Peritoneal Inflammation after Twenty-Week Exposure to Dialysis Solution: Effect of Solution versus Catheter–Foreign Body Reaction

♦ BackgroundWe hypothesized that both sterile solutions and foreign body reaction to the peritoneal dialysis catheter are associated with inflammatory changes in rats exposed to hypertonic solution.♦ MethodsFour hypertonic solutions (30 – 40 mL) were injected daily via needle and syringe over 20 weeks in 4 groups of rats: 4.25% standard clinical solution (LAC), LAC plus pyridoxamine (PYR), LAC plus ethyl pyruvate (EP), and a biocompatible 4% dextrose solution (BIC). Two groups received catheters: a non-injected 4-week catheter group (C4) and a group injected for 20 weeks with the BIC solution (CI). Control animals (CON) were not injected. In the C4 group, adherent cells were separated from the catheter and examined by culture and electron microscopy to ensure that animals were bacteria free prior to exposure to solution. Animals underwent transport experiments to determine mass transfer coefficients of mannitol (MTCM) and albumin (MTCA), osmotic filtration flux (Josm), and hydrostatic pressure-driven flux (Jp). After euthanasia, tissues were examined for submesothelial thickness, vascular density, and immunohistochemistry for various cytokines.♦ ResultsThe catheter cell layer was free of bacteria and consisted of macrophages, lymphocytes, mesothelial cells, and fibroblastic cells. Marked differences in angiogenesis and submesothelial thickening were noted for the catheter groups. Transport differences were mixed: MTCMwas significantly less for the CI group and MTCAwas variable among the groups. There were no differences among groups for Josmor Jp. Inflammatory markers in the catheter-adherent cells correlated with inflammatory changes in the tissue. These data demonstrate significant changes in submesothelial thickness, angiogenesis, transport function, and inflammatory markers between animals injected with sterile solutions over 20 weeks with and without catheters.♦ ConclusionsAn indwelling catheter amplifies peritoneal inflammation from dialysis solutions through a foreign body reaction. Our data also suggest that additives to existing solutions may have limited the effect on inflammatory response to non-biocompatible solutions.

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Histologic Study of Homograft Cartilages Implanted in the Middle Ear

Otolaryngology ◽

10.1177/019459988809800602 ◽

1988 ◽

Vol 98 (6) ◽

pp. 546-551 ◽

Cited By ~ 26

Author(s):

Etsuo Yamamoto ◽

Michitaka Iwanaga ◽

Manabu Fukumoto

Keyword(s):

Foreign Body ◽

Connective Tissue ◽

Middle Ear ◽

Foreign Body Reaction ◽

Fibrous Connective Tissue ◽

Histologic Study ◽

Second Stage ◽

The Matrix ◽

Inflammatory Changes ◽

Histologic Changes

We examined conditions of the micro-sliced homograft cartilages implanted in the middle ear, implanted cartilages removed at revision surgery or implanted cartilages removed at the second stage of staged tympanoplasty, both macroscopically and histologically. Macroscopically, the appearance and shape of the cartilages remained unchanged, with no evidence of erosion. There was no evidence of any foreign body reaction or rejection phenomenon. In general, no marked histologic changes of the matrix tissues were found, although chondrocytes showed degenerative changes. There was partial absorption of cartilage and replacement by fibrous connective tissue when inflammatory changes occurred in the middle ear. It is concluded that implanted homograft cartilage maintains its stiffness for more than 6 months in a healthy, aerated middle ear and appears to be clinically useful for tympanoplasty.

