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Wang J, Chen Z, Wu L, Liao Y, Yu B. Tofacitinib for managing granuloma formation after dermal filler injection: three case reports and literature review. J DERMATOL TREAT 2024; 35:2338281. [PMID: 38632962 DOI: 10.1080/09546634.2024.2338281] [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: 12/27/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Granuloma formation is an uncommon and persistent skin inflammatory condition caused by the injection of dermal fillers. The exact cause of this reaction is not well understood, but it may be associated with irritating components or abnormal immune function. Treating granulomas can be difficult. However, recent research has shown that Janus kinase (JAK) inhibitors hold promise as a potential therapy for refractory granulomatous diseases. OBJECTIVES The aim was to evaluate the efficacy and safety of tofacitinib as a treatment for granulomas secondary to filler injection and the possible mechanisms were discussed and summarized. METHODS This study focuses on three cases of patients who experienced granuloma formation after receiving filler injections and were subsequently treated with tofacitinib. The efficacy and safety of the treatment were evaluated using parameters such as photographs and monitoring for any adverse reactions. In addition, a literature review was conducted to explore the underlying mechanisms and potential effects of tofacitinib. RESULTS All three cases recovered from swelling and nodules without side effects through the off-label use of oral tofacitinib. Existing data review reveals some approaches for cutaneous granulomatous disorders like inhibiting macrophage activation and downregulation of the JAK-STAT pathway. CONCLUSION This report emphasizes the effectiveness of JAK inhibitors in treating granulomas caused by filler injections. Recent advancements in understanding the underlying mechanisms of granulomatous reactions have paved the way for JAK inhibitors to be regarded as a promising treatment choice. However, further research is necessary to fully assess the safety and long-term effectiveness of using tofacitinib for granuloma treatment.
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Affiliation(s)
- Jieyi Wang
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, China
| | - Zhuoxuan Chen
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, China
| | - Lin Wu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yan Liao
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, China
| | - Bo Yu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, China
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Yang Y, Yan J, Yang J, Wang P, Liu Y, Wang X. Janus kinase inhibitor Abrocitinib as an Off-Label treatment for tattoo granuloma with uveitis (TAGU). Australas J Dermatol 2024; 65:297-299. [PMID: 38450752 DOI: 10.1111/ajd.14248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Yutong Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jia Yan
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jin Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yeqiang Liu
- Department of Dermatopathology, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
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3
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Zhang X, Lian H, Song X, Li J. Bacillus Calmette-Guérin-induced kidney granulomas. Kidney Int 2024; 105:1131. [PMID: 38642981 DOI: 10.1016/j.kint.2023.10.011] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 09/27/2023] [Accepted: 10/17/2023] [Indexed: 04/22/2024]
Affiliation(s)
- Xueyan Zhang
- Department of Basic Nursing, School of Nursing, Binzhou Medical University, Yantai, China
| | - Huixiu Lian
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Xiaolei Song
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Jun Li
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China.
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Hoffmann SS, Thiesson EM, Johansen JD, Hviid A. Association between atopic disease and vaccination granulomas: A nested case-control study. Contact Dermatitis 2024; 90:411-419. [PMID: 38059542 DOI: 10.1111/cod.14472] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Vaccination granulomas are observed in 1% of all children vaccinated with an aluminium-adsorbed vaccine. Most children with granulomas also have aluminium contact allergy (CA). CA and atopic diseases are both highly prevalent among children and may be associated. OBJECTIVE To investigate the association between vaccination granulomas and atopic dermatitis (AD), asthma and rhinitis in children. METHODS We sourced a cohort of all Danish children born from 2009 to 2017 and conducted a nested case-control study, with cases defined as children with vaccination granulomas, matched to controls 1:10 on sex, socioeconomic class, gestational age and season of birth. All cases and controls were vaccinated with aluminium-adsorbed vaccines and followed until their second birthday. We used conditional logistic regression to estimate the odds ratios (ORs). RESULTS The study included 2171 cases with vaccination granulomas, and 21 710 controls. Children with a diagnosis of AD had a significantly higher risk of a vaccination granuloma (OR 1.50, 95% confidence intervals [CI] 1.25-1.80). No significant association was found between granulomas and asthma or rhinitis. The association between granulomas and AD was even higher in an additional sensitivity-analysis, following the children until their fourth birthday (OR 2.71, 95% CI 2.36-3.11). CONCLUSION AD was significantly associated with vaccination granulomas, but not with other atopic diseases, within both the first 2 and 4 years of life.
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Affiliation(s)
- Stine Skovbo Hoffmann
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | | | - Jeanne Duus Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Anders Hviid
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Pharmacovigilance Research Center, Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
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5
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Cao Y, Afzal MZ, Gutmann EJ, Shirai K. Rare immune-related adverse events in a patient with metastatic melanoma: a case report highlighting sarcoidosis-like reactions triggered by immune-checkpoint inhibitors. Melanoma Res 2024; 34:70-75. [PMID: 37830935 DOI: 10.1097/cmr.0000000000000925] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Pembrolizumab and ipilimumab/nivolumab (ipi/nivo) combination are FDA-approved immune checkpoint inhibitor (ICI) therapies for metastatic melanoma. ICIs could result in various inflammation responses known as immune-related adverse events (IRAEs). We report a patient with metastatic melanoma who developed multiple IRAEs including sarcoidosis-like reaction (SLR), diabetic ketoacidosis (DKA), and worsening hypothyroidism on ICIs. A 71-year-old man with stage IIIC melanoma and lymph node metastasis began adjuvant therapy with pembrolizumab in May 2021. A surveillance positron emission tomography-computed tomography (PET-CT) scan four months later showed diffuse nodal uptake indicating potential metastases although the patient remained asymptomatic. His treatment was temporarily switched to ipi/nivo before biopsy was obtained for definitive diagnosis, which revealed non-caseating granulomas consistent with SLR. After resuming pembrolizumab, he developed DKA and worsening hypothyroidism in November 2021, both of which were attributed to IRAEs. His surveillance PET scan in March 2022 again revealed new hypermetabolic activity in several bones, subcutaneous tissue, and the left inguinal lymph node. Left inguinal node biopsy showed disease recurrence, while biopsies of hypermetabolic subcutaneous nodules and bone demonstrated non-caseating granulomas. Our case described a patient on ICIs who developed several IRAEs. SLR is often asymptomatic but remains a diagnostic challenge due to its indistinguishable appearance on imaging studies compared to metastasis. Better understanding of IRAEs and improved surveillance strategies are needed for optimal patient outcomes.
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Affiliation(s)
- Yuanzhen Cao
- Department of Internal Medicine, Dartmouth-Hitchcock Medical Center
| | - Muhammad Zubair Afzal
- Section of Hematology/Oncology, Dartmouth Cancer Center, Dartmouth-Hitchcock Medical Center
| | - Edward J Gutmann
- Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Keisuke Shirai
- Section of Hematology/Oncology, Dartmouth Cancer Center, Dartmouth-Hitchcock Medical Center
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Geetha SD, Chavarria HD, Abdelwahed M, Kataria N, Bijol V, Das K. Granulomatous myocarditis arising from intravesical Bacillus Calmette-Guérin therapy leading to death diagnosed by postmortem examination: a case report. J Med Case Rep 2024; 18:12. [PMID: 38195538 PMCID: PMC10777644 DOI: 10.1186/s13256-023-04310-4] [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: 05/02/2023] [Accepted: 12/06/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Intravesical Bacillus Calmette-Guérin (BCG) is used as a standard adjuvant therapy for non-muscle invasive urothelial cancer. Most patients tolerate the treatment well, with mild side effects. Systemic complications are extremely rare, occur due to BCG dissemination and are associated with immunocompromised state and urothelial breach. CASE PRESENTATION We present a case of a 78-year-old male, a former smoker, with history of non-muscle invasive urothelial carcinoma status post partial resection followed by intravesical BCG therapy. An autopsy was performed due to the sudden nature of his death. Autopsy showed multiple necrotizing granulomas in the brain, atrium, ventricles, lungs, kidneys, and urinary bladder. Stains for acid-fast bacilli and fungi were negative. In addition, bilateral lungs showed evidence of bronchopneumonia secondary to cytomegalovirus. CONCLUSION Granulomatous myocarditis arising from BCG therapy is extremely rare. Our patient with urothelial cancer treated with BCG developed multiorgan granulomas, most likely due to a hypersensitivity reaction to intravesical BCG. Arrhythmia induced by granulomatous myocarditis was the cause of his death. Although there have been few cases of systemic BCG-osis causing fatal sepsis leading to death, a cardiac cause of death is unique.
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Affiliation(s)
- Saroja D Geetha
- Northwell Health, Department of Pathology, Zucker School of Medicine, North Shore University Hospital/Long Island Jewish Medical Center, 2200 Northern Blvd, Suite 104, Greenvale, NY, 11548, USA.
| | - Hector D Chavarria
- Northwell Health, Department of Pathology, Zucker School of Medicine, North Shore University Hospital/Long Island Jewish Medical Center, 2200 Northern Blvd, Suite 104, Greenvale, NY, 11548, USA
| | - Mohammed Abdelwahed
- Northwell Health, Department of Pathology, Zucker School of Medicine, North Shore University Hospital/Long Island Jewish Medical Center, 2200 Northern Blvd, Suite 104, Greenvale, NY, 11548, USA
| | - Nidhi Kataria
- Northwell Health, Department of Pathology, Zucker School of Medicine, North Shore University Hospital/Long Island Jewish Medical Center, 2200 Northern Blvd, Suite 104, Greenvale, NY, 11548, USA
| | - Vanesa Bijol
- Northwell Health, Department of Pathology, Zucker School of Medicine, North Shore University Hospital/Long Island Jewish Medical Center, 2200 Northern Blvd, Suite 104, Greenvale, NY, 11548, USA
| | - Kasturi Das
- Northwell Health, Department of Pathology, Zucker School of Medicine, North Shore University Hospital/Long Island Jewish Medical Center, 2200 Northern Blvd, Suite 104, Greenvale, NY, 11548, USA
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7
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Ho SR, Huang HC. Silver nitrate burns following umbilical granuloma treatment. Pediatr Neonatol 2024; 65:94-95. [PMID: 37648605 DOI: 10.1016/j.pedneo.2023.06.004] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/11/2023] [Accepted: 06/16/2023] [Indexed: 09/01/2023] Open
Affiliation(s)
- Shau-Ru Ho
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsin-Chung Huang
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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Li C, Shen C, Zhang W. Infectious Granuloma With Mycobacterium abscessus After Facial Injection of Botulinum Toxin: A Case Report. J Craniofac Surg 2024; 35:e48-e50. [PMID: 37888985 PMCID: PMC10749676 DOI: 10.1097/scs.0000000000009790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Botulinum toxin injections have garnered increasing employment in facial rhytidectomy due to their demonstrable efficacy and safety profile. In this study, the authors present the case of a 39-year-old woman who manifested painful crimson nodules and multiple abscesses on her face, which manifested 1 week postinjection. Subsequent histopathological scrutiny unveiled the development of histiocytic granulomas accompanied by infiltrates of inflammatory cells, and microbiological investigation and polymerase chain reaction assays identified the causative agent as Mycobacterium abscessus .
