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VEXAS syndrome is a rare entity secondary to UBA1 gene mutations, located on the X chromosome. This mutation generates, as a consequence, a characteristic vacuolation on haematopoietic stem-cells. It is characterized by multiple autoinflammatory and haematologic manifestations, which respond and end up being dependent on corticosteroid treatment. In this publication we present a 2-case series diagnosed at our hospital and make a brief literature review of the published evidence so far. [ABSTRACT FROM AUTHOR]

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The COVID-19 pandemic has brought challenges for people with rheumatic diseases in addition to those facing the general population, including concerns about increased risks of infection with severe acute respiratory syndrome and poor coronavirus disease 2019 (COVID-19) outcomes with increased mortality. There is increasing evidence that COVID-19 can cause an alteration of the immune system with the development of autoimmune phenomena that can range from the production of autoantibodies to the appearance of autoimmune rheu- matic diseases, the main diseases being reported: vasculitis and arthritis, as well as idiopathic inflammatory myopathies, systemic lupus erythematosus and sarcoidosis, and isolated cases of systemic sclerosis and adult Still's disease. These findings highlight the potential spectrum of systemic and rheumatic autoimmune diseases that could be precipitated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. With these initial data, we try to review in the following article the clinical relationships between COVID-19 and autoimmune rheumatic diseases, as well as other data of interest such as the consequences of the pandemic with the gender of health personnel, a rigorous topical issue. The data now available suggest that rheumatic disease is associated with a small additional risk of SARS-CoV-2 infection, and that COVID-19 outcomes are primarily influenced by comorbidities and particular disease states or treatments. Despite considerable advances in our knowledge of which therapeutic agents provide benefit in COVID-19 and what constitute effective vaccination strategies, the specific considerations that apply to people with rheumatic disease have not yet been definitively addressed. An overview of the most important COVID-19 studies to date involving people with rheumatic disease may contribute to our understanding of the clinical care requirements of this population. [ABSTRACT FROM AUTHOR]

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Copyright of Colombian Journal of Nephrology / Revista Colombiana de Nefrología is the property of Colombian Association of Nephrology & Hypertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Takayasu arteritis is a large-vessel vasculitis which affects large-caliber elastic arteries, primarily the aorta and its main branches. It mainly affects women between 20-30 years, so it is rare in children. Case report: We describe the case of a 15-year-old female who was followed up since she was 9 years old due to celiac disease. At the age of 13, anaemia of chronic disorders associated to elevated C-reactive protein and erythrocyte sedimentation were detected. The patient remained asymptomatic. After excluding other diseases, we requested a positron emission computed tomography (PET-CT); lesions compatible with large-vessel vasculitis were detected. Cardiology evaluation showed an aneurysm in the right coronary artery. Angio-CT suggested Takayasu type III arteritis. Conclusions: The delay in the diagnosis of Takayasu arteritis in pediatric patients is quite common. In this case, we have found phase II lesions, with no previous phase I symptoms. However, PET-CT allowed the diagnosis of vasculitis, key to the diagnosis of the patient. [ABSTRACT FROM AUTHOR]

What we currently know as anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis had previously been recognized in 1923, 1937 and 1951 in autopsies and later renamed microscopic polyangiitis, granulomatosis with polyangiitis (Wegener) and eosinophilic granulomatosis with polyangiitis. In 1954, granulomatosis with polyangiitis (Wegener) was reported for the first time in a clinical journal and in 1964 AlarconSegovia included it in its classification. At first, the finding of ANCA in patients with glomerulonephritis with extra-renal manifestations did not attract attention. Van der Woude used them as a diagnostic and monitoring tool for patients with granulomatosis with polyangiitis (Wegener). The Chapel-Hill nomenclature revised in 2012 subdivided small-vessel vasculitides into 2 subtypes: immune complex vasculitis and ANCA-associated vasculitis. In 2022, a group of experts endorsed by the ACR/EULAR developed and validated the classification criteria for these 3 types of ANCA-associated vasculitis. [ABSTRACT FROM AUTHOR]

