COVID-19 Vaccination in Patients with Myasthenia Gravis: A Single-Center Case Series

In this study, we report the safety of coronavirus disease 2019 (COVID-19) vaccine in patients with myasthenia gravis (MG). Patients who were vaccinated against COVID-19 were included. Demographics, clinical characteristics, medications, and vaccination information were collected. The main observation outcome is the worsening of MG symptoms within 4 weeks following COVID-19 vaccination. A total of 22 patients with MG vaccinated for COVID-19 were included. Ten (45.5%) patients had ocular MG (OMG), and 12 (55.5%) patients had generalized MG (GMG). Six (27.3%) patients were female, and the mean (SD) onset age was 45.4 (11.8) years. Nineteen (86.4%) patients were seropositive for acetylcholine receptors (AChR) antibody. Seven (31.8%) patients underwent thymectomy, and four of them confirmed thymoma pathologically. Twenty-one patients were administrated with inactivated vaccines, and the remaining one was administrated with recombinant subunit vaccine. Twenty (90.9%) patients did not present MG symptom worsening within 4 weeks of COVID-19 vaccination, and two (9.1%) patients reported slight symptom worsening but resolved quickly within a few days. Our findings suggest inactivated COVID-19 vaccines might be safe in MG patients with Myasthenia Gravis Foundation of America (MGFA) classification I to II, supporting the recommendation to promote vaccination for MG patients during the still expanding COVID-19 pandemic.

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MO291RITUXIMAB IS EFFECTIVE AND SAFE IN ADULTS WITH STEROID-DEPENDENT NEPHROTIC SYNDROME: A LONG-TERM, SINGLE-CENTER EXPERIENCE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab104.0049 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Gemma Patella ◽

Alessandro Comi ◽

Giuseppe Coppolino ◽

Nicolino Comi ◽

Giorgio Fuiano ◽

...

Keyword(s):

Nephrotic Syndrome ◽

Case Series ◽

Adult Patients ◽

Single Center ◽

Single Center Experience ◽

Steroid Dependent ◽

The Mean ◽

Steroid Dependent Nephrotic Syndrome

Abstract Background and Aims Steroid-dependent nephrotic syndrome (SDNS) may require a prolonged multi-drug therapy with risk of drug toxicity and renal failure. Rituximab (RTX) treatment has been found to be helpful in reducing the steroid dosage and the need for immunosuppressants (ISs), but little data are currently available regarding very long-term outcomes in adults. We herein describe a long-term, single-center experience of RTX use in a large series of adults with SDNS. Method We studied 23 adult patients with SDNS (mean age 54.2±17.1 y; 65% male; BMI 28.5±4.7), mostly consequent to membranous (47.8%) or focal glomerulonephritis (30.2 %) who were eligible to start a RTX regimen. Before entering the RTX protocol, proteinuria and eGFR were 7.06±3.87 g/24h and 65.9±28.2 ml/min/1.73 m2, respectively; albumin and CD19/CD20 ratio were 2.9±0.9 g/L and 0.99±0.01 respectively; the mean number of ISs was 2.39±0.89 and the mean annual rate of relapses was 2.2±0.9. Results Patients were followed over a mean follow-up of 64 months (range: 12-144). After RTX (mean dose: 1202.1±372.4 mg) the rate of relapses was virtually nullified (p<0.001). eGFR remained roughly stable (62.1±19.8 ml/min/1.73 m2, p=NS), while proteinuria, albumin, CD19/CD20 and BMI all significantly improved (p ranging from 0.01 to 0.001). The mean number of additional ISs was also reduced (0.44±0.12; p<0.001) and RTX enabled discontinuation of steroids in 13/23 (56.5%) patients. No major adverse events related to therapy were recorded. Conclusion Findings from this large case-series with a remarkable very long follow-up reinforce the role of RTX as an efficient and safe weapon to improve outcomes in adult patients suffering from SDNS.

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Clinical Characteristics of Anti-PL-12 Antibody-Positive Interstitial Pneumonia: A Single-Center Case Series

10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a4617 ◽

2019 ◽

Author(s):

M. Asaoka ◽

H. Kitamura ◽

K. Isomoto ◽

H. Okabayashi ◽

A. Sekine ◽

...

