scholarly journals Clinical and Immunopathologic Profile of Mexican Patients with IgG4 Autoimmune Pancreatitis

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
María T. Bourlon ◽  
Christianne Bourlon ◽  
Yemil Atisha-Fregoso ◽  
Fredy Chable-Montero ◽  
Marco A. Teliz ◽  
...  
Keyword(s):  
Weight Loss ◽  
Autoimmune Pancreatitis ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Serum Levels ◽  
Current Data ◽  
Histological Subtypes ◽  
Sclerosing Pancreatitis ◽  
The Mean ◽  
Mexican Patients

Autoimmune pancreatitis is part of the spectrum of IgG4-associated diseases. Its diagnostic criteria and histological subtypes have been formally proposed recently and although based on current data it has been suggested that there are differences in clinical presentation among populations, more research is needed to properly establish if this heterogeneity exists. In this paper, we describe 15 cases of autoimmune pancreatitis diagnosed at a Mexican centre of reference, all of them associated to the lymphoplasmocytic sclerosing pancreatitis variant. The mean age at the onset of symptoms was 47.5 ± 14.4 years, and 53% of patients were male. The main manifestations were weight loss (87%), obstructive jaundice (53%), and acute (27%) and chronic (27%) pancreatitis. Only 20% of patients had high IgG4 serum levels at the time of diagnosis. All patients receiving prednisone responded favourably, both in their pancreatic and extrapancreatic manifestations. Clinical manifestations of Mexican patients showed certain differences with respect to those usually reported.

The anti-thrombotic effects of vitamin D and their possible relationship with antiphospholipid syndrome

Lupus ◽  
2018 ◽  
Vol 27 (14) ◽  
pp. 2181-2189 ◽  
Author(s):  
M García-Carrasco ◽  
E A Jiménez-Herrera ◽  
J L Gálvez-Romero ◽  
C Mendoza-Pinto ◽  
S Méndez-Martínez ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Antiphospholipid Syndrome ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Serum Levels ◽  
Protective Role ◽  
Current Data ◽  
Current Evidence ◽  
Autoimmune Conditions

The importance of the immunomodulatory effects of vitamin D has recently been associated with autoimmune and chronic inflammatory diseases. Vitamin D deficiency has been linked to the development of autoimmune conditions. Antiphospholipid syndrome is an autoimmune disease characterized by thrombotic events and obstetric complications in patients with antiphospholipid antibodies. Current data show that patients with antiphospholipid syndrome have a high prevalence of vitamin D deficiency even without classic risk factors. Several studies have suggested vitamin D may have anti-thrombotic functions. In antiphospholipid syndrome, low vitamin D serum levels have been associated with thrombotic manifestations, suggesting a possible protective role of vitamin D in antiphospholipid syndrome. This literature review presents current evidence on the haemostatic functions of vitamin D and their possible relationship with the clinical manifestations of antiphospholipid syndrome.

Relative value of serum cytokines and clinical factors in predicting weight loss in advanced pancreatic cancer (PC).

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 208-208
Author(s):  
D. R. Fogelman ◽  
X. S. Wang ◽  
M. Hassan ◽  
D. Li ◽  
M. M. Javle ◽  
...  
Keyword(s):  
Weight Loss ◽  
High Risk ◽  
Clinical Symptoms ◽  
Advanced Pancreatic Cancer ◽  
Serum Levels ◽  
Baseline Serum ◽  
Mean Values ◽  
Cytokine Analysis ◽  
Predict Weight Loss ◽  
The Mean

