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Detiger SE, Hötte GJ, Verdijk RM, de Keizer ROB, van Hagen PM, van Laar JAM, Paridaens D. Adult orbital xanthogranuloma: long-term follow-up of treated cases. Eye (Lond) 2023; 37:2475-2481. [PMID: 36526862 PMCID: PMC10397269 DOI: 10.1038/s41433-022-02357-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 11/04/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adult orbital xanthogranulomatous disease (AOXGD) is a group of rare disorders. Four subtypes are identified: adult-onset xanthogranuloma (AOX), adult-onset asthma and periocular xanthogranuloma (AAPOX), necrobiotic xanthogranuloma (NBX), and Erdheim-Chester disease (ECD). Therapy options vary and little is known about the long-term effect of the treatment. In this study, we will describe the clinical behaviour, effect of treatment, and long-term outcome in a consecutive series of patients with AOXGD. METHODS This is a descriptive, retrospective study with a long follow-up term of 21 patients with histologically proven AOXGD, treated between 1989 and 2021 in the Rotterdam Eye Hospital and Erasmus MC University Medical Center. RESULTS Twenty-one patients with histologically proven AOXGD were included. The follow-up ranged from 2-260 months (median of 67 months). Six of the nine patients with AOX were treated with surgery alone, with recurrence in two. Three received systemic therapy, with recurrence in one. All four patients with AAPOX received systemic treatment, the disease recurred in two. Two patients with NBX were treated with surgery alone, with recurrence in one. Four required additional therapy with recurrence in two. Both patients with ECD required systemic therapy. CONCLUSIONS Recognition of AOXGD is important, in particular, because of the potential severe systemic locations in the different subtypes. Surgical excision might be a sufficient therapy for patients with AOX. Patients with AAPOX, NBX, and ECD warrant systemic therapy. Currently, there is no conclusive evidence for a superior treatment strategy, but further studies are necessary to investigate treatment options.
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Affiliation(s)
- S E Detiger
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands.
| | - G J Hötte
- The Rotterdam Eye Hospital, Department of Oculoplastic, Orbital and Lacrimal Surgery, Rotterdam, The Netherlands
| | - R M Verdijk
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands
- Department of Pathology, Section of Ophthalmic Pathology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - R O B de Keizer
- The Rotterdam Eye Hospital, Department of Oculoplastic, Orbital and Lacrimal Surgery, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - P M van Hagen
- Departments of Internal Medicine and Immunology, section Clinical Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J A M van Laar
- Departments of Internal Medicine and Immunology, section Clinical Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - D Paridaens
- The Rotterdam Eye Hospital, Department of Oculoplastic, Orbital and Lacrimal Surgery, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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2
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van Ipenburg JA, Naus NC, Dubbink HJ, van Ginderdeuren R, Missotten GS, Paridaens D, Verdijk RM. Prognostic value of TERT promoter mutations in conjunctival melanomas in addition to clinicopathological features. Br J Ophthalmol 2020; 105:1454-1461. [PMID: 33127831 DOI: 10.1136/bjophthalmol-2020-317405] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/29/2020] [Accepted: 10/08/2020] [Indexed: 12/23/2022]
Abstract
AIMS To evaluate the prognostic value of clinical, histopathological and molecular features and to relate different treatment modalities to clinical outcome in conjunctival melanomas (CM). METHODS Retrospective review of clinical, histopathological and BRAF V600E and telomerase reverse transcriptase (TERT) promoter mutation status and treatment modalities, correlated to recurrence and metastasis in 79 patients with CM, diagnosed between 1987 and 2015 in three tertiary referral centres in the Netherlands and Belgium. RESULTS Out of 78 evaluable patients, recurrences occurred in 16 patients and metastasis in 12 patients (median follow-up time 35 months (0-260 months)). Tumour thickness >2 mm, pT status, the presence of epithelioid cells, ulceration and mitoses was significantly correlated with metastasis (p value 0.046, 0.01, 0.02, 0.001 and 0.003, respectively). Furthermore, CM frequently harbour BRAF V600E and TERT promoter mutations (29% and 43%, respectively). TERT promoter mutations were correlated to shorter metastasis-free survival (p value 0.002). No significant correlation was found for clinical parameters and metastatic disease. Palpebral, forniceal and caruncular melanomas were more prone to develop recurrences (p value: 0.03). Most CM were treated with excision with adjuvant therapy. CONCLUSION In line with the recommendations in the Eighth Edition of the American Joint Committee on Cancer Staging for CM, the pathology report should include information about pT status, tumour thickness, presence of epithelioid cells, ulceration and mitoses. Furthermore, information about the presence of a TERT promoter mutation and BRAF V600E mutation is of interest for therapeutic decision making. The presence of a TERT promoter mutation is correlated to metastatic disease.
