Modern rheumatology case reports最新文献_第7页

Reversible dementia associated with communicating hydrocephalus secondary to spinal hypertrophic pachymeningitis in ANCA-associated vasculitis. anca相关血管炎中继发于脊髓肥厚性厚膜脑膜炎的可逆性痴呆与交通性脑积水相关。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf051

Yuki Terashima, Yoshitaka Ueda, Naoto Yokogawa

引用次数: 0

Loose body migrated into the rotator cuff in synovial chondromatosis: a case report. 滑膜软骨瘤病患者游离体迁移至肩袖1例报告。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf044

Kazushige Seki, Kiminori Yukata, Kenzo Fujii, Hiroshi Fujii, Takashi Sakai

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An autopsy of a patient with polyarteritis nodosa who developed fatal intestinal perforation accompanied by systemic multiple aneurysms and arterial thrombosis. 一例结节性多动脉炎并发致命性肠穿孔并伴有全身多发动脉瘤和动脉血栓形成的尸检报告。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae079

Nao Tsugita, Ippei Miyagawa, Masanobu Ueno, Miyabi Takahashi, Shumpei Kosaka, Shingo Nakayamada, Yoshiya Tanaka

{"title":"An autopsy of a patient with polyarteritis nodosa who developed fatal intestinal perforation accompanied by systemic multiple aneurysms and arterial thrombosis.","authors":"Nao Tsugita, Ippei Miyagawa, Masanobu Ueno, Miyabi Takahashi, Shumpei Kosaka, Shingo Nakayamada, Yoshiya Tanaka","doi":"10.1093/mrcr/rxae079","DOIUrl":"10.1093/mrcr/rxae079","url":null,"abstract":"The patient was a 48-year-old man who had developed acute myocardial infarction 3 years earlier. He started experiencing recurrent attacks of abdominal pain 2 years earlier. One month before the presentation, he developed perforative peritonitis, which was treated with right hemicolectomy. Preoperative computed tomography revealed systemic thrombotic aneurysms and fibrinoid necrotising vasculitis was detected in the vessels of the serosa of the resected intestinal specimen. These findings led to a diagnosis of polyarteritis nodosa. Despite the start of remission induction therapy with high-dose glucocorticoid and intermittent intravenous cyclophosphamide, the effect of immunosuppressive therapy was limited. Approximately 1 month after treatment initiation, he died from small intestinal perforation. Polyarteritis nodosa often exhibits nonspecific clinical symptoms, which make an early diagnosis difficult in some cases. Although the prognosis depends on the presence of ischaemic lesions due to a ruptured aneurysm or intra-aneurysmal thrombi, it is not rare for the diagnosis to be made following acute myocardial infarction or acute abdominal pain. In young patients with iscahemic organ dysfunction without any arteriosclerotic lesions at low risk of developing cardiovascular events, early diagnosis can be made by performing a whole-body examination with a differential diagnosis of polyarteritis nodosa.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808998","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 polyarteritis nodosa with severe lower limb ulcer that was treated with prednisolone and tocilizumab. 强的松龙联合托珠单抗治疗结节性多动脉炎合并严重下肢溃疡1例。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae085

Naoto Okubo, Yuki Oba, Daisuke Ikuma, Hiroki Mizuno, Masayuki Yamanouchi, Tatsuya Suwabe, Yoshifumi Ubara, Naoki Sawa

{"title":"A case of polyarteritis nodosa with severe lower limb ulcer that was treated with prednisolone and tocilizumab.","authors":"Naoto Okubo, Yuki Oba, Daisuke Ikuma, Hiroki Mizuno, Masayuki Yamanouchi, Tatsuya Suwabe, Yoshifumi Ubara, Naoki Sawa","doi":"10.1093/mrcr/rxae085","DOIUrl":"10.1093/mrcr/rxae085","url":null,"abstract":"Polyarteritis nodosa (PAN) is a rare systemic necrotising vasculitis that can lead to the formation of refractory lower limb ulcers requiring amputation. The standard treatment for severe PAN involves combination therapy with steroids and cyclophosphamide; however, some cases prove to be challenging. Recently, case reports have described the use of biological agents for PAN treatment. We present the case of a 61-year-old Japanese man with cutaneous PAN and refractory recurrent lower limb ulcers. In 2017, the patient was admitted to the hospital because of exacerbation of a right lower limb ulcer. Despite combination therapy with corticosteroids, cyclophosphamide, and endovascular therapy, the gangrene in the right lower leg progressed, and amputation was performed. The patient was temporarily stabilised with prednisolone monotherapy. In 2019, new ulcers were observed on the left lower limb. Owing to steroid resistance, subcutaneous tocilizumab (162 mg/week) was initiated. Over a few months, the ulcer healed completely, and left lower limb amputation was avoided. Therefore, tocilizumab could potentially be one of the treatment options for severe cases in the future.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824935","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

