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Sogbe M, Blanco-Di Matteo A, Di Frisco IM, Bastidas JF, Salterain N, Gavira JJ. Systemic lupus erythematosus myocarditis after COVID-19 vaccination. Reumatol Clin 2023; 19:114-116. [PMID: 36211224 PMCID: PMC9525201 DOI: 10.1016/j.reuma.2022.06.003] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/27/2022] [Indexed: 02/01/2023]
Abstract
Introduction Cases of acute myocarditis have been after administration of the BNT162b2 and Ad26.COV2.S vaccine. Objective Describe another possible mechanism of myocarditis after COVID-19 vaccination. Case presentation We describe the clinical case of a 72-year-old female with pleuritic chest pain one week after the third of the BNT162b2 mRNA vaccine. Serological tests for cardiotropic pathogens were negative, and autoimmunity screening was positive with anti-nuclear antibody (ANA) in 1:160 dilution, Anti-double-stranded DNA (anti-dsDNA), and anti-histone antibodies. 18F-fluoro-deoxy-glucose (FDG) positron emission tomography/computed tomography (PET/CT) showed a focal myocardial and pericardial inflammatory process in the cardiac apex. Results and discussion Systemic lupus erythematosus (SLE) diagnosis was made with myocardial affection. As far as we know, this is the first report of a case of lupus myocarditis after the COVID-19 vaccine. Conclusion Given the pathogenic rationales, the association between SLE and myocarditis should be considered.
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Affiliation(s)
- Miguel Sogbe
- Internal Medicine Department, Clínica Universidad de Navarra, Pamplona, Spain,Corresponding author
| | | | | | | | - Nahikari Salterain
- Department of Cardiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan José Gavira
- Department of Cardiology, Clínica Universidad de Navarra, Pamplona, Spain
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Bronte A, Rosales JJ, Bastidas JF, Lozano MD, Rodriguez P, García-Velloso MJ. Pancreatic involvement in a patient with multiple myeloma revealed by [ 18F]FDG PET/CT. A rare manifestation of extramedullary disease. Rev Esp Med Nucl Imagen Mol 2021; 41 Suppl 1:S48-S50. [PMID: 34838474 DOI: 10.1016/j.remnie.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/19/2021] [Accepted: 08/21/2021] [Indexed: 10/19/2022]
Affiliation(s)
- A Bronte
- Department of Nuclear Medicine, Clínica Universidad de Navarra, Pamplona, Spain.
| | - J J Rosales
- Department of Nuclear Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | - J F Bastidas
- Department of Nuclear Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | - M D Lozano
- Department of Pathological Anatomy, Clínica Universidad de Navarra, Pamplona, Spain
| | - P Rodriguez
- Department of Hematology and Hemotherapy, Clínica Universidad de Navarra, Pamplona, Spain
| | - M J García-Velloso
- Department of Nuclear Medicine, Clínica Universidad de Navarra, Pamplona, Spain
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Bronte A, Bastidas JF, Rosales JJ, Zuaznabar J, Herraiz M, Richter JA. Variation of enterohepatic circulation observed with 75SeHCAT images in the first three hours. Scintigraphic patterns and analysis of their association with the diagnosis of bile acid malabsorption. Rev Esp Med Nucl Imagen Mol 2021; 40:351-357. [PMID: 34752368 DOI: 10.1016/j.remnie.2021.05.011] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 01/25/2021] [Indexed: 10/21/2022]
Abstract
OBJETIVE To evaluate the enterohepatic circulation of 75-Selenium turoselecolic acid (75Se-SeHCAT) during the first 3 h and its correlation with the abdominal retention at the 7th day (AR7), as contribution to the clinical study of biliar acid malabsorption (BAM). MATERIALS AND METHODS 38 patients with chronic diarrhea were retrospectively studied. Acquisition protocol included static abdominal images at 1st, 2nd and 3rd hour and the 7th day after oral administration of the radiopharmaceutical. Images of 1-3 h determined 5 patterns of enterohepatic circulation that, due to their location, were characterized as: 1) gallbladder 2-3 h, 2) gallbladder 3 h, 3) gallbladder-abdomen 2-3 h, 4) abdomen, 5) upper left abdomen. The association of these patterns with the AR7 (Fisher, STATA) were investigated. Patients were classified as Non BAM (AR7 > 15%), mild-BAM (AR7 15-10%), moderate-BAM (AR7 10-5%) or severe-BAM (AR7 < 5%). RESULTS 19 patients had an AR7 diagnostic of BAM (7 mild-BAM, 5 moderate-BAM, 7 severe-BAM). The pattern "gallbladder at 2-3 h" was statistically associated with Non BAM (p 0,008), while "gallbladder-abdomen at 2-3 h" was correlated with having BAM (p 0,029). CONCLUSION Variations detected at the abdominal level in images during the first 3 h were associated with changes in intestinal absorption and the incorporation of the radiopharmaceutical into the pool of bile acids, so visual interpretation of the images at 2nd and 3rd hour could be useful in the final assessment of the study.