Behçet's disease is a chronic, multisystemic, and relapsing inflammatory pathology that frequently manifests with oral and genital ulcers and ocular and skin lesions. It rarely exhibits gastrointestinal involvement, which varies depending on the affected gastrointestinal segment; these have in common the predominance of ulcerated lesions and, consequently, a greater risk of bleeding from the digestive tract. A clinical case of a 28-year-old female patient who consulted for a clinical picture of melenic stools and oral ulcers is described. As a crucial clinical history, she had been diagnosed with Behçet's disease since adolescence, associated with severe gastrointestinal complications. An esophagogastroduodenoscopy was performed with findings of antral erythematous gastropathy and a colonoscopy with a report of ulcerated ileitis. Treatment with azathioprine and corticosteroids was indicated, significantly improving the clinical picture. [ABSTRACT FROM AUTHOR]

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Copyright of Galicia Clínica is the property of Sociedad Gallega de Medicina Interna and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Trench foot is considered the most common non-combat related military injury and we have known of its existance since Napoleon's time. However, this vasoneuropathy remains a poorly understood condition and, therefore, a diagnostic challenge. With the report of 2 clinical cases treated in our hospital during Filomena storm, which occurred in Spain in January 2021, with Madrid as one of the most affected areas, we intend to contribute a little more knowledge, in order to improve cases identification and the correct management that, surely will improve our patients prognosis, without forgetting preventive measures. In our experience, a rigorous diagnostic study (vascular and electroneurophysiological) and a vasodilatador treatment with sciatic popliteal block, 5-phosphodiesterase inhibitors and dihydropyridine calcium antagonists have been decisive. [ABSTRACT FROM AUTHOR]

Granulomatosis with polyangiitis (GPA) is an autoimmune vasculitis which rarely affects the lower genitourinary tract. We share the case of a 53-year-old man who presented with a retroperitoneal mass and thereafter developed a left multiseptated hydrocele that conditioned a testicular infarction. The pathology report of the orchidectomy was consistent with GPA. [ABSTRACT FROM AUTHOR]

Introduction: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides are rare clinical entities with broad manifestations that are associated with diagnostic challenges. Prompt treatment is associated with significant prognostic improvement. Case report: 45-year-old female presenting with constitutional symptoms of 2 months of evolution, associated in the last 2 weeks with progressive hypoacusis. Acute renal lesion associated with active urinary sediment data was evidenced. The requested immune profile was positive for ANCA PR-3, and the renal biopsy confirmed the diagnosis of Granulomatosis with Polyangiitis. Immunosuppressive treatment with cyclophosphamide was started, with little improvement in renal function and requiring chronic hemodialysis. The wide variety of clinical manifestations associated with ANCA vasculitis lead to the inability to diagnose them early and hypoacusis, although described, is a rare initial manifestation. Conclusion: AAV are rare clinical entities and when they present with atypical manifestations, they are often a diagnostic challenge. It is imperative to consider it in cases of constitutional symptoms, associated with renal, otorhinolaryngologic and pulmonary manifestations. [ABSTRACT FROM AUTHOR]

BACKGROUND: Patients with microscopic polyangiitis have organ multisystemic involvement. Alveolar hemorrhage is seen with some frequency, and can be injured simultaneously the kidney, musculoskeletal, and others. The diagnostic approach in a critically ill patient can be affected by large number of factors caused by complications of hospitalization in an intensive care unit. CLINICAL CASE: A 66-year-old female patient with diffuse alveolar hemorrhage secondary to microscopic polyangiitis. CONCLUSIONS: Being a non-frequent entity, microscopic polyangiitis requires minimal clinical suspicion to start the diagnostic approach with paraclinical examinations according to the presentation of the disease, with computed tomography, bronchoscopy with bronchioalveolar lavage before suspected diffuse alveolar hemorrhage; and/or renal biopsy in the case of acute kidney injury with urine sediment. There is currently medical treatment that allows to obtain an adequate clinical response. In addition, new therapies are specifically found to improve clinical outcomes and reduce adverse effects associated with treatment. [ABSTRACT FROM AUTHOR]

