scholarly journals Cytomegalovirus ileocolitis in a rheumatoid arthritis patient: case report and literature review

Reumatismo ◽  
2015 ◽  
Vol 67 (1) ◽  
Author(s):  
M. S. Dag ◽  
I. H. Turkbeyler ◽  
Z. A. Ozturk ◽  
B. Kısacık ◽  
E. Tutar ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Immunosuppressive Agents ◽  
Outpatient Service ◽  
Immunosuppressive Drugs ◽  
Chronic Inflammatory Disease ◽  
Severe Diarrhea ◽  
Immunosuppressed Patients ◽  
Oral Valganciclovir ◽  
Polymerase Chain ◽  
Endoscopic Picture

Rheumatoid arthritis (RA) is an autoimmune, systemic, chronic, inflammatory disease generally treated with various immunosuppressive drugs. Cytomegalovirus (CMV) is an opportunistic, viral infection that is commonly seen in immunosuppressed patients. A sixty-four-year old female diagnosed with RA and treated with immunosuppressive agents was admitted to our rheumatology outpatient service with complaints of diarrhea and abdominal pain, which had lasted longer than four weeks. The patient’s colonoscopy revealed inflamed and ulcerated areas in the colon and in the terminal ileum. A biopsy showed intra-nuclear inclusion particles consistent with CMV. We started an oral valganciclovir therapy in this serum-CMV-polymerase chain reaction-positive patient. The concomitant use of immunosuppressive agents and anti-viral drugs eased the patient’s complaints, and the endoscopic picture improved. Consequently, cytomegalovirus ileocolitis in immunosuppressed patients admitted with severe diarrhea must be considered in the differential diagnosis.

A Case of Cutaneous Sterile Pyogranuloma/Granuloma Syndrome in a Maltese

2014 ◽  
Vol 50 (4) ◽  
pp. 278-283 ◽  
Author(s):  
Shinpei Kawarai ◽  
Shinobu Matsuura ◽  
Saburo Yamamoto ◽  
Akio Kiuchi ◽  
Nobuyuki Kanemaki ◽  
...  
Keyword(s):  
Immunosuppressive Agents ◽  
Skin Lesions ◽  
Immunosuppressive Drugs ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Mild Anemia ◽  
Polymerase Chain ◽  
Term Management ◽  
Mycobacterium Spp

Cutaneous sterile pyogranuloma/granuloma syndrome (SPGS) is a locally restricted multinodular dermatitis. Affected dogs are typically healthy, but a few show systemic signs. Herein, a case of a dog presenting with generalized ulcerative dermatitis with systemic signs of mild anemia and an increased C-reactive protein level is described. Cutaneous SPGS was diagnosed by histopathology, negative staining causative organisms, and polymerase chain reaction for Mycobacterium spp. Successful treatment was achieved by immunosuppressive drugs, including prednisolone and azathioprine, administered for at least 20 mo. Recurrences of skin lesions were observed when prednisolone and/or azathioprine were discontinued. Long-term management with immunosuppressive agents may be required if the affected dog exhibits severe symptoms of cutaneous SPGS.

scholarly journals Intravenous immunoglobulin as a therapeutic option for patients with worsening COVID-19 under rituximab

2021 ◽  
Vol 14 (6) ◽  
pp. e243338
Author(s):  
Joana Vasconcelos ◽  
Rita Portugal ◽  
Rita Torres ◽  
Sandra Falcão
Keyword(s):  
Rheumatoid Arthritis ◽  
Intravenous Immunoglobulin ◽  
Inflammatory Markers ◽  
Therapeutic Option ◽  
Immunosuppressive Agents ◽  
Significant Elevation ◽  
Radiological Progression ◽  
Persistent Fever ◽  
Immunosuppressed Patients

Severe cases of the new COVID-19 are being reported in immunosuppressed patients. The risk seems to depend on the type of immunosuppressive agents used and it is particularly important in patients under the long-lasting effect of rituximab. Information regarding the best therapeutic approach to these patients is scarce and further studies are needed. We present a case of a young woman with rheumatoid arthritis treated with rituximab (last administration 4 months before her admission). She presented with a deteriorating and prolonged SARS-CoV-2 infection, with persistent fever, significant elevation of inflammatory markers and radiological progression. Glucocorticoids and antibiotic therapy were initiated, with no response. Intravenous immunoglobulin was then used with a rapid and exuberant response, anticipating a promising role of this therapy in immunosuppressed patients with COVID-19 under the effect of rituximab.

