Modern Rheumatology Case Reports最新文献_第2页

Primary angiitis of the central nervous system in a patient with transient episodes of headache and aphasia: A case report. 一过性头痛和失语患者的原发性中枢神经系统血管炎：病例报告。

Modern Rheumatology Case Reports Pub Date : 2023-12-29 DOI: 10.1093/mrcr/rxad034

Michail Papantoniou, Stefanos Korfias, Theodoros Argyrakos, Panagiotis Aggelidakis, Antonios Tavernarakis

{"title":"Primary angiitis of the central nervous system in a patient with transient episodes of headache and aphasia: A case report.","authors":"Michail Papantoniou, Stefanos Korfias, Theodoros Argyrakos, Panagiotis Aggelidakis, Antonios Tavernarakis","doi":"10.1093/mrcr/rxad034","DOIUrl":"10.1093/mrcr/rxad034","url":null,"abstract":"Primary angiitis of the central nervous system (PACNS) refers to a rare form of vasculitis of unknown cause, with a challenging diagnostic work-up. We report the case of a 57-year-old patient who presented with transient episodes of headache and global aphasia. Cerebrospinal fluid (CSF) examination revealed lymphocytic pleocytosis with moderate elevated protein and normal glucose. CSF and serum tests for infections and autoimmune/paraneoplastic antibodies were negative, except CSF polymerase chain reaction testing that detected Epstein-Barr virus (EBV). Magnetic resonance imaging of the brain with intravenous gadolinium showed meningeal enhancement and pachymeningitis. Due to continuous relapsing episodes of aphasia, a leptomeningeal and brain tissue biopsy was performed and revealed lesions of granulomatous necrotising vasculitis of medium-sized leptomeningeal and intracranial vessels, as well as negative in situ hybridism for EBV. A diagnosis of primary granulomatous necrotising angiitis of the central nervous system was made, and the patient was treated with intravenous methylprednisolone and oral cyclophosphamide, showing excellent response to treatment. Diversity in clinical and laboratory features makes it difficult for PACNS to be distinguished by other systemic vasculitides. Laboratory tests and neuroimaging can provide guidance in evaluation of the patients and exclude other possible causes, but tissue biopsy remains the gold standard for a definite diagnosis.","PeriodicalId":18677,"journal":{"name":"Modern Rheumatology Case Reports","volume":" ","pages":"117-120"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9973806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pyoderma gangrenosum after surgery for forefoot deformity in a patient with rheumatoid arthritis: A case report. 类风湿性关节炎患者前足畸形手术后的脓疱疮：病例报告。

Modern Rheumatology Case Reports Pub Date : 2023-12-29 DOI: 10.1093/mrcr/rxad051

Yu Mori, Takuya Izumiyama, Kazuaki Otsuka, Ryuichi Kanabuchi, Jun Yamamoto, Mana Sekine, Naoko Mori, Yoshihide Asano, Toshimi Aizawa

引用次数: 0

Secondary fibromyalgia: An entity to be remembered-A case series with axial spondyloarthritis. 继发性纤维肌痛：需要牢记的一个实体--轴性脊柱关节炎病例系列。

Modern Rheumatology Case Reports Pub Date : 2023-12-29 DOI: 10.1093/mrcr/rxad023

Ebru Yilmaz

引用次数: 0

Successful treatment with belimumab for immune thrombocytopenia associated with systemic lupus erythematosus: A report of two cases. 贝利木单抗成功治疗系统性红斑狼疮相关免疫性血小板减少症：两个病例的报告。

Modern Rheumatology Case Reports Pub Date : 2023-12-29 DOI: 10.1093/mrcr/rxad055

Kyohei Nakayama, Yasuhiro Tamimoto, Tsuyoshi Nakayama

引用次数: 0

Successful peficitinib monotherapy for the new-onset skin manifestations of rheumatoid vasculitis after long-term treatment with tocilizumab for rheumatoid arthritis. 佩非替尼单药成功治疗类风湿关节炎患者长期使用托西珠单抗治疗后新出现的类风湿血管炎皮肤表现。

