scholarly journals Reactivation of Old Scars in an Elderly Man Revealing Löfgren's Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Vishnu Vardhan Reddy Munagala ◽  
Vaishali Tomar ◽  
Amita Aggarwal
Keyword(s):  
Rare Case ◽  
Erythema Nodosum ◽  
Febrile Illness ◽  
High Resolution Computed Tomography ◽  
Short Course ◽  
Oral Steroids ◽  
Hilar Adenopathy ◽  
Löfgren’S Syndrome ◽  
Systemic Symptoms ◽  
Noncaseating Granulomas

Here, we report the case of a 55-year-old man with reactivation of old cutaneous scars associated with a febrile illness, episcleritis, polyarthralgias, erythema nodosum and hilar adenopathy. High-resolution computed tomography (HRCT) revealed right paratracheal, bilateral hilar, and subcarinal lymphadenopathy without any nodular densities in both lung fields. A scar biopsy revealed multiple noncaseating granulomas and confirmed the diagnosis of sarcoidosis. A short course of oral steroids led to regression of systemic symptoms, and the scars returned to baseline size. This patient represented a rare case of simultaneous Löfgren’s syndrome and scar sarcoidosis.

scholarly journals Löfgren’s Syndrome

2021 ◽  
Author(s):  
Shiyu Wang ◽  
Shailendra Singh
Keyword(s):  
Erythema Nodosum ◽  
Rare Presentation ◽  
Prompt Treatment ◽  
Hilar Adenopathy ◽  
Löfgren’S Syndrome ◽  
Acute Polyarthritis ◽  
Oral Glucocorticoids ◽  
Symptomatic Control

Löfgren’s syndrome presents as acute sarcoid arthritis, with a triad of hilar adenopathy, acute polyarthritis and erythema nodosum. Löfgren’s syndrome is self-limited, erythema nodosum, hilar adenopathy and acute polyarthritis usually resolve within a few weeks to months, however polyarthritis can last for up to 2 years. Treatment involves symptomatic control with NSAIDs/colchicine or oral glucocorticoids until symptoms resolve, if disease is resistant to these therapies, hydroxychloroquine, methotrexate or infliximab can be used. Löfgren’s syndrome is a rare presentation of sarcoidosis occurring in only about 5–10% of sarcoid patients. It is, however, important to recognize as it is the most common form of acute sarcoid arthritis and prompt treatment can prevent unnecessary prolonged discomfort for patients.

FDG-PET/CT Assessment of Pulmonary Sarcoidosis: A Guide for Internists

2018 ◽  
Vol 15 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Marco Tana ◽  
Silvio di Carlo ◽  
Marcello Romano ◽  
Massimo Alessandri ◽  
Cosima Schiavone ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Fdg Pet ◽  
Correct Diagnosis ◽  
Pulmonary Sarcoidosis ◽  
High Resolution Computed Tomography ◽  
Inflammatory Conditions ◽  
Positron Emission ◽  
Pet Ct ◽  
Noncaseating Granulomas ◽  
Fdg Pet Ct

Background:18F-fluorodeoxyglucose positron emission tomography integrated with computed tomography (18-F-FDG-PET/CT) is getting wide consensus in the diagnosis and staging of neoplastic disorders and represents a useful tool in the assessment of various inflammatory conditions. </P><P> Discussion: Sarcoidosis is an uncommon disease characterized by the systemic formation of noncaseating granulomas. Lungs are the sites most often affected, and investigation with high resolution computed tomography and biopsy is essential to achieve a correct diagnosis. 18-F-FDGPET/ CT is effective in the assessment of pulmonary sarcoidosis by demonstrating pulmonary and extrathoracic involvement and findings correlate well with pulmonary function in patients affected.Conclusion:This review would illustrate the usefulness and limits of 18-F-FDG-PET/CT in the assessment of pulmonary sarcoidosis.

scholarly journals A Rare Case of Invasive Mucormycosis in a Diabetic Patient Treated with a Short Course of Dexamethasone

