51
|
Pannecoeck R, Serruys D, Benmeridja L, Delanghe JR, van Geel N, Speeckaert R, Speeckaert MM. Vascular adhesion protein-1: Role in human pathology and application as a biomarker. Crit Rev Clin Lab Sci 2015; 52:284-300. [PMID: 26287391 DOI: 10.3109/10408363.2015.1050714] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Vascular adhesion protein-1 (VAP-1) is a member of the copper-containing amine oxidase/semicarbazide-sensitive amine oxidase (AOC/SSAO) enzyme family. SSAO enzymes catalyze oxidative deamination of primary amines, which results in the production of the corresponding aldehyde, hydrogen peroxide and ammonium. VAP-1 is continuously expressed as a transmembrane glycoprotein in the vascular wall during development and facilitates the accumulation of inflammatory cells into the inflamed environment in concert with other leukocyte adhesion molecules. The soluble form of VAP-1 is released into the circulation mainly from vascular endothelial cells. Over- and under-expression of sVAP-1 result in alterations of the reported reaction product levels, which are involved in the pathogenesis of multiple human diseases. The combination of enzymatic and adhesion capacities as well as its strong association with inflammatory pathologies makes VAP-1 an interesting therapeutic target for drug discovery. In this article, we will review the general characteristics and biological functions of VAP-1, focusing on its important role as a prognostic biomarker in human pathologies. In addition, the potential therapeutic application of VAP-1 inhibitors will be discussed.
Collapse
Affiliation(s)
| | | | | | | | - Nanja van Geel
- c Department of Dermatology , Ghent University Hospital , Gent , Belgium
| | | | | |
Collapse
|
52
|
Frech TM, Revelo MP, Ryan JJ, Shah AA, Gordon J, Domsic R, Hant F, Assassi S, Shanmugam VK, Hinchcliff M, Steen V, Khanna D, Bernstein EJ, Cox J, Luem N, Drakos S. Cardiac metabolomics and autopsy in a patient with early diffuse systemic sclerosis presenting with dyspnea: a case report. J Med Case Rep 2015; 9:136. [PMID: 26055398 PMCID: PMC4469401 DOI: 10.1186/s13256-015-0587-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/06/2015] [Indexed: 12/15/2022] Open
Abstract
Introduction Diffuse systemic sclerosis is associated with high mortality; however, the pathogenesis of cardiac death in these patients is not clear. Case presentation A 56-year-old Caucasian female patient presented with dyspnea and requested to donate her body to science in order to improve understanding of diffuse systemic sclerosis pathogenesis. She had extensive testing for dyspnea including pulmonary function tests, an echocardiogram, cardiac magnetic resonance imaging, and right heart catheterization to characterize her condition. Her case highlights the morbidity seen in this disease, including the presence of extensive skin thickening, digital ulcerations, and scleroderma renal crisis. Conclusion In this case report, we present the finding of cardiac tissue metabolomics, which may indicate a problem with vasodilation as a contributor to cardiac death in diffuse systemic sclerosis. The use of autopsy and tissue metabolomics in rare disease may help clarify disease pathogenesis.
Collapse
Affiliation(s)
- Tracy M Frech
- Department of Internal Medicine, University of Utah and Veterans Affair Medical Center, Salt Lake City, UT, USA.
| | - Monica P Revelo
- University of Utah Department of Pathology, Salt Lake City, UT, USA.
| | - John J Ryan
- Department of Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, USA.
| | - Ami A Shah
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | | | | | - Faye Hant
- Medical University of South Carolina, Charleston, SC, USA.
| | | | | | | | | | | | | | - James Cox
- Departments of Biochemistry and Metabolomics Core Facility, University of Utah School of Medicine, HSC Cores, Salt Lake City, UT, USA.
| | - Nick Luem
- University of Utah Department of Pathology, Salt Lake City, UT, USA.
| | - Stavros Drakos
- Department of Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, USA.
