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Gregory P Van Stavern

Publications and source records attributed to Gregory P Van Stavern.

5 recordsLinked to original sources
PubMed2006

Adalimumab-associated optic neuritis.

We present, to our knowledge, the first published cases of optic neuritis associated with adalimumab, a medication in the class of anti-tumor necrosis factor-alpha (TNF-alpha) antagonists. Approved in recent years by the FDA, adalimumab (Humira, Abbott Laboratories; Abbott Park, IL) is a recombinant monoclonal antibody that targets and blocks the physiologic effects of TNF. Other TNF antagonists have had associations with optic neuritis and demyelinating events.

Adalimumab↗
PubMed2004

Clinical characterization of idiopathic intracranial hypertension at the Detroit Medical Center.

BACKGROUND: Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri (PTC), is a condition characterized by increased intracranial pressure without clinical, laboratory or radiologic evidence of an intracranial space-occupying lesion, meningeal inflammation or venous outflow obstruction. Previous population-based studies evaluated the presenting clinical features of IIH in North-Eastern Libya, Iowa, Louisiana, Minnesota, Northern Ireland, Israel and Western Turkey. However, we report the demographic patterns of a metropolitan North American city. METHODS: We performed a retrospective study of all patients with an initial IIH diagnosis and follow-up at the Detroit Medical Center (DMC), Michigan from 1985 to 2002. Medical records of 174 patients were reviewed, with 77 patients fitting the diagnostic criteria. RESULTS: Seventy-seven patients, 71 females (92.2%) and 6 males (7.8%) were identified. Age ranged from 10 to 50 years, with a mean of 34 years. Fifty patients (65%) were African-American and 24 patients (31%) were Caucasian. The most common presentation was isolated headache (28.6%). Nineteen patients (24.7%) were asymptomatic. Obesity was described in 65 of 74 patients (87.8%) evaluated for body dimensions. CONCLUSIONS: We report an increased number of asymptomatic patients after routine ophthalmic examination. Obese females in metropolitan Detroit would benefit from routine eye evaluations to avoid potential visual loss related to papilledema.

Adolescent↗
PubMed2004

Ischemic pituitary apoplexy associated with the lupus anticoagulant.

PURPOSE: To report a case of ischemic pituitary apoplexy secondary to a hypercoagulable state following elective orthopedic surgery. DESIGN: Observational case report. METHODS: A 48-year-old Caucasian man underwent an uneventful, left-sided total hip replacement and corrective osteotomy of the proximal femur. Two days post-operative, he developed a frontal headache and blurred vision in both eyes. RESULTS: Ophthalmic examination revealed right VIth cranial nerve palsy. Imaging studies indicated pituitary apoplexy with a large hypodense pituitary lesion with widening of the sella turcica. Laboratory findings included positive lupus anticoagulant, a normal prothrombin time (PT), and an elevated activated partial thromboplastin time (aPTT). Five days after the initial symptoms, a transsphenoidal pituitary resection was performed. At a 6 months follow-up, the VIth nerve paresis was completely resolved. CONCLUSIONS: This case describes ischemic pituitary apoplexy associated with a pre-operatively elevated aPTT and positive lupus anticoagulant. This is the first report, to our knowledge, of atypical apoplexy concurrent with antiphospholipid (aPL) antibodies following an uneventful surgery. The results we obtained on this patient suggest that an associated hypercoaguable state may increase the risk of thrombosis following elective orthopedic surgery.

Antibodies, Antiphospholipid↗
PubMed2004

Neuro-ophthalmic manifestations of systemic disease--hematology.

The hematopoietic system is a complex mixture of circulating blood cells, plasma, and plasma proteins. Disorders of the hematologic system may result from excess or impaired production of blood cells, destruction of blood cells, or abnormal function of existing blood cells. The afferent and efferent visual systems may both be affected by blood cell disorders, and the specific manifestation is dependent upon which cell line is involved, the type of dysfunction, and the characteristics of the target tissue. This article reviews the ocular and neuro-ophthalmic manifestation of hematologic disorders.

Eye Diseases↗