Systemic vasculitis can affect blood vessels of all sizes, causing necrosis and inflammation. Granulomatosis with polyangiitis (GPA) is a vasculitis of small and medium blood vessels. Clinical manifestations may be local or diffuse in the gastrointestinal tract. We present a patient's case with systemic vasculitis associated with anti-cytoplasmic antibodies (ANCA), myeloperoxidase (MPO) antibodies (microscopic polyangiitis) confirmed through renal biopsy, presenting a 15-day clinical picture consisting of asthenia, adynamia, subjective oliguria, edema of the upper and lower limbs, hyporexia, and melena. The digital rectal examination was positive for melena in the physical examination, later presenting melena with secondary anemization. An endoscopic video capsule was performed, showing findings compatible with enteric vasculitis. During his stay, he presented multisystemic involvement due to renal, pulmonary, neurological, and gastrointestinal involvement, managed in the intensive care unit (ICU), where systemic steroid pulses and hemodialysis started. Conclusion: although gastrointestinal vasculitis is a rare complication, it occurs and threats patients' lives. Differential diagnosis should cover other inflammatory diseases, especially Crohn's disease. Gastrointestinal vasculitis early diagnosis significantly influences prognosis, as prompt steroid therapy can change the course of the disease. [ABSTRACT FROM AUTHOR]

Kawasaki disease (KD) is a multisystemic vasculitis that presents in childhood. It is usually an acute, febrile, self-limited disease of unknown etiology and may develop cardiovascular alterations; its clinical expression is variable as it presents inflammation of medium caliber vessels and multiple tissues: pulmonary, meningeal, cardiac, urinary, gastrointestinal, musculoskeletal, neurological or lymphatic. Diagnosis is clinical, and treatment aims to reduce the duration of clinical symptoms and prevent the presence of coronary aneurysms. Objective: to describe the clinical case of an infant patient with KD, in which clinical criteria characteristic of this pathology were identified. Case report: a 22-month-old male patient was admitted to the emergency room with a 14-day evolutionary clinical picture consisting of fever, emetic episodes, abdominal pain, unresponsive to acetaminophen, and diarrheal episodes. Two days later, he manifested generalized exanthema in the inguinal region that spread to the right testicle, back, and thorax. Subsequently, he presented bilateral nonpurulent conjunctivitis for three days. He received treatment with topical steroids and oral antihistamines; partial improvement with subsequent evolution in right testicular edema and bilateral desquamation in hands and feet. KD was suspected, a transthoracic echocardiogram was sent without coronary aneurysmal dilatations, and treatment with ASA was started without indication, given the evolution of immunoglobulin. Conclusions: KD is infrequent in childhood and should be suspected in patients with prolonged febrile symptoms unresponsive to conventional treatments and in whom the presence of other pathologies is ruled out. [ABSTRACT FROM AUTHOR]

Anti-phosphatidylserine/prothrombin (aPS/PT) antibodies have been described in cutaneous Polyarteritis Nodosa (PAN) in association with specific manifestations. To determine aPS/PT antibodies in patients with PAN and its correlation with clinical manifestations. Cross-sectional comparative study including PAN patients and 20 controls (10 Microscopic Polyangiitis [MPA] and 10 Behçet's disease [BD]). Clinical and demographic variables, treatment, serological markers, prognosis, activity and damage indexes were evaluated. aPS/PT, anti-cardiolipin (aCL), anti-beta 2 glycoprotein 1 (anti-B2GP1) antibodies, and lupus anticoagulant (LA) were determined. Fourteen patients with PAN were included, 11 (79%) women, with disease duration of 207 months, and mostly inactive disease. Only one patient with PAN and one with BD were positive for aPS/PT IgG. LA was the most frequent antibody identified. One patient with MPA and one with BD were positive for aCL IgM; one with MPA for anti-B2GP1 IgG, and one with PAN for anti-B2GP1 IgM. aPS/PT antibodies are not frequent in patients with longstanding inactive PAN. [ABSTRACT FROM AUTHOR]

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents a clinical case of a 63-year-old patient with septic vasculitis as a manifestation of catheter-related bloodstream infection. The patient presented purpuric lesions on her feet and timely diagnosis and treatment were performed. Other possible causes of the lesions were ruled out and septic vasculitis was identified as the main cause. Recognizing this dermatological manifestation in the context of sepsis can help better understand the disease process. [Extracted from the article]

