scholarly journals Third cranial nerve palsy (ptosis, diplopia) accompanied by orbital swelling: case report of unusual clinical presentation of giant cell arteritis associated with polymyalgia rheumatica

2012 ◽  
Author(s):  
Prassede Bravi ◽  
Patricia Tolaini
Keyword(s):  
Polymyalgia Rheumatica ◽  
Wide Spectrum ◽  
Systemic Vasculitis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Temporal Artery ◽  
Older Individuals ◽  
Ocular Manifestations ◽  
Adequate Dose ◽  
Wide Range

IntroductionGiant cell arteritis (GCA) is the most common systemic vasculitis in older individuals, characterized by granulomatosus inflammation of the wall of large and medium-sized arteries. The wide spectrum of arterial sites involved leads to ischemia of different organs resulting in a wide range of clinical signs and symptoms. Temporal artery is commonly involved (temporal arteritis). Unusual patterns of presentation, such as extraocular motility disorders and orbital swelling, may be early and transient manifestations of GCA and precede the permanent visual loss due to ischemic optic neuropathy.Case reportWe describe a patient with uncommon manifestations of GCA consisting of transient recurrent diplopia, ptosis, orbital swelling together with more typical clinical features of the disease such as musculoskeletal manifestations (polymyalgia rheumatica) and facial pain: all signs and symptoms promptly resolved under corticosteroid therapy without relapse.Conclusions A high level of suspicion of GCA in individuals over the age of 50 years is needed to prevent the development of severe complications. Clinicians should be aware of uncommon manifestations of the disease such as head–neck swelling and ophthalmoplegia: management guidelines have stated that prompt administration of adequate dose of corticosteroids as soon as ocular manifestations of GCA are noted may almost totally prevent blindness.

An Update of Gorlin-Goltz Syndrome

2018 ◽  
Vol 7 (3) ◽  
pp. 38-41 ◽  
Author(s):  
Aliya Hasan ◽  
Dapo Akintola ◽  
Aliya Hasan ◽  
Dapo Akintola
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Oral Manifestations ◽  
Early Referral ◽  
Goltz Syndrome ◽  
Dental Practitioners ◽  
Wide Range ◽  
Risk Of Malignancy ◽  
Clinical Signs And Symptoms

Gorlin-Goltz syndrome encompasses a variety of clinical signs and symptoms including important oral manifestations which general dental practitioners should be aware of. In light of the risk of malignancy it is important to be aware of this syndrome and recognise the need for early referral for multidisciplinary management. This paper aims to discuss Gorlin-Goltz syndrome, the pathophysiology of the condition and address the wide range of clinical manifestations. The author will pay particular attention to the oral manifestations of the condition and the management of such anomalies.

scholarly journals Use of Biologic Agents in Ocular Manifestations of Rheumatic Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Courtney L. Kraus ◽  
Susan M. Culican
Keyword(s):  
Rheumatic Disease ◽  
Disease Burden ◽  
Biologic Therapy ◽  
Signs And Symptoms ◽  
Biologic Agents ◽  
Efficacy And Safety ◽  
Ocular Manifestations ◽  
Wide Range ◽  
Treatment Paradigm ◽  
Rheumatic Conditions

Biologic agents have dramatically shifted the treatment paradigm for rheumatic disease. Use of these agents can decrease disease burden, allow the patient to be weaned from corticosteroids, and reduce the likelihood of relapse. Eye disease associated with rheumatic conditions may present with a wide range of signs and symptoms. This coexisting pathology should not be overlooked and should be considered a reason for initiation or continuation of biologic therapy. Additionally, many of the ocular manifestations of rheumatic disease respond preferentially to specific targeting molecules. This paper summarizes the available studies on the use, efficacy, and safety of biologic agents in the treatment of ocular manifestations of rheumatic disease.

scholarly journals In silico and in vitro evaluation of primers for molecular differentiation of Leishmania species

2021 ◽  
Vol 30 (1) ◽  
Author(s):  
Beatriz Batista Trigo ◽  
Fernanda Muller de Oliveira-Rovai ◽  
Marco Milanesi ◽  
Pier Kenji Rauschkolb Katsuda Ito ◽  
Yuri Tani Utsunomiya ◽  
...  
Keyword(s):  
In Silico ◽  
Wide Spectrum ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Laboratory Diagnosis ◽  
Leishmania Infection ◽  
Pcr Analysis ◽  
In Vitro Evaluation ◽  
Leishmania Spp

