Acta Clinica Belgica最新文献_第3页

Bisphosphonates in a kidney transplant recipient with persistent hyperparathyroidism: think twice. 双膦酸盐在肾移植受者持续甲状旁腺功能亢进：三思而后行。

IF 0.9 4区医学

Acta Clinica Belgica Pub Date : 2026-02-01 Epub Date: 2025-11-22 DOI: 10.1080/17843286.2025.2587287

Thijs Engelen, Pieter Evenepoel

{"title":"Bisphosphonates in a kidney transplant recipient with persistent hyperparathyroidism: think twice.","authors":"Thijs Engelen, Pieter Evenepoel","doi":"10.1080/17843286.2025.2587287","DOIUrl":"10.1080/17843286.2025.2587287","url":null,"abstract":"Introduction: Bone disease after kidney transplantation is complex, converging features of senile, postmenopausal, glucocorticoid-induced, and chronic kidney disease (CKD)-associated osteoporosis.Case presentation: We present a case of a 60-year-old female kidney transplant recipient with osteoporosis, who failed to show an improvement in areal bone mineral density (aBMD) after 5 years of annual intravenous therapy with 5 mg zoledronate. After thorough examination, persistent hyperparathyroidism and subsequent hypophosphatemia were pointed to as the most likely explanation.Discussion: Persistent hyperparathyroidism is a common finding in kidney transplant patients. Therapy with antiresorptive agents may mask the bone phenotype of persistent hyperparathyroidism, delaying the initiation of parathyroid hormone (PTH) suppressive therapy. Meanwhile, PTH driven hypophosphatemia may be a cause of antiresorptive treatment failure.Conclusion: Present case emphasizes the importance of controlling CKD-mineral and bone disorders prior to initiating bone targeting drugs, as also has been recommended by recent consensus manuscripts. In an era in which bone turnover markers gain importance in guiding PTH suppressive and osteoporosis therapy, antiresorptive agents may complicate the diagnosis of hyperparathyroidism by masking the bone phenotype.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"28-32"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence, diagnosis and treatment of sarcopenic obesity in older adults: a systematic review and a meta-analysis. 老年人肌肉减少性肥胖的患病率、诊断和治疗：一项系统综述和荟萃分析。

IF 0.9 4区医学

Acta Clinica Belgica Pub Date : 2025-12-01 Epub Date: 2025-11-06 DOI: 10.1080/17843286.2025.2583187

Gözde Şengül Ayçiçek, Arzu Okyar Baş, Erdem Karabulut, Meltem Gülhan Halil

{"title":"Prevalence, diagnosis and treatment of sarcopenic obesity in older adults: a systematic review and a meta-analysis.","authors":"Gözde Şengül Ayçiçek, Arzu Okyar Baş, Erdem Karabulut, Meltem Gülhan Halil","doi":"10.1080/17843286.2025.2583187","DOIUrl":"10.1080/17843286.2025.2583187","url":null,"abstract":"Objectives: Sarcopenic obesity (SO) is a syndrome increasingly recognized in older adults. We aimed to conduct a systematic review and a meta-analysis to reveal the global prevalence of SO in olders, and the effects of non-pharmacological interventions on the different components of SO.Methods: A comprehensive search of 3270 studies was conducted between 2009 and 2021 from PubMed, Scopus, and Cochrane databases. After screening we included 57 studies. Statistical analysis was performed in R software. The standardized mean difference was used as the effect size and heterogeneity was evaluated with I2 statistic. Low muscle mass(MM) or low MM plus low muscle strength(MS) were used for the diagnosis of sarcopenia, body fat percentage (BF%), waist circumference (WC) or body mass index (BMI) parameters were used for the diagnosis of obesity. Intervention studies included exercise-based interventions, nutritional-based interventions,combined interventions, and electrical acupuncture.Results: The global SO prevalence was 7%. The prevalence of SO, depending on the sarcopenia definition, was 8% and 5% due to MM and MM plus MS, respectively. The prevalence of SO, depending on the definition of obesity, was 8%, 5%, and 7% according to BF%, BMI, and WC, respectively. In the overall intervention groups, BF% was reduced, MS and MM was increased. Exercise appears to have a more pronounced effect on sarcopenia.Conclusion: The global prevalence of SO in the older population was 7%. MS and MM improved, and BF% decreased significantly in the overall intervention groups, with a more pronounced effect in exercise intervention studies.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"226-249"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Construction and validation of a risk prediction model for secondary acute kidney injury in patients with acute upper gastrointestinal bleeding. 急性上消化道出血患者继发性急性肾损伤风险预测模型的构建与验证

