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NCBI: db=pubmed; Term=vasculitis AND ((English[lang] OR French[lang]) AND adult[MeSH] AND "last 90 days"[PDat])
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Dermatological aspects of tularaemia: a study of 168 cases.

mar, 13/11/2018 - 15:44
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Dermatological aspects of tularaemia: a study of 168 cases.

Clin Exp Dermatol. 2018 Oct;43(7):770-774

Authors: Polat M, Karapınar T, Sırmatel F

Abstract
BACKGROUND: Tularaemia is a zoonotic infectious disease caused by Francisella tularensis, an aerobic, uncapsulated, gram-negative coccobacillus. Several case reports have appeared on the dermatological manifestations of tularaemia, but relatively few longer-term studies are available.
AIM: To identify skin features of tularaemia that aid in its diagnosis.
METHODS: In total, 168 patients (68 male, 100 female) diagnosed with tularaemia were retrospectively examined. All dermatological data for these patients were evaluated.
RESULTS: Of the 168 patients, 149 (88.69%) had tularaemia of the oropharyngeal type, 12 (7.73%) had the ulceroglandular type, 5 (2.9%) had the oculoglandular type and 2 (0.59%) had the pulmonary type. Secondary skin manifestations were found in 26 patients (15.47%). Sweet syndrome (SS) was found in 11 patients (6.54%), most of whom presented with the oropharyngeal form, while erythema nodosum (EN) was found in 7 patients (4.16%), dermatitis in 2 (1.19%), urticaria in 2 (1.19%), acneiform eruptions in 1 (0.59%), vasculitis-like eruptions in 1 (0.59%) and SS + EN in 1 (0.59%). Patients with the oropharyngeal form had a statistically significant (P < 0.001) higher number of skin findings than patients with the other forms.
CONCLUSIONS: In clinical practice, tularaemia may present with various cutaneous manifestations, and dermatologists who work in endemic regions must be aware of the possibility of this disease.

PMID: 29761532 [PubMed - indexed for MEDLINE]

A rare endoscopic appearance of granulomatosis with polyangiitis involving the intestine: a case report.

sam, 10/11/2018 - 14:46
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A rare endoscopic appearance of granulomatosis with polyangiitis involving the intestine: a case report.

BMC Gastroenterol. 2018 Oct 25;18(1):154

Authors: Pan SW, Wang C, Zhang X, Zhang L, Yan QQ, Zhao CJ, Chang C, Luan XD

Abstract
BACKGROUND: The involvement of granulomatosis with polyangiitis is less frequent in the intestine.
CASE PRESENTATION: We present a case of Wegener's granulomatosis with unusual endoscopic appearance, involvement in a young man's gastrointestinal tract. A 45-year-old man was diagnosed with Wegener's granulomatosis 11 years ago, and relapsed with abdominal pain and melena. A colonoscopy was performed, and the appearance of mucosal lesions with an unusual annular black membrane was observed. A black ring-shaped membranous tissue adhered to the surface of the colon wall, which could be traversed by an endoscopic forepart.
CONCLUSION: Biopsy of the black membrane revealed degenerative colonic mucosal tissues, while deep colonic biopsy revealed inflammatory granulation tissues. This has not been reported in previous documents.

PMID: 30359222 [PubMed - indexed for MEDLINE]

Coronary artery bypass for multiple coronary artery aneurysms due to Kawasaki disease.

sam, 10/11/2018 - 14:46
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Coronary artery bypass for multiple coronary artery aneurysms due to Kawasaki disease.

J Card Surg. 2018 10;33(10):651-652

Authors: Turkyilmaz S, Kavala AA

PMID: 30199921 [PubMed - indexed for MEDLINE]

CT analysis of the aorta in giant-cell arteritis: a case-control study.

sam, 10/11/2018 - 14:46
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CT analysis of the aorta in giant-cell arteritis: a case-control study.

