scholarly journals Diplopia, Convergent Strabismus, and Eye Abduction Palsy in a 12-Year-Old Boy with Autoimmune Thyroiditis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Pedro Marques ◽  
Sandra Jacinto ◽  
Maria do Carmo Pinto ◽  
Catarina Limbert ◽  
Lurdes Lopes
Keyword(s):  
Intracranial Pressure ◽  
Autoimmune Thyroiditis ◽  
Brain Mri ◽  
Pseudotumor Cerebri ◽  
Clinical Criteria ◽  
Vascular Abnormalities ◽  
Convergent Strabismus ◽  
Normal Composition ◽  
Free Thyroxine Level

Pseudotumor cerebri (PTC) is defined by clinical criteria of increased intracranial pressure, elevated intracranial pressure with normal cerebrospinal fluid (CSF) composition, and exclusion of other causes such tumors, vascular abnormalities, or infections. The association of PTC with levothyroxine (LT4) has been reported. A 12-year-old boy has been followed up for autoimmune thyroiditis under LT4. Family history was irrelevant for endocrine or autoimmune diseases. A TSH level of 4.43 μUI/mL (0.39–3.10) motivated a LT4 adjustment from 75 to 88 μg/day. Five weeks later, he developed horizontal diplopia, convergent strabismus with left eye abduction palsy, and papilledema. Laboratorial evaluation revealed elevated free thyroxine level (1.05 ng/dL [0.65–1.01]) and low TSH, without other alterations. Lumbar puncture was performed and CSF opening pressure was 24 cm H2O with normal composition. Blood and CSF cultures were sterile. Brain MRI was normal. LT4 was temporarily discontinued and progressive improvement was observed, with a normal fundoscopy at day 10 and reversion of diplopia one month later. LT4 was restarted at lower dose and gradually titrated. The boy is currently asymptomatic. This case discloses the potential role of LT4 in inducing PTC. Despite its rarity and unclear association, PTC must be seen as a potential complication of LT4, after excluding all other intracranial hypertension causes.

Retinal microcirculation abnormalities in patients with systemic sclerosis: an explorative optical coherence tomography angiography study

Rheumatology ◽  
2021 ◽  
Author(s):  
Adriano Carnevali ◽  
Giuseppe Giannaccare ◽  
Valentina Gatti ◽  
Caterina Battaglia ◽  
Giorgio Randazzo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Flow Index ◽  
Digital Ulcers ◽  
Optical Coherence ◽  
Vascular Abnormalities ◽  
Capillary Plexus ◽  
Retinal Microcirculation ◽  
Vascular Plexuses

Abstract Objectives To investigate subclinical and clinical abnormalities in retinal and choroidal vascular plexuses in patients with SSc by means of optical coherence tomography angiography (OCT-A). Methods A total of 20 consecutive SSc patients were recruited and compared with 20 healthy subjects. Quantitative analysis of vessel density (VD), choriocapillaris plexus flow index (CCP-FI) and choroidal vascularity index were performed on OCT-A images in the superficial capillary plexus (SCP), deep capillary plexus (DCP) and CCP for all patients. Images were further reviewed by two independent readers for the assessment of qualitative abnormalities, including tortuosity, rarefaction areas, megacapillaries and macular-foveal capillaries. Results The DCP-VD in the whole scan and in the perifoveal, superior, inferior, nasal and temporal regions was significantly lower in the SSc group. The CCP-FI was significantly higher in SSc patients. When comparing SSc patients with and without digital ulcers, significantly decreased SCP-VD was demonstrated in the whole, perifoveal, superior, inferior, temporal and nasal regions. No difference in any of the OCT-A parameters was observed when comparing patients with and without interstitial lung disease. Qualitative analysis of OCT-A revealed at least one abnormality in 95% of patients. Conclusion We showed the ability of OCT-A to disclose early ocular vascular abnormalities in patients with SSc. Our results may represent a hypothesis-generating basis for exploring the potential role of OCT-A in diagnosis, monitoring and prognosis stratification in SSc.

Cerebrospinal Fluid Dynamics and Rhinorrhea: The Role of Shunting in Repair

1983 ◽  
Vol 91 (4) ◽  
pp. 399-403 ◽  
Author(s):  
Arnold Komisar ◽  
Stephen Weitz ◽  
Robert J. Ruben
Keyword(s):  
Intracranial Pressure ◽  
Surgical Repair ◽  
Skull Fracture ◽  
Increased Intracranial Pressure ◽  
Csf Rhinorrhea ◽  
Initial Management ◽  
Parasellar Region ◽  
Csf Leakage ◽  
Pathophysiologic Mechanisms

CSF rhinorrhea can have many causes: traumatic, neoplastic, and iatrogenic origins are common. Most traumatic rhinorrhea ceases after a trial of conservative management. While obvious erosion or traumatic destruction of vital structures may be the underlying cause, other pathophysiologic mechanisms may be working in the formation of CSF rhinorrhea, which may require the combined skills of the otolaryngologist and the neurosurgeon. Leakage of CSF is seen in “high-pressure rhinorrhea,” a pathophysiologic state wherein the underlying problem is poor CSF resorption. The result is increased intracranial pressure and eventual rhinorrhea or otorrhea. Areas of CSF leakage correspond to sites of congenital weakness in the cribriform plate region, the parasellar region, or the temporal bone. Weak areas in old base-of-skull fracture sites may leak with increased intracranial pressure. The initial management should stress correction of the deranged pathophysiology, namely shunting. Surgical repair is secondary to controlling the abnormal CSF dynamics.