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Traumatic Exogenous Uveitis

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633160 ◽

1988 ◽

Vol 01 (01) ◽

pp. 35-37 ◽

Cited By ~ 1

Author(s):

B. P. Wilcock ◽

Melanie M. Williams

Keyword(s):

Weight Loss ◽

Foreign Body ◽

Ciliary Body ◽

Foreign Body Reaction ◽

Anterior Segment ◽

Tissue Formation ◽

Ocular Tissues ◽

Granulation Tissue Formation ◽

Orbital Muscle ◽

Inflammatory Changes

A young dog was presented to the veterinary ophthalmology service with marked unilateral anterior uveitis and blindness, extreme pain, anorexia and weight loss. Porcupine quill migration into the orbital and ocular tissues was suspected due to an encounter with a porcupine three weeks previously. Surgical orbital extenteration and exploration revealed two porcupine quill segments penetrating the oculus bulbi and extending into the orbital tissues. The location and movement of the quills within the globe and orbital muscle cone during mastication accounted for the deep pain, anorexia and weight loss. The quills incited a sterile foreign body reaction with fibroplasia and granulation tissue formation in the sclera and ciliary body. The eye was avisual due to the anterior segment structural and inflammatory changes.

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Foreign Body Reaction to Exogenous Pulmonary Surfactant in an Infant with Hydrops and Cardiomyopathy

Fetal and Pediatric Pathology ◽

10.3109/15513819609168663 ◽

1996 ◽

Vol 16 (1) ◽

pp. 83-88

Author(s):

Robert Bendon ◽

Jim Greenberg ◽

Sue Heffelfinger

Keyword(s):

Foreign Body ◽

Pulmonary Surfactant ◽

Foreign Body Reaction

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Delayed Cerebral Edema: Possible Association with an Inflammatory Foreign Body Reaction

Interdisciplinary Neurosurgery ◽

10.1016/j.inat.2021.101207 ◽

2021 ◽

pp. 101207

Author(s):

Sook Young Sim ◽

Chan-Young Choi

Keyword(s):

Foreign Body ◽

Cerebral Edema ◽

Foreign Body Reaction

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Granuloma Caused by Carbon Deposition in the Dermis

Case Reports in Dermatological Medicine ◽

10.1155/2014/686489 ◽

2014 ◽

Vol 2014 ◽

pp. 1-2

Author(s):

Rintaro Shibuya ◽

Yuichiro Endo ◽

Akihiro Fujisawa ◽

Miki Tanioka ◽

Yoshiki Miyachi

Keyword(s):

Computed Tomography ◽

Foreign Body ◽

Malignant Melanoma ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Foreign Body Reaction ◽

Carbon Deposition ◽

Case Reports ◽

Initial Injury ◽

Pencil Lead

Pencil core granuloma is characterized by a delayed foreign-body reaction against retained fragments of pencil lead. Previous case reports presented pencil core granuloma resembling malignant melanoma, haemangioma, or soft tissue sarcoma. We present a case of pencil core granuloma arising from the palm 25 years after the initial injury. The patient presented a bluish nodule that had been present over 25 years before. The nodule initially measured 5 mm in diameter. However, five years before presentation, it suddenly enlarged to the size of 30 mm during six months. Computed tomography (CT) of the lesion revealed a linear radiopaque structure of 8 mm long with a mass on its distal end. Surgical resection revealed a bluish muddy mass and pencil lead. Histological examination revealed degenerative tissue with calcification surrounded by massive amounts of black granular material in the middle and lower dermis.

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Delayed Foreign Body Reaction to Steel Wire Suture Resembling Basal Cell Carcinoma

Actas Dermo-Sifiliográficas (English Edition) ◽

10.1016/j.adengl.2011.11.011 ◽

2011 ◽

Vol 102 (9) ◽

pp. 740-742

Author(s):

J. Neila ◽

M. Perea ◽

J.J. Ríos-Martín ◽

F.M. Camacho

Keyword(s):

Foreign Body ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Foreign Body Reaction ◽

Steel Wire ◽

Wire Suture

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Foreign body reaction after cochlear implantation

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2011.08.004 ◽

2011 ◽

Vol 75 (11) ◽

pp. 1455-1458 ◽

Cited By ~ 15

Author(s):