208 Background: The identification of PC patients at high risk for cachexia may allow for early intervention to prevent this outcome. Symptoms such as pain, nausea, and anorexia might predict weight loss. Likewise, inflammatory cytokines are also associated with cachexia. We evaluated the ability of each to predict weight loss in patients beginning treatment for PC. Methods: We evaluated 44 newly diagnosed advanced or metastatic PC patients for baseline symptomatology via the M. D. Anderson Symptom Inventory (MDASI). This survey assesses symptom severity, such as nausea, vomiting, fatigue, pain, diarrhea, and constipation, on a 1-10 scale. Baseline serum levels of IL-1a, IL-1b, IGF-1, CXCL-12, CXCL-16, CRP, IL-6, IL-8, VEGF, CEA, and CA 19-9 were assessed. Logistic regression analysis was performed to determine the odds ratio (OR) and confidence interval (CI) for the association of different parameters with 10% weight loss at 60 days from treatment initiation. Student t-test was used to compare the mean values across different strata. Results: A weight loss of >10% was observed in 15 patients (34%). Only the use of mild (but not strong) opioids was associated with weight loss; estimated OR = 6.2 (C.I. 1.2-31.9, p=.03). No association was observed for the MDASI parameters. Baseline levels of cytokines were available for 23 patients. We observed significant differences in the mean values of CXCL-16 (p=.05) and IL-6 (p=.045) in patients with weight loss as compared to those without weight loss. Moreover, serum level of erythropoietin may be negatively associated with weight loss (p=0.06). Conclusions: Alterations in serum cytokine levels may correlate more strongly with cachexia than clinical symptoms and underscore the importance of cytokine analysis in identifying PC patients at high risk for cachexia. [Table: see text]

scholarly journals Hen’s egg allergy: an update

2018 ◽  
Vol 17 (2) ◽  
pp. 156-166
Author(s):  
M. M. Fedotova ◽  
O. S. Fedorova ◽  
U. V. Konovalova ◽  
E. M. Kamaltynova ◽  
T. A. Nagaeva ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Binding Capacity ◽  
Clinical Manifestations ◽  
Cross Reactivity ◽  
Current Data ◽  
Egg Allergy ◽  
Ige Binding ◽  
Hen’S Egg ◽  
Allergenic Proteins ◽  
Common Problems

Hen’s egg allergy is one of the most common problems in pediatrics. This pathology is associated with severe clinical manifestations, often with a risk of anaphylactic reactions. This review presents current data on the epidemiology and clinical presentation, as well as aspects of the natural history and management of hen’s egg allergy. The paper will provide data on allergenic proteins of hen’s egg, including data on structure, physicochemical properties, IgE-binding capacity, and cross-reactivity. Finally, practical information about egg allergy and immunization will be presented.

scholarly journals HMGB1, NLRP3, IL-6 and ACE2 Levels Are Elevated in COVID-19 with Headache: A Window to the Infection-Related Headache Mechanism

2021 ◽  
Author(s):  
Hayrunnisa Bolay ◽  
Ömer Karadaş ◽  
Bilgin Öztürk ◽  
Rıza Sonkaya ◽  
Bahar Taşdelen ◽  
...  
Keyword(s):  
Weight Loss ◽  
Angiotensin Ii ◽  
Serum Levels ◽  
Pulmonary Involvement ◽  
Sectional Study ◽  
Trigeminal Neurons ◽  
Moderate Disease ◽  
The Mean ◽  
Second Wave ◽  
D Dimer

Abstract BACKGROUND AND AIM: Pathogenesis of COVID-19 -related headache is unknown, though the induction ofthe trigeminal neurons throughinflammation is proposed. Weaimed to investigatekey systemic circulating inflammatory moleculesand their clinical relations in COVID-19 patients with headache. METHODS: Thiscross-sectional study enrolled 88COVID-19 patients,hospitalized on a regular ward during the second wave of the pandemic.Clinical characteristics of COVID-19 patients were recorded,and laboratory testswere studied.RESULTS: The mean agesof 48 COVID-19 patients with headache (47.71±10.8) and 40 COVID-19 patients without headache (45.70±12.72) were comparable. COVID-19 patients suffered from headache had significantly higher serum levels of HMGB1, NLRP3, ACE2, and IL-6 than COVID-19 patients without headache, whereasCGRP and IL-10 levels were similar in the groups. Angiotensin II level was significantly decreased in the headache group.COVID-19 patients with headache showedan increased frequency of pulmonary involvement and increased D- dimer levels. Furthermore, COVID-19 was more frequently associated with weight loss, nausea, and diarrhea in patients with headache. The frequency of anosmia and ageusia did not reach significant levelsbetween the two groups. Serum NLRP3 levels were correlated with headache duration and hospital stay, while headache response to paracetamol was negatively correlated with HMGB1 and positively associated with IL-10 levels. CONCLUSION: Stronger inflammatory response is associated with headache in hospitalized COVID-19 patients with moderate disease severity.Increased levels of the circulating inflammatory and/or nociceptive molecules like HMGB1, NLRP3, and IL-6 may play a role in the potential induction of the trigeminalsystem and manifestation of headache secondary to SARS-CoV-2 infection.