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Zhuravskii SG, Yukina GY, Sukhorukova EG, Kryzhanovskaya EA, Polovnikov IV, Belorus AO, Spivak YM, Galagudza MM. The Pattern of Granuloma Formation in the Liver of Rats as a Reflection of the Mechanism of Internalization of Submicron Silicon Particles. Bull Exp Biol Med 2024; 176:399-402. [PMID: 38342809 DOI: 10.1007/s10517-024-06032-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: 05/11/2023] [Indexed: 02/13/2024]
Abstract
A morphological analysis of the liver of Wistar rats was performed 2 months after a single intravenous injection of porous silicon particles of different sizes (60-80, 250-300, and 500-600 nm; 2 mg/ml, 1 ml). Histological, immunohistochemical, and electron microscopic methods showed the development of CD68+ granulomas in all experimental groups. Injection of 60-80-nm porous silicon particles led to the formation of single large granulomas (>2000 μm2), while 500-600-nm nanoparticles caused the formation of numerous smaller granulomas. The mechanism of involution of granulomas by apoptosis of Kupffer cells and the absence of subsequent connective tissue remodeling of the organ tissue is shown.
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Affiliation(s)
- S G Zhuravskii
- I. P. Pavlov First St. Petersburg State Medical University, Ministry of Health of the Russian Federation, St. Petersburg, Russia.
- V. A. Almazov National Medical Research Center, Ministry of Health of the Russian Federation, St. Petersburg, Russia.
| | - G Yu Yukina
- I. P. Pavlov First St. Petersburg State Medical University, Ministry of Health of the Russian Federation, St. Petersburg, Russia
| | - E G Sukhorukova
- I. P. Pavlov First St. Petersburg State Medical University, Ministry of Health of the Russian Federation, St. Petersburg, Russia
| | - E A Kryzhanovskaya
- I. P. Pavlov First St. Petersburg State Medical University, Ministry of Health of the Russian Federation, St. Petersburg, Russia
| | - I V Polovnikov
- I. P. Pavlov First St. Petersburg State Medical University, Ministry of Health of the Russian Federation, St. Petersburg, Russia
| | - A O Belorus
- V. I. Ul'yanov (Lenin) St. Petersburg Electrotechnical University "LETI", St. Petersburg, Russia
| | - Yu M Spivak
- V. I. Ul'yanov (Lenin) St. Petersburg Electrotechnical University "LETI", St. Petersburg, Russia
| | - M M Galagudza
- I. P. Pavlov First St. Petersburg State Medical University, Ministry of Health of the Russian Federation, St. Petersburg, Russia
- V. A. Almazov National Medical Research Center, Ministry of Health of the Russian Federation, St. Petersburg, Russia
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Durkin AJ, Catena D, Woltjen N, Boyle K, Polling M, Weng J, Chim JH. Surgical Management of Polymethylmethacrylate-Collagen Gel Complications in the Lower Eyelid: A Case Series. Ann Plast Surg 2023; 90:12-18. [PMID: 36534095 DOI: 10.1097/sap.0000000000003364] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND As nonsurgical rejuvenation with fillers continues to grow in popularity, patients are increasingly interested in more durable results. Polymethylmethacrylate (PMMA)-collagen gel is unique among fillers in that the PMMA microspheres are not completely absorbed and phagocytosed by the body. This durability coupled with the biophysical properties of PMMA makes it a poor choice for periorbital rejuvenation, an unforgiving and highly complex anatomic area. METHODS Between 2011 and 2018, 14 patients with PMMA granulomas in various facial areas self-referred to the senior author's practice. Of these patients, 11 were managed nonsurgically; however, all 3 patients who presented with granulomas in the infraorbital area required surgery to remove the filler and restore a natural aesthetic. RESULTS The 3 patients with significant swelling and PMMA filler nodules in the infraorbital area with unacceptable cosmetic appearance were females between the ages of 50 and 55 years. Nonsurgical protocols were unsuccessful, and surgical removal was required. All subjects have been followed for a minimum of 2 years with no immediate- or long-term postoperative complications secondary to PMMA removal. Patients remain satisfied with the outcome of the surgery. CONCLUSIONS Despite the evidence that the periorbital area is prone to adverse events when injected with particulate fillers, misguided enthusiasm for PMMA-collagen gel as a durable treatment continues to lead to unnecessary and severe complications in patients. The case studies presented here highlight that this product should not be introduced into the periorbital area. We also describe a surgical treatment approach for its removal if complications arise.
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Affiliation(s)
| | | | | | | | | | - John Weng
- Florida State University College of Medicine, Tallahassee
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11
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Ravndal L, Bergfors E, Behzadi M, Barstad B, Steinkjer B, Kjosavik S. Post-vaccination aluminium granulomas in children. Tidsskr Nor Laegeforen 2022; 142:21-0398. [PMID: 35239278 DOI: 10.4045/tidsskr.21.0398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Persistent itching subcutaneous granulomas related to aluminium-containing vaccines are poorly recognised in health care. They are often associated with aluminium hypersensitivity. CASE PRESENTATION An intensely itching subcutaneous nodule appeared on the left thigh of a 17-month-old girl at the injection site for an aluminium adsorbed diphtheria-tetanus-pertussis-polio-HiB vaccine given at 3, 5 and 12 months. Ultrasound suggested a vascular malformation among other differential diagnoses. An MR investigation under general anaesthesia was planned, but the diagnosis was confirmed prior to this by a positive epicutaneous test with aluminium. INTERPRETATION Despite a typical history of an itchy vaccination granuloma, the child underwent a thorough hospital workup to rule out malignancy. The diagnosis was delayed for two years. Vaccination granulomas have a good prognosis but can persist for many years. It is important to recognise the condition early in primary health care to avoid unnecessary anxiety and investigations.
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12
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Soliman E, Bhalla S, Elhassanny AEM, Malur A, Ogburn D, Leffler N, Malur AG, Thomassen MJ. Myeloid ABCG1 Deficiency Enhances Apoptosis and Initiates Efferocytosis in Bronchoalveolar Lavage Cells of Murine Multi-Walled Carbon Nanotube-Induced Granuloma Model. Int J Mol Sci 2021; 23:ijms23010047. [PMID: 35008476 PMCID: PMC8744594 DOI: 10.3390/ijms23010047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/12/2021] [Accepted: 12/17/2021] [Indexed: 12/14/2022] Open
Abstract
The use of carbon nanotubes has increased in the past few decades. Carbon nanotubes are implicated in the pathogenesis of pulmonary sarcoidosis, a chronic granulomatous inflammatory condition. We developed a murine model of chronic granulomatous inflammation using multiwall carbon nanotubes (MWCNT) to investigate mechanisms of granuloma formation. Using this model, we demonstrated that myeloid deficiency of ATP-binding cassette (ABC) cholesterol transporter (ABCG1) promotes granuloma formation and fibrosis with MWCNT instillation; however, the mechanism remains unclear. Our previous studies showed that MWCNT induced apoptosis in bronchoalveolar lavage (BAL) cells of wild-type (C57BL/6) mice. Given that continual apoptosis causes persistent severe lung inflammation, we hypothesized that ABCG1 deficiency would increase MWCNT-induced apoptosis thereby promoting granulomatous inflammation and fibrosis. To test our hypothesis, we utilized myeloid-specific ABCG1 knockout (ABCG1 KO) mice. Our results demonstrate that MWCNT instillation enhances pulmonary fibrosis in ABCG1 KO mice compared to wild-type controls. Enhanced fibrosis is indicated by increased trichrome staining and transforming growth factor-beta (TGF-β) expression in lungs, together with an increased expression of TGF-β related signaling molecules, interleukin-13 (IL-13) and Smad-3. MWCNT induced more apoptosis in BAL cells of ABCG1 KO mice. Initiation of apoptosis is most likely mediated by the extrinsic pathway since caspase 8 activity and Fas expression are significantly higher in MWCNT instilled ABCG1 KO mice compared to the wild type. In addition, TUNEL staining shows that ABCG1 KO mice instilled with MWCNT have a higher percentage of TUNEL positive BAL cells and more efferocytosis than the WT control. Furthermore, BAL cells of ABCG1 KO mice instilled with MWCNT exhibit an increase in efferocytosis markers, milk fat globule-EGF factor 8 (MFG-E8) and integrin β3. Therefore, our observations suggest that ABCG1 deficiency promotes pulmonary fibrosis by MWCNT, and this effect may be due to an increase in apoptosis and efferocytosis in BAL cells.
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Affiliation(s)
- Eman Soliman
- Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (E.S.); (S.B.); (A.M.); (D.O.); (N.L.)