No association between ITGAV rs3738919 and rs3768777 polymorphisms and rheumatoid arthritis susceptibility in Iranian population

2016 ◽  
Vol 40 (6) ◽  
Author(s):  
Abbas-Ali Fallah ◽  
Saeid Morovvati ◽  
Kazem Ahmadi ◽  
Gholam Hossein Alishiri ◽  
Mahdi Fasihi-Ramandi
Keyword(s):  
Rheumatoid Arthritis ◽  
Fragment Length Polymorphism ◽  
Cartilage Damage ◽  
Chronic Inflammatory Disease ◽  
Chain Reaction ◽  
Genotype Frequencies ◽  
Polymerase Chain ◽  
Genetic And Environmental Factors ◽  
Iranian Patients ◽  
Arthritis Susceptibility

AbstractBackground:Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by angiogenesis, cell proliferation and bone and cartilage damage in the affected joint. Many genetic and environmental factors contribute to RA susceptibility.Methods:Iranian patients with confirmed RA, aged over 50 years, were compared with healthy controls for allelic and genotypic frequencies of these polymorphisms. The subjects and controls were matched through their race, age and sex. After whole genome extraction, we compared genotype frequencies of analyzed alleles in RA patients and controls using a polymerase chain reaction (PCR)-restriction fragment length polymorphism assay. Association ofResults:Statistical analysis indicated no association between RA andConclusions:This study did not find any association between RA and

Impact of immunosuppressive agents on clinical manifestations and outcome of Staphylococcus aureus bloodstream infection – A propensity score matched analysis in two large, prospectively evaluated cohorts

2021 ◽  
Author(s):  
Johannes Camp ◽  
Lina Glaubitz ◽  
Tim Filla ◽  
Achim J Kaasch ◽  
Frieder Fuchs ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Propensity Score ◽  
Bloodstream Infection ◽  
Cox Regression ◽  
Immunosuppressive Agents ◽  
Late Complications ◽  
Competing Risk ◽  
Immunosuppressed Patients ◽  
Staphylococcus Aureus Bloodstream Infection ◽  
Baseline Characteristics

Abstract Background Staphylococcus aureus bloodstream infection (SAB) is a common, life-threatening infection. The impact of immunosuppressive agents on the outcome of patients with SAB is incompletely understood. Methods Data from two large prospective, international, multicenter cohort studies (INSTINCT and ISAC) between 2006 and 2015 were analyzed. Patients receiving immunosuppressive agents were identified and a 1:1 propensity score (PS) matched analysis was performed to adjust for baseline characteristics of patients. Overall survival and time to SAB-related late complications (SAB relapse, infective endocarditis, osteomyelitis, or other deep-seated manifestations) were analyzed by Cox regression and competing risk analyses, respectively. This approach was then repeated for specific immunosuppressive agents (corticosteroids [CSMT] and immunosuppressive agents other than steroids [IMOTS]). Results Of 3,188 analyzed patients, 309 were receiving immunosuppressive treatment according to our definitions and were matched to 309 non-immunosuppressed patients. After PS matching, baseline characteristics were well balanced. In the Cox regression analysis, we observed no significant difference in survival between the two groups (death during follow-up: 105/309 (33.9 %) immunosuppressed patients vs. 94/309 (30.4 %) non-immunosuppressed, hazard ratio 1.20 (95% CI 0.84–1.71). Competing risk analysis showed a cause-specific hazard ratio (CSHR) of 1.81 (95% CI 0.85–3.87) for SAB-related late-complications in patients receiving immunosuppressive agents. CSHR was higher in patients taking IMOTS (3.69; 95% CI 1.41–9.68). Conclusions Immunosuppressive agents were not associated with an overall higher mortality. The risk for SAB-related late complications in patients receiving specific immunosuppressive agents such as IMOTs warrants further investigations.

scholarly journals Treatment of Rheumatoid Arthritis with Traditional Chinese Medicine

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Wen-Yuan Lee ◽  
Hsin-Yi Chen ◽  
Kuan-Chung Chen ◽  
Calvin Yu-Chian Chen
Keyword(s):  
Rheumatoid Arthritis ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Protein Complex ◽  
Chronic Inflammatory Disease ◽  
Dynamics Simulation ◽  
Current Therapy ◽  
Potential Candidate ◽  
Interleukin 6 Receptor ◽  
The Stability