| |
Collapse
|
53
|
Manetti M. Deciphering the alternatively activated (M2) phenotype of macrophages in scleroderma. Exp Dermatol 2015; 24:576-8. [DOI: 10.1111/exd.12727] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2015] [Indexed: 01/05/2023]
Affiliation(s)
- Mirko Manetti
- Section of Anatomy and Histology; Department of Experimental and Clinical Medicine; University of Florence; Florence Italy
| |
Collapse
|
54
|
Moaveni D, Cohn J, Brodt J, Hoctor K, Ranasinghe J. Scleroderma and pulmonary hypertension complicating two pregnancies: use of neuraxial anesthesia, general anesthesia, epoprostenol and a multidisciplinary approach for cesarean delivery. Int J Obstet Anesth 2015; 24:375-82. [PMID: 26119257 DOI: 10.1016/j.ijoa.2015.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 05/01/2015] [Accepted: 05/03/2015] [Indexed: 10/23/2022]
Abstract
Literature regarding the anesthetic care of patients with scleroderma during labor and delivery is limited to remote case reports. No recent publications provide information on the anesthetic management of patients with coexisting pulmonary hypertension. This report describes the anesthetic and multidisciplinary management of two pregnant patients with concomitant scleroderma and pulmonary hypertension undergoing cesarean delivery; one with neuraxial anesthesia and one with general anesthesia. Considerations for neuraxial and general anesthesia in patients with concurrent scleroderma and pulmonary hypertension are discussed.
Collapse
Affiliation(s)
- D Moaveni
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
| | - J Cohn
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - J Brodt
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - K Hoctor
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - J Ranasinghe
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| |
Collapse
|
55
|
Terao M, Yang L, Matsumura S, Yutani M, Murota H, Katayama I. A vitamin D analog inhibits Th2 cytokine- and TGFβ -induced periostin production in fibroblasts: a potential role for vitamin D in skin sclerosis. DERMATO-ENDOCRINOLOGY 2015; 7:e1010983. [PMID: 26413189 PMCID: PMC4579972 DOI: 10.1080/19381980.2015.1010983] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/09/2015] [Accepted: 01/19/2015] [Indexed: 02/05/2023]
Abstract
Scleroderma is an autoimmune disease characterized by extracellular matrix deposition and inflammation. Topical vitamin D analogs have been reported as effective treatments for scleroderma. We previously reported that a matricellular protein, periostin (POSTN), contributes to pathogenesis of scleroderma as POSTN knockout mice were resistant to bleomycin (BLM)-induced scleroderma. We investigated whether a vitamin D analog affects the expression of POSTN in dermal fibroblasts and in a BLM-induced scleroderma model. The vitamin D analog, maxacalcitol (22-oxacalcitriol [OCT]), was applied to dermal fibroblasts and POSTN expression was measured. The effect of OCT on Th2 cytokine- and TGFβ-induced POTSN and Collagen 1 α 1 (Col1A1) expression was also assessed. In vivo, OCT was administered to BLM-induced scleroderma model and outcomes were determined by dermal thickness, collagen density and POSTN expression. Treatment with OCT significantly decreased POSTN expression in dermal fibroblasts. Th2 cytokine- and TGFβ-induced expression of POSTN and Col1A1 was also suppressed by OCT. In vivo, OCT administration decreased the density of collagen bundles and POSTN expression in a BLM-induced scleroderma model. In addition to the previously reported immunosuppressive effect, the vitamin D analog OCT might be effective to treat scleroderma, in part through inhibition of Th2 cytokine- and TGFβ-induced POSTN expression.
