Pediatric Allergy/Immunology/Rheumatology
Total Page：16
File Type：pdf, Size：1020Kb
Load more
Recommended publications
-
Reactive Arthritis This Sheet Has Been Written for People Affected by Reactive Arthritis
ARTHRIINFORMATIONTI SHEETS ARTHRIINFORMATIONTI SHEETS Reactive arthritis This sheet has been written for people affected by reactive arthritis. It provides general information to help you understand how you may be affected. This sheet also covers how reactive arthritis usually resolves over time. What is reactive arthritis? It is not known why some people who get these Reactive arthritis is a condition that causes infections develop reactive arthritis and some do not. inflammation, pain and swelling of the joints. It usually A certain gene called HLA-B27 is associated with develops after an infection, often in the bowel or genital reactive arthritis, especially inflammation of the spine. areas. The infection causes activity in the immune However this is a perfectly normal gene and there are system. The normal role of your body’s immune system many more people who have this gene and do not get is to fight off infections to keep you healthy. In some reactive arthritis. people this activity of the immune system causes joints to become inflamed, however the joints themselves How is it diagnosed? are not actually infected. About one in 10 people with Your doctor will diagnose reactive arthritis from your specific types of infections will get reactive arthritis. symptoms and a physical examination. Your doctor may also order blood tests for inflammation, such as the What are the symptoms? erythrocyte sedimentation rate (ESR) and C-reactive Reactive arthritis usually begins a few weeks after an protein (CRP) tests. Blood tests may also help to rule infection. Symptoms can affect many parts of the body out other types of arthritis. -
Management of Liver Complications in Sickle Cell Disease
| MANAGEMENT OF SICKLE CELL DISEASE COMPLICATIONS BEYOND ACUTE CHEST | Management of liver complications in sickle cell disease Abid R. Suddle Institute of Liver Studies, King’s College Hospital, London, United Kingdom Downloaded from https://ashpublications.org/hematology/article-pdf/2019/1/345/1546038/hem2019000037c.pdf by DEUSCHE ZENTRALBIBLIOTHEK FUER MEDIZIN user on 24 December 2019 Liver disease is an important cause of morbidity and mortality in patients with sickle cell disease (SCD). Despite this, the natural history of liver disease is not well characterized and the evidence basis for specific therapeutic intervention is not robust. The spectrum of clinical liver disease encountered includes asymptomatic abnormalities of liver function; acute deteriorations in liver function, sometimes with a dramatic clinical phenotype; and decompensated chronic liver disease. In this paper, the pathophysiology and clinical presentation of patients with acute and chronic liver disease will be outlined. Advice will be given regarding initial assessment and investigation. The evidence for specific medical and surgical interventions will be reviewed, and management recommendations made for each specific clinical presen- tation. The potential role for liver transplantation will be considered in detail. S (HbS) fraction was 80%. The patient was managed as having an Learning Objectives acute sickle liver in the context of an acute vaso-occlusive crisis. • Gain an understanding of the wide variety of liver pathology Treatment included IV fluids, antibiotics, analgesia, and exchange and disease encountered in patients with SCD blood transfusion (EBT) with the aim of reducing the HbS fraction • Develop a logical approach to evaluate liver dysfunction and to ,30% to 40%. With this regimen, symptoms and acute liver dys- disease in patients with SCD function resolved, but bilirubin did not return to the preepisode baseline. -
2U11/13U195 Al
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date Χ n n 20 October 2011 (20.10.2011) 2U11/13U195 Al (51) International Patent Classification: ka Pharmaceutical Co., Ltd., 1-7-1, Dosho-machi, Chuo- C12P 19/34 (2006.01) C07H 21/04 (2006.01) ku, Osaka-shi, Osaka 541-0045 (JP). (21) International Application Number: (74) Agents: KELLOGG, Rosemary et al; Swanson & PCT/US201 1/032017 Bratschun, L.L.C., 8210 SouthPark Terrace, Littleton, Colorado 80120 (US). (22) International Filing Date: 12 April 201 1 (12.04.201 1) (81) Designated States (unless otherwise indicated, for every kind of national protection available): AE, AG, AL, AM, English (25) Filing Language: AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, (26) Publication Language: English CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (30) Priority Data: HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, 61/323,145 12 April 2010 (12.04.2010) US KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, (71) Applicants (for all designated States except US): SOMA- ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, LOGIC, INC. [US/US]; 2945 Wilderness Place, Boulder, NO, NZ, OM, PE, PG, PH, PL, PT, RO, RS, RU, SC, SD, Colorado 80301 (US). OTSUKA PHARMACEUTI¬ SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, CAL CO., LTD. -
Confidential