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Affiliation(s)
- A Bronte
- Department of Nuclear Medicine, Clinica Universitaria de Navarra, Pamplona, Navarra, Spain.
| | - J F Bastidas
- Department of Nuclear Medicine, Clinica Universitaria de Navarra, Pamplona, Navarra, Spain
| | - Juan J Rosales
- Department of Nuclear Medicine, Clinica Universitaria de Navarra, Pamplona, Navarra, Spain
| | - J Zuaznabar
- Department of Internal Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | - M Herraiz
- Department of Digestive, Clínica Universidad de Navarra, Pamplona, Spain
| | - J A Richter
- Department of Nuclear Medicine, Clinica Universitaria de Navarra, Pamplona, Navarra, Spain
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Bronte A, Bastidas JF, Rosales JJ, Zuaznabar J, Herraiz M, Richter JA. Variation of enterohepatic circulation through the image with 75SeHCAT in the first 3 hours. Scintigraphic patterns and análisis of its association with the diagnosis of bile acid malabsorption. Rev Esp Med Nucl Imagen Mol 2021; 40:S2253-654X(21)00054-8. [PMID: 33926852 DOI: 10.1016/j.remn.2021.01.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 11/29/2022]
Abstract
OBJETIVE To evaluate the enterohepatic circulation of 75-Selenium turoselecolic acid (75Se-SeHCAT) during the first 3 hours and its correlation with the abdominal retention at the 7th day (AR7), as contribution to the clinical study of biliar acid malabsorption (BAM). MATERIALS AND METHODS 38 patients with chronic diarrhea were retrospectively studied. Acquisition protocol included static abdominal images at 1st, 2nd and 3rd hour and the 7th day after oral administration of the radiopharmaceutical. Images of 1 to 3 hours determined 5 patterns of enterohepatic circulation that, due to their location, were characterized as: 1) gallbladder 2-3 hours, 2) gallbladder 3 hours, 3) gallbladder-abdomen 2-3 hours, 4) abdomen, 5) upper left abdomen. The association of these patterns with the AR7 (Fisher, STATA) were investigated. Patients were classified as Non BAM (AR7>15%), mild-BAM (AR7: 15-10%), moderate-BAM (AR7: 10-5%) or severe-BAM (AR7<5%). RESULTS 19 patients had an AR7 diagnostic of BAM (7 mild-BAM, 5 moderate-BAM, 7 severe-BAM). The pattern "gallbladder at 2-3 hours" was statistically associated with Non BAM (p 0,008), while "gallbladder-abdomen at 2-3 hours" was correlated with having BAM (p 0,029). CONCLUSION Variations detected at the abdominal level in images during the first 3 hours were associated with changes in intestinal absorption and the incorporation of the radiopharmaceutical into the pool of bile acids, so visual interpretation of the images at 2nd and 3rd hour could be useful in the final assessment of the study.
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Affiliation(s)
- A Bronte
- Servicio de Medicina Nuclear, Clinica Universitaria de Navarra, Pamplona, Navarra, España.