2021 ◽  
Vol 22 ◽  
Author(s):  
Gurchetan Randhawa ◽  
Sean Hagaman ◽  
Mahsa Pourabdollah Tootkaboni ◽  
Sanchit V. Kundal ◽  
Sharad Oli ◽  
...  
Keyword(s):  
Diabetic Patient ◽  
Rare Case ◽  
Short Course

scholarly journals Acute and Chronic Sarcoid Arthropathies: Characteristics and Treatments From a Retrospective Nationwide French Study

2020 ◽  
Vol 7 ◽  
Author(s):  
Carlotta Cacciatore ◽  
Pierre Belnou ◽  
Sara Thietart ◽  
Carole Desthieux ◽  
Mathilde Versini ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Skin Lesions ◽  
Tnf Inhibitors ◽  
Joint Involvement ◽  
Clinical Phenotypes ◽  
Treatment Regimens ◽  
French Study ◽  
Histological Criteria ◽  
Multicenter Analysis ◽  
Löfgren’S Syndrome

Introduction: We aimed to analyze patients with acute and chronic joint involvements in sarcoidosis.Methods: This is a retrospective multicenter analysis of patients with proven sarcoidosis, as defined by clinical, radiological, and histological criteria, with at least one clinical and/or ultrasonographic synovitis.Results: Thirty-nine patients with sarcoid arthropathy were included, and among them 19 had acute sarcoidosis (Lofgren's syndrome). Joint involvement and DAS44-CRP were not significantly different in acute and chronic sarcoid arthropathies. Acute forms were more frequent than chronic sarcoid arthropathy in Caucasians, without any difference of sex or age between these 2 forms. Joint involvement was frequently more symmetrical in acute than chronic forms (100 vs. 70%; p &lt; 0.05), with a more frequent involvement in wrists and ankles in acute forms, whereas the tender and swollen joint counts and the DAS44-CRP were similar between the 2 groups. Skin lesions were significantly more frequent in patients with acute forms [17 (89%) vs. 5 (25%); p &lt; 0.05] and were erythema nodosum in all patients with Löfgren's syndrome and sarcoid skin lesions in those with chronic sarcoidosis. Among 20 patients with chronic sarcoidosis, treatment was used in 17 (85%) cases, and consisted in NSAIDs alone (n = 5; 25%), steroids alone (n = 5; 25%), hydroxychloroquine (n = 2; 20%), methotrexate (n = 3; 15%), and TNF inhibitors (n = 2; 10%). A complete/partial joint response was noted in 14 (70%) cases with a DAS44-CRP reduction of 2.07 [1.85–2.44] (from 3.13 [2.76–3.42] to 1.06 [0.9–1.17]; p &lt; 0.05).Conclusion: Sarcoid arthropathies have different clinical phenotypes in acute and chronic forms and various treatment regimens such as hydroxychloroquine and methotrexate could be used in chronic forms.

Rezidivierende isolierte Unterschenkelmuskelvenenthrombose bei Soleusvenenaneurysma

VASA ◽  
2002 ◽  
Vol 31 (4) ◽  
pp. 277-279 ◽  
Author(s):  
Schwarz ◽  
Zimmermann ◽  
Hänig ◽  
Schröder ◽  
Schellong
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Rare Case ◽  
Calf Muscle ◽  
Venous Aneurysm ◽  
Low Molecular Weight ◽  
Therapeutic Dosage ◽  
Follow Up Study ◽  
Short Course

A rare case of venous aneurysm involving the soleal muscle vein in an 18-year-old woman is presented. The patient showed three episodes of ultrasonographically proven calf muscle thrombosis within 2 years. After a short course of low-molecular-weight heparin at a therapeutic dosage, complete thrombus recanalization was achieved. To prevent further thrombotic episodes, surgery including ligation and resection of the aneurysm was performed. At the 3-month follow-up study the patient had completely recovered.

scholarly journals Short-course oral steroids as an adjunct therapy for chronic rhinosinusitis

2016 ◽  
Author(s):  
Karen Head ◽  
Lee Yee Chong ◽  
Claire Hopkins ◽  
Carl Philpott ◽  
Anne GM Schilder ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Adjunct Therapy ◽  
Short Course ◽  
Oral Steroids

scholarly journals Leptospirosis presented with erythema nodosum on four limbs: an unusual presenting