Eur Radiol. 2018 Sep;28(9):3676-3684

Authors: Berthod PE, Aho-Glélé S, Ornetti P, Chevallier O, Devilliers H, Ricolfi F, Bonnotte B, Loffroy R, Samson M

Abstract
OBJECTIVES: Giant cell arteritis (GCA) is a large-vessel vasculitis whose diagnosis is confirmed by temporal artery biopsy. However, involvement of large vessels, especially the aorta, can be shown by imaging, which plays an increasing role in GCA diagnosis. The threshold above which aortic wall thickening, as measured by computed tomography (CT), is considered pathological is controversial, with values ranging from 2 to 3 mm. This study assessed aortic morphology by CT scan and its diagnostic value in GCA.
METHODS: Altogether, 174 patients were included (64 with GCA, 43 with polymyalgia rheumatica and 67 controls). All patients had a CT scan at diagnosis or at inclusion for controls. Aortic wall thickness, aortic diameter and scores for atheroma were measured. Assessor was blinded to each patient's group.
RESULTS: Aortic diameters and atheroma scores were similar between groups. Aortic wall thickness was greater in the GCA group, even after the exclusion of GCA patients with aortic wall thickness ≥3 mm. The receiver operating characteristic (ROC) curve showed that a wall thickness of 2.2 mm was the optimal threshold to diagnose GCA (sensitivity, 67%; specificity, 98%).
CONCLUSIONS: Measuring aortic wall thickness by CT scan is effective to diagnose GCA. The optimal threshold to regard aortic wall thickening as pathological was ≥2.2 mm.
KEY POINTS: • Imaging, including CT scan, plays an increasing role in GCA diagnosis • CT measurement of aortic wall thickness is useful to diagnose GCA • A 2.2-mm threshold allows the diagnosis of thickened aortic wall in GCA.

PMID: 29600479 [PubMed - indexed for MEDLINE]

Thromboangiitis obliterans episode: autoimmune flare-up or reinfection?

mer, 07/11/2018 - 14:06
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Thromboangiitis obliterans episode: autoimmune flare-up or reinfection?

Vasc Health Risk Manag. 2018;14:247-251

Authors: Mohareri M, Mirhosseini A, Mehraban S, Fazeli B

Abstract
Background: The possible role of infectious pathogens in the development of thromboangiitis obliterans (TAO) was considered soon after the disease was first described. However, it is not yet known whether infectious pathogens induce thrombotic vasculitis or if they cause a type of autoimmune disease. To investigate whether TAO relapses are more likely due to reinfection or autoimmune flare, the serum levels of toll-like receptor (sTLR) 4, sTLR2, C-reactive protein (CRP), and neopterin were evaluated in TAO patients during both the acute and quiescent phases of the disease as well as in a gender-, age-, and smoking habit-matched control group.
Methods: Following a cross-sectional study design, 28 patients in the acute phase of TAO and 23 patients in the quiescent phase participated in this study. In addition, 31 matched controls were enrolled.
Results: Toll-like receptor (TLR) 4 was significantly higher in patients in the acute phase of the disease than in patients in the quiescent phase (P=0.012). Also, TLR4 was significantly higher in the patients with CRP >7 µm/mL than in the patients with lower CRP (P=0.031). Notably, TLR4 in the patients in the quiescent phase of TAO was significantly lower than in the controls (P=0.006). No significant difference in the level of TLR2 was found among the groups (P>0.05). Neopterin was significantly higher in the acute phase of TAO in comparison to the quiescent phase (P=0.003) and the controls (P=0.005).
Conclusion: These findings indicate that the trigger of TAO might be Gram-negative bacteria, which can be hidden or immunologically suppressed in the quiescent phase of TAO, leading to a lower level of TLR4 accompanying the normal level of neopterin. However, relapses might develop according to toxic or hypoxic cell injuries. Hence, TLR4 shedding will increase, and therefore, sTLR4 could become closer to the level demonstrated in the controls.

PMID: 30319267 [PubMed - indexed for MEDLINE]

Vascular wall imaging in reversible cerebral vasoconstriction syndrome - a 3-T contrast-enhanced MRI study.

mer, 07/11/2018 - 14:06
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Vascular wall imaging in reversible cerebral vasoconstriction syndrome - a 3-T contrast-enhanced MRI study.

