Modern rheumatology case reports最新文献_第6页

Stress fracture of the clavicle associated with sternocostoclavicular hyperostosis combined with bony ankylosis of the acromioclavicular joint and ossification of the coracoclavicular ligament. 锁骨应力性骨折，伴有胸锁关节骨质增生、肩锁关节骨性强直和锁骨韧带骨化。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae017

Rie Kurose, Yuji Wakai

引用次数: 0

Lymphoproliferative disorder progressing after partial remission following immunosuppressive drugs withdrawal in a patient with rheumatoid arthritis. 一名类风湿性关节炎患者在停用免疫抑制剂后病情部分缓解，但淋巴组织增生性疾病仍在发展。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae007

Kazuo Fukumoto, Ryu Watanabe, Minako Tsutsumi, Teruhito Takakuwa, Masafumi Miyamoto, Noriyuki Hayashi, Shinsuke Yamada, Yutaka Furumitsu, Masayuki Hino, Motomu Hashimoto

{"title":"Lymphoproliferative disorder progressing after partial remission following immunosuppressive drugs withdrawal in a patient with rheumatoid arthritis.","authors":"Kazuo Fukumoto, Ryu Watanabe, Minako Tsutsumi, Teruhito Takakuwa, Masafumi Miyamoto, Noriyuki Hayashi, Shinsuke Yamada, Yutaka Furumitsu, Masayuki Hino, Motomu Hashimoto","doi":"10.1093/mrcr/rxae007","DOIUrl":"10.1093/mrcr/rxae007","url":null,"abstract":"Lymphoproliferative disorders (LPDs) are serious complications that arise in patients with rheumatoid arthritis (RA) receiving immunosuppressive drugs (ISDs). Here, we reported a 73-year-old woman diagnosed with RA at 60 years of age and treated with methotrexate, bucillamine, prednisolone, and infliximab. She was referred to our hospital, Osaka Metropolitan University Hospital, with general malaise, pancytopenia, a right adrenal mass, and enlarged periaortic lymph nodes. Epstein-Barr virus was detected in serum. We suspected LPD development and performed a bone marrow biopsy, on which no malignant cells could be detected. Upon ISDs withdrawal, her symptoms and blood counts improved, and the right adrenal mass and enlarged lymph nodes regressed. The patient was followed up for clinical LPD. However, 7 months after the initial visit to our hospital, she developed fever and pancytopenia. A repeat bone marrow biopsy confirmed the diagnosis of Epstein-Barr virus-positive diffuse large B-cell lymphoma complicated by haemophagocytic syndrome. After pulse steroid therapy, the patient received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone therapy, which resulted in a complete response. In conclusion, when LPDs develop in patients with RA during ISD treatment, LPDs can progress and complicate haemophagocytic syndrome after partial remission following ISDs withdrawal. Therefore, we should carefully follow up RA patients with LPDs, and aim to achieve an early diagnosis of LPD and promptly initiate chemotherapy.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725471","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}

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Clinical utility of anti-Ro52 antibody confirmation in anti-MDA5 antibody-positive dermatomyositis: A case report. 抗 MDA5 抗体阳性皮肌炎患者抗 Ro52 抗体确认的临床实用性：病例报告

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae027

Hitoshi Kodera, Reina Hirano, Masahiro Akiyama, Yoshifuji Matsumoto

{"title":"Clinical utility of anti-Ro52 antibody confirmation in anti-MDA5 antibody-positive dermatomyositis: A case report.","authors":"Hitoshi Kodera, Reina Hirano, Masahiro Akiyama, Yoshifuji Matsumoto","doi":"10.1093/mrcr/rxae027","DOIUrl":"10.1093/mrcr/rxae027","url":null,"abstract":"This case report highlights dermatomyositis (DM) characterised by the concurrent presence of anti-melanoma differentiation-associated protein 5 (anti-MDA5) and anti-Ro52 antibodies. A 64-year-old woman initially presented with erythema on the palms, which later spread to the dorsum of the hands, followed by involvement of the face, forehead, and upper eyelids. The patient reported joint pain, fatigue, and dyspnea. Physical examination revealed characteristic cutaneous manifestations, including heliotrope rash and Gottron's sign, accompanied by skin ulceration and muscle weakness. Blood tests showed elevated levels of creatine phosphokinase and C-reactive protein. A high-resolution computed tomography (HRCT) scan revealed interstitial lung disease (ILD) with an organising pneumonia (OP) pattern. Magnetic resonance imaging (MRI) confirmed the presence of myositis. Autoantibody analysis revealed concurrent positivity for both anti-MDA5 and anti-Ro52 antibodies. At the time of diagnosis, she had no respiratory impairment, but had an elevated C-reactive protein and high levels of anti-MDA5 antibody. She was started on triple combination therapy with glucocorticoids, cyclophosphamide, and tacrolimus. She had worsening oxygenation and elevated ferritin during the first weeks of treatment, but then her symptoms improved. Early detection of a co-positive anti-Ro52 antibody led to early initiation of triple combination therapy and a good prognosis.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946721","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 of systemic lupus erythematosus in a patient with Noonan syndrome with recurrent severe hypoglycaemia. 一例患有努南综合征并反复出现严重低血糖的系统性红斑狼疮患者。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae004