CONFIDENTIAL CHILD’S MEDICAL INFORMATION The following is important information about my child’s medical condition and how the condition may affect their ability to fully participate in a regular school setting. The goal is to try to normalize every day school routines/activities while also meeting my child’s unique needs in the least disruptive manner. This document is not intended to replace any existing Individual Educational Plan (IEP) or the 504 Plan, but rather to serve as a supplement or addendum to enhance my child’s education. Medical information will be updated at the beginning of each new school year and throughout the school year as deemed necessary. “We may not look sick, but turn our bodies inside out and they will tell different stories.” Wade Sutherland CHILD’S NAME: ____________________________________________________________________________ ACADEMIC YEAR: _____________________GRADE: __________DOB: __________________AGE: _________ HOME ADDRESS: __________________________________________________________________________ PARENT/LEGAL GUARDIAN: ________________________________________________________________ PARENT/LEGAL GUARDIAN CONTACT NUMBER: ______________________________________________ SCHOOL: ________________________________________________________________________________ EMERGENCY CONTACT (2 PEOPLE) NAME: __________________________________________________________________________________ RELATIONSHIP: ____________________________ PHONE NUMBER: ________________________________ NAME: __________________________________________________________________________________ -
Eosinophilic Cellulitis (Wells Syndrome): a Case Report
International Journal of Research in Dermatology Baabdullah AM et al. Int J Res Dermatol. 2021 May;7(3):450-453 http://www.ijord.com DOI: https://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20211708 Case Report Eosinophilic cellulitis (wells syndrome): a case report Ahmad Mohammad Baabdullah1, Khalid Ali Al Hawsawi2, Bashayr Saad Alhubayshi3*, Marwa Rashed Gammash4 1Department of Dermatology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia 2 Department of Dermatology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia 3Taibah College of Medicine, Taibah University, Almadinah Almunawwarah, Saudi Arabia 4Collage of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Received: 14 January 2021 Accepted: 08 February 2021 *Correspondence: Dr. Bashayr Saad Alhubayshi, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Eosinophilic Cellulitis is also known as Wells syndrome is uncommon dermatitis, characterized by the infiltration of eosinophils in the dermis. The exact etiology of the disease is unknown. Clinically, it is highly varied but commonly the presentation is pruritic erythematous plaque. We report a case of one and half years old healthy boy who developed itchy bullae on the dorsum of his hand with multiple erythematous papules over his extremities that started immediately after his vaccines. Histopathological examination of the lesion showed infiltrate eosinophils with typical flame figures. The case was successfully treated with corticosteroid course. -
Oral Allergy Syndrome (OAS)
Oral Allergy Syndrome (OAS) The itchy, watery eyes, or that sudden tingling, itching or burning sensation in your mouth is all too familiar: it must be ragweed season again! After your soccer game, the juicy watermelon you share with a friend makes your mouth itchy, and you decide that maybe next time you will have to pass on the watermelon. But this is strange: you knew you were allergic to ragweed, but your reaction to watermelon is brand new. Although there is still so much we do not know about allergies, we do know that certain types of foods, or pollen like ragweed, are common culprits when it comes to giving the body an allergic reaction. Allergic reactions happen when a person’s immune system recognizes certain proteins called allergens, as foreign or unsafe. The body’s immune system then triggers an allergic response, like the swelling in your tongue and lips, to fight off the allergen. Oral Allergy Syndrome Some allergies can be much more complex, even downright sneaky. Oral Allergy Syndrome (OAS) is one such allergy. Certain types of fruits, vegetables, and nuts can trigger OAS, but you can also develop OAS even if you were not previously allergic to any of these foods. OAS only occurs in people who have pollen allergies. It is caused by allergens in fruit, vegetables and nuts that are very similar to allergens in pollen. Most only experience oral symptoms, but about 10% can experience nausea or stomach upset, and less than 5% will develop more serious whole-body allergic reactions, such as generalized hives, trouble breathing, or loss of consciousness. -
Anaphylaxis During the Perioperative Period
