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Noorani S, Da J, Kalva P, Smith M, Hogan RN, Truong-Le M. Concomitant Seropositive Ocular Myasthenia and Biopsy-Proven Temporal Arteritis. J Neuroophthalmol 2024; 44:e60-e61. [PMID: 36730230 DOI: 10.1097/wno.0000000000001775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Sahar Noorani
- Department of Neurology (SN, RNH, MT-L), University of Texas Southwestern Medical Center, Dallas, Texas; University of Texas Southwestern Medical School (JD, PK), Dallas, Texas; Department of Ophthalmology (MS, RNH, MT-L), University of Texas Southwestern Medical Center, Dallas, Texas; and Department of Pathology (RNH), University of Texas Southwestern Medical Center, Dallas, Texas
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Panevin TS, Zotkin EG, Troshina EA. [Autoimmune polyendocrine syndrome in adults. Focus on rheumatological aspects of the problem: A review]. TERAPEVT ARKH 2023; 95:881-887. [PMID: 38159022 DOI: 10.26442/00403660.2023.10.202484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Indexed: 01/03/2024]
Abstract
Autoimmune polyglandular syndromes (APS) are a heterogeneous group of clinical conditions characterized by functional impairment of multiple endocrine glands due to loss of central or peripheral immune tolerance. These syndromes are also often accompanied by autoimmune damage to non-endocrine organs. Taking into account the wide range of components and variants of the disease, APS is usually divided into a rare juvenile type (APS 1) and a more common adult type (APS 2-4). APS type 1 is caused by a monogenic mutation, while APS types 2-4 have a polygenic mode of inheritance. One subtype of adult APS (APS 3D) is characterized by a combination of autoimmune thyroid disease and autoimmune rheumatic disease. This review considers the available literature data on combinations that meet the above criteria. Many studies have noted a significantly higher prevalence of rheumatic diseases in patients with autoimmune thyroid disease compared with the control group. Also, as in a number of rheumatic diseases, a more frequent occurrence of autoimmune thyroiditis, primary hypothyroidism and Graves' disease was noted.
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Affiliation(s)
- T S Panevin
- Nasonova Research Institute of Rheumatology
- Far Eastern State Medical University
| | - E G Zotkin
- Nasonova Research Institute of Rheumatology
| | - E A Troshina
- National Medical Research Center for Endocrinology
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3
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Papo M, Friedrich C, Delaval L, de Boysson H, Viallard JF, Bachmeyer C, Sené T, Humbert S, Duffau P, Contis A, Agard C, Gombert B, Puyade M, Foucher A, Alary AS, Danlos FX, Régent A, Mouthon L, Guillevin L, Samson M, Kosmider O, Terrier B. Myeloproliferative neoplasms and clonal hematopoiesis in patients with giant cell arteritis: a case-control and exploratory study. Rheumatology (Oxford) 2021; 61:775-780. [PMID: 33836046 DOI: 10.1093/rheumatology/keab337] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/02/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Giant cell arteritis (GCA) is a large vessel vasculitis for which triggering factors remain unknown. Clonal hematopoiesis (CH) was associated with atherosclerosis through the induction of inflammation in myeloid cells, and data suggest that CH expansion and inflammation may support each other to induce a proinflammatory loop. Our objective was to describe the impact of JAK2p.V617F-mutated myeloproliferative neoplasms (MPN) on GCA and to screen MPN-free patients for CH mutations. METHODS We performed a retrospective case-control study comparing characteristics of 21 GCA patients with MPN and 42 age and gender-matched GCA patients without MPN. Also, 18 GCA patients were screened for CH through Next Generation Sequencing. RESULTS The most frequent associated MPN was essential thrombocythemia (ET) (n = 11). Compared to controls, GCA patients with MPN had less frequent cephalic symptoms (71.4 vs. 97.6%, p = 0.004) and higher platelets count at baseline [485 (346-586) vs. 346 [IQR 296-418] x 109/L, p = 0.02). There was no difference between groups for other clinical features. Overall survival was significantly shorter in patients with MPN compared to controls [HR 8.2 (95% CI 1.2-56.6), p = 0.03]. Finally, screening for CH using NGS in 15 GCA patients without MPN revealed CH in 33%. CONCLUSION GCA patients with MPN display higher platelets count and shorter overall survival than controls. This association could not be fortuitous given the possible pathophysiological relationship between the two diseases. CH was found in one third of GCA patients, which may be higher than the expected prevalence for similar age, what should be confirmed in a larger cohort.
