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Bukawa K, Fukuzawa S, Yamagata K, Uchida F, Ishibashi-Kanno N, Nagai H, Bukawa H. A Case of Tophaceous Pseudogout with Destruction of the Skull Base at the Temporomandibular Joint. Indian J Otolaryngol Head Neck Surg 2023; 75:1109-1113. [PMID: 37274956 PMCID: PMC10235287 DOI: 10.1007/s12070-022-03387-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
We report a case of tophaceous pseudogout that occurred in the temporomandibular joint (TMJ) and presented with skull base destruction. The patient was a 73-year-old woman, who complained of an obstructed ear sensation in December 2021. The otolaryngological examination was unremarkeable, and a computed tomography scan revealed a calcified lesion in the left TMJ. Suspected of having osteochondroma, the patient was brought to our hospital. She was performed tumor resection as much as possible under general anesthesia revealed nodular pseudogout. The patient refused to undergo total resection due to the necessary craniotomy and the risk of postoperative complications. Instead, the patient decided to undergo following-up. One year and 4 months have passed since the biopsy operation, but there is no tendency to re-increase.
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Affiliation(s)
- Kotaro Bukawa
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Satoshi Fukuzawa
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Kenji Yamagata
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Fumihiko Uchida
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Naomi Ishibashi-Kanno
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Hiroki Nagai
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Hiroki Bukawa
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
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Imagama T, Seki K, Seki T, Tokushige A, Matsuki Y, Yamazaki K, Nakashima D, Okazaki T, Hirata K, Yamamoto M, Tanaka H, Sakai T. Synovial fluid presepsin as a novel biomarker for the rapid differential diagnosis of native joint septic arthritis from crystal arthritis. Int J Infect Dis 2020; 102:472-477. [PMID: 33278715 DOI: 10.1016/j.ijid.2020.10.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate whether presepsin can be used as a novel biomarker to differentiate between native joint septic arthritis (NJSA) and crystal arthritis (CA). METHODS This study included 75 patients diagnosed with either NJSA (n = 21) or CA (n = 54). Presepsin in synovial fluid and blood, C-reactive protein, and procalcitonin were measured and compared between the NJSA and CA groups. Receiver operating characteristic (ROC) curve analyses were performed to differentiate between the two groups. RESULTS Synovial fluid and blood presepsin were significantly higher in the NJSA group than in the CA group (p < 0.0001 and p < 0.01, respectively). The area under the ROC curve for synovial fluid presepsin in the NJSA group compared with the CA group was 0.93 (sensitivity 85.7%, specificity 85.2%, positive predictive value 69.2%, negative predictive value 93.9%, positive likelihood ratio 5.79, negative likelihood ratio 0.17). Among the tests, synovial fluid presepsin was the most accurate. CONCLUSIONS Measurement of synovial fluid presepsin is reliable for the early diagnosis of NJSA, and synovial fluid presepsin could be used as a novel biomarker for differentiating between NJSA and CA.
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Affiliation(s)
- Takashi Imagama
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan.
| | - Kazushige Seki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Toshihiro Seki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Atsunori Tokushige
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Yuta Matsuki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Kazuhiro Yamazaki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Daisuke Nakashima
- Department of Orthopedic Surgery, St. Hill Hospital, 3-7-18, Imamurakita, Ube 755-0155, Japan
| | - Tomoya Okazaki
- Department of Orthopedic Surgery, Yamaguchi Prefectural Grand Medical Center, 10077, Osaki, Hofu, 747-8511, Japan
| | - Kenji Hirata
- Department of Orthopedic Surgery, Yamaguchi Prefectural Grand Medical Center, 10077, Osaki, Hofu, 747-8511, Japan
| | - Manabu Yamamoto
- Department of Orthopedic Surgery, Tokuyama Central Hospital, 1-1, Koda, Shunan, 745-8522, Japan
| | - Hiroshi Tanaka
- Department of Orthopedic Surgery, Yamaguchi Prefectural Grand Medical Center, 10077, Osaki, Hofu, 747-8511, Japan
| | - Takashi Sakai
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
