Vasculitis involving the skin

Here we summarize vasculitides involving the skin. Among cutaneous vasculitides there are three major groups, one is a systemic vasculitis with cutaneous involvement, another a systemic vasculitis with skin limited appearance, and the last group is a single organ vasculitis, that only affects the skin. We summarize the importance of the proper diagnosis in this heterogeneous group based on both clinical and histopathologic examinations, and present information on the complex underlying pathology

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Isolated intestinal polyarteritis nodosa in an elderly patient

BMJ Case Reports ◽

10.1136/bcr-2020-241431 ◽

2021 ◽

Vol 14 (3) ◽

pp. e241431

Author(s):

Ariana González-Meléndez ◽

Eduardo J Medina-Parrilla ◽

Román Vélez ◽

Luis M Vilá

Keyword(s):

Abdominal Pain ◽

Polyarteritis Nodosa ◽

Elderly Population ◽

Systemic Vasculitis ◽

Exploratory Laparotomy ◽

The Elderly ◽

High Dose ◽

Systemic Involvement ◽

Intestinal Pseudo Obstruction ◽

Single Organ

Polyarteritis nodosa (PAN) is a necrotising systemic vasculitis involving medium-sized and small-sized vessels. PAN limited to a single organ is rare, particularly in the elderly population. Herein, we present a 73-year-old-woman who developed severe abdominal pain. Mesenteric angiography showed multifocal areas of segmental dilation and narrowing of the superior mesenteric, ileocolic and right colonic arteries. Exploratory laparotomy revealed multiple areas of necrosis of the jejunum for which resection was performed. Histopathological exam disclosed mesenteric vasculitis with fibrinoid necrosis of the arterial wall with leucocytic infiltrates and haemorrhages consistent with PAN. She was started on high-dose corticosteroids with an initial good response. However, 6 months later, she developed intestinal pseudo-obstruction for which oral cyclophosphamide was started. After 5 months of cyclophosphamide therapy, she remained stable without further relapses. Our case suggests that PAN should be considered in elderly patients presenting with abdominal pain even in the absence of systemic involvement.

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Gastrointestinal symptoms as first remarkable signs of ANCA-associated granulomatosis with polyangiitis: a case report and reviews

BMC Gastroenterology ◽

10.1186/s12876-021-01730-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nóra Ledó ◽

Ákos Géza Pethő

Keyword(s):

Gastrointestinal Bleeding ◽

Granulomatosis With Polyangiitis ◽

Systemic Vasculitis ◽

Case Reports ◽

Gastrointestinal Symptoms ◽

Case Presentation ◽

Life Threatening ◽

Proper Diagnosis ◽

Duodenal Bleeding ◽

Inflammatory Bowel

Abstract Background Systemic vasculitis associated with antineutrophil cytoplasmic autoantibodies (ANCA) have an extremely wide variety of symptoms, therefore the fast and proper diagnosis is difficult to establish even for experienced physicians. Gastrointestinal manifestations in ANCA-associated granulomatosis with polyangiitis (GPA) may be present, however, severe, life-threatening complications (such as perforations) are rare. Case presentation A case of an 18-year-old male patient is presented, where gastrointestinal symptoms (abdominal pain, vomiting, diarrhoea) were the first remarkable signs of GPA. The initial diagnosis of inflammatory bowel disease delayed the administration of proper immunosuppressive therapy, which might have contributed to the rare and life-threatening complication of arterial duodenal bleeding with perforation. Our systematic review of the literature found only a few case reports where gastrointestinal symptoms were the first signs of GPA, however, this entity might be more frequent if physicians would think of this possibility more often. Conclusions Gastrointestinal bleeding is a rare but potential lethal complication of vasculitis. Consequently, we recommend investigating the patients diagnosed with GPA for gastrointestinal bleeding during the treatment.

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Bilateral Facial Palsy in Rapidly Progressive Course of Wegener’s Granulomatosis: A Case Report

Case Reports in Otolaryngology ◽

10.1155/2013/875108 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Anna Roszkowska ◽

Monika Morawska-Kochman ◽

Hanna Temporale ◽

Małgorzata Sikorska-Żuk ◽

Tomasz Kręcicki

Keyword(s):

Facial Nerve ◽

Wegener’S Granulomatosis ◽

Systemic Vasculitis ◽

Neck Region ◽

Wegener's Granulomatosis ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Head And Neck Region ◽

Proper Diagnosis ◽

Surgical Treatments

Introduction. Wegener’s granulomatosis belongs to a group of systemic vasculitis diseases, which is characterized by necrotizing vasculitis and presence of granulomas. In a lot of cases, the first symptoms of the disease are observed in the head and neck region, but the bilateral facial nerve palsy occurs very rarely.Objective. The objective of our report was to describe the unusual course of Wegener’s granulomatosis with the bilateral facial nerve paralysis, which subsided after application of steroids and immunosuppressive therapy in combination with surgical treatment.Results and Conclusions. Hearing loss may precede other symptoms in Wegener’s granulomatosis. Ear pain and otorrhea may suggest the diagnosis of bacterial purulent otitis media and delay the proper diagnosis. In the presented case, considering the clinical course, it was necessary to apply both pharmacological and surgical treatments.