IF 0.9 4区医学

Acta Clinica Belgica Pub Date : 2025-12-01 Epub Date: 2025-11-05 DOI: 10.1080/17843286.2025.2583186

Jiang Liu, Donglin Tang, Qin Zhang, Peng Luo

{"title":"Construction and validation of a risk prediction model for secondary acute kidney injury in patients with acute upper gastrointestinal bleeding.","authors":"Jiang Liu, Donglin Tang, Qin Zhang, Peng Luo","doi":"10.1080/17843286.2025.2583186","DOIUrl":"10.1080/17843286.2025.2583186","url":null,"abstract":"Objective Acute upper gastrointestinal bleeding (AUGIB) is one of the most common critical conditions in clinical practice and is characterized by rapid progression and a high incidence of secondary acute kidney injury (AKI). This study aimed to analyze the clinical characteristics of patients with AUGIB, identify related risk factors for secondary AKI, and develop a predictive model for AKI risk in this patient population. Methods A retrospective analysis was conducted on 300 patients with AUGIB admitted to our department. Patients were categorized based on the occurrence of AKI within 7 days. Univariate analysis and Least Absolute Shrinkage and Selection Operator (LASSO) regression were used for feature selection, followed by multivariable logistic regression to construct a predictive model. The model's performance was rigorously evaluated through bootstrap internal validation, calibration curves, and decision curve analysis (DCA). Results Seven independent risk factors were identified and incorporated into the SCORE-AKI: a history of renal insufficiency, hypertension, shock index > 1, Glasgow Coma Scale score ≤14, hemoglobin < 60 g/L, platelet count < 50 × 109/L, and serum creatinine > 103 μmol/L. The model showed strong discrimination with a bootstrap-corrected area under the curve (AUC) of 0.808, which was significantly superior to the Glasgow Blatchford score (AUC: 0.722, p < 0.001). The model also demonstrated excellent calibration and a positive net benefit across clinical decision thresholds. Conclusion The SCORE-AKI model is a accurate, well-calibrated, and clinically useful tool that outperforms the GBS for predicting secondary AKI risk in patients with AUGIB, potentially aiding in early risk stratification and preventive intervention.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"193-207"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pan-immune-inflammation value predicts sustained ventricular arrhythmias in NSTEMI: a novel inflammatory risk marker. 泛免疫炎症值预测非stemi患者持续室性心律失常：一种新的炎症风险标志物。

IF 0.9 4区医学

Acta Clinica Belgica Pub Date : 2025-10-01 Epub Date: 2025-10-02 DOI: 10.1080/17843286.2025.2569339

Yusuf Bozkurt Şahin, Veysel Ozan Tanık, Göktürk Kaan Koçu, Mehmet Taha Özkan, Murat Akdoğan, Özden Seçkin, Çağatay Tunca, Ali Sezgin, Kürşat Akbuğa, Bülent Özlek

