Open muscle biopsy

2002 ◽  
Vol 4 (3) ◽  
pp. 235-238 ◽  
Author(s):  
Jeromy Brink
Keyword(s):  
2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1848.1-1848
Author(s):  
T. Mori ◽  
N. Yokogawa ◽  
K. Shimada

Background:We previously reported the utility of open muscle biopsies in diagnosing vasculitis [1]. The number of open muscle biopsies performed at our department has increased to over 200. The purpose of the present study was to evaluate the diagnostic utility of vasculitis and the safety of the open muscle biopsies.Objectives:To clarify the diagnostic utility of vasculitis and the safety profile of the open muscle biopsy.Methods:We retrospectively examined all cases of open muscle biopsy performed between May 2012 and June 2018 in our department. The biopsy results, the presence or absence of adverse events, and blood test data at the time of the biopsy were extracted from the patients’ electronic medical records.Results:Between May 2012 and June 2018, 210 open muscle biopsies were performed, 120 of which were done for vasculitis diagnosis. Diagnostic histopathological findings were obtained in 42 of the 120 cases (35%). The definitive diagnosis in these cases was microscopic polyangiitis (30 cases), eosinophilic granulomatosis with polyangiitis (seven cases), granulomatosis with polyangiitis (one case), polyarteritis nodosa (three cases), and other vasculitis (one case). In 57 cases with myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) ≥ 10 U/ml, 31 cases (54.3%) showed histopathology of vasculitis. In six cases with protainase-3-ANCA (PR3-ANCA) ≥ 10 U/ml, histopathology of vasculitis was found in one case (16.7%).In all 210 open muscle biopsy cases, complications included minor wound dehiscence (11 cases) and small subcutaneous hematoma (six cases), which were able to be managed by local treatment. Albumin was significantly lower in the patients with wound dehiscence (mean 3.2 vs 2.7, p = 0.049)Serious complications included anaphylaxis due to local anesthesia (one case), compartment syndrome due to hematoma (one case), hematoma requiring surgical removal (one case), and arterial hemorrhage requiring surgical intervention (one case). The patients in the latter three hemorrhagic cases were receiving antiplatelet drugs.Conclusion:An open muscle biopsy is useful for diagnosing vasculitis, especially for MPO-ANCA-positive anca-associated vasculitis. Its safety profile is acceptable. Serious adverse events are rare, but the procedure should be performed carefully when patients are receiving antiplatelet drugs.References:[1]Nunokawa T. et al. The use of muscle biopsy in the diagnosis of systemic vasculitis affecting small to medium-sized vessels: A prospective evaluation in Japan. Scand. J. Rheumatol. 2016;45:210–214Disclosure of Interests:None declared


2014 ◽  
Vol 25 (3) ◽  
pp. 265-271 ◽  
Author(s):  
Eva Tschiedel ◽  
Oliver Müller ◽  
Ulrike Schara ◽  
Ursula Felderhoff-Müser ◽  
Christian Dohna-Schwake

Neurology ◽  
1983 ◽  
Vol 33 (5) ◽  
pp. 547-547 ◽  
Author(s):  
A. J. Tahmoush ◽  
P. D. Bowen ◽  
R. F. Bonner ◽  
T. J. Mancini ◽  
W. K. Engel

2014 ◽  
pp. 645 ◽  
Author(s):  
Julius Dengler ◽  
Peter Linke ◽  
Hans J. Gdynia ◽  
Stefan Wolf ◽  
Albert C. Ludolph ◽  
...  

2009 ◽  
Vol 17 (1) ◽  
pp. 136-142 ◽  
Author(s):  
C.-H. Lai ◽  
G. Melli ◽  
Y.-J. Chang ◽  
R. L. Skolasky ◽  
A. M. Corse ◽  
...  

2017 ◽  
Vol 230 (02) ◽  
pp. 68-72 ◽  
Author(s):  
Eva Tschiedel ◽  
Oliver Müller ◽  
Adela Marina ◽  
Ursula Felderhoff-Müser ◽  
Christian Dohna-Schwake

Abstract Background The use of Propofol and Remifentanil for analgosedation in children is common and safe. For sedation monitoring clinical scores as Comfort Score (CS) as well as bispectral index (BIS) are frequently applied. The impact of BIS for sedation monitoring in pediatric patients is still under debate. This prospective study aims to investigate whether dual sedation monitoring of CS and BIS compared with monitoring of CS alone during muscle biopsies in children can reduce sedative doses, reduce awakening time and prevent complications. Methods 50 pediatric patients requiring sedation for open muscle biopsy were prospectively enrolled. Analgosedation was performed with remifentanil and propofol. Patients were randomly assigned to 2 groups: In 25 patients, sedation was monitored using CS alone, and in 25 patients CS and BIS monitoring were simultaneously applied. The primary outcome was the propofol dose applied during muscle biopsy. Secondary outcome parameters were recovery time and the frequency of complications. Results The median CS during the intervention in both groups was equal (11, P=1.000). The median BIS in group 2 was 59. No complications occurred in either group. There was no difference in propofol dose in either group (8.4 vs. 7.2 mg/kg/h; P=0.58) and no difference in the duration until eye opening (9 vs. 11 min; P=0.081). Conclusion For children undergoing minor surgical procedures under analgosedation, BIS monitoring does not affect the sedative dose, the time until eye opening or the frequency of complications.


PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 583A-583A
Author(s):  
Mihir Thacker ◽  
Monica Payares Lizano ◽  
Brian Deignan ◽  
Corrine Link ◽  
Kenneth Rogers ◽  
...  

2014 ◽  
Vol 99 (791) ◽  
pp. 40-40
Author(s):  
Fernando Leiva-Cepas

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