scholarly journals THE ONSET OF CLINICAL MANIFESTATIONS IN INFLAMMATORY BOWEL DISEASE PATIENTS

2018 ◽  
Vol 55 (3) ◽  
pp. 290-295
Author(s):  
Viviane Gomes NÓBREGA ◽  
Isaac Neri de Novais SILVA ◽  
Beatriz Silva BRITO ◽  
Juliana SILVA ◽  
Maria Carolina Martins da SILVA ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Weight Loss ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Clinical Manifestations ◽  
Inflammatory Bowel ◽  
The Mean ◽  
Mean Time

ABSTRACT BACKGROUND: The diagnosis of inflammatory bowel disease is often delayed because of the lack of an ability to recognize its major clinical manifestations. OBJECTIVE: Our study aimed to describe the onset of clinical manifestations in inflammatory bowel disease patients. METHODS: A cross-sectional study. Investigators obtained data from interviews and the medical records of inflammatory bowel disease patients from a reference centre located in Brazil. RESULTS: A total of 306 patients were included. The mean time between onset of symptoms and diagnosis was 28 months for Crohn’s disease and 19 months for ulcerative colitis. The main clinical manifestations in Crohn’s disease patients were weight loss, abdominal pain, diarrhoea and asthenia. The most relevant symptoms in ulcerative colitis patients were blood in the stool, faecal urgency, diarrhoea, mucus in the stool, weight loss, abdominal pain and asthenia. It was observed that weight loss, abdominal pain and distension, asthenia, appetite loss, anaemia, insomnia, fever, nausea, perianal disease, extraintestinal manifestation, oral thrush, vomiting and abdominal mass were more frequent in Crohn’s patients than in ulcerative colitis patients. The frequencies of urgency, faecal incontinence, faeces with mucus and blood, tenesmus and constipation were higher in ulcerative colitis patients than in Crohn’s disease patients. The mean time from the onset of clinical symptoms to the diagnosis of Crohn’s disease was 37 months for patients with ileocolonic location, 26 months for patients with ileum location and 18 months for patients with colon location. In ulcerative colitis patients, the mean time from the onset of symptoms to diagnosis was 52 months for proctitis, 12 months for left-sided colitis and 12 months for extensive colitis. CONCLUSION: Ulcerative colitis presented a high frequency of intestinal symptoms, and Crohn’s disease showed a high frequency of systemic manifestations at the onset of manifestation. There was a long delay in diagnosis, but individuals with more extensive disease and more obvious symptoms showed a shorter delay.

scholarly journals A Case Report of Prurigo Nodularis-Like Lesions in a Patient with Lepromatous Leprosy

2020 ◽  
Vol 12 (3) ◽  
pp. 236-240
Author(s):  
Siwanon Nawalerspanya ◽  
Siripan Sangmala ◽  
Kumpol Aiempanakit
Keyword(s):  
Case Report ◽  
Peripheral Nerves ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Lepromatous Leprosy ◽  
Histological Subtypes ◽  
Prurigo Nodularis ◽  
Biopsy Specimens ◽  
Variant Pattern ◽  
Erythematous Plaques

Leprosy or Hansen’s disease is a chronic granulomatous infection that primarily affects the peripheral nerves and, consequently, the skin. Clinical manifestations vary from hypopigmentation to erythematous plaques, and it can present with leonine facies. We report a case of a patient with an uncommon clinical presentation of prurigo nodularis-like lesions without loss of sensation, for which two biopsy specimens demonstrated different histological subtypes. The first was the classic histology of lepromatous leprosy, whereas the other specimen revealed an atypical histoid leprosy variant pattern. This case report describes a patient with an atypical presentation of leprosy.

scholarly journals Experience in the Approach to Insulinoma: A Case Series

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Ángela María Victoria ◽  
Karen Daniela Cándelo ◽  
Pedro Tomás Argüello ◽  
Karen Milena Fériz ◽  
Luz Ángela Casas ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Case Series ◽  
Signs And Symptoms ◽  
Serum Levels ◽  
Lesion Size ◽  
Current Data ◽  
Common Symptom ◽  
C Peptide ◽  
Low Incidence ◽  
Clinical And Pathological Features

