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Metabolic Bone Disease and Systemic Disorders of the Temporal Bone
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Victoria Alexander, Parag Patel
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides affects small and large vessels. Immunofluorescence testing is done for c-ANCA/p-ANCA and ELISA testing for MPO and PR3 antibodies. Localised tissue biopsies from nose/ear provide low diagnostic yield.
Vasculitides
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Ivy M. Obonyo, Virginia A. Jones, Kayla A. Clark, Maria M. Tsoukas
Laboratory studies: Histologic study will show eosinophilia in the tissues (>10%), disseminated small vessel vasculitis, extravascular granulomatous change, and fibrinoid necrosis (Figure 13.11). When active, C-reactive protein (CRP) and ESR may be elevated. IgE is also elevated in patients with EGPA, but this is not specific. Elevated IgG4 levels are more specific and should be measured. Up to 90% of EGPA patients are positive for p-ANCA, but this is not diagnostic. Eotaxin-3, a chemokine that attracts eosinophils, is both sensitive and specific to EGPA when active.
Small vessel vasculitis
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Renu George, Ankan Gupta, Aswin M. Nair
Like the other SVV subtypes, no confirmatory test exists for EGPA, and the diagnosis remains predominantly on clinical grounds. P-ANCA positivity is associated with higher incidence of life-threatening complications. Manifestations necessitating immediate intervention include mononeuritis (wrist/foot drop), alveolar hemorrhage (0%–4%), and rapidly progressive renal failure. Features associated with less favorable prognosis (original Five Factor Score) include elevated creatinine (>1.58 mg/dL), proteinuria >1 g/day, CNS, gastrointestinal, or myocardial involvement [47].
Recurrent noninfectious preseptal cellulitis secondary to cocaine use and levamisole-associated vasculitis
Published in Baylor University Medical Center Proceedings, 2022
Wesley M. Gillette, Sonali Singh
Diagnosis is guided by characteristic purpuric lesions and variable autoantibody positivity with or without leukopenia following recent cocaine use.6 A majority of patients are reported to have high-titer p-ANCA,7 and other common autoantibody findings include c-ANCA, ANA, anti-dsDNA, anti-Smith, rheumatoid factor, and lupus anticoagulant.8,9 Though histopathology is useful, especially in cases where the timing of cocaine use and symptom onset is questionable, it is not necessary to make the diagnosis.10,11 Cocaine cessation alone can resolve most cases.1 Corticosteroids may be beneficial but should be reserved for refractory cases due to the risk of superinfection associated with leukopenia.12 In our case, oral prednisone was felt to be appropriate due to the patient’s worsening clinical status despite cocaine cessation. Other reported management strategies include plasmapheresis13 as well as nonsteroidal anti-inflammatory drugs or colchicine.6
28-year-old male anabolic steroid abuser with Susac syndrome. An interdisciplinary case report
Published in Modern Rheumatology Case Reports, 2019
Natalia Lewczuk, Alexander Zdebik, Joanna Bogusławska, Magdalena Targońska, Anna Turno-Kręcicka
The patient received vinpocetine 10 mg 3×/day to improve retinal blood flow and to avoid further progression of ischaemic changes in the fundus of the eye. He was also referred to an internal examination and performed tests for a complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), cholesterol and triglycerides in the serum, blood tests for factor V-Leiden, protein C and protein S mutation, homocysteine levels, antithrombin III, anti-phospholipid, c-antineutrophil cytoplasmic antibodies (c-ANCA) and p-antineutrophil cytoplasmic antibodies (p-ANCA), an antinuclear antibody-screening (ANA-screening), venereal disease research lab (VDRL) and Western blot. Immunofluorescence staining for c-ANCA (proteinase 3) and p-ANCA (myeloperoxidase) antibodies has been performed. No cytoplasmic and perinuclear staining in ethanol-fixed neutrophils has been detected. An enzyme-linked immunosorbent assay test for c-ANCA and p-ANCA has therefore not been performed. All performed tests and serological screenings for infectious agents mentioned earlier above were negative. Carotid artery Doppler ultrasonography and transthoracic echocardiography did not show any changes. Holter-ECG readings and blood pressure was normal. The patient was examined by a neurologist because of chronic headaches. On examination the patient was conscious, co-operative, well-oriented, without meningeal signs and with a natural muscle tone and strength (Table 1).
Immunoglobulin A vasculitis associated with inflammatory bowel disease: a retrospective cohort study
Published in Scandinavian Journal of Rheumatology, 2021
M Villatoro-Villar, CS Crowson, KJ Warrington, A Makol, MJ Koster
In total, nine patients with IBD and IgAV were identified; 67% of patients were Caucasian, six were male and three female. CD and UC were diagnosed in seven and two patients, respectively. The matched group included 18 patients with IgAV but without IBD. Table 1 summarizes the baseline characteristics of the IBD-IgAV cases and non-IBD-IgAV controls at the time of IgAV diagnosis. Two patients had positive p-ANCA with negative MPO. The remaining seven patients had negative ANCA serologies.