Collapse
Affiliation(s)
- Mika Terao
- Department of Dermatology; Graduate School of Medicine; Osaka University ; Suita, Osaka, Japan
| | - Lingli Yang
- Department of Dermatology; Graduate School of Medicine; Osaka University ; Suita, Osaka, Japan
| | - Sayaka Matsumura
- Department of Dermatology; Graduate School of Medicine; Osaka University ; Suita, Osaka, Japan
| | - Mizuki Yutani
- Department of Dermatology; Graduate School of Medicine; Osaka University ; Suita, Osaka, Japan
| | - Hiroyuki Murota
- Department of Dermatology; Graduate School of Medicine; Osaka University ; Suita, Osaka, Japan
| | - Ichiro Katayama
- Department of Dermatology; Graduate School of Medicine; Osaka University ; Suita, Osaka, Japan
| |
Collapse
|
56
|
Liu M, Yang J, Li M. Tanshinone IIA attenuates interleukin-17A-induced systemic sclerosis patient-derived dermal vascular smooth muscle cell activation via inhibition of the extracellular signal-regulated kinase signaling pathway. Clinics (Sao Paulo) 2015; 70:250-6. [PMID: 26017791 PMCID: PMC4418395 DOI: 10.6061/clinics/2015(04)06] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 01/26/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Salvia miltiorrhiza has long been used to treat systemic sclerosis. Tanshinone IIA, one of the phytochemicals derived from the roots of Salvia miltiorrhiza, exhibits multiple biological activities. The present study aimed to investigate whether tanshinone IIA has an effect on the interleukin-17A-induced functional activation of systemic sclerosis patient-derived dermal vascular smooth muscle cells. METHODS Systemic sclerosis patient-derived dermal vascular smooth muscle cells were incubated with various dosages of tanshinone IIA in the presence of interleukin-17A or the serum of systemic sclerosis patients. Cell proliferation was assessed using Cell Counting Kit-8. The expression of collagen 1 and 3 in cells was evaluated by immunofluorescence. Cell migration was measured using a transwell assay. The expression of phospho-extracellular signal-regulated kinase was detected by Western blotting. RESULTS Our data demonstrate that tanshinone IIA exerts an inhibitory effect on interleukin-17A-induced systemic sclerosis patient-derived dermal vascular smooth muscle cell proliferation, collagen synthesis and migration. CONCLUSION These findings suggest that tanshinone IIA might serve as a promising therapeutic agent for the treatment of systemic sclerosis.
Collapse
MESH Headings
- Abietanes/pharmacology
- Abietanes/therapeutic use
- Adult
- Anti-Inflammatory Agents, Non-Steroidal/pharmacology
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Blotting, Far-Western
- Cell Migration Assays
- Cell Movement/drug effects
- Cell Proliferation/drug effects
- Cells, Cultured/drug effects
- Collagen Type I/analysis
- Collagen Type III/analysis
- Enzyme Activation/drug effects
- Extracellular Signal-Regulated MAP Kinases/drug effects
- Extracellular Signal-Regulated MAP Kinases/metabolism
- Female
- Fluorescent Antibody Technique
- Humans
- Interleukin-17/analysis
- Interleukin-17/metabolism
- Male
- Middle Aged
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/metabolism
- Reproducibility of Results
- Salvia miltiorrhiza/chemistry
- Scleroderma, Systemic/drug therapy
- Scleroderma, Systemic/metabolism
- Statistics, Nonparametric
- Time Factors
Collapse
Affiliation(s)
- Mengguo Liu
- Fudan University, Zhongshan Hospital, Department of Dermatology, Shanghai, China
- Fudan University, Huashan Hospital, Department of Dermatology, Shanghai, China
| | - Ji Yang
- Fudan University, Zhongshan Hospital, Department of Dermatology, Shanghai, China
| | - Ming Li
- Fudan University, Zhongshan Hospital, Department of Dermatology, Shanghai, China
- E-mail:
| |
Collapse
|
57
|
Huang XL, Wang YJ, Yan JW, Wan YN, Chen B, Li BZ, Yang GJ, Wang J. Role of anti-inflammatory cytokines IL-4 and IL-13 in systemic sclerosis. Inflamm Res 2015; 64:151-9. [PMID: 25725697 DOI: 10.1007/s00011-015-0806-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 02/16/2015] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The aim of this paper is to review the anti-inflammatory cytokines IL-4 and IL-13 and their receptor signals; we discuss new insight into their possible roles in systemic sclerosis (SSc) and their overlapping function in SSc. INTRODUCTION SSc is a connective tissue disease characterized by fibrosis. The exact etiology of SSc is unknown, and no therapy has been proved effective in modifying its course. Recently the roles of IL-4 and IL-13 in the development of SSc have been extensively considered. The possible roles of IL-4 and IL-13, especially their overlapping function, in SSc are not well documented. METHODS A literature survey was performed using a PubMed database search to gather complete information regarding IL-4 and IL-13 and their role in inflammation. RESULTS AND CONCLUSIONS The participation of complex pathways of IL-4 and IL-13 in the process of inflammation and fibrosis action in SSc is still not very clear, and some pathogenesis of regulation found in vitro needs to be further proved. There is still more work which could be done to achieve useful developments with therapeutic benefit in SSc.