| | - J F Bastidas
- Servicio de Medicina Nuclear, Clinica Universitaria de Navarra, Pamplona, Navarra, España
| | - Juan J Rosales
- Servicio de Medicina Nuclear, Clinica Universitaria de Navarra, Pamplona, Navarra, España
| | - J Zuaznabar
- Servicio de Medicina Nuclear, Clinica Universitaria de Navarra, Pamplona, Navarra, España
| | - M Herraiz
- Servicio de Medicina Nuclear, Clinica Universitaria de Navarra, Pamplona, Navarra, España
| | - J A Richter
- Servicio de Medicina Nuclear, Clinica Universitaria de Navarra, Pamplona, Navarra, España
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Grisanti F, Prieto E, Bastidas JF, Sancho L, Rodrigo P, Beorlegui C, Iñarrairaegui M, Bilbao JI, Sangro B, Rodríguez-Fraile M. 3D voxel-based dosimetry to predict contralateral hypertrophy and an adequate future liver remnant after lobar radioembolization. Eur J Nucl Med Mol Imaging 2021; 48:3048-3057. [PMID: 33674893 DOI: 10.1007/s00259-021-05272-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/17/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Volume changes induced by selective internal radiation therapy (SIRT) may increase the possibility of tumor resection in patients with insufficient future liver remnant (FLR). The aim was to identify dosimetric and clinical parameters associated with contralateral hepatic hypertrophy after lobar/extended lobar SIRT with 90Y-resin microspheres. MATERIALS AND METHODS Patients underwent 90Y PET/CT after lobar or extended lobar (right + segment IV) SIRT. 90Y voxel dosimetry was retrospectively performed (PLANET Dose; DOSIsoft SA). Mean absorbed doses to tumoral/non-tumoral-treated volumes (NTL) and dose-volume histograms were extracted. Clinical variables were collected. Patients were stratified by FLR at baseline (T0-FLR): < 30% (would require hypertrophy) and ≥ 30%. Changes in volume of the treated, non-treated liver, and FLR were calculated at < 2 (T1), 2-5 (T2), and 6-12 months (T3) post-SIRT. Univariable and multivariable regression analyses were performed to identify predictors of atrophy, hypertrophy, and increase in FLR. The best cut-off value to predict an increase of FLR to ≥ 40% was defined using ROC analysis. RESULTS Fifty-six patients were studied; most had primary liver tumors (71.4%), 40.4% had cirrhosis, and 39.3% had been previously treated with chemotherapy. FLR in patients with T0-FLR < 30% increased progressively (T0: 25.2%; T1: 32.7%; T2: 38.1%; T3: 44.7%). No dosimetric parameter predicted atrophy. Both NTL-Dmean and NTL-V30 (fraction of NTL exposed to ≥ 30 Gy) were predictive of increase in FLR in patients with T0 FLR < 30%, the latter also in the total cohort of patients. Hypertrophy was not significantly associated with tumor dose or tumor size. When ≥ 49% of NTL received ≥ 30 Gy, FLR increased to ≥ 40% (accuracy: 76.4% in all patients and 80.95% in T0-FLR < 30% patients). CONCLUSION NTL-Dmean and NTL exposed to ≥ 30 Gy (NTL-V30) were most significantly associated with increase in FLR (particularly among patients with T0-FLR < 30%). When half of NTL received ≥ 30 Gy, FLR increased to ≥ 40%, with higher accuracy among patients with T0-FLR < 30%.
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Affiliation(s)
- Fabiana Grisanti
- Department of Nuclear Medicine, Clínica Universidad de Navarra, Pamplona, Spain.
| | - Elena Prieto
- Department of Medical Physics, Clínica Universidad de Navarra, Pamplona, Spain
| | | | - Lidia Sancho
- Department of Nuclear Medicine, Clínica Universidad de Navarra, Madrid, Spain
| | - Pablo Rodrigo
- Department of Nuclear Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | | | | | | | - Bruno Sangro
- Liver Unit, Clínica Universidad de Navarra-IDISNA and CIBEREHD, Pamplona, Spain
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Abstract
ABSTRACT A 75-year-old man presented with dyspnea for more than 2 months, with blood test showing low platelet count and cardiac ultrasound showing severe pulmonary hypertension (>54 mm Hg). A CT pulmonary angiogram showed a filling defect in the pulmonary trunk, right and left pulmonary arteries, raising the possibilities of pulmonary embolism or artery sarcoma. FDG PET/CT was performed for further evaluation and showed low uptake in the pulmonary wall, which supported the diagnosis of pulmonary embolism. Patient was treated with anticoagulants with no changes on repeated CT pulmonary angiogram. Patient underwent surgery, and histopatological examination revealed a pulmonary artery sarcoma.
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Affiliation(s)
| | - Laura García
- Pathology, Clínica Universidad de Navarra, Pamplona, Spain
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