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At least 253 records · Page 14Linked to original sources

Behcet's disease with HIV infection: response to antiretroviral therapy.

The differential diagnosis of oral ulcerations in a patient with AIDS/HIV infection is often challenging to the clinician. While old diseases have appeared in a new garb, many new ones are also being recognized. The association of Behetaet's disease and AIDS/HIV infection has been recently recognized. We present an HIV-positive patient having oro-genital aphthosis conforming to the diagnostic criteria for Behetaet's disease. Erythema nodosum, periphlebitis, erythematous papulopustular lesions, half and half nails, ocular congestion, raised ESR and dimorphic anemia were some other features present. He had low CD4+/CD8+ counts. He had no other HIV-related disease. He responded well to triple anti-retroviral treatment alone. The possible pathomechanism of the occurrence of both diseases is also discussed.

Adult↗

Schistosoma mansoni infections in T-cell deprived mice, and the ameliorating effect of administering homologous chronic infection serum. II. Pathology.

Liver changes occurring in mice deprived of their T-cells by a combination of thymectomy and anti-mouse thymocyte serum, and in immunologically intact control mice, were followed during the early stages of heavy Schistosoma mansoni infections. Lesions in both groups began developing by day 38 and were maximal by day 48. Hepatic changes in control mice culminated in large hypersensitivity granulomas, tissue eosinophilia, portal periphlebitis, fibrosis, vascular obstruction, and infarction leading to arterialization and preferential sinusoidal channeling. Deprived mice showed greatly reduced egg reactions composed principally of macrophages, monocytes, and occasional neutrophils, and only minimal alteration of liver architecture; however, focal and disseminated hepatocellular lesions became prominent as the infections progressed, and by day 48 virtually every hepatocyte was affected. Typically, hepatocytes showed microvesicular cytoplasmic damage (steatosis) or ballooning degeneration with accompanying nuclear pyknosis or karyorrhexis. This cellular pathology may be attributed to the direct or indirect effect of eggs or egg products on liver cells. The administration of chronic infection serum obtained from immunocompetent mice to T-cell deprived mice dramatically eliminated the hepatocellular lesions. It also increased eosinophil participation and fibrosis in the egg reactions but did not restore the size and other cellular features typical of egg hypersensitivity granulomas. Serum from uninfected normal mice was found to lack these effects.

Animals↗

Trichobilharzia physellae (Digenea: Schistosomatidae) from endemic waterfowl on the high plains of Texas.

Adult Trichobilharzia physellae were recovered from the liver and mesenteric veins of green-winged teal, Anas creca, blue-winged teal, A. discors, and pintail, A. acuta, breeding on the High Plains of Texas. Wild ducks naturally-infected with these schistosomes were emaciated with mild to severe atrophy of the breast musculature. The liver was considerably enlarged, pale and somewhat friable. Numerous viable and dead T. physellae were recovered from the cut surface. On histologic examination, viable adult schistosomes were observed in the portal veins and dead, partly calcified T. physellae were found in the interlobular bile ducts. The normal liver architecture was well preserved but there was mild to extensive fibroplasia of most portal triads. An intense inflammatory response consisting mainly of eosinophils and fibroblasts with a few histiocytes, epithelioid cells, plasma cells, and lymphocytes surrounded the infected triads. There was pressure atrophy of adjacent hepatic parenchyma, hyperplasia or atrophy of the bile duct epithelium, bile stasis in smaller interlobular ducts, ectasia of larger portal ducts, focal areas of inflammatory cells throughout the liver, and periphlebitis of portal veins. The basic lesion presented as an obstructive fibrosis of the portal triads. These lesions are compared with those reported in infections by other schistosome species in their respective hosts. The oculate, apharyngeate, furcocercous cercariae of T. physellae were recovered from the snail first intermediate host, Physa anatina. Attempts to infect domestic mallard ducks via skin penetration by these cercariae were unsuccessful. This is the first record of a cercarial dermatitis-producing schistosome species from the Texas Panhandle and the first detailed description of such extensive lesions produced by adult schistosomes in the liver of a vertebrate host.

Animals↗

[Eales disease with neurologic manifestation: differential diagnosis of multiple sclerosis. Report of two cases].