Abstract Leishmaniasis is a zoonotic disease caused by over 20 species of protozoan parasites of the genus Leishmania. Infection is commonly spread by sandflies and produces a wide spectrum of clinical signs and symptoms. Therefore, from an epidemiological and therapeutic standpoint, it is important to detect and differentiate Leishmania spp. The objective of this study was to combinate in silico and in vitro strategies to evaluate the analytical specificity of primers previously described in the literature. According to electronic PCR (e-PCR) analysis, 23 out of 141 pairs of primers selected through literature search matched their previously reported analytical specificity. In vitro evaluation of nine of these primer pairs by quantitative PCR (qPCR) confirmed the analytical specificity of five of them at the level of Leishmania spp., L. mexicana complex or Leishmania and Viannia subgenera. Based on these findings, the combination of e-PCR and qPCR is suggested to be a valuable approach to maximize the specificity of new primer pairs for the laboratory diagnosis of infections with Leishmania spp.

scholarly journals Clinical manifestations of cow milk protein intolerance in infants

2005 ◽  
Vol 133 (7-8) ◽  
pp. 348-352
Author(s):  
Marija Mladenovic ◽  
Nedeljko Radlovic ◽  
Zoran Lekovic ◽  
Dragana Ristic ◽  
Dragana Zivanovic ◽  
...  
Keyword(s):  
Milk Protein ◽  
Wide Spectrum ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Cow Milk ◽  
Type I ◽  
Digestive Disorders ◽  
Clinical Signs And Symptoms ◽  
Protein Intolerance

Introduction. The disorder of cow milk protein intolerance is characterized by a wide spectrum of clinical manifestations caused by hypersensitivity of type I, II, or IV, and occurs in 2-3% of children, mostly infants. Objective. The aim of this study was to present our experiences and observations of clinical signs and symptoms of cow milk protein intolerance in infants aged below 12 months. Method. The investigation was carried out on a sample of 55 infants, aged between 1.5-9 months (x=4.2l?1.25), who had cow milk protein intolerance. Diagnosis of illness was based on characteristic anamnestic, clinical, and laboratory parameters, as well as on an adequate patient's response to antigen elimination. Results. The clinical presentation of cow milk protein intolerance was dominated by cutaneous problems, found in 40/55 (72.73%) infants, followed by digestive disorders, found in 31 (56.36%), while respiratory tract disorders were observed least frequently (14.55%). None of the patients developed anaphylactic shock. Changes involving only one system were found in 35 (63.64%) patients; of these 20 (36.36%) were cutaneous and 15 (27.27%) digestive. Twenty (36.36%) infants displayed multisystemic changes; of these 12 were cutaneus with digestive, 4 were cutaneus with respiratory, while 4 infants had cutaneous, digestive, and respiratory disorders. Of the 55 infants with cow milk protein intolerance, 26 (47.27%) had urticaria, 22 (40.00%) perioral erythema, 21 (38.18%) diarrhoea (15 haemorrhagic, 6 non-haemorrhagic), 13 (23.64%) vomiting, 12 (21.82%) Quincke's oedema, 12 (21.82%) eczema, 5 (9.09%) obstructive bronchitis, while 3 (5.45%) infants had laryngitis. In 5 (9.09%) patients we found a significant body weight deficit and in 3 (5.45%), sideropenic anaemia, while longitudinal growth retardation was not registered in any of the patients. Conclusion. Our study showed that the disorder of cow milk protein intolerance predominantly involved cutaneous disorders as well as combinations of cutaneous and digestive disorders, while respiratory system disorders proved to be relatively rare.

scholarly journals Scorpion Venom and the Inflammatory Response

2010 ◽  
Vol 2010 ◽  
pp. 1-16 ◽  
Author(s):  
Vera L. Petricevich
Keyword(s):  
Inflammatory Response ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Biological Properties ◽  
Scorpion Venom ◽  
Multiple Organ ◽  
Chemical Compositions ◽  
Wide Range ◽  
Clinical Signs And Symptoms ◽  
High Doses

Scorpion venoms consist of a complex of several toxins that exhibit a wide range of biological properties and actions, as well as chemical compositions, toxicity, and pharmacokinetic and pharmacodynamic characteristics. These venoms are associated with high morbility and mortality, especially among children. Victims of envenoming by a scorpion suffer a variety of pathologies, involving mainly both sympathetic and parasympathetic stimulation as well as central manifestations such as irritability, hyperthermia, vomiting, profuse salivation, tremor, and convulsion. The clinical signs and symptoms observed in humans and experimental animals are related with an excessive systemic host inflammatory response to stings and stings, respectively. Although the pathophysiology of envenomation is complex and not yet fully understood, venom and immune responses are known to trigger the release of inflammatory mediators that are largely mediated by cytokines. In models of severe systemic inflammation produced by injection of high doses of venom or venoms products, the increase in production of proinflammatory cytokines significantly contributes to immunological imbalance, multiple organ dysfunction and death. The cytokines initiate a cascade of events that lead to illness behaviors such as fever, anorexia, and also physiological events in the host such as activation of vasodilatation, hypotension, and increased of vessel permeability.

scholarly journals Polymialgia Rheumatica, Giant Cell Arteritis or Both?