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Sophia Bhalla
- Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (E.S.); (S.B.); (A.M.); (D.O.); (N.L.)
| | - Ahmed E. M. Elhassanny
- Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA;
| | - Anagha Malur
- Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (E.S.); (S.B.); (A.M.); (D.O.); (N.L.)
| | - David Ogburn
- Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (E.S.); (S.B.); (A.M.); (D.O.); (N.L.)
| | - Nancy Leffler
- Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (E.S.); (S.B.); (A.M.); (D.O.); (N.L.)
| | - Achut G. Malur
- Department of Microbiology & Immunology, St. George’s University, St. George 999166, Grenada;
| | - Mary Jane Thomassen
- Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (E.S.); (S.B.); (A.M.); (D.O.); (N.L.)
- Correspondence:
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Abstract
ABSTRACT We report the case of a 45-year-old woman with a history of right breast reconstruction with silicone implant for breast cancer. An 18F-FDG PET/CT performed several years later revealed the presence of 18F-FDG-avid nodules at the periphery of the silicone implant, in the right internal mammary chain, and in the contralateral breast. Needle core biopsies were positive for bilateral silicone granulomas, without any sign of malignancy. This case displays intense 18F-FDG uptake in silicone granulomas affecting the contralateral breast after implant reconstruction.
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Affiliation(s)
| | | | - Wassim Raffoul
- Plastic Surgery Department, Lausanne University Hospital, Lausanne, Switzerland
| | - John O Prior
- From the Nuclear Medicine and Molecular Imaging Department
| | - Marie Meyer
- From the Nuclear Medicine and Molecular Imaging Department
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Echeverría I, de Miguel R, Asín J, Rodríguez-Largo A, Fernández A, Pérez M, de Andrés D, Luján L, Reina R. Replication of Small Ruminant Lentiviruses in Aluminum Hydroxide-Induced Granulomas in Sheep: a Potential New Factor for Viral Dissemination. J Virol 2020; 95:e01859-20. [PMID: 33115880 PMCID: PMC7944437 DOI: 10.1128/jvi.01859-20] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/23/2020] [Indexed: 12/29/2022] Open
Abstract
Aluminum (Al)-based salts are widely used adjuvants in ruminants and other species to strengthen the immune response elicited against vaccine antigen(s). However, they can lead to the formation of long-lasting granulomas composed of abundant activated macrophages. Small ruminant lentiviruses (SRLV) are widely distributed macrophage-tropic retroviruses that cause persistent infections in sheep and goats. Infected monocytes/macrophages and dendritic cells establish an inflammatory microenvironment that eventually leads to clinical manifestations. The aim of this work was to study the effect of Al-induced granulomas in the replication and pathogenesis of SRLV. Eleven adult, naturally SRLV-infected sheep showing clinical arthritis were distributed in vaccine (n = 6), adjuvant-only (n = 3), and control (n = 2) groups and inoculated with commercial Al-based vaccines, Al hydroxide adjuvant alone, or phosphate-buffered saline, respectively. In vitro studies demonstrated viral replication in Al-induced granulomas in 5 out of 10 sheep. Immunohistochemistry (IHC) evinced granular, intracytoplasmic SRLV presence in macrophages within granulomas. Viral sequences obtained from granulomas, blood monocytes, and other tissues were highly similar in most animals, suggesting virus circulation among body compartments. However, notable differences between isolated strains in granulomas and other tissues in specific animals were also noted. Interestingly, the B2 subtype was the most commonly found SRLV genotype, reaching a wider body distribution than previously described. Recombination events between genotypes B2 and A3 along the gag region were identified in two sheep. Our results indicate that Al-hydroxide-derived granulomas may represent an ideal compartment for SRLV replication, perhaps altering natural SRLV infection by providing a new, suitable target tissue.IMPORTANCE Granulomas are inflammation-derived structures elicited by foreign bodies or certain infections. Aluminum adjuvants included in vaccines induce granulomas in many species. In sheep, these are persistent and consist of activated macrophages. Small ruminant lentiviruses (SRLV), which are macrophage-tropic lentiviruses, cause a chronic wasting disease affecting animal welfare and production. Here, we studied the occurrence of SRLV in postvaccination granulomas retrieved from naturally infected ewes after vaccination or inoculation with aluminum only. SRLV infection was confirmed in granulomas by identification of viral proteins, genomic fragments, and enzymatic activity. The infecting SRLV strain, previously found exclusively in carpal joints, reached the central nervous system, suggesting that occurrence of SRLV in postvaccination granulomas may broaden tissue tropism. SRLV recombination was detected in inoculated animals, a rare event in sheep lentiviruses. Potentially, virus-host interactions within granulomas may modify viral pathogenesis and lead to more widespread infection.
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Affiliation(s)
- Irache Echeverría
- Institute of Agrobiotechnology, CSIC-Government of Navarra, Mutilva, Spain
| | - Ricardo de Miguel
- Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | - Javier Asín
- Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | | | - Antonio Fernández
- Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | - Marta Pérez
- Department of Animal Anatomy, Embryology and Genetics, University of Zaragoza, Zaragoza, Spain
- AgriFood Institute of Aragon (IA2), Zaragoza, Spain
| | - Damián de Andrés
- Institute of Agrobiotechnology, CSIC-Government of Navarra, Mutilva, Spain
| | - Lluís Luján
- Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain
- AgriFood Institute of Aragon (IA2), Zaragoza, Spain
| | - Ramsés Reina
- Institute of Agrobiotechnology, CSIC-Government of Navarra, Mutilva, Spain
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Hoffmann S, Elberling J. Vaccination Granuloma Itch Treated with Capsaicin 8% Patches. Acta Derm Venereol 2020; 100:adv00339. [PMID: 33170300 PMCID: PMC9309702 DOI: 10.2340/00015555-3687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Stine Hoffmann
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, 2900 Hellerup, Denmark. E-mail:
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16
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Ng BKL, Su HYL, Tsai KL. Oleogranuloma of the Rectum Mimic Malignancy. Am J Gastroenterol 2020; 115:1747. [PMID: 33156089 DOI: 10.14309/ajg.0000000000000776] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Benjamin Kwan Lok Ng
- Division of Colon and Rectal Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Harvey Yu-Li Su
- Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
| | - Kai-Lung Tsai
- Division of Colon and Rectal Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Affiliation(s)
| | - Alina G Bridges
- Department of Dermatology, Mayo Clinic, Rochester, MN; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
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18
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Palese E, Nudo M, Pallotta S, Curzio M. Granuloma inframammary adultorum, a case report. Dermatol Online J 2020; 26:13030/qt21r0588p. [PMID: 33054951] [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] [Received: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 06/11/2023] Open
Abstract
Granuloma inframammary adultorum represents a variant of erosive papulonodular dermatosis; we report a case of a patient with bilateral erosive plaques and nodules predominantly located under the breast.
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Affiliation(s)
- Enzo Palese
- Dermatologic Surgery and Laser Therapy Unit, Istituto Dermopatico dell'Immacolata, Rome
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19
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Aedma SK, Chidharla A, Kelting S, Kasi A. Oxaliplatin-associated sarcoid-like reaction masquerading as recurrent colon cancer. BMJ Case Rep 2020; 13:e229548. [PMID: 32907862 PMCID: PMC7481089 DOI: 10.1136/bcr-2019-229548] [Citation(s) in RCA: 3] [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] [Accepted: 08/04/2020] [Indexed: 11/04/2022] Open
Abstract
A 54-year-old man with stage IV B metastatic colorectal cancer with liver and peritoneal metastasis was treated with cytoreductive surgery (extended left colectomy, right partial hepatectomy, resection of right diaphragm nodule) and perioperative oxaliplatin-based chemotherapy. The patient was cancer-free for 6 months, at which point a surveillance positron emission tomography-CT scan showed metabolically active hepatosplenic lesions and mediastinal and bilateral hilar lymph nodes. An endobronchial ultrasound bronchoscopy-guided fine needle aspiration of the mediastinal and hilar lymph nodes revealed non-necrotising granulomas. The workup was negative for bacterial, fungal or mycobacterial infection, cancer or autoimmune disease. Carcinoembryonic antigen and COLVERA (a circulating tumour DNA liquid biopsy test for the detection of recurrent colon cancer) tests were negative. Subsequently the rare diagnosis of a sarcoidosis-like reaction from oxaliplatin-based chemotherapy was made. Repeat imaging after 3 months showed resolution of the hepatosplenic lesions and lymphadenopathy, alike.
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Affiliation(s)
| | - Anusha Chidharla
- Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
| | - Sarah Kelting
- Medical Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Anup Kasi
- Medical Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA
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20
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Tonin B, Colato C, Bruni M, Girolomoni G. Late granuloma formation secondary to hyaluronic acid injection. Dermatol Online J 2020; 26:13030/qt9fj4f3ts. [PMID: 32898402] [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] [Received: 08/20/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023] Open
Abstract
Hyaluronic acid injection to rejuvenate or to correct defects is a very common practice in aesthetic medicine. Although it is considered highly safe because of biocompatibility and biodegradability, adverse reactions can occur. Herein, we report a patient with foreign body granuloma formation that presented as multiple subcutaneous nodules on both arms, following injections of hyaluronic acid performed about six years earlier. Our case is unique with respect to timing and area of granuloma appearance.
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Affiliation(s)
- Beatrice Tonin
- Section of Dermatology, Department of Medicine, University of Verona, Verona.