ABNORMAL CAPILLARY MORPHOLOGY IN CONGENITAL HEART DISEASE

PEDIATRICS ◽  
1966 ◽  
Vol 37 (2) ◽  
pp. 316-322
Author(s):  
Stella B. Kontras ◽  
JoAnn G. Bodenbender
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Septal Defect ◽  
Chronic Hypoxia ◽  
Normal Children ◽  
Vascular Abnormalities ◽  
Definitive Surgery ◽  
Vascular Compartment

Capillary morphology has been studied in 111 normal children. In 98% of these cases, straight hairpin forms make up over 80% of the capillaries examined. Thirty children with congenital heart disease showed 80% abnormal capillary patterns consisting of dilated, tortuous, and branched loops. These were most marked in cyanotic tetralogy of Fallot and ventricular septal defect with pulmonary hypertension. These cases also were associated with microscopic hemorrhages, increased capillary fragility and actual postoperative hemorrhagic complications. Definitive surgery in two cases, though improving the patient, did not result in changes in the abnormal capillary patterns. It is suggested that the role of the capillary structure in rheology of blood in the microvasculature has largely been ignored and that abnormalities in this vascular compartment may affect perfusion of tissues. The association of abnormalities in coagulation studies, hemorrhage, and thrombosis with congenital heart disease may in part be related to the morphologic vascular abnormalities. The abnormal capillary findings may be due to maturational arrest or dysmaturity of this portion of the cardiovascular system or may be the result of chronic hypoxia.

Abstract 636: Gut Microflora Influences Pathology in the Kawasaki Disease (KD) Vasculitis Mouse Model

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Daiko Wakita ◽  
Yosuke Kurashima ◽  
Yoshihiro Takasato ◽  
Youngho Lee ◽  
Kenichi Shimada ◽  
...  
Keyword(s):  
Mouse Model ◽  
Immune Responses ◽  
Critical Role ◽  
Gut Microflora ◽  
Vascular Abnormalities ◽  
Coronary Arteritis ◽  
Specific Pathogen ◽  
New Perspective ◽  
Bacteria And Fungi

Background: KD is the leading cause of acquired heart disease in the US. We have demonstrated the critical role of innate immune responses via IL-1R/MyD88 signaling in the Lactobacillus casei cell wall extract (LCWE)-induced KD mouse model. The diversity and composition of microflora (both bacterial and fungal) have been associated with the regulation and alterations of immune responses and various pathologies. However, the role of gut microbiota in immunopathology of KD has not been investigated. Objective: To evaluate the role of gut microflora in development of coronary arteritis, and vascular abnormalities in KD mouse model. Methods and Results: We investigated the role of gut microflora in the LCWE-induced KD mouse model, using Specific-Pathogen Free (SPF) and Germ Free (GF) mice (C57BL/6). GF mice showed a significant decrease of KD lesions, including coronary arteritis compared with SPF mice. The development of LCWE-induced AAA, which we recently discovered in this mouse model, was also markedly diminished in GF mice. In addition to GF mice, we also investigated the specific role of commensal bacteria and/or fungi, and determined whether altered microorganism burden in this KD mouse model contributes to disease severity. To deplete bacteria and/or fungi in the gut microflora, we exposed pregnant SPF mice and their offspring to antibiotics cocktail (Abx) or antifungal drug (fluconazole; Fluc) in their drinking water for 5 wks and induced KD. The mice treated with Abx or Fluc had significantly reduced coronary arteritis and AAA compared to controls. The Abx plus Fluc administration showed marked decrease of KD vasculitis. Conclusions: We demonstrate here that gut microflora play a critical role in the development of KD vasculitis in LCWE-induced mouse model. Our results suggest that both bacteria and fungi in the intestinal microbiota may control the induction and severity of KD vasculitis. These findings provide a new perspective on the potential role of the microbiome in KD pathogenesis and may offer new diagnostic and therapeutic strategies for KD patients.

scholarly journals Serenoa repens extract additionally to quinolones in the treatment of chronic bacterial prostatitis. The preliminary results of a long term observational study

2013 ◽  
Vol 85 (4) ◽  
pp. 190 ◽  
Author(s):  
Konstantinos Stamatiou ◽  
Nikolaos Pierris
Keyword(s):  
Sexual Dysfunction ◽  
Chronic Prostatitis ◽  
Bacterial Eradication ◽  
Serenoa Repens ◽  
Chronic Bacterial Prostatitis ◽  
Local Pain ◽  
Clinical Criteria ◽  
Preliminary Results

Introduction: Chronic prostatitis displays a variety of symptoms (mainly local pain exhibiting variability in origin and intensity). The purpose of this article is to briefly present the preliminary results of our study examining the role of phytotherapeutic agents in the treatment of chronic prostatitis patients. Materials and methods: The study included in total fifty-six consecutive patients who visited the outpatient department. Subjects were randomized into two groups. Subjects in the first group (28 patients) received prulifloxacin 600 mg for 15 days, while subjects in the second group (28 patients) received prulifloxacin 600 mg for 15 days and Serenoa repens extract for 8 weeks. The response was tested using laboratory and clinical criteria. Results: We found statistically significant differences between the two groups regarding pain regression and no statistically significant regarding bacterial eradication. Moreover however while sexual dysfunction improvement was equally achieved in both groups, improvement of urinary symptoms was more evident in the 2nd group especially after the completion of the antibiotic treatment. Conclusions: Serenoa repens extract for 8 weeks seems to improve prostatitis related pain. Further randomized, placebo-controlled studies are needed to substantiate safer conclusions.

Sign in / Sign up

Export Citation Format

Share Document