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АнтиNMDAr Encephalitis и COVID-19 в пациенте с системным ANCA-Vasculitis и периодическим вирусом Варичелла Зостер.

ВВЕДЕНИЕ: Существует сложная взаимосвязь между системным автоматическим иммунитетом, иммунодепрессией и инфекциями. Любой или любой из них может привести к неврологическим проявлениям, требующим усердия со стороны неврачей. В настоящем докладе сообщается о пациенте с иммунодепрессивным лечением от васкулита, который привел к зостному менингоэнцефалиту. Это еще более осложняется развитием энцефалита против NMDAr, этиология которого не определена и более подробно обсуждается в настоящем документе. В конце концов у пациента во время госпитализации появился COVID-19, и он умер от респираторных инф

Совпадение в аннотации оригинала
INTRODUCTION: There is a complex interplay between systemic autoimmunity, immunosuppression, and infections. Any or all of these can result in neurologic manifestations, requiring diligence on the part of neurologists. CASE REPORT: We herein report a case of a patient on immunosuppressive treatment for a vasculitis that resulted in zoster meningoencephaliti…

Large Vessel Vasculitis: Multimodality Imaging Findings and Technical Principles.

Vasculitides are disorders characterized by inflammation of blood vessels and are typically classified by their size. Large vessel vasculitis (LVV) is divided into two main categories of giant cell arteritis (GCA) and Takayasu arteritis (TA). Although there are key distinguishing factors in their presentation, in reality, both conditions can behave nonspecifically with generalized symptoms making diagnosis challenging. Noninvasive imaging has a role in identifying, classifying, and staging LVV; often with a multimodality approach including US, CT and MRI with angiography, and fluorine 18 (18F)…

Rituximab as Rescue Therapy for Atezolizumab-Induced IgA Vasculitis.

Immune checkpoint inhibitors have transformed cancer therapy but are associated with immune-related adverse events, including kidney injury. Although acute interstitial nephritis is the most common renal immune-related adverse events, glomerular diseases such as immunoglobulin A (IgA) vasculitis remain rare and poorly characterized. We report the first biopsy-confirmed case of IgA vasculitis with crescentic glomerulonephritis associated with the programmed death-ligand 1 inhibitor atezolizumab. A 75-year-old man with metastatic small-cell neuroendocrine prostate carcinoma developed a skin palp…

Purplish Terminal Ileum: Adult IgA Vasculitis Mimicking Crohn's Disease.

Immunoglobulin A (IgA) vasculitis is a systemic small-vessel vasculitis with frequent gastrointestinal involvement; however, isolated terminal ileitis mimicking Crohn's disease is rare in adults. We report a case of a previously healthy adult patient who presented with acute abdominal pain and bloody diarrhea, with imaging and endoscopic findings suggestive of Crohn's disease. Colonoscopy revealed isolated terminal ileitis with a distinctive purplish cyanotic appearance. The development of palpable purpura and biopsies demonstrating IgA deposition in the skin and ileal tissue confirmed the dia…

Pseudovasculitic Scurvy Mimicking Small Vessel Vasculitis: A Case Report.

Background and clinical significance: Scurvy, resulting from vitamin C deficiency, is rare in the 21st century, particularly in high-income settings. Its nonspecific presentation and ability to mimic a wide range of conditions make diagnosis incredibly challenging. Pseudovasculitic petechial lesions of the lower limbs may be misdiagnosed as systemic vasculitis, often leading to extensive investigations and delayed treatment. Case presentation: We report the case of a 45-year-old woman who presented with progressive lower limb pain, swelling, and vasculitis-like petechial rash with ecchymoses. …

Capillaroscopic alterations characterization in patients with primary systemic vasculitis.

BACKGROUND: Clinical manifestations in systemic vasculitis may be due to decreased arterial and venous flow because inflammation. There are few studies characterizing the changes in microcirculation in these diseases. Capillaroscopy can help detect changes in the microvasculature. OBJECTIVE: Characterize capillaroscopy alterations in primary systemic vasculitis's patients and associated factors. PATIENTS: Cross-sectional, observational, and comparative study. Thirty-two patients with systemic vasculitis (PGA n = 17, PAM n = 4, AT n = 4, PHS n = 3, PAN n = 2, and others n = 2) and 32 controls…

Tubercular retinal vasculitis in widefield optical coherence tomography angiography.