Modern Rheumatology Case Reports Pub Date : 2023-12-29 DOI: 10.1093/mrcr/rxad025

Yuki Oba, Naoki Sawa, Daisuke Ikuma, Hiroki Mizuno, Noriko Inoue, Akinari Sekine, Eiko Hasegawa, Masayuki Yamanouchi, Tatsuya Suwabe, Yuko Yamaguchi, Yutaka Takasawa, Yoshifumi Ubara

{"title":"Successful peficitinib monotherapy for the new-onset skin manifestations of rheumatoid vasculitis after long-term treatment with tocilizumab for rheumatoid arthritis.","authors":"Yuki Oba, Naoki Sawa, Daisuke Ikuma, Hiroki Mizuno, Noriko Inoue, Akinari Sekine, Eiko Hasegawa, Masayuki Yamanouchi, Tatsuya Suwabe, Yuko Yamaguchi, Yutaka Takasawa, Yoshifumi Ubara","doi":"10.1093/mrcr/rxad025","DOIUrl":"10.1093/mrcr/rxad025","url":null,"abstract":"Rheumatoid vasculitis (RV) is a severe extra-articular systemic manifestation of rheumatoid arthritis (RA). Its prevalence has been decreasing for decades because of improved early diagnosis of RA and advances in RA treatment, but it remains a life-threatening disease. The standard treatment for RV has been a glucocorticoid and disease-modifying antirheumatic drugs. Biological agents, including antitumour necrosis factor inhibitors, are also recommended for refractory cases. However, there are no reports of Janus kinase (JAK) inhibitor use in RV. We experienced a case of an 85-year-old woman with a 57-year history of RA who had been treated with tocilizumab for 9 years after receiving three different biological agents over 2 years. Her RA seemed to be in remission in her joints, and her serum C-reactive protein had decreased to 0.0 mg/dL, but she developed multiple cutaneous leg ulcers associated with RV. Because of her advanced age, we changed her RA treatment from tocilizumab to the JAK inhibitor peficitinib in monotherapy, after which the ulcers improved within 6 months. This is the first report to indicate that peficitinib is a potential treatment option for RV that can be used in monotherapy without glucocorticoids or other immunosuppressants.","PeriodicalId":18677,"journal":{"name":"Modern Rheumatology Case Reports","volume":" ","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9493441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case in which baricitinib was effective for both rheumatoid arthritis and essential thrombocythemia. 巴利替尼对类风湿关节炎和原发性血小板增多症均有效的病例。

Modern Rheumatology Case Reports Pub Date : 2023-12-29 DOI: 10.1093/mrcr/rxad012

Rioko Migita, Atsushi Tanaka, Kazuki Tanimoto, Junki Hiura, Yasutaka Kimoto, Takahiko Horiuchi, Yasushi Inoue

{"title":"A case in which baricitinib was effective for both rheumatoid arthritis and essential thrombocythemia.","authors":"Rioko Migita, Atsushi Tanaka, Kazuki Tanimoto, Junki Hiura, Yasutaka Kimoto, Takahiko Horiuchi, Yasushi Inoue","doi":"10.1093/mrcr/rxad012","DOIUrl":"10.1093/mrcr/rxad012","url":null,"abstract":"We experienced a case of rheumatoid arthritis and JAK2V617F mutation-positive essential thrombocythemia treated with baricitinib. The patient was a 72-year-old male. He was diagnosed with rheumatoid arthritis at a local clinic in April 2018. Methotrexate (MTX) was started and the dose was increased to 16 mg/week. In October of the same year, anaemia was observed and MTX was reduced, but anaemia progressed. Blood tests showed pancytopenia, and he was referred to Rheumatology on suspicion of drug-induced pancytopenia. Pancytopenia improved with discontinuation of MTX and administration of folic acid. His platelet count was markedly increased to 1,400,000/μl at one point, decreased to 400,000/μl, and then gradually increased to 700,000-1,000,000/μl. Despite taking an antiplatelet drug, he developed cerebral infarction in June 2019. The JAK2V617F mutation was noted, and he was diagnosed with essential thrombocythemia. Hydroxycarbamide was started, but the effect was insufficient. Baricitinib, a JAK1/2 inhibitor indicated for rheumatoid arthritis, was started in August with the expectation that it would also be effective for essential thrombocythemia. The platelet count decreased to ∼400,000-600,000 cells/μl, and a decrease in the C-reactive protein level and the improvement of arthritis were noted. We report this case because it is considered to be a valuable case, suggesting that baricitinib may be effective for essential thrombocythemia.","PeriodicalId":18677,"journal":{"name":"Modern Rheumatology Case Reports","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9545338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Simultaneous hybrid closed-wedge supramalleolar osteotomy and ankle arthrodesis for post-traumatic varus ankle arthritis with periarticular deformity: A case report. 同时进行混合闭合楔形踝上截骨术和踝关节置换术治疗创伤后伴有关节周围畸形的外翻性踝关节炎：病例报告。

