1
|
Chang ML, Cheng JS, Le PH, Chen WT, Ku HP, Chien RN. Evolutionary relationship between antimitochondrial antibody positivity and primary biliary cholangitis in Taiwan: a 16-year hospital cohort study. Therap Adv Gastroenterol 2024; 17:17562848241241227. [PMID: 38560427 PMCID: PMC10981211 DOI: 10.1177/17562848241241227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
Background How antimitochondrial antibody (AMA)-positive patients evolve to have primary biliary cholangitis (PBC) in viral hepatitis-endemic areas is unknown. Objectives We aimed to investigate this evolution in Taiwan. Design/methods A 16-year medical center-based cohort study of 2,095,628 subjects was conducted in Taiwan, an Asian country endemic to viral hepatitis. AMA-positive subjects were those with positive AMA with alkaline phosphatase (ALP) ⩽1.5 times the upper limit of normal (ULN), and PBC was defined as positive AMA with ALP >1.5 × ULN. Results AMA-positive subjects had a lower average age- and sex-adjusted prevalence than PBC patients (4.68/105 versus 11.61/105, p = 0.0002), but their incidence was comparable (0.99/105 versus 1.12/105, p = 0.36). The former group had a borderline significantly lower mean age (56.59 years versus 58.10 years, p = 0.06) and a lower female-to-male ratio (2.85:1 versus 5.44:1, p < 0.0001). Both AMA-positive subjects (prevalence change: 20.0%, p < 0.01; incidence change: -9.2%, p < 0.01) and PBC patients (prevalence change: 14.6%, p < 0.01; incidence change: -4.7%, p < 0.01) prevalence rate increased but the incidence rate decreased. Among the 423 AMA-positive subjects, 77 (18.2%) developed PBC, for a mean duration of 1.757 years. Compared with AMA-positive subjects, PBC patients had similar concurrent chronic hepatitis B (CHB) rates (2.7% versus 4.3%, p = 0.197) but lower chronic hepatitis C (CHC) rates (3.69% versus 15.60%, p < 0.01). Conclusion PBC was more prevalent than AMA-positive subjects, and PBC patients had a higher female-to-male ratio than AMA-positive subjects, of whom 18.2% developed PBC (mean lag: 1.757 years). Upward trends in prevalence rates and downward trends in incidence rates were noted for both AMA-positive subjects and PBC. CHB was rare, CHC was more prevalent among PBC patients than the general population, and CHC was less prevalent among PBC than among AMA-positive subjects.
Collapse
Affiliation(s)
- Ming-Ling Chang
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, No. 5, Fu Hsing Street, Kuei Shan, Taoyuan 333423, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jur-Shan Cheng
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Puo-Hsien Le
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Ting Chen
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsin-Ping Ku
- Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Rong-Nan Chien
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
2
|
A Case of Acquired Hemophilia A in a Patient with Exposure to COVID-19. Case Rep Hematol 2022; 2022:9494249. [PMID: 35360457 PMCID: PMC8964211 DOI: 10.1155/2022/9494249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/10/2022] [Indexed: 12/24/2022] Open
Abstract
Acquired Hemophilia A (AHA) is a very rare autoimmune condition involving immune-mediated depletion of Factor VIII, resulting in spontaneous hemorrhage. Failure to recognize AHA as a possible etiology of hemorrhage can result in delayed diagnosis and treatment. The COVID-19 pandemic has given rise to several hematologic conditions and complications, with a rare manifestation being Acquired Hemophilia A (AHA). An interesting case of AHA following SARS-CoV-2 infection is described, along with the treatment approach and a brief review of several cases describing AHA in association with COVID-19.
Collapse
|
3
|
|
4
|
Di Marco M, Ramassone A, Pagotto S, Anastasiadou E, Veronese A, Visone R. MicroRNAs in Autoimmunity and Hematological Malignancies. Int J Mol Sci 2018; 19:ijms19103139. [PMID: 30322050 PMCID: PMC6213554 DOI: 10.3390/ijms19103139] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 10/02/2018] [Indexed: 12/13/2022] Open
Abstract
Autoimmunity and hematological malignancies are often concomitant in patients. A causal bidirectional relationship exists between them. Loss of immunological tolerance with inappropriate activation of the immune system, likely due to environmental and genetic factors, can represent a breeding ground for the appearance of cancer cells and, on the other hand, blood cancers are characterized by imbalanced immune cell subsets that could support the development of the autoimmune clone. Considerable effort has been made for understanding the proteins that have a relevant role in both processes; however, literature advances demonstrate that microRNAs (miRNAs) surface as the epigenetic regulators of those proteins and control networks linked to both autoimmunity and hematological malignancies. Here we review the most up-to-date findings regarding the miRNA-based molecular mechanisms that underpin autoimmunity and hematological malignancies.