Collapse
Affiliation(s)
- Xiao-Lei Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, 230032, Hefei, Anhui, People's Republic of China
| | | | | | | | | | | | | | | |
Collapse
|
58
|
Harberts E, Zhou H, Fishelevich R, Liu J, Gaspari AA. Ultraviolet radiation signaling through TLR4/MyD88 constrains DNA repair and plays a role in cutaneous immunosuppression. THE JOURNAL OF IMMUNOLOGY 2015; 194:3127-35. [PMID: 25716994 DOI: 10.4049/jimmunol.1402583] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
UV radiation (UVR) induces DNA damage, leading to the accumulation of mutations in epidermal keratinocytes and immunosuppression, which contribute to the development of nonmelanoma skin cancer. We reported previously that the TLR4-MyD88 signaling axis is necessary for UV-induced apoptosis. In the dinitrofluorobenzene contact hypersensitivity model, UV-irradiated MyD88-deficient (MyD88(-/-)) C57BL/6 mice had intact ear swelling, exaggerated inflammation, and higher levels of dinitrofluorobenzene-specific IgG2a compared with wild-type (WT) mice. Even with normal UV-induced, dendritic cell migration, DNA damage in the local lymph nodes was less pronounced in MyD88(-/-) mice compared with WT mice. Cultured, UV-irradiated WT APCs showed cleavage (inactivation) of the DNA damage-recognition molecule PARP, whereas PARP persisted in MyD88(-/-) and TLR4(-/-) APCs. Epidermal DNA from in vivo UV-irradiated MyD88(-/-) mice had an increased resolution rate of cyclobutane pyrimidine dimers. Both in vitro treatment of MyD88(-/-) APCs with and intradermal in vivo injections of PARP inhibitor, PJ-34, caused WT-level cyclobutane pyrimidine dimer repair. Lymphoblasts deficient in DNA repair (derived from a xeroderma pigmentosum group A patient) failed to augment DNA repair after MyD88 knockdown after UVR, in contrast to lymphoblasts from a healthy control. These data suggest that interference with the TLR4/MyD88 pathway may be a useful tool in promoting DNA repair and maintaining immune responses following UVR-induced damage.