{"title":"Pan-immune-inflammation value predicts sustained ventricular arrhythmias in NSTEMI: a novel inflammatory risk marker.","authors":"Yusuf Bozkurt Şahin, Veysel Ozan Tanık, Göktürk Kaan Koçu, Mehmet Taha Özkan, Murat Akdoğan, Özden Seçkin, Çağatay Tunca, Ali Sezgin, Kürşat Akbuğa, Bülent Özlek","doi":"10.1080/17843286.2025.2569339","DOIUrl":"10.1080/17843286.2025.2569339","url":null,"abstract":"Background: Systemic inflammation contributes to arrhythmogenesis in acute coronary syndromes, but its role in NSTEMI-related ventricular arrhythmias remains poorly defined. The pan-immune-inflammation value (PIV) is a novel composite biomarker reflecting immune and thrombotic activity derived from routine blood counts. This study aimed to assess the association between PIV and the risk of sustained VT/VF in NSTEMI.Methods: In this retrospective cohort study, 1,788 NSTEMI patients who underwent percutaneous coronary intervention were analyzed. The primary endpoint was the occurrence of sustained VT or VF during hospitalization. PIV was calculated as (neutrophil × platelet × monocyte)/lymphocyte. Logistic regression, ROC analysis, Kaplan - Meier curves, reclassification indices (NRI, IDI), and restricted cubic spline modeling were used.Results: VT/VF occurred in 34 patients (1.9%). Those with VT/VF had significantly higher PIV values (median 1132 vs. 329, p < 0.001). In multivariable analysis, PIV remained an independent predictor (OR: 1.356 per 1000 unit increase; 95% CI: 1.028-1.787; p = 0.031). The risk of VT/VF rose progressively across PIV quartiles (Q4 vs. Q1 OR: 4.0, p for trend < 0.001). Adding PIV to conventional predictors improved risk classification (NRI: +0.089; IDI: 0.007). Kaplan - Meier analysis showed significantly reduced arrhythmia-free survival in high-PIV tertiles (log-rank p < 0.001), and cubic spline modeling revealed a non-linear association with increased arrhythmic risk at higher PIV levels.Conclusions: Elevated PIV is independently associated with malignant ventricular arrhythmias in NSTEMI. As an accessible biomarker, PIV may aid early arrhythmic risk stratification and guide clinical surveillance strategies.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"146-158"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Listeria monocytogenes rhombencephalitis: a case report and review of current literature. 单核细胞增生李斯特菌菱形脑炎1例报告及文献复习。

IF 0.9 4区医学

Acta Clinica Belgica Pub Date : 2025-10-01 Epub Date: 2025-10-22 DOI: 10.1080/17843286.2025.2570834

Laurens Berton, Pieter Lottefier, Tom Claikens, Benedicte Dubois, Philippe Demaerel, Steven Vanderschueren, Liesbet Henckaerts

{"title":"Listeria monocytogenes rhombencephalitis: a case report and review of current literature.","authors":"Laurens Berton, Pieter Lottefier, Tom Claikens, Benedicte Dubois, Philippe Demaerel, Steven Vanderschueren, Liesbet Henckaerts","doi":"10.1080/17843286.2025.2570834","DOIUrl":"10.1080/17843286.2025.2570834","url":null,"abstract":"Background: Listeria monocytogenes Meningoencephalitis is a rare but potentially severe and lethal infectious disease caused by Listeria monocytogenes invading the central nervous system. The infection mainly affects the immunocompromised, neonates and older adults.Case report: A 71-year-old woman without relevant medical history was referred to the emergency department with febrile gastroenteritis. Upon admission, neurological examination was normal. Ten hours after admission, an acute neurological deterioration was observed, with the patient exhibiting incoherent speech and ocular motility abnormalities. She appeared lethargic, not oriented in time or place, and with nuchal rigidity. Cranial nerve testing revealed a left-sided internuclear ophthalmoplegia and a left-sided nervus abducens palsy. A tentative diagnosis of meningoencephalitis was made. Empirical treatment was initiated with high-dose amoxicillin, high-dose ceftriaxone, and high-dose aciclovir. Lumbar puncture was performed, and both culture and polymerase chain reaction were positive for Listeria monocytogenes. Antibiotic therapy was narrowed to high-dose amoxicillin. Magnetic resonance imaging showed edema within the brainstem and signs of a small abscess. The patient developed an acute kidney injury and therapy was switched to high-dose meropenem. Her neurological symptoms improved but the left internuclear ophthalmoplegia and nervus abducens palsy remained present.Conclusions: Listeria monocytogenes Meningoencephalitis is a severe infectious disease with marked morbidity that can occur in previously immunocompetent hosts, regardless of age.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"166-173"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of intermittent fasting and ketogenic diet in metabolic syndrome and type 2 diabetes. 间歇性禁食和生酮饮食在代谢综合征和2型糖尿病中的作用。

IF 0.9 4区医学

Acta Clinica Belgica Pub Date : 2025-08-01 Epub Date: 2025-07-30 DOI: 10.1080/17843286.2025.2540287

