scholarly journals Pembrolizumab induced scleroderma

2020 ◽  
Vol 6 (4) ◽  
pp. 6
Author(s):  
Reem Alkilany ◽  
Stanley Ballou
Keyword(s):  
Lung Cancer ◽  
Vascular Dysfunction ◽  
Case Reports ◽  
Severe Disease ◽  
Connective Tissue Disorder ◽  
Multiple Organ ◽  
Organ Involvement ◽  
White Female ◽  
Multisystem Disease ◽  
First Case

Systemic sclerosis (SSc) is a rare connective tissue disorder. It is a chronic multisystem disease characterized by vascular dysfunction and progressive fibrosis of tissue, with skin hardening and thickening (known as scleroderma) being the hallmark of the disease. It tends to affect females more than males and has a higher prevalence in African American population with earlier onset and more severe disease. While scleroderma can be a manifestation of conditions other than SSC, the presence of skin thickening of the fingers, extending proximally to metacarpophalangeal joints is sufficient to classify a patient as having SSc. SSc treatment is challenging given the heterogeneity of the disease, multiple organ involvement, different subtypes and poorly understood etiology and pathogenesis. Yet, systemic immunosuppressive therapy is often the treatment of choice. Here we present a 60-year-old white female who developed skin thickening of her fingers extending to the forearms and of her proximal thighs after being treated with pembrolizumab for metastatic non-small cell lung cancer. It was difficult to determine internal organ involvement given her history of metastatic lung cancer, but scleroderma specific autoantibodies were negative. Her symptoms improved after treatment with methotrexate and stopping pembrolizumab. This is one of the first case reports of scleroderma secondary to pembrolizumab.

scholarly journals Docetaxel-Induced Systemic Sclerosis with Internal Organ Involvement Masquerading as Congestive Heart Failure

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Bumsoo Park ◽  
Raghavendra C. Vemulapalli ◽  
Amit Gupta ◽  
Maria E. Shreve ◽  
Della A. Rees
Keyword(s):  
Systemic Sclerosis ◽  
Case Reports ◽  
Organ Involvement ◽  
Internal Organs ◽  
Skin Changes ◽  
Cutaneous Side Effects ◽  
First Case ◽  
Kidney Involvement ◽  
Cutaneous Side Effect ◽  
Diffuse Cutaneous Systemic Sclerosis

Systemic sclerosis, or scleroderma, is a complex medical disorder characterized by limited or diffuse skin thickening with frequent involvement of internal organs such as lungs, gastrointestinal tract, or kidneys. Docetaxel is a chemotherapeutic agent which has been associated with cutaneous side effects. An uncommon cutaneous side effect of docetaxel is scleroderma-like skin changes that extend from limited to diffuse cutaneous systemic sclerosis. Several case reports have been published regarding the association of docetaxel and systemic sclerosis. However, those reports demonstrated the association between docetaxel and scleroderma-like skin changes without internal organ involvement. Here, we report a case of systemic sclerosis with pulmonary arterial hypertension and a microangiopathic kidney involvement induced by docetaxel chemotherapy. After an exhaustive literature review, this could be the first case of docetaxel-induced systemic sclerosis involving internal organs.

Alectinib continuation during COVID 19 ‘antiviral’ treatment: Risk or benefit?

2021 ◽  
pp. 107815522110201
Author(s):  
Mehmet Hadi Akkus ◽  
Omur Kaman ◽  
Mutlu Dogan
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Dose Adjustment ◽  
Kinase Inhibitors ◽  
Case Reports ◽  
Antiviral Treatment ◽  
Daily Routine ◽  
Alk Inhibitors ◽  
Lung Cancer Patients ◽  
First Case