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21
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Camacho L, Latendresse JR, Muskhelishvili L, Law CD, Delclos KB. Effects of intravenous and oral di(2-ethylhexyl) phthalate (DEHP) and 20% Intralipid vehicle on neonatal rat testis, lung, liver, and kidney. Food Chem Toxicol 2020; 144:111497. [PMID: 32540476 DOI: 10.1016/j.fct.2020.111497] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 01/09/2023]
Abstract
The highest human exposures to the plasticizer di(2-ethylhexyl) phthalate (DEHP) occur through intravenous (iv) exposure from medical procedures. Rodent toxicity studies, mainly using oral exposures, have identified male reproductive toxicity after developmental exposure to DEHP as the primary concern. Other organs are also affected by DEHP and route may influence the degree of target organ involvement. Cammack et al. (2003) reported a critical study focused on testicular toxicity using oral and iv exposures of neonatal Sprague-Dawley rats to 60, 300, or 600 mg/kg body weight/day DEHP in Intralipid vehicle. The present study followed the same dosing paradigm and included assessment of additional organs to evaluate the potential utility of this design for DEHP alternatives. Reduction of testis weight was observed in all DEHP treatment groups and germ cell and Sertoli cell toxicity was observed at the two highest doses with both routes. Lung granulomas occurred in all iv DEHP groups, possibly related to increased fat particle size in DEHP lipid emulsions. Lung alveolar development was inhibited after both oral and iv high dose DEHP. Toxicity of oral Intralipid vehicle was observed in germ and Sertoli cells. The lack of such effects after iv vehicle exposure suggested that this may be a gut-mediated effect.
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Affiliation(s)
- Luísa Camacho
- Division of Biochemical Toxicology, National Center for Toxicological Research, Jefferson, AR, 72079, USA
| | | | | | - Charles D Law
- Division of Neurotoxicology, National Center for Toxicological Research, Jefferson, AR, 72079, USA
| | - K Barry Delclos
- Division of Biochemical Toxicology, National Center for Toxicological Research, Jefferson, AR, 72079, USA.
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Bezerra Rodrigues Dantas L, Silva ALM, da Silva Júnior CP, Alcântara IS, Correia de Oliveira MR, Oliveira Brito Pereira Bezerra Martins A, Ribeiro-Filho J, Coutinho HDM, Rocha Santos Passos F, Quintans-Junior LJ, Alencar de Menezes IR, Pezzani R, Vitalini S. Nootkatone Inhibits Acute and Chronic Inflammatory Responses in Mice. Molecules 2020; 25:molecules25092181. [PMID: 32392744 PMCID: PMC7248960 DOI: 10.3390/molecules25092181] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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] [Received: 04/08/2020] [Revised: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 12/20/2022] Open
Abstract
Nootkatone (NTK) is a sesquiterpenoid found in essential oils of many species of Citrus (Rutaceae). Considering previous reports demonstrating that NTK inhibited inflammatory signaling pathways, this study aimed to investigate the effects of this compound in mice models of acute and chronic inflammation. Murine models of paw edema induced by carrageenan, dextran, histamine, and arachidonic acid, as well as carrageenan-induced peritonitis and pleurisy, were used to evaluate the effects of NTK on acute inflammation. A murine model of granuloma induced by cotton pellets was used to access the impact of NTK treatment on chronic inflammation. In the acute inflammation models, NTK demonstrated antiedematogenic effects and inhibited leukocyte recruitment, which was associated with decreased vascular permeability, inhibition of myeloperoxidase (MPO), interleukin (IL)1-β, and tumor necrosis factor (TNF)-α production. In silico analysis suggest that NTZ anti-inflammatory effects may also occur due to inhibition of cyclooxygenase (COX)-2 activity and antagonism of the histamine receptor type 1 (H1). These mechanisms might have contributed to the reduction of granuloma weight and protein concentration in the homogenates, observed in the chronic inflammation model. In conclusion, NTK exerted anti-inflammatory effects that are associated with inhibition of IL1-β and TNF-α production, possibly due to inhibition of COX-2 activity and antagonism of the H1 receptor. However, further studies are required to characterize the effects of this compound on chronic inflammation.
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Affiliation(s)
- Lindaiane Bezerra Rodrigues Dantas
- Departamento de Saúde, Centro Universitário Dr. Leão Sampaio-UNILEÃO, Av. Leão Sampaio, 400-Lagoa Seca, Juazeiro do Norte 63040-000, Ceará, Brazil; (L.B.R.D.); (A.L.M.S.)
| | - Ana Letícia Moreira Silva
- Departamento de Saúde, Centro Universitário Dr. Leão Sampaio-UNILEÃO, Av. Leão Sampaio, 400-Lagoa Seca, Juazeiro do Norte 63040-000, Ceará, Brazil; (L.B.R.D.); (A.L.M.S.)
| | - Cícero Pedro da Silva Júnior
- Laboratory of Pharmacology and Molecular Chemistry, Department of Biological Chemistry, Regional University of Cariri, Rua Coronel Antônio Luis 1161, Pimenta, Crato 63105-000, Ceará, Brazil; (C.P.d.S.J.); isabel-alcantara-@hotmail.com (I.S.A.); (M.R.C.d.O.); (A.O.B.P.B.M.); (I.R.A.d.M.)
| | - Isabel Sousa Alcântara
- Laboratory of Pharmacology and Molecular Chemistry, Department of Biological Chemistry, Regional University of Cariri, Rua Coronel Antônio Luis 1161, Pimenta, Crato 63105-000, Ceará, Brazil; (C.P.d.S.J.); isabel-alcantara-@hotmail.com (I.S.A.); (M.R.C.d.O.); (A.O.B.P.B.M.); (I.R.A.d.M.)
| | - Maria Rayane Correia de Oliveira
- Laboratory of Pharmacology and Molecular Chemistry, Department of Biological Chemistry, Regional University of Cariri, Rua Coronel Antônio Luis 1161, Pimenta, Crato 63105-000, Ceará, Brazil; (C.P.d.S.J.); isabel-alcantara-@hotmail.com (I.S.A.); (M.R.C.d.O.); (A.O.B.P.B.M.); (I.R.A.d.M.)
| | - Anita Oliveira Brito Pereira Bezerra Martins
- Laboratory of Pharmacology and Molecular Chemistry, Department of Biological Chemistry, Regional University of Cariri, Rua Coronel Antônio Luis 1161, Pimenta, Crato 63105-000, Ceará, Brazil; (C.P.d.S.J.); isabel-alcantara-@hotmail.com (I.S.A.); (M.R.C.d.O.); (A.O.B.P.B.M.); (I.R.A.d.M.)
| | - Jaime Ribeiro-Filho
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador 45500-000, Bahia, Brazil;
| | - Henrique Douglas Melo Coutinho
- Microbiology and Biology Molecular Laboratory, Department of Chemical Biology, Regional University of Cariri, Crato 63105-000, Ceara, Brazil;
| | - Fabíolla Rocha Santos Passos
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Sergipe 49100-000, Brazil; (F.R.S.P.); (L.J.Q.-J.)
| | - Lucindo José Quintans-Junior
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Sergipe 49100-000, Brazil; (F.R.S.P.); (L.J.Q.-J.)
| | - Irwin Rose Alencar de Menezes
- Laboratory of Pharmacology and Molecular Chemistry, Department of Biological Chemistry, Regional University of Cariri, Rua Coronel Antônio Luis 1161, Pimenta, Crato 63105-000, Ceará, Brazil; (C.P.d.S.J.); isabel-alcantara-@hotmail.com (I.S.A.); (M.R.C.d.O.); (A.O.B.P.B.M.); (I.R.A.d.M.)
| | - Raffaele Pezzani
- O.U. Endocrinology, Department of Medicine (DIMED), University of Padova, via Ospedale 105, 35128 Padova, Italy;
- AIROB, Associazione Italiana per la Ricerca Oncologica di Base, 35128 Padova, Italy
| | - Sara Vitalini
- Department of Agricultural and Environmental Sciences, Milan State University, via G. Celoria 2, 20133 Milan, Italy
- Correspondence: ; Tel.: +39-02-50316766
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Nakano-Narusawa Y, Yokohira M, Yamakawa K, Saoo K, Imaida K, Matsuda Y. Single Intratracheal Quartz Instillation Induced Chronic Inflammation and Tumourigenesis in Rat Lungs. Sci Rep 2020; 10:6647. [PMID: 32313071 PMCID: PMC7170867 DOI: 10.1038/s41598-020-63667-4] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 04/01/2020] [Indexed: 12/11/2022] Open
Abstract
Crystalline silica (quartz) is known to induce silicosis and cancer in the lungs. In the present study, we investigated the relationship between quartz-induced chronic inflammation and lung carcinogenesis in rat lungs after a single exposure to quartz. F344 rats were treated with a single intratracheal instillation (i.t.) of quartz (4 mg/rat), and control rats were treated with a single i.t. of saline. After 52 or 96 weeks, the animals were sacrificed, and the lungs and other organs were used for analyses. Quartz particles were observed in the lungs of all quartz-treated rats. According to our scoring system, the lungs of rats treated with quartz had higher scores for infiltration of lymphocytes, macrophages and neutrophils, oedema, fibrosis, and granuloma than the lungs of control rats. After 96 weeks, the quartz-treated rats had higher incidences of adenoma (85.7%) and adenocarcinoma (81.0%) than control rats (20% and 20%, respectively). Quartz-treated and control rats did not show lung neoplastic lesions at 52 weeks after treatment. The number of lung neoplastic lesions per rat positively correlated with the degree of macrophage and lymphocyte infiltration, oedema, fibrosis, and lymph follicle formation around the bronchioles. In conclusion, single i.t. of quartz may induce lung cancer in rat along with chronic inflammation.
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Affiliation(s)
- Yuko Nakano-Narusawa
- Oncology Pathology, Department of Pathology and Host-Defence, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan
| | - Masanao Yokohira
- Oncology Pathology, Department of Pathology and Host-Defence, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan
| | - Keiko Yamakawa
- Oncology Pathology, Department of Pathology and Host-Defence, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan
| | - Kousuke Saoo
- Oncology Pathology, Department of Pathology and Host-Defence, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan
- Kaisei General Hospital, Kagawa, 762-0007, Japan
| | - Katsumi Imaida
- Oncology Pathology, Department of Pathology and Host-Defence, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan.
| | - Yoko Matsuda
- Oncology Pathology, Department of Pathology and Host-Defence, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan.
