Dipeptidyl peptidase-4 inhibitor-associated bullous pemphigoid, likely triggered by scabies, in a hemodialysis patient with human leukocyte antigen-DQB1*03:01

AbstractBullous pemphigoid (BP) is the most common autoimmune subepidermal bullous diseases. Autoantibodies against hemidesmosomal adhesion proteins might be involved in the developing process. BP usually affects the elderly with high mortality whereas the drug-induced BP is often improved and rarely relapses after the withdrawal of the suspected drug. An accumulated evidence suggests that dipeptidyl peptidase-4 inhibitor (DPP-4I), which has been widely used as the antidiabetic drug improves glycemic control with little risk for hypoglycemia, could be an inducer of DPP-4I-associated BP (DPP-4I-BP). While the precise mechanism remains unclear, a unique immunological profile with human leukocyte antigen (HLA)-DQB1*03:01 could be a biomarker of genetic susceptibility to DPP-4I-BP. Here, we encountered an interesting case of DPP-4I-BP with HLA-DQB1*03:01, which was likely triggered by scabies. A 56-year-old Japanese male with type 2 diabetes on hemodialysis was referred to our hospital due to worsened blisters. Prior to his admission, he had been on linagliptin, a DPP-4I, for 5  months. He then suffered from scabies 2 weeks before his admission while the treatment with ivermectin failed to improve his symptom. Based on his clinical symptom, positive for anti-BP180 autoantibody in serum, and the pathological alterations of skin biopsy specimens, he was diagnosed with DPP- 4I-BP. Importantly, he also carried an HLA-DQB1*03:01 allele. Oral prednisolone was subsequently adm...
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research

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We present a case of a 51 ‐year‐old Japanese woman diagnosed with eosinophilic granulomatous polyangiitis (EGPA), a rare vasculitis that can occur in patients with eosinophilia and history of asthma, allergic rhinitis, and sinusitis, with immunoglobulin (Ig) G4 hypergammaglobulinaemia and salivary gland swelling. AbstractA 51 ‐year‐old woman was admitted to our hospital for cough, fever, purpura in the legs, and salivary gland swelling. Six years ago, she had been diagnosed with bronchial asthma and was treated with a combination of inhaled corticosteroid and long‐acting beta2‐agonist. Blood examination showed ...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research
Purpose: To assess the benefits and risks of co-administering maintenance prednisolone with docetaxel and androgen-deprivation therapy (ADT) in hormone sensitive metastatic prostate cancer (HSMPC).
Source: Clinical Oncology - Category: Radiology Authors: Source Type: research
Authors: Gökaslan S, Demirbaş H, Özer Gökaslan Ç Abstract BACKGROUND/AIM: Multiple sclerosis (MS) is an autoimmune disease characterized by neurodegeneration or demyelination, and the relapsing?remitting phase of MS is characterized by acute exacerbation of disease activity. The most commonly used non-invasive approach to assess autonomic function is the determination of heart rate turbulence (HRT) and heart rate variability (HRV). The aim of this study was to evaluate the presence of cardiovascular autonomic dysfunction using HRT and HRV parameters determined via 24-hour Holter ECG monitorin...
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
Authors: Mumcu G, Alibaz Öner F, Ergun SAT, Direskeneli RH Abstract Behcet's disease (BD) is a systemic and inflammatory disorder mainly present along the ancient Silk Road, from Mediterranean Sea to East Asia. A wide range of prevalence figures (0.1-420/100.000) are reported for BD, also among Turkish populations of similar genetic background living in different countries. Recently, a decline of the incidence of BD and a change of the disease spectrum to less-severe manifestations are reported from Japan and Korea, two genetically homogenous, affluent populations with limited immigration. We hypothesize that ...
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
What have we learned about optimizing cardiorenal protection in advanced CKD from landmark papers published in 2018?Nephrology Dialysis Transplantation
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Nephrology Journal Article Source Type: news
A new predictive scoring system could have an important role in the screening and diagnosis of patients with primary aldosteronism.Clinical Endocrinology
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Diabetes & Endocrinology Journal Article Source Type: news
Venous needle dislodgement (VND) during dialysis is a rarely occurring adverse event, which becomes life-threatening if not handled promptly. Because the standard venous pressure alarm, implemented in most dialysis machines, has low sensitivity, a novel approach using extracted cardiac information to detect needle dislodgement is proposed. Four features are extracted from the arterial and venous pressure signals of the dialysis machine, characterizing the mean venous pressure, the venous cardiac pulse pressure, the time delay, and the correlation between the two pressure signals. The features serve as input to a support ve...
Source: ASAIO Journal - Category: Medical Devices Tags: Renal/Extracorporeal Blood Treatment Source Type: research
A 43 ‐year‐old man who was treated with interferon‐beta for multiple sclerosis was presented with hypertension, headache, nausea/vomiting, blurred vision, and renal dysfunction. The treatment with drugs and dialysis relieved the symptoms. Despite plasmapheresis is known to cause improvement in rena l function, no such improvement was seen in patient. AbstractA 43 ‐year‐old man who was treated with interferon‐beta for multiple sclerosis was presented with hypertension, headache, nausea/vomiting, blurred vision, and renal dysfunction. The treatment with drugs and dialysis relieved the symptoms. Despite plasmapher...
Source: Clinical Case Reports - Category: General Medicine Authors: Tags: CASE REPORT Source Type: research
Publication date: Available online 29 March 2020Source: Microbes and InfectionAuthor(s): Mohammad Abdul Alim, Andreas Kupz, Suchandan Sikder, Catherine Rush, Brenda Govan, Natkunam Ketheesan
Source: Microbes and Infection - Category: Infectious Diseases Source Type: research
Characteristics of non ‐obese Asians with elevated 1‐h plasma glucose are unknown. Individuals with elevated 1‐h plasma glucose have lower insulinogenic index and adiponectin. Insulin sensitivity was similar between the low and high 1‐h plasma glucose groups. AbstractElevated 1 ‐h plasma glucose (1h‐PG; ≥155 mg/dL) during an oral glucose tolerance test is a risk factor for type 2 diabetes. However, the metabolic characteristics of non‐obese Asians with elevated 1h‐PG are unknown. Thus, we studied 59 non‐obese Japanese men with normal glucose tolerance. We div ided study participants into the Low 1h‐PG group (
Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: Short Report Source Type: research
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