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Affiliation(s)
| | - N C Naus
- Ophthalmology, Erasmus MC, Medical Centre, Rotterdam, Netherlands
| | - H J Dubbink
- Erasmus Medical Center, Rotterdam, Zuid-Holland,Netherlands
| | - R van Ginderdeuren
- Department of Ophthalmology and Pathology, University Hospital Leuven, Leuven, Belgium
| | - G S Missotten
- Ophthalmology, KU Leuven University Hospitals Leuven Gasthuisberg Campus Hospital Pharmacy, Leuven, Flanders, Belgium
| | - D Paridaens
- Rotterdam Eye Hospital, Rotterdam, Netherlands
| | - R M Verdijk
- Pathology, Erasmus University Medical Center, Rotterdam, Netherlands /
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3
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Abstract
Cellular angiofibroma is a benign mesenchymal tumor most commonly located in the distal genital tract of both men and women. Although extragenital locations have been reported rarely, this is the first report of cellular angiofibroma of the orbit. A 58-year-old man presented with a mass in the left superomedial orbit since 2 years. Magnetic resonance imaging showed a well-demarcated lesion with a homogeneous intermediate signal intensity on both T1- and T2-weighted images, homogeneous contrast enhancement and high signal intensity on diffusion-weighted images. Complete excision was performed through a medial upper eyelid crease incision. Histopathology showed a vascular CD34-positive and STAT6-negative spindle cell tumor with monoallelic loss of FOXO1, indicating cellular angiofibroma.
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Affiliation(s)
- G J Hötte
- Department of Oculoplastic, Orbital and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - R M Verdijk
- Department of Oculoplastic, Orbital and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Department of Pathology, Section Ophthalmic Pathology, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - M Gardeniers
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - D Paridaens
- Department of Oculoplastic, Orbital and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Department of Ophthalmology, Orbital Service, Erasmus MC, University Medical Center Rotterdam, The Netherlands
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4
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Vergouwen DPC, Rothova A, Berge JCT, Verdijk RM, van Laar JAM, Vingerling JR, Schreurs MWJ. Current insights in the pathogenesis of scleritis. Exp Eye Res 2020; 197:108078. [PMID: 32504648 DOI: 10.1016/j.exer.2020.108078] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 12/19/2022]
Abstract
Scleritis is a sight-threatening inflammation characterized by severe pain and redness of the eye. It can cause blindness by severe complications like scleral and corneal necrosis, keratitis, and uveitis. The pathogenesis of scleritis is largely unknown due to a combination of the rarity of the disease, the little available human tissue-based research material, and the lack of animal models. The immune system is assumed to play a crucial role in the pathogenesis of scleritis. Multiple clues indicate probable antigenic stimuli in scleritis, and the involvement of matrix metalloproteinases in the destruction of scleral tissue. In this article we review the current insights into the pathogenesis of scleritis, and we suggest new hypotheses by implementing knowledge of systemic autoimmune disease pathogenesis. Understanding the pathogenesis of scleritis is crucial to improve the clinical management, as well as to find novel treatment modalities.