Rheumatoid arthritis (RA) is a chronic inflammatory disease that will affect quality of life and, working efficiency, and produce negative thoughts for patients. Current therapy of RA is treated with disease-modifying antirheumatic drugs (DMARDs). Although most of these treatment methods are effective, most patients still have a pleasant experience either due to poor efficacy or side effects or both. Interleukin-6 receptor (IL6R) is important in the pathogenesis of RA. In this study, we would like to detect the potential candidates which inhibit IL6R against RA from traditional Chinese medicine (TCM). We use TCM compounds from the TCM Database@Taiwan for virtually screening the potential IL6R inhibitors. The TCM candidate compound, calycosin, has potent binding affinity with IL6R protein. The molecular dynamics simulation was employed to validate the stability of interaction in the protein complex with calycosin. The analysis indicates that protein complex with calycosin is more stable. In addition, calycosin is known to be one of the components ofAngelica sinensis, which has been indicated to have an important role in the treatment of rheumatoid arthritis. Therefore, calycosin is a potential candidate as lead compounds for further study in drug development process with IL6R protein against rheumatoid arthritis.

Treatment of Severe Cryptosporidium-Related Diarrhea with Octreotide in a Patient with AIDS

1988 ◽  
Vol 22 (2) ◽  
pp. 134-136 ◽  
Author(s):  
Michael D. Katz ◽  
Brian L. Erstad ◽  
Cathryn Rose
Keyword(s):  
Gastrointestinal Hormones ◽  
Somatostatin Analog ◽  
Secretory Diarrhea ◽  
Inhibitory Effects ◽  
Severe Diarrhea ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Antiparasitic Drugs ◽  
Long Acting ◽  
Immunodeficiency Syndrome

Cryptosporidiosis commonly causes severe diarrhea in immunosuppressed patients. There currently are no antiparasitic drugs consistently effective for this infection. This case describes a 26-year-old hemophiliac patient with acquired immunodeficiency syndrome and cryptosporidiosis whose diarrhea improved with continuous intravenous administration of a long-acting somatostatin analog, octreotide. Somatostatin has a variety of inhibitory effects on gastrointestinal hormones as well as a possible nonspecific effect on gastrointestinal mucosal fluid and electrolyte secretion. The somatostatin analog should be considered for patients with secretory diarrhea refractory to other forms of therapy.

scholarly journals Mitomycin C Induces Apoptosis in Rheumatoid Arthritis Fibroblast-Like Synoviocytes via a Mitochondrial-Mediated Pathway

2015 ◽  
Vol 35 (3) ◽  
pp. 1125-1136 ◽  
Author(s):  
Chuqi Yan ◽  
Dechao Kong ◽  
Dong Ge ◽  
Yanming Zhang ◽  
Xishan Zhang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cell Viability ◽  
Mitomycin C ◽  
Apoptotic Cell ◽  
Chronic Inflammatory Disease ◽  
Cell Counting ◽  
Terminal Deoxynucleotidyl Transferase ◽  
Control Treatment ◽  
Induced Apoptosis ◽  
Fibroblast Like Synoviocytes

Background/Aims: Rheumatoid arthritis (RA) is a systemic chronic inflammatory disease characterised by prominent synoviocyte hyperplasia and a potential imbalance between the growth and death of fibroblast-like synoviocytes (FLS). Mitomycin C (MMC) has previously been demonstrated to inhibit fibroblast proliferation and to induce fibroblast apoptosis. However, the effects of MMC on the proliferation and apoptosis of human RA FLS and the potential mechanisms underlying its effects remain unknown. Methods: Cell viability was determined using the Cell Counting Kit-8 assay. Apoptotic cell death was analysed via Annexin V-FITC/PI double staining and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labelling. The production of intracellular reactive oxygen species (ROS) was assessed via flow cytometry, and the changes in mitochondrial membrane potential (ΔΨm) were visualized based on JC-1 staining via fluorescence microscopy. The expression of apoptosis-related proteins was determined via Western blot. Results: Treatment with MMC significantly reduced cell viability and induced apoptosis in RA FLS. Furthermore, MMC exposure was found to stimulate the production of ROS and to disrupt the ΔΨm compared to the control treatment. Moreover, MMC increased the release of mitochondrial cytochrome c, the ratio of Bax/Bcl-2, the activation of caspase-9 and caspase-3, and the subsequent cleavage of poly(ADP-ribose) polymerase. Conclusion: Our findings suggest that MMC inhibits cell proliferation and induces apoptosis in RA FLS, and the mechanism underlying this MMC-induced apoptosis may involve a mitochondrial signalling pathway.

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