospital Palembang

2016 ◽  
Vol 5 (2) ◽  
pp. 193
Author(s):  
Yohanes Febrianto ◽  
Sutomo Tanzil ◽  
Theodorus Parulian
Keyword(s):  
Internal Medicine ◽  
Heart Disease ◽  
Medical Records ◽  
Geriatric Patients ◽  
Age Group ◽  
Internal Medicine Ward ◽  
Drug Utilization Study ◽  
Short Acting ◽  
Infectious Origin ◽  
Male Patients

<p>One of the most frequently prescribed drugs in geriatric patients is a benzodiazepine, especially a short-acting such as alprazolam. Unfortunately, alprazolam is oftenly used inappropriately because this drug has a short acting effect. Geriatric patients are more sensitive to this drug that can lead to the dependence. However, there is still lack of data on the use of this drug in geriatric patients. The aim of this study was to determine the prevalence of the use of alprazolam. A drug utilization study has been done for 2 months through analysis of patient’s medical records in the internal medicine ward at RSMH Palembang from June 1<sup>st</sup>, 2012 to May 31<sup>st</sup>, 2013. There were 25 out of 1634 patients receiving alprazolam, but only 23 patients whose data were obtained from the available medical records. Prevalence of alprazolam use was 1.408%. Based on gender, the prevalence was 1.798% in female and 1.09% in male patients. Proportion by age group was 91.3%, 8.7% and 0% in age group 60-74 years, 75-90 years and over 90 years, respectively. Based on the job, the population study comprised of the housewive (52.1%), unemployment (39.1%), and entrepreneur and farmer (4.3% together). The indication of usage was atheroscerotic heart disease, diarrhoea and gastroenteritis of presumed infectious origin, unspecified gastritis, and thyrotoxic heart disease. In other words, it could be said that the usage of alprazolam was inappropriate.</p>

scholarly journals Present Tense: A Peculiar Case of Pemphigus Vulgaris Presenting with Tense Blisters during the COVID-19 Pandemic

2021 ◽  
Vol 55 (5) ◽  
Author(s):  
Dianne Katherine R. Salazar-Paras ◽  
Mae N. Ramirez-Quizon
Keyword(s):  
Pemphigus Vulgaris ◽  
Direct Immunofluorescence ◽  
Bullous Dermatosis ◽  
Present Tense ◽  
Peculiar Case

Pemphigus vulgaris is an autoimmune bullous dermatosis presenting with flaccid blisters and erosions. The morphology of pemphigus reflects the more superficial intraepidermal level of split seen histologically in contrast with pemphigoid, where the level of split is deep below the epidermis. This is a case of a 58-year-old male clinically presenting with arcuate tense bullae, which are more characteristic of the pemphigoid group of disorders, which revealed an intraepidermal split and tombstoning pattern of the basal epidermis on histopathology. Direct immunofluorescence revealed intercellular IgG and C3 distribution. Although this patient presented clinically with tense bullae, the histopathology and direct immunofluorescence results were consistent with pemphigus vulgaris.

scholarly journals Histopathological evaluation of most frequent liver diseases in cats

2009 ◽  
Vol 63 (1-2) ◽  
pp. 103-112 ◽  
Author(s):  
Branislav Kureljusic ◽  
Darko Marinkovic ◽  
Jelena Obadovic ◽  
Milena Djordjevic ◽  
Vladimir Kukolj
Keyword(s):  
Liver Diseases ◽  
Histological Analysis ◽  
Final Diagnosis ◽  
Clinical Findings ◽  
Histological Changes ◽  
Histopathological Evaluation ◽  
Precise Diagnosis ◽  
Close Cooperation ◽  
The University ◽  
Age And Sex

Histological analysis was performed on the liver of 27 cats of different breeds, age and sex, autopsied at the Department of Pathological Morphology of the Faculty of Veterinary Medicine of the University of Belgrade, and findings showed lymphoplasmocytic cholangiohepatitis, different degrees of fibrosis, passive hyperemia, fatty changes, cholestase, and neoplasms. The mentioned entities occurred very rarely as individual morphological manifestations, because the liver has different functions so that one morphological change often causes others to follow. Thus, for example, fibrosis was often followed by intrahepatic cholestase. Histopathological evaluation of liver disease is important not only in the autopsied samples, but also in diagnostics of liver diseases, in samples obtained by biopsy, which is important for making a precise diagnosis. The interpretation of the established histological changes in the liver requires close cooperation between clinicians and pathologists, because the final diagnosis is made on the grounds of morphological, biochemical and clinical findings.

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