1
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Abstract
Subcutaneous fat necrosis associated with acute pancreatitis in a 54-year-old man was reported. The acute pancreatitis was proved histologically after gastrectomy for coincident early gastric carcinoma. The patient was successfully treated with prednisolone and his skin lesions subsided within a month.
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Affiliation(s)
- H Ishizaki
- Department of Dermatology, Kanazawa University School of Medicine, Kanazawa 920, Japan
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2
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Affiliation(s)
- M Neuville
- Service de pneumologie A, centre de compétence des maladies pulmonaires rares, hôpital Bichat, Assistance Publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75877 Paris cedex 18, France; Université Paris Diderot, Sorbonne Paris Cité, 75877 Paris cedex 18, France
| | - C Taillé
- Service de pneumologie A, centre de compétence des maladies pulmonaires rares, hôpital Bichat, Assistance Publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75877 Paris cedex 18, France; Université Paris Diderot, Sorbonne Paris Cité, 75877 Paris cedex 18, France
| | - M-P Debray
- Service de radiologie, hôpital Bichat, Assistance Publique-Hôpitaux de Paris, 75877 Paris cedex 18, France
| | - M Aubier
- Service de pneumologie A, centre de compétence des maladies pulmonaires rares, hôpital Bichat, Assistance Publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75877 Paris cedex 18, France; Université Paris Diderot, Sorbonne Paris Cité, 75877 Paris cedex 18, France
| | - B Crestani
- Service de pneumologie A, centre de compétence des maladies pulmonaires rares, hôpital Bichat, Assistance Publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75877 Paris cedex 18, France; Université Paris Diderot, Sorbonne Paris Cité, 75877 Paris cedex 18, France.
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3
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Shi Z, Ma L, Wang H, Yang Y, Li X, Schreiber A, Sun W, Hu Z, Xue Y, Teng J, Zhao X, Lu W. Insulin and hypertonic glucose in the management of aseptic fat liquefaction of post-surgical incision: a meta-analysis and systematic review. Int Wound J 2013; 10:91-7. [PMID: 22325039 PMCID: PMC7950496 DOI: 10.1111/j.1742-481x.2012.00949.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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] [Indexed: 01/13/2023] Open
Abstract
A meta-analysis and systematic review assessing randomised controlled trials (RCTs) was sought to determine whether subcutaneous injection of insulin with hypertonic glucose promotes healing in postoperative incisions with aseptic fat liquefaction. We searched the Cochrane library, Pubmed, EMBASE, National Science Digital Library (NSDL) and China Biological Medicine Database (CBMdisc) for literature published from 1 January 1990 to 30 September 2011. RCTs that evaluated subcutaneous injection of insulin with hypertonic glucose as a treatment for postoperative wound with fat liquefaction were sought. Wound healing was the primary endpoint. Jadad score and Cochrane Collaboration's tool were used for assessing quality of studies and risk of bias. We abstracted data regarding time to wound healing, cost and adverse effects. The random-effects inverse variance model was used for all analyses using weighted mean difference and 95% confidence interval. Eight trials (414 participants) were identified that met the inclusion criteria. Subcutaneous injection of insulin with hypertonic glucose significantly reduces time to healing by 6·33 days compared with conventional drainage, with less cost. There was no report concerning adverse effects. Subcutaneous injection of insulin with hypertonic glucose may improve the healing process in postoperative wounds with aseptic fat liquefaction.
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Affiliation(s)
- Zhongjie Shi
- Department of Cancer Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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4
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Marszałek A, Maciejewska J, Bowszyc-Dmochowska M, Prokurat A. Subcutaneous fat necrosis of the newborn - a case report and review of literature. POL J PATHOL 2010; 61:240-244. [PMID: 21290349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- Andrzej Marszałek
- Cahir and Department of Clinical Pathomorphology, Collegium Medicum in Bydgoszcz, Nicolai Copernici University in Toruń.
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5
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Abstract
Rothmann-Makai syndrome (lipogranulomatosis subcutanea) is a rare variant of Weber-Christian disease, but lacks visceral involvements and systemic manifestations. We herein report the case of a 56-year-old Chinese woman with this disorder who complained of subcutaneous tender nodules over her extremities, trunk, and face of 2 years' duration. She was firstly treated with 300 mg of oral roxythromycin for 8 weeks and subsequently treated with 400 mg of oral clarithromycin for the next 8 weeks. However, no significant effect was observed. She was then administered 200 mg of oral minocycline hydrochloride. After 1 week, her skin symptoms rapidly improved and no relapse has been observed in a follow-up period of 3 months. Considering that tetracycline antibiotics, but not macrolide antibiotics, inhibit the activity of pancreatic lipase in vitro, the efficiency of tetracycline antibiotics may be a clue to clarifying the pathogenesis of this disorder.