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Affiliation(s)
- D P C Vergouwen
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Immunology, Laboratory Medical Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - A Rothova
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - J C Ten Berge
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - R M Verdijk
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - J A M van Laar
- Department of Immunology, Laboratory Medical Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Internal Medicine, Section Clinical Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - J R Vingerling
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - M W J Schreurs
- Department of Immunology, Laboratory Medical Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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5
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Verscheijden LFM, van Hattem AC, Pertijs JCLM, de Jongh CA, Verdijk RM, Smeets B, Koenderink JB, Russel FGM, de Wildt SN. Developmental patterns in human blood-brain barrier and blood-cerebrospinal fluid barrier ABC drug transporter expression. Histochem Cell Biol 2020; 154:265-273. [PMID: 32448916 PMCID: PMC7502061 DOI: 10.1007/s00418-020-01884-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2020] [Indexed: 01/04/2023]
Abstract
When drugs exert their effects in the brain, linear extrapolation of doses from adults could be harmful for children as the blood-brain barrier (BBB) and blood-CSF barrier (BCSFB) function is still immature. More specifically, age-related variation in membrane transporters may impact brain disposition. As human data on brain transporter expression is scarce, age dependent [gestational age (GA), postnatal age (PNA), and postmenstrual age (PMA)] variation in immunohistochemical localization and staining intensity of the ABC transporters P-glycoprotein (Pgp), breast cancer resistance protein (BCRP), and multidrug resistance-associated proteins 1, 2, 4, and 5 (MRP1/2/4/5) was investigated. Post mortem brain cortical and ventricular tissue was derived from 23 fetuses (GA range 12.9-39 weeks), 17 neonates (GA range 24.6-41.3 weeks, PNA range 0.004-3.5 weeks), 8 children (PNA range 0.1-3 years), and 4 adults who died from a wide variety of underlying conditions. In brain cortical BBB, immunostaining increased with age for Pgp and BCRP, while in contrast, MRP1 and MRP2 staining intensity appeared higher in fetuses, neonates, and children, as compared to adults. BCSFB was positively stained for Pgp, MRP1, and MRP2 and appeared stable across age, while BCRP was not detected. MRP4 and MRP5 were not detected in BBB or BCSFB. In conclusion, human BBB and BCSFB ABC membrane transporters show brain location and transporter-specific maturation.
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Affiliation(s)
- L F M Verscheijden
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Institutes for Molecular Life and Health Sciences, Nijmegen, The Netherlands
| | - A C van Hattem
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Institutes for Molecular Life and Health Sciences, Nijmegen, The Netherlands
| | - J C L M Pertijs
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Institutes for Molecular Life and Health Sciences, Nijmegen, The Netherlands
| | - C A de Jongh
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Institutes for Molecular Life and Health Sciences, Nijmegen, The Netherlands
| | - R M Verdijk
- Section Neuropathology and Ophthalmic Pathology, Department of Pathology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - B Smeets
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J B Koenderink
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Institutes for Molecular Life and Health Sciences, Nijmegen, The Netherlands
| | - F G M Russel
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Institutes for Molecular Life and Health Sciences, Nijmegen, The Netherlands
| | - S N de Wildt
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Institutes for Molecular Life and Health Sciences, Nijmegen, The Netherlands.
- Intensive Care and Department of Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
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6
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Hötte GJ, Meijer N, Verdijk RM, Paridaens D. Accelerated growth of orbital schwannomas during pregnancy does not correlate with sex hormone- or growth factor receptor status. Orbit 2020; 40:120-126. [PMID: 32264727 DOI: 10.1080/01676830.2020.1747498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Purpose: Until now, three cases of growth of an orbital schwannoma during pregnancy have been published. We aim to provide additional insight in the effect of pregnancy on orbital schwannomas. Methods: We present two additional cases of accelerated growth of orbital schwannomas during pregnancy and investigate receptor expression profiles for estrogen, progesterone, androgen, VEGF, EGF, FGF, PDGF-Rβ and ki-67 in the two pregnant cases and six non-pregnant cases. Results: Case 1: A 26-year-old woman developed unilateral exophthalmos during pregnancy, with normal visual acuity and ocular motility. During a subsequent pregnancy, again the exophthalmos progressed. MRI showed a mass suggestive of schwannoma. After delivery, resection of the lesion was performed through an anterior approach. Pathology confirmed schwannoma. The expression profile was positive for estrogen- and FGF receptors and ki-67, but negative for progesterone-, androgen- and other growth factor receptors. Case 2: A 24-year-old woman presented with diplopia and unilateral pain during pregnancy. She had normal visual acuity, but a mild exophthalmos and elevation deficit. MRI revealed an extraconal mass suggestive of schwannoma. After delivery, resection was performed through an anterior approach. Pathology confirmed the diagnosis. The expression profile was positive for ki-67, but negative for sex hormone- and growth factor receptors. In the six non-pregnant cases the expression profiles varied, with only one subject showing a strong expression of estrogen-, progesterone- and androgen receptors. Conclusions: Orbital schwannomas can experience growth during pregnancy. The underlying mechanism remains unclear as hormone- and growth factor expression profiles show no correlation to the pregnant state.