Collapse
Affiliation(s)
- Mirco Di Marco
- Ageing Research Center and Translational medicine-CeSI-MeT, 66100 Chieti, Italy.
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| | - Alice Ramassone
- Ageing Research Center and Translational medicine-CeSI-MeT, 66100 Chieti, Italy.
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| | - Sara Pagotto
- Ageing Research Center and Translational medicine-CeSI-MeT, 66100 Chieti, Italy.
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| | - Eleni Anastasiadou
- Harvard Medical School Initiative for RNA Medicine, Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
| | - Angelo Veronese
- Ageing Research Center and Translational medicine-CeSI-MeT, 66100 Chieti, Italy.
- Department of Medicine and Aging Science (DMSI), "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| | - Rosa Visone
- Ageing Research Center and Translational medicine-CeSI-MeT, 66100 Chieti, Italy.
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| |
Collapse
|
5
|
Kondo Y, Ninomiya M, Kimura O, Machida K, Funayama R, Nagashima T, Kobayashi K, Kakazu E, Kato T, Nakayama K, Lai MMC, Shimosegawa T. HCV infection enhances Th17 commitment, which could affect the pathogenesis of autoimmune diseases. PLoS One 2014; 9:e98521. [PMID: 24905921 PMCID: PMC4048196 DOI: 10.1371/journal.pone.0098521] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 05/02/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Various kinds of autoimmune diseases have been reported to have a significant relationship with persistent hepatitis c virus (HCV) infection and Th17 cells. Previously, our group reported that the existence of HCV in T lymphocytes could affect the development of CD4+ helper T cells and their proliferation, in addition to the induction of immunoglobulin hyper-mutation. METHODS Therefore, we analyzed the relationship between persistent infection of HCV and the mechanism of Th17 cell induction ex vivo and in vitro. RESULTS The prevalence of autoimmune-related diseases in chronic hepatitis c patients (CH-C) was significantly higher than in other types of chronic hepatitis (hepatitis B and NASH). A significantly higher frequency of IL6 and TGF-β double-high patients was detected in CH-C than in other liver diseases. Moreover, these double-high patients had significantly higher positivity of anti-nuclear antibody, cryoglobulinemia, and lymphotropic HCV and higher amounts of IL1-β, IL21, IL23. In addition to the previously reported lymphotropic SB-HCV strain, we found a novel, genotype 1b lymphotropic HCV (Ly-HCV), by deep sequencing analysis. Lymphotropic-HCV replication could be detected in the lymphoid cells with various kinds of cytokine-conditions including IL1β, IL23, IL6 and TGF-β in vitro. Infection by HCV could significantly enhance the development of Th17 cells. The HCV protein responsible for inducing the Th17 cells was HCV-Core protein, which could enhance the STAT-3 signaling and up-regulate the expression of RORγt as a Th17 master gene. CONCLUSION Infection by lymphotropic HCV might enhance the Th17 development and contribute to understanding the pathogenesis of autoimmune-related diseases.
