Gotowa bibliografia na temat „Lupus erythematous disseminated”

Mycobacteriumchelonae is one of the rapidly growing non-tuberculous mycobacteria that can be isolated from water, soils and aerosols. Localised infections have been reported associated with tattoo parlours, pedicures and cosmetic procedures. But disseminated infection is usually associated with individuals who are immunocompromised, predominantly affecting limbs but sparing abdomen and back. We herein present a case where patient was on immunosuppressive therapy and developed locally severe infection around right ankle. A 69-year-old woman known to rheumatology presents in outpatients with severe pain in right ankle, unable to bear weight, oedematous right foot and lower leg. There was extensive erythematous cellulitic skin rash around right ankle and lower leg. She had background history of systemic lupus erythematosus with previous history of cardiac myositis and left foot drop. She had six cycles of cyclophosphamide for flare of lupus and after last cycle developed this presentation. Skin biopsy was arranged with dermatologist, cultures from which grew M.chelonae. She was admitted and started on triple regimen for M.chelonae as per Microbiology guidelines with intention to complete 6–12 months treatment. Patient responded very well to treatment but unfortunately, she died after 5 months on treatment due to other comorbidities and likely cause of death was cardiac arrhythmia.

Stabilizes inactivated state of sodium channels, thereby making neurons less excitable may reduce activity of nucleus ventralis of the thalamus or decrease synaptic transmission or summation of temporal stimulation leading to neuronal discharge.A adult of 68 years old patient came to dermatology department with chief complaints of neuralgia over scalp to relieve the symptoms physician prescribed carbamazepine 200mg Po OD. During his 2ndweek of treatment patient developed pain,fever,sore throat followed by skin rash.Better vigilance is necessary for implementation of safe and effective treatment for each individual patient.in order to prevent serious adverse drug reactions of this drug,close monitoring drug treatment course, creating awareness, recognition of the problem and careful management of all the patients who receive medication are essential,because use of carbamazepine causes thrombocytopenia, leukopenia, leukocytosis, eosinophilia, anemia, pruritic and erythematous rashes, urticaria, photosensitivity reactions, alterations in skin pigmentation, exfoliative dermatitis, erythema multiforme and nodosum, purpura, aggravation of disseminated lupus erythematosus,Abnormalities in liver function tests, cholestatic and hepatocellular jaundice, hepatitis; very rare cases of hepatic failure, Pancreatitis ,Pulmonary hypersensitivity characterized by fever, dyspnea, pneumonitis, or pneumonia Keywords: Carbamazepine, Induced Drug Rash with Eosinophilia and Systemic Symptoms, adverse drug reaction.

Abstract BACKGROUND AND IMPORTANCE Infectious intracranial aneurysms are a rare subset of intracranial aneurysms caused by bacterial, fungal, or viral sources. Intracranial aneurysms of fungal etiology carry a high mortality risk and typically occur in immunocompromised patients via direct extension of skull base infections, or more rarely, after intracranial surgery. CLINICAL PRESENTATION We present the case of a 27-yr-old female with systemic lupus erythematous and primary pulmonary mucormycosis, who suffered a subarachnoid hemorrhage from a ruptured fusiform distal middle cerebral artery aneurysm. Despite undergoing a successful extracranial-to-intracranial bypass and aneurysm excision, the patient ultimately died following progressive disseminated infection and a secondary intracranial hemorrhage of unknown etiology. Pathological examination of the excised artery confirmed Mucor infection. CONCLUSION To the best of our knowledge, this case represents one of the first mycotic cerebral aneurysms from mucormycosis in a patient without an underlying skull base infection or previous intracranial surgery. Despite optimal surgical management, clinical outcomes for mycotic cerebral aneurysms are largely dependent on the success of medical therapies at controlling systemic disease.