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Affiliation(s)
- G J Hötte
- Department of Oculoplastic, Orbital and Lacrimal Surgery, the Rotterdam Eye Hospital , Rotterdam, The Netherlands
| | - N Meijer
- Department of Oculoplastic, Orbital and Lacrimal Surgery, the Rotterdam Eye Hospital , Rotterdam, The Netherlands
| | - R M Verdijk
- Department of Oculoplastic, Orbital and Lacrimal Surgery, the Rotterdam Eye Hospital , Rotterdam, The Netherlands.,Department of Pathology, Section Ophthalmic Pathology, Erasmus MC University Medical Center Rotterdam , Rotterdam, The Netherlands
| | - D Paridaens
- Department of Oculoplastic, Orbital and Lacrimal Surgery, the Rotterdam Eye Hospital , Rotterdam, The Netherlands.,Department of Ophthalmology, Orbital Service, Erasmus MC University Medical Center Rotterdam , Rotterdam, The Netherlands.,Oculoplastic & Orbital Service, ELZA Clinic , Zurich, Switzerland
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7
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Schauwvlieghe AFAD, Bredius RGM, Verdijk RM, Smiers FJW, van der Beek MT, Goemans BF, Zwaan CM, Brüggemann RJ, Rijnders BJA. Management of cerebral azole-resistant Aspergillus fumigatus infection: A role for intraventricular liposomal-amphotericin B. J Glob Antimicrob Resist 2020; 22:354-357. [PMID: 32251868 DOI: 10.1016/j.jgar.2020.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/17/2020] [Accepted: 03/20/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES In the pre-azole era, central nervous system (CNS) infections with Aspergillus had a dismal outcome. Survival improved with voriconazole but CNS infections caused by azole-resistant Aspergillus fumigatus preclude its use. Intravenous liposomal-amphotericin B (L-AmB) is the preferred treatment option for azole-resistant CNS infections but has suboptimal brain concentrations. METHODS We describe three patients with biopsy-proven CNS aspergillosis where intraventricular L-AmB was added to systemic therapy. Two patients with azole-resistant aspergillosis and one patient with azole-susceptible CNS aspergillosis were treated with intraventricular L-AmB at a dose of 1mg weekly. RESULTS We describe three patients successfully treated with a combination of intravenous and intraventricular L-AmB. All three patients survived but one patient developed serious headaches, most likely not related to this treatment. CONCLUSIONS Intraventricular L-AmB may have a role in the treatment of therapy-refractory CNS aspergillosis when added to systemic therapy.
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Affiliation(s)
- A F A D Schauwvlieghe
- Department of Internal Medicine, Section of Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands.
| | - R G M Bredius
- Department of Paediatric Immunology, Section of Infections, Haematology, and Stem Cell Transplantation, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - R M Verdijk
- Department of Pathology, Erasmus Medical Center, Rotterdam, Netherlands
| | - F J W Smiers
- Department of Paediatric Immunology, Section of Infections, Haematology, and Stem Cell Transplantation, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - M T van der Beek
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - B F Goemans
- Department of Haemato-oncology, Princess Máxima Centre for Paediatric Oncology, Utrecht, Netherlands
| | - C M Zwaan
- Department of Haemato-oncology, Princess Máxima Centre for Paediatric Oncology, Utrecht, Netherlands; Department of Paediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands
| | - R J Brüggemann
- Department of Pharmacy, Radboud Institute of Health Science, Radboud University Medical Center, Nijmegen, Netherlands; Center of Expertise in Mycology, Radboudumc, Nijmegen, Netherlands
| | - B J A Rijnders
- Department of Internal Medicine, Section of Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
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8
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Hötte GJ, Koudstaal MJ, Verdijk RM, Titulaer MJ, Claes JFHM, Strabbing EM, van der Lugt A, Paridaens D. Intracranial actinomycosis of odontogenic origin masquerading as auto-immune orbital myositis: a fatal case and review of the literature. BMC Infect Dis 2019; 19:763. [PMID: 31477035 PMCID: PMC6720412 DOI: 10.1186/s12879-019-4408-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/25/2019] [Indexed: 11/13/2022] Open
Abstract
Background Actinomycetes can rarely cause intracranial infection and may cause a variety of complications. We describe a fatal case of intracranial and intra-orbital actinomycosis of odontogenic origin with a unique presentation and route of dissemination. Also, we provide a review of the current literature. Case presentation A 58-year-old man presented with diplopia and progressive pain behind his left eye. Six weeks earlier he had undergone a dental extraction, followed by clindamycin treatment for a presumed maxillary infection. The diplopia responded to steroids but recurred after cessation. The diplopia was thought to result from myositis of the left medial rectus muscle, possibly related to a defect in the lamina papyracea. During exploration there was no abnormal tissue for biopsy. The medial wall was reconstructed and the myositis responded again to