Collapse
Affiliation(s)
- Yasuteru Kondo
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
- * E-mail:
| | - Masashi Ninomiya
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
| | - Osamu Kimura
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
| | - Keigo Machida
- Department of Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Ryo Funayama
- Division of Cell Proliferation, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
| | - Takeshi Nagashima
- Division of Cell Proliferation, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
| | - Koju Kobayashi
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
| | - Eiji Kakazu
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
| | - Takanobu Kato
- Department of Virology II, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Keiko Nakayama
- Division of Cell Proliferation, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
| | - Michael M. C. Lai
- Department of Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- China Medical University, Taichung, Taiwan
| | - Tooru Shimosegawa
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
| |
Collapse
|
6
|
Susuki J, Nawata M, Koike M, Wada R, Sekigawa I, Iida N, Hashimoto H. Two cases of reactive hemophagocytic syndrome: a patient with adult-onset Still's disease and a patient with herpes zoster and autoimmune abnormalities. Mod Rheumatol 2014; 11:336-9. [DOI: 10.3109/s10165-001-8066-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
7
|
de Carvalho LG, Marchevsky RS, dos Santos DRL, de Oliveira JM, de Paula VS, Lopes LM, Van der Poel WHM, González JE, Munné MS, Moran J, Cajaraville ACRA, Pelajo-Machado M, Cruz OG, Pinto MA. Infection by Brazilian and Dutch swine hepatitis E virus strains induces haematological changes in Macaca fascicularis. BMC Infect Dis 2013; 13:495. [PMID: 24148233 PMCID: PMC3870956 DOI: 10.1186/1471-2334-13-495] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 10/18/2013] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Hepatitis E virus (HEV) has been described as an emerging pathogen in Brazil and seems to be widely disseminated among swine herds. An autochthonous human case of acute hepatitis E was recently reported. To obtain a better understanding of the phenotypic profiles of both human and swine HEV strains, a experimental study was conducted using the animal model, Macaca fascicularis. METHODS Six cynomolgus monkeys (Macaca fascicularis) were inoculated intravenously with swine HEV genotype 3 that was isolated from naturally and experimentally infected pigs in Brazil and the Netherlands. Two other monkeys were inoculated with HEV genotype 3 that was recovered from Brazilian and Argentinean patients with locally acquired acute and fulminant hepatitis E. The haematological, biochemical, and virological parameters of all animals were monitored for 67 days. RESULTS Subclinical hepatitis was observed in all monkeys after inoculation with HEV genotype 3 that was recovered from the infected swine and human patients. HEV RNA was detected in the serum and/or faeces of 6 out of the 8 cynomolgus monkeys between 5 and 53 days after inoculation. The mild inflammation of liver tissues and elevations of discrete liver enzymes were observed. Seroconversions to anti-HEV IgM and/or IgG were detected in 7 animals. Reactivities to anti-HEV IgA were also detected in the salivary samples of 3 animals. Interestingly, all of the infected monkeys showed severe lymphopenia and a trend toward monocytosis, which coincided with elevations in alanine aminotransferase and antibody titres. CONCLUSIONS The ability of HEV to cross the species barrier was confirmed for both the swine (Brazilian and Dutch) and human (Argentinean) strains, thus reinforcing the zoonotic risk of hepatitis E in South America. Cynomolgus monkeys that were infected with HEV genotype 3 developed subclinical hepatitis that was associated with haematological changes. Haematological approaches should be considered in future studies of HEV infection.
Collapse
Affiliation(s)
- Lilian G de Carvalho
- Centre for Laboratory Animal Breeding, Department of Primatology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Renato S Marchevsky
- Laboratory of Neurovirulence, Institute of Technology on Immunobiologicals, Bio-Manguinhos, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Debora RL dos Santos
- Laboratory of Veterinary Viruses, Department of Veterinary Microbiology and Immunology, UFRRJ, Rio de Janeiro, Brazil
| | - Jaqueline M de Oliveira
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Vanessa S de Paula
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Leilane M Lopes
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Wilhelmus HM Van der Poel
- Central Veterinary, Institute of Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Jorge E González
- National Reference Laboratory in Viral Hepatitis, National Institute of Infectious Diseases, Buenos Aires, Argentina
| | - Maria S Munné
- National Reference Laboratory in Viral Hepatitis, National Institute of Infectious Diseases, Buenos Aires, Argentina
| | - Julio Moran
- Dr. Julio Moran Laboratories, Ebmatingen, Zurich, Switzerland
| | - Ana Carolina R A Cajaraville
- Laboratory of Virological Technology, Institute of Technology on Immunobiologicals, Bio-Manguinhos, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Marcelo Pelajo-Machado
- Laboratory of Pathology, Oswaldo Cruz Institute/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Oswaldo G Cruz
- Programme of Scientific Computation, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Marcelo A Pinto
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| |
Collapse
|
8
|
Thien F, Puy R. Facilitation of drug hypersensitivity reactions - the role of acid suppression? Clin Exp Allergy 2013; 43:271-2. [DOI: 10.1111/cea.12075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- F. Thien
- Department of Respiratory Medicine; Box Hill Hospital; Eastern Health and Monash University; Melbourne; Australia
| | - R.M. Puy
- Department of Allergy, Immunology and Respiratory Medicine; The Alfred Hospital and Monash University; Melbourne; Australia
| |
Collapse
|
9
|
Treat JR. Skin signs of severe systemic medication reactions. Curr Probl Pediatr Adolesc Health Care 2012; 42:193-7. [PMID: 22884025 DOI: 10.1016/j.cppeds.2012.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 02/27/2012] [Indexed: 11/30/2022]
Abstract
Cutaneous medication reactions are often isolated to the skin and result in no serious systemic sequelae. There are a few rarer, but dangerous, medication reactions that can either be harbingers of life-threatening systemic reactions or lead to multisystem disease through their effects on the skin and mucous membranes. This article will further discuss these severe systemic medication reactions.