Paradoxical pyoderma gangrenosum secondary to adalimumab successfully treated with methotrexate: A case report. 甲氨蝶呤成功治疗阿达木单抗继发的矛盾性坏疽性脓皮病1例。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae073

Kristy El Morr, Mohamad Ali Rida

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Successful treatment of recurrent haemarthrosis after total knee arthroplasty using genicular artery embolisation in a patient with rheumatoid arthritis. 类风湿性关节炎患者膝动脉栓塞成功治疗全膝关节置换术后复发性关节血肿1例。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf030

Mayu Iiboshi, Hiroyasu Mizuhara, Kenta Makabe, Yasunori Omata, Takeyuki Watadani, Sakae Tanaka, Takumi Matsumoto

{"title":"Successful treatment of recurrent haemarthrosis after total knee arthroplasty using genicular artery embolisation in a patient with rheumatoid arthritis.","authors":"Mayu Iiboshi, Hiroyasu Mizuhara, Kenta Makabe, Yasunori Omata, Takeyuki Watadani, Sakae Tanaka, Takumi Matsumoto","doi":"10.1093/mrcr/rxaf030","DOIUrl":"10.1093/mrcr/rxaf030","url":null,"abstract":"Recurrent haemarthrosis after total knee arthroplasty (TKA) is a rare but challenging complication, with an incidence ranging from 0.3% to 1.6%. Conservative treatment, including rest, joint aspiration, and oral tranexamic acid, is often the first-line approach, but approximately two-thirds of cases require more invasive procedures. Genicular artery embolisation (GAE) has emerged as a promising alternative to synovectomy for refractory cases, offering high success rates with fewer complications. While most reports of GAE for recurrent haemarthrosis focus on patients with osteoarthritis, data on its use in patients with rheumatoid arthritis (RA) are scarce. We report a case of a 79-year-old woman with RA who presented with recurrent haemarthrosis 11 years after TKA. Despite conservative treatment, her haemarthrosis persisted. Angiography revealed three hypervascular areas supplied by branches of the superior lateral, superior medial, and middle genicular arteries. Embolisation was successfully performed using gelatin sponge, resulting in complete symptom resolution without recurrence at the 2-year follow-up. This case highlights the potential of GAE as a viable treatment option for recurrent haemarthrosis in patients with RA, particularly those with multiple bleeding sites or when synovectomy is unsuccessful or impractical. Careful evaluation from multiple angiographic angles is crucial to detect all bleeding sources, especially in post-TKA cases where metal implants may obscure vascular regions. Although further studies are needed, GAE may represent a safe and effective alternative for managing recurrent haemarthrosis in patients with RA.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164417","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

Development of Takayasu arteritis during deep molecular response of chronic myeloid leukaemia: a case report and literature review. 慢性髓系白血病深部分子反应过程中高须动脉炎的发展：1例报告及文献复习。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf041

Hideyuki Iwai, Ryuji Tanosaki

{"title":"Development of Takayasu arteritis during deep molecular response of chronic myeloid leukaemia: a case report and literature review.","authors":"Hideyuki Iwai, Ryuji Tanosaki","doi":"10.1093/mrcr/rxaf041","DOIUrl":"10.1093/mrcr/rxaf041","url":null,"abstract":"The coexistence of Takayasu arteritis (TA) and chronic myeloid leukaemia (CML) is extremely rare, with most reported cases occurring either concurrently or during active disease. We report a unique case of TA developing during a deep molecular response (MR) of CML. A 28-year-old female was diagnosed with CML in December 2020 and achieved a deep MR with bosutinib treatment. After 3.5 years of successful CML treatment, she developed symptoms including fatigue, low-grade fever, and chest pain. Imaging revealed wall thickening of multiple large vessels characteristic of TA. The patient responded well to prednisolone therapy while maintaining the MR of CML. A review of published cases identified eight previous reports of TA associated with myeloid disorders. Our case is distinctive for the development of TA during sustained deep MR of CML, contrasting with previous reports where vasculitis typically occurred during active disease or at initial presentation. This case highlights the importance of monitoring for vasculitic complications in CML patients, even during MR. The temporal relationship between these conditions suggests that inflammatory mechanisms leading to vasculitis might persist or develop independently of CML disease activity, challenging the conventional understanding of their association as a purely paraneoplastic phenomenon.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639139","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

Complete resolution of large vessel vasculitis associated with colorectal cancer following resection of tumour. 肿瘤切除后大肠癌相关大血管炎的完全解决。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf048

