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Cazzaniga J, Georgiyeva K, Siguenza A, Gonzalez T, Ferraro P. Using Diagnostic Radiological Imaging Modalities to Explore Neurological Dysfunction and Renal Failure in the Intersection of Hemophagocytic Lymphohistiocytosis, Macrophage Activation Syndrome, and Lupus. Cureus 2024; 16:e54005. [PMID: 38496127 PMCID: PMC10944546 DOI: 10.7759/cureus.54005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/11/2024] [Indexed: 03/19/2024] Open
Abstract
This comprehensive case report and literature review explore the intricate intersection of hemophagocytic lymphohistiocytosis (HLH), macrophage activation syndrome (MAS), and systemic lupus erythematosus (SLE) in a 39-year-old patient, emphasizing the challenging diagnostic and therapeutic landscape. The patient's journey includes neurological dysfunction, renal failure, and clinical complexities, showcasing the rarity of these overlapping conditions. The report explains the diagnostic process, clinical and laboratory findings, specialty consultations, and treatment decisions leading to the diagnosis of SLE with features of MAS overlapping with HLH. By offering insights into the latest research and clinical perspectives, this case report contributes to a deeper understanding of these disorders, aiming to guide clinicians in recognizing and managing such intricate cases effectively.
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Affiliation(s)
- Juliana Cazzaniga
- Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | | | | | | | - Pablo Ferraro
- Hematology and Oncology, Memorial Healthcare System, Pembroke Pines, USA
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Bhangu JK, Javed K, Manshahia PK, Nahar S, Kanda S, Chatha U, Odoma VA, Pitliya A, AlEdani EM, Khan S. The Association of Hypertension With Posterior Reversible Encephalopathy Syndrome in Systemic Lupus Erythematosus Patients: A Systematic Review. Cureus 2023; 15:e50620. [PMID: 38226131 PMCID: PMC10788701 DOI: 10.7759/cureus.50620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 12/16/2023] [Indexed: 01/17/2024] Open
Abstract
Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy syndrome (RPLS), is a rare disorder that most commonly affects the posterior part of the brain. Two common causes of PRES are hypertension and autoimmune diseases such as systemic lupus erythematosus (SLE). This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 recommendations and aimed at finding the association between hypertension and PRES in SLE patients. We searched medical databases such as PubMed, PubMed Central (PMC), Cochrane Library, and Multidisciplinary Digital Publishing Institute (MDPI) for relevant medical literature. The identified papers were screened, subjected to inclusion and exclusion criteria, and ran through quality appraisal tools, after which 16 papers were finalized. The finalized papers explored the roles of hypertension in SLE patients diagnosed with PRES. In this review, we identified a link between hypertension and PRES-SLE patients. We aimed to explain the role of hypertension in the development of PRES in SLE patients. This study also explains the different treatment modalities to be used for treating the patients presenting with PRES and differentiates other neuropsychiatric illnesses commonly present in SLE patients from PRES. It's important to make an accurate clinical diagnosis by understanding the clinical features and neuroimaging results of PRES for future care since it may even be incurable in some circumstances.
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Affiliation(s)
- Japneet K Bhangu
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Khalid Javed
- Anesthesiology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Prabhleen Kaur Manshahia
- Internal Medicine/Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Medicine, All India Institute of Medical Sciences, Rishikesh, IND
- Internal Medicine, Jean-Charles Medical Institute, Orlando, USA
| | - Shamsun Nahar
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Srishti Kanda
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Uzair Chatha
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Victor A Odoma
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Cardiovascular/Oncology (Acuity Adaptable Unit), Indiana University Health, Bloomington, USA
| | - Aakanksha Pitliya
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Esraa M AlEdani
- Dermatology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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