Collapse
Affiliation(s)
- James R Treat
- Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
10
|
Konstantinou GN, Papadopoulos NG, Tavladaki T, Tsekoura T, Tsilimigaki A, Grattan CEH. Childhood acute urticaria in northern and southern Europe shows a similar epidemiological pattern and significant meteorological influences. Pediatr Allergy Immunol 2011; 22:36-42. [PMID: 21261743 DOI: 10.1111/j.1399-3038.2010.01093.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Acute urticaria (AU) is a common condition that often presents in childhood. Although there is a general perception of cyclic annual trends in AU, no one has tried to identify any seasonal variation on its prevalence and incidence, associate environmental influences and impute geographic, ethnic, or even genetic features that may contribute to its onset. We aimed to analyze the influence of climate and geographic parameters on annual fluctuation of AU cases referred to the Emergency Departments (EDs) of Norwich (UK) and Heraklion (Crete, Greece), compare all identifiable potential triggers and severity, and calculate the prevalence and incidence of AU. Record-based data of all children up to 14 yr of age referred to both EDs between June 2005 and May 2007 were examined retrospectively. Demographic characteristics and any potential identifiable triggers of AU were recorded and compared. Poisson's regression was utilized to examine any influence of meteorological parameters on AU incidence. Edwards' test for seasonality was applied to identify any significant seasonal trend of the AU incidence within each city. Seven hundred and twenty-nine AU cases were identified (324 in Norwich and 405 in Heraklion), among 56,624 total referrals (28,931 and 27,693 cases, respectively). Respiratory infections were found to be the most commonly associated potential triggers of AU and food allergens the least. AU cases and incidence rates in both cities were equally distributed during the study period. A non-significant seasonal trend in AU incidence (October, April-May) was observed in Norwich, in contrast to a significant seasonal pattern (December, February-May) of AU in Heraklion. Temperature was inversely associated with AU incidence, while the statistically significant effect of relative humidity varied. Acute childhood urticaria shows a similar epidemiological pattern in northern and southern Europe regardless of the expected differences in genetic, geographic, and environmental background. Temperature and humidity are correlated with AU incidence. Seasonality of several acute respiratory viral infections, the most prominent associated trigger of AU, coincides with the observed AU seasonality, suggesting a potential linkage. However, this needs to be elucidated from larger epidemiological studies.
Collapse
Affiliation(s)
- George N Konstantinou
- Allergy and Clinical Immunology Department, 424 General Military Training Hospital, Thessaloniki, Greece.
| | | | | | | | | | | |
Collapse
|
11
|
Özcan D, Seçkin D, Bilezikçi B, Arslan H. The role of human herpesvirus-6, Epstein-Barr virus and cytomegalovirus infections in the etiopathogenesis of different types of cutaneous drug reactions. Int J Dermatol 2010; 49:1250-4. [DOI: 10.1111/j.1365-4632.2010.04531.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
12
|
DRESS syndrome with fatal results induced by sodium valproate in a patient with brucellosis and a positive cytoplasmic antineutrophilic cytoplasmic antibody test result. Rheumatol Int 2010; 32:2181-4. [DOI: 10.1007/s00296-010-1463-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 03/12/2010] [Indexed: 10/19/2022]
|
13
|
Martin DN, Mikhail IS, Landgren O. Autoimmunity and hematologic malignancies: associations and mechanisms. Leuk Lymphoma 2009; 50:541-50. [DOI: 10.1080/10428190902780677] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
14
|
Funk GA, Gosert R, Hirsch HH. Viral dynamics in transplant patients: implications for disease. THE LANCET. INFECTIOUS DISEASES 2007; 7:460-72. [PMID: 17597570 DOI: 10.1016/s1473-3099(07)70159-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Viral infections cause substantial morbidity and mortality in transplant patients. Quantifying viral loads is widely appreciated as a direct means to diagnose and monitor the course of viral infections. Recent studies indicate that the kinetics of viral load changes rather than single viral load measurements better correlate with organ involvement. In this Review, we will summarise the current knowledge regarding the kinetics of viruses relevant to transplantation including cytomegalovirus, Epstein-Barr virus, the herpes viruses 6 and 7, hepatitis C virus, GB virus C, adenovirus, and the emerging human polyomavirus type BK. We discuss the implications of viral kinetics for organ pathology as well as for the evaluation of antiviral interventions in transplant patients.
