Modern rheumatology case reports最新文献_第7页

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 : 2024-12-14 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":"https://doi.org/10.1093/mrcr/rxae085","url":null,"abstract":"Polyarteritis nodosa (PAN) is a rare systemic necrotizing 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 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 stabilized with PSL 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":"2024-12-14","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

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Modern rheumatology case reports Pub Date : 2024-12-13 DOI: 10.1093/mrcr/rxae083

Shion Kachi, Hideki Oka, Shuji Sumitomo, Shigeo Hara, Koichiro Ohmura

{"title":"IgG4-related disease with epithelioid granulomas: a case and a review of the literature.","authors":"Shion Kachi, Hideki Oka, Shuji Sumitomo, Shigeo Hara, Koichiro Ohmura","doi":"10.1093/mrcr/rxae083","DOIUrl":"https://doi.org/10.1093/mrcr/rxae083","url":null,"abstract":"IgG4-related disease (IgG4-RD) is a systemic, immune-mediated, fibroinflammatory disorder that affects multiple organs. Histopathologically, the supportive findings of IgG4-RD include dense lymphocytic infiltrates, obliterative phlebitis, storiform fibrosis, and elevated numbers of IgG4-positive plasma cells. However, the presence of granulomatous inflammation is generally considered highly atypical, suggesting alternative diagnoses such as sarcoidosis and lymphoma. Here, we present a case of IgG4-RD involving granulomatous lymphadenopathy. Labial salivary gland biopsy findings were consistent with IgG4-related sialadenitis. Elevated serum IgG4 levels, hypocomplementemia, and abnormal imaging findings in the kidneys and pancreas indicated an association with IgG4-RD. The patient was treated with prednisolone, which resulted in a significant improvement in the serum IgG4 and complement levels and a notable reduction in lymph node swelling. Although granulomatous inflammation is rare, integrating clinical, serological, radiological, and pathological parameters can ensure an accurate assessment within the appropriate clinicopathological context.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819734","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 report of a 14-year-old male patient with large vessel vasculitis following COVID-19. 14岁男性新冠肺炎合并大血管炎1例报告。

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Modern rheumatology case reports Pub Date : 2024-12-12 DOI: 10.1093/mrcr/rxae081

Hiroki Nemoto, Yoshihiro Nozaki, Takashi Matsumoto, Kaori Kiyoki, Takumi Ishiodori, Atsushi Morita, Kazuo Imagawa, Takashi Murakami, Miho Takahashi, Hironori Imai, Hidetoshi Takada

{"title":"A case report of a 14-year-old male patient with large vessel vasculitis following COVID-19.","authors":"Hiroki Nemoto, Yoshihiro Nozaki, Takashi Matsumoto, Kaori Kiyoki, Takumi Ishiodori, Atsushi Morita, Kazuo Imagawa, Takashi Murakami, Miho Takahashi, Hironori Imai, Hidetoshi Takada","doi":"10.1093/mrcr/rxae081","DOIUrl":"https://doi.org/10.1093/mrcr/rxae081","url":null,"abstract":"Most reported cases of large vessel vasculitis (LVV) following coronavirus disease 2019 (COVID-19) have involved adults, with paediatric cases being rare. We present the case of a 14-year-old boy who developed LVV following COVID-19. Initially, he presented with fever and cough, and nasopharyngeal polymerase chain reaction testing confirmed COVID-19. His symptoms spontaneously resolved without specific COVID-19 treatments. However, 10 days after contracting COVID-19, his fever recurred, and his inflammatory markers were significantly elevated. His condition did not meet the criteria for Kawasaki disease or multisystem inflammatory syndrome in children associated with COVID-19. Contrast-enhanced computed tomography revealed arterial wall thickening in the aorta and carotid arteries, indicative of LVV. Upon initiation of high-dose immunoglobulin therapy and aspirin, his fever subsided, and his inflammatory markers and imaging findings normalised. Differential diagnosis ruled out infections, immune disorders, and Takayasu arteritis (TAK), a common cause of aortitis in children. Over a 1-year follow-up period, there was no recurrence and no stenotic lesions in large vessels. This finding suggests that the patient experienced transient LVV following COVID-19. Cytokine profile analysis performed before and after treatment revealed elevated levels of interleukin (IL)-6, IL-8, and IL-12/IL-23p40, typically associated with the active phase of TAK. Importantly, IL-17A and tumour necrosis factor-α levels were normal, as elevations in these cytokines have been linked to TAK recurrence. Notably, some cases of LVV following COVID-19 do not respond well to treatment; further research, including case accumulation and cytokine profile analysis, is needed to better predict prognosis.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815435","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