BACKGROUND: Eales disease is a condition associating recurrent vitreous and retinal hemorrhage related to retinal periphlebitis. This ophthalmological disease is sometimes associated with central nervous system manifestations. CASE REPORT: Two patients with Eales disease of the retina developed a progressively worsening neurological deficit several years later. DISCUSSION: Evidence of multifocal anomalies of the white matter initially suggested a possible association of Earles disease with multiple sclerosis. Pathology findings enable formal differentiation of these two entities. Earles disease with neurological manifestations remains an uncommon condition and constitutes a differential diagnosis of multiple sclerosis.

Adult↗

Exudative retinal detachment and retinitis associated with acquired syphilitic uveitis.

PURPOSE: To describe three cases of exudative retinal detachment and focal retinitis associated with acquired syphilitic uveitis. METHODS: Three patients who were referred for evaluation of uveitis were examined. Slit-lamp examination, ophthalmoscopy, B-scan ultrasonography, fundus photography, and fluorescein angiography were performed before and after therapy. RESULTS: Each patient had uveitis with exudative retinal detachment, periphlebitis, and focal retinitis. Laboratory testing (fluorescent treponemal antibody absorption) revealed positive serology for active syphilis in all cases. Human immunodeficiency virus antibody testing was negative in all patients. Retinal detachment resolved in all cases after treatment with intravenous penicillin. Despite resolution of subretinal fluid, visual acuity remained poor in eyes in which the macula was detached. CONCLUSION: Syphilis is a cause of exudative retinal detachment. Antibiotic therapy can lead to retinal reattachment. Early recognition and treatment may prevent severe vision loss.

Adult↗

Tuberculous retinal vasculitis.

A patient who was referred to the eye department for routine ocular assessment prior to commencement of antituberculous therapy was found to have periphlebitis in both eyes despite being visually asymptomatic. Fluorescein angiography confirms the presence of vasculitis without any retinal oedema or areas of non-perfusion, which may sometimes accompany the condition. Within 2 months of systemic treatment, the ocular signs regressed without any permanent effect on vision. This case highlights a rare ocular complication associated with systemic tuberculosis which fortunately did not result in loss of vision due to prompt treatment.

Adult↗

[Ophthalmic tuberculosis, especially in Denmark].

The contagiousity of tuberculosis was demonstrated by Carl J. Salomonsen in 1877, injecting human caseous material in rabbit eyes, causing granulomatous iritis. It was five years before Robert Koch found the bacterium: Mycobacterium tuberculosis (MT). Marius Tscherning as professor emeritus from the University of Copenhagen, injected bovine MT and sanocrysin (Mølgaard's goldderivate) into rabbit eyes, causing corneal phlyctenules, but no ophthalmic reaction developed with only MT or sanocrysin alone (1928-29), not published). Emil Frandsen in 1959 examined 113 BCG vaccinated persons, who developed benign phlyctenules in 11%, 6-8 weeks after vaccination, and some cases of chronic iridocyclitis and chorioiditis. In 1158 non-vaccinated, some with serious tuberculosis, Frandsen found serious phlyctenules, chronic iridocyclitis, chorioiditis (especially disseminated) and periphlebitis, but not acute iridocyclitis of tuberculous origin. Phlyctenules and other TB-eye-diseases are described from Greenland 1926-76. Ophthalmic tuberculosis is still an important issue, also in Denmark today.

Denmark↗

[Onset of Behçet's disease as meningoencephalitis and sudden blindness].

CASE REPORT: A 41-year-old man presented a clinical picture characterized by lymphocytic meningoencephalitis, visual loss in both eyes and transverse sinus thrombosis. This picture was treated with prednisone and anticoagulation. Fundus examination showed complete occlusive arteritis, periphlebitis, peripheral ischemia and perfusion macular defects affecting both eyes. The picture was suggestive of Behçet's disease. Azathioprine was added to the treatment without improvement in visual acuity. Four months later oral aphthous ulcers developed, confirming the suspected diagnosis. DISCUSSION: Behçet's disease may appear with the sudden onset of visual loss secondary to massive occlusive retinal vasculitis. The critical state of neuro-Behçet disease may delay the diagnosis. This combination of visual and neurological symptoms is associated with a poor visual prognosis (Arch Soc Esp Oftalmol 2002; 77: 275-278).

