Thrombotic Microangiopathies with Rheumatologic Involvement
Thrombotic microangiopathies are heterogeneous disorders characterized by microangiopathic hemolytic anemia with thrombocytopenia and renal injury. There are a variety of causes, including metabolic disorders, infections, medications, complement disorders, pregnancy, malignancy, and autoimmune disorders. This review focuses on renal thrombotic microangiopathy in the setting of rheumatologic diseases. Systemic lupus erythematosus is the most common autoimmune disease associated with thrombotic microangiopathy. Other etiologies include scleroderma renal crisis and antiphospholipid antibody syndrome, which can be primary or secondary to autoimmune diseases including systemic lupus erythematosus. There have also been case reports of thrombotic microangiopathy in the setting of rheumatoid arthritis and dermatomyositis.
Publication date: Available online 29 February 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Jing Xiao, Kristi Fu, Kristina Duan, Junling Wang, Sowmya Sunkara, Xiaoming Guan
Publication date: Available online 2 April 2020Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Gabriele Saccone, Floriana Carbone, Fulvio Zullo
CONCLUSION: Rates of perinatal complications in our series are more reassuring than the ubiquitously quoted rates from small and dated studies. The diagnosis of primary hyperparathyroidism may be easily missed during pregnancy, owing to its non-specific presentation. A high index of suspicion and measurement of ionized calcium levels is encouraged, especially for patients with excessive nausea and vomiting, nephrolithiasis, atypical presentations of hypertensive disorders, or isolated polyhydramnios. Mild degrees of calcium derangement do not preclude adverse perinatal outcomes. Surgery appears to be safe, even in the thir...
Publication date: Available online 2 April 2020Source: Trends in Endocrinology &MetabolismAuthor(s): Jeremy Gingrich, Elvis Ticiani, Almudena Veiga-Lopez
CONCLUSION: The timing of treatment for gallstone disease is an essential determinant of therapeutic success. PMID: 32234195 [PubMed - in process]
DISCUSSION: Our case highlights how DIL should be on the differential when seemingly disparate symptoms develop in a patient receiving DIL-associated medications. Lupus is one of the "great imitators," in which symptoms can be ascribed to many different underlying causes. Although this patient's presentation may have been confounded by concomitant histoplasmosis, his improvement with cessation of hydralazine treatment argues in favor of DIL. His continued atypical serologic test results could be residual from his DIL and should normalize with time. However, it raises the question whether this bout of DIL has unma...
Publication date: Available online 3 April 2020Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Joel P. Brooks, Cristine Radojicic, Marc A. Riedl, Scott D. Newcomer, Aleena Banerji, F. Ida Hsu
Authors: Köklü H, Üstün H, Köklü S PMID: 32233283 [PubMed - in process]
Conclusions: Collagenous gastritis in children is mainly characterized by symptoms of anaemia, abdominal pain or diarrhea. Gastroscopy with fundic biopsies helps to confirm diagnosis and treatment with PPI's (associated with oral iron supplement in case of anaemia) seems to be the most efficient choice to achieve clinical and sometimes histological remission. Long-term outcome of these young patients is unknown. A better understanding of the pathogenesis could lead to new medications focusing on this histological remission. PMID: 32233270 [PubMed - in process]