J Headache Pain. 2018 Aug 30;19(1):74

Authors: Chen CY, Chen SP, Fuh JL, Lirng JF, Chang FC, Wang YF, Wang SJ

Abstract
BACKGROUND: Limited histopathology studies have suggested that reversible cerebral vasoconstriction syndromes (RCVS) does not present with vascular wall inflammation. Previous vascular imaging studies have had inconsistent vascular wall enhancement findings in RCVS patients. The aim of this study was to determine whether absence of arterial wall pathology on imaging is a universal finding in patients with RCVS.
METHODS: We recruited patients with RCVS from Taipei Veterans General Hospital prospectively from 2010 to 2012, with follow-up until 2017 (n = 48). We analyzed the characteristics of vascular wall enhancement in these patients without comparisons to a control group. All participants received vascular wall imaging by contrasted T1 fluid-attenuated inversion recovery with a 3-T magnetic resonance machine. The vascular wall enhancement was rated as marked, mild or absent.
RESULTS: Of 48 patients with RCVS, 22 (45.8%) had vascular wall enhancement (5 marked and 17 mild). Demographics, clinical profiles, and cerebral artery flow velocities were similar across patients with versus without vascular wall enhancement, except that patients with vascular wall enhancement had fewer headache attacks than those without (p = 0.04). Follow-up imaging completed in 14 patients (median interval, 7 months) showed reduced enhancement in 9 patients, but persistent enhancement in 5.
CONCLUSION: Almost half of our RCVS patients exhibited imaging enhancement of diseased vessels, and it was persistent for approximately a third of those patients with follow-up imaging. Both acute and persistent vascular wall enhancement may be unhelpful for differentiating RCVS from central nervous system vasculitis or subclinical atherosclerosis.

PMID: 30167985 [PubMed - indexed for MEDLINE]

Takayasu Arteritis Presenting as Unexplained Pulmonary Consolidation: A Case Report.

mer, 07/11/2018 - 14:06
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Takayasu Arteritis Presenting as Unexplained Pulmonary Consolidation: A Case Report.

Vasc Endovascular Surg. 2018 Oct;52(7):579-582

Authors: Koike H, Ashizawa K, Hayashi H, Sakamoto I, Nakamura S, Nishino A, Hayashi T, Uetani M

Abstract
Although Takayasu arteritis (TA) is rare as a form of chronic inflammatory arteritis, it is important that it is diagnosed early because the 10-year survival rate is only 84% to 87%. Many reported patients have been young women in East Asia. We report a case of a young woman who originally presented with unexplained pulmonary consolidation. Five years later, contrast-enhanced computed tomography (CT) imaging showed thickening of the walls of the aorta and its branches and of the main and right pulmonary artery (PA), and occlusion of the left subclavian and left PAs. A diagnosis of TA was made based on these CT findings. Patients with TA often have PA involvement, and this can be the initial site of arteritis. Therefore, TA should be included in the differential diagnosis of young women with unexplained pulmonary consolidation.

PMID: 29742991 [PubMed - indexed for MEDLINE]

Spontaneous Isolated Inferior Mesenteric Artery Dissection With Chronic Mesenteric Ischemia: Case Report and Endovascular Management.

mer, 07/11/2018 - 14:06
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Spontaneous Isolated Inferior Mesenteric Artery Dissection With Chronic Mesenteric Ischemia: Case Report and Endovascular Management.

Vasc Endovascular Surg. 2018 Oct;52(7):561-564

Authors: Giragani S, Balani A, Reddy V, Bommakanti KT, Alwala S, Kumar A

Abstract
We report the clinical details, imaging findings, and management for a 39-year-old female presenting with recurrent episodes of pain in abdomen due to systemic lupus erythematous vasculitis associated with spontaneous isolated inferior mesenteric dissection. Spontaneous mesenteric artery dissection is an uncommon cause of mesenteric ischemia. Symptomatic spontaneous isolated inferior mesenteric artery (IMA) dissection is a rare condition, and its association with systemic lupus erythematosus is not previously described in the English literature. The optimal treatment options are debatable and include medical management, surgical reconstruction, and endovascular therapy. We wish to highlight spontaneous isolated IMA dissection as a rare etiology for chronic mesenteric ischemia and its management by endovascular methods.