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Affiliation(s)
- Matthias Papo
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Chloé Friedrich
- Laboratory of Hematology, Cochin Institute, Paris University, AP-HP, Paris, France
| | - Laure Delaval
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Hubert de Boysson
- Department of Internal Medicine, UNICAEN, EA4650 SEILIRM, Caen Normandie University Hospital, Caen, France
| | - Jean-François Viallard
- Department of Internal Medicine and Infectious Diseases, Haut Lévêque University Hospital, Bordeaux University, Pessac, France
| | - Claude Bachmeyer
- Department of Internal Medicine, AP-HP, Tenon Hospital, Sorbonne University, Paris, France
| | - Thomas Sené
- Department of Internal Medicine, Rothschild Foundation Hospital, Paris, France
| | - Sébastien Humbert
- Internal Medicine Department, University Hospital Besancon, Besançon, France
| | - Pierre Duffau
- Department of Internal Medicine and Clinical Immunology, Saint Andre Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France; CNRS UMR 5164, Immuno ConcEpT, Bordeaux University, 33076 Bordeaux, France
| | - Anne Contis
- Department of Internal Medicine and Clinical Immunology, Saint Andre Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France; CNRS UMR 5164, Immuno ConcEpT, Bordeaux University, 33076 Bordeaux, France
| | | | - Bruno Gombert
- Department of Rheumatology, La Rochelle Hospital, La Rochelle, France
| | - Mathieu Puyade
- Department of Internal Medicine and Infectious Diseases, Poitiers Universitary Hospital, Poitiers, France
| | - Aurélie Foucher
- Department of Internal Medicine, CHU de La Réunion, Saint Pierre, France
| | - Anne-Sophie Alary
- Laboratory of Hematology, Cochin Institute, Paris University, AP-HP, Paris, France
| | - François-Xavier Danlos
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Alexis Régent
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Luc Mouthon
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Loïc Guillevin
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Maxime Samson
- Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Bourgogne-Franche-Comté, Dijon, France
| | - Olivier Kosmider
- Laboratory of Hematology, Cochin Institute, Paris University, AP-HP, Paris, France
| | - Benjamin Terrier
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
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Aslanbekova N, Liozon E, Palat S, Bezananary H, Gondran G, Fauchais A, Ly K. Maladies systémiques ou auto-immunes associées à l’artérite à cellules géantes. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Deshayes S, Liozon E, Chanson N, Sacré K, Moulinet T, Blanchard-Delaunay C, Espitia O, Groh M, Versini M, Le Gallou T, Kahn JE, Grobost V, Humbert S, Samson M, Mourot Cottet R, Mazodier K, Dartevel A, Campagne J, Dumont A, Bienvenu B, Lambert M, Daumas A, Saadoun D, Aouba A, de Boysson H. Concomitant association of giant cell arteritis and malignancy: a multicenter retrospective case-control study. Clin Rheumatol 2019; 38:1243-1249. [PMID: 30617596 DOI: 10.1007/s10067-018-04407-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Some studies suggest that there is an increased risk of malignancies in giant cell arteritis (GCA). We aimed to describe the clinical characteristics and outcomes of GCA patients with concomitant malignancy and compare them to a GCA control group. METHOD Patients with a diagnosis of GCA and malignancy and with a maximal delay of 12 months between both diagnoses were retrospectively included in this study and compared to a control group of age-matched (3:1) patients from a multicenter cohort of GCA patients. RESULTS Forty-nine observations were collected (median age 76 years). Malignancies comprised 33 (67%) solid neoplasms and 16 (33%) clonal hematologic disorders. No over-representation of a particular type of malignancy was observed. Diagnosis of GCA and malignancy was synchronous in 7 (14%) patients, while malignancy succeeded GCA in 29 (59%) patients. Malignancy was fortuitously diagnosed based on abnormalities observed in laboratory tests in 26 patients, based on imaging in 14 patients, and based on symptoms or clinical examination in the nine remaining patients. Two patients had a concomitant relapse of both conditions. When compared to the control group, patients with concomitant GCA and malignancy were more frequently male (p < 0.001), with an altered general state (p < 0.001), and polymyalgia rheumatica (p < 0.01). CONCLUSIONS This study does not indicate an over-representation of any particular type of malignancy in GCA patients. Initial follow-up dictated by vasculitis may have led to an early identification of malignancy. Nevertheless, GCA male patients with an altered general state and polymyalgia rheumatica might more frequently show concomitant malignancies.