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Almeida DIE, Costa E, Neves JS, Cerqueira M, Ribeiro AR. Cutaneous vasculitis and granulomatous hepatitis as paradoxical adverse events of Infliximab. Acta Reumatol Port 2020; 45:156-157. [PMID: 32895360] [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: 06/11/2023]
Abstract
Biological agents revolutionised the treatment of inflammatory arthropathies. Paradoxical adverse events (PAEs) are rare immunological side effects caused by such agents. The authors report concurrent presentation of two rare PAEs of tumor-necrosis-factor alpha inhibitors (iTNFa) - cutaneous vasculitis and granulomatous hepatitis - in a patient with psoriatic arthritis treated with infliximab and briefly discuss aspects of diagnosis, pathophysiology and management of such events in light of the available evidence.
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25
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Paulucci BP. PMMA Safety for Facial Filling: Review of Rates of Granuloma Occurrence and Treatment Methods. Aesthetic Plast Surg 2020; 44:148-159. [PMID: 31637504 DOI: 10.1007/s00266-019-01522-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 10/09/2019] [Indexed: 12/17/2022]
Abstract
PMMA is composed of microspheres suspended in bovine collagen. Once injected in a dermal area, the carrier is absorbed, giving place to collagen that gives volume and maintains the spheres in the place. This process may give origin to exacerbate foreign body reaction and granuloma. The frequency of such complication is not clear. The primary objective was to review and compare the frequencies of granuloma between the published studies. The secondary aim was to compare the therapies and efficacies. The series of cases in which PMMA was used as facial filler were reviewed, and the rate of granulomas was compared; the case report studies describing those complications were also reviewed, and the therapies and outcomes were quantified. The data showed general frequency of PMMA-related complications of 4.9% and granulomas 1.9%; the incidence of granuloma was 1/2075 patients-year, and the time to development ranged from 6 to 180 months. The most used therapies were steroid, surgery or both, with satisfactory results. In conclusion, considering the actual risks and benefits of PMMA, we may affirm that it is a safe filler; doctors and patients must be conscious of potential risks when deciding for its use. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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26
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Grose E, Ramien M. Interstitial granulomatous drug reaction related to hydrochlorothiazide. Dermatol Online J 2019; 25:13030/qt1gs433hj. [PMID: 31450282] [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] [Received: 08/02/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023] Open
Abstract
Interstitial granulomatous drug reaction is a rare condition presenting as erythematous-to-violaceous plaques on the lateral trunk, axillae, buttocks, and thighs. Calcium-channel blockers, angiotensin converting enzyme inhibitors, beta-blockers, and statins have been described as drugs that can trigger interstitial granulomatous drug reaction. We present a case of interstitial granulomatous drug reaction related to hydrochlorothiazide and our approach to management of this condition. The diagnosis was confirmed with a skin biopsy and a rechallenge of hydrochlorothiazide, which exacerbated the patient's symptoms. The patient improved significantly with rigorous photoprotection, combination dapsone-alitretinoin therapy, and discontinuation of hydrochlorothiazide.
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Affiliation(s)
- Elysia Grose
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario.
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Almogairen SM. Abatacept induced granulomatous hepatitis with a sarcoidosis- like reaction: a blinded trial in mice. BMC Pharmacol Toxicol 2019; 20:26. [PMID: 31064410 PMCID: PMC6503540 DOI: 10.1186/s40360-019-0303-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Received: 06/16/2018] [Accepted: 04/22/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Abatacept is increasingly used for rheumatoid arthritis (RA) and juvenile idiophathic arthritis (JIA) treatment. However little is known about the risk of hepatotoxicity. The aim of this study was to determine whether the inhibition of the T cell CD28 receptor by abatacept results in acute hepatitis in BALB/c mice. METHODS Twenty BALB/c mice were studied. Ten mice received subcutaneous (SC) injection of abatacept (0.25mg per 25g body weight per 0.03 ml normal saline) at 0, 2, 4 and 8 weeks. For the control group, 10 mice received a SC injection of normal saline (NS) (0.03 ml). At the 10th week post injection, the mice were sacrificed, and histopathological studies were conducted. RESULTS Of the abatacept-treated group, 3/10 mice died. Liver histology for the abatacept-treated group showed that 6/7 displayed histopathological changes in the lobular cellular infiltrates of eosinophils, lymphocytes and histiocytes, in addition to granuloma formation. In contrast, only minimal inflammation was observed in 3/10 mice in the control group (p=0.036). CONCLUSION Abatacept may play a role in inducing granulomatous hepatitis with a sarcoidosis-like reaction. Additional data including transaminases, antinuclear antibodies (ANA), Antimitochondrial antibodies (AMA) and other auto antibodies should be tested.
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Affiliation(s)
- Sultan M Almogairen
- Rheumatology Division, Department of Medicine, College of Medicine, King Saud University, P O Box 2925, Riyadh, 11461, Saudi Arabia.
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Kim LB, Shkurupy VA, Putyatina AN. Correlations between the Levels of the Main Extracellular Matrix Components in Mouse Liver in Chronic BCG-Induced Granulomatosis. Bull Exp Biol Med 2019; 166:469-472. [PMID: 30788744 DOI: 10.1007/s10517-019-04374-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 06/21/2018] [Indexed: 11/26/2022]
Abstract
Correlations between extracellular matrix components in mouse liver revealed the pathogenetically determined dynamic structure of these interrelations (some correlations appeared while others disappeared) at various terms of BCG-induced granulomatosis. The correlations between the studied parameters were strong during the first (postinfection days 3-10) and the second (postinfection days 60-90) periods but became moderate during the third period manifested by chronic inflammation (postinjection day 180). The greatest number of correlations was observed at the beginning of the stabilization period (postinjection day 60). At this period, the content of all structural components of hepatic proteoglycans closely correlated with that of hydroxyproline. These findings attested to systemic changes in metabolism of extracellular matrix components and interrelation between some structural units of proteoglycans in the liver and the components of extracellular matrix in the lungs. The common and typical organ-specific correlations in the liver and lungs suggest the existence of correlations between different organs during progression of BCG-induced granulomatosis.
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Affiliation(s)
- L B Kim
- Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia.
| | - V A Shkurupy
- Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
- Novosibirsk State Medical University, Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - A N Putyatina
- Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
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Peixoto A, Martins Rocha T, Santos-Antunes J, Aguiar F, Bernardes M, Vaz C, Pereira P, Macedo G. Etanercept-induced granulomatous hepatitis as a rare cause of abnormal liver tests. Acta Gastroenterol Belg 2019; 82:93-95. [PMID: 30888761] [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: 06/09/2023]
Abstract
The authors report the case of a 76 year-old man with rheumatoid arthritis treated with prednisolone and etanercept. The patient was seen for persistent changes in liver tests lasting for six months, with a mixed pattern. The patient denied intake of new drugs or dietary/herbal supplements. Imaging studies showed mild steatosis. Additional study for chronic liver diseases only revealed positivity for anti-nuclear antibodies. Liver biopsy revealed noncaseating granulomas in some portal tracts. Consequent etiologic study for granulomatous diseases showed negative or normal results. So it was decided to suspend etanercept, with a subsequent gradual improvement on analytical parameters that normalized three months later. To date, only one case of granulomatous liver disease associated with an anti-TNF agent was described in the literature. This case also raises the question whether the development of granulomatous processes associated with anti-TNF agents has been underdiagnosed due to the presence of other concomitant immunosuppressant therapies.
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Affiliation(s)
- A Peixoto
- Centro Hospitalar de São João, Gastroenterology Department, Porto WGO Training Center, Porto Medical School, University of Porto
| | - T Martins Rocha
- Centro Hospitalar de São João, Rheumatology Department, Porto Medical School, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-019, Porto, Portugal
| | - J Santos-Antunes
- Centro Hospitalar de São João, Gastroenterology Department, Porto WGO Training Center, Porto Medical School, University of Porto
| | - F Aguiar
- Centro Hospitalar de São João, Rheumatology Department, Porto Medical School, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-019, Porto, Portugal
| | - M Bernardes
- Centro Hospitalar de São João, Rheumatology Department, Porto Medical School, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-019, Porto, Portugal
| | - C Vaz
- Centro Hospitalar de São João, Rheumatology Department, Porto Medical School, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-019, Porto, Portugal
| | - P Pereira
- Centro Hospitalar de São João, Gastroenterology Department, Porto WGO Training Center, Porto Medical School, University of Porto
| | - G Macedo
- Centro Hospitalar de São João, Gastroenterology Department, Porto WGO Training Center, Porto Medical School, University of Porto
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Rzeczycki P, Yoon GS, Keswani RK, Sud S, Baik J, Murashov MD, Bergin IL, Stringer KA, Rosania GR. An Expandable Mechanopharmaceutical Device (2): Drug Induced Granulomas Maximize the Cargo Sequestering Capacity of Macrophages in the Liver. Pharm Res 2018; 36:3. [PMID: 30406478 DOI: 10.1007/s11095-018-2541-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/31/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Drug-induced liver injuries (DILI) comprise a significant proportion of adverse drug reactions leading to hospitalizations and death. One frequent DILI is granulomatous inflammation from exposure to harmful metabolites that activate inflammatory pathways of immune cells of the liver, which may act as a barrier to isolate the irritating stimulus and limit tissue damage. METHODS Paralleling the accumulation of CFZ precipitates in the liver, granulomatous inflammation was studied to gain insight into its effect on liver structure and function. A structural analog that does not precipitate within macrophages was also studied using micro-analytical approaches. Depleting macrophages was used to inhibit granuloma formation and assess its effect on drug bioaccumulation and toxicity. RESULTS Granuloma-associated macrophages showed a distinct phenotype, differentiating them from non-granuloma macrophages. Granulomas were induced by insoluble CFZ cargo, but not by the more soluble analog, pointing to precipitation being a factor driving granulomatous inflammation. Granuloma-associated macrophages showed increased activation of lysosomal master-regulator transcription factor EB (TFEB). Inhibiting granuloma formation increased hepatic necrosis and systemic toxicity in CFZ-treated animals. CONCLUSIONS Granuloma-associated macrophages are a specialized cell population equipped to actively sequester and stabilize cytotoxic chemotherapeutic agents. Thus, drug-induced granulomas may function as drug sequestering "organoids" -an induced, specialized sub-compartment- to limit tissue damage.