Introduction: Insulinomas are rare pancreatic neuroendocrine tumors derived from beta cells responsible for insulin secretion. These tumors are typically manifested by hypoglycemia signs and symptoms, which might be non-specific leading to a delay in the diagnosis. The present study describes the experience in the approach of patients with insulinoma at Fundación Valle del Lili, Cali, Colombia.Case Presentation: A retrospective search of patients with the diagnosis of insulinoma within the database of the pathology service was performed between March 2002 and February 2017. Parameters such as the lesion size and localization, the immunohistochemistry findings, the serum levels of glucose, the insulin and C-peptide levels, the presence of metastasis, and the development of diabetes after surgery were evaluated. A total of nine patients with a diagnosis of insulinoma were enrolled in the study. The cohort comprised of seven men and two women, aged 30–50 years. Whipple triad was present in seven patients. The most common symptom was hypoglycemia-related syncope. All patients underwent surgical resection of the tumor with subsequent resolution of the symptoms. Only one patient was diagnosed with diabetes in the postoperative period.Conclusion: In the last 15 years, only nine cases of insulinoma were detected at the Fundación Valle del Lili, which is consistent with the low incidence of the disease. A higher frequency of the disease is noted in men, unlike that in the literature. However, other clinical and pathological features from large studies are in agreement with the current data. Nevertheless, continual experience in the management and identification of these cases is essential as common clinical manifestations may not be observed.

scholarly journals From Pathogenesis, Clinical Manifestation, and Diagnosis to Treatment: An Overview on Autoimmune Pancreatitis

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Ou Cai ◽  
Shiyun Tan
Keyword(s):  
Autoimmune Pancreatitis ◽  
Clinical Manifestations ◽  
Type I ◽  
International Consensus ◽  
Glucocorticoid Treatment ◽  
Immunoglobulin G4 ◽  
Lymphoplasmacytic Sclerosing Pancreatitis ◽  
Serum Igg4 ◽  
Sclerosing Pancreatitis ◽  
Upper Abdominal

Autoimmune pancreatitis (AIP) is a special type of chronic pancreatitis which is autoimmune mediated. The international consensus diagnostic criteria (ICDC) 2011 proposed two types of AIP: type I is associated with histological pattern of lymphoplasmacytic sclerosing pancreatitis (LPSP), characterized by serum IgG4 elevation, whereas type 2 is named idiopathic duct-centric pancreatitis (IDCP), with granulocytic epithelial lesion (GEL) and immunoglobulin G4 (IgG4) negative. The pathogenic mechanism is unclear now; based on genetic factors, disease specific or related antigens, innate and adaptive immunity may be involved. The most common clinical manifestations of AIP are obstructive jaundice and upper abdominal pain. The diagnosis can be made by a combination of parenchymal and ductal imaging, serum IgG4 concentrations, pancreatic histology, extrapancreatic disease, and glucocorticoid responsiveness according to ICDC 2011. Because of the clinical and imaging similarities with pancreatic cancer, general work-up should be done carefully to exclude pancreatic malignant tumor before empirical trial of glucocorticoid treatment. Glucocorticoid is the most common drug for AIP to induce remission, while there still exists controversy on steroid maintenance and treatment for relapse. Further studies should be done to identify more specific serum biomarkers for AIP, the pathogenic mechanisms, and the treatment for relapse.

Vitamin B12 Status among Healthy Indian Population: A Review

2019 ◽  
Vol 56 (2) ◽  
pp. 197
Author(s):  
Anku Malik ◽  
Geeta Trilok Kumar
Keyword(s):  
Selection Criteria ◽  
Indian Population ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Serum Levels ◽  
Current Data ◽  
Water Soluble ◽  
Health Concern ◽  
Vitamin B ◽  
Laboratory Techniques