REVIEW ARTICLE Anaphylaxis During the Perioperative Period David L. Hepner, MD*, and Mariana C. Castells, MD, PhD† *Department of Anesthesiology, Perioperative and Pain Medicine, and †Allergy and Clinical Immunology Training Program, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Anesthesiologists use a myriad of drugs during the provi- perioperative period. Symptoms may include all organ sion of an anesthetic. Many of these drugs have side ef- systems and present with bronchospasm and cardiovas- fects that are dose related, and some lead to severe cular collapse in the most severe cases. Management of immune-mediated adverse reactions. Anaphylaxis is the anaphylaxis includes discontinuation of the presumptive most severe immune-mediated reaction; it generally oc- drug (or latex) and anesthetic, aggressive pulmonary and curs on reexposure to a specific antigen and requires the cardiovascular support, and epinephrine. Although a se- release of proinflammatory mediators. Anaphylactoid re- rum tryptase confirms the diagnosis of an anaphylactic actions occur through a direct non-immunoglobulin reaction, the offending drug can be identified by skin- E-mediated release of mediators from mast cells or from prick, intradermal testing, or serologic testing. Prevention complement activation. Muscle relaxants and latex of recurrences is critical to avoid mortality and morbidity. account for most cases of anaphylaxis during the (Anesth Analg 2003;97:1381–95) he term “anaphylaxis” was coined by Nobel reactions in which immune-complex formation and dep- prize recipients Portier and Richet (1) in 1902, osition leads to tissue damage (3). Anaphylactoid reac- T when they described a dog that had tolerated a tions occur through a direct nonimmune-mediated re- previous injection of actinotoxin, a jellyfish toxin, but lease of mediators from mast cells and/or basophils or reacted with bronchial spasm, cardiorespiratory ar- result from direct complement activation, but they rest, and death to a smaller dose 14 days later. -
Reactive Arthritis
PATIENT FACT SHEET Reactive Arthritis Reactive arthritis is an inflammatory disease that Most often, these bacterial infections are in the genitals occurs in reaction to infections by certain bacteria. or bowels, including the sexually transmitted infection Arthritis may show up a month after the infection. Once Chlamydia trachomatis, and bowel infections like called Reiter’s syndrome, it is a “spondyloarthropathy.” Campylobacter, Salmonella, Shigella and Yersinia. Reactive arthritis often affects men between 20 and CONDITION 50. It’s usually short in duration, but can be chronic in some people. DESCRIPTION Reactive arthritis symptoms include pain and swelling discharge from the genitals, but a urine or genital swab in knees, ankles or heels; severe swelling of toes or test can show signs of this infection. Bowel infections fingers; and persistent lower back pain that tends to may cause diarrhea. be more severe at night or in the morning. It may cause Most people with these very common infections irritated, red eyes, burning during urination, or a rash on don’t get reactive arthritis. People who test positive for the palms or soles of the feet. the HLA-B27 gene may be at higher risk for severe or To diagnose reactive arthritis, a rheumatologist may chronic arthritis, but those who test negative may get SIGNS/ look for these symptoms as well as signs of the original reactive arthritis too. People with weakened immune SYMPTOMS infection. Chlamydia may cause watery or pus-like systems from HIV or AIDS may develop reactive arthritis. Effective treatments are available for reactive arthritis. Later-stage, or chronic reactive arthritis, may be It is treated according to how far the disease has treated with disease-modifying antirheumatic drugs progressed. -
Nutrition Perspectives
Volume 44 Issue 2, March/April 2019 NutritionUniversity of California, Davis, Department ofPerspectives Nutrition and the Center for Nutrition in Schools Magnesium Helps Keep Vitamin D Levels Table of From Being Too Low or Too High Contents If some is good, more is better, right? Not always, Magnesium Helps especially when it comes to Keep Vitamin D 1 vitamin D. Vitamin D plays Levels From Being an integral role in calcium Too Low or Too High absorption and in bone health. Vitamin D deficiency has been linked to variety of Letter from diseases, including certain 2 types of cancer, multiple the Editors sclerosis cardiovascular disease, arthritis, osteoporosis, diabetes, and rickets. On the other hand, too much vitamin D can cause What is Oral toxicity, with symptoms such as GI discomfort, diarrhea, irregular 3 heartbeat, drowsiness, headaches, and muscle and joint pain. Allergy Syndome? Past studies suggest that magnesium supplementation may help maintain levels of vitamin D in the blood in the sweet spot of not too high or too low. Spicy Food May Help In order to understand how magnesium affects vitamin D in Preventing High 5 regulation, researchers at the Vanderbilt-Ingram Cancer Center Blood Pressure conducted a study to determine how magnesium supplements impact vitamin D levels in the blood. Participants (n=180) that were considered high risk Compound in Pomegranates May of developing colon cancer 7 were randomly assigned to Help Prevent Damage receive either a magnesium from IBD in Mice supplement or a placebo. Over 12 weeks, participants visited the clinic three times Fat Around the Middle May Be to provide blood samples and 8 have their height and weight Influenced by the Types of Food We Eat Magnesium continued on page 3 Volume 44 Letter from the Editors Welcome to a special UC Davis student edition of Nutrition Perspectives. -
Accuracy and Reliability of Palpation and Percussion for Detecting Hepatomegaly: a Rural Hospital-Based Study