2018 ◽  
Vol 15 (6) ◽  
pp. 51-58
Author(s):  
Adina Cociorvei ◽  
Mădălina Ababei
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Temporal Arteritis ◽  
Morning Stiffness ◽  
Systemic Vasculitis ◽  
Diagnostic Algorithm ◽  
Signs And Symptoms ◽  
Temporal Artery ◽  
Clinical Suspicion ◽  
Temporal Artery Biopsy

AbstractGiant cell arteritis (GCA), or temporal arteritis, is the most common systemic vasculitis, and the greatest risk factor for developing GCA is aging. The disease almost never occurs before age 50, and its incidence rises steadily thereafter, peaking between ages 70 to 79, the risk of development being two times higher in women.Polymialgia rheumatica (PMR) is an inflammatory rheumatic condition characterized clinically by aching and morning stiffness at the shoulders, hip girdle, and neck. PMR is almost exclusively a disease of adults over the age of 50, with a prevalence that increases progressively with advancing age. The peak incidence of PMR occurs between ages 70 and 80, the same as in the case ofGCA. PMRis 2-3 times more common in women than in men.PMR is two to three times more common than GCA and occurs in about 50% of patients with GCA. The percentage of patients with PMR who experience GCA at some point varies widely in reported series ranging from 5 to 30 percent. PMR can precede, accompany or follow GCA. The diagnostic in the case of PMR is made first of all on clinical features, in the patients in whom another disease to explain the findings is not present. For GCA we must follow the diagnostic algorithm presented below (figure 1) and keep in mind that a negative result for temporal artery biopsy does not exclude the diagnostic if clinical suspicion of GCA is highWe present the case of a 81 year-old male with signs and symptoms from both conditions, PMR and GCA.

scholarly journals Clinical characteristics of rotaviruses disease

2004 ◽  
Vol 4 (2) ◽  
pp. 22-24 ◽  
Author(s):  
Šukrija Zvizdić ◽  
Sađida Telalbašić ◽  
Edina Bešlagić ◽  
Semra Čavaljuga ◽  
Jasminka Maglajlić ◽  
...  
Keyword(s):  
Young Children ◽  
Wide Spectrum ◽  
Age Groups ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Latex Agglutination ◽  
Hospitalized Patients ◽  
Viral Gastroenteritis ◽  
Age Group ◽  
Stool Samples

Rotaviruses are the major causes of viral gastroenteritis in infant and the young children. There are a wide spectrum of clinical signs and symptoms of rotavirosis. Rotavirus infection is fecal-oral infection. Rotaviruses prove with Latex agglutination test and electron microscopy. In a four year period 943 stool samples out of 527 hospitalized patients had been analyzed. A presence of rotavirus is proved with a LA and EM tests at 170 (32,2%) patients age 0-7 years, in their stool samples. Analyzing age groups of these patients, it was found that the rotavirusesinfection the most frequently occurred at age group from 7-24 months. From 170 positive patients, 122 or 71,8% were in this age group. At all patients was found diarrhea, vomiting in a 90,5% cases. Mild fever had 65,5% patients, signs of a respiratory infection appeared at 60,7% patients, abdominal pain at 13,3% patients. Severe dehydration had 49,9% patients and metabolic acidosis had 79,2% cases. Macroscopically blood in stool had 6,4% patients, slime in a stool 46,0% patients was found, and aholic stool had 8,4% patients. In all hospitalized patients disease lasted in average 12,6 days, and the hospitalization in average 10,2 days. None of the patient had any kind of complication, all of them very successfully cured. These results confirm that rotaviruses are important health problem among infant and the young children in Bosnia and Herzegovina.

Anti-malignin Antibody Evaluation: A Possible Challenge for Cancer Management

1997 ◽  
Vol 12 (4) ◽  
pp. 141-147 ◽  
Author(s):  
C. Botti ◽  
A. Martinetti ◽  
S. Nerini-Molteni ◽  
L. Ferrari
Keyword(s):  
Early Detection ◽  
Early Detection Of Cancer ◽  
Wide Spectrum ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Response To Treatment ◽  
Anatomical Site ◽  
Cancer Management ◽  
Invasive Test ◽  
Clinical Signs And Symptoms

The major problem in the management of cancer is the difficulty of an early diagnosis. Clinical signs and symptoms generally appear late in the course of the disease. The availability of a non-invasive test which detects a blood molecule closely associated with the malignant transformation of the cells could be of help in the early detection of cancer. Malignin is a 10 kDa polypeptide located in the cytoplasmic and outer membranes of all malignant cells. Anti-malignin antibodies (AMAs) are IgM immunoglobulins spontaneously produced by the host against the oncoprotein malignin when neoplastic transformation occurs; since AMAs are IgM, they can represent an “early” transformation indicator useful for the early detection of cancer. Elevated AMA serum concentrations, measured by means of TARGET®@ reagent, have been demonstrated inpatients with a wide spectrum of non-terminal active cancers, regardless of the anatomical site and histotype of the tumor. The AMA test showed a sensitivity and specificity of 95% on first determination and >99% on repeated determinations, and has been reported to be a promising diagnostic tool for the early detection of cancer, as well as for monitoring of the response to treatment and possibly for screening of an asymptomatic population.