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
Lotfollah Davoodi ◽  
Armaghan Kazeminejad ◽  
Hamed Jafarpour ◽  
Alireza Razavi
Keyword(s):  
Rare Case ◽  
Erythema Nodosum ◽  
Clinical Manifestations ◽  
Common Disease ◽  
Clinical Form ◽  
Case Presentation ◽  
Typical Form ◽  
Wide Range ◽  
Adipose Inflammation ◽  
Subcutaneous Adipose

Abstract Leptospirosis is a common disease between humans and animals characterized by a wide range of clinical manifestations. Erythema nodosum (EN) is a common clinical form of panniculitis or subcutaneous adipose inflammation caused by hypersensitivity responses to antigens, but the presence of EN in a subject with leptospirosis is a very rare case presentation. We will present a 42-year-old man with a headache, myalgia, nausea and rigid tender on the shin and both forearms, which was a typical form of EN lesions.

scholarly journals A57 VALPROATE INDUCED DRESS SYNDROME CAUSING MIXED LIVER INJURY

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 67-68
Author(s):  
R Schneider ◽  
R Verstegen ◽  
J Hulst ◽  
S Ito ◽  
V Ng
Keyword(s):  
Liver Injury ◽  
Early Recognition ◽  
Oral Steroid ◽  
Fatty Acid Transport ◽  
Dress Syndrome ◽  
Elevated Liver Enzymes ◽  
Oral Steroids ◽  
Synthetic Function ◽  
Sick Children ◽  
Systemic Symptoms

Abstract Background Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome occurs with 1 in every 1,000 to 10,000 drug exposures and has a mortality rate of up to 10%. It is one mechanism by which medications can induce liver injury with elevated liver enzymes seen in the majority of cases. In children, aromatic anticonvulsants are the drugs most commonly associated with DRESS syndrome. Valproate, a non-aromatic anti-epileptic, is not known to have a heightened risk of hypersensitivity syndromes and is often the anti-epileptic of choice in patients who develop hypersensitivity syndromes from other anti-epileptics. Valproate hepatotoxicity is normally caused by its inhibition of fatty acid transport and mitochondrial β-oxidation; vanishing bile duct syndrome is also reported. Aims We present a case, to the best of our knowledge the first in paediatrics, in which valproate causes DRESS syndrome and a secondary, predominantly cholestatic, liver injury. Methods Literature review and case report. Results A previously healthy 14-year-old girl was diagnosed with new-onset seizures and started on valproate. Three weeks later, she developed a pruritic exanthem. Despite discontinuing her valproate, the rash persisted and she developed fever and jaundice. She was admitted to the ICU at the Hospital for Sick Children with a diagnosis of DRESS syndrome (RegiSCAR DRESS score 7) for treatment with IV steroids. At admission, she had a skin eruption, fever, leukocytosis (22.86 x109/L), eosinophilia (1.03x109/L), atypical lymphocytes (1.62 x109/L), lymphadenopathy, and internal organ involvement (BiliC 138, GGT 501, INR 1.3, ALT 543, AST 370, Crt 109). Of note, her EBV PCR was positive. By discharge, her rash improved and kidney function normalized. Her cholestasis persisted, despite improvement in her transaminases and eosinophilia (BiliC 163, INR 1.0, GGT 338, ALT 506, AST 220, Eos 0.98x109/L). She was discharged home on an oral steroid wean, ursodeoxycholic acid, levocarnitine, and levetiracetam. Upon reaching a daily dose of 20mg of prednisone, her rash and pruritus worsened, she had lost 7kg, and she was readmitted for IV steroids. Her rash improved within 4 days and she was discharged on a slower steroid taper, with the addition of cholestyramine and insulin for steroid induced diabetes. At present (2 ½ months after diagnosis), she continues her oral steroids and has persistent liver injury and pruritus. Conclusions We report the first paediatric case of valproate induced DRESS syndrome causing a significant cholestatic presentation with otherwise preserved liver synthetic function. The prolonged cholestasis and pruritus may be a result of the natural course of DRESS syndrome, EBV reactivation/infection, or polypharmacy. Early recognition of DRESS syndrome as a mechanism of valproate induced liver injury in children is essential for earlier diagnosis and initiation of targeted therapy. Funding Agencies None

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