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Doi T, Doi T, Kawamura N, Matsui T, Komiya A, Tei Z, Niitsuma G, Kunogi J. The usefulness of neutrophil CD64 expression for diagnosing infection after orthopaedic surgery in dialysis patients. J Orthop Sci 2016; 21:546-551. [PMID: 27188928 DOI: 10.1016/j.jos.2016.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/29/2016] [Accepted: 04/09/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dialysis patients undergoing orthopaedic surgery are at high risk for postoperative infection. Diagnosis of postoperative infection is difficult in dialysis patients due to presentation of signs and symptoms similar to infection, such as fever and elevated inflammatory marker levels. Neutrophil CD64 expression (CD64), a marker of infection, is upregulated by microbial wall components and several cytokines (interferon-γ and tumor necrosis factor-α). The purpose of this study is to evaluate the usefulness of CD64 for diagnosing postoperative infection in dialysis patients post orthopaedic surgery. PATIENTS AND METHODS Between 2013 and 2014, we prospectively studied 36 dialysis patients (18 men, 18 women; mean age 65.9 years; 49 to 83) who underwent orthopaedic surgery. Dialysis patients were classified into three groups according to their postoperative course as follows; non-infected patients, infection suspected patients, and infected patients. Inflammatory markers such as white blood cell count (WBC), C-reactive protein (CRP) and CD64 were measured before operation and one week after surgery. Using the receiver-operating characteristic (ROC) curve and Akaike's Information Criterion (AIC), the cutoff value of CD64 and CRP was calculated leading to a determination of which inflammatory marker is best accurate for detecting postoperative infection. RESULTS We found that postoperative CD64 and CRP levels presented a statistically significant difference between infected patients and non-infected patients (p < 0.05). Furthermore, comparison of the ROC curve and AIC value between postoperative CD64 and CRP levels exhibited that CD64 was more accurate infectious marker than CRP. CONCLUSION CD64 is a useful marker for detecting postoperative infection after orthopaedic surgery in dialysis patients.
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Affiliation(s)
- Toru Doi
- Department of Spine and Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan; Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Tokuhide Doi
- Hakucho, Geriatric Health Care Facility for the Elderly, Tokyo, Japan
| | - Naohiro Kawamura
- Department of Spine and Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Toshihiro Matsui
- Department of Rheumatology, Sagamihara National Hospital, National Hospital Organization, Kanagawa, Japan
| | - Akiko Komiya
- Department of Clinical Laboratory, Sagamihara National Hospital, National Hospital Organization, Kanagawa, Japan
| | - Zaika Tei
- Department of Spine and Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Gaku Niitsuma
- Department of Spine and Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Junichi Kunogi
- Department of Spine and Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
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Titova E, Aune MW, Fonn K, Henriksen AH, Åsberg A. Neutrophil CD64 Expression as a Diagnostic Marker in Patients Hospitalized with Exacerbations of COPD: A Prospective Observational Study. Lung 2015; 193:717-24. [PMID: 26174093 DOI: 10.1007/s00408-015-9762-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 07/01/2015] [Indexed: 12/18/2022]
Abstract
PURPOSE The expression of the neutrophil high-affinity Fc-gamma receptor (CD64) can be used as a diagnostic marker for bacterial infection and sepsis. The aims of this study were to determine the diagnostic accuracy of CD64 compared to C-reactive protein (CRP) and white blood cell count (WBC) in patients hospitalized with acute exacerbations of COPD (AECOPD) and to investigate the kinetics of CD64 expression. METHODS The present study is a prospective, single-centre observation study. Blood samples were collected from patients hospitalized with AECOPD at admission and after 6, 24 and 48 h. Retrospective reviews on the patients' medical records were performed blinded to the CD64 results. The CD64 was measured using the Leuko64 kit from Trillium Diagnostics, LLC (Maine, USA) with the CELL-DYN Sapphire Haematology System (Abbott Laboratories, Illinois, USA). Diagnostic accuracy of the CD64, CRP and WBC was compared using a receiver operating characteristic (ROC) curve analysis. RESULTS A total of 113 patients were included. Thirty-six patients (32 %) had pulmonary infiltrate on chest X-ray at admission (PI). The CD64 was higher in samples from patients with AECOPD and PI than those without PI at admission (median 1.25 vs. 0.60, p = 0.002) and during 48 h of follow-up. The area under the ROC curve of CD64, CRP and WBC was 0.69, 0.73 and 0.64, respectively, (p = 0.42 for the test of difference). CONCLUSION Neutrophil CD64 expression has about the same diagnostic accuracy as CRP in diagnosing pneumonia in patients hospitalized with AECOPD, but does not add to the diagnostic accuracy of CRP and WBC count.
