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HIV-associated multiple intracranial aneurysms and stroke in an adult patient: successful treatment with a combination of glucocorticoid and antiviral agents
AbstractA 35-year-old Iranian man with an 18-year history of human immunodeficiency virus (HIV) infection developed sudden left-sided hemiparesis and mild dysarthria. Based on laboratory results, brain and neck computerized tomography angiography (CTA), echocardiography, hypercoagulability tests, and vasculitis tests, the patient was diagnosed with a stroke with multiple intracranial aneurysms secondary to HIV. Cerebral aneurysms and stroke are uncommon in HIV-infected patients, and the aneurysms ’ exact cause and risk factors are unknown. There is currently no effective regimen or definitive treatment for HIV-associated...
Source: Journal of NeuroVirology - December 13, 2022 Category: Neurology Source Type: research

Immunoglobulin G4-Related Disease Presenting as Temporal Bone Lesion with Facial Nerve Palsy
We report a case of IgG4-RD with infiltration of the temporal bone and surrounding structures in a patient with systemic vasculitis on systemic steroids. A 31-year-old woman presented with right-sided facial weakness, headache, and right ear hearing loss. On examination, redness and retraction of the right tympanic membrane and facial paresis (House-Brackman IV) were noted. Computed tomography imaging showed mastoiditis, temporal lobe stroke, and brain abscess. Magnetic resonance imaging (MRI) showed infiltration in the infratemporal fossa, nasopharynx, spreading along the Eustachian tube and perineurally along the branche...
Source: ORL - June 7, 2022 Category: ENT & OMF Source Type: research

Case Report: Myxedema Coma Caused by Immunoglobulin A Vasculitis in a Patient With Severe Hypothyroidism
Myxedema coma is a critical disorder with high mortality rates. Disruption of the compensatory mechanism for severe and long-term hypothyroidism by various causes leads to critical conditions, including hypothermia, respiratory failure, circulatory failure, and central nervous system dysfunction. Infectious diseases, stroke, myocardial infarction, sedative drugs, and cold exposure are considered the main triggers for myxedema coma. A 59-year-old Japanese woman presented with bilateral painful purpura on her lower legs. She was diagnosed with coexisting immunoglobulin A (IgA) vasculitis and severe IgA vasculitis with nephri...
Source: Frontiers in Immunology - February 18, 2022 Category: Allergy & Immunology Source Type: research

P030  Antiphospholipid syndrome and giant cell arteritis: a coincidence or connection?
Conclusion In summary, this is a case of GCA and APS, treated with prednisolone, aspirin, warfarin and tocilizumab. There is increasing evidence describing the presence of antiphospholipid antibodies in patients with vasculitis. However, the role of these antibodies in GCA and the clinical significance rema ins unclear. This case reports highlights the need for physicians to consider APS in patients who have a history of GCA and subsequently develop arterial or venous embolic events.Disclosure L. Sammut: None.E. Htut: None.
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research

P211  Aortitis: clinical experience within a tertiary centre
Conclusion Systemic inflammatory response syndrome was the commonest presenting feature. Those without GCA-like symptoms received a delayed diagnosis, which increases the risk of preventable vascular events. CT-PET remained the main diagnostic tool. Prednisolone treatment was prolonged with burdensome side- effects. Methotrexate remained the DMARD of choice, but leflunomide also showed good results. Vascular complications are common and need attention.Disclosure R.S. Andev: None.N. Ahmad: None.R. Luqmani: None.S. Dubey: None.
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research

Case presentation: the dancing man from sierra leone
Discussion Making this diagnosis is challenging, as brain imaging often shows non specific changes and blood results are usually normal. CSF may reveal raised proteins and WBCs. A high index of suspicion is required to arrange a brain biopsy as this confirms the diagnosis.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Al-Rifai, M. S., Salek-Haddadi, A. Tags: Immunology (including allergy), Neuroimaging, Stroke, Radiology, Drugs: musculoskeletal and joint diseases, Vascularitis, Surgical diagnostic tests ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Clinical profile and long-term outcome of granulomatosis with polyangiitis (GPA): A corporate hospital-based study from northern India
Conclusion GPA remits with standard treatment but relapses frequently, leading to substantial morbidity. Mortality is uncommon.
Source: Indian Journal of Rheumatology - July 18, 2015 Category: Rheumatology Source Type: research

ANCA associated vasculitis - Evaluation of diagnosis, treatment and outcome in a group of 68 patients
Conclusions: Significant differences exist between GPA and MPA at the initial presentation that can predict the evolution of the disease. The management of patients with ANCA-associated vasculitides is difficult and marked by the adverse effects of the therapy.
Source: European Respiratory Journal - December 23, 2014 Category: Respiratory Medicine Authors: Belaconi, I., Toma, C., Stancu, S., Dumitrache-Rujinski, S., Tudose, C., Croitoru, A., Grigoriu, L., Leonte, D., Magheran, E., Bogdan, M. Tags: 1.13 Clinical Problems - Other Source Type: research

Teaching NeuroImages: Macaroni sign
A 35-year-old patient with previously diagnosed and currently untreated Takayasu arteritis presented with motor aphasia. The symptom had started 24 hours before presentation and ceased after another 12 hours. Cranial MRI and magnetic resonance angiography were normal. Plasma concentration of C-reactive protein was elevated (9.1 mg/dL). Duplex ultrasonography showed hypoechoic, homogeneous thickening of the intima–media complex of the left common carotid artery (figure). This finding, also referred to as "macaroni sign," has been reported in Takayasu arteritis.1,2 The patient was transferred to the rheumatologic depar...
Source: Neurology - June 30, 2014 Category: Neurology Authors: Siepmann, T., Bodechtel, U. Tags: Ultrasound, Autoimmune diseases, Vasculitis, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research