Introduction Serious Acute Respiratory Syndrome Coronavirus 2 (SARSCoV2) has led to COVID 19 pandemic a year ago and it has not been globally taken under control yet. COVID 19 tends to have poorer prognosis in cancer patients. Additionally, we have no well-established guidelines for management of these patients during pandemic, in terms of treatment of ‘cancer’ and treatment of ‘COVID 19’. Tyrosine kinase inhibitors (TKIs) are given without any break in cancer patients to have better survival outcomes in daily routine. However, there is no well-established data to continue or delay ALK inhibitors in lung cancer patients infected with SARS-CoV2. Concomittant use of ALK inhibitors and COVID 19 antiviral treatment is a dilemma because of the lack of data in this area. Case Report A 47-year old female metastatic ALK positive nonsquamous cell lung cancer patient on alectinib, a second generation ALK inhibitor was diagnosed with symptomatic COVID 19. She was given favipiravir for COVID 19 while continuing alectinib. Management and outcome: The patient continued alectinib during COVID 19 antiviral treatment without any break. She tolerated ‘concomittant’ alectinib & favipiravir. She had partial remission after three months of alectinib without any dose adjustment despite active COVID 19 medication. Discussion To best of our knowledge, this is the first case who continued alectinib without dose adjustment during antiviral COVID-19 medication without clinically worsening. There is limited data about ‘concomittant’ use of TKIs and antiviral COVID 19 medication in the literature. There are some case reports, but they generally tended to delay or suspend TKIs during COVID 19 antiviral medication. Our case differs from them in terms of continuation of alectinib without any break or additional side effects during favipiravir for symptomatic COVID 19. We consider that our case might contribute to the literature in terms of management of cancer patients on targeted therapy during COVID 19 antiviral treatment. However, clinical trials are needed in this area.

scholarly journals SARS-CoV-2 infection: can ferroptosis be a potential treatment target for multiple organ involvement?

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Ming Yang ◽  
Ching Lung Lai
Keyword(s):  
Cell Death ◽  
Programmed Cell Death ◽  
Science Studies ◽  
Severe Disease ◽  
Multiple Organ ◽  
Organ Involvement ◽  
Treatment Target ◽  
New Treatment

AbstractSince the outbreak of the new coronavirus in 2019 (SARS-CoV-2), many studies have been performed to better understand the basic mechanisms and clinical features of the disease. However, uncertainties of the underlying mechanisms of multiple organ involvement remain. A substantial proportion of severe coronavirus disease 2019 (COVID-19) patients have lymphopenia, low serum iron levels, and multiple organ involvement. Several therapeutic agents have been used for different stages of the disease, but the treatment for severe disease is still suboptimal. Understanding the mechanism of programmed cell death in COVID-19 may lead to better therapeutic strategies for these patients. On the basis of observations of basic science studies and clinical researches on COVID-19, we hypothesize that ferroptosis, a novel programmed cell death, may be an important cause of multiple organ involvement in COVID-19 and it might serve as a new treatment target. In spite of the existing findings on the involvement of ferroptosis in SARS-CoV-2 infection, there is no reported study to uncover how does ferroptosis acts in SARS-CoV-2 infection yet. Uncovering the role of ferroptosis in SARS-CoV-2 infection is essential to develop new treatment strategies for COVID-19. Intracellular cell iron depletion or new generation of ferroptosis inhibitors might be potential drug candidates for COVID-19. We hope this hypothesis may launch a new wave of studies to uncover the association of ferroptosis and SARS-CoV-2 infection in vitro and in vivo.

A Case Series of SARS-CoV-2 RT-PCR-Positive Hospitalized Infants 60 Days of Age or Younger From 2 New York City Pediatric Emergency Departments

2021 ◽  
Vol 60 (4-5) ◽  
pp. 247-251
Author(s):  
Ameer Hassoun ◽  
Nessy Dahan ◽  
Christopher Kelly
Keyword(s):  
New York ◽  
Case Reports ◽  
Severe Disease ◽  
Case Series ◽  
Pediatric Emergency ◽  
Rt Pcr ◽  
Vulnerable Group ◽  
Mild Disease ◽  
Young Infants ◽  
Novel Coronavirus

The emergence of novel coronavirus disease-2019 poses an unprecedented challenge to pediatricians. While the majority of children experience mild disease, initial case reports on young infants are conflicting. We present a case series of 8 hospitalized infants 60 days of age or younger with coronavirus disease-2019. A quarter of these patients had coinfections (viral or bacterial). None of these infants had severe disease. Continued vigilance in testing this vulnerable group of infants is warranted.