BACKGROUND: Erythema elevatum diutinum is a rare leukocytoclastic vasculitis. Its pathophysiology is not fully understood, but it is associated with immune complex deposition, complement activation, and inflammatory cytokines. The initial manifestations are macules, papules and purpuric plaques and finally fibrotic nodules with symmetrical distribution, mainly on the extensor and articular surfaces. CLINICAL CASES: We report two cases of erythema elevatum diutinum in association with two different entities. Case 1 : a 69-year-old man with papillary renal cell carcinoma of the left kidney, in whom a new association of erythema elevatum diutinum with sunitinib and everolimus was documented. Case 2: a 36-year-old man was diagnosed with erythema elevatum diutinum associated with stage 3 HIV. CONCLUSIONS: Due to the wide spectrum of cutaneous manifestations and associations, erythema elevatum diutinum is a diagnostic challenge that requires an extensive paraclinical study and must be confirmed with skin biopsy. Clinical suspicion and early diagnosis can achieve a more effective treatment. [ABSTRACT FROM AUTHOR]

ANCA vasculitis associated to propylthiouracil (PTU) is a rare condition with an incidence of 0.47-0.71 cases per 100,000 patients. It affects mainly minor caliber blood vessels. The skin, kidneys and lungs are the organs most affected. To make the diagnosis it is necessary to have a high index of suspicion and rely on histopathologic findings of skin lesions plus a positive ANCA test. Stopping the inducing drug is usually necessary to manage this condition. We report the case of a 45-year-old woman who consumed PTU for two years for the treatment of hyperthyroidism presenting with painful purpuric plaques in the lower limbs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pyoderma gangrenosum is an autoinflammatory neutrophilic dermatosis of polygenic origin, characterized by painful, necrotic and sterile ulcers which are triggered by the phenomenon of patergia in up to 50% of our patients. OBJECTIVE: To describe the clinical characteristics of patients with a diagnosis of pyoderma gangrenosum, associated comorbidities and histopathological findings. MATERIALS AND METHODS: A retrospective, observational, analytical study performed from January 2010 to December 2019 at the Dermatology Service of the Northeast National Medical Center no. 25 of the Mexican Institute of Social Security in Monterrey, Nuevo Leon, Mexico. RESULTS: A total of 28 patients were collected, of which the majority were female, the mean age of presentation was 41 years and 3 were pediatric. In 22 out of 28 patients pyoderma gangrenosum was secondary and the most associated comorbidity was hematological disease, followed by inflammatory bowel disease. The predominant histopathological findings were neutrophilic inflammatory infiltrate. CONCLUSIONS: Pyoderma gangrenosum is a disease with low incidence, but high morbidity, our series of cases is one of the largest reported nationwide where in 22 out of 28 patients pyoderma gangrenosum was secondary to some underlying pathology, hence the relevance of performing the complete study of this dermatosis. [ABSTRACT FROM AUTHOR]

IgA vasculitis, also known as Henoch-Schönlein purpura, is a leukocytoclastic vasculitis that involves small vessels with deposition of IgA immune complexes. It can include skin, joints, kidneys, and gastrointestinal tract. Its presentation in adults is rare, and the clinical forms are usually more aggressive. The objective of this study is to describe the course and evolution of IgA vasculitis, in a 59-years-old patient, with purples in the lower limbs and trunk, macroscopic hematuria, and lower limb edema. The complementary ones showed elevated creatinines, nephrotic range proteinuria, elevated IgA and negative antibodies against the cytoplasm of neutrophils. Neoplastic causes were dismissed. The anatomical-pathological study of the kidney concluded IgA vasculitis. [ABSTRACT FROM AUTHOR]

Se presenta el caso de una paciente de 29 años con antecedente de lupus eritematoso sistémico diagnosticado 15 años antes, que desarrolló nefropatía lúpica actualmente en diálisis peritoneal, cuadro de miopericarditis en 2012 y bajo tratamiento inmunosupresor. Inició con deterioro de su clase funcional por disnea y angina 2 semanas previas al ingreso. Se le realizó ecocardiograma, el cual reportó insuficiencias mitral y tricuspídea graves. Posteriormente presentó angina en reposo asociada a descarga adrenérgica y vagal. A su ingreso se descarta actividad lúpica por reumatología. Por presentación clínica, cambios en electrocardiograma y biomarcadores, se realizó cateterismo cardiaco, que reportó enfermedad coronaria trivascular con ectasia coronaria Markis I y disección coronaria de ramo intermedio y circunfleja posterior a la primera marginal obtusa. Se consideró por el servicio de cirugía cardiotorácica realizar intervención con puente coronario posterior a disección del ramo intermedio, marginal obtusa y posterolateral, así como cambio valvular mitral y plastia tricuspídea. La disección coronaria espontánea es más frecuente en las mujeres (70%); puede presentarse como angina inestable y hasta como muerte súbita. La asociación con lupus eritematoso sistémico es poco frecuente, con una incidencia del 0.42%. En la nefropatía lúpica es una manifestación poco frecuente de vasculitis extrarrenal. El tratamiento de elección depende del número de vasos afectados y del estado hemodinámico, por lo que es necesario individualizarlo para cada paciente. [ABSTRACT FROM AUTHOR]