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Affiliation(s)
- Y Asano
- Department of Dermatology, Kanto Medical Center NTT EC, Shinagawa-ku, Tokyo, Japan.
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6
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Vijayakumar M, Prahlad N, Nammalwar BR, Shanmughasundharam R. Subcutaneous fat necrosis with hypercalcemia. Indian Pediatr 2006; 43:360-3. [PMID: 16651678] [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: 05/08/2023]
Abstract
Subcutaneous fat necrosis of the newborn (SCFN) is an uncommon condition and may be complicated by hypercalcemia. A 28-day-old neonate, presenting with SCFN, hypercalcemia and nephrocalcinosis was managed with intravenous saline followed by furosemide, oral prednisolone, potassium citrate and etidronate.
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Affiliation(s)
- M Vijayakumar
- Department of Pediatric Nephrology and Neonatology, Kanchi Kamakoti CHILDS Trust Hospital, Chennai 600 034, Tamilnadu, India.
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7
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Abstract
Subcutaneous fat necrosis (SFN) of the newborn is an uncommon disorder of the adipose tissue, mostly affecting full-term or post-term newborns who experience perinatal distress. The lesions of SFN typically occur during the first six weeks of life; they are usually self-limited and no specific therapy is required. The disorder may be rarely complicated with hypercalcaemia. We present the case of a neonate with perinatal asphyxia who manifested SFN followed by hypocalcaemia instead of hypercalcaemia and a biochemical profile of pseudohypoparathyroidism four weeks after the eruption of skin lesions. The infant was treated with alfacalcidiol. Blood biochemistry was normalized within one week and serum parathyroid hormone levels declined to normal over the next two months. It is suggested that perinatal asphyxia was the common etiopathogenetic factor for the development of both SFN and pseudohypoparathyroidism.
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Affiliation(s)
- K Karochristou
- First Department of Pediatrics, Athens University, Aghia Sofia Childrens' Hospital, Athens, Greece
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9
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Fehér J, Hagymási K. [Treatment of non-alcoholic steatohepatitis]. Orv Hetil 2004; 145:631-4. [PMID: 15119118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- János Fehér
- Semmelweis Egyetem, Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Budapest.
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10
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Abstract
Subcutaneous fat necrosis of the newborn (SCFN) is characterized by indurated violet skin nodules and, occasionally, life-threatening hypercalcemia. Current treatments of patients with SCFN-related hypercalcemia are often only partially successful and may be associated with prolonged hypercalcemia. We now report the use of etidronate, a bisphosphonate, to control hypercalcemia in an infant with SCFN.
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Affiliation(s)
- A M Rice
- Section of Pediatric Endocrinology, Department of Pediatrics, Yale University Medical School, New Haven, Connecticut 06520, USA
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11
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Ito M, Ohira H, Miyata M, Suzuki T, Sato Y, Kaise S, Nishimaki T, Sakuma H, Nihei Y, Iwatsuki K, Kasukawa R. Cytophagic histiocytic panniculitis improved by combined CHOP and cyclosporin A treatment. Intern Med 1999; 38:296-301. [PMID: 10337947 DOI: 10.2169/internalmedicine.38.296] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In a 31-year-old Japanese man with cytophagic histiocytic panniculitis (CHP) remission was achieved by a combination of combined chemotherapy CHOP and cyclosporin A treatment. He was admitted to our hospital in January 1994 with recurrent high fever of 40.2 degrees C and tender and violaceous subcutaneous nodules on his trunk, arms and legs. He developed pancytopenia, hemorrhagic diathesis, liver dysfunction. Histological examination of the biopsied subcutaneous nodule revealed a lobular panniculitis with fat necrosis and a massive infiltration of histiocytes phagocytosing nuclear debris. He was treated initially with 40 mg/day prednisolone. However, following a reduction in prednisolone dosage, his symptoms reappeared. CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) therapy was then initiated. Three courses of CHOP treatment alleviated his symptoms and cyclosporin A was used to maintain his condition for 15 months. His medication was then discontinued and he has been in complete remission for 10 months. Combined treatment of cyclosporin A and CHOP combined chemotherapy was shown to be effective for this patient with severe CHP.