steroids. Within weeks a myositis on the right side occurred, with CT evidence of muscle swelling. Several months later he presented with right hemiparesis and dysarthria. Despite treatment the patient deteriorated, developed extensive intracranial hemorrhage, and died. Autopsy showed bacterial aggregates suggestive of actinomycotic meningoencephalitis with septic thromboembolism. Retrospectively, imaging studies showed abnormalities in the left infratemporal fossa and skull base and bilateral cavernous sinus. Conclusions In conclusion, intracranial actinomycosis is difficult to diagnose, with potentially fatal outcome. An accurate diagnosis can often only be established by means of histology and biopsy should be performed whenever feasible. This is the first report of actinomycotic orbital involvement of odontogenic origin, presenting initially as bilateral orbital myositis rather than as orbital abscess. Infection from the upper left jaw extended to the left infratemporal fossa, skull base and meninges and subsequently to the cavernous sinus and the orbits. Electronic supplementary material The online version of this article (10.1186/s12879-019-4408-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- G J Hötte
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands. .,Department of Orbital Oculoplastic and Lacrimal Surgery, The Rotterdam Eye Hospital, PO box 70030, 3000 LM, Rotterdam, The Netherlands.
| | - M J Koudstaal
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - R M Verdijk
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M J Titulaer
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J F H M Claes
- Department of Neurology, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands
| | - E M Strabbing
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A van der Lugt
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - D Paridaens
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Orbital Oculoplastic and Lacrimal Surgery, The Rotterdam Eye Hospital, PO box 70030, 3000 LM, Rotterdam, The Netherlands
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9
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Detiger SE, Karim AF, van Laar JAM, Paridaens D, Verdijk RM. The histological absence of IgG4 positive plasma cells in juvenile xanthogranuloma; comments on 'Systemic juvenile xanthogranuloma: a case report and brief review'. Clin Exp Dermatol 2018; 44:91-92. [PMID: 30240020 DOI: 10.1111/ced.13745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 11/29/2022]
Affiliation(s)
- S E Detiger
- The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH, Rotterdam, The Netherlands
| | - A F Karim
- Departments of Internal Medicine and Immunology, Section of Clinical Immunology, Erasmus MC, Rotterdam, The Netherlands.,Department of Internal Medicine, Groene Hart Hospital, Gouda, The Netherlands
| | - J A M van Laar
- Departments of Internal Medicine and Immunology, Section of Clinical Immunology, Erasmus MC, Rotterdam, The Netherlands
| | - D Paridaens
- The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH, Rotterdam, The Netherlands
| | - R M Verdijk
- The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH, Rotterdam, The Netherlands.,Department of Pathology, Section of Ophthalmic Pathology, Erasmus MC, Rotterdam, The Netherlands
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10
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Karim AF, Bansie RD, Rombach SM, Paridaens D, Verdijk RM, van Hagen PM, Van Laar JAM. The treatment outcomes in IgG4-related disease. Neth J Med 2018; 76:275-285. [PMID: 30152392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION IgG4-related disease (IgG4-RD) is an emerging systemic inflammatory disease involving nearly all organs eventually leading to fibrosis. Prompt and adequate treatment to prevent irreversible organ damage is therefore pivotal. To evaluate the treatment outcomes, we studied a well-defined cohort of patients with IgG4-RD. METHOD 32 patients with histologically confirmed IgG4-RD diagnosed between 1999 and April 2017 were included and reviewed for demographic and clinical characteristics. The response to treatment with glucocorticoids, disease modifying antirheumatic drugs, rituximab and other therapeutic interventions were evaluated. RESULTS Glucocorticoids as well as rituximab appeared successful therapeutic drugs leading to clinical remission (complete or partial remission) in all patients. Recurrences, however, were frequently seen (62% versus 100%, respectively). Diseases modifying antirheumatic drugs (DMARDs), including azathioprine, methotrexate and mycophenolate mofetil were effective in less than half of the cases. A minority of patients was treated with alternative treatments including hydroxychloroquine, thalidomide and infliximab which all appeared effective. Surgical intervention and radiotherapy in local disease seemed to induce clinical remission and were associated with low recurrence rates. CONCLUSION Glucocorticoids and rituximab induce substantial responses as well as primary surgical intervention and radiotherapy, while the efficacy of DMARDs is limited. Based on the few data available, hydroxychloroquine, infliximab and thalidomide may be promising treatment options for second or third line strategies.