Charlotte Delrue, Reinhart Speeckaert, Marijn M Speeckaert

{"title":"The role of intermittent fasting and ketogenic diet in metabolic syndrome and type 2 diabetes.","authors":"Charlotte Delrue, Reinhart Speeckaert, Marijn M Speeckaert","doi":"10.1080/17843286.2025.2540287","DOIUrl":"10.1080/17843286.2025.2540287","url":null,"abstract":"Objectives: To review the current evidence on intermittent fasting (IF) and ketogenic diet (KD) as dietary interventions for the management of metabolic syndrome (MetS) and type 2 diabetes mellitus (T2D), including their mechanisms of action, clinical benefits, and potential when used in combination.Methods: A narrative review of recent scientific literature examining the physiological mechanisms, clinical outcomes, and practical implementation of IF and KD in patients with MetS and T2D. The focus is on studies evaluating glycemic control, body weight, lipid profiles, and inflammation, as well as the proposed shared biochemical pathways involving AMPK activation and mTOR inhibition.Results: Both IF and KD independently show clinically significant benefits in improving metabolic parameters in MetS and T2D, including reductions in HbA1c, fasting glucose, body weight, and triglycerides. Mechanistically, both approaches enhance insulin sensitivity, promote autophagy, reduce inflammation, and activate energy-regulating pathways (AMPK) while inhibiting mTOR. Emerging evidence suggests that combining IF and KD may offer synergistic metabolic effects, although data on long-term safety, adherence, and patient-specific suitability remain limited.Conclusions: IF and KD represent promising, non-pharmacologic strategies for improving metabolic health in patients with MetS and T2D.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"100-114"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Elevated blood eosinophil counts in stable COPD patients in Belgian primary care: prevalence and clinical characteristics. 比利时初级保健中稳定型COPD患者血嗜酸性粒细胞计数升高：患病率和临床特征

IF 1.1 4区医学

Acta Clinica Belgica Pub Date : 2025-06-01 Epub Date: 2025-06-14 DOI: 10.1080/17843286.2025.2519712

Inès Van Rossem, Sander Deridder, Aline Beckwée, Dirk Devroey, Johan Vansintejan

{"title":"Elevated blood eosinophil counts in stable COPD patients in Belgian primary care: prevalence and clinical characteristics.","authors":"Inès Van Rossem, Sander Deridder, Aline Beckwée, Dirk Devroey, Johan Vansintejan","doi":"10.1080/17843286.2025.2519712","DOIUrl":"10.1080/17843286.2025.2519712","url":null,"abstract":"Objectives: Recently, eosinophilic Chronic Obstructive Pulmonary Disease (COPD) has been identified as a clinically relevant phenotype, as patients with elevated blood eosinophil counts (BEC) demonstrate a better response to maintenance inhaled corticosteroids (ICS). This real-world study in Belgian primary care describes the distribution of BECs and the ICS use in stable COPD patients.Methods: This study retrospectively analysed data from two primary care practices using the most recent values retrievable from the electronic health record. Patients were dichotomized based on BEC GOLD thresholds of 100 and 300 cells/µL.Results: Eighty stable COPD patients (60% male, mean (SD) age of 70.7 (9.7)years, mean FEV1 (SD) of 65.4 (17.5) % Predicted) were included. Amongst them, 46% used ICS maintenance therapy. BEC values ranged from 0 to 667 cells/µL with a median (IQR) of 182 (80-291) cells/µL. 71% and 23% of patients presented BEC > 100 and ≥ 300 cells/µL, respectively. The mean age in the BEC≥300 group was significantly higher than in the BEC<300 group (MD = 7.2 y; p = 0.005). No other significant differences in demographic characteristics, dyspnea, FEV1 % Predicted, ≥1 moderate/severe exacerbations in the previous year, current maintenance ICS use, number of comorbidities or Charlson Comorbidity Index were detected between groups.Conclusion: In this primary care population in Belgium, elevated BECs and maintenance ICS use are prevalent. Besides age, clinical characteristics were comparable between eosinophil-based groups whether the 100 or 300 cells/µL threshold was used.Trial registration: Not applicable given the retrospective nature of the study.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"29-34"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The burden of ascites in cirrhosis. 肝硬化腹水的负担。

IF 1.1 4区医学

Acta Clinica Belgica Pub Date : 2025-02-01 Epub Date: 2025-05-19 DOI: 10.1080/17843286.2025.2506472

J Bekaert, M Aerts, S François, S Raevens, H Degroote, A Geerts, X Verhelst, H Van Vlierberghe, H Reynaert