Keyword(s):

Interstitial Pneumonia ◽

Clinical Characteristics ◽

Case Series ◽

Single Center

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Fetal Macrocephaly: A Novel Sonographic Finding in Congenital Myotonic Dystrophy

American Journal of Perinatology Reports ◽

10.1055/s-0040-1716742 ◽

2020 ◽

Vol 10 (03) ◽

pp. e294-e299

Author(s):

Shiri Shinar ◽

Parry Balakumar ◽

Vibhuti Shah ◽

Karen Chong ◽

Tami Uster ◽

...

Keyword(s):

Differential Diagnosis ◽

Myotonic Dystrophy ◽

Case Series ◽

Single Center ◽

Third Trimester ◽

Biparietal Diameter ◽

Congenital Myotonic Dystrophy ◽

Appropriate For Gestational Age ◽

History Of ◽

The Mean

Abstract Objective Sonographic clues to the diagnosis of congenital myotonic dystrophy (CDM) are limited, particularly in the absence of family history of myotonic dystrophy (DM). We reviewed cases of CDM for unique prenatal findings. Study Design A single-center case series of fetuses with CMD with characteristic prenatal findings confirmed postnatally. Results Four fetuses with pre- or postnatally diagnosed CDM presented with macrocephaly in utero. While head measurements were appropriate for gestational age until midgestation, third-trimester head circumference and biparietal diameter were both >2 standard deviation (SD) above the mean in all. Abdominal and femur measurements were otherwise appropriate for gestation. Postnatally, the occipitofrontal circumference was >2 SD above the mean in all, confirming the diagnosis of macrocephaly. Conclusion CDM should be included in the differential diagnosis of third-trimester macrocephaly, especially in the presence of additional sonographic clues and when maternal medical history and physical examination are suggestive of DM.

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Malignant Transformation of Mature Cystic Teratoma: Is Squamous Cell Carcinoma Different From the Other Types of Neoplasm?

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001375 ◽

2018 ◽

Vol 28 (9) ◽

pp. 1650-1656 ◽

Cited By ~ 2

Author(s):

Munetoshi Akazawa ◽

Sachiko Onjo

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Malignant Transformation ◽

Squamous Cell ◽

Clinical Characteristics ◽

Case Series ◽

Cystic Teratoma ◽

The Other ◽

The Mean

ObjectivesMalignant transformation of mature cystic teratoma (MCT) is rare. Unlike squamous cell carcinoma (SCC) in MCT, the other types of neoplasm in MCT have not been discussed in publications. We analyzed the clinical characteristics and prognosis of the other types of neoplasm (non-SCC) compared with those of SCC.MethodsA systematic literature search of literature published from 2000 to 2017 was conducted in PubMed, Web of Science, and Scopus. We reviewed case series that included all pathological types of malignant transformation.ResultsA total of 155 cases from 15 case series, including our cases, were included. Of the cases, 90 (58%) were SCC and 65 (42%) were non-SCC, including adenocarcinoma, carcinoid tumor, thyroid carcinoma, sarcoma, adenosquamous carcinoma, melanoma, sebaceous carcinoma, oligodendroglioma, signet ring cell carcinoma, and transitional cell carcinoma, in descending order of frequency. The mean ages of patients with SCC and non-SCC were 50.5 and 48.9 years, respectively. The mean tumor sizes were 14.7 cm in SCC and 13.9 cm in non-SCC. Surgical approaches were similar. First-line chemotherapy for epithelial ovarian cancers was the most commonly used regimen in SCC and non-SCC. Overall survival did not differ significantly, showing better prognosis in stage I and poor prognosis in stages II, III, and IV. A difference in overall survival was observed among pathological types of non-SCC.ConclusionsClinical characteristics and outcomes did not differ significantly between SCC and non-SCC. However, chemotherapy regimens differed to some extent, and the possibility of difference in overall survival among pathological types of non-SCC was suggested.