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Affiliation(s)
- M Ito
- Department of Internal Medicine II, Fukushima Medical University School of Medicine
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12
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Affiliation(s)
- A R Stanford
- Department of Dermatology, National Naval Medical Center, Bethesda, Maryland 20889-5600, USA
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13
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Viravan S, Wisuthsarewong W, Manonukul J, Tanphaichitr VS. Successful treatment of cytophagic histiocytic panniculitis by cyclosporin A: a case report. Asian Pac J Allergy Immunol 1997; 15:161-6. [PMID: 9438549] [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: 02/05/2023]
Abstract
This is a report of a case, 7 1/2 year-old-boy having chronic febrile and recurrent crops of painful subcutaneous nodules on lower extremities, which had previously been diagnosed as Weber-Christian disease, which progressed to have cytophagic histiocytic activity in the skin, bone marrow with abnormal liver function and hemorrhagic diathesis. He was subsequently treated with corticosteroid without good response. After he was diagnosed as having cytophagic histiocytic panniculitis, cyclosporin A was administered intravenously in an initial dosage of 1 mg/kg/day and in oral maintenance dose of 10 mg/kg/day with a successful response and the patient completely recovered within 6 months with mild hypertension as an adverse effect.
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Affiliation(s)
- S Viravan
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Venkataramani A, Behling CA, Lyche KD. Sclerosing mesenteritis: an unusual cause of abdominal pain in an HIV-positive patient. Am J Gastroenterol 1997; 92:1059-60. [PMID: 9177537] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Sclerosing mesenteritis is a rare, idiopathic, and benign mesenteric lesion that is characterized by fat necrosis, fibrosis, and chronic inflammation. We report a case of sclerosing mesenteritis presenting as recurrent abdominal pain in an HIV-positive patient. Because of the wider differential diagnosis in such cases, the patient underwent an extensive workup culminating in a laparoscopy with biopsy. Tamoxifen has been shown to be useful in the treatment of desmoid tumors and idiopathic retroperitoneal fibrosis. We present the first case of sclerosing mesenteritis to respond to tamoxifen therapy. Because this drug is relatively safe and simple to dose, its utility as therapy for patients with this benign but debilitating disease should be considered.
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Affiliation(s)
- A Venkataramani
- Department of Medicine, University of California, San Diego 92103-8413, USA
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Vernace MA, Bellucci AG, Mossey RT, Susin M, Mailloux LU, Wilkes BM, Katz S, Eskreis D. Minimal change nephropathy associated with sclerosing mesenteritis. Nephron Clin Pract 1996; 73:473-6. [PMID: 8832610 DOI: 10.1159/000189113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 02/02/2023] Open
Abstract
A 65-year-old man with sclerosing mesenteritis developed the nephrotic syndrome. Percutaneous renal biopsy revealed classical histologic findings of minimal change nephropathy with a mild interstitial nephritis. Immunomodulation with prednisone led to a rapid and complete remission of the proteinuria but did not alter the course of the underlying sclerosing mesenteritis. The association of lymphomatous and nonlymphomatous neoplasms with minimal change nephropathy has been well-described. Our review of the literature indicates a parallel association of malignant lymphoma with sclerosing mesenteritis and a variety of disorders that constitute a spectrum of disease. The occurrence of this histopathologic form of renal injury and therapeutic response in the setting of a known lymphoreticular disorder suggests a role for a generalized alteration in cell-mediated immunity and not a tumor-induced elaboration of a factor(s) that directly damages the glomerular filtration barrier.
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Affiliation(s)
- M A Vernace
- Department of Medicine, North Shore University Hospital, Manhasset, NY 11030, USA
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16
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Abstract
We present two patients with subcutaneous fat necroses (SCFN) in whom endocrinologic studies revealed an association with elevated prostaglandin E (PGE) levels. A boy born after prolonged labor complicated by meconium aspiration developed erythematous, indurated plaques over the back, arms, buttocks, and cheeks at 4 days of age. A biopsy specimen of involved skin showed panniculitis with foci of necrotic adipocytes containing radially arranged, needle-shaped clefts and a granulomatous infiltrate in the septae. Laboratory studies revealed hypercalcemia of 13.6 mg/dl (normal 8.8-10.1 mg/dl), elevated 1.25-1.25(OH)2D3, and increased urinary excretion of PGE2. The child was hospitalized and treated with systemic steroids and diuretics, with resolution of SCFN and hypercalcemia. The second patient was a girl born with cyanotic heart disease. A diagnosis of Ebstein anomaly was made, and intravenous PGE1 was started to keep patent the ductus arteriosus. Four days later erythematous, indurated plaques were noted on the knee, back, and anterior chest. A skin biopsy specimen revealed SCFN. There was no associated laboratory abnormality. On discontinuing PGE1, no new lesions formed and the existing panniculitis resolved. These two cases demonstrate the association between SCFN and elevated PGE levels (endogenous in patient 1, exogenous in patient 2). No previous reports of SCFN after the administration of PGE1 have appeared in the literature.