Modern Rheumatology Case Reports Pub Date : 2023-12-29 DOI: 10.1093/mrcr/rxad033

Hayato Kobayashi, Yoji Shido

{"title":"Simultaneous hybrid closed-wedge supramalleolar osteotomy and ankle arthrodesis for post-traumatic varus ankle arthritis with periarticular deformity: A case report.","authors":"Hayato Kobayashi, Yoji Shido","doi":"10.1093/mrcr/rxad033","DOIUrl":"10.1093/mrcr/rxad033","url":null,"abstract":"The treatment of end-stage ankle arthritis associated with extra-articular tibial deformity, especially for ankles deformed by previous traumatic injuries and/or surgical treatment, is extremely challenging but rewarding. Only one previous report describes simultaneous tibial deformity correction and ankle arthrodesis for tibial malalignment and ipsilateral ankle arthritis. Here, we describe a unique case of post-traumatic ankle osteoarthritis concomitant with extra-articular varus deformity in a 77-year-old female. We have combined medial opening-wedge supramalleolar osteotomy (SMO) and lateral closed-wedge SMO in this case, which we termed 'hybrid' closed-wedge SMO, to overcome the limitations of traditional closed-wedge SMO. The patient was successfully treated with simultaneous hybrid closed-wedge SMO and ankle arthrodesis using a single lateral locking plate. To our knowledge, this is the first report describing the successful introduction of a hybrid closed-wedge osteotomy procedure in the distal tibia. Three years after surgery, the patient could walk without assistance and swim normally. The patient experienced no discomfort or pain in the operated ankle and was satisfied with the results. Radiographs confirmed that the pre-existing ankle joint line was parallel to the ground and almost invisible. The hind foot alignment was slightly valgus. No progression of the subtalar joint arthritis was detected. The simultaneous hybrid closed-wedge SMO and ankle arthrodesis was technically difficult but effective. This technique preserves leg length and subtalar joint motion. Additionally, a single lateral incision minimises the risk of impaired blood supply. The one-stage surgical treatment reduces the recovery time, duration of hospitalisation, and surgical costs. Rigid locking fixation with careful postoperative weight-bearing is required for uneventful bone healing.","PeriodicalId":18677,"journal":{"name":"Modern Rheumatology Case Reports","volume":" ","pages":"37-42"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9601339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Polyarteritis nodosa diagnosed in a young male after COVID-19 vaccine: A case report. 一名年轻男性在接种 COVID-19 疫苗后被诊断为多发性结节炎：病例报告

Modern Rheumatology Case Reports Pub Date : 2023-12-29 DOI: 10.1093/mrcr/rxad037

Ayako Makiyama, Yoshiyuki Abe, Hoshiko Furusawa, Masahiro Kogami, Taiki Ando, Kurisu Tada, Mitsuho Onimaru, Akihiro Ishizu, Ken Yamaji, Naoto Tamura

引用次数: 1

Thrombotic thrombocytopenic purpura that developed 3 years after systemic lupus erythematosus had remitted with rituximab therapy. 在接受利妥昔单抗治疗后，系统性红斑狼疮病情缓解了 3 年，又出现了血栓性血小板减少性紫癜。

Modern Rheumatology Case Reports Pub Date : 2023-12-29 DOI: 10.1093/mrcr/rxad032

Reina Tsuda, Toshiki Kido, Ikuma Okada, Aoi Kobiyama, Masatoshi Kawataka, Miho Yamazaki, Ryoko Asano, Hiroyuki Hounoki, Koichiro Shinoda, Kazuyuki Tobe