Collapse
Affiliation(s)
- Erin Harberts
- Department of Microbiology and Immunology, University of Maryland, Baltimore, MD 21201; Department of Dermatology, University of Maryland, Baltimore, MD 21201; and
| | - Hua Zhou
- Department of Dermatology, University of Maryland, Baltimore, MD 21201; and
| | - Rita Fishelevich
- Department of Dermatology, University of Maryland, Baltimore, MD 21201; and
| | - Juan Liu
- Department of Dermatology, University of Maryland, Baltimore, MD 21201; and
| | - Anthony A Gaspari
- Department of Microbiology and Immunology, University of Maryland, Baltimore, MD 21201; Department of Dermatology, University of Maryland, Baltimore, MD 21201; and Research Service, Baltimore Veterans Affairs Medical Center, Baltimore, MD 21201
| |
Collapse
|
59
|
Liu M, Yang J, Xing X, Cui X, Li M. Interleukin-17A promotes functional activation of systemic sclerosis patient-derived dermal vascular smooth muscle cells by extracellular-regulated protein kinases signalling pathway. Arthritis Res Ther 2014; 16:4223. [PMID: 25551434 PMCID: PMC4316765 DOI: 10.1186/s13075-014-0512-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 12/15/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Dermal vascular smooth muscle cells (DVSMCs) are important for vascular wall fibrosis in microangiopathy of systemic sclerosis (SSc). T helper 17 cell-associated cytokines, particularly interleukin-17A (IL-17A), have been demonstrated to play a role in the pathogenesis of SSc. However, the effect of IL-17A on the DVSMCs in microangiopathy of SSc has not been established. In the present study, we investigated the effect of IL-17A on the SSc patient-derived DVSMCs. METHODS DVSMCs from patients with SSc and healthy subjects were incubated using IL-17A or serum derived from patients with SSc. Subsequently, the proliferation, collagen synthesis and secretion, and migration of DVSMCs were analysed using a cell counting kit-8 (CCK-8), dual-luciferase reporter assay, real-time reverse transcription-polymerase chain reaction (RT-PCR), Western blot, enzyme-linked immunosorbent assay (ELISA) and transwell assay. The protein phosphorylation of signalling pathways in the process of IL-17A-mediated DVSMC activation was investigated and validated by specific signalling pathway inhibitor. RESULTS IL-17A and serum from patients with SSc could promote the proliferation, collagen synthesis and secretion, and migration of DVSMCs. IL-17A neutralising antibody could inhibit the IL-17A-induced activation of DVSMCs. Additionally, IL-17A induced the activation of extracellular-regulated protein kinases 1/2 (ERK1/2) in DVSMCs, and ERK1/2 inhibitor could block the IL-17A-elicited activation of DVSMCs. CONCLUSIONS Our results suggested that IL-17A derived from patients with SSc might induce the proliferation, collagen synthesis and secretion, and migration of DVSMCs via ERK1/2 signalling pathway, raising the likelihood that IL-17A and ERK1/2 might be promising therapeutic targets for the treatment of SSc-related vasculopathy.
Collapse
|
60
|
Ascites as the presenting symptom of multiple myeloma in a scleroderma patient. Case Rep Rheumatol 2014; 2014:235958. [PMID: 25506023 PMCID: PMC4258353 DOI: 10.1155/2014/235958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 11/04/2014] [Indexed: 11/17/2022] Open
Abstract
Several reports have demonstrated associations between scleroderma and cancer and between multiple myeloma and autoimmune diseases. Few papers have also reported the concurrence of scleroderma and multiple myeloma. We report a case of multiple myeloma that developed in a male patient after 28 years of fulfilling a diagnosis of scleroderma. The main presenting feature of multiple myeloma was ascites, solely explained by the increased vascular permeability that occurs in this disease.
Collapse
|
61
|
Doolittle DA, Lehman VT, Schwartz KM, Wong-Kisiel LC, Lehman JS, Tollefson MM. CNS imaging findings associated with Parry–Romberg syndrome and en coup de sabre: correlation to dermatologic and neurologic abnormalities. Neuroradiology 2014; 57:21-34. [DOI: 10.1007/s00234-014-1448-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 09/28/2014] [Indexed: 10/24/2022]
|
62
|
Michel MC. Hope for disease-modifying treatment of systemic sclerosis/scleroderma. J Pharmacol Exp Ther 2014; 350:480-2. [PMID: 25053235 DOI: 10.1124/jpet.114.213520comm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Martin C Michel
- Department of Pharmacology, Johannes Gutenberg University, Mainz, Germany; and Department of Translational Medicine and Clinical Pharmacokinetics, Boehringer Ingelheim Pharma GmbH, Ingelheim, Germany
| |
Collapse
|
63
|
Zeng L, Cui J, Wu H, Lu Q. The emerging role of circulating microRNAs as biomarkers in autoimmune diseases. Autoimmunity 2014; 47:419-29. [PMID: 24953646 DOI: 10.3109/08916934.2014.929667] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The highly conserved RNAs known as microRNAs (miRNAs) are a class of small, single-stranded, non-coding RNAs that play a critical role in the regulation of host genome expression at the posttranscriptional level. MiRNA-mediated gene regulation is vital for normal cellular functions, such as the cell differentiation, proliferation and apoptosis, and nearly one-third of human messenger RNAs might be miRNA targets. Increasing evidence has suggested that miRNAs play a critical role in the regulating the immune system and preventing autoimmune disorders. Circulating miRNAs, which can be easily detected by a non-invasive methods, have been proven to be able to distinguish diseased individuals from healthy subjects. In addition, these circulating miRNAs have relatively high sensitivity and specificity and thus have been developed as biomarkers for the diagnosis and monitoring of human diseases. To date, nearly 100 circulating miRNAs have been proven to be biomarkers for various diseases, and this number continues to rise. This review aims to summarize the most promising identified circulating miRNAs as potential biomarkers in autoimmune diseases and to discuss current challenges and future directions in the field.