Shotaro Masuoka, Takashi Tanaka, Miwa Kanaji, Karin Furukawa, Keiko Koshiba, Zento Yamada, Eri Watanabe, Mai Kawazoe, Shun Ito, Ayako Fuchigami, Toshihiro Nanki

{"title":"A case of systemic lupus erythematosus in a patient with Noonan syndrome with recurrent severe hypoglycaemia.","authors":"Shotaro Masuoka, Takashi Tanaka, Miwa Kanaji, Karin Furukawa, Keiko Koshiba, Zento Yamada, Eri Watanabe, Mai Kawazoe, Shun Ito, Ayako Fuchigami, Toshihiro Nanki","doi":"10.1093/mrcr/rxae004","DOIUrl":"10.1093/mrcr/rxae004","url":null,"abstract":"Noonan syndrome (NS) is a dominantly inherited genetic disorder with mutations in genes encoding components or regulators of the Rat sarcoma virus/mitogen-activated protein kinase pathway. Its diagnosis is based on characteristic features, including typical facial features, a short stature, congenital heart disease, mild developmental delay, and cryptorchidism. Patients with NS sometimes develop autoimmune diseases, such as Hashimoto's thyroiditis and, rarely, systemic lupus erythematosus (SLE). We herein present a 29-year-old Japanese female with NS complicated by SLE and repeated severe hypoglycaemia. The patient was diagnosed with SLE based on thrombocytopenia, nephritis, a positive antinuclear antibody titre (1:640), and a positive anti-dsDNA antibody. The patient was treated with a glucocorticoid, mycophenolate mofetil, and tacrolimus, which attenuated both SLE and hypoglycaemia. Since insulin receptor antibody levels were higher to the upper normal range and decreased after treatment, hypoglycaemia probably appeared to be attributed to type B insulin resistance syndrome. We herein present the first case of SLE in NS complicated by type B insulin resistance syndrome. Although NS is a rare disease, we need to consider the complication of autoimmune diseases, including SLE.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139521422","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

Post-renal acute kidney injury complicated by urinary tract obstruction due to massive blood clots and severe thrombocytopenia in a patient with systemic lupus erythematosus: A case report. 一名系统性红斑狼疮患者因大量血凝块和严重血小板减少导致肾后急性肾损伤并发尿路梗阻：病例报告。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae014

Yuya Fujita, Shuzo Sato, Shuhei Yoshida, Tomoyuki Asano, Haruki Matsumoto, Jumpei Temmoku, Naoki Matsuoka, Hiroshi Ohkawara, Norshalena Shakespear, Kiyoshi Migita

{"title":"Post-renal acute kidney injury complicated by urinary tract obstruction due to massive blood clots and severe thrombocytopenia in a patient with systemic lupus erythematosus: A case report.","authors":"Yuya Fujita, Shuzo Sato, Shuhei Yoshida, Tomoyuki Asano, Haruki Matsumoto, Jumpei Temmoku, Naoki Matsuoka, Hiroshi Ohkawara, Norshalena Shakespear, Kiyoshi Migita","doi":"10.1093/mrcr/rxae014","DOIUrl":"10.1093/mrcr/rxae014","url":null,"abstract":"Systemic lupus erythematosus (SLE) is often seen with antiphospholipid antibody syndrome (APS), and these conditions may occur concurrently with severe immune thrombocytopenia (ITP) and even acute kidney injury (AKI); however, post-renal AKI due to bleeding is uncommon. Here, we describe a case of post-renal AKI and anuria in a patient with SLE and APS, which were attributable to urinary tract obstruction due to massive blood clots caused by secondary ITP. A 50-year-old Japanese woman was admitted to our hospital with anuria, abdominal tenderness, purpura in the trunk and in both legs, and severe thrombocytopenia. She had been receiving medical treatment for APS and SLE till the age of 45 years. Computed tomography revealed a blood clot without extravasation in both urinary tracts, and she was diagnosed with post-renal AKI due to complete obstruction of the urinary system. Additionally, based on her medical history, elevated platelet-associated Immunoglobulin G (IgG) levels, and increased megakaryocyte count, she was diagnosed with secondary ITP complicated by SLE and APS. She also had elevated APS-related autoantibodies, including antiphosphatidylserine/prothrombin Immunoglobulin M (IgM), and IgG. However, concomitant serositis such as lupus enteritis or cystitis was not seen. She was treated with a combination of glucocorticoids, intravenous immunoglobulin, and continuous haemodialysis/haemofiltration, which resulted in rapid improvement of her symptoms and renal dysfunction. Secondary ITP-induced massive bleeding of urinary tract can cause post-renal AKI. Appropriate diagnosis and aggressive treatment are necessary to improve prognosis in such patients.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121714","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

Stellate ganglion block in the treatment of SAPHO syndrome: A case report. 星状神经节阻滞治疗 SAPHO 综合征：病例报告。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae008