Toxoplasma is a common parasite worldwide that mainly affects the brain, lungs and eyes. Although toxoplasmic encephalitis is a lethal disease without treatment, past case reports show most patients with systemic lupus erythematosus who developed toxoplasmic encephalitis were misdiagnosed and treated as neuropsychiatric systemic lupus erythematosus, which led to unfavorable outcomes. We herein describe a case of disseminated toxoplasmosis affecting all the above organs with atypical symptoms, which developed with exacerbation of systemic lupus erythematosus. She had initially manifested with retinochoroiditis without vitritis, mild cognitive impairment and an isolated lung mass. These are completely different from the classic symptoms of toxoplasmosis that have been reported in patients with HIV infection and/or those after hematopoietic transplantation. Our case, together with previously reported cases, suggests the manifestation of toxoplasmosis that develops in systemic lupus erythematosus patients can be different from that seen in conventional cases and varies between individual patients. Our case highlights both the difficulty in and the importance of diagnosing toxoplasmosis in patients with systemic lupus erythematosus and provides helpful information to identify this rare, devastating, yet treatable disease.

Lupus erythematosus is an autoimmune collagen disorder with multiple organs involvement. Subacute cutaneous lupus erythematosus represents about 10% of Lupus erythematosus cases and is frequently drug induced. A 83-year-old female patient, otherwise healthy, presented for disseminated annular lesions with mild pruritus lasting for 5 days.The patient denied any new drug usage in the last two months.Laboratory findings showed raised Anti-Ro antibodies and Anti-La (SS-B). The patient received systemic corticotherapy with the remission of the lesions in one month.Subacute cutaneous lupus erythematosus can present with bullous skin lesions and can arise in elderly people without drug usage.

Telangiectasia is a persistent dilation of small-caliber skin vessels (arterioles, venules, capillaries) of a non-inflammatory nature, manifested by polymorphously convoluted and dilated vessels. Telangiectasias are classified according to the cause of occurrence, the form of changes in the vascular pattern, time and localization, and are also divided into 3 large groups ― essential (idiopathic); symptomatic in various diseases; congenital and hereditary syndromes and diseases accompanied by vascular anomalies. In addition, telangiectasias can be single and multiple, located locally or disseminated, differ in shape, location, color; sometimes they bleed. Differential diagnosis is carried out with flaming and telangiectatic nevus; multiple senile, glomerular, bundle angiomas; Fabry angiokeratoma, Sivatts poikiloderma. In addition, telangiectasia is a typical clinical symptom in the erythematous-telangiectatic form of rosacea, systemic scleroderma, discoid lupus erythematosus, nodular form of basal cell carcinoma, hyper- and atrophic scars, late radiation dermatitis. The article describes a case from the clinical practice of effective treatment of telangiectasias on the skin of the face using a neodymium crystal laser, which is of interest, among other things, due to the complexity of diagnosis within the existing International Classification of Diseases 10 revision, therefore the diagnosis is made syndromally based on macro- and microscopic morphological features. In addition, there is no single approach to the treatment of the pathology in question. External therapy, as well as systemic drugs, are often ineffective, sclerotherapy and exposure to a high-power vascular laser have a more pronounced clinical effect (broadband light; neodymium laser; pulsed dye laser; alexandrite, diode, ruby laser). Based on the recommendations of the laser manufacturer on percutaneous vascular coagulation and modern theories about the pathogenesis of telangiectasias, an algorithm for treatment with a long-pulse laser with a wavelength of 1064 nm on a clinical example is proposed. By prescribing a course of treatment of vascular malformation by laser percutaneous coagulation, we expect to obtain the destruction of pathologically dilated vessels of the papillary and mesh layer of the dermis by gluing the walls of the vessels (preferably) or complete thrombosis of their lumen while maintaining the structures of the dermis and epidermis intact. Laser percutaneous vascular coagulation has demonstrated excellent treatment results in a short period of time, significantly reducing the number of pathologically altered vessels. The rehabilitation period after laser coagulation of blood vessels did not exceed 3 days and was manifested by moderate edema of soft tissues in the area of laser exposure, hyperemia and single petechial hemorrhages, which resolved themselves. Laser coagulation of skin telangiectsies is a highly effective method with a long-term clinical effect.