Collapse
Affiliation(s)
- Li Zeng
- Department of Dermatology, The 2nd Xiangya Hospital, Central South University, Hunan Key Laboratory of Medical Epigenetics , Changsha , China
| | | | | | | |
Collapse
|
64
|
Kraus V, Lawson EF, von Scheven E, Tihan T, Garza J, Nathan RG, Cordoro KM, Waubant E. Atypical cases of scleroderma en coup de sabre. J Child Neurol 2014; 29:698-703. [PMID: 24667737 DOI: 10.1177/0883073813520494] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Scleroderma en coup de sabre typically presents with a cutaneous induration, but involvement of the underlying bone, eye, and brain is common. We report on 4 pediatric cases with atypical initial clinical presentations. All cases were seen at the University of California San Francisco. Patients 1 and 2 presented to the Pediatric Rheumatology Clinic with uveitis and orbital pseudotumor in December 2009 and March 2010, respectively. Patients 3 and 4 were mimicking acquired demyelinating disorders of the brain, acute demyelinating encephalomyelitis and multiple sclerosis, and were referred to the Pediatric Multiple Sclerosis center in 2008.
Collapse
Affiliation(s)
- Verena Kraus
- 1Pediatric Neurology, Klinikum rechts der Isar, Technische Universität, München, Munich, Germany
| | | | | | | | | | | | | | | |
Collapse
|
65
|
Wong B, Piliouras P, Mortimore R, Zonta M, Tucker S. Lower limb linear morphoea in a pregnant woman with known Graves' disease and cytomegalovirus immunoglobulin M positivity. Australas J Dermatol 2014; 56:e96-8. [PMID: 24712973 DOI: 10.1111/ajd.12173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 02/23/2014] [Indexed: 11/28/2022]
Abstract
We report a case of linear morphoea in a 21-year-old woman with known Graves' disease who was also cytomegalovirus (CMV) IgM-positive and in her early first trimester of pregnancy. The histopathology showed hyalinisation of the dermis with perivascular superficial and deep lymphocytic infiltrates extending into the septae of the subcutis and impinging on adjacent lobules; there was also fibrosis of the subcutis. Magnetic resonance imaging showed T2 high intensity of the subcutaneous tissue and intermuscular planes of the thigh and leg. It is well known that morphoea can follow pregnancy and thyroid disease and that CMV is postulated to contribute in some patients. This case highlights a combination of risk factors for this disease that have not been reported collectively in the literature to our knowledge.
Collapse
Affiliation(s)
| | - Peter Piliouras
- Dermatology Department, Cairns Base Hospital, Cairns, Australia
| | - Rohan Mortimore
- Department of Anatomical Pathology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Mark Zonta
- Townsville Hospital, Townsville, Australia
| | - Simon Tucker
- Dermatology Department, Cairns Base Hospital, Cairns, Australia
| |
Collapse
|