Effective Use of Ultra-High Molecular Weight Polyethylene Cable and Krackow Suture for Stretched Out Patellar Tendon due to Scarring in a Case with Rheumatoid Arthritis Post-Total Knee Arthroplasty. 超高分子量聚乙烯电缆和Krackow缝线有效治疗类风湿性关节炎全膝关节置换术后瘢痕性髌腱拉伸1例。

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Modern rheumatology case reports Pub Date : 2024-12-12 DOI: 10.1093/mrcr/rxae074

Eiji Kinoshita, Naoki Kondo, Osamu Tanifuji, Rika Kakutani, Nariaki Hao, Hiroyuki Kawashima

{"title":"Effective Use of Ultra-High Molecular Weight Polyethylene Cable and Krackow Suture for Stretched Out Patellar Tendon due to Scarring in a Case with Rheumatoid Arthritis Post-Total Knee Arthroplasty.","authors":"Eiji Kinoshita, Naoki Kondo, Osamu Tanifuji, Rika Kakutani, Nariaki Hao, Hiroyuki Kawashima","doi":"10.1093/mrcr/rxae074","DOIUrl":"https://doi.org/10.1093/mrcr/rxae074","url":null,"abstract":"Patellar tendon rupture is a severe complication following total knee arthroplasty. We encountered a case of rheumatoid arthritis with an incomplete rupture of the patellar tendon post-total knee arthroplasty. An 84-year-old woman was diagnosed with an incomplete rupture of the right patellar tendon 3 months post-total knee arthroplasty of her right knee. The patient exhibited a 45° extension lag 6 months post-total knee arthroplasty, necessitating reconstruction surgery. Intraoperative findings revealed incomplete rupture of the patellar tendon that was stretched out, diagnosed as incomplete patellar tendon rupture. Due to knee valgus instability (passive knee valgus showed 20°), the thickness of the tibial insert was adjusted from 11 mm to 15 mm, resulting in improved valgus instability. The scarring region of the patellar tendon was resected to 10 mm in length, and the tendon was repaired using an ultra-high molecular weight polyethylene cable (Nesplon cable) and Krackow suture. The repair was secured by making a figure-8 pattern with the cable. After the reconstruction surgery, the knee was immobilized at 0° extension for 3 weeks, followed by the initiation of range-of-motion exercises. Three months later, the extension lag was reduced to -15°, and the patient could walk without orthosis and reported neither instability nor surgical site infection at 8 months after the surgery. In conclusion, this case is notable due to the rarity of incomplete (stretched out) patellar tendon rupture post-total knee arthroplasty and demonstrates the effectiveness of Nesplon cable with Krackow suture in reconstruction surgery.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815391","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

Refractory skin ulcers and afebrile bacteremia with Staphylococcus aureus in anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis: a case report. 抗黑色素瘤分化相关基因5抗体阳性皮肌炎伴金黄色葡萄球菌难治性皮肤溃疡和发热菌血症1例报告

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Modern rheumatology case reports Pub Date : 2024-12-12 DOI: 10.1093/mrcr/rxae082

