1/352. Positive antineutrophil cytoplasmic antibodies-associated vasculitis presenting with hemoptysis and a mediastinal mass.A patient with end-stage renal failure, due to IgA nephropathy, was found to have a mediastinal mass. biopsy specimen of the mass showed a necrotizing vasculitis. Antineutrophil antibodies to myeloperoxidase were strongly positive. To our knowledge, no case of a mediastinal mass due vasculitis has been reported in the literature, and our observation should lead to broadening of the spectrum of clinical manifestations of vasculitis.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
2/352. Infantile disseminated visceral giant cell arteritis presenting as sudden infant death.The rare clinicopathological entity 'disseminated visceral giant cell arteritis' (DVGCA) was first described in 1978. It is characterized by widespread small-vessel giant cell angitis and extravascular granulomas. A normal and healthy 7-month-old boy who presented unexpectedly with sudden infant death syndrome (SIDS) is reported. Histological examination at autopsy revealed giant cell angitis of the aorta, common carotid, coronary, pulmonary, celiac, mesenteric and common iliac arteries. There were also granulomas in the tracheal wall and liver. To our knowledge, this is the first documented case of DVGCA occurring in an infant younger than 12 months of age. A review of the literature on DVGCA is presented in this report, and the differential diagnosis is discussed.- - - - - - - - - - ranking = 1.4276670774004keywords = arteritis (Clic here for more details about this article) |
3/352. Necrotizing vasculitis of the skin and uterine cervix associated with minocycline therapy for acne vulgaris.In recent years, minocycline has become a commonly used agent for the treatment of acne vulgaris and rosacea. With this increased use have come reports of severe and in some cases life-threatening toxicity, often occurring in otherwise healthy young women after prolonged courses of minocycline. These adverse reactions include hepatotoxicity, drug-induced lupus erythematosus, eosinophilic pneumonitis, and hypersensitivity syndrome. We describe a 35-year-old woman who had necrotizing vasculitis of the skin and uterine cervix after 2 years of minocycline therapy for acne vulgaris. skin and cervical biopsies revealed acute inflammation involving through-and-through necrosis of vessel walls with thrombosis, focal fibrinoid change, and a perivascular lymphohistiocytic infiltrate. The disease fully resolved within 3 months of discontinuance of the minocycline therapy. patients should be informed of these rare but potentially serious adverse effects before the initiation of minocycline therapy. Early recognition of these complications can result in complete resolution.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
4/352. Pathologic findings in a steroid-responsive optic nerve infarct in giant-cell arteritis.OBJECTIVE: To investigate the pathophysiologic mechanism of optic nerve infarction in giant-cell arteritis (GCA). BACKGROUND: Previous pathologic reports of optic nerve infarction in GCA involved patients who were blind at the time of death. The optic nerve infarcts were primarily retrolaminar in localization. Simultaneous short ciliary and ophthalmic artery vasculitis was found in all patients. methods: Clinical neurologic and ophthalmologic examination, temporal artery biopsy, and neuroimaging tests were performed in a patient with an anterior ischemic optic neuropathy secondary to GCA. Pathologic examination of the viscera, eye, and brain were performed at autopsy 1 month later. RESULTS: A prelaminar/retrolaminar infarct was found in this patient. Subsiding vasculitis was limited to the short ciliary arteries, sparing the central retinal, pial, and ophthalmic arteries. CONCLUSIONS: The authors believe that the visual improvement observed in this patient was the result of preserved, anterior optic nerve collateral circulation, as well as the neuroprotective and anti-inflammatory effect of the corticosteroids.- - - - - - - - - - ranking = 1.4276670774004keywords = arteritis (Clic here for more details about this article) |
5/352. Diaphragmatic paresis as a manifestation of large artery vasculitis.We describe the initial presentation and followup of a 54-year-old Caucasian woman who presented in 1995 with bilateral arteritis of the axillary arteries and acute onset dyspnea. Chest radiograph, chest fluoroscopy, and pulmonary function studies confirmed the diagnosis of right hemidiaphragmatic paresis. Prednisolone and methotrexate therapy and short term anticoagulation were initiated and she experienced no further sequelae during 2 years of followup.- - - - - - - - - - ranking = 0.28553341548008keywords = arteritis (Clic here for more details about this article) |
