scholarly journals Disseminated Nocardia infection in a female patient with idiopathic thrombocytopenic purpura and long-term glucocorticoid use

2018 ◽  
Vol 27 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Shu Li ◽  
Qingbian Ma ◽  
Shuo Li ◽  
Yaan Zheng ◽  
Yujiao Chen ◽  
...  
Keyword(s):  
Female Patient ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Opportunistic Infections ◽  
Combined Therapy ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
The Body ◽  
Thrombocytopenic Purpura ◽  
Insidious Onset

Introduction: Nocardiosis is a rare kind of opportunistic infections. Because of its insidious onset and atypical clinical manifestations, diagnosis and early treatment are often delayed. Case presentation: Here we present a 60-year-old Chinese female patient with systemic Nocardia infection, who had been diagnosed with idiopathic thrombocytopenic purpura previously and was misdiagnosed for up to 6 months prior to presenting at our hospital and ultimately achieved clinical cure. Discussion: The patient took prednisone because of ITP for several years which led to immunosuppression. Nocardia infection began from the skin rupture and then spread all over the body with multiple system involvement. The pus culture eventually found Nocardia. Sulphonamides have been the standard treatment for decades and there are several other options. Patients with severe Nocardia infection or immunosuppression are suggested a combined therapy. Conclusion: Nocardiosis is an infection that often resulted in delayed diagnosis because of lack of specificity of the clinical profile and the difficulty in culturing the bacteria. It should be included in the differential diagnosis of patients in which there are cutaneous, respiratory or neurological manifestations, especially in immunosuppressed individuals.

scholarly journals B Cell Activating Factor, Renal Allograft Antibody-Mediated Rejection, and Long-Term Outcome

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Haiyan Xu ◽  
Xiaozhou He ◽  
Renfang Xu
Keyword(s):  
B Cell ◽  
Renal Allograft ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Direct Proof ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Antibody Mediated Rejection ◽  
B Cell Activating Factor

Antibody-mediated rejection (ABMR) of renal allograft lacks typical phenotypes and clinical manifestations, always resulting in delayed diagnosis and treatment. It has been considered to be an elemental factor influencing the improvement of the long-term outcome of renal allograft. The B cell activating factor (BAFF) signal plays a fundamental function in the process of antibody-mediated immune response. Data from recipients and the nonhuman primate ABMR model suggest that the BAFF signal participates in the ABMR of renal allograft, while there are objections. The challenges in the diagnosis of ABMR, different study population, and details of research may explain the discrepancy. Large quantities of dynamic, credible data of BAFF ligands and their association with renal allograft pathological characteristics would constitute a direct proof of the role of BAFF in the progression of renal allograft ABMR.

scholarly journals The external environment of birds as a factor of immunobiochemical conditions

2020 ◽  
Vol 9 (3) ◽  
pp. 152-157
Author(s):  
Rinat R. Fatkullin ◽  
Aikumis K. Saken
Keyword(s):  
Metabolic Disorders ◽  
Clinical Manifestations ◽  
The Body ◽  
Household Waste ◽  
Trophic Chain ◽  
Behavioral Strategies ◽  
The Public ◽  
Initial Stage ◽  
Highly Sensitive

Abnormal environmental factors contribute to advanced behavioral strategies in higher regulatory centers as well as to the assessment of possible morphofunctional and energy transformations in the body. Animals, especially birds, which are characterized by curiosity, are highly sensitive to the presence of environmental pollution, since they interact with elements of the environment and surroundings. Contamination of broiler products can also be caused by contaminated soil and dust, unknown sources of persistent heavy metals and organic pollutants that are unknown to the public, such as car wreckage, household waste, and so on. In general, adverse factors that regularly affect small details do not require significant changes in the body at the initial stage, mainly affect non-specific mechanisms that lead to long-term activation. The paper contains significant work based on the analysis of microbiogenic links in the trophic chain, but the formation of processes associated with metabolic disorders from the development of trace elements to clinical manifestations is still insufficiently studied, so it is difficult to diagnose and treat previously unknown animal diseases in veterinary practice.

scholarly journals THE USE OF A VITAMIN-MINERAL COMPLEX IN THE COMBINED THERAPY OF PATIENTS WITH OBESITY AND TYPE 2 DIABETES MELLITUS: A CLINICAL TRIAL

2021 ◽  
Vol 22 (1) ◽  
pp. 60-71
Author(s):  
I.A. Lapik ◽  
◽  
K.M. Gapparova ◽  
A.V. Galchenko ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Combined Therapy ◽  
Clinical Manifestations ◽  
Micronutrient Deficiency ◽  
The Body ◽  
Control Group ◽  
Mineral Complex ◽  
Patients With Diabetes

Low caloric diet is used in the complex treatment of patients with diabetes mellitus and obesity. However, the reduced caloric food can inadvertently lead to decreased intake of micronutrients. The main goal of the research was to assess the necessity and effectiveness of the vitamin-mineral complex in the treatment of type 2 diabetes with obesity. Methods: 80 females suffering from type 2 diabetes and obesity, ranging from 40 to 65 years old participated in the study. The total patients were divided into two groups, each containing 40 patients. All patients were given a personalized diet and 1000mg of metformin every day. The experimental group, besides that, received vitamin-mineral complex. The biochemical analysis of the blood, composition of the body, and the complaint on micronutrient deficiency were taken before the experiment and after 14 days of the therapy. Results: Supplementation of the vitamin-mineral complex was associated with higher blood serum levels of vitamins B6, B12, B9, C, D, potassium, calcium, magnesium and zinc, and lower levels of glucose. Clinical manifestations, associated with micronutrient deficiency, were significantly decreased in patients who were given vitamin-mineral complex. All these changes were valid both in relation to the initial level in the study group and to the indicators after treatment in the control group. Conclusion: Micronutrient supplements may be a very important part of the combined therapy of patients with diabetes mellitus and obesity.