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Affiliation(s)
- H Sharata
- Department of Medicine, University of Wisconsin-Madison 53705, USA
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Katamoto H, Kurihara S, Shimada Y. Effects of isoprothiolane and phytosterol on lipogenesis and lipolysis in adipocytes from rats of dietary fat necrosis. Nihon Juigaku Zasshi 1990; 52:1189-97. [PMID: 2287126 DOI: 10.1292/jvms1939.52.1189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
To study effects of isoprothiolane and phytosterol on dietary fat necrosis, 3 groups of rats were fed hardened-tallow (HT) diet. Two groups of rats received either isoprothiolane (50 mg/kg) or phytosterol (20 mg/kg) orally once a day consecutively for 10 weeks. One group of rats received standard diet (CE-2) as a control. Fat necrotic lesions were observed in epididymal and perirenal adipose tissues from all rats in the 3 groups fed HT diet. Rats with fat necrosis were characterized by visceral type obesity and saturation in fatty acid composition of triglyceride in adipose tissue. The highest glucose conversion to total lipids was seen in adipocytes from the rats given phytosterol. There was no lipolytic response to epinephrine stimulation (1-100 microM) in adipocytes from the rats given only HT diet, while similar response of adipocytes from the 2 groups treated with either drug to those from the rats fed standard diet was observed. The levels of total saturated fatty acids of phospholipid in adipose tissue from the rats given either drug were lower than that of the rats given only HT diet. These data suggest that either drug alters fatty acid composition of phospholipid in fat cell membrane and enhances lipolysis of the cells.
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Affiliation(s)
- H Katamoto
- Department of Veterinary Surgery, College of Agriculture, University of Osaka Prefecture, Japan
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18
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Shimada Y, Katamoto H, Ishida S, Kobayashi K, Tohzyoh H. Therapeutic effect of isoprothiolane on bovine fat necrosis. Nihon Juigaku Zasshi 1988; 50:1017-24. [PMID: 3199611 DOI: 10.1292/jvms1939.50.1017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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19
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Oka A, Yamasaki T, Shibatani M, Suzuki T, Saito T. Efficacy of isoprothiolane for the treatment of fat necrosis in cattle. Br Vet J 1988; 144:507-14. [PMID: 3056570 DOI: 10.1016/0007-1935(88)90091-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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20
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Abstract
A distinctive form of ulcerative panniculitis develops in a subset of persons with alpha-1-antitrypsin deficiency. This association may be more widely recognized if routine determinations of alpha-1-antitrypsin are performed on patients in whom neutrophilic, ulcerative panniculitis develops without specific, defined underlying causes. Therapies that appear to be of the greatest potential benefit include treatment with dapsone and alpha-1-proteinase inhibitor replacement. Astute recognition of alpha-1-antitrypsin-deficient panniculitis and assessment of response to these and other therapies will ultimately lead to a more complete understanding of the cause of this distinctive and uniquely associated disease.
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Affiliation(s)
- M R Pittelkow
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905
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Coto V, Oliviero U, Lucariello A, Cerini R, Cocozza M, Cacciatore L, Porfido FA, Lingetti M, Scarpellino F, Talarico M. [Clinical study on the anti-lipidemia and anti-steatosis effectiveness of the pantetheine-phosphorylcholine pharmacologic combination]. Clin Ter 1986; 118:415-21. [PMID: 3780171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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22
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Abstract
A case of disseminated fat necrosis in pancreatic disease which presented as an apparent arthritis is reported. The intravenous administration of aprotinin as a form is described.
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23
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Abstract
The clinical and histological findings in 88 patients in whom hepatotoxicity with valproate has been reported were reviewed. The characteristic lesion is microvesicular steatosis. Hepatotoxicity appears to be an idiosyncratic reaction and is most likely to appear within 6 months from the start of therapy, especially in young patients on comedication. The condition may be reversible if the drug is immediately withdrawn in patients who show acute gastrointestinal symptoms, drowsiness or lethargy, jaundice, or change in seizure pattern. Clinical monitoring is more important than laboratory monitoring. The outcome of pregnancies in 344 women who received valproate in the first trimester was reviewed. There were 225 normal babies and 68 abnormal babies. The role of valproate in the aetiology of neural tube defects remains uncertain, but mothers treated with valproate should receive prenatal counselling.
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