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Single-organ gallbladder vasculitis: Characterization and distinction from systemic vasculitis involving the gallbladder. An analysis of 57 patients

La Presse Médicale ◽

10.1016/j.lpm.2013.02.209 ◽

2013 ◽

Vol 42 (4) ◽

pp. 740

Author(s):

J. Hernández-Rodríguez ◽

C.D. Tan ◽

E.R. Rodríguez ◽

G.S. Hoffman

Keyword(s):

Systemic Vasculitis ◽

Single Organ

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Systemic vasculitis with cutaneous involvement, in the Department of Dermatology, Faculty of Medical Sciences, National University of Asuncion

Anales de la Facultad de Ciencias Médicas (Asunción) ◽

10.18004/anales/2017.050(02)23-034 ◽

2017 ◽

Vol 50 (2) ◽

pp. 23-34

Author(s):

Lorena Re M ◽

Beatriz Di Martino ◽

M Rodríguez Mais ◽

L Bolla

Keyword(s):

Systemic Vasculitis ◽

Medical Sciences ◽

Cutaneous Involvement ◽

National University

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The Potentials of Scanning Microscopy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100101505 ◽

1968 ◽

Vol 26 ◽

pp. 352-353

Author(s):

A. V. Crewe

Keyword(s):

Salient Feature ◽

Secondary Emission ◽

Resolving Power ◽

X Rays ◽

Scanning Microscope ◽

Forming Process ◽

Additional Tool ◽

Detection Systems ◽

Conventional Microscope ◽

Present Information

If the resolving power of a scanning electron microscope can be improved until it is comparable to that of a conventional microscope, it would serve as a valuable additional tool in many investigations.The salient feature of scanning microscopes is that the image-forming process takes place before the electrons strike the specimen. This means that several different detection systems can be employed in order to present information about the specimen. In our own particular work we have concentrated on the use of energy loss information in the beam which is transmitted through the specimen, but there are also numerous other possibilities (such as secondary emission, generation of X-rays, and cathode luminescence).Another difference between the pictures one would obtain from the scanning microscope and those obtained from a conventional microscope is that the diffraction phenomena are totally different. The only diffraction phenomena which would be seen in the scanning microscope are those which exist in the beam itself, and not those produced by the specimen.

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Fine Structure of Type IV Glycogenosis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100098812 ◽

1981 ◽

Vol 39 ◽

pp. 464-465

Author(s):

P.K. Simons

Keyword(s):

Needle Biopsy ◽

Tissue Concentration ◽

Inborn Errors ◽

Rare Type ◽

Type Iv ◽

Iron Copper ◽

Proper Diagnosis ◽

Type Iv Glycogenosis ◽

Loss Of Appetite ◽

Enzymatic Defect

Glycogenosis is defined as any condition in which the tissue concentration of glycogen is increased. There are currently ten recognized variants of glycogenosis that are heritable inborn errors of metabolism. The specific enzymatic defect in each of the variants is known or at least suspected. In all cases, the enzymatic defect prevents the proper metabolism or formation of the glycogen molecule. The clinical and histologic differences between the types of glycogenosis is important to a proper diagnosis after the presence of such a condition is realized. This study was initiated to examine the ultrastructure of the rare Type IV Glycogenosis (Amylopectinosis) of which there is very little morphologic characterization in the literature.Liver tissue was obtained by needle biopsy from a 12-month-old Oriental female who was originally admitted to the hospital after observation of poor development, loss of appetite, and hepatomegaly. The majority of the tissue was fixed for light microscopy in neutral buffered formalin and processed using routine and special staining procedures (reticulin, trichrome, iron, copper, PAS, PAS-diastase and PAS-pectinase.

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Quick Reference: Chapter 1: The Musculoskeletal System: The Hand and Upper Extremity

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2000.sepoct03 ◽

2000 ◽

Vol 5 (5) ◽

pp. 4-5

Keyword(s):

Dorsal Column ◽

Persistent Pain ◽

Illness Behavior ◽

Abnormal Illness Behavior ◽

Organ Systems ◽

Spinal Cord Dorsal ◽

Objective Basis ◽

Dorsal Column Stimulation ◽

Underlying Pathology

Abstract Spinal cord (dorsal column) stimulation (SCS) and intraspinal opioids (ISO) are treatments for patients in whom abnormal illness behavior is absent but who have an objective basis for severe, persistent pain that has not been adequately relieved by other interventions. Usually, physicians prescribe these treatments in cancer pain or noncancer-related neuropathic pain settings. A survey of academic centers showed that 87% of responding centers use SCS and 84% use ISO. These treatments are performed frequently in nonacademic settings, so evaluators likely will encounter patients who were treated with SCS and ISO. Does SCS or ISO change the impairment associated with the underlying conditions for which these treatments are performed? Although the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) does not specifically address this question, the answer follows directly from the principles on which the AMA Guides impairment rating methodology is based. Specifically, “the impairment percents shown in the chapters that consider the various organ systems make allowance for the pain that may accompany the impairing condition.” Thus, impairment is neither increased due to persistent pain nor is it decreased in the absence of pain. In summary, in the absence of complications, the evaluator should rate the underlying pathology or injury without making an adjustment in the impairment for SCS or ISO.

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