{"title":"Thrombotic thrombocytopenic purpura that developed 3 years after systemic lupus erythematosus had remitted with rituximab therapy.","authors":"Reina Tsuda, Toshiki Kido, Ikuma Okada, Aoi Kobiyama, Masatoshi Kawataka, Miho Yamazaki, Ryoko Asano, Hiroyuki Hounoki, Koichiro Shinoda, Kazuyuki Tobe","doi":"10.1093/mrcr/rxad032","DOIUrl":"10.1093/mrcr/rxad032","url":null,"abstract":"Patients with systemic lupus erythematosus (SLE) occasionally develop thrombotic thrombocytopenic purpura (TTP), which can be fatal. Here, we report a case of TTP developing 3 years after SLE remitted with rituximab (RTX) therapy. A 50-year-old woman was treated with RTX for marked immune thrombocytopenic purpura and autoimmune haemolytic anaemia due to SLE relapse. After induction of remission, she was treated with prednisolone alone without maintenance therapy with RTX. Approximately 3 years later, she was readmitted with marked thrombocytopenia and severe renal dysfunction. On admission, she was diagnosed with TTP for the first time based on severe reduction in a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) activity and detection of ADAMTS13 inhibitors. CD19+ B cells in the patient's serum increased to 34%, suggesting that B cells had reactivated once the effect of RTX had subsided. The patient was successfully treated with plasmapheresis, glucocorticoid pulse therapy, and RTX. There are no previous reports of newly diagnosed TTP with ADAMTS13 inhibitor production after having achieved remission of SLE with RTX. Therefore, our report also discusses the potential mechanisms of production of new autoantibodies after B-cell depletion therapy.","PeriodicalId":18677,"journal":{"name":"Modern Rheumatology Case Reports","volume":" ","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9673006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful treatment of refractory enteritis and arthritis with combination of tumour necrosis factor and interleukin-6 inhibition in patients with ulcerative colitis. 联合使用肿瘤坏死因子和白细胞介素 6 抑制剂成功治疗溃疡性结肠炎患者的难治性肠炎和关节炎。

Modern Rheumatology Case Reports Pub Date : 2023-12-29 DOI: 10.1093/mrcr/rxad031

Sho Ishigaki, Yasushi Kondo, Yuichiro Ota, Po-Sung Chu, Hironari Hanaoka, Tsutomu Takeuchi, Yuko Kaneko

{"title":"Successful treatment of refractory enteritis and arthritis with combination of tumour necrosis factor and interleukin-6 inhibition in patients with ulcerative colitis.","authors":"Sho Ishigaki, Yasushi Kondo, Yuichiro Ota, Po-Sung Chu, Hironari Hanaoka, Tsutomu Takeuchi, Yuko Kaneko","doi":"10.1093/mrcr/rxad031","DOIUrl":"10.1093/mrcr/rxad031","url":null,"abstract":"An 18 year-old man with autoimmune hepatitis-primary sclerosing cholangitis-overlap syndrome and ulcerative colitis was admitted due to relapsed enteritis and polyarthritis after cessation of infliximab. Colonoscopy and articular ultrasonography revealed large ulcers in the colon with crypt abscess in the specimens and active enthesitis and synovitis, respectively. His intestinitis was improved with golimumab but arthritis was persistent. Golimumab was switched to secukinumab, which was effective for arthritis. However, colitis was flared resulting in total colorectal resection. One month after colectomy, polyarthritis was relapsed. Tocilizumab ameliorated arthritis but enteritis emerged again, and switching tocilizumab to adalimumab improved enteritis but arthritis exacerbated. Finally, we restarted tocilizumab for arthritis with continued adalimumab for enteritis. The dual cytokine blocking strategy, tumour necrosis factor-α and interleukin-6 inhibition, subsided both of his refractory enteritis and arthritis and maintained remission for more than 3 years without any serious adverse event. Our case suggests that enteritis and arthritis in inflammatory bowel disease may be different in pathophysiology and raises the possible usefulness of simultaneous inhibition of two inflammatory cytokines in such cases.","PeriodicalId":18677,"journal":{"name":"Modern Rheumatology Case Reports","volume":" ","pages":"33-36"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9973808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0