CHMP recommends approval of rituximab (MabThera®) for granulomatosis with polyangiitis (Wegener's) and microscopic polyangiitis
Source: European Medicines Agency Area: News The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has recommended the approval of a new indication for rituximab (MabThera®) - for use in combination with glucocorticoids, for the induction of remission in adult patients with severe, active Granulomatosis with polyangiitis (Wegener's) (GPA) and Microscopic polyangiitis (MPA). Detailed recommendations for the use of this product will be described in the updated summary of product characteristics (SmPC), which will be published in the revised European public assessment report (EPAR) after the variation to the marketing authorisation has been granted by the European Commission.
Conditions: ANCA Associated Vasculitis; Microscopic Polyangiitis; Churg-Strauss Syndrome; Wegener Granulomatosis Interventions: Drug: Hydroxychloroquine; Drug: Placebo Sponsors: Guy's and St Thomas' NHS Foundation Trust; Medical Research Council Not yet recruiting
Authors: Chandrashekhara SH, Ojha V, Raju SN, Kumar S PMID: 32186466 [PubMed - as supplied by publisher]
An 86-year-old man was evaluated complaining a painful lesion situated in the tongue with 45-day duration. Medical history revealed anemia, heart disease, vasculitis, and glomerulitis associated with the previous diagnosis of Wegener granulomatosis. Positive reaction for antineutrophil cytoplasmic autoantibodies (ANCA) was reported. Intraoral examination revealed an asymptomatic ulceration on the dorsum of the tongue surrounded by a whitish area that measures its 2.0 × 1.0 cm in its largest diameters.
Paracoccidioidomycosis (PCM) is a systemic mycosis whose etiologic agent is the thermodimorphic fungus of the genus Paracoccidioides. Differential diagnosis may include oral squamous cell carcinoma (SCC), tuberculosis, histoplasmosis, and Wegener granulomatosis. A 45-year-old male patient was attended in an oral medicine service with complaint of "infection of the tongue." Intraoral examination found deep ulcer of granulomatous bed with raised edges and hard palpation in the lateral tongue and mouth floor with 2 months of evolution.
Publication date: Available online 4 December 2019Source: Journal of Cardiology CasesAuthor(s): Davit Saghabalyan, Dirk Schiller, Sven LerchAbstractGranulomatosis with polyangiitis is a rare systemic inflammatory disorder mainly affecting the small vessels. Cardiac involvement is rare, conduction delay being the most rare one. This case reports on a middle-aged male patient with heart failure symptoms due to a 1st degree atrioventricular block with a marked PR prolongation of 480 ms on electrocardiography (ECG). Because of heart failure symptoms as well as elevated N-terminal pro-B-type natriuretic peptide and no othe...
PMID: 31804881 [PubMed - in process]
This article highlights the challenges to early-stage diagnosis of initial multiple gingival enlargements because histologic biopsies are often nonspecific and histology alone may not be sufficient to make a correct diagnosis of GPA from gingival specimens. Because strawberry gingivitis may be the first manifestation of GPA, awareness of it should be increased so that it can be diagnosed by its unique clinical appearance and additional related diagnostic parameters even if the histologic gingival findings are nonspecific.
Conclusions: Examination of surgical material ensures verification of the diagnosis, determination of MDR/XDR MBT and lung cells, creates conditions for adequate chemotherapy. All of these proves the necessity of surgical treatment for lung tuberulomas.
ConclusionsIdiopathic granulomatous hypophysitis, a rare inflammatory disease of the pituitary gland, is a diagnosis of exclusion for which both medical and surgical management are reported in the literature. We present a case of idiopathic granulomatous hypophysitis who was symptom free with no complications of hypopituitarism following its transsphenoidal resection after 9 months of follow-up.