Chenhao Jiang, Liangyu Cai, Jiannan Zhang, Hongmei Zhou

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A case of osteogenesis imperfecta diagnosed after subchondral insufficiency fracture of bilateral femoral heads. 一例双侧股骨头软骨下发育不全骨折后诊断出的成骨不全症。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae021

Nobuhiko Okada, Keisuke Watarai, Kota Ozawa, Tsuyoshi Miyajima, Akira Ohtake, Yuho Kadono

{"title":"A case of osteogenesis imperfecta diagnosed after subchondral insufficiency fracture of bilateral femoral heads.","authors":"Nobuhiko Okada, Keisuke Watarai, Kota Ozawa, Tsuyoshi Miyajima, Akira Ohtake, Yuho Kadono","doi":"10.1093/mrcr/rxae021","DOIUrl":"10.1093/mrcr/rxae021","url":null,"abstract":"Osteogenesis imperfecta (OI) is a heterogeneous disorder characterised by bone fragility. Herein, we report a case of OI diagnosed after subchondral insufficiency fracture (SIF) of bilateral femoral heads. A 37-year-old woman was referred to Saitama Medical University Hospital due to left hip pain without any trauma that lasted for 2 months. She was subsequently diagnosed with SIF of the left femoral head. After 3 months, she further developed SIF of the right hip without any trauma. Magnetic resonance imaging of the bilateral hips showed linear low-signal changes of the subchondral bone and bone marrow oedema of the femoral head on T2-weighted coronal and sagittal images, diagnosing of both SIFs. The bone mineral density was 0.851 g/cm2 (T-score, -1.3) at the lumbar spine, 0.578 g/cm2 (T-score, -1.9) at the right femoral neck, and 0.582 g/cm2 (T-score, -1.9) at the left femoral neck. Considering that the patient had multiple histories of fracture, blue sclera, and mild bilateral sensorineural hearing loss, she satisfied the diagnostic criteria for OI. Genetic testing revealed a mutation in COL1A1 (NM_000088.3, c.3806G>A: p. Trp1269*). After 7 months of conservative therapy, her symptoms improved. After 4 years, both hips were pain-free with no evidence of osteoarthritis progression. OI can result in insufficiency fractures due to bone fragility in adolescence and adulthood or later, and none of the cases of OI, except for the current case, were diagnosed as a result of bilateral SIF.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072084","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}

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A case of IgG4-related disease associated with ulcerative colitis that was successfully treated with a JAK inhibitor. 一例与溃疡性结肠炎相关的 IgG4 相关疾病患者成功接受了 JAK 抑制剂的治疗。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae025

Tomonao Tanaka, Satsuki Aochi, Masaaki Uehara, Hiromichi Shimizu, Motohisa Yamamoto

引用次数: 0

Successful treatment of lupus protein-losing enteropathy with belimumab: A case report. 贝利木单抗成功治疗狼疮蛋白丢失性肠病：病例报告

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae010

Marenori Kojima, Hironari Hanaoka, Kaito Aoki, Hiromi Matsushita, Hiroshi Ito, Hidehiro Yamada

引用次数: 0

A successful plasma exchange in bridging to rituximab for severe neuropsychiatric lupus and lupus nephritis with viral infections and aspiration pneumonia. 严重神经精神狼疮和狼疮肾炎合并病毒感染和吸入性肺炎患者成功进行血浆置换，过渡到利妥昔单抗治疗。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxad069

Maki Kagitani, Youhei Fujiki, Takayasu Suzuka, Katsumasa Ooe, Aya Sakamoto, Tohru Takeuchi, Haruhito Azuma

{"title":"A successful plasma exchange in bridging to rituximab for severe neuropsychiatric lupus and lupus nephritis with viral infections and aspiration pneumonia.","authors":"Maki Kagitani, Youhei Fujiki, Takayasu Suzuka, Katsumasa Ooe, Aya Sakamoto, Tohru Takeuchi, Haruhito Azuma","doi":"10.1093/mrcr/rxad069","DOIUrl":"10.1093/mrcr/rxad069","url":null,"abstract":"Systematic lupus erythematosus (SLE) is a chronic autoimmune disease involving several organs such as the kidneys, skin, vessels, and central nervous system. Neuropsychiatric SLE (NPSLE) is a life-threatening condition that needs treatment with the combination of glucocorticoids and Immunosuppressants (IS). This includes cyclophosphamide and rituximab (RTX) which can lead to several infections. Therapeutic apheresis is an optional treatment for inflammatory diseases and has less risks of infections than IS. Plasma exchange (PE) is one of the most common apheresis, and is recommended for the management of NPSLE. We report a refractory NPSLE case with bacterial pneumonia and cytomegalovirus antigenemia. PE was performed prior to RTX. After the initiation of RTX which was incompatible due to infection such as aspiration pneumonia and cytomegalic virus, PE was scheduled considering the pharmacokinetics of RTX. Her SLE activity was well managed after PE and RTX without flare. PE treatment plan bridging to IS and RTX may effectively work in refractory SLE patients with infections.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815962","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