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Periprosthetic Infections of the Shoulder Joint: Characteristics and 5-Year Outcome of a Single-Center Series of 19 Cases

Antibiotics ◽

10.3390/antibiotics10091125 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1125

Author(s):

Mohamad Bdeir ◽

Franz-Joseph Dally ◽

Elio Assaf ◽

Sascha Gravius ◽

Elisabeth Mohs ◽

...

Keyword(s):

Treatment Failure ◽

Total Shoulder Arthroplasty ◽

Joint Infection ◽

Total Duration ◽

Case Series ◽

Single Center ◽

Reactive Protein ◽

Joint Characteristics ◽

Treatment Failure Rate ◽

The Mean

Periprosthetic shoulder infection (PSI) remains a devastating complication after total shoulder arthroplasty (TSA). Furthermore, there is a paucity in the literature regarding its diagnostic and therapeutic management, especially the absence of therapy concepts devised exclusively for PSI. The aim of the presenting study is to examine the characteristics and outcome of patients with PSI who were treated according to well-established algorithms developed originally for periprosthetic joint infection (PJI) of the hip and knee and determine if these algorithms can be applied to PSI. This single-center case series included all patients with a PSI presenting between 2010 and 2020. Recorded parameters included age, sex, affected side, BMI, ASA score, Charlson comorbidity index, preoperative anticoagulation, indication for TSA (fracture, osteoarthritis or cuff-arthropathy), and type of infection (acute or chronic PSI). The outcome was divided into treatment failure or infect resolution. Staphylococcus epidermidis and aureus were the commonest infecting pathogens. Acute PSI was mainly treated with debridement, irrigation, and retention of the prosthesis (DAIR) and chronic cases with two/multiple-stage exchange. The treatment failure rate was 10.5%. C-reactive protein was preoperatively elevated in 68.4% of cases. The mean number of operative revisions was 3.6 ± 2.6, and the mean total duration of antibiotic treatment was 72.4 ± 41.4 days. The most administered antibiotic was a combination of clindamycin and fluoroquinolone. In summary, the data of the current study suggest that therapeutical algorithms and recommendations developed for the treatment of PJI of the hip and knee are also applicable to PSI.

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Asymptomatic COVID-19 Have Longer Treatment Cycle Than Moderate Type of Confirmed Patients

10.1101/2020.05.16.20103796 ◽

2020 ◽

Cited By ~ 1

Author(s):

Wei Zhang ◽

Qinying Long ◽

Yanbiao Huang ◽

Changju Chen ◽

Jinhua Wu ◽

...

Keyword(s):

Clinical Characteristics ◽

Treatment Cycle ◽

Clinical Laboratory ◽

Case Series ◽

Interquartile Range ◽

Control Group ◽

Single Center ◽

Clinical Trial Registry ◽

The Difference ◽

Novel Coronavirus

ABSTRACTObjectivesA kind of pneumonia caused by unknown causes that occurred in Wuhan, Hubei, China in December 2019, was reported as a result of novel coronavirus infection on January 7, 2020, and then WHO named it COVID-19. To compare the difference of epidemiology and clinical characteristics between asymptomatic COVID-19 infections and moderate type of confirmed cases.MethodsRetrospective, single-center cohort study of COVID-19 involving 52 infections of both 26 asymptomatic and 26 moderate type of confirmed cases in the recovery stage at Guizhou Provincial Staff Hospital in Guiyang, China, from January 29, to March 31, 2020; final date of follow-up was April 22. This study was registered in Chinese Clinical Trial Registry Center. Documented the asymptomatic COVID-19 infections and moderate type of confirmed cases. Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Epidemiological and clinical characteristics of asymptomatic COVID-19 infections and moderate type of confirmed cases were compared.ResultsThe median treatment cycle of asymptomatic COVID-19 infections was 16 days (interquartile range, 11-20 days) and longer than 13 days (interquartile range, 10-15 days) of moderate type of confirmed cases (p=0.049). The median incubation period of asymptomatic COVID-19 infections was 10 days (interquartile range, 0-21 days), while the control group was 7 days (interquartile range, 1-15 days) (p=0.27). On the initial chest computerized tomography (CT) check, 18 (69.2%, 18/26) asymptomatic COVID-19 infections were no imaging changes, which was of no significance compared with 12 (46.2%, 12/26) patients with moderate type of confirmed patients (p=0.092).ConclusionsIn this single-center study, we found that asymptomatic COVID-19 infections have longer treatment cycle than those moderate type of confirmed cases.Key PointsIn this single-center case series involving 52 infections with asymptomatic and moderate type of COVID-19 cases, asymptomatic COVID-19 infections have longer treatment cycle than those moderate type of confirmed patients.