PMID: 29716480 [PubMed - indexed for MEDLINE]

Aortic calcification in longstanding, undiagnosed Takayasu arteritis.

dim, 04/11/2018 - 11:18
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Aortic calcification in longstanding, undiagnosed Takayasu arteritis.

Lancet. 2018 09 15;392(10151):950

Authors: Janarthanan M, Rathinasamy J

PMID: 30238890 [PubMed - indexed for MEDLINE]

Immuno-monitoring reveals an extended subclinical disease activity in tocilizumab-treated giant cell arteritis.

jeu, 01/11/2018 - 08:31
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Immuno-monitoring reveals an extended subclinical disease activity in tocilizumab-treated giant cell arteritis.

Rheumatology (Oxford). 2018 10 01;57(10):1795-1801

Authors: Gloor AD, Yerly D, Adler S, Reichenbach S, Kuchen S, Seitz M, Villiger PM

Abstract
Objective: Tocilizumab is effective in inducing and maintaining remission of GCA. Despite clinical and serological control of disease, magnetic resonance angiography may show persistence of inflammatory signals of unknown significance in arterial walls. Thus, there is an unmet need for tools to detect subclinical disease activity.
Methods: Immune-inflammatory markers were measured in prospectively collected sera of the first randomized, double-blind, placebo-controlled trial investigating the use of tocilizumab in GCA. As a comparison, immune-inflammatory markers were also measured in sera from age- and sex-matched healthy volunteers. The biomarkers were quantified using luminex technology.
Results: Of all the parameters determined, only MMP-3, pentraxin-3 and sTNFR2 were significantly elevated, while ICAM-1 and CD163 were significantly decreased during the early stages of the study, at time points of full clinical remission under treatment with tocilizumab plus glucocorticoids. In contrast, tocilizumab monotherapy towards the end of the study resulted in an almost complete normalization of immune-inflammatory molecules, as defined by the healthy controls. MMP-3 levels showed a weak association with magnetic resonance signal intensity; none of the biomarkers predicted relapse occurring within 6 months after study end.
Conclusion: The data documented a subclinical disease activity in GCA that was more pronounced during the early stages of treatment and almost disappeared towards the study end. They indicated that tocilizumab treatment of at least 52 weeks is necessary in order to reset a broad range of immune-inflammatory pathways.
Trial registration: ClinicalTrials.gov, http://clinicaltrials.gov, NCT01450137.

PMID: 29961816 [PubMed - indexed for MEDLINE]

Late relapses of hepatitis C virus-cured mixed cryoglobulinaemia associated with infection or cancer.

jeu, 01/11/2018 - 08:31
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Late relapses of hepatitis C virus-cured mixed cryoglobulinaemia associated with infection or cancer.

Rheumatology (Oxford). 2018 10 01;57(10):1870-1871

Authors: Visentini M, Quartuccio L, Del Padre M, Colantuono S, Minafò YA, Fiorilli M, De Vita S, Casato M

PMID: 29868896 [PubMed - indexed for MEDLINE]

A Unique Infusion Reaction to Vedolizumab in a Patient With Crohn's Disease.

jeu, 01/11/2018 - 08:31
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A Unique Infusion Reaction to Vedolizumab in a Patient With Crohn's Disease.

Gastroenterology. 2018 10;155(4):981-982

Authors: Gold SL, Magro C, Scherl E

PMID: 29614303 [PubMed - indexed for MEDLINE]

Conventional immunosuppressive therapy in severe Behcet's Uveitis: the switch rate to the biological agents.

lun, 29/10/2018 - 06:13
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Conventional immunosuppressive therapy in severe Behcet's Uveitis: the switch rate to the biological agents.