Diagnostic of immune-mediated neuropathies

2011 ◽  
Vol 152 (39) ◽  
pp. 1560-1568
Author(s):  
Péter Diószeghy
Keyword(s):  
Systemic Vasculitis ◽  
Correct Diagnosis ◽  
Clinical Signs ◽  
Sensory Neuropathy ◽  
Signs And Symptoms ◽  
Motor Neuropathy ◽  
Vasculitic Neuropathy ◽  
Functional Variants ◽  
Precise Knowledge ◽  
Immune Mediated

Separate discussion of immune-mediated neuropathies from other neuropathies is justified by the serious consequences of the natural course of these diseases, like disability and sometimes even life threatening conditions. On the other hand nowadays effective treatments already exist, and with timely and correct diagnosis an appropriately chosen treatment may result in significant improvement of quality of life, occasionally even complete recovery. These are rare diseases, and the increasing number of different variants makes it more difficult to recognize them. Their diagnosis is based on the precise knowledge of clinical signs and symptoms, and it is verified by the help of neurophysiologic and laboratory, first of all CSF examinations. Description of clinical features of the classic acute immune-mediated neuropathy, characterized by ascending paresis and demyelination is followed by a summary of characteristics of newly recognized axonal, regional and functional variants. Chronic immune-mediated demyelinating polyneuropathies are not diagnosed in due number even today. This paper does not only present the classic form but it also introduces the ever increasing special variants, like distal acquired demyelinating sensory neuropathy, Lewis-Sumner syndrome, multifocal motor neuropathy and paraproteinemic neuropathies. Vasculitic neuropathies can be divided into two groups: systemic and non-systemic ones. The first sign of a vasculitic neuropathy is a progressive, painful mononeuropathy; the classic clinical presentation is the mononeuritis multiplex. It is characterized by general signs like fever, loss of weight, fatigue. In systemic vasculitis organ specific symptoms are also present. From the paraneoplastic diseases the subacute sensory neuropathy and the sensory neuronopathy are members of the immune-mediated neuropathies, being most frequently associated with small cell lung cancer. Orv. Hetil., 2011, 152, 1560–1568.

scholarly journals Dermatologic manifestations of granulomatosis with polyangiitis: A case report and literature review

2019 ◽  
Vol 6 (4) ◽  
pp. 19
Author(s):  
Ashley Thomas ◽  
Nithya Krishnan ◽  
Nicole Vesely ◽  
Myint Thway ◽  
Rafik Jacob
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Clinical Signs ◽  
Granulomatous Inflammation ◽  
Signs And Symptoms ◽  
Organ Damage ◽  
Skin Lesions ◽  
African American Female ◽  
Cutaneous Manifestations ◽  
Serologic Testing

Granulomatosis with polyangiitis (GPA) is an ANCA-associated, systemic vasculitis of small and medium-sized blood vessels. GPA causes inflammation and destruction to the vessel wall and eventual tissue and organ damage. It classically affects the tissues and vasculature of the sinuses, lungs, and kidneys. The organ damage results in epistaxis, cough, hemoptysis, shortness of breath and/or even kidney failure. Cutaneous manifestations are rare, but have been reported. We discuss the case of a 27-year-old African American female who presented with skin lesions on her bilateral forearms and hands, several years after diagnosis and treatment for GPA. The lesions were isolated papules, located on bilateral elbows, palms, and the lateral edge of the 3rd digit on her left hand. The lesions were intensely pruritic and non-painful. A skin biopsy of the lesions showed neutrophilic and granulomatous inflammation with nuclear debris, a largely non-specific histopathologic finding. An extensive autoimmune work up revealed elevated c-ANCA/PR3-ANCA levels supporting a diagnosis of cutaneous GPA. GPA is diagnosed by a combination of clinical signs and symptoms, serologic testing, and histology from biopsy of affected organs. Patient’s who meet the criteria should be tested for anti-neutrophil cytoplasmic antibody (ANCA), specifically c-ANCA/PR3-ANCA. A positive ANCA is supportive for GPA diagnosis. However, a negative ANCA does not rule out disease. Patients with cutaneous findings suggestive of GPA and positive c-ANCA/PR3-ANCA serologic testing should be closely followed up, which will lead to overall better prognosis, improved health outcomes and reduced patient and health care expenses.

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