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Affiliation(s)
- Phillip Rzeczycki
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, 428 Church Street, Ann Arbor, Michigan, 48109, USA
| | - Gi Sang Yoon
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, 428 Church Street, Ann Arbor, Michigan, 48109, USA
| | - Rahul K Keswani
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, 428 Church Street, Ann Arbor, Michigan, 48109, USA
| | - Sudha Sud
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, 428 Church Street, Ann Arbor, Michigan, 48109, USA
| | - Jason Baik
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, 428 Church Street, Ann Arbor, Michigan, 48109, USA
| | - Mikhail D Murashov
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, 428 Church Street, Ann Arbor, Michigan, 48109, USA
| | - Ingrid L Bergin
- Unit for Laboratory Animal Medicine, Medical School Office of Research, University of Michigan, 2800 Plymouth Road, Ann Arbor, Michigan, 48109, USA
| | - Kathleen A Stringer
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, 428 Church Street, Ann Arbor, Michigan, 48104, USA
| | - Gus R Rosania
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, 428 Church Street, Ann Arbor, Michigan, 48109, USA.
- University of Michigan College of Pharmacy, Ann Arbor, Michigan, 48109, USA.
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Abstract
BACKGROUND We observed in cystoprostatectomy specimens that Bacillus Calmette-Guérin (BCG) granulomatous prostatitis tended preferentially to affect the peripheral zone (PZ) and aimed to study the matter, postulating that assessment of its distribution might contribute to understanding pathogenetic processes. METHODS Entire prostate glands from 27 men (47-83 years; mean = 69 years), who had previously received intravesical BCG therapy for non-muscle-invasive urothelial carcinoma of the bladder, were studied as whole-mount sections to determine the anatomical distribution and histopathological characteristics of BCG prostatitis. RESULTS Twenty-two (81.5%) showed BCG-type granulomatous inflammation. It often radiated from close to the prostatic urethra toward to the gland periphery as a wedge-shaped area related to one or more duct systems. Twenty-one of these prostate glands (95.5%) showed predominantly or exclusively PZ involvement. Eighteen (81.8%) involved only the PZ, while three cases (13.6%) also showed involvement of the transitional zone (TZ). One case (4.5%) involved only the TZ. No granulomas were seen in the central zone or anterior fibromuscular septum. CONCLUSIONS Our observations imply the microanatomical arrangement of prostatic ducts is a factor in the pathogenesis of BCG prostatitis. PZ ducts enter the urethra at less obtuse angles than those from other zones and are likely to be more prone to urine reflux and damage from suspended BCG. We speculate that prostatic duct microanatomy could also play a role in the pathogenesis of other prostatic diseases, including conventional prostatitis and adenocarcinoma.
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Affiliation(s)
- Ryan Butel
- Department of Histopathology, Norfolk and Waveney Cellular Pathology Service, The Cotman Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK
| | - Richard Ball
- Department of Histopathology, Norfolk and Waveney Cellular Pathology Service, The Cotman Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK
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Min MS, Yao J, Chee N, Sapadin AN, Shim-Chang H. Xanthogranulomatous reaction to trametinib for metastatic malignant melanoma. Cutis 2018; 102:283-286. [PMID: 30489553] [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: 06/09/2023]
Abstract
Trametinib, a mitogen-activated extracellular signal-regulated kinase (MEK) inhibitor, has demonstrated great promise in treating metastatic melanoma associated with BRAF V600E and V600K mutations; however, it also is highly associated with cutaneous adverse events (AEs). As both BRAF and MEK inhibitors become increasingly used to treat malignant melanoma, it is important to better characterize these AEs so that we can manage them. Herein, we present a case of a 66-year-old man who developed erythematous scaly papules on the face and bilateral upper extremities after beginning therapy with trametinib. The severity of the reaction worsened on trametinib monotherapy compared to combination therapy with a BRAF inhibitor. Biopsy revealed a xanthogranulomatous reaction.
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Affiliation(s)
- Michelle S Min
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Nicole Chee
- New York University, New York, New York, USA
| | - Allen N Sapadin
- Department of Dermatology, Hackensack University Medical Center, New Jersey, USA
| | - Helen Shim-Chang
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Marsidi N, Beijnen JH, van Zuuren EJ. Palladium-induced granulomas analysed with inductively coupled plasma mass spectrometry. Contact Dermatitis 2018; 79:41-42. [PMID: 29492982 PMCID: PMC6001695 DOI: 10.1111/cod.12979] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 01/18/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Nick Marsidi
- Department of DermatologyLeiden University Medical CentreLeidenThe Netherlands
| | - Jos H. Beijnen
- Department of Clinical PharmacologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
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Woodbeck R, Metelitsa AI, Naert KA. Granulomatous Tumoral Melanosis Associated With Pembrolizumab Therapy: A Mimicker of Disease Progression in Metastatic Melanoma. Am J Dermatopathol 2018; 40:523-526. [PMID: 29924748 DOI: 10.1097/dad.0000000000001066] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 12/15/2022]
Abstract
Immune checkpoint inhibitor therapy has revolutionized the treatment of advanced melanoma, with these agents significantly improving survival for patients with metastatic disease. With the increasing use of these agents, the number of adverse reactions secondary to their use has also increased. Sarcoidosis and sarcoid-like reactions are one such immune checkpoint inhibitor-related adverse event. We report a case of sarcoid-like granulomatous tumoral melanosis in a patient on the programmed cell death-1 (PD-1) receptor inhibitor pembrolizumab for metastatic melanoma. This is, to our knowledge, the first reported case of a sarcoidal form of tumoral melanosis in a patient on anti-PD-1 therapy. We postulate that this reflects tumor regression in response to pembrolizumab-induced immune activation, with concomitant therapy-triggered induction of a sarcoid-like reaction. These findings and the literature review presented herein should alert clinicians and pathologists to the possibility of regressed lesions with sarcoid-like features presenting as mimickers of disease progression in patients undergoing immunotherapy for advanced melanoma.
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Affiliation(s)
- Randi Woodbeck
- Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada
| | - Andrei I Metelitsa
- Institute for Skin Advancement, Calgary, Alberta, Canada
- Division of Dermatology, University of Calgary, Calgary, Alberta, Canada
| | - Karen A Naert
- Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada
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Stueckle TA, Davidson DC, Derk R, Kornberg TG, Battelli L, Friend S, Orandle M, Wagner A, Dinu CZ, Sierros KA, Agarwal S, Gupta RK, Rojanasakul Y, Porter DW, Rojanasakul L. Short-Term Pulmonary Toxicity Assessment of Pre- and Post-incinerated Organomodified Nanoclay in Mice. ACS Nano 2018; 12:2292-2310. [PMID: 29451776 PMCID: PMC6357971 DOI: 10.1021/acsnano.7b07281] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Organomodified nanoclays (ONCs) are increasingly used as filler materials to improve nanocomposite strength, wettability, flammability, and durability. However, pulmonary risks associated with exposure along their chemical lifecycle are unknown. This study's objective was to compare pre- and post-incinerated forms of uncoated and organomodified nanoclays for potential pulmonary inflammation, toxicity, and systemic blood response. Mice were exposed via aspiration to low (30 μg) and high (300 μg) doses of preincinerated uncoated montmorillonite nanoclay (CloisNa), ONC (Clois30B), their respective incinerated forms (I-CloisNa and I-Clois30B), and crystalline silica (CS). Lung and blood tissues were collected at days 1, 7, and 28 to compare toxicity and inflammation indices. Well-dispersed CloisNa caused a robust inflammatory response characterized by neutrophils, macrophages, and particle-laden granulomas. Alternatively, Clois30B, I-Clois30B, and CS high-dose exposures elicited a low grade, persistent inflammatory response. High-dose Clois30B exposure exhibited moderate increases in lung damage markers and a delayed macrophage recruitment cytokine signature peaking at day 7 followed by a fibrotic tissue signature at day 28, similar to CloisNa. I-CloisNa exhibited acute, transient inflammation with quick recovery. Conversely, high-dose I-Clois30B caused a weak initial inflammatory signal but showed comparable pro-inflammatory signaling to CS at day 28. The data demonstrate that ONC pulmonary toxicity and inflammatory potential relies on coating presence and incineration status in that coated and incinerated nanoclay exhibited less inflammation and granuloma formation than pristine montmorillonite. High doses of both pre- and post-incinerated ONC, with different surface morphologies, may harbor potential pulmonary health hazards over long-term occupational exposures.