BMC Ophthalmol. 2018 Oct 05;18(1):261

Authors: Celiker H, Kazokoglu H, Direskeneli H

Abstract
BACKGROUND: To report the switch rate of conventional immunosuppressive (CIS) therapies to the biological agents (BA) in patients with refractory Behcet's uveitis (BU).
METHODS: In this retrospective study, clinical records were reviewed of 76 patients' 116 eyes presenting with BU who had been treated with immunosuppressive drug therapy. Mann Whitney U test was used for the intergroup comparisons of parameters without normal distribution as well as calculation of descriptive statistical methods (mean, standard deviation, median, frequency and rate). Wilcoxon Signed Ranks test was used for the intragroup comparisons of parameters without normal distribution. Pearson's Chi-Square test and Fisher-Freeman-Halton test were used for the comparisons of qualitative data.
RESULTS: Except for one, all patients were first treated with CIS regimens for BU. Thirty-one patients (41.3%) who were unresponsive to CIS regimens were switched to IFNα2a therapy. After that, eight of these cases were switched to the anti-TNF-α treatments. The presence of initial ocular complications were found to be statistically higher in BA treated patients than the CIS treated cases (p < 0.001). Both in CIS treated and in BA treated cases, an increase in visual acuity (VA) was observed during the last examination compared to the initial examination and was significant (p < 0.001 and p = 0.018, respectively).
CONCLUSIONS: CIS treatment was found to be effective and safe, as suggested in the management guidelines for severe BU. Biological therapy was also found effective for the improvement of the VA. We observed that 58.7% of cases could be treated with strong immunosuppressive therapies, however, nearly half of the patients could have lost their VA if BAs were not existent. During the treatment course of severe cases with BU, classical therapy stage must still be protected as the first-line therapy due to the their reasonable activity and safety.

PMID: 30290779 [PubMed - indexed for MEDLINE]

FET PET in Primary Central Nervous System Vasculitis.

lun, 29/10/2018 - 06:13
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FET PET in Primary Central Nervous System Vasculitis.

Clin Nucl Med. 2018 Sep;43(9):e322-e323

Authors: Burghaus L, Kabbasch C, Deckert M, Ruge MI, Fink GR, Langen KJ, Galldiks N

Abstract
Primary central nervous system vasculitis is confined to the brain and spinal cord. While serological markers of inflammation are usually normal, conventional angiography may confirm the diagnosis. The diagnostic method of choice is central nervous system biopsy. A 57-year-old man suffered from a first generalized epileptic seizure. MRI revealed a contrast-enhancing lesion, and O-(2-[F]fluoroethyl)-L-tyrosine amino acid PET displayed increased metabolic activity, both findings highly suggestive of a malignant glioma. Surprisingly, histology obtained following stereotactic biopsy revealed small-vessel vasculitis.

PMID: 30080188 [PubMed - indexed for MEDLINE]

Sweet's syndrome: a clinical entity need to discriminate against acute haematogenous periprosthetic joint infection.

lun, 29/10/2018 - 06:13
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Sweet's syndrome: a clinical entity need to discriminate against acute haematogenous periprosthetic joint infection.

Knee Surg Sports Traumatol Arthrosc. 2018 Sep;26(9):2692-2696

Authors: Lee JH, Kim KB, Lee JR, Chung MJ, Wang SI

Abstract
Sweet's syndrome (SS) or acute febrile neutrophilic dermatosis is an uncommon condition. It is characterized by fever, polymorphonuclear leukocytosis, painful erythematous cutaneous plaques, and dense dermal infiltrate of neutrophils without vasculitis at the site of skin lesions. Lesions in SS might enlarge and coalesce with increasing dermal oedema, resulting in pseudo-vesicular appearance mimicking joint infections. Here, a rare case of SS mimicking acute haematogenous periprosthetic infection in a 74-year-old woman with a history of total knee arthroplasty is reported. This report aims to elaborate clinical various manifestations of SS in a patient with a history of total knee arthroplasty. In addition, this report describes how to discriminate inflammation between SS and periprosthetic joint infection. Level of evidence V.

PMID: 28875344 [PubMed - indexed for MEDLINE]

Childhood- versus Adult-Onset Polyarteritis Nodosa Results from the French Vasculitis Study Group Registry.

ven, 26/10/2018 - 04:14
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Childhood- versus Adult-Onset Polyarteritis Nodosa Results from the French Vasculitis Study Group Registry.