PURPOSE: To demonstrate the utility of widefield swept-source optical coherence tomography angiography (SS-OCTA) in identifying microvascular abnormalities in patients with presumed tubercular retinal vasculitis (TRV). OBSERVATIONS: We present a case series of three patients with presumed TRV confirmed by positive QuantiFERON-TB Gold testing. All patients exhibited clinical signs of occlusive retinal vasculitis, including perivascular inflammation, peripheral capillary nonperfusion, and neovascular complications. Widefield SS-OCTA (DREAM OCT, Intalight) using a single-shot 26 × 21-mm scan rev…

Highlights from the breakout session: vasculitis in paediatric rheumatology.

The 21st International Vasculitis Workshop, held in Barcelona, Spain, from April 7 to 10, 2024, highlighted advances in pediatric vasculitis, focusing on a holistic, multidisciplinary approach. Common childhood vasculitides, including IgA Vasculitis (IgAV) and Kawasaki Disease (KD), were discussed. The Ankara 2008 criteria for IgAV, endorsed by EULAR and PReS, were evaluated for their performance in adults, showing high sensitivity but necessitating further refinement for improved specificity. Studies on genetic associations, such as Human Leukocyte Antigen (HLA) polymorphisms in IgAV, and bio…

[Granulomatous primary central nervous system vasculitis in a child].

A 14-year-old boy was admitted to the hospital due to a single episode of afebrile seizure and four hours of impaired consciousness. Three m … punctate hemorrhages within lesions in the bilateral frontal and left parietal lobes, suggestive of vasculitis. Brain biopsy demonstrated inflammatory granulomatous lesions. No secondary causes were identified, and the final diagnosis was granulomatous primary central nervous system vasculitis. The patient's condition improved after treatment with methylpred …

Drug- and vaccine induced ANCA-associated vasculitis: An overview.

Many different drugs and/or vaccines may cause vasculitis which can be sometimes very severe. The clinical presentation varies from isolated skin vasculitis to multi-organ involvement with pulmonary-renal manifestations and/or cerebral vasculitis. Whereas causality is difficult to prove and rechallenges are considered unethical, pathophysiological mechanisms suggesting causality have been demonstrated for drugs such as hydralazine, propylthiouracil, levamisole, and immune checkpoint inhibitors. An important pathophysiological mechanism of drug-induced anti-neutrophil autoantibody (ANCA)-associ…

Relapsing ANCA-associated vasculitis presenting as a mediastinal mass.

Anti-neutrophil cytoplasmic antibody-associated vasculitides (AAV) represent a heterogeneous multisystem group of disorders typified by necr … agement options.Here, we present the case of a young man with pre-existing myeloperoxidase-positive vasculitis, describing a subacute cluster of symptoms and subsequently found to have an anterior mediastinal mass. Urgent tissue sampling excluded other aetiologies and ultimately delineated this as a surprising complication of vasculitis, allowing for prompt …

The relationship between retinal vascular tortuosity and retinal vasculitis.

AIMS: This study investigates the association between retinal vascular tortuosity and retinal vasculitis. METHODS: A retrospective review of medical records was conducted for 135 patients diagnosed with retinal vasculitis at our institution from June 2022 to June 2024. The presence and type of retinal vascular tortuosity were assessed, and logistic regression analysis was used to evaluate associations with viral infections, autoimmune conditions, and other clinical features. RESULTS: Of 256 patients with posterior uveitis, 135 patients were identified with retinal vasculitis, and 37 (27.4%) ex…

An acute Q fever with vessel vasculitis: case report.

BACKGROUND: Q fever (QF) is a relatively rare zoonotic infectious disease, and complications such as vasculitis and endocarditis are uncommon but severe. This article reports a case of acute QF complicated by vasculitis. CASE PRESENTATION: The patient presented with a week of recurrent fever. Upon admission, inflammatory markers and liver transaminases were elevated, and a weak positive result for Chlamydia pneumoniae Immunoglobulin M (IgM) antibodies was detected. After treatment with levofloxacin and doxycycline, the fever persisted. Blood metagenomic next-generation sequencing (mNGS) sugge…

Cerebral vasculitis in leptospirosis: An uncommon MRI case presentation.

Cerebral vasculitis is a rare but serious complication in leptospirosis, typically resulting from an immune-mediated inflammatory response. Neurological involvement occurs in approximately 10%-15% of leptospirosis cases, but true cerebral vasculitis remains exceedingly rare. MRI plays a crucial role in identifying vascular involvement by revealing vessel abnormalities, including inflammation and microbleeds. In leptospirosis, MRI helps confirm diagnosis, monitor progression, and guide clinical decisions, including immunosuppressive therapy. This case highlights the importance of early neuroima…