11/26. breast conservation therapy. Severe breast fibrosis after radiation therapy in patients with collagen vascular disease.Two patients with collagen vascular disease (rheumatoid arthritis and scleroderma) had extremely poor cosmetic results after breast radiation therapy (RT). The patient with rheumatoid arthritis received 5251 cGy at 210 cGy per day, followed by a 1600 cGy iridium-192 implant boost. Between 8 and 11 months post-RT she had severe breast fibrosis, retraction, and pain that required a mastectomy for relief. The patient with scleroderma received 5040 cGy at 180 cGy per day without a boost. Between 1 and 4 months post-RT the systemic symptoms of scleroderma progressed and the breast became hard and retracted. Both rheumatoid arthritis and scleroderma are chronic systemic diseases characterized by severe inflammation and an autoimmune component. The presence of scleroderma at or before treatment should be considered a contraindication to breast RT, whereas the presence of active rheumatoid arthritis should be considered a relative contraindication. An autoimmune mechanism will be presented to explain both the fibrosis and the systemic progression of collagen vascular disease that was observed.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
12/26. Thrombotic microangiopathic nephropathy in scleroderma and lupus anticoagulant.A 47-year-old woman with overlap scleroderma-polymyositis syndrome and positive circulating lupus anticoagulant developed scleroderma nephropathy, characterized by rapidly progressive renal failure caused by thrombotic microangiopathy with widespread thrombi in small arteries and glomeruli. The possible relationship between lupus anticoagulant and the development of thrombosis at the small renal vessels level with the triggering of the scleroderma crisis is discussed.- - - - - - - - - - ranking = 0.14359504902418keywords = microangiopathy (Clic here for more details about this article) |
13/26. Treatment of peripheral gangrene due to systemic sclerosis with intravenous pentoxifylline.Vascular problems are very common in systemic sclerosis with 95% of patients suffering with Raynaud's phenomenon at some stage in their illness. Acute ischaemic lesions are much less common, but when they occur are a serious complication, and are often difficult to treat. Many drugs have been used in this situation, including both oral and intravenous vaso-dilators and low molecular weight dextran, each with varying degrees of success. The phospho-diesterase inhibitor, pentoxifylline, is reported to be useful in peripheral vascular disease, and in Raynaud's phenomenon, and the intravenous form is indicated for acute peripheral ischaemia, though its use in the context of connective tissue disease has not so far been reported. We now report the use of intravenous pentoxifylline in two patients with acute peripheral gangrene due to systemic sclerosis.- - - - - - - - - - ranking = 0.16666666666667keywords = vascular disease (Clic here for more details about this article) |
14/26. Peripheral neuropathy in course of progressive systemic sclerosis. light and ultrastructural study.Progressive systemic sclerosis (PSS) is a chronic inflammatory disease of the connective tissue with involvement of the skin and other organs. The disease is characterized by an abnormal accumulation of collagen in all tissues and by microangiopathy. The involvement of the peripheral nervous system during PSS is very unusual and few cases are reported in the literature. A morphological study on the neuropathy associated with sclerodermia has been performed in rare cases. In this paper we demonstrate the role that the vascular lesions have in the pathogenesis of neuropathy during scleroderma. In particular, the primary role of the peripheral microangiopathy during PSS (observed in different clinical cases) is verified.- - - - - - - - - - ranking = 0.28719009804837keywords = microangiopathy (Clic here for more details about this article) |
15/26. Lower limb amputation secondary to large vessel involvement in scleroderma.A 34-year-old woman with scleroderma was admitted to hospital with pain and weakness of her left foot. She was subsequently shown to have developed a popliteal artery occlusion associated with progressive lower limb ischaemia. This culminated in below-knee amputation. Marked intimal hyperplasia of the large vessels in the leg was noted histologically. An increasing number of cases of large vessel involvement in scleroderma, a disease that primarily affects the microvasculature, has been reported. Scleroderma should be regarded as a rare cause of large vessel peripheral vascular disease.- - - - - - - - - - ranking = 0.16666666666667keywords = vascular disease (Clic here for more details about this article) |
16/26. Cancer associated with collagen-vascular disease.Two cases of cancer, each associated with a different collagen-vascular disease, are reported. The first patient, a 71-year-old white man, had a history of acute dermatomyositis and malignancy for a few weeks only. death was associated with adenocarcinoma of the lesser curvature of the stomach with metastases to the liver and beyond. The second patient, a 69-year-old white man, had had symptoms associated with Raynaud's phenomenon for more than a decade and difficulty in swallowing, attributed to progressive systemic sclerosis for more than two years. He died with an epidermoid carcinoma of the esophagus with extension to the lung and metastases to the liver and lungs.- - - - - - - - - - ranking = 0.83333333333333keywords = vascular disease (Clic here for more details about this article) |
17/26. Vascular ulcers in scleroderma.Seven patients with scleroderma and either livedo reticularis or atrophie blanche lesions had ulcers of the lower extremity. Livedoid vasculitis, periarteritis nodosa, or endarteritis obliterans lesions were associated with the ulcers. Five patients had livedoid vasculitis, one patient had associated lupus panniculitis, and one patient had rheumatoid arthritis. Four patients had elevated ESRs, four had positive antinuclear antibody tests, and two had positive tests for rheumatoid factor. patients with scleroderma and livedoid vasculitis or livedo reticularis and ulcers should be examined to rule out underlying vascular disease or endarteritis obliterans.- - - - - - - - - - ranking = 0.16666666666667keywords = vascular disease (Clic here for more details about this article) |
18/26. Cranial nerve involvement in systemic sclerosis (scleroderma): a report of 10 cases.Ten patients with the diagnosis of systemic sclerosis developed cranial nerve involvement. A trigeminal sensory neuropathy evolved insidiously in all patients and in five of these it was a presenting complaint. The glossopharyngeal nerve was involved in one patient. taste was impaired in one patient and a unilateral loss of taste with fasciculations of the tongue were noted in another. tinnitus was a complaint in three patients, two of whom had bilateral impairment of hearing. Facial weakness was noted in five patients. In three, this weakness was bilateral, while in the others the weakness was unilateral, and a past history of acute onset was obtained. The microangiopathy of systemic sclerosis is felt to be primarily responsible for these neurological deficits. The deposition of fibrous tissue may be a secondary phenomenon and contribute to the process by compression of nerves.- - - - - - - - - - ranking = 0.14359504902418keywords = microangiopathy (Clic here for more details about this article) |
19/26. Spontaneous pneumoperitoneum with pneumatosis cystoides intestinalis in a patient with mixed connective tissue disease.pneumatosis cystoides intestinalis (PCI), a disorder in which gas filled cysts develop within the bowel wall, has been associated with collagen vascular disease, usually progressive systemic sclerosis (PSS). We have extended the spectrum of collagen vascular disease associated with PCI by this report of a patient with mixed connective tissue disease (MCTD) who developed PCI and recurrent spontaneous pneumoperitoneum (SP). Possible pathogenetic mechanisms are reviewed and the management of the asymptomatic patient with pneumoperitoneum, PCI and collagen vascular disease is discussed.- - - - - - - - - - ranking = 0.5keywords = vascular disease (Clic here for more details about this article) |
20/26. Central retinal vein occlusion and scleroderma: implications for sclerodermatous vascular disease.A patient with scleroderma (progressive systemic sclerosis) who developed central retinal vein occlusion is described. The aetiology of this condition is discussed and the role of possible sclerodermatous vascular disease is highlighted. It is suggested that studies of fundal vasculature could be useful in the clinical assessment of sclerodermatous vascular disease.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
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