Autoimmun Rev. 2018 Oct;17(10):984-989

Authors: Iudici M, Quartier P, Pagnoux C, Merlin E, Agard C, Aouba A, Roblot P, Cohen P, Terrier B, Mouthon L, Guillevin L, Puéchal X, French Vasculitis Study Group

Abstract
OBJECTIVE: To investigate differences between childhood (cPAN)- and adult-onset polyarteritis nodosa (aPAN) patients.
METHODS: cPAN patients' clinical findings at onset and outcomes were compared to those of aPAN patients from the French Vasculitis Study Group registry matched for year of enrollment and initial systemic versus cutaneous disease. Their information on medications, disease activity and damage were collected. Kaplan-Meier relapse-free survival curves and the log-rank test were used to analyze cPAN versus aPAN differences for predefined outcomes.
RESULTS: Twenty-one children with systemic and 13 with cutaneous PAN were compared with 84 systemic- and 27 cutaneous-matched aPAN patients. Median follow-up exceeded 5 years for both groups. At study entry, mononeuritis multiplex was less frequent in systemic cPAN than systemic aPAN (P = 0.04), and purpura and myalgias were less frequent in cutaneous cPAN than cutaneous aPAN (P < 0.03). During follow-up, systemic cPAN relapsed more often than matched systemic aPAN (P < 0.0001), while relapse rates were similar for cutaneous disease (P > 0.05). Mostly minor relapses, predominantly involving the skin, occurred in all 4 groups. At last visit, damage accrual was comparable for cPAN and aPAN patients, but fewer systemic cPAN patients were treatment-free (15% versus 42%; P = 0.03). Two (6%) cPAN and 8 (7%) aPAN patients died.
CONCLUSION: Systemic PAN is equally severe in children and adults and carries a higher risk of relapse. The main cutaneous PAN features seem not to be influenced by age at disease onset.

PMID: 30114520 [PubMed - indexed for MEDLINE]

A case of Behçet's disease with various gastrointestinal findings.

ven, 26/10/2018 - 04:14
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A case of Behçet's disease with various gastrointestinal findings.

Clin J Gastroenterol. 2018 Oct;11(5):354-358

Authors: Tominaga K, Kamimura K, Takahashi K, Yokoyama J, Terai S

Abstract
Behçet's disease (BD) is a systemic inflammatory disorder involving the oral and genital mucosa, skin, eyes, gastrointestinal tract, joints, vasculature, and nervous. The gastrointestinal lesions accompanying with BD can extend along the full length of the tract, from the mouth to the anus, and show various clinical characteristics which is difficult to be differentiate from the other inflammatory bowel diseases including ulcerative colitis and Crohn's disease. Hence, the differential diagnosis is difficult and can affect treatment outcomes. We report here, a BD case showing varied gastrointestinal lesions and endoscopic findings. The information, endoscopic findings, differential diagnosis, and treatment approach in this case might help physicians to distinguish from other diseases and to manage similar cases.

PMID: 29667077 [PubMed - indexed for MEDLINE]

Thrombosed Aneurysm of the Posterior Inferior Cerebellar Artery and Lateral Medullary Ischemia as the Initial Presentation of Polyarteritis Nodosa: Case Report and Literature Review.

ven, 26/10/2018 - 04:14
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Thrombosed Aneurysm of the Posterior Inferior Cerebellar Artery and Lateral Medullary Ischemia as the Initial Presentation of Polyarteritis Nodosa: Case Report and Literature Review.