Behçet disease is a variable vessel multysistemic vasculitic inflamatory disorder characterized by recurrent oral, genital, aphtous ulcers, posterior bilateral panuveitis, joint manifestations and occasionally compromiso of the central nervous system and large vessels. The varied clinical mmanifestations and the lack of pathognomonic test make the disease a diagnostic challenge whose prevalence in Colombia is unknown. The diagnosis is bases on diagnostic criterio proposed in absence of a Gold Estandard test. Regarding the etiology, varios theories have been studied incluiding those of inmunological origin especially due to the existence of HLA-B51, followed by those that blame infectious agents, endotelial damage among others. A case is presented, corresponding to a famale patient of 35 years og age with chronic and recurrent symptoms of oral trush, the presence of dermatological lesions and the appearance of genital ulcers is presented. Discarding inmunomediated, infectious and inflammatory causes. Considering a picture of recurrent bipolar aphtosis and faced with dermatológical symptoms, it vas proposes to apply the diagnostic criterio of the International Team for the Revision of the Internacional Criteria for Behcet Disease with a score of 4, which supports the diagnosis of Behcets disease. Management was based on the introduction of therapeutic measures bases on systemic corticosteroids and immunosuppressants, with an adequate clinical reponse. [ABSTRACT FROM AUTHOR]

Copyright of Ciencia e Innovación en Salud is the property of Universidad Simon Bolivar (USB) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Galicia Clínica is the property of Sociedad Gallega de Medicina Interna and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Haemorrhagic bullous form of IgA vasculitis (IgAV), or Schönlein-Henoch purpura, is an unusual presentation of the disease in paediatric patients (<2%). Blistering eruptions can sometimes be very striking, leading to hospital admissions and administration of high-dose steroids and even immunosuppressants. Review of the literature, however, does not suggest that this clinical form carries a worse prognosis than the other forms of IgAV. In fact, the prognosis of the disease depends on the organic involvement. We present the case of a 5-year-old girl that is very representative. She developed palpable purpura and four days later the skin lesions evolved into blistering lesions. She did not receive any anti-inflammatory nor immunosuppressive treatment and the lesions spontaneously subsided within 14 days. She did not develop any extracutaneous nor systemic involvement. [ABSTRACT FROM AUTHOR]

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Background: The Wiskott-Aldrich syndrome is a combined immunodefi ciency associated with a syndrome linked to the X chromosome, which is characterized by eczema, recurrent infections, and thrombocytopenia. Other manifestations include autoimmune disorders such as hemolytic anemia or thrombocytopenic purpura mediated by the immune system, increased susceptibility to malignant tumors, including lymphoma or leukemia. Case report: A 7-year-old male patient with a diagnosis of Wiskott-Aldrich syndrome who was treated with intravenous gamma globulin, antimicrobial prophylaxis with trimethoprim/sulfamethoxazole, and fluconazole, as well as with prednisone and cyclosporine due to hemolytic anemia and uveitis. Suddenly, he presented a deviation of the left labial commissure, so he was hospitalized. The studies showed a giant aneurysm of the aorta root, ascending aorta, descending aorta, and right coronary aorta, with insidious cardiac symptoms; therefore, he was referred to the vascular surgery department. Conclusions: Vasculitis in Wiskott-Aldrich syndrome is rare and it is usually asymptomatic in early stages, so an annual cardiovascular evaluation should be performed in order to avoid the complications of an aneurysm, which can be deleterious in this type of immunodeficiency where the possibility of death from bleeding is high. [ABSTRACT FROM AUTHOR]

