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Orthopaedics and musculoskeletal system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
14.26. Which of the following is/are characteristic of juvenile rheumatoid arthritis?Unexplained high fever.Morning joint stiffness.Skin rash.Generalized lymphadenopathy.Specific autoantibody.
Unexplained Fever In Hematologic Disorders Section 1. Benign Hematologic Disorders
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Generalized lymphadenopathy can be caused by systemic infections (Table 2). In some cases an enlarged spleen may be present as well. One of the most common causes of generalized lymphadenopathy and splenomegaly in young people is Epstein-Barr virus (EBV) associated with infectious mononucleosis. Other viral infections, such as cytomegalic virus infection (CMV), viral hepatitis, and influenza (Table 2) can produce a similar picture. In all of these, atypical lymphocytes can be found in the peripheral blood. A high titer of EBV is diagnostic of infectious mononucleosis.
Lymphocyte and plasma cell malignancies
Published in Gabriel Virella, Medical Immunology, 2019
Juan Carlos Varela, Gabriel Virella
Hairy cell leukemia is a rare lymphoid B-cell malignancy, predominantly affecting middle-age males (median age of diagnosis: 55 years). The clinical presentation is nonspecific and includes malaise, fatigue, and frequent infectious episodes. The physical examination usually shows splenomegaly and, sometimes, generalized lymphadenopathy. Laboratory data show pancytopenia, anemia being most frequent, followed by thrombocytopenia, and leukopenia. The diagnosis is based on the finding of atypical lymphocytes with numerous finger-like (or hairy) projections in the peripheral blood (the name of the disease derives from the morphological characteristics of the abnormal lymphocytes). The abnormal cells express light-chain membrane immunoglobulins, often of several isotypes (IgG3 often predominating), and also express classical B-cell markers (CD19, CD20, CD22).
Angioimmunoblastic T-cell lymphoma with exuberant plasmacytosis and spontaneous tumor lysis syndrome
Published in Baylor University Medical Center Proceedings, 2022
Hafsa Faisal, Syed Ather Hussain, Rachel David, Stephen Silver
Angioimmunoblastic T-cell lymphoma (AITL) is a subtype of mature peripheral T-cell lymphoma and a rare form of non-Hodgkin lymphoma, accounting for 1% to 2% of all non-Hodgkin lymphomas.1 It commonly presents with fevers, night sweats, skin rash, unintentional weight loss, effusions, hepatosplenomegaly, and generalized lymphadenopathy of several weeks’ duration.1 It was first described in 1954 and was initially thought to be an inflammatory proliferation of atypical T cells.2 However, in 2001 it was finally recognized as a distinct hematolymphoid neoplasm.2 Herein, we present a unique case of AITL associated with severe plasmacytosis, mimicking a plasma cell leukemia, with a hospital course complicated by spontaneous tumor lysis syndrome (sTLS).
Shingles: a harbinger of chronic HIV infection
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
S. Zachariah, A. Sullivan, A. Donato
HIV can be difficult to diagnose due to the non-specific and variable presentation during the early stages of disease. As many as 50% of initial HIV-infected patients suffer from flu-like or mononucleosis-like illness [5]. Symptoms can include fever, malaise, generalized rash, and generalized lymphadenopathy. More advanced stages of HIV present as life-threatening malignancies and opportunistic infections, otherwise known as acquired immunodeficiency syndrome (AIDS) defining illnesses. An AIDS defining illness is defined as CD4 < 200 cells/µL or several opportunistic infections, including pneumocystis pneumonia, cytomegalovirus disease, and invasive cervical cancer (but not including recurrent herpes zoster) [6]. When an AIDS defining illness is encountered, it should prompt consideration for an underlying HIV infection.
Lymphocytes subsets in correlation with clinical profile in CVID patients without monogenic defects
Published in Expert Review of Clinical Immunology, 2021
Farzaneh Tofighi Zavareh, Abbas Mirshafiey, Reza Yazdani, Abbas Ali Keshtkar, Hassan Abolhassani, Yasser Bagheri, Arezou Rezaei, Samaneh Delavari, Nima Rezaei, Asghar Aghamohammadi
Twenty-six genetically unsolved CVID patients (9 females, 35%) with a median age of 31 years (range 16 to 49 years) were included in this study as well as 26 age- and sex-matched healthy controls (HC). The IO group with the only complaint of infectious diseases was comprised of 15 patients (58%) and the CE group consisted of 8 patients (31%), diagnosed with chronic continual diarrhea. There were four patients reported with AI phenotype (15%); 2 of them suffered from rheumatoid arthritis, 1 from psoriasis and 1 from hypothyroidism. Moreover, 3 patients (11%) were in the LP group: one with splenomegaly, one with chronic lymphocytic hyperplasia and the last with generalized lymphadenopathy. Four patients showed overlaps in their clinical features, 2 presented with both LP and CE features, one presented with AI and CE and 1 presented with AI and LP (Figure 1). No difference was observed between clinical groups regarding patients’ age at onset of symptoms and delay in diagnosis (Table 1). The patients also showed no significant variation in age of evaluation. All patients had received IVIg for several years (median 9, range 2 to 21 years).