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Affiliation(s)
- Elena Titova
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, 7006, Trondheim, Norway. .,Department of Thoracic Medicine, Trondheim University Hospital, 7006, Trondheim, Norway.
| | - Marthe Wedø Aune
- Department of Immunology and Transfusion Medicine, Trondheim University Hospital, 7006, Trondheim, Norway.
| | - Kristin Fonn
- Department of Immunology and Transfusion Medicine, Trondheim University Hospital, 7006, Trondheim, Norway.
| | - Anne Hildur Henriksen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, 7006, Trondheim, Norway. .,Department of Thoracic Medicine, Trondheim University Hospital, 7006, Trondheim, Norway.
| | - Arne Åsberg
- Department of Clinical Chemistry, Trondheim University Hospital, Trondheim, 7006, Norway.
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Oppegaard O, Skodvin B, Halse AK, Langeland N. CD64 as a potential biomarker in septic arthritis. BMC Infect Dis 2013; 13:278. [PMID: 23783182 PMCID: PMC3689602 DOI: 10.1186/1471-2334-13-278] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 06/13/2013] [Indexed: 11/19/2022] Open
Abstract
Background Traditional inflammatory markers are generally unhelpful in discerning septic arthritis from inflammatory joint disease due to their lack of specificity. We wished to explore the discriminatory power of the novel inflammatory marker, Fc-gamma-receptor type 1, CD64, in patients presenting with acute arthritis. Methods Patients were recruited prospectively in the time period June 2009 to December 2011. Thirty-six patients presenting with an acute flare of chronic rheumatic arthritis, 31 with crystal-induced arthritis and 23 with septic arthritis were included. Traditional inflammatory markers, CD64 and procalcitonin (PCT) were measured and their diagnostic abilities were compared. Results CD64 and PCT both demonstrated a specificity of 98%, but poor sensitivities of 59% and 52%, respectively. White blood cell count (WBC), and erythrocyte sedimentation rate (ESR) did not have significant discriminatory power, while C-reactive protein (CRP) proved to have the best diagnostic accuracy as measured by area under the ROC curve (AUC 0.92, 95% confidence-interval 0.87-0.98). Subgroup analysis excluding patients with septic arthritis without concurrent bacteremia, and likewise exclusion of the patients with septic arthritis caused by coagulase negative staphylococci, both improved the diagnostic accuracy of CD64 and PCT, but not of WBC and CRP. Conclusions CD64 and PCT are highly specific for infectious disease, but they predominantly measure bacteremia. Their use in hospital practice has yet to be defined, and especially so in localized infections.
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Affiliation(s)
- Oddvar Oppegaard
- Department of Medicine, Haukeland University Hospital, Bergen, Norway.
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Li S, Huang X, Chen Z, Zhong H, Peng Q, Deng Y, Qin X, Zhao J. Neutrophil CD64 expression as a biomarker in the early diagnosis of bacterial infection: a meta-analysis. Int J Infect Dis 2012; 17:e12-23. [PMID: 22940278 DOI: 10.1016/j.ijid.2012.07.017] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Revised: 07/05/2012] [Accepted: 07/05/2012] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Neutrophil CD64 expression is widely reported as an efficacious biomarker to differentiate infected patients from other non-infected patients. This meta-analysis was conducted to comprehensively and quantitatively summarize the accuracy of neutrophil CD64 in the early diagnosis of bacterial infection. METHODS A systematic review of related studies was conducted, and the sensitivity, specificity, and other data about the accuracy of CD64 expression on neutrophils were pooled using random effects models with 95% confidence intervals (CI) as the effect measurements. Summary receiver operating characteristic (SROC) curves and the Q* value were also calculated in the meta-analysis. Heterogeneity was tested, as well as the publication bias. Potential sources of heterogeneity were explored by assessing whether or not certain covariates significantly influenced the summary diagnostic odds ratio (SDOR). RESULTS A total of 26 studies including 3944 patients met the inclusion criteria for the final analysis. The summary estimate was 0.76 (95% CI 0.74-0.78) for sensitivity and 0.85 (95% CI 0.83-0.86) for specificity. The positive likelihood ratio (PLR), negative likelihood ratio (NLR), SDOR, and area under the SROC of neutrophil CD64 expression with Q* value were 6.67 (95% CI 4.67-9.53), 0.24 (95% CI 0.18-0.31), 34.29 (95% CI 19.59-60.01), and 0.92 (Q*=0.85), respectively. The pooled data from the included studies had high heterogeneity and the Egger test suggested a publication bias. CONCLUSIONS On the basis of our meta-analysis, neutrophil CD64 expression could be a promising and meaningful biomarker for diagnosing bacterial infection. Nevertheless, more large prospective studies should be carried out before the neutrophil CD64 test is used widely in the clinical setting because of the various cut-off values.
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Affiliation(s)
- Shan Li
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
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