Tokio Katakura, Tsuyoshi Shirai, Yusho Ishii, Hiroko Sato, Hiroshi Fujii

{"title":"Refractory skin ulcers and afebrile bacteremia with Staphylococcus aureus in anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis: a case report.","authors":"Tokio Katakura, Tsuyoshi Shirai, Yusho Ishii, Hiroko Sato, Hiroshi Fujii","doi":"10.1093/mrcr/rxae082","DOIUrl":"https://doi.org/10.1093/mrcr/rxae082","url":null,"abstract":"The skin ulcers sometimes appear in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM), and usually associates with disease activity. Here, we report a case of 41-year-old woman with anti-MDA5 antibody-positive DM, who developed refractory skin ulcers during the remission induction therapy, which were proven to be associated with clinically silent Staphylococcus aureus bacteremia with septic thrombi in her lung. The patient was referred to our hospital for the treatment of amyopathic DM with interstitial lung disease. Anti-MDA5-positive DM was diagnosed, and she was treated with triple therapy combined with tofacitinib because poor prognostic factors existed. Although the remission induction therapy improved most of symptoms, she developed erythematous rashes with ulcer on her left auricle and forearm, which were refractory to topical immunosuppressive medications. Despite the absence of systemic symptoms or elevated inflammatory markers, blood and wound cultures revealed S. aureus, and a new cavitary lesion was detected in her left lung. Subsequent antibiotic therapy resolved both the cutaneous and pulmonary lesions. This case highlights the importance of considering bacteremia and performing blood cultures when DM-related skin ulcers resist conventional treatments, even without fever during immunosuppressive therapy.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815392","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

Above-Knee Amputation in a 69-Year-Old Male with Gouty Tophi Complicated by Necrotizing Fasciitis - A Case Report. 69岁男性痛风性痛风伴坏死性筋膜炎行膝上截肢1例。

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Modern rheumatology case reports Pub Date : 2024-12-10 DOI: 10.1093/mrcr/rxae080

Metasebia Worku Abebe, Abigya Aschalew Asfaw

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Glucocorticoid sparing effect on Adalimumab for refractory Pyoderma gangrenosum in patients with Rheumatoid Arthritis: A Case series. 阿达木单抗对类风湿关节炎患者顽固性坏疽性脓皮病的糖皮质激素节约作用：一个病例系列。

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Modern rheumatology case reports Pub Date : 2024-12-09 DOI: 10.1093/mrcr/rxae075

Shin-Ichiro Ohmura, Naomi Morishita, Haruka Yonezawa, Toshitaka Yukishima, Yusuke Ohkubo

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Seronegative rheumatoid arthritis found in an 85-year-old woman during preoperative investigations for knee replacement surgery for osteoarthritis. 血清阴性类风湿关节炎发现于85岁妇女在术前调查膝关节置换手术骨关节炎。

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Modern rheumatology case reports Pub Date : 2024-12-09 DOI: 10.1093/mrcr/rxae076

Haruka Nakano, Makoto Hirao, Dong Seop Kim, Gensuke Okamura, Yoshihiko Hoshida, Takaaki Noguchi, Yuki Etani, Kosuke Ebina, Seiji Okada, Jun Hashimoto, Shiro Ohshima

引用次数: 0

Muscle vasculitis in patients with polymyalgia rheumatica; three case series. 风湿性多肌痛患者的肌肉血管炎三个案例系列。

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Modern rheumatology case reports Pub Date : 2024-12-09 DOI: 10.1093/mrcr/rxae072

Haruka Moriya, Yuichiro Fujieda, Yuta Inoue, Kenichi Miyamoto, Mamiko Anada, Daiki Tanaka, Akihiko Kudo, Megumi Abe, Azusa Nagai, Ryo Hisada, Michihito Kono, Masaru Kato, Olga Amengual, Yoshihiro Matsuno, Ichiro Yabe, Tatsuya Atsumi

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Imaging using diffusion-weighted whole-body imaging with background signal suppression for methotrexate-associated lymphoproliferative disorder: A case report. 甲氨蝶呤相关淋巴细胞增生性疾病的扩散加权全身成像背景信号抑制1例报告。

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Modern rheumatology case reports Pub Date : 2024-12-09 DOI: 10.1093/mrcr/rxae078

Takeshi Mochizuki, Naoko Otani, Mari Ando, Ryo Hiroshima, Koichiro Yano, Katsunori Ikari, Ken Okazaki

引用次数: 0