La consommation de soja, connait une croissance notable en France. Cependant, le soja contient des isoflavones (IFs), des composés phytochimiques aux effets perturbateurs endocriniens à des doses élevées. Cette thèse s'attache à évaluer les risques associés aux IFs et à l’Entérolactone (ENL), autre phyto-estrogène notable, et à proposer des solutions favorisant une consommation de soja sûre.Objectifs :(1) Évaluer l’exposition des Français∙es aux IFs et valider de nouveaux outils d’estimation.(2) Étudier les effets endocriniens des IFs et de l’ENL chez l’humain, en se focalisant sur le lupus érythémateux disséminé (LED) et le cancer du sein triple négatif.(3) Développer des techniques pour réduire les teneurs en IFs des aliments à base de soja.Méthodologie :(1) Exposition aux IFs et à l’ENL :- Analyses d’aliments et validation de questionnaires alimentaires spécifiques pour évaluer la consommation de soja et l’exposition aux IFs et aux lignanes en France.- Dosages des IFs dans les fluides biologiques (sang, urine) et les cheveux.(2) Effets endocriniens des IFs et de l’ENL :- Étude cas-témoin sur le LED, comparant l'exposition aux IFs et à l’ENL de patientes et de volontaires saines- Études in vitro de l’effet des IFs sur la prolifération de cellules de cancer du sein triple négatif, ainsi que des interactions des IFs avec le récepteur des estrogènes GPER.(3) Réduction des teneurs en IFs:- Développement de procédés (pré)industriels pour réduire les IFs des fèves de soja.- Étude des recettes traditionnelles asiatiques de soja et de leurs effets sur la réduction des IFs.Résultats :(1) Exposition aux IFs et à l’ENL :- L'exposition aux IFs en France est significative, même chez les non-consommateur∙ices de soja, à cause du "soja caché" présent dans les aliments ultra-transformés.- Les questionnaires alimentaires sont validés et les IFs et l’ENL sont dosés avec succès dans les cheveux.(2) Effets endocriniens des IFs et ENL :- Les résultats préliminaires suggèrent une association entre l'ENL et une réduction du risque de LED mais l'effectif limité de l'étude ne permet pas de conclure sur l’impact des IFs.- Les IFs et leurs conjugués circulants pourraient induire la prolifération des cellules cancéreuses du sein triple négatives, via une interaction avec le GPER.(3) Réduction des teneurs en IFs :- Des rinçages industriels permettent de réduire les IFs des fèves de soja de 50%.- Les recettes traditionnelles asiatiques et les rinçages domestiques réduisent significativement les IFs des aliments à base de soja.Discussion :La consommation de soja nécessite une vigilance particulière en raison des effets endocriniens des IFs. Des recherches complémentaires sont nécessaires pour comprendre ces effets et proposer des recommandations pour une consommation sûre du soja.Conclusion :Si la consommation de soja, traditionnelle en Asie et présentant un intérêt nutritionnel certain, elle soulève des questions quant à ses répercussions sur la santé humaine à cause de la présence d’IFs estrogéniques et antithyroïdiennes. Cette thèse apporte des éléments de réponse sur l'exposition aux IFs en France, leurs effets potentiels sur le LED et les cancers du sein triple négatifs, et propose des solutions pour réduire les teneurs en IFs des aliments à base de soja
The consumption of soy, a valuable source of plant-based protein, has seen a steady rise in France. However, soy contains isoflavones (IFs) which are phytoestrogens with endocrine-disrupting effects at high doses. This thesis investigates the risks associated with IFs and enterolactone (ENL), another notable phytoestrogen, and explores strategies for promoting safe soy consumption.Objectives:1. Assess French exposure to IFs and ENL, and validate tools for accurate estimation.2. Investigate the endocrine effects of IFs and ENL in humans, focusing on systemic lupus erythematosus (SLE) and triple-negative breast cancer.3. Develop techniques to reduce the IFs content of soy-based food products.Methodology:(1) IF and ENL Exposure Assessment:- Food analyses and dietary intake assessment to quantify the French exposure to IFs and lignans.- Development and validation of food questionnaire to evaluate soy and lignans consumption.- Measurements of IFs and ENL in biological fluids (blood, urine) and hair.(2) Endocrine effects of IFs and ENL:- Case-control study on SLE, comparing IFs and ENL exposure in patients and in healthy controls.- In vitro studies on triple-negative breast cancer cells, analyzing the effect of IFs on cell proliferation and their interactions with the GPER, a membrane estrogen receptor.(3) Reduction of IF levels:- Development of (pre)industrial rinsing processes to decrease IFs content in soybeans.- Investigation of traditional Asian recipes and domestic water rinsing techniques for reducing IFs in soy-based foods.Results:(1) IFs and Lignans exposure:- French exposure to IFs is significant, even for non-soy consumers, due to “hidden soy” in ultra-processed foods.- The developed food questionnaires are validated, and a method for IFs and ENL analysis in hair is presented.(2) Endocrine effects of IFs and ENL:- Preliminary findings from the SLE cohort suggest a potential association between ENL and a healthier status. However, the limited sample size necessitates further investigation to definitively exclude an impact of IFs.- IFs and their circulating conjugates might promote triple-negative breast cancer cells proliferation through the GPER.(3) Reducing IF levels:- Industrial rinsing processes can effectively reduce IFs content in soybean by 50%.- Traditional Asian preparation methods and domestic rinsing significantly decrease IFs in soy-based products.Discussion:Soy consumption warrants specific attention due to the endocrine effects of IFs. Further research is crucial to gain a more comprehensive understanding of these effects and formulate recommendations for safe soy consumption.Conclusion:While soy consumption holds nutritional value and boasts a long tradition in Asia, its high isoflavone content raises questions about its potential impact on human health. This thesis contributes preliminary insights into French exposure to IFs, their possible effects on SLE and triple-negative breast cancer, and proposes solutions for mitigating IFs levels in soy-based foods