Hye Jin Lim ◽

Eun-So Lee ◽

Hun Yi Park ◽

Keehyun Park ◽

Yun-Hoon Choung

Keyword(s):

Foreign Body ◽

Cochlear Implantation ◽

Foreign Body Reaction

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Material dependent differences in inflammatory gene expression by giant cells during the foreign body reaction

Journal of Biomedical Materials Research Part A ◽

10.1002/jbm.a.31420 ◽

2007 ◽

Vol 83A (3) ◽

pp. 879-886 ◽

Cited By ~ 26

Author(s):

D.T. Luttikhuizen ◽

P.Y.W. Dankers ◽

M.C. Harmsen ◽

M.J.A. van Luyn

Keyword(s):

Gene Expression ◽

Foreign Body ◽

Foreign Body Reaction ◽

Giant Cells ◽

Inflammatory Gene Expression ◽

Inflammatory Gene

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P045 Nothing is too 'cagey' for the rheumatologist

Rheumatology ◽

10.1093/rheumatology/keab247.042 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Muhammad F Kazmi

Keyword(s):

Weight Loss ◽

Inflammatory Markers ◽

Low Grade ◽

Careful Monitoring ◽

Chronic Infections ◽

Asian Origin ◽

Travel History ◽

Chest Clinic ◽

History Of ◽

Inflammatory Changes

Abstract Background/Aims Rheumatological conditions can present with a number of non-specific features like arthralgia, fever, fatigue, weight loss along with raised inflammatory markers and positive antibodies. Due to this, when similar symptoms are referred for input it is very important to consider other ‘mimics’. We report a case of Pigeon fancier’s lung presenting with these symptoms which was referred as likely connective tissue disease. Methods A 52-year-old lady of South Asian origin was referred by her GP with six month history of 3kg weight loss, arthralgia, fatigue, low grade fever and persistently raised inflammatory markers (ESR ranging from 50-64 mm/hr, CRP 10-14 mg/L, normal BMI). On further questioning there was history of mouth ulcers, non-specific rash, occasional cough but no Raynaud’s or joint swelling. Blood investigations showed weakly positive ANA and RF but negative ENA, DNA, antiCCP , CK, C3,C4. C-ANCA was positive but PR3 negative. CXR was clear and tests for chronic infections including TB were negative. Due to lack of objective CTD signs, plan was to take a careful monitoring approach to see if clinical features evolved. A month later due to worsening cough, a CT chest/abdomen arranged by GP showed ground-glass changes consistent with pneumonitis and hence her rheumatology appointment was expedited to see if there was an autoimmune unifying diagnosis. She was also referred by her GP to the chest clinic in view of CT report and mild shortness of breath. Results On further review, again there were no objective CTD signs. On direct questioning there was history of travelling before worsening chest symptoms to South Asia. Also around a year before her symptoms started she was given an African grey parrot. Based on this, serology for Avian precipitin was checked which showed strongly positive IgG antibodies to avian antigens (Budgerigar droppings and feathers, Pigeon feathers IgG Abs) confirming the diagnosis of pigeon fanciers lung. She fulfilled the diagnostic criteria and was asked to avoid the trigger. Urgent respiratory input was arranged where diagnosis was agreed with and disease was deemed sub-acute in presentation. Due to PFTs showing low transfer factor of 38%, Prednisolone was started with significant improvement within few days. Review of CT chest only showed inflammatory changes and no established fibrosis predicting excellent prognosis as delay in treatment can cause irreversible pulmonary fibrosis. Conclusion A number of conditions can mimic rheumatological conditions which usually turn out to be either infectious or malignant in origin. This case highlights the importance of considering other differentials and along with taking a travel history also asking for other possible triggers like pets. In similar scenarios the diagnosis may be ‘cagey’ but as rheumatologists we are expected to answers questions which others can’t. Disclosure M.F. Kazmi: None.

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