Accuracy and reliability of palpation and percussion for detecting hepatomegaly: a rural hospital-based study Rajnish Joshi, Amandeep Singh, Namita Jajoo, Madhukar Pai,* S P Kalantri Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram 442 102, Maharashtra; and *Division of Epidemiology, University of California at Berkeley, Berkeley, CA 94720, USA Background: Palpation and percussion are standard Although many physicians believe that physical bedside techniques used to diagnose hepatomegaly. examination can accurately identify hepatomegaly, some Ultrasonography is a noninvasive and accurate method published reports suggest that physical signs lack accu- for measurement of liver size, but many patients in racy and reliability.1,2,3 To our knowledge, no study from developing countries have limited access to it. We India has evaluated the accuracy of physical examina- compared the accuracy of palpation and percussion tion in the assessment of enlarged liver. We conducted in a rural population in central India, using this study to determine how accurately doctors can ultrasonography as a reference standard. Methods: distinguish an enlarged liver from a normal sized one, The study design was a blinded, cross-sectional analysis and how often they agree with one another while as- of a hospital-based case series. Three physicians, sessing liver size. blind to clinical data and to each others results, independently used palpation and percussion to detect Methods hepatomegaly. Diagnostic accuracy was measured by We enrolled consecutive patients admitted to the Medi- computing sensitivity, specificity, and likelihood ratio cine wards between February 1 and 15, 2003. Patients values. Inter-physician agreement was assessed using with pleural diseases (effusion or pneumothorax) or the kappa statistic. -
Case Report and Review of Wells' Syndrome in Childhood Amy E
Bullous “Cellulitis” With Eosinophilia: Case Report and Review of Wells’ Syndrome in Childhood Amy E. Gilliam, MD*; Anna L. Bruckner, MD‡; Rene´e M. Howard, MD*; Brian P. Lee, MD§; Susan Wu, MD§; and Ilona J. Frieden, MD* ABSTRACT. A 1-year-old girl presented with acute on- but later simplified the name to eosinophilic celluli- set of edematous erythematous plaques associated with tis.2 bullae on her extremities and accompanied by peripheral Wells’ syndrome is seen more commonly among eosinophilia. She was afebrile, and the skin lesions were adults but has been observed among children. Some pruritic but not tender. The patient was treated with hypothesize that this syndrome may represent a hy- intravenously administered antibiotics for presumed cel- persensitivity response to a circulating antigen.2 As- lulitis, without improvement. However, the lesions re- sponded rapidly to systemic steroid therapy. On the basis sociated precipitants include insect bites, medication of lesional morphologic features, peripheral eosino- reactions, recent immunization, myeloproliferative philia, and cutaneous histopathologic features, a diagno- disorders, malignancies, and infections. We describe sis of Wells’ syndrome was made. Wells’ syndrome is a case of a young child with no identifiable triggering extremely rare in childhood, with 27 pediatric cases re- factors, and we review the evidence for evaluation ported in the literature. Because it is seen so infre- and management of these pediatric cases. quently, there are no specific guidelines for evaluation and management of Wells’ syndrome among children. CASE REPORT The diagnosis should be considered for children with A previously healthy, 1-year-old girl presented with acute on- presumed cellulitis and eosinophilia who fail to respond set of edematous erythematous plaques, with associated bullae, on to antibiotics. -
Bullous Eosinophilic Annular Erythema
Volume 27 Number 5| May 2021 Dermatology Online Journal || Photo Vignette 27(5):16 Bullous eosinophilic annular erythema Yun Pei Koh1, Hong Liang Tey1-3 Affiliations: 1National Skin Centre, Singapore, 2Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 3Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore Corresponding Author: Koh Yun Pei, National Skin Centre, 1 Mandalay Road, Singapore 308405, Singapore, Tel: 65-2534455, Email: [email protected] areas of central clearing (Figure 1). Some plaques Abstract were studded with tense vesicles containing yellow Eosinophilic annular erythema is an idiopathic acute serous fluid, coalescing to form large bullae over his eosinophilic dermatosis. It is a rare condition, with left flank (Figure 2). Total body surface area involved approximately 30 cases reported in the English was 12%. literature. It features annular, figurate urticarial edematous plaques primarily affecting the trunk and Histological examination showed superficial and proximal limbs. During evaluation of a patient, deep perivascular infiltrate of predominantly secondary causes of eosinophilic inflammation such eosinophils and some lymphocytes (Figure 3). as allergy-related conditions (eczema, drug, urticaria, Epidermal involvement, apoptotic keratinocytes, contact dermatitis), parasitic infestations, and interface dermatitis, blistering, vasculitis, or autoimmune dermatoses will need to be excluded. granulomatous inflammation were all absent. Direct We present an unusual case of a 47-year-old patient who developed this condition. Keywords: eosinophilic dermatoses, urticaria Introduction Idiopathic primary eosinophilic dermatoses are a group of primarily eosinophil-driven skin disease characterized by moderate-to-dense eosinophilic skin infiltration with no significant infiltration of other leukocytes. Our case is consistent with one subtype of these conditions—eosinophilic annular erythema (EAE).