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Affiliation(s)
- Todd A. Stueckle
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Donna C. Davidson
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Ray Derk
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Tiffany G. Kornberg
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
- Department of Basic Pharmaceutical Sciences, West Virginia University, Morgantown, West Virginia 26506, United States
| | - Lori Battelli
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Sherri Friend
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Marlene Orandle
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Alixandra Wagner
- Department of Chemical and Biomedical Engineering, West Virginia University, Morgantown, West Virginia 26506, United States
| | - Cerasela Zoica Dinu
- Department of Chemical and Biomedical Engineering, West Virginia University, Morgantown, West Virginia 26506, United States
| | - Konstantinos A. Sierros
- Department of Mechanical and Aerospace Engineering, West Virginia University, Morgantown, West Virginia 26506, United States
| | - Sushant Agarwal
- Department of Chemical and Biomedical Engineering, West Virginia University, Morgantown, West Virginia 26506, United States
| | - Rakesh K. Gupta
- Department of Chemical and Biomedical Engineering, West Virginia University, Morgantown, West Virginia 26506, United States
| | - Yon Rojanasakul
- Department of Basic Pharmaceutical Sciences, West Virginia University, Morgantown, West Virginia 26506, United States
| | - Dale W. Porter
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Liying Rojanasakul
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
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Benavente-Villegas F, Díaz-Corpas T, García-Briz M, Moneva-Léniz L, Sánchez-Motilla J, Prats-Máñez A, Fuertes-Prosper A, Soriano-Sarrió P. [Not Available]. Dermatol Online J 2018; 24:13030/qt89q966n7. [PMID: 29469769] [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] [Received: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 06/08/2023] Open
Abstract
La práctica de tatuajes tienen más de 8000 años de antigüedad, existiendo un incremento continuo en la sociedad occidental en las últimos 3 décadas La introducción de una sustancia exógena en la pielpuede provocar una respuesta inmunológica en su contra, estando descritas reacciones cutáneas por hipersensibilidad a una variedad de pigmentos, las que se limitan al área de un determinado color,atribuyéndose a los materiales inyectados. El color más reportado en la literatura es el rojo, que tradicionalmente se confeccionaban a base dederivados del mercurio (cinabrio). Diversos patrones histológicos de reacción están descritos, siendo el más frecuente el liquenoide. Presentamos una serie de 10 pacientes con reacción de hipersensibilidad a tatuaje rojo, con patrón histológico predominante dereacción granulomatosa y con moderada respuesta a tratamiento. Es importante cuando se está ante un patrón granulomatoso de reacción descartar sarcoidosis sistémica e infecciones por micobacterias.
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Safwan Ali Khan M, Khatoon N, Al-Sanea MM, Gamal Mahmoud M, Rahman HU. Methanolic Extract of Leathery Murdah, Terminalia coriacea (Roxb.) Wight and Arn. Leaves Exhibits Anti-Inflammatory Activity in Acute and Chronic Models. Med Princ Pract 2018. [PMID: 29514164 PMCID: PMC6062723 DOI: 10.1159/000488199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate anti-inflammatory activity of methanolic extract of Terminalia coriacea. MATERIALS AND METHODS A methanolic extract of T. coriacea leaves was studied in albino Wistar rats with carrageenan-induced paw edema, an acute model, and cotton pellet-induced granuloma, a chronic model, at 3 oral test doses (125, 250, and 500 mg/kg). Aspirin 100 mg/kg was used as a positive control. Paw volume and wet and dry weights of cotton pellets were determined. The data were analyzed by one-way ANOVA followed by Dunnett's multiple comparison test. RESULTS The test extract at doses of 125 and 250 mg/kg decreased paw volume and wet and dry weights of cotton pellets. The highest test dose (500 mg/kg) displayed a response comparable to that of the standard drug (p < 0.01) on paw volume. The extract produced similar (p < 0.05) decrease in wet weight of the cotton pellet at 125 and 250 mg/kg, whereas the effect of 500 mg/kg of the extract was comparable to that of aspirin 100 mg/kg (p < 0.01). The extract of T. coriacea at 500 mg/kg induced the most significant (p < 0.01) effect on wet weight of granulomatous tissue. CONCLUSION The methanolic extract of T. coriacea leaves successfully decreased paw edema as well as dry and wet weights of granulomatous tissue in both acute and chronic inflammatory models thus confirming the anti- edematogenic, antitransudative, and antiproliferative properties of T. coriacea.
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Affiliation(s)
- Mohammed Safwan Ali Khan
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Pharmacology, Anwarul Uloom College of Pharmacy affiliated to Jawaharlal Nehru Technological University, Hyderabad, India
- *Mohammed Safwan Ali Khan, Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka 2014, Al Jouf Province (Saudi Arabia), E-Mail or
| | - Nishath Khatoon
- Department of Pharmacology, Anwarul Uloom College of Pharmacy affiliated to Jawaharlal Nehru Technological University, Hyderabad, India
| | - Mohammad M. Al-Sanea
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Mohamed Gamal Mahmoud
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Hidayat Ur Rahman
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
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Everett AS, Pavlidakey PG, Contreras CM, De Los Santos JF, Kim JY, McKee SB, Kaufman HL, Conry RM. Chronic granulomatous dermatitis induced by talimogene laherparepvec therapy of melanoma metastases. J Cutan Pathol 2018; 45:48-53. [PMID: 28940544 DOI: 10.1111/cup.13048] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 05/05/2017] [Revised: 09/08/2017] [Accepted: 09/15/2017] [Indexed: 01/03/2023]
Abstract
Talimogene laherparepvec (TVEC) is the first oncolytic viral immunotherapy approved by the FDA, for advanced melanoma consisting of genetically modified herpes simplex type 1 virus which selectively replicates causing tumor lysis, expressing granulocyte macrophage-colony stimulating factor (GM-CSF) and activating dendritic cells. Intratumoral injection of TVEC produces objective response in 41% of stage IIB-IV M1a melanoma. However, clinical response assessment can be problematic due to immune-related inflammation at established tumor sites. Herein, we report 5 cases of granulomatous dermatitis developing at sites of TVEC injection associated with pathologic complete response in 4 of 5 patients. Over 5 months, TVEC injections were administrated in a median of 20 tumors per patient for 9 median doses prior to biopsy of persistent, indurated nodules. Granulomatous dermatitis with melanophages and melanin pigment incontinence was observed in all samples without evidence of melanoma cells in 4 patients. The fifth patient was rendered melanoma-free by resection of the 1 nodule out of 4 with persistent tumor. Repetitive administration of TVEC or other oncolytic viral immunotherapies mimicking unresolved infection can produce granulomatous inflammation confounding assessment of the degree of tumor response and need for additional TVEC therapy. Tumor biopsies are encouraged after 4 to 6 months of TVEC administration to differentiate melanoma from granulomatous inflammation. Patients with confirmed granulomatous dermatitis replace continued with remained in remission after treatment discontinuation. Inflammatory nodules typically regress spontaneously.
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Affiliation(s)
- Ashlyn S Everett
- Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Peter G Pavlidakey
- Dermatopathology Services, Division of Dermatology and Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Carlo M Contreras
- Department of Surgery - General Surgery Oncology, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Ju Y Kim
- Navigate BioPharma Services, Inc., A Novartis Subsidiary, Carlsbad, California
| | - Svetlana B McKee
- Division of Hematology Oncology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Howard L Kaufman
- Department of Surgery and Medicine, Rutgers University, New Brunswick, New Jersey
| | - Robert M Conry
- Division of Hematology Oncology, University of Alabama at Birmingham, Birmingham, Alabama
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O'Daniel G. Management of Late-Onset, Recurrent Facial Nodular Reaction After Poly-L-Lactic (PLLA) Injections. J Drugs Dermatol 2017; 16:1297-1299. [PMID: 29240867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Despite a well-established safety profile for poly-L-lactic acid (PLLA), known complications of nodules, papules and granulomas can occur. The author presents a case of late-onset facial nodules after treatment with PLLA dermal filler for facial volumization. The late-onset nodules appeared 16 months post-initial injection and were initially treated with intralesional steroids followed by 5-fluorouracil, and oral corticosteroids. It took over a year of treatment with oral corticosteroids and periodic intralesional steroid injections for the nodules to resolve. The author describes in detail the course of the nodules as well as the clinical management.
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Abstract
Acute interstitial nephritis is commonly seen in kidney biopsies of patients with acute renal failure; however, granulomatous interstitial nephritis (GIN) is rare. We identified 46 cases of GIN in a 17-year period in this institution and we investigated their most probable etiologies. Complete clinical information was available in 38 patients. Seventeen of 38 patients (44.7%) were classified as drug-induced. Renal sarcoidosis was responsible for 28.9% of cases, and the remaining 15.9% of cases included Wegeners granulomatosis, foreign body giant cell reaction, GIN secondary to intravesical bacillus Calmette-Guerin therapy for bladder cancer, and xanthogranulomatous pyelonephritis. Clinical investigation failed to reveal possible etiology in 4 patients (10.5%), classified as idiopathic. We concluded that three quarters of our cases were either drug-induced or due to sarcoidosis; only a small proportion of our cases occurred secondary to any other cause or to unknown factors.
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Affiliation(s)
- Vanesa Bijol
- Department of Pathology, Brigham and Womens Hospital--Harvard Medical School, Boston, MA, USA
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41
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Tani Y, Foster PM, Sills RC, Chan PC, Peddada SD, Nyska A. Epididymal Sperm Granuloma Induced by Chronic Administration of 2-Methylimidazole in B6C3F1 Mice. Toxicol Pathol 2016; 33:313-9. [PMID: 15814360 DOI: 10.1080/01926230590922866] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 10/25/2022]
Abstract
Two-year mouse and rat bioassay studies of 2-methylimidazole (2-MI) conducted by the National Toxicology Program revealed that epididymal sperm granuloma(SG)s occurred only in male B6C3F1 mice in a dose-related manner. The present study characterized 2-MI-induced SGs in these epididymides. Groups of 50 male B6C3F1 mice were fed diets containing 0, 625, 1250, or 2500 ppm 2-MI for 105 weeks; the doses were equivalent to average daily doses of approximately 13, 40, or 130 mg/kg. Testes and epididymides were histopathologically reexamined. 2-Methylimidazole increased the incidence of epididymal SGs (0%, 0%, 6%, 12%, respectively). Histologically, most of the SGs exhibited rupture of epididymal ducts with focal aggregations of macrophages in interstitia. Lesions occurred in the proximal caput of the epididymis and/or efferent ducts, not in the corpus and cauda. In the testis, incidences of germinal epithelial atrophy (GEA) increased dose-relatedly (2%, 8%, 16%, 28%, respectively). All mice with epididymal SG developed testicular GEA. The grading scores of testicular GEA tended to be more severe in mice with SGs than those without. No epididymal SG or testicular GEA was observed in 6-month-interim-sacrificed mice. The results imply that 2-year treatment of B6C3F1 mice with 2-MI can induce epididymal SGs, primarily followed by more severe testicular GEA. The potential mechanism of SG induction by 2-MI is discussed.
