scholarly journals Hypertrophic pachymeningitis and orbital tumor associated with Granulomatosis with polyangiitis: report of a clinical case

2021 ◽  
pp. 28-30
Author(s):  
S. Argüello ◽  
M. Avatte ◽  
R. Larocca ◽  
R. Movía

A 65-year-old patient, with a diagnosis of Granulomatosis with Polyangeitis (GPA) of 18 years of evolution, whose debut was with respiratory failure and hemoptysis, receiving induction treatment with corticosteroids together with cyclophosphamide, and then maintenance treatment with azathioprine 150 mg per day, with periods of flare-up of the disease that responded to treatment with corticosteroids for short periods. He came to the clinic for a 3-month-long chronic headache refractory to treatment with non-steroidal anti-inflammatory drugs (NSAIDs), associated with left ocular proptosis and ipsilateral orbital pain. presenting elevated acute phase reactants (ers and c-reactive protein). It is evidenced by brain magnetic resonance with gadolinium, enhancement of the cerebral dura and cerebellum store, also presenting formation in the left orbit.

Author(s):  
Rohit S Loomba ◽  
Enrique G Villarreal ◽  
Juan S Farias ◽  
Gaurav Aggarwal ◽  
Saurabh Aggarwal ◽  
...  

Background There is limited information regarding the role of biomarker levels at predicting mortality in patients with the novel coronavirus pandemic (Covid-19). The purpose of this study is to determine the differences in serum biomarker levels in adults with Covid-19 who survived hospitalization from those who did not. Methods A comprehensive search was completed on PubMed, EMBASE, and Cochrane libraries to identify studies of interest. Endpoints of interest were blood counts, hepatic function test, acute phase reactants, cytokines and cardiac biomarkers. Results A total of 10 studies with 1,584 patients were included in the pooled analyses. Biomarkers that were noted to be significantly higher in those who died from Covid-19 (coronavirus disease 2019) included: white blood cell count, neutrophil count, C-reactive protein, high sensitivity C-reactive protein, procalcitonin, ferritin, D-dimer, interleukins 6, lactate dehydrogenase, creatine kinase, prothrombin time, aspartate aminotransferase, alanine aminotransferase, total bilirubin, and creatinine. Lymphocyte count, platelet count, and albumin were significantly lower in patients who died. Conclusion This pooled analysis of 10 studies including 1,584 patients identified significant differences in biomarkers on admission in patients who survived from those who did not. Further research is needed to develop risk stratification models to help with judicious use of limited healthcare resources.


Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1966 ◽  
Author(s):  
Øystein Bruserud ◽  
Helene Hersvik Aarstad ◽  
Tor Henrik Anderson Tvedt

The acute phase reaction is a systemic response to acute or chronic inflammation. The serum level of C-reactive protein (CRP) is the only acute phase biomarker widely used in routine clinical practice, including its uses for prognostics and therapy monitoring in cancer patients. Although Interleukin 6 (IL6) is a main trigger of the acute phase reactions, a series of acute phase reactants can contribute (e.g., other members in IL6 family or IL1 subfamily, and tumor necrosis factor α). However, the experience from patients receiving intensive chemotherapy for hematological malignancies has shown that, besides CRP, other biomarkers (e.g., cytokines, soluble cytokine receptors, soluble adhesion molecules) also have altered systemic levels as a part of the acute phase reaction in these immunocompromised patients. Furthermore, CRP and white blood cell counts can serve as a dual prognostic predictor in solid tumors and hematological malignancies. Recent studies also suggest that biomarker profiles as well as alternative inflammatory mediators should be further developed to optimize the predictive utility in cancer patients. Finally, the experience from allogeneic stem cell transplantation suggests that selected acute phase reactants together with specific markers of organ damages are useful for predicting or diagnosing graft versus host disease. Acute phase proteins may also be useful to identify patients (at risk of) developing severe immune-mediated toxicity after anticancer immunotherapy. To conclude, future studies of acute phase predictors in human malignancies should not only investigate the conventional inflammatory mediators (e.g., CRP, white blood cell counts) but also combinations of novel inflammatory parameters with specific markers of organ damages.