Adult↗

[Myomas and pregnancy--obstetrics dilemma of the next decade?].

OBJECTIVES: This article describes the most frequent reasons, complications and appropriate treatment of pregnancy with uterine myomas and pregnancy after the myomectomy. MATERIALS AND METHODS: It is the analysis of pregnancies and deliveries of 24 women hospitalised in Medical Academy of Gdańsk. RESULTS: The typical complications were observed: early pregnancy loss, premature labor, cervical incompetence, abnormal presentation of the fetus, fetal death, periphlebitis and infertility. CONCLUSIONS: 1. Pregnancy connected with myomas is a high risk pregnancy because of a great number of complications. 2. There is a coincidence of myomas and pregnancy in older group of the patients. 3. The indications to cesarean section are connected rather with older age of women than with myomas. 4. Therefore it is proposed to change the indications for myomectomy during the caesarean section. It seems to be safe to join myomectomy with cesarean section because of low number of complications after this operation.

Adult↗

[Retinal arteritis in a case of sarcoidosis. A case report].

Retinal vasculitis is a common finding and occurs in 10% - 83% of patients with sarcoidosis. In most cases, there are bilateral, peripheral and nonischemic periphlebitis. In contrast, periarterial involvement is rarely observed. We report a case of retinal vasculitis associated with sarcoidosis and its differential diagnosis. Sarcoidosis should not be excluded in case of periarteritis.

Aged↗

[Bilateral peripheral retinal neovascularization in a patient with multiple sclerosis].

We present the case of a 32-year-old man suffering from multiple sclerosis who had developed bilateral peripheral neovascularization of the retina. The main disease had been diagnosed 10 years before, whereas in his ophthalmic history the patient reported an incident of retrobulbar optic neuritis in his left eye occurring 3 years before. The patient was referred to our clinic in order to investigate the cause of a sudden loss of vision in his left eye. Ophthalmic examination and fluorescein angiography revealed the presence of a bilateral peripheral retinal neovascularization with an intravitreous hemorrhage in the left eye. Systemic clinical and laboratory investigation were negative for other causes of retinal neovascularization except multiple sclerosis, which is associated with periphlebitis in 10% of cases. Chronic retinal ischemia may lead to retinal neovascularization.

Adult↗

Case of the month. Acute frosted angiitis.

A 42-year-old woman presented with acute visual loss in the left eye with funduscopic evidence of marked retinal periphlebitis (frosted angiitis) and a macular star. Extensive serologic testing identified no etiology. The purpose of this report is to review the clinical features and systemic associations of acute frosted angiitis, a rare ophthalmologic entity.

Adult↗

[Proliferative retinal vasculitis and multiple sclerosis: a case report].

INTRODUCTION: Retinal periphlebitis can precede the neurological effects of multiple sclerosis and reveal the disease. Although these occurrences of vasculitis are noted in 10% - 35% of multiple sclerosis patients, proliferative retinopathy is, on the contrary, an exceptional complication. CASE REPORT: We report the case of a 28-year-old woman who presented bilateral, proliferative, retinal vasculitis complicated with recurrent vitreous hemorrhages occurring with multiple sclerosis. Initially, there was a unilateral, central venous thrombosis in a particularly ischemic and proliferative form. After a neurological, biological and radiological check-up, the diagnosis of multiple sclerosis was pronounced and treatment with Interferon was started. A pan-retinal laser photocoagulation and vitrectomy with proliferative membrane peeling were performed. After a follow-up of 2.5 years, a bilateral epiretinal membrane on the macula with a chronic macular edema persisted, with visual acuity limited to 0.2 Parinaud 4 in the right eye and 0.5 Parinaud 2 in the left eye. DISCUSSION: This case shows that the diagnosis of multiple sclerosis must be established in cases of ischemic retinal vasculitis, especially as the literature does not seem to report a correlation between the retinal vascular affect and how far multiple sclerosis has progressed. Moreover, the visual prognosis of these proliferative lesions remains uncertain. CONCLUSION: Multiple sclerosis can be revealed initially, although exceptionally, by bilateral, proliferative and severe retinal vasculitis complicated with recurrent vitreous hemorrhages and tractional retinal detachment.