Richard Weir, Graham Raftery

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A case of IgG4-related disease potentially triggered by COVID-19 vaccination: longitudinal serum IgG4 monitoring from prevaccination. 1例可能由COVID-19疫苗接种引发的IgG4相关疾病：预防接种后血清IgG4的纵向监测

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf039

Ryuhei Ishihara, Ryu Watanabe, Ayaka Yao, Tomohiro Kuwamoto, Masao Katsushima, Kazuo Fukumoto, Sayaka Tanaka, Yoshinori Kakutani, Atsushi Shibata, Shinsuke Yamada, Wakaba Fukushima, Hiroshi Kakeya, Tetsuo Shoji, Masanori Emoto, Taro Shimono, Motomu Hashimoto

{"title":"A case of IgG4-related disease potentially triggered by COVID-19 vaccination: longitudinal serum IgG4 monitoring from prevaccination.","authors":"Ryuhei Ishihara, Ryu Watanabe, Ayaka Yao, Tomohiro Kuwamoto, Masao Katsushima, Kazuo Fukumoto, Sayaka Tanaka, Yoshinori Kakutani, Atsushi Shibata, Shinsuke Yamada, Wakaba Fukushima, Hiroshi Kakeya, Tetsuo Shoji, Masanori Emoto, Taro Shimono, Motomu Hashimoto","doi":"10.1093/mrcr/rxaf039","DOIUrl":"10.1093/mrcr/rxaf039","url":null,"abstract":"We report a case of a 64-year-old Japanese man who developed IgG4-related pericoronary arteritis following mRNA-based COVID-19 vaccination. The patient presented with anterior chest pain and imaging revealed perivascular soft tissue thickening around the coronary arteries, along with pancreatic enlargement, enlarged prostate, and periaortitis. Laboratory tests showed markedly elevated serum IgG4 levels (1740 mg/dl). Histopathological findings from prostate biopsy were consistent with IgG4-related disease. Notably, retrospective analysis of preserved serum samples demonstrated a sharp increase in IgG4 levels following the third BNT162b2 vaccine dose, suggesting a possible link between vaccination and disease onset. The patient responded to prednisolone, with significant clinical and radiological improvement. However, IgG4 levels rebounded during tapering, requiring additional immunosuppressive therapy with azathioprine and planned rituximab treatment. This case represents the first documented instance tracking longitudinal changes in serum IgG4 levels from prevaccination through disease onset. While a definitive causal relationship between COVID-19 vaccination and IgG4-related disease remains unproven, this case highlights the need for further investigation into the potential immunopathogenic mechanisms involved.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585946","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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The role of syphilis in exacerbating axial spondyloarthritis symptoms: A case report on diagnosis and management. 梅毒在加重轴型脊柱炎症状中的作用：1例诊断和治疗报告。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf023

Junya Kitai, Takahiro Seno, Naoka Kamio, Masataka Kohno, Tomoyuki Shirase, Yutaka Kawahito

{"title":"The role of syphilis in exacerbating axial spondyloarthritis symptoms: A case report on diagnosis and management.","authors":"Junya Kitai, Takahiro Seno, Naoka Kamio, Masataka Kohno, Tomoyuki Shirase, Yutaka Kawahito","doi":"10.1093/mrcr/rxaf023","DOIUrl":"10.1093/mrcr/rxaf023","url":null,"abstract":"Syphilis, caused by Treponema pallidum, is resurging globally, with diverse clinical manifestations. While musculoskeletal involvement is recognised, its role in exacerbating axial spondyloarthritis (ax-SpA) or causing infectious spondylitis is poorly understood. We report the case of a 48-year-old man with long-standing ax-SpA who experienced spontaneous remission until a severe flare triggered by primary syphilis, characterised by an ulcerative lesion on the upper lip. Imaging studies revealed ankylosis of the sacroiliac joints and new inflammatory changes in the lumbar spine. Specifically, plain radiography demonstrated complete ankylosis of the sacroiliac joints, while magnetic resonance imaging revealed bone contrast enhancement, consistent with active inflammation. Syphilis infection was confirmed both serologically and by immunohistochemical staining of tissue samples. Targeted antibiotic therapy with penicillin G and amoxicillin-probenecid led to significant clinical and radiological improvement. This case highlights syphilis as a potential trigger for ax-SpA exacerbation or an infectious spinal process. Recognising syphilis in patients with unexplained axial inflammation can prevent unnecessary immunosuppressive therapy and guide effective management. With the rising incidence of syphilis, prompt diagnosis and treatment are critical for preventing spinal pathology progression and improving outcomes.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145364","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