scholarly journals Fetus in fetu: two case reports from North African country

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Moutaz Ragab ◽  
Omar Nagy Abdelhakeem ◽  
Omar Mansour ◽  
Mai Gad ◽  
Hesham Anwar Hussein
Keyword(s):  
Histopathological Examination ◽  
Case Reports ◽  
Abdominal Mass ◽  
Mature Teratoma ◽  
Surgical Techniques ◽  
Rare Condition ◽  
Mass Effect ◽  
Fetus In Fetu ◽  
Vascular Connection ◽  
First Case

Abstract Background Fetus in fetu is a rare congenital anomaly. The exact etiology is unclear; one of the mostly accepted theories is the occurrence of an embryological insult occurring in a diamniotic monochorionic twin leading to asymmetrical division of the blastocyst mass. Commonly, they present in the infancy with clinical picture related to their mass effect. About 80% of cases are in the abdomen retroperitoneally. Case presentation We present two cases of this rare condition. The first case was for a 10-year-old girl that presented with anemia and abdominal mass, while the second case was for a 4-month-old boy that was diagnosed antenatally by ultrasound. Both cases had vertebrae, recognizable fetal organs, and skin coverage. Both had a distinct sac. The second case had a vascular connection with the host arising from the superior mesenteric artery. Both cases were intra-abdominal and showed normal levels of alpha-fetoprotein. Histopathological examination revealed elements from the three germ layers without any evidence of immature cells ruling out teratoma as a differential diagnosis. Conclusions Owing to its rarity, fetus in fetu requires a high degree of suspicion and meticulous surgical techniques to avoid either injury of the adjacent vital structures or bleeding from the main blood supply connection to the host. It should be differentiated from mature teratoma.

scholarly journals Bittersweet: infective complications of drug-induced glycosuria in patients with diabetes mellitus on SGLT2-inhibitors: two case reports

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Caroline Bartolo ◽  
Victoria Hall ◽  
N. Deborah Friedman ◽  
Chloe Lanyon ◽  
Andrew Fuller ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Fungal Infections ◽  
Case Reports ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Urogenital Tract ◽  
Hypoglycemic Agents ◽  
Drug Induced ◽  
First Case ◽  
Increased Risk

Abstract Background Sodium-glucose co-transporter 2 (SGLT2) inhibitors are novel hypoglycemic agents which reduce reabsorption of glucose at the renal proximal tubule, resulting in significant glycosuria and increased risk of genital mycotic infections (GMI). These infections are typically not severe as reported in large systematic reviews and meta-analyses of the medications. These reviews have also demonstrated significant cardiovascular benefits through other mechanisms of action, making them attractive options for the management of Type 2 diabetes mellitus (T2DM). We present two cases with underlying abnormalities of the urogenital tract in which the GMI were complicated and necessitated cessation of the SGLT2 inhibitor. Case presentations Both cases are patients with T2DM on empagliflozin, an SGLT2 inhibitor. The first case is a 64 year old man with Candida albicans balanitis and candidemia who was found to have an obstructing renal calculus and prostatic abscess requiring operative management. The second case describes a 72 year old man with Candida glabrata candidemia who was found to have prostatomegaly, balanitis xerotica obliterans with significant urethral stricture and bladder diverticulae. His treatment was more complex due to fluconazole resistance and concerns about urinary tract penetration of other antifungals. Both patients recovered following prolonged courses of antifungal therapy and in both cases the SGLT2 inhibitor was ceased. Conclusions Despite their cardiovascular benefits, SGLT2 inhibitors can be associated with complicated fungal infections including candidemia and patients with anatomical abnormalities of the urogenital tract may be more susceptible to these infections as demonstrated in these cases. Clinicians should be aware of their mechanism of action and associated risk of infection and prior to prescription, assessment of urogenital anatomical abnormalities should be performed to identify patients who may be at risk of complicated infection.

scholarly journals Malignant rhabdoid tumours of the small intestine with multiple organ involvement: Case report

2021 ◽  
Vol 79 ◽  
pp. 386-389
Author(s):  
Aya Noguchi ◽  
Hirofumi Imoto ◽  
Hiroshi Yoshida ◽  
Shigeyuki Asano ◽  
Michiaki Unno ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Multiple Organ ◽  
Organ Involvement
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