Collapse
Affiliation(s)
- Georg A Funk
- Transplantation Virology, Institute for Medical Microbiology, University of Basel, Basel, Switzerland
| | | | | |
Collapse
|
15
|
Schauer P, Salaun N, Bazin S, Labrouze JM, Bourguignon G. DRESS syndrome associé à une pan-uvéite bilatérale : à propos d’un cas. J Fr Ophtalmol 2006; 29:659-64. [PMID: 16885897 DOI: 10.1016/s0181-5512(06)73828-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION DRESS syndrome (drug rash or reaction with eosinophilia and systemic symptoms) is a rare but life-threatening drug hypersensitivity syndrome with a potential viral cofactor. The syndrome is characterized by rash, fever, hematological disorders (eosinophilia, lymphocytosis), and systemic symptoms (adenopathy, multiorgan involvement). CASE REPORT We report the first description of acute bilateral panuveitis with elevated intraocular pressure associated with anticonvulsant-induced DRESS syndrome, hypogammaglobulinemia, and HHV-6 reactivation in a 63-year-old-woman. Complete general and ophthalmological recovery was obtained 4 weeks after the end of anticonvulsant drug exposure without corticosteroid prescription, with the patient remaining free of disease after 6 months. DISCUSSION Our data suggest that uveitis may be one of multivisceral involvements described in drug hypersensitivity syndrome. The data also suggest that HHV-6 may play a role in the complex pathogenesis of DRESS as well as in the development of immune inflammatory disorders such as bilateral panuveitis with elevated intraocular pressure and alteration of retinal and choroidal circulation in this patient.
Collapse
Affiliation(s)
- P Schauer
- Service d'Ophtalmologie, Hôpital d'instruction des Armées Robert Picqué, Bordeaux.
| | | | | | | | | |
Collapse
|
16
|
Abstract
PURPOSE OF REVIEW Hypersensitivity drug reactions are but one of the many different types of adverse drug reactions. They may be potentially life-threatening, prolong hospitalization, affect drug prescribing patterns of physicians and result in socioeconomic costs. This review summarizes current knowledge on the incidence, prevalence, mortality and risk factors for these reactions in different populations. RECENT FINDINGS Hypersensitivity reactions represent about one third of all adverse drug reactions. Adverse drug reactions affect 10-20% of hospitalized patients and more than 7% of the general population. Severe reactions including anaphylaxis, drug hypersensitivity syndromes, Stevens Johnson syndrome and toxic epidermal necrolysis are also associated with significant morbidity and mortality. Although several risk factors have been identified, their clinical importance has not been fully understood. Future progress in immunogenetics and pharmacogenetics may help identify populations at risk for specific types of reactions. SUMMARY Well designed epidemiological studies on hypersensitivity drug reactions are lacking as most studies have been on adverse drug reactions. Such studies will be helpful in identifying patients at risk of developing such reactions, in particular severe reactions, and implementing early preventive measures.
Collapse
Affiliation(s)
- Eva Rebelo Gomes
- Allergy Department, INSERM U454 - IFR3, Arnaud de Villeneuve Hospital, University Hospital of Montpellier, Montpellier, France
| | | |
Collapse
|
17
|
Satoh A, Ikai T, Miwa H, Imai N, Hiramatsu A, Tajima E, Yamamoto H, Wakabayashi M, Miura K, Ito M, Shikami M, Imamura A, Mihara H, Kato Y, Nitta M. Acute promyelocytic leukemia with drug-induced hypersensitivity syndrome associated with Epstein-Barr virus infection. Intern Med 2004; 43:74-8. [PMID: 14964584 DOI: 10.2169/internalmedicine.43.74] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report a case of acute promyelocytic leukemia (APL) with drug-induced hypersensitivity syndrome associated with Epstein-Barr virus (EBV) infection. A 33-year-old woman was admitted because of APL. After complete remission was obtained with the use of all-trans retinoic acid (ATRA), intensive chemotherapy was administered. She developed high grade fever and severe systemic erythematous eruptions followed by cervical lymphoadenopathy, hepatosplenomegaly, hepatitis and hypotension in a state of myelosuppression during consolidation chemotherapy. Systemic corticosteroids alleviated the symptoms. Since an anti-EB VCA IgM antibody titer was continuously positive, persistent infection of EBV was suspected. In this case, EBV infection may have contributed to the development of drug-induced hypersensitivity syndrome.