Le lupus erythemateux dissemine est une maladie auto-immune caracterisee par la production d'anticorps antidna double brin qui sont un marqueur du lupus erythemateux dissemine et qui sont consideres comme etant responsable des lesions tissulaires du lupus par l'intermediaire du depot de complexes immuns dna anti-dna. Des anticorps anti dna monoclonaux specifiques du dna double brin ont ete produits dans des modeles experimentaux de souris lupiques b/w. Nous avons montre que ces anticorps anti-dna monoclonaux reconnaissent 5 polypeptides a la surface de differents types cellulaires concernes dans la pathogenie du lupus. Nous avons montre qu'il existe un motif antigenique commun entre le dna double brin et ces polypeptides membranaires. Nous avons isole ces polypeptides membranaires et produit un anticorps polyclonal contre ces polypeptides. Nous suggerons que ces polypeptides membranaires pourraient jouer le role d'immunogene que ne joue pas le dna double brin

Primary neuroinflammatory disorders of the central nervous system (multiple sclerosis, neuromyelitis optica (NMO), transverse myelitis, optic neuritis, acute disseminated encephalomyelitis (ADEM), primary angiitis of the central nervous system, autoimmune limbic encephalitis, and Susac’s syndrome) and multisystem diseases with inflammatory involvement of the central nervous system (sarcoidosis, systemic lupus erythematosus (SLE), giant cell arteritis, Behçet’s disease, Sjögren’s, and other vasculitides) are discussed in depth, covering the aetiology, clinical features and evidence-based treatment.

Context: Acute Disseminated Encephalomyelitis (ADEM) usually happens after an infectious event, vaccination reaction and with history of immunosuppression. Clinical features can be varied: headache, fever, seizure, blurred vision, ataxia, motor deficits and mental confusion. Case report: A 35-yearsold woman, in a social risk situation, complained about pain and blurred vision, history of cocaine abuse, victim of sexual and physical abuse and recent Measles vaccination. She had corneal ulcer with bilateral endophthalmitis and optic nerve infection. Despite intravitreal injections of Vancomycin + Ceftazidime, patient had to eviscerate the left eye. After surgery, patient evolved with mental confusion and paraparesis, CSF cell 69, lymphomonocyte, proteins 257, MRI showed central bulbar hyperintensity, lesions in the dentate nucleus and periaqueductal of gray substance in T2 / FLAIR, thoracic and lumbar spine with demyelinating pattern, extensive longitudinal myelitis. Patient obtained clinical improvement after treatment with Methylprednisolone 1gr for 5 days. It is important to discard other hypothesis: transverse myelitis, neuromyelitis optica, multiple sclerosis and systemic lupus erythematosus. The diagnosis is clinical and radiological with multifocal and confluent areas of hypersignal on MRI, CSF analysis reveals high protein and lymphocytic pleocytosis. Treatment with Methylprednisolone is the first choice and then Plasmapheresis. Conclusion: there are several risk factors for the development of ADEM correlated with a rapid and aggressive evolution in this patient.