Introduction: superficial temporal artery aneurysms have been reported very infrequently in world literature. This rare condition, when it occurs, is closely associated with trauma, aneurysms in other arteries, Marfan syndrome, giant cell arteritis, which is the most common form of systemic vasculitis in adults over 50 years of age and, very rarely, atherosclerosis. If superficial temporal aneurysms are rare, exceptional are bilateral aneurysms. Case report: an unreported case is presented in the literature of a patient without a traumatic history, in which bilateral vascular dilations of both superficial temporal arteries were found. Conclusion: whenever there is a mass in the parietal area, it is mandatory to explore all vascular paths and palpate the temporal arteries thoroughly to look for inflammatory manifestations or the decrease or loss of pulses. [ABSTRACT FROM AUTHOR]

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Background/aim: Abnormal capillaroscopic findings have been reported in vasculitic syndromes such as Behçet's disease, Henoch- Schönlein purpura, and Wegener's granulomatosis. This study was conducted to define the capillaroscopic changes in patients with Takayasu arteritis (TA). Materials and methods: We studied 28 TA patients (27 females). The nail folds from the 2nd to 5th fingers on both hands were examined with video capillaroscopy for all. A patient was defined as having an abnormal capillaroscopic examination if more than 1 morphologic abnormality was present in at least 2 nail folds. Results: The median capillary density of TA patients was 9 (range: 9-11). There were no patients with capillary disorganization or avascular areas. Tortuous capillaries were detected in all patients. The other common morphological capillary abnormalities included enlarged/dilated capillaries (39.3%), branching capillaries (35.7%), and hemorrhages (32.1%). Only 1 patient had giant capillaries with early scleroderma-like pattern. Overall, there were 11 (39.3%) patients with abnormal capillaroscopic findings. There were more patients with abnormal capillaroscopic findings in the subgroup of TA patients whose upper extremity blood pressure could not be measured as compared to those whose blood pressure could be measured (66.7% vs. 26.3% patients; P = 0.04). Conclusion: Capillaroscopic abnormalities are frequently seen in TA patients. We consider that abnormal capillaroscopic findings in TA patients reflect the impaired blood flow due to narrowed or occluded arteries rather than the primary capillary involvement of the disease process. [ABSTRACT FROM AUTHOR]

In 1924, the Turkish dermatologist Hulusi Behçet evaluated the first cases, and they were published in 1937, later this syndrome was recognized with the name of Behcet's disease. Behcet's disease is characterized by chronic systemic vasculitis with inflammatory involvement and a recurrent pattern. The involvement of the central nervous system is observed in approximately 10% of cases. Objective: The objective of this report is to present a clinical case of a patient who suffered Behcet 's disease with neurological compromise, its timely diagnosis, management and immunosuppressive post-treatment results. Materials and methods: A clinical case is presented of a 41-year-old patient who presented with sudden dysarthria, fluid swallowing disorders and weakness of the left half body. An updated review of the subject and the different treatment options is carried out. This case was rapidly managed with corticosteroids, immunosuppressants and motor rehabilitation. Results: The patient recovered her motor function completely after 30 days, responding satisfactorily to the pharmacological management established. [ABSTRACT FROM AUTHOR]

Leukocytoclastic vasculitis is an autoimmune disorder that affects small vessels, and causes inflammation, destruction and necrosis of the same. It is often underdiagnosed. The etiology is multifactorial, the pathophysiology is complex and immunomodulators are the most important medications in their treatment. This article aims to review the current state of knowledge in leukocytoclastic vasculitis with emphasis on diagnosis and treatment. Articles published in the period from 1990 to 2017 were reviewed. The browsers were Google Crome and Firefox and the search engine was Scholar google. The database consulted was: MEDLINE, RIMA Astra-Zeneca and the clinical practice guidelines of the Mexican health system (CENETEC); 108 relevant publications to the subject were reviewed, prioritizing those belonging to journals indexed in MEDLINE and Science Citation Index-JCR. Studies are required to integrate clinical and treatment subgroups and investigate the mechanisms of tissue damage in each subgroup. Immunomodulation plays a central role in the treatment. [ABSTRACT FROM AUTHOR]