{"title":"The burden of ascites in cirrhosis.","authors":"J Bekaert, M Aerts, S François, S Raevens, H Degroote, A Geerts, X Verhelst, H Van Vlierberghe, H Reynaert","doi":"10.1080/17843286.2025.2506472","DOIUrl":"10.1080/17843286.2025.2506472","url":null,"abstract":"Objectives: Liver cirrhosis is a leading cause of morbidity and mortality worldwide, with complications such as ascites, spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS) significantly worsening prognosis. This paper aims to review the pathophysiology, diagnostic approaches, and management strategies for ascites and the complication of it, emphasizing the role of portal hypertension.Methods: We conducted a comprehensive review of the literature on liver cirrhosis, portal hypertension, ascites formation, and related complications. Existing evidence was evaluated and ranked using the GRADE system: A (high) to D (verly low). Recommendation strength was graded 1 (strong) or 2 (weak).Results: Portal hypertension is the key factor in ascites development. Non-invasive tools such as liver stiffness measurement (LSM) have proven to be effective in identifying patients at risk for clinically significant portal hypertension (CSPH), thus guiding treatment decisions. Carvedilol, recommended over propranolol, offers superior efficacy in reducing portal pressure. Diuretics, in combination with a moderate sodium-restricted diet, are the first-line treatment for ascites. However, refractory ascites requires advanced interventions. Spontaneous bacterial peritonitis (SBP) remains a major complication in patients with ascites, while hepatorenal syndrome - acute kidney injury (HRS-AKI) demands early recognition and timely vasoconstrictor therapy.Conclusions: Liver cirrhosis and the complication of it significantly impact patient quality of life and survival. Portal hypertension is a critical driver of ascites and other complications, making early identification through non-invasive diagnostic methods essential for appropriate management. Medical treatments, including non-selective beta-blockers (NSBBs), diuretics, and advanced procedures, offer substantial benefits in controlling ascites and preventing further decompensation.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"8-16"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe hypocalcemia due to osteoblastic bone metastases in a patient with hypoparathyroidism: a case report. 甲状旁腺功能减退患者因成骨细胞骨转移引起的严重低钙血症1例报告。

IF 1.1 4区医学

Acta Clinica Belgica Pub Date : 2025-02-01 Epub Date: 2025-05-14 DOI: 10.1080/17843286.2025.2505864

Ode Devos, Christof Vulsteke, Emmanuelle Versele, An Deman, Heidi Hannon

引用次数: 0

Asymptomatic hypercalcemia, caused by sarcoid-like granulomatosis, induced by checkpoint inhibition. 无症状高钙血症，由结节样肉芽肿病引起，由检查点抑制诱导。

IF 1.1 4区医学

Acta Clinica Belgica Pub Date : 2025-02-01 Epub Date: 2025-05-19 DOI: 10.1080/17843286.2025.2506467

Vandemaele N, Stragier B, Tamsin A, De Bock M

{"title":"Asymptomatic hypercalcemia, caused by sarcoid-like granulomatosis, induced by checkpoint inhibition.","authors":"Vandemaele N, Stragier B, Tamsin A, De Bock M","doi":"10.1080/17843286.2025.2506467","DOIUrl":"10.1080/17843286.2025.2506467","url":null,"abstract":"Objectives: To illustrate the diagnostic challenges, as well as the importance of early recognition of rare immunotherapy-induced complications, presenting a case and literature of sarcoid-like granulomatous reaction.Methods: This report presents a case of asymptomatic hypercalcemia, revealing a sarcoid-like granulomatosis in a patient with metastatic melanoma, treated with an immune checkpoint inhibitor (ICI). In the discussion, an overview of the existing literature is provided through a PubMed search.Results: Thorough investigations are essential to rule out disease progression and other possible explanations. Ultimately, biopsy with extensive staining led to the diagnosis of sarcoid-like granulomatosis. As there is no consensus in treatment, we suggest a case-by-case assessment, if possible by discussion within the multidisciplinary treatment team, to decide discontinuation of the causal ICI-therapy or the use of systemic steroids as supportive therapy.Conclusion: This case demonstrates the importance of a broad differential diagnosis when identifying an asymptomatic hypercalcemia as well as new CT-graphic lesions, since the diagnosis of sarcoid-like granulomatosis can avoid not only unnecessary changes in treatment plans, avoiding toxicity, but also be a sign of good prognosis.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-7"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0