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Affiliation(s)
- S Deshayes
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000, Caen, France
| | - E Liozon
- Department of Internal Medicine, CHU Limoges, Limoges, France
| | - N Chanson
- Department of Internal Medicine, Hôpital Bichat, Paris, France
| | - K Sacré
- Department of Internal Medicine, Hôpital Bichat, Paris, France
| | - T Moulinet
- Department of Internal Medicine, Hôpitaux Privés de Metz, Metz, France
| | - C Blanchard-Delaunay
- Department of Internal Medicine, Centre Hospitalier Georges Renon, Niort, France
| | - O Espitia
- Department of Internal Medicine, CHU Nantes, Nantes, France
| | - M Groh
- Department of Internal Medicine, National Referral Center for Hypereosinophilic Syndromes (CEREO), Hôpital Foch, Suresnes, France
| | - M Versini
- Institut Arnault Tzanck, Saint Laurent du Var, France
| | - T Le Gallou
- Department of Internal Medicine, CHU Rennes, Rennes, France
| | - J-E Kahn
- Department of Internal Medicine, Hôpital Ambroise Paré, Boulogne Billancourt, France
| | - V Grobost
- Department of Internal Medicine, CHU Estaing, Clermont-Ferrand, France
| | - S Humbert
- Department of Internal Medicine, CHU de Besançon, Besançon, France
| | - M Samson
- Department of Internal Medicine and Clinical Immunology, CHU Dijon, Dijon, France
| | - R Mourot Cottet
- Department of Internal Medicine, Hôpital Civil, Strasbourg, France
| | - K Mazodier
- Department of Internal Medicine, Hôpital de la Conception, Marseille, France
| | - A Dartevel
- Department of Internal Medicine, CHU Grenoble, Grenoble, France
| | - J Campagne
- Department of Infectious and Systemic Diseases, Hôpital d'Instruction des Armées, Metz, France
| | - A Dumont
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000, Caen, France
| | - B Bienvenu
- Department of Internal Medicine, Hôpital Saint Joseph, Marseille, France
| | - M Lambert
- Department of Internal Medicine, CHU de Lille, Lille, France
| | - A Daumas
- Department of Geriatric and Internal Medicine, CHU de Marseille, Marseille, France
| | - D Saadoun
- Department of Internal Medicine, Hôpital Pitié Salpétrière, Paris, France
| | - A Aouba
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000, Caen, France
| | - H de Boysson
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000, Caen, France.