Stroke is the second and third cause of mortality and disability worldwide, respectively.Its incidence has increased in low and middle-income countries, due to infectiousdiseases, including HIV. The pathophysiology of ischemic stroke in this populationis directly and indirectly related to the infection; indirectly, through cardioembolismand coagulopathies, such as: antiphospholipid syndrome and thrombotic thrombocytopenicpurpura. With respect to the direct form, it is presented through vasculardiseases as: accelerated atherosclerosis, non-atherosclerotic vasculopathy, cerebraldisease of small vessels and vasculitis associated with HIV; in the latter, infectiouscauses are highlighted. In the clinical context, the presentation is similar in the HIVnegative and positive population; generally, a focal neurological deficit is evidenced.However, they can occur atypically, with acute confusion, fever and sudden loss ofconsciousness; this clinical spectrum is more common in the context of HIV. In thediagnosis the Cincinnati and NIHSS scales are used in the same way as in the healthypopulation. In addition, cranial CT without contrast is the first diagnostic aid, togetherwith electrocardiogram and hematological tests. The treatment is based on eliminatingblood obstruction; the main method is thrombolysis by the tissue plasminogen activator.This disease is gaining strength in the population with HIV and it is important toknow the existing relationship. [ABSTRACT FROM AUTHOR]

Copyright of Revista Veterinaria is the property of Universidad Nacional del Nordeste and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Multiple artery aneurysms are a rare pathological condition which may be caused by different etiologies. Therefore, its location, morphology and clinical presentation may vary in a case to case basis. Case report: A 51-year-old woman, prior history of dyslipedemia presents with upper abdominal pain. Abdominal tomographic scans showed aneurysm of the pancreaticduodenal artery and retroperitoneal hematoma. Emergent surgical evacuation of the hematoma was performed, with no other findings. In the postoperative period, the patient suffers hypertensive crisis and a new tomographic scan is conducted observing multiple dilations in different visceral arteries. The patient is treated conservatively and is being studied for a possible vasculitis. Discussion: Multi-aneurysmatic artery disease is a very rare entity, its etiology is determined by clinical and histopathological correlation. Although establishing a diagnosis in which the clinical presentation completely corresponds, is a real challenge. Unlike degenerative aneurysms due to atherosclerosis, multi-aneurysmatic disease commonly involves visceral arteries. Open surgery is considered safe treatment option and should be established in the segments causing symptoms. Endovascular treatment is less invasive, being the technique of choice in patients with high comorbidity and in cases of complicated surgery with rupture. [ABSTRACT FROM AUTHOR]

Henoch-Schonlein purpura as paraneoplasic vasculitis of solid tumors is found in 9-11% of cases reported in adults with stomach, breast, lung, prostate and kidney carcinomas; it is little frequent as paraneoplastic of multiple myeloma. This paper reports the case of a patient that suffered from Henoch-Schonlein purpura as initial manifestation of multiple myeloma. [ABSTRACT FROM AUTHOR]

Resumen Objetivo El sistema nervioso central (SNC) puede estar afectado en una variedad de enfermedades inflamatorias de los vasos sanguíneos, generalmente conocidas como vasculitis. El diagnóstico clínico de dicha afectación en etapas tempranas es difícil, ya que un leve deterioro cognitivo puede ser el único síntoma. Se planteó la hipótesis de que la SPECT de perfusion cerebral podría mostrar la afectación del SNC y podría servir para controlar el curso de la enfermedad. El propósito de este estudio fue evaluar si y cuándo una mejora de la perfusión cerebral puede ser registrada por SPECT durante el seguimiento de estas enfermedades. Material y métodos Dieciocho pacientes afectados por Lupus eritematoso sistémico (LES), 22 por vasculitis indiferenciada (VI), 5 por la enfermedad de Behcet (EB) y 5 por el síndrome de Sjogren Primario (SSp) se incluyeron en este estudio prospectivo. Se realizó una SPECT de perfusión cerebral con 99m Tc-HMPAO antes del tratamiento, y se repitió durante el seguimiento a diferentes intervalos de tiempo. El análisis de imagen se realizó en 10 áreas cerebrales utilizando un software específico. Resultados En los pacientes con LES no se encontró una mejora significativa de la perfusión cerebral. Por el contrario, en la VI la captación cerebral del trazador comenzó a mejorar significativamente desde el vigésimo cuarto mes (18/22 pacientes). Los pacientes con EB mostraron una mejora de los hallazgos gammagráficos (5/5 pacientes), mientras que sólo se obtuvo un resultado similar en dos de los pacientes con SSp. Conclusiones En conclusión, el SPECT cerebral parece ser capaz de monitorizar la enfermedad en VI, evaluando cuándo se puede registrar una mejoría de la perfusión cerebral. En los pacientes con LES, esta técnica gammagráfica no ha encontrado una mejoría significativa en la perfusión del SNC. Objective The central nervous system (CNS) may be involved in a variety of inflammatory diseases of the blood vessels, generally known as vasculitis. The clinical diagnosis of such involvement in early stages is difficult, since a mild cognitive impairment can be the only symptom. It was hypothesized that brain-perfusion SPECT would be able to reveal CNS involvement and to monitor the course of the disease. The purpose of this study was assess if and when an improvement of cerebral perfusion can be registered by SPECT during the follow-up of these diseases. Material and methods Eighteen patients affected by Systemic Lupus Erythematosus (SLE), 22 by undifferentiated vasculitis (UV), 5 by Behcet's disease (BD) and 5 by primary Sjogren's Syndrome (pSS) were enrolled in this prospective study. A 99m Tc-HMPAO brain perfusion SPECT was performed before the treatment and was repeated during the follow-up at different time intervals. Image analysis was performed on 10 cerebral areas using a specific software. Results In the SLE patients, no significant improvement of brain perfusion was found. On the contrary, in the UV the cerebral uptake of the tracer significantly improved from the twenty-fourth month (18/22 patients). Patients with BD showed an improvement of scintigraphic findings (5/5 patients), while a similar result was obtained only in 2 of the patients with pSS. Conclusions In conclusion, brain SPECT seems to be able to monitor the disease in UV, indicating the moment when an improvement of the cerebral perfusion is achieved. In SLE patients this scintigraphic technique did not show a significant improvement in CNS perfusion. [ABSTRACT FROM AUTHOR]