2008 ◽  
Vol 54 (1) ◽  
pp. 24-38 ◽  
Author(s):  
René R S Packard ◽  
Peter Libby

Abstract Recent investigations of atherosclerosis have focused on inflammation, providing new insight into mechanisms of disease. Inflammatory cytokines involved in vascular inflammation stimulate the generation of endothelial adhesion molecules, proteases, and other mediators, which may enter the circulation in soluble form. These primary cytokines also induce production of the messenger cytokine interleukin-6, which stimulates the liver to increase production of acute-phase reactants such as C-reactive protein. In addition, platelets and adipose tissue can generate inflammatory mediators relevant to atherothrombosis. Despite the irreplaceable utility of plasma lipid profiles in assessment of atherosclerotic risk, these profiles provide an incomplete picture. Indeed, many cardiovascular events occur in individuals with plasma cholesterol concentrations below the National Cholesterol Education Program thresholds of 200 mg/dL for total cholesterol and 130 mg/dL for low-density lipoprotein (LDL) cholesterol. The concept of the involvement of inflammation in atherosclerosis has spurred the discovery and adoption of inflammatory biomarkers for cardiovascular risk prediction. C-reactive protein is currently the best validated inflammatory biomarker; in addition, soluble CD40 ligand, adiponectin, interleukin 18, and matrix metalloproteinase 9 may provide additional information for cardiovascular risk stratification and prediction. This review retraces the biology of atherothrombosis and the evidence supporting the role of inflammatory biomarkers in predicting primary cardiovascular events in this biologic context.


2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Alejandro Sanchez ◽  
Colleen Azen ◽  
Brenda Jones ◽  
Stan Louie ◽  
Fred Sattler

Background. Tuberculosis causes inflammation and muscle wasting. We investigated how attenuation of inflammation relates to repletion of body composition during treatment in an underserved population.Design. Twenty-four patients (23 to 79 years old) with pulmonary tuberculosis and inflammation (pretreatment albumin  g/dL, C-reactive protein [CRP]  μg/dL, and beta-2-microglobulin  μg/L) were evaluated and had BIA over 24 weeks.Results. Weight increased by  kg (5.5%; ) at week 4 and by  kg (15.6%; ) at week 24. Repletion of body mass was primarily fat, which increased by  kg at week 4 and  kg at week 24 ( and versus baseline). Fat-free mass (FFM), body cell mass (BCM), and phase angle did not increase until study week 8. Albumin rose to  g/dL by week 4 () and slowly increased thereafter. CRP levels declined by~50% at each interval visit.Conclusions. During the initial treatment, acute phase reactants returned towards normal. The predominant accrual of fat mass probably reflects ongoing, low levels of inflammation.


Author(s):  
Hakan Guzel ◽  
Sahin Kahramanca ◽  
Oskay Kaya ◽  
Gulay Ozgehan ◽  
Demet Yilmazer ◽  
...  

The need and timing of surgical intervention in patients with adhesive bowel obstruction is a dilemma. We aimed to investigate the role of three acute-phase reactants, namely procalcitonin (PCT), fibrinogen and C-reactive protein (CRP) in this clinical condition We chose a rat model whose mechanical bowel obstruction was created with caecum ligation. There were two study groups and one control group. Each group contained ten subjects. The study groups had and six-hour obstruction samples. Blood PCT, fibrinogen and CRP levels were measured before and after the surgical procedure. These parameters were compared between the groups and they were also evaluated with the degree of histopathological changes occurred in terminal ileal tissue samples. Compared with the control group, PCT measurements showed a mild decrease in the early phase of obstruction but a significant elevation in the late phase (p: 0,977 and p: 0,001). Unlike PCT, fibrinogen levels increased at first but decreased later (p: 0,978 and p: 0,326). We observed an increase in CRP levels parallel to the prolonged duration of obstruction (p: 0,987 and p: 0,134). With regard to mucosal injury, PCT levels increased at first, and then decreased (p: 0,003). On the other hand, fibrinogen and CRP levels decreased at first, and then increased (p: 0,139 and p: 0,102). The acute-phase reactants PCT, fibrinogen and CRP associated with the duration of obstruction may help to determine the time of surgical intervention in patients with adhesive mechanical bowel obstruction.


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