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Affiliation(s)
- A F Karim
- Department of Internal Medicine, section Clinical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands
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11
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Abstract
PURPOSE To describe a clinical case of biopsy-proven Merkel cell carcinoma of the eyelid following golimumab therapy for rheumatoid arthritis (RA). METHODS Interventional case report. RESULTS A 73-year-old woman with a history of chronic RA presented with a right upper eyelid mass. She had been treated with golimumab (tumor necrosis factor (TNF) inhibitors) injection therapy for the past 6 months. A biopsy showed findings suggestive of a Merkel cell carcinoma of the eyelid. CONCLUSIONS Merkel cell carcinoma may be associated with anti-TNF treatment and should be included in the differential diagnosis of an eyelid tumor in patients treated with TNF inhibitors.
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Affiliation(s)
- H Hanafi
- a Department of Oculoplastic & Orbital Surgery , The Rotterdam Eye Hospital , Rotterdam , The Netherlands
| | - R M Verdijk
- b Department of Pathology , ErasmusMC University Medical Center, Rotterdam , The Netherlands
| | - D Paridaens
- a Department of Oculoplastic & Orbital Surgery , The Rotterdam Eye Hospital , Rotterdam , The Netherlands
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12
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Karim AF, Verdijk RM, Guenoun J, van Hagen PM, van Laar JAM. An inflammatory condition with different faces: immunoglobulin G4-related disease. Neth J Med 2016; 74:110-115. [PMID: 27020990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibro-inflammatory condition with involvement of different organs. The pathophysiological mechanism is unclear, but fibrosis is the hallmark of this disease. Early recognition is critical to avoid irreversible organ damage. Recently improved histological testing boosts the diagnostic yield. We present three cases of patients with IgG4-RD to emphasise the broad clinical presentation of this disease. CASE DESCRIPTIONS Patient A, a 63-year-old male with bilateral orbital swelling due to IgG4-RD, was shown to suffer from IgG4-RD in a multifocal pattern as demonstrated by PET scanning. Patient B, a 53-year-old male with a long-standing abdominal mass of unknown origin, eventually proved to have IgG4-RD. Patient C was a 32-year-old male admitted with pleural effusion and pericardial tamponade. Histological diagnosis after pericardiectomy confirmed IgG4-RD. DISCUSSION IgG4-RD has many faces and may mimic other conditions, such as malignancy and infectious diseases. Knowledge of this disease is needed to avoid unnecessary diagnostics and delay in treatment. IgG4- RD may be suspected based on specific clinical findings such as elevated serum IgG4 levels, but the diagnosis can only be established histologically. Although corticosteroids are an effective first choice of therapy, the relapse rate after this treatment remains high. The role of disease-modifying antirheumatic drugs in the treatment of IgG4-RD has not been outlined yet, but there is increasing evidence that rituximab might be an effective second-line therapy. CONCLUSION IgG4-RD is a disease with many faces requiring early recognition and therapy to avoid permanent damage of the organs.