Collapse
Affiliation(s)
- Atsushi Satoh
- Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine, Aichi-gun, Aichi
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Huang YL, Hong HS, Wang ZW, Kuo TT. Fatal sodium valproate-induced hypersensitivity syndrome with lichenoid dermatitis and fulminant hepatitis. J Am Acad Dermatol 2003; 49:316-9. [PMID: 12894087 DOI: 10.1067/s0190-9622(03)00748-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Anticonvulsant hypersensitivity syndrome caused by sodium valproate (Depakene) has rarely been reported. Here we describe a patient who presented with nonspecific polymorphous eruptions, fulminant hepatitis, and jaundice. Lichenoid dermatitis was found in the skin biopsy specimen. Toxic hepatitis and microvesicular steatosis were found in the liver biopsy specimen, consistent with valproate hepatotoxicity.
Collapse
Affiliation(s)
- Yau-Li Huang
- Department of Dermatology Chang Gung Memorial Hospital, Taipei, Taiwan
| | | | | | | |
Collapse
|
19
|
Seta N, Shimizu T, Nawata M, Wada R, Mori K, Sekigawa I, Iida N, Maeda M, Hashimoto H. A possible novel mechanism of opportunistic infection in systemic lupus erythematosus, based on a case of toxoplasmic encephalopathy. Rheumatology (Oxford) 2002; 41:1072-3. [PMID: 12209046 DOI: 10.1093/rheumatology/41.9.1072] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
20
|
Sekigawa I, Okada M, Ogasawara H, Naito T, Kaneko H, Hishikawa T, Iida N, Hashimoto H. Lessons from similarities between SLE and HIV infection. J Infect 2002; 44:67-72. [PMID: 12076063 DOI: 10.1053/jinf.2001.0959] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE We attempted to obtain deeper understanding of systemic lupus erythematosus (SLE) and human immunodeficiency virus (HIV) infection through comparative studies between both diseases. METHOD For this purpose, we reviewed and discussed lessons from similarities in both diseases based on our own and reported findings in literatures. RESULT Such comparative studies may contribute to the progress in understanding the clinical or pathogenetic features of these diseases. CONCLUSION Further studies into the relationship between SLE and HIV infection may bring to light important clues to assist in the development of better treatments for each disease.
Collapse
Affiliation(s)
- I Sekigawa
- Department of Medicine, Juntendo University Izu-Nagaoka Hospital, 1129 Nagaoka, Izu-Nagaoka-cho, Tagata-gun, Shizuoka, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
Immune panels of many autism-spectrum children reveal signs of atypical infections and shifted cell counts. In conjunction with trait-related cerebral hypometabolism and hypoperfusion, these findings suggest a hypothesis: Several autism-spectrum subgroups derive from intra-monocyte pathogens such as measles virus, cytomegalovirus, human herpesvirus 6, and Yersinia enterocolitica. Furthermore, with much inter-child variation, their effects manifest as diminished hematopoiesis, impaired peripheral immunity, and altered blood-brain barrier function often accompanied by demyelination. In some such children, one or more of these pathogens persists as a chronic-active, seemingly subclinical infection etiologically significant to the child's autistic traits. Within these subgroups, immune impairments and atypical infections may be treatable.
Collapse
Affiliation(s)
- T Binstock
- Institute for Molecular Introspections, Estes Park, Colorado, USA.
| |
Collapse
|
22
|
Mizukawa Y, Shiohara T. Onset of porokeratosis of Mibelli in organ transplant recipients: lack of a search for transmissible agents in these patients. J Am Acad Dermatol 2001; 44:143-4. [PMID: 11148495 DOI: 10.1067/mjd.2001.109845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|