La diagnosi precoce di malattia

2019 ◽  
Vol 31 (1) ◽  
pp. 58-60
Author(s):  
Federica Rossi ◽  
Federico Pieruzzi
Keyword(s):  
Wide Spectrum ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
The Body ◽  
Lysosomal Storage ◽  
Cerebrovascular Complications ◽  
Risk Patients ◽  
Alpha Galactosidase ◽  
Stage Renal Disease ◽  
End Stage

Anderson-Fabry disease is an X-linked, lysosomal, storage disorder characterized by the decreased activity of alpha-Galactosidase A, which results in accumulation of globotriaosylceramide (Gb-3) in cells and tissues throughout the body, leading to a wide spectrum of clinical manifestations. Patients are often misdiagnosed or diagnosed late in their life. This is due to the phenotypic heterogeneity, the poor awareness of this rare disease, and many pitfalls when making a differential diagnosis, in adulthood, as well as in the early stages. Delayed diagnosis has significant clinical implications, because the progression of the disease over time can lead to irreversible end-stage renal disease and life-threatening cardiovascular or cerebrovascular complications. Early diagnosis remains essential in order to start an early treatment and reduce the progression of the disease, thus maximizing the chance to improve patient outcomes. Newborn screening, high-risk patients’ identification, and increasing pediatricians’ and clinicians’ knowledge on this condition, are good strategies to avoid late referrals of Anderson-Fabry patients to reference centers.

scholarly journals A Case of Pregnancy Complicated with Evans Syndrome with Sequential Development of Autoimmune Warm Antibody Hemolytic Anemia and Idiopathic Thrombocytopenic Purpura

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Haruka Suzuki ◽  
Koji Yamanoi ◽  
Jumpei Ogura ◽  
Takahiro Hirayama ◽  
Koji Yasumoto ◽  
...  
Keyword(s):  
Hemolytic Anemia ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Macrocytic Anemia ◽  
Evans Syndrome ◽  
Thrombocytopenic Purpura ◽  
Sequential Development ◽  
Healthy Female ◽  
Long Term Follow Up ◽  
Haptoglobin Level

The simultaneous or sequential development of autoimmune hemolytic anemia (AIHA) and idiopathic thrombocytopenic purpura (ITP) is known as Evans syndrome. We experienced a case of Evans syndrome that developed AIHA during pregnancy and ITP long after delivery. The patient was a 35-year-old pregnant woman (gravida 2, para 1). A routine blood test at 28 weeks of gestation revealed moderate macrocytic anemia. Her haptoglobin level was markedly low, and a direct antiglobulin test (DAT) was positive. Based on these results, AIHA was considered. A healthy female newborn with bodyweight 3575 g was vaginally delivered uneventfully. After delivery, the DAT remained positive, but anemia did not develop. At 203 days after delivery, ITP was detected. Because AIHA and ITP developed sequentially, she was diagnosed with Evans syndrome. When AIHA occurs during pregnancy, long-term follow-up is needed because ITP can develop sequentially.

Clonal B-cell populations in patients with idiopathic thrombocytopenic purpura

Blood ◽  
1990 ◽  
Vol 76 (11) ◽  
pp. 2321-2326 ◽  
Author(s):  
D van der Harst ◽  
D de Jong ◽  
J Limpens ◽  
PM Kluin ◽  
Y Rozier ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
B Cells ◽  
Autoimmune Diseases ◽  
B Cell ◽  
Malignant Lymphoma ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Clinical Manifestations ◽  
Cell Populations ◽  
Dna Rearrangement ◽  
Thrombocytopenic Purpura

Idiopathic thrombocytopenic purpura (ITP) may be associated with other autoimmune diseases and the development of lymphoproliferative malignancies. In Sjogren's disease, Graves' disease, and essential mixed cryoglobulinemia, which are also associated with the development of B-cell neoplasia, clonal B-cell expansions have been detected. Eleven patients with ITP were investigated for the presence of a clonal excess (CE) using kappa-lambda flow cytometry and DNA analysis for rearrangement of immunoglobulin heavy and light chain genes in blood and/or spleen lymphocytes. In 10 of 11 patients, clonal B-cell populations were found by one or both tests. In three of these patients, oligoclonal B-cell populations were suggested by the combined findings. In all four patients with a small paraproteinemia, the isotype was confirmed by either flow cytometry or DNA rearrangement analysis. Our data suggest that the oligoclonal expansions are not restricted to CD5+ B cells, as in the majority of patients this subset was below the detection level of flow cytometry or DNA rearrangement analysis. None of the patients developed clinical manifestations of malignant lymphoma during a follow-up period of 10 to 44 months after sampling. We conclude that clonal excess populations of B cells are not a unique feature of malignant lymphoma, but may occur in autoimmune diseases, suggesting a benign (oligo)clonal B-cell proliferation.

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