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Familial spontaneous pneumothorax: importance of screening for Birt–Hogg–Dubé syndrome

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz171 ◽

2019 ◽

Vol 57 (1) ◽

pp. 39-45 ◽

Cited By ~ 3

Author(s):

Yanguo Liu ◽

Huajie Xing ◽

Yu Huang ◽

Shushi Meng ◽

Jun Wang

Keyword(s):

Recurrence Rate ◽

Spontaneous Pneumothorax ◽

Clinical Characteristics ◽

Primary Spontaneous Pneumothorax ◽

Treatment Modalities ◽

Onset Age ◽

Female Ratio ◽

The Mean ◽

Male To Female ◽

Bhd Syndrome

Abstract OBJECTIVES The goal of this study was to investigate the prevalence of Birt–Hogg–Dubé (BHD) syndrome in patients with familial spontaneous pneumothorax (FSP) and the clinical characteristics of pneumothorax related to BHD syndrome compared with those of primary spontaneous pneumothorax. METHODS A total of 37 families diagnosed with FSP from 2007 to 2017 were enrolled in this study. The FLCN gene, which is responsible for BHD syndrome, was sequenced using the Sanger method in 25 probands. For the patients with confirmed BHD syndrome-related pneumothorax, clinical characteristics including the median onset age of pneumothorax, the male-to-female ratio, the mean height and body mass index (BMI) and the recurrence rate after different treatment modalities were obtained and compared with those of patients with primary spontaneous pneumothorax. RESULTS Of the 25 probands with FSP, 16 [64.0%, 95% confidence interval (CI) 43.8–84.2%] harboured FLCN germline mutations. In the patients with BHD syndrome-related pneumothorax, the median onset age of pneumothorax was 34 years; the male-to-female ratio was 1.3:1; and the mean height and BMI were 167.0 ± 8.6 cm and 23.6 ± 3.4 kg/m2, respectively. These characteristics were significantly different from those in patients with primary spontaneous pneumothorax from the same centre. The recurrence rate of BHD syndrome-related pneumothorax after conservative therapy was 53.1% (95% CI 38.6–67.5%) compared with 9.1% (95% CI 0–19.4%) after surgical treatment. CONCLUSIONS BHD syndrome is one of the most common causes of FSP. Patients with FSP should be recommended for mutation screening for the FLCN gene to facilitate early diagnosis and proper intervention.

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Clinical Characteristics of Patients With Coronavirus Disease 2019 in Japan: A Single-Center Case Series

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa244 ◽

2020 ◽

Vol 222 (2) ◽

pp. 194-197 ◽

Cited By ~ 3

Author(s):

Ken-ichiro Kobayashi ◽

Takahiro Kaki ◽

Shinsuke Mizuno ◽

Kenji Kubo ◽

Nobuhiro Komiya ◽

...

Keyword(s):

Computed Tomography ◽

Polymerase Chain Reaction ◽

Clinical Characteristics ◽

Case Series ◽

Ground Glass ◽

Single Center ◽

Chain Reaction ◽

Pharyngeal Swab ◽

Polymerase Chain

Abstract We report a case series of 6 patients with confirmed coronavirus disease 2019 (COVID-19) in Wakayama prefecture, Japan. All 6 of the patients tested positive via pharyngeal swab polymerase chain reaction (PCR) tests, and 2 of the 6 were still positive at 3 weeks after onset. All of the patients exhibited bilateral ground glass opacities on computed tomography (CT). This article also reports narrative information on the spectrum of symptoms collected directly from the patients. It would be difficult to triage patients with COVID-19 based on the typical symptoms of fever and/or cough, although PCR and CT are definitive in diagnosis.

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