Diffuse lymphadenopathy as a manifestation of ankylosing spondylitis

Torticollis as a Sole Presentation of Spondyloarthritis in a 4-Year-Old Child

Spondyloarthritis presents in various and occasionally unusual ways that imitates other diseases. Without forthcoming risk factors, such atypical presentation may elude diagnosis for months. The case presented here of a child, aged 4 years, who is negative for human leukocyte antigen B27 (HLA-B27) and with no family history of HLA-B27 related disease, who developed torticollis with neck pain and lymphadenopathy, highlights the necessity of continually evaluating a diagnosis, especially when treatment fails to produce expected results. Painful torticollis in a child with adenopathy often is infectious in nature or potentially due to Griesel syndrome when persistent. Chronic arthritis of the cervical spine may enter the differential diagnosis when torticollis is persistent, and early recognition and aggressive treatment is necessary to prevent permanent functional impairment.

Plantaricin NC8 αβ exerts potent antimicrobial activity against Staphylococcus spp. and enhances the effects of antibiotics

The use of conventional antibiotics has substantial clinical efficacy, however these vital antimicrobial agents are becoming less effective due to the dramatic increase in antibiotic-resistant bacteria. Novel approaches to combat bacterial infections are urgently needed and bacteriocins represent a promising alternative. In this study, the activities of the two-peptide bacteriocin PLNC8 αβ were investigated against different Staphylococcus spp. The peptide sequences of PLNC8 α and β were modified, either through truncation or replacement of all L-amino acids with D-amino acids. Both L- and D-PLNC8 αβ caused rapid disruption of lipid membrane integrity and were effective against both susceptible and antibiotic resistant strains. The D-enantiomer was stable against proteolytic degradation by trypsin compared to the L-enantiomer. Of the truncated peptides, β1–22, β7–34 and β1–20 retained an inhibitory activity. The peptides diffused rapidly (2 min) through the bacterial cell wall and permeabilized the cell membrane, causing swelling with a disorganized peptidoglycan layer. Interestingly, sub-MIC concentrations of PLNC8 αβ substantially enhanced the effects of different antibiotics in an additive or synergistic manner. This study shows that PLNC8 αβ is active against Staphylococcus spp. and may be developed as adjuvant in combination therapy to potentiate the effects of antibiotics and reduce their overall use.

Lymphadenopathy in an oriental with ankylosing spondylitis

We report a case of a patient suffering from enlargement of multiple lymph nodes and low back pain for one year. The diagnosis of ankylosing spondylitis was made by bilateral sacroilitis and HLA-B27 positivity. Lymph nodes biopsy revealed lymphoid hyperplasia. No other cause for the lymphadenopathy was found after a thorough study. Furthermore, high serum IgA and C-reactive protein which were most likely related to active ankylosing spondylitis existed together with lymph node enlargement. Therefore, it was a case of ankylosing spondylitis associated with generalised lymphadenopathy which was the first reported in an oriental person. Several other possible cases also existed. We suggested that ankylosing spondylitis should be considered for young adult patients with lymphadenopathy.