6/352. "Pseudo-conduction block" in vasculitic neuropathy.The predominant electrophysiologic feature of vasculitic mononeuropathy multiplex is axonal loss. Electrophysiologic findings interpreted as conduction block have, however, also been reported to occur in neuropathy secondary to necrotizing vasculitis. We report 3 patients with mononeuropathy multiplex and biopsy proven vasculitis in whom eight nerves met criteria for conduction block. In each circumstance, serial study demonstrated conversion of the electrophysiologic findings to those most consistent with severe axonal loss. "Conduction block" in vasculitic mononeuropathy multiplex is secondary to focal axonal conduction failure presumably related to infarctive axonal injury. The term conduction block should be used with caution in this disorder and only if serial studies demonstrate findings consistent with this electrophysiologic diagnosis.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
7/352. Fibrosing alveolitis predating microscopic polyangiitis.A 65 year old male was diagnosed with "cryptogenic fibrosing alveolitis (CFA)" and treated successfully with prednisone. In the year following prednisone-tapering he presented with livedo reticularis, segmental pauci-immune glomerulonephritis and necrotizing vasculitis of the peripheral nerves, increased pulmonary fibrosis, and the presence of p-ANCA antibodies. Aggressive immunosuppressive treatment of this microscopic polyangiitis (MPA) was successful and also resulted in stabilization of the pulmonary fibrosis. This case illustrates that MPA may present itself monosymptomatic as CFA.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
8/352. microscopic polyangiitis diagnosed at hysterectomy.A 78 year old female developed polyneuropathy, weight loss, malaise, and joint pain. Necrotizing vasculitis was diagnosed at hysterectomy, and later renal biopsy demonstrated focal segmental necrotizing glomerulonephritis. The pathological findings together with the presence of pANCA was consistent with a diagnosis of microscopic polyangiitis (MPA). This is the first clinical description of MPA with involvement of the uterus.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
9/352. Unusual complications in an inflammatory abdominal aortic aneurysm.An unusual case of an inflammatory abdominal aortic aneurysm (IAAA) associated with coronary aneurysms and pathological fracture of the adjacent lumbar vertebrae. The associated coronary lesions in cases of IAAA are usually occlusions. In the present case, it was concluded that a possible cause of the coronary aneurysm was coronary arteritis and the etiology of the pathological fracture of the lumbar vertebrae was occlusion of the lumbar penetrating arteries due to vasculitis resulting in aseptic necrosis. Inflammatory AAA can be associated with aneurysms in addition to occlusive disease in systemic arteries. The preoperative evaluation of systemic arterial lesions and the function of systemic organs is essential.- - - - - - - - - - ranking = 0.28823088971816keywords = arteritis, essential (Clic here for more details about this article) |
10/352. De novo ANCA-associated vasculitis occurring 14 years after kidney transplantation.A cadaveric kidney transplant recipient, with no history of a connective tissue disease, was admitted with malaise, arthralgias, diplopia, mild headache, and a painful left eye. The patient was on maintenance immunosuppression for 14 years with cyclosporine and methylprednisolone. Initial laboratory data indicated an elevated serum creatinine from baseline, 2 proteinuria, and 50 to 100 red blood cells (RBCs)/high-power field (HPF) in the urine. Renal biopsy was consistent with necrotizing vasculitis involving glomerular capillaries, with crescent formation and an absence of immune complexes. Perinuclear antineutrophil cytoplasmic autoantibodies (P-ANCA) and anti-myeloperoxidase (MPO) were found to be elevated. To the best of our knowledge, this is the first reported case of an ANCA-associated small vessel vasculitis (SVV) developing in a renal transplant recipient without history of connective tissue disease.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
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