Background. Primary Central Nervous System Vasculitis (VPSNC) is an heterogeneous and infrequent disease characterized for vasculitis limited to the brain and spinal cord. The diagnosis is oriented by angiography and confirmed by biopsy. The treatment of VPSNC is based on the combination of steroids and cyclophosphamide, but nevertheless, some patients are intolerant or do not have favorable response to this treatment. To our knowledge there is only two other reports (three patients total) of VPSNC treated with Rituximab. Case report. We document the case of a female patient, 28 years old with diagnosis of VPSNC pseudotumoral variant, angiographically negative. In consideration of refractoriness of pseudotumoral variant with first-line treatment, we decided to administer treatment with Rituximab. Conclusions. Rituximab can be considered in a future to be a fistline treatment for VPSNC. [ABSTRACT FROM AUTHOR]

The rheumatoid vasculitis is the most serious complication of rheumatoid arthritis, with high morbidity and mortality. It is an inflammatory process that affects small and medium vessels and that has heterogeneous manifestations, being the cutaneous lesions and neuropathy the most common. Its incidence has declined in the last decades because of the early use of disease modifying antirheumatic drugs. Despite the use of cyclophosphamide and the existence of biologic drugs, achieving the control of the disease continues to be a challenge. We present the case of a 50 year-old man, without relevant antecedents, only tabaco use, that presented with a vasculitic neuropathy, rheumatoid factor and cyclic citrullinated peptide antibody positive. This bibliographic review has the intention to update the knowledge of this entity and to be considered a differential diagnosis. [ABSTRACT FROM AUTHOR]

It presents a patient who comes to Otorhinolaryngology Consultation with abundant nasal and secretions and fetids, nasal obstruction, increased volume of the nose with tumor appearance and pain of one year of evolution; a previous biopsy only showed necrosis. Treatment was imposed but it did not improve. Presented a greater nasal obstruction and a new nasal mucosa biopsy was performed; it was diagnosed as a Wegener's granulomatosis. The interesting thing about the case lies in the difficulty in making the diagnosis because clinically it simulated a tumor and in the biopsies the necrosis predominated, with only a few areas of granulomas. [ABSTRACT FROM AUTHOR]

The case of a 41 year-old patient from Cali, living in Guadalajara de Buga, is presented. The individual presented with several ulcers covered by fetid sero-purulent haemorrhagic scars in the inferior limbs, and necrotic purpuric lesions of different sizes in the rest of the skin. The patient is also a chronic smoker and regular cocaine user; he was hospitalized with the diagnoses of over-infected chronic ulcers and possible vasculitis due to cocaine consumption. [ABSTRACT FROM AUTHOR]

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