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Affiliation(s)
- Yoshiro Tani
- Laboratory of Experimental Pathology, National Institute of Environmental Sciences, NIH, Research Triangle Park, NC 27709, USA
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Mirijello A, Pacilli M, Pennacchia I, Manfrini A, Pacilli G. Giant "turtle-egg tumors": a forgotten complication of quinine injections. Intern Emerg Med 2016; 11:269-71. [PMID: 26099280 DOI: 10.1007/s11739-015-1275-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 06/15/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Antonio Mirijello
- Department of Emergency Medicine, IRCCS Casa Sollievo della Sofferenza, v. le Cappuccini 1, 71013, San Giovanni Rotondo, FG, Italy.
| | - Mario Pacilli
- Department of Surgery, University of Foggia School of Medicine, Foggia, Italy
| | - Ilaria Pennacchia
- Institute of Pathology, Catholic University of Sacred Heart, Rome, Italy
| | - Antonio Manfrini
- Department of Emergency Medicine, IRCCS Casa Sollievo della Sofferenza, v. le Cappuccini 1, 71013, San Giovanni Rotondo, FG, Italy
| | - Giuseppe Pacilli
- Department of Emergency Medicine, IRCCS Casa Sollievo della Sofferenza, v. le Cappuccini 1, 71013, San Giovanni Rotondo, FG, Italy
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Petrovici A, Kaiser MJ, Louis R, Nguyen Dang D. [Sarcoid-like granulomatosis in patients treated with anti-TNFα]. Rev Med Liege 2016; 71:124-128. [PMID: 27311243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Over recent years, anti-TNFα have been used to treat rheumatoid arthritis. The principal secondary effect of anti-TNFα is tuberculosis infections. Another paradoxical effect, previously less well understood, is the development of sarcoid-like granulomatous reactions. We report the case of a 36 year old woman who had been treated for 9 years with anti-TNF alpha. She developed a pulmonary sarcoid-like gra-nulomatosis, complication that is rare but not exceptional in patients treated with TNF-blockers. Discontinuation of anti TNF usually led to recovery. It has been suggested that these reactions mainly occur with etanercept, but this requires further confirmation.
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Abstract
Since most liposuction incisions heal uneventfully, difficult healing in such incisions must be investigated. In the cases of two gynecomastia liposuction patients in which a water-based lubricating gel was used on the liposuction incisions, the incisions failed to heal. For both patients, workup uncovered palisading granulomas at the lateral inframammary fold incision sites several months after otherwise successful surgeries. These two cases are presented and the previous literature is reviewed, with consideration given to the etiology and prevention of such granulomas. LEVEL OF EVIDENCE 5: Risk.
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Affiliation(s)
- Frederick G Weniger
- Dr Weniger is a plastic surgeon in private practice in Bluffton, SC. Dr White is a dermatopathologist in private practice in Ridgeland, SC. Mr Barrero Castedo is an undergraduate student at Duke University, Durham, NC
| | - Peter F White
- Dr Weniger is a plastic surgeon in private practice in Bluffton, SC. Dr White is a dermatopathologist in private practice in Ridgeland, SC. Mr Barrero Castedo is an undergraduate student at Duke University, Durham, NC
| | - Carlos E Barrero Castedo
- Dr Weniger is a plastic surgeon in private practice in Bluffton, SC. Dr White is a dermatopathologist in private practice in Ridgeland, SC. Mr Barrero Castedo is an undergraduate student at Duke University, Durham, NC
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Abstract
Currently, tumor necrosis factor alpha (TNF-alpha) inhibitors are widely used for many autoimmune disorders. However, they cause an immunocompromised status that sometimes leads to many cutaneous side effects including atypical infections. Herein, we report the first case of adalimumab-related Majocchi's granuloma.A 43-year-old Taiwanese male patient with chronic plaque-type psoriasis developed numerous tender nodules 1 month after adalimumab injection. The nodules responded poorly to bacterial folliculitis treatment. After repeated skin biopsies for pathology and tissue fungal culture, Majocchi's granuloma was confirmed. Adalimumab was withheld, and 12 weeks of terbinafine treatment was given. On completion of treatment, the nodular skin lesions and dystrophic nail lesions improved dramatically.The information, including time span, clinical features, histological findings, and improvement following withdrawal of adalimumab and treatment with an oral antifungal agent, indicates that Majocchi's granuloma was adalimumab-related. Psoriasis patients are more susceptible to dermatophyte infection due to local and systemic immunosuppressant therapy. It is important to perform a thorough examination for latent dermatophyte infection, including skin and nail lesions, before treatment with TNF-alpha inhibitors and during traditional psoriasis treatment. When atypical presentation together with treatment failure is noted in psoriasis patients prescribed biologics, clinicians should investigate evidence of dermatophyte infection and provide proper treatment. Sometimes, multiple skin biopsies and tissue fungal cultures are required to establish a correct diagnosis.
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Affiliation(s)
- Wan-Yi Chou
- From the Department of Dermatology, China Medical University Hospital (W-YC, C-JH); and China Medical University, Taichung, Taiwan (W-YC, C-JH)
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Mohammadi F, Sadeghi L, Mohammadi A, Tanwir F, Yousefi Babadi V, Izadnejad M. The effects of Nano titanium dioxide (TiO2NPs) on lung tissue. ACTA ACUST UNITED AC 2015; 116:363-7. [PMID: 26084738 DOI: 10.4149/bll_2015_069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The application of nanoparticles is widely spread in all aspects of modern life because of their unique features such as small size and high surface area. High surface area can be very reactive and produce reactive oxygen species (ROS). These nanoparticles can damage human and animal cells by increasing oxidative stress mechanism. Titanium dioxide nanoparticles (TiO2NPs) are among the top five nanoparticles used in consumer products, paints, and pharmaceutical preparations.TiO2 NPs have various capabilities such as robust oxidation, biocompatibility and photocatalytic properties. They are frequently used in a wide range of sciences, including pharmaceuticals, cosmetics, medicine and engineering. The ever increasing industrial and consumer applications of TiO2NPs raise concern over the possible risk association with their environmental exposure. METHODS This study investigates the effects of TiO2NP on lung tissue by intraperitoneal injection to rats at different doses (15, 30, 60 and 70 mg/kg). RESULTS Our results showed that intraperitoneal injection of TiO2NP creates capillary congestion and hemorrhage in alveolar wall, granulomas in lung parenchyma, and hemosiderin depositions in blood vessels adjacent to bronchioles without any inflammation. The pulmonary side effects could be due to the production of ROS post TiO2NP exposure (Tab. 1, Fig. 5, Ref. 27). Text in PDF www.elis.sk.
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Andersen RMØ, Zachariae C, Johansen JD. [Aluminium allergy and granulomas induced by vaccinations for children]. Ugeskr Laeger 2015; 177:868-871. [PMID: 26539576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Vaccination with aluminium-adsorbed vaccines can induce aluminium allergy with persistent itching subcutaneous nodules at the injection site – vaccination granulomas. In this article we give an overview of childhood aluminium-adsorbed vaccines available in Denmark. Through literature studies we examine the incidence, the symptoms and the prognosis for the vaccination granulomas and the allergy. Finally we discuss the status in Denmark.
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Fukui S, Nakai Y, Matsumoto Y, Kagebayashi Y, Samma S. [Investigation of incidence and risk factors of subcutaneous granulomas induced by injection of leuprorelin acetate]. Hinyokika Kiyo 2015; 61:55-59. [PMID: 25812594] [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: 06/04/2023]
Abstract
We investigated the incidence of granuloma and its related factors in 180 patients with prostate cancer who showed subcutaneous granuloma formation during androgen deprivation therapy with subcutaneously administered leuprorelin acetate. A granuloma was defined as a persistent induration over 30 mm in diameter in the injected portion. Small indurations which often developed and disappeared after every injection were excluded. The survey was performed using a questionnaire after receiving written informed consent. Among the 180 patients with prostate cancer, 21 (11.7%) developed a granuloma at the injection portion, and subsequently the injection of leuprorelin acetate had to be discontinued. Eighteen of the 21 patients alternatively received goserelin acetate. Three patients had high-grade granulomas with ulcer and abscess formation, and were successfully treated with oral antibiotics. The average duration between the first injection of leuprorelin acetate and granuloma formation was 20.2 months (range : 4 to 62 months). There was no association between granuloma formation and patient backgrounds, such as allergic predisposition and past history. Twenty-one of the 180 prostatic cancer patients developed subcutaneous granuloma induced by the injection of leuprorelin acetate. The investigation showed an unexpectedly high incidence of granuloma formation. We must explain the risk of developing subcutaneous granuloma to the patients before introducing leuprorelin acetate.
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Affiliation(s)
- Shinji Fukui
- The Department of Urology, Nara Prefecture General Medical Center
| | - Yasushi Nakai
- The Department of Urology, Nara Prefecture General Medical Center
| | | | | | - Shoji Samma
- The Department of Urology, Nara Prefecture General Medical Center
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van der Bent SAS, Vellinga D. A woman with asymmetrical facial swelling. Neth J Med 2014; 72:284-288. [PMID: 24930465] [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: 06/03/2023]
Affiliation(s)
- S A S van der Bent
- Department of Dermatology, Rijnland Hospital, Leiderdorp, the Netherlands
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Waring TP, Hegde P, Foley RJ. Airbag lung: an unusual case of sarcoid-like granulomatous lung disease after a rollover motor vehicle accident. Conn Med 2014; 78:273-276. [PMID: 24974560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Sarcoid-like granulomatous lung disease (SLGLD) is a condition associated with the formation of noncaseating, nonnecrotizing granulomas. The final by-product of airbag deployment is alkaline silicates or glass. Silicates trapped and sequestered in the lung parenchyma are a potential mediator for immune system activation and development of sarcoid-like granulomatous lung disease.
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