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Jolobe OMP. The potential for dual pathology in temporal arteritis. QJM 2018; 111:67. [PMID: 29186538 DOI: 10.1093/qjmed/hcx228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- O M P Jolobe
- From the Manchester Medical Society, Simon Building, Brunswick Street, Manchester M13 9PL, UK
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Yin X, Hu L, Wang X. Effects of thyroid cystectomy for primary hyperparathyroidism on immune function. Pak J Med Sci 2016; 32:215-20. [PMID: 27022378 PMCID: PMC4795871 DOI: 10.12669/pjms.321.8928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: To evaluate the effects of thyroid cystectomy for primary hyperparathyroidism on immune function. Methods: Ninety-two patients with parathyroid cysts complicated with primary hyperparathyroidism were randomly divided into a treatment group and a control group (n=46). The treatment group received endoscopic thyroidectomy through the anterior chest wall via the areolar approach, and the control group was treated with conventional open thyroidectomy. Results: The two groups had similar immune function indices as well as thyroid hormone, serum calcium and phosphorus levels before surgery (P>0.05). After surgery, FT3 and FT4 levels significantly increased in both groups, whereas that of TSH significantly decreased (P<0.05). The levels of the two groups differed significantly on the postoperative 5th day (P<0.05). NK%, CD3+%, CD4+% and CD8+%, which significantly fluctuated on the postoperative 1st day in both groups (P<0.05), were basically recovered on the postoperative 5th day in the treatment group that had significantly different outcomes from those of the control group (P<0.05). On the postoperative 1st and 5th days, the treatment group had significantly lower serum calcium level and significantly higher serum phosphorus level than those of the control group (P<0.05). The surgeries were successfully performed for all patients. During three months of follow-up, the treatment group was significantly less prone to complications such as surgical site infection, recurrent laryngeal nerve injury, parathyroid crisis and hoarseness than the control group (P<0.05). Conclusion: For treatment of primary hyperparathyroidism, endoscopic thyroidectomy through the anterior chest wall via the areolar approach decreased the incidence rate of complications, as well as promoted the recovery of serum calcium and phosphorous levels, probably by only mildly affecting immune function and thyroid hormone levels.
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Affiliation(s)
- Xiangdang Yin
- Xiangdang Yin, Department of Oral-Maxillofacial-Thyroid Oncosurgery, Jilin Cancer Hospital, Changchun 130001, China
| | - Liang Hu
- Liang Hu, First Department of Respiratory Diseases, Children's Hospital of Changchun, Changchun 130051, China
| | - Xiaochun Wang
- Xiaochun Wang, Department of Oral-Maxillofacial-Thyroid Oncosurgery, Jilin Cancer Hospital, Changchun 130001, China
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8
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Marzouk S, Hriz H, Jallouli M, Cherif Y, Bahloul Z. [Association sarcoidosis and Horton disease: report of a case]. Pan Afr Med J 2015. [PMID: 26213599 PMCID: PMC4506795 DOI: 10.11604/pamj.2015.20.98.5946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
La sarcoïdose peut être associée à d'autres maladies inflammatoires. Elle est exceptionnellement associée à une maladie de Horton posant un problème nosologique sur le caractère fortuit ou non de cette association. Nous rapportons l'observation d'une patiente, âgée de 68 ans, chez qui le diagnostic de sarcoïdose avec atteinte rénale, hépatique, oculaire, articulaire et signes généraux a été retenu et ayant été traitée par corticothérapie avec une bonne évolution. 3 ans plus tard elle a présenté des céphalées fronto-temporales associées à une claudication massétérienne et un syndrome inflammatoire biologique. La biopsie de l'artère temporale a conclu à une artérite à cellules géantes. L’évolution a été favorable sous corticothérapie. L'association d'une maladie de Horton à une sarcoïdose suggère un lien éventuel entre ces deux affections.