J Stroke Cerebrovasc Dis. 2018 Aug;27(8):e168-e171

Authors: Boukobza M, Dossier A, Laissy JP

Abstract
A 27-year-old woman with a previously undiagnosed polyarteritis nodosa (PAN) developed lateral medullary stroke related to a thrombosed posterior inferior cerebellar artery (PICA)-origin aneurysm. A concurrent thrombosis of the PICA was identified on high-resolution 3-dimensional CUBE T1 magnetic resonance imaging sequence at 3 T. Body computed tomography angiography, magnetic resonance imaging-magnetic resonance angiography, and digital angiography revealed multiple tiny aneurysms of the visceral arteries and bilateral kidney infarcts. On the basis of these findings and of laboratory data, the patient was diagnosed as having PAN. Intracranial aneurysms (IAs) are extremely rare in PAN and usually manifest as subarachnoid or cerebral hemorrhage. Ischemic manifestation of small thrombosed IA is a rare occurrence. This case highlights (1) an uncommon complication in patients with PAN (16 other cases of IAs in patients with PAN found in the literature), (2) an unusual initial presentation of PAN, and (3) a thrombosed PICA-origin aneurysm responsible for an ischemic stroke and for secondary thrombosis of the parent vessel.

PMID: 29602618 [PubMed - indexed for MEDLINE]

Evaluation of Kawasaki's disease-associated coronary artery aneurysms with 3D CT cinematic rendering.

ven, 26/10/2018 - 04:14
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Evaluation of Kawasaki's disease-associated coronary artery aneurysms with 3D CT cinematic rendering.

Emerg Radiol. 2018 Aug;25(4):449-453

Authors: Rowe SP, Zimmerman SL, Johnson PT, Fishman EK

Abstract
Kawasaki's disease (KD) is a vasculitis that predominantly affects children and can lead to the development of coronary artery aneurysms. These aneurysms can subsequently thrombose and occlude, which may lead to chest pain and other signs and symptoms of acute coronary syndrome in young patients. Coronary CT angiography, including 3D visualization techniques, is a common modality used in the follow-up of KD patients. In this series of three patients, we present the typical coronary artery imaging findings that can appear in these patients, with an emphasis on the use of the novel 3D technique of cinematic rendering (CR). CR utilizes a different lighting model than other 3D methods and is able to produce highly-detailed, photorealistic images. The potential advantages of CR images in understanding the complex mediastinal vascular anatomy and the relationships of coronary artery aneurysms to other anatomic structures are emphasized.

PMID: 29488043 [PubMed - indexed for MEDLINE]

Could be serum uric acid a risk factor for thrombosis and/or uveitis in Behcet's disease?

ven, 26/10/2018 - 04:14
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Could be serum uric acid a risk factor for thrombosis and/or uveitis in Behcet's disease?

Vascular. 2018 Aug;26(4):378-386

Authors: Atıl A, Deniz A

Abstract
Introduction Serum uric acid level increases in many inflammatory conditions. Uric acid triggers the vascular inflammation and artery damage, which causes to an increased risk of endothelial dysfunction and atherosclerosis. It is not clear in the literature whether uric acid contributes to uveitis by similar mechanisms. We investigated whether uric acid level increases in Behcet's disease patients with thrombosis or anterior uveitis. Patients and methods We reviewed the medical records of 914 Behcet's disease. After screening for exclusion criteria, there were 50 Behcet's disease patients with thrombotic complication and as the control group 202 BD patients without any vascular complication were included to the study. In the Anterior uveitis group, there were 53 Behcet's disease patients. The Control group consisted of 39 Behçet's disease patients without eye findings. Results Mean uric acid value was 4.96 ± 1.06 mg/dl in Behcet's disease patients with thrombosis whereas 4.08 ± 0.94 mg/dl in controls, indicating a significant difference ( p < 0.001). There was no significant difference between the mean ages of the patients in both groups. The mean age of the BD group without eye findings was 39.31 ± 10.47 years and that of the Behcet's disease with Anterior Uveitis group was 37.72 ± 9.65 years ( p = 0.453). The mean serum UA in the BD group without eye findings was 4.21 ± 1.21 mg/dl, while in the BD with Anterior Uveitis group it was 4.57 ± 1.37 mg/dl ( p = 0.201). Conclusion The extent of increase in uric acid level was greater in Behcet's disease patients that have a thrombotic complication compared to those without thrombotic complication. Uric acid seems to play a role in the pathogenesis of thrombosis. It is concluded that the elevation of serum uric acid level in patients with anterior uveitis with Behcet's disease is not statistically significant.

PMID: 29360007 [PubMed - indexed for MEDLINE]

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