Adrenal Cortex Hormones↗

Pulmonary pathology in rabbits infected with the Baling and Koyan strains of Schistosoma malayensis.

Two distinct strains of Schistosoma malayensis exist in Malaysia (designated the Baling and Koyan strains). Both these strains show intraspecific variations in pathology (Greer et al, 1988). To evaluate the differences in the pulmonary pathology resulting from infections of the two different strains of Malaysian schistosome, a total of 20 experimental rabbits were infected, 10 each with cercariae of the Koyan strains. Pathological changes were studied over a period of 28 weeks. Granulomas in the lung occurring as a result of infection with the Baling strain were compared with those caused by infection with the Koyan strain. Although both strains produced parenchymatous and alveolar lesions, granulomas caused by the Baling strain of Malaysian schistosome were more numerous and larger (when comparing mean diameter as well as area of granuloma, p < 0.05). In addition, pulmonary vascular hypertensive changes were present in Baling strain infected rabbits. These comprised of pulmonary arteriolar endothelial swelling and damage, intimal elastosis and medial hypertrophy. Angiitis and pulmonary periphlebitis were also noted occasionally. In contrast, Koyan strain infection resulted in fewer and smaller granulomas. Pulmonary vascular changes were minimal.

Animals↗

A case of frosted-branch retinal angiitis in a child.

We report the case of a patient with frosted-branch angiitis of the retina in a 3-year-old girl. She had acute visual disturbances OU, and we observed iritis, retinal edema, and retinal angiitis. Retinal angiitis showed the same condition as previously described, the so-called acute frosted retinal periphlebitis accompanied with vascular sheathing. Her eyes improved rapidly after administration of an oral corticosteroid, and during the ensuing four months, she had no recurrences.

Child, Preschool↗

[Segmental retinal arteritis and retinochorioiditis].

Acute ocular toxoplasmosis is characterized by a focal retinochoroidal infiltrate, often appearing in the immediate vicinity of an old retinochoroidal scar (satellite lesion). There are atypical forms of ocular toxoplasmosis, including retinal granulomas, intraretinal and subretinal neovascularization, preretinal gliosis and retinal detachment. In rare instances, associated immunological phenomena, i.e. concomitant vasculitis and perivasculitis, have been described. We report on a 28-year-old male patient presenting with signs of congenital toxoplasmosis with intracerebral calcifications and internal hydrocephalus (Whytt's disease). Ocular manifestations included an acute retinochoroidal infiltrate adjacent to a retinochoroidal scar and segmental retinal periarteritis. All arterioles were involved, but there was no inflammation of the venules. Fluorescein angiography revealed filling irregularities of the vessel segments involved. Like a tubercular patient with segmental periarteritis reported on as long ago as 1939, our patient had undergone treatment for active tuberculosis of the lung 6 years earlier. Considering the fact that segmental periarteritis without concomitant periphlebitis is very rarely seen, the coincidence of acute toxoplasmosis and previous tuberculosis suggests a complex immunological etiology of retinal vasculitis. This assumption may be supported by the fact that a combined systemic treatment with pyrimethamine, trimethoprim, sulfamethoxazole and prednisolone reduced the retinochoroidal inflammation and periarterial infiltrates.

Adult↗

[Migrating and recurrent superficial phlebitis and Takayasu's disease (apropos of a case)].

This case of recurrent migratory superficial phlebitis is reported because of the highly unusual nature of the lesion observed. The picture was dominated by periphlebitis with inflammatory granuloma, giant cells and elastophagia. When the condition had been present for sixteen months, an aortic arch syndrome developed in an inflammatory context. In this light, various auto-immunological etiologies were considered, among them Takayashu's arteritis of which, in the author's opinion, this would be the first case to be combined with venopathy.

Adult↗

[Ocular changes in demyelinating diseases].

To synthetize the main ocular changes in the demyelinating diseases of CNS. The most important changes in this diseases are the neuro-ophthalmological ones: retrobulbar optic neuritis, papillitis, oculomotor nerves palsies. Also the demyelinating diseases can have an ophthalmological involvement represented by: retinal periphlebitis, pars planitis.

Demyelinating Diseases↗