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Affiliation(s)
- Sameh Marzouk
- Service de Médecine Interne, CHU Hédi Chaker, Sfax, Tunisie
| | - Hela Hriz
- Service de Médecine Interne, CHU Hédi Chaker, Sfax, Tunisie
| | - Moez Jallouli
- Service de Médecine Interne, CHU Hédi Chaker, Sfax, Tunisie
| | - Yosra Cherif
- Service de Médecine Interne, CHU Hédi Chaker, Sfax, Tunisie
| | - Zouhir Bahloul
- Service de Médecine Interne, CHU Hédi Chaker, Sfax, Tunisie
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Mantero V, Rigamonti A, Bianchi G, Piamarta F, Rossi G, Pozzetti U, Salmaggi A. Pitfall in neurology: giant cell arteritis mimicking ocular myasthenia gravis. Neurol Sci 2015; 36:665-6. [DOI: 10.1007/s10072-015-2074-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 01/09/2015] [Indexed: 10/24/2022]
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10
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Is primary hyperparathyroidism a pathogenic factor in some conditions mediated by B lymphocytes hyperactivity? Med Hypotheses 2013; 81:111-3. [DOI: 10.1016/j.mehy.2013.03.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 02/26/2013] [Accepted: 03/29/2013] [Indexed: 01/31/2023]
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Myasthenia gravis and stroke in the setting of giant cell arteritis. Case Rep Rheumatol 2013; 2013:505686. [PMID: 23781375 PMCID: PMC3679761 DOI: 10.1155/2013/505686] [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: 04/11/2013] [Accepted: 05/04/2013] [Indexed: 11/17/2022] Open
Abstract
This case report concerns the diagnosis of two independent chronic diseases in a patient hospitalized for stroke, myasthenia gravis (MG) and giant cell arteritis (GCA). MG has been found to be associated with several diseases, but there are very few cases documenting its coexistence with GCA. We report the case of a 79-year-old woman initially hospitalized for stroke. Patient's concurrent symptoms of blepharoptosis, dysphagia, and proximal muscle weakness were strongly suggestive of myasthenia gravis. The persistent low-grade fever and elevated inflammatory markers in combination with the visual deterioration that developed also raised the suspicion of GCA. Histological examination confirmed GCA, while muscle acetylcholine receptor antibodies were also present. Even though in medicine one strives to interpret a patient's symptoms with one diagnosis, when one entity cannot fully interpret the clinical and laboratory findings, clinicians must consider the possibility of a second coexisting illness.
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12
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Paraneoplastic rheumatic syndromes: report of eight cases and review of literature. Rheumatol Int 2011; 32:1485-9. [PMID: 22090010 DOI: 10.1007/s00296-011-2252-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Accepted: 10/22/2011] [Indexed: 12/19/2022]
Abstract
Malignant neoplasms are associated with a wide variety of paraneoplastic rheumatological syndromes. The paraneoplastic nature should be based on specific criteria. We report a series of eight cases of paraneoplastic rheumatic syndromes revealing an underlying neoplasia. Our series consists of six men and two women, with a mean age of 46.1 (20-69 years). The first case is a hypertrophic osteoarthropathy of Pierre Marie that occurred in a 20-year-old man 1 month after treatment for his nasopharyngeal carcinoma; the paraclinical examinations showed lung and bone metastasis. The second case is that of a bilateral shoulder-hand syndrome revealing an invasive squamous cell carcinoma of the cervix in a 63-year-old woman. The third case involved a 69-year-old patient who had surgery 2 years ago for prostate adenocarcinoma and presented with polymyalgia rheumatica revealing bone metastasis. We also report two cases of leukemia in adults revealed by polyarthritis. The sixth observation is that of a paraneoplastic scleroderma that occurred concomitantly with prostate cancer. The seventh case of an acute arthritis showed a B lymphoma. The eighth case is that of a 52-year-old patient who presented with inflammatory arthralgias, and digital clubbing revealing a squamous cell carcinoma of the skin. Paraneoplastic rheumatism remains a rare event, but knowledge of it is essential for early diagnosis of underlying cancer.
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Montalto M, Biolato M, Gallo A, Racco S, Marrone G, Manna R, Grieco A, Gasbarrini G. Severe Giant Cell Arteritis Associated with Essential Thrombocythaemia. Int J Immunopathol Pharmacol 2010; 23:1271-4. [DOI: 10.1177/039463201002300433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Giant-cell arteritis (GCA) is a chronic vasculitis of the elderly usually involving the ophthalmic arteries, which can result in visual loss. High platelet counts may have some pathogenic significance in the obstruction of the ophthalmic circulation and a few cases of associated essential thrombocythaemia and GCA have been described. Here we report a case of severe temporal arteritis associated with essential thrombocythaemia.
