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Sjögren's Disease
Published in Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide, Clinical Innovation in Rheumatology, 2023
Management of systemic disease. Over the past decade, there has been a dramatic increase in the number of clinical trials conducted in SjD, both those initiated by investigators and those sponsored by pharmaceutical companies.
Muscle Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Kourosh Rezania, Peter Pytel, Betty Soliven
The main goals are prevention and treatment of systemic disease. In general, patients do not complain much about myotonia. Any improvement in myotonia may not necessarily translate to functional benefit for patients whose symptoms are more as a result of weakness than myotonia.
Sarcomas
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
The major change in the management of soft-tissue sarcomas has been in the development of limb-preserving treatment in the place of amputation. The main difficulty now lies in the prevention and treatment of systemic disease – currently treatments remain unsatisfactory but greater understanding of molecular pathways and drugs that can target these pathways are hoped to improve the situation.
Combined Ophthalmology and Rheumatology Evaluation in Systemic Autoimmune Diseases with Ocular Involvement: A Third Level Reference Center in Mexico
Published in Ocular Immunology and Inflammation, 2023
Pablo Baquero-Ospina, Rebeca Paquentín-Jiménez, Claudia Hubbe-Tena, Luz Elena Concha-Del-Rio
All patients were evaluated simultaneously by an ophthalmologist and rheumatologist. In most patients, a presumptive diagnosis was made from initial inflammatory eye manifestations and was corroborated with complete medical history, physical examination, and laboratory studies. All patients who were diagnosed with a systemic disease fulfilled the disease’s classification criteria. For all patients, infectious causes of ocular diseases were ruled out using Venereal Disease Research Laboratory (VDRL) and Fluorescent Treponemal Antibody-Absorption (FTA-ABS) for syphilis; Purified Protein Derivative (PPD), or QuantiFERON and chest radiography or CT thorax scan for tuberculosis; and herpes family virus, Toxocaracanis, Borrelia burgdorferi and/or Bartonella henselae antibody tests when these were suspected.
Clinical Profile, Systemic Association, Treatment and Visual Outcome of Patients with Scleritis in an Eye Care Center in Mexico City
Published in Ocular Immunology and Inflammation, 2023
Natalia Andrea Suarez Avellaneda, Yasha Bobadilla Marroquin, Carlos Emiliano Rodriguez Lopez, Maria Fernanda Loya Carrera, Miguel Pedroza-Seres
The association with systemic disease was present in 43.8% of our patients, coinciding with the range described in literature of 36–44%.1,15 Unlike us a cohort conducted in Arabia found systemic association only in 23% of the cases.16 RA was the most frequent disease in our study (21.6%), followed by GPA (17.2%). Surgery-induced necrotizing scleritis (SINS) usually develops in the surgical area. About 50–90% of patients with SINS will have a systemic autoimmune disease, although in most cases this is not identified at the time of scleritis.17 We found 4 patients with SINS (mainly associated with pterygium surgery), in 2 of them an associated systemic disease (RA and GPA) was documented. Infectious scleritis is a less common entity and requires antimicrobial therapy,18 in our cohort, 3% of cases were secondary to infections, a percentage slightly lower than that described in literature (5–18%).1 We consider that we had a lower proportion of patients with infectious scleritis because there were few patients with risk factors for this entity (postsurgical or a history of ocular trauma), furthermore microbiological confirmation is not always possible.
Kidney-limited AL amyloidosis: a case report and review of the literature
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Sara Velayati, Alexander Belkin, Gurwinder Sidhu Kumar, Zubin J Tharayil, Neeru Kumar, Samir Patel
AL systemic amyloidosis occurs as a result of abnormal light chain protein deposition, of which 80% are associated with the Lambda (λ) chain and involve almost all vital organs. The heart and kidneys, with 82% and 68% of cases reported, respectively, are the most common sites of deposition. Additionally, the liver, nervous system, and gastrointestinal tract are often involved, and multiple organ systems are frequently affected [5]. Localized amyloidosis is rare but has been reported in the upper airways, orbits, urinary tracts, skin, and nails; this almost never progresses to systemic disease. Amyloidosis can also be accompanied by other plasma cell dyscrasias such as multiple myeloma (MM) or monoclonal gammopathy of undetermined significance (MGUS); these should be evaluated and excluded at the time of diagnosis. As noted, systemic disease commonly involves multiple organs, and there is a predilection for one organ to be affected more than others. The kidneys are frequently involved in systemic amyloidosis, but it is extremely rare for the kidneys to be the sole organ involved in the disease process [6].