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Affiliation(s)
- A F Karim
- Department of Internal Medicine-Immunology, Erasmus MC, Rotterdam, the Netherlands
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Segers D, Galuzina J, Verdijk RM, Manintveld OC. Right atrial and ventricular angiosarcoma. Eur Heart J 2013; 34:3361. [DOI: 10.1093/eurheartj/eht416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Verdijk RM, Wilke M, Beslier V, Kloosterman A, Brand A, Goulmy E, Mutis T. Escherichia coli-nitroreductase suicide gene control of human telomerase reverse transcriptase-transduced minor histocompatibility antigen-specific cytotoxic T cells. Bone Marrow Transplant 2004; 33:963-7. [PMID: 15048139 DOI: 10.1038/sj.bmt.1704470] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Adoptive immunotherapy with ex vivo generated cytotoxic T lymphocytes (CTLs) is applied for the treatment of leukemia relapses or viral infections after allogeneic stem cell transplantation. A common problem of adoptive immunotherapy strategies is the ex vivo expansion of the generated T cells to sufficient numbers. CTLs can be efficiently expanded by ectopic expression of the human telomerase gene (hTert). However, hTert transduction may also increase the chance for malignant transformation. Therefore, we explored the feasibility of suicide gene control of ex vivo generated CTLs expanded through the ectopic expression of hTert. To this end, we compared the efficacy of the new Escherichia coli-nitroreductase (E. coli-Ntr) suicide gene with the well-known herpes simplex virus-thymidine kinase (HSV-Tk). Introduction of hTert provided the transduced CTLs with a distinct growth advantage over the nontransduced CTLs. The hTert-E. coli-Ntr double-transduced CTLs retained their antigen-specific functions. Treatment of hTert-E. coli-Ntr double-transduced CTLs with metronidazole significantly inhibited the proliferation to a similar extent to the treatment of hTert-HSV-Tk double-transduced CTLs with ganciclovir. This is the first application of the E. coli-nitroreductase gene for the elimination of human T cells with metronidazole.
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Affiliation(s)
- R M Verdijk
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
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Verdijk RM, Mutis T, Esendam B, Kamp J, Melief CJ, Brand A, Goulmy E. Polyriboinosinic polyribocytidylic acid (poly(I:C)) induces stable maturation of functionally active human dendritic cells. J Immunol 1999; 163:57-61. [PMID: 10384099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
For vaccination strategies and adoptive immunotherapy purposes, immature dendritic cells (DC) can be generated from adherent monocytes using GM-CSF and IL-4. Presently, the only clinically applicable method to induce stable maturation of DC is the use of supernatants of activated monocytes (monocyte-conditioned medium (MCM)). MCM contains an undefined mixture of cytokines and is difficult to standardize. Here we report that stable maturation of DC can be simply induced by the addition of polyriboinosinic polyribocytidylic acid (poly(I:C)), a synthetic dsRNA clinically applied as an immunomodulator. Poly(I:C)-treated DC show a mature phenotype with high expression levels of HLA-DR, CD86, and the DC maturation marker CD83. This mature phenotype is retained for 48 h after cytokine withdrawal. In contrast to untreated DC, poly(I:C)-treated DC down-regulate pinocytosis, produce high levels of IL-12 and low levels of IL-10, induce strong T cell proliferation in a primary allo MLR, and effectively present peptide Ags to HLA class I-restricted CTL. In conclusion, we present a simple methodology for the preparation of clinically applicable mature DC.
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Affiliation(s)
- R M Verdijk
- Department of Immunohematology and Blood Bank, Leiden University Medical Center, Leiden, The Netherlands.
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Abstract
In order to investigate the effect of indomethacin for inhibition of the cyclooxygenase pathway on the hatching process of mouse blastocysts, 508 mouse blastocysts were cultured in modified HAM F10 medium containing 0, 8, 79 or 788 microM indomethacin, added after 24 h of incubation. Hatching was scored after 72 h of incubation. In another series of experiments, indomethacin was added only after blastulation had occurred. Indomethacin in doses of 8 microM and 79 microM, added after 24 h of incubation or after blastulation had occurred, did not influence successful hatching. A dose of 788 microM indomethacin interfered with hatching, but this dose appeared to be toxic for the embryo.
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Affiliation(s)
- R M van der Weiden
- Department of Obstetrics, Gynecology and Reproduction, Leiden University Hospital, The Netherlands
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