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Affiliation(s)
- M. Montalto
- Department of Internal Medicine, Catholic University of Rome, Italy
| | - M. Biolato
- Department of Internal Medicine, Catholic University of Rome, Italy
| | - A. Gallo
- Department of Internal Medicine, Catholic University of Rome, Italy
| | - S. Racco
- Department of Internal Medicine, Catholic University of Rome, Italy
| | - G. Marrone
- Department of Internal Medicine, Catholic University of Rome, Italy
| | - R. Manna
- Department of Internal Medicine, Catholic University of Rome, Italy
| | - A. Grieco
- Department of Internal Medicine, Catholic University of Rome, Italy
| | - G. Gasbarrini
- Department of Internal Medicine, Catholic University of Rome, Italy
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14
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Poyet R, Kerebel S, Landais C, Aletti M, Graffin B, Paris JF, Carli P. [Oedematous polyarthritis and myopericarditis as presenting features of periarteritis nodosa]. Rev Med Interne 2008; 30:453-5. [PMID: 18760865 DOI: 10.1016/j.revmed.2008.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Revised: 06/20/2008] [Accepted: 07/08/2008] [Indexed: 10/21/2022]
Abstract
Remitting symmetrical seronegative synovitis with pitting edema (RS3PE) syndrome is a rare type of seronegative polyarthritis occurring in the elderly. It can be associated to various diseases. We report a case of RS3PE syndrome associated with myopericarditis, leading to the diagnosis of polyarteritis nodosa in a 71-year-old patient admitted to the hospital for a febrile acute polyarthritis with pitting edema of the hands associated with a marked inflammatory syndrome. On second day of hospitalization, a sustained chest pain led to the diagnosis of myopericarditis. Muscular biopsy showed necrotizing vasculitis, characteristic of polyarteritis nodosa. The coexistence of RS3PE and myopericarditis has never been described in the literature. Its association with polyarteritis nodosa is also very rare and only one case has been previously reported.
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Affiliation(s)
- R Poyet
- Service de cardiologie et maladies vasculaires, hôpital d'instruction des armées Sainte-Anne, 83800 Toulon-Naval, France.
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15
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A case of polyarteritis nodosa presenting initially as peripheral vascular disease. J Gen Intern Med 2008; 23:1528-31. [PMID: 18560943 PMCID: PMC2518022 DOI: 10.1007/s11606-008-0683-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2007] [Revised: 04/16/2008] [Accepted: 05/01/2008] [Indexed: 10/21/2022]
Abstract
Polyarteritis nodosa is a rare necrotizing vasculitis that can be progressive and fatal, and its initial presenting symptom may be leg claudication due to peripheral vascular ischemia. To date, there have been fewer than ten case reports of polyarteritis nodosa presenting as peripheral vascular disease. We report a case of a 38-year-old man initially diagnosed to have premature peripheral vascular disease who presented 1 year later with symptoms consistent with giant cell arteritis and subsequently developed bowel ischemia leading to a fatal outcome. Based on the autopsy and the patient's clinical course, the final diagnosis was polyarteritis nodosa. This case illustrates the challenges in diagnosing polyarteritis nodosa and the importance of considering vasculitis in young patients presenting with atypical presentations of diseases such as peripheral vascular disease or giant cell arteritis.
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16
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Liozon E, Petit B, Ouattara B, Rhaïem K, Galinat S, Vidal E. [Multinodular goitre with widespread vasculitis of thyroid arteries revealing temporal giant cell arteritis]. Rev Med Interne 2007; 28:885-7. [PMID: 17629594 DOI: 10.1016/j.revmed.2007.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2007] [Accepted: 06/15/2007] [Indexed: 10/23/2022]
Abstract
We describe a 62-year-old woman with slowly growing usual nodular goitre in whom diffuse giant cell arteritis (GCA) of the thyroid arteries was found upon thyroidectomy, revealing otherwise unsuspected biopsy-proven temporal arteritis. To our knowledge, this association had been previously reported in only three instances. In each case, GCA of the thyroid arteries appeared clinically silent, did not produce significant glandular dysfunction, and was uncovered thanks to a planned thyroidectomy for nodular goitre. These observations highlight that thyroid artery involvement by GCA, even widespread, as in our patient, may be overlooked clinically and may produce little or no thyroid dysfunction.
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Affiliation(s)
- E Liozon
- Service de médecine interne A, hôpital universitaire Dupuytren, CHU Dupuytren, 2, avenue Martin-Luther-King, 87000 Limoges cedex, France.
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