Vitamin B<sub>12</sub> is a water-soluble micronutrient found in animal foods. Its deficiency is not uncommon in India owing to vegetarianism but often unrecognized due to diverse clinical manifestations, involving hematologic and behavioral and neurologic deterioration. The present review is to collate the current data on vitamin B<sub>12</sub>status among healthy Indian population. A total of 620 studies were identified using PubMed, out of which 40 studies that matched the selection criteria, were shortlisted and reviewed. The results highlight inadequate vitamin B<sub>12</sub> status in most age groups, with the prevalence of deficiency reaching 100%, 78.5%, 61.7% and 75.4% in infants, children and adolescents, adults, elderly and pregnant women, respectively based on varying cut offs. However, due to variation in the biomarkers and cutoffs used for defining clinical and sub-clinical vitamin B<sub>12</sub> deficiency and varied laboratory techniques used for analysis, direct comparison of the prevalence of deficiency in the studied population is difficult. Nevertheless, this review highlights that vitamin B<sub>12</sub> deficiency is an emerging public health concern that requires further research involving dietary intake of vitamin B<sub>12</sub> and serum levels in population groups in India to understand many aspects of vitamin B<sub>12</sub> absorption, bioavailability and metabolism.

scholarly journals A Reappraisal of Clinical Characteristics of Typhoid Fever

2012 ◽  
Vol 34 (3) ◽  
pp. 80-85 ◽  
Author(s):  
ABM Shahidul Alam ◽  
Sanjana Zaman ◽  
Farhana Chaiti ◽  
Naveen Sheikh ◽  
Gopen Kumar Kundu
Keyword(s):  
Typhoid Fever ◽  
Clinical Presentation ◽  
Current Knowledge ◽  
Clinical Manifestations ◽  
Health Resources ◽  
Signs And Symptoms ◽  
Salmonella Typhi ◽  
Widal Test ◽  
Missed Diagnosis ◽  
The Mean

Background: Recent reports from developing countries show that the clinical presentation, diagnosis and treatment of typhoid have significantly altered often leading to missed diagnosis. The incidence of complications is also reported to be variable. The consequence of missed diagnosis is immense in terms of burden on limited health resources and patients’ suffering. Therefore, its clinical spectrum requires constant reappraisal to update our physicians with current knowledge. This study was carried out to determine the changes in clinical pattern of typhoid fever. Patients & Methods: A total of 106 children, aged up to 14 years, diagnosed primarily as typhoid fever, were included as study population. The diagnostic criteria were either positive blood culture for Salmonella typhi or Salmonella paratyphi or at least a four-fold rise in antibody titre on Widal test. The study included mode of clinical presentations, treatment received before admission, Widal test findings and culture and sensitivity to antibiotics. Results: The mean age of the patients was 5.2 years and males were a little than the females. The mean duration of illness was 11.2±3.3 days. Majority of the patients presented with classical signs and symptoms like step ladder pattern of fever (nearly 70%) coated tongue (69.8%), diarrhoea (49.1%), toxemia (68.9%), relative leucopenia (71.7%), hepatomegaly (55.7%), pain in the right hypochondrium (41.5%) and splennomegaly (18.9%). Very few cases had a typical manifestations. Over 85% of the patients had raised SGPT (>40 IU/L) and 13.8% had detectable jaundice (serum billirubin >3 mg/dl). Widal test demonstrated that about 45% of the patients’ ‘O’ antibody titer increased to 4-fold, 27.4% to 8-fold or more. In case of antibody ‘H’, 35.8% exhibited 4-fold and 39.7% 8-fold or more increase. Of the 103 cases, 68(66%) were positive for Salmonella typhi. Majority of the isolated organisms was sensitive to cefixime, ceftriaxone and gentamycin (83%, 84% and 82% respectively). The second line of sensitivity was obtained to amikacin (64.2%), meropenem (50%), ciprofloxacin (46.2%), imepenem (46.2%) and azithromycin (43.4%). The least sensitive drugs were amoxicillin (28.3%), cotrimoxazole (27.4%) and chloramphenicol (22.6%). Onethird (33.8%) of the patients had multidrug resistant (MDR) strains. However, No significant association was found between multi-drug resistant (MDR) strains and atypical clinical manifestations. Conclusion: Clinical presentation of most typhoid fever still conforms with the classic pattern. High fever, anorexia, coated tongue, diarrhoea, relative leucopenia and hepatosplenomegaly are still common manifestations of typhoid fever. So, majority of the patients could be treated blindly based on clinical diagnosis. However, treatment should be given with first line of drugs like cefexime or ceftriaxone. DOI: http://dx.doi.org/10.3357/bjch.v34i3.10357 BJCH 2010; 34(3): 80-85

Sign in / Sign up

Export Citation Format

Share Document