Background: Hematological involvement, including anemia, leukopenia, lymphopenia, and thrombocytopenia, is one of the most common manifestations of childhood-onset systemic lupus erythematosus (cSLE). Specifically, relatively severe forms of hematological involvement, such as macrophage activation syndrome (MAS) and thrombotic microangiopathy, occur in the course of the disease. Positivity for anti-double stranded-DNA (ds-DNA) antibody and hypocomplementemia are important as not only criteria of diagnosing cSLE but also in the determination of the disease activity.
Case report: A 13-year-old boy without pre-existing disease was referred to our hospital chiefly complaining of a fever for > 7 days, long-lasting malaise, nausea, and non-malar face rash. His blood examination showed pancytopenia and hyperferritinemia, but positive results for anti-ds-DNA antibody and hypocomplementemia were not recognized. Bone marrow aspiration revealed no evidence of malignant diseases, hemophagocytic lymphohistiocytosis, or MAS. A renal biopsy for the differential diagnosis of proteinuria and hematuria revealed class IIIa +V lupus nephritis, leading to the diagnosis of cSLE.
Conclusions: It is important for cSLE to be considered in patients with pancytopenia, even those without positive anti-ds-DNA antibody findings or hypocomplementemia, and for aggressive approaches to be adopted for the differential diagnosis, including a renal biopsy.
{"title":"A Boy Presenting with a Fever and Pancytopenia Diagnosed with Systemic Lupus Erythematosus without a Positive Anti-ds-DNA Antibody Result or Hypocomplementemia: A Case Report.","authors":"Yuichi Kama, Kenta Kuruma, Tomofumi Otomo, Takashi Sakama, Kosuke Akiyama, Hiromitsu Takakura, Daisuke Toyama, Kota Hirai, Hiroyuki Mochizuki, Masahiko Kato","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Hematological involvement, including anemia, leukopenia, lymphopenia, and thrombocytopenia, is one of the most common manifestations of childhood-onset systemic lupus erythematosus (cSLE). Specifically, relatively severe forms of hematological involvement, such as macrophage activation syndrome (MAS) and thrombotic microangiopathy, occur in the course of the disease. Positivity for anti-double stranded-DNA (ds-DNA) antibody and hypocomplementemia are important as not only criteria of diagnosing cSLE but also in the determination of the disease activity.</p><p><strong>Case report: </strong>A 13-year-old boy without pre-existing disease was referred to our hospital chiefly complaining of a fever for > 7 days, long-lasting malaise, nausea, and non-malar face rash. His blood examination showed pancytopenia and hyperferritinemia, but positive results for anti-ds-DNA antibody and hypocomplementemia were not recognized. Bone marrow aspiration revealed no evidence of malignant diseases, hemophagocytic lymphohistiocytosis, or MAS. A renal biopsy for the differential diagnosis of proteinuria and hematuria revealed class IIIa +V lupus nephritis, leading to the diagnosis of cSLE.</p><p><strong>Conclusions: </strong>It is important for cSLE to be considered in patients with pancytopenia, even those without positive anti-ds-DNA antibody findings or hypocomplementemia, and for aggressive approaches to be adopted for the differential diagnosis, including a renal biopsy.</p>","PeriodicalId":38819,"journal":{"name":"Tokai Journal of Experimental and Clinical Medicine","volume":"47 4","pages":"177-181"},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40492413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: To date, topical allergic rhinitis drugs must be applied intranasally. We studied the efficacy, safety, and impact on co-existing asthma symptoms of transdermal delivery of diphenhydramine through the nasal ala.
Methods: We enrolled outpatients with symptomatic allergic rhinitis and asthma who were on stable medication for at least 4 weeks. Patients applied diphenhydramine ointment, 0.07 g measured with weighing spoon (0.7 mg diphenhydramine), to the nasal ala twice a day for 2 weeks, followed by 2 weeks' washout. Effects were assessed with the Japanese Allergic Rhinitis Standard Quality of Life Questionnaire (JRQLQ) and Self-assessment of Allergic Rhinitis and Asthma (SACRA) and Asthma Control Test (ACT) questionnaires.
Results: Ten patients participated in the study. Two patients experienced acute exacerbation of asthma during the intervention phase, but no other adverse effects occurred. Self-assessments indicated efficacy in treating nasal symptoms in 5 patients. No significant changes in scores were seen, although mean total JRQLQ score showed a numerical improvement (from 34.3 [21.0] to 14.4 [8.8]; P = 0.0547). Asthma symptoms improved subjectively in 2 patients.
Conclusions: The efficacy of transdermal application of diphenhydramine on the nasal ala for treating allergic rhinitis was not conclusive, but appears to be effective in certain patients.
{"title":"A Pilot Study of Transdermal Application of Diphenhydramine to the Nasal Ala in Patients with Allergic Rhinitis and Asthma.","authors":"Mitsuhiro Kamimura, Toshiya Inui, Atsuto Mouri, Hiroaki Todo, Kenji Sugibayashi, Koichiro Asano","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>To date, topical allergic rhinitis drugs must be applied intranasally. We studied the efficacy, safety, and impact on co-existing asthma symptoms of transdermal delivery of diphenhydramine through the nasal ala.</p><p><strong>Methods: </strong>We enrolled outpatients with symptomatic allergic rhinitis and asthma who were on stable medication for at least 4 weeks. Patients applied diphenhydramine ointment, 0.07 g measured with weighing spoon (0.7 mg diphenhydramine), to the nasal ala twice a day for 2 weeks, followed by 2 weeks' washout. Effects were assessed with the Japanese Allergic Rhinitis Standard Quality of Life Questionnaire (JRQLQ) and Self-assessment of Allergic Rhinitis and Asthma (SACRA) and Asthma Control Test (ACT) questionnaires.</p><p><strong>Results: </strong>Ten patients participated in the study. Two patients experienced acute exacerbation of asthma during the intervention phase, but no other adverse effects occurred. Self-assessments indicated efficacy in treating nasal symptoms in 5 patients. No significant changes in scores were seen, although mean total JRQLQ score showed a numerical improvement (from 34.3 [21.0] to 14.4 [8.8]; P = 0.0547). Asthma symptoms improved subjectively in 2 patients.</p><p><strong>Conclusions: </strong>The efficacy of transdermal application of diphenhydramine on the nasal ala for treating allergic rhinitis was not conclusive, but appears to be effective in certain patients.</p>","PeriodicalId":38819,"journal":{"name":"Tokai Journal of Experimental and Clinical Medicine","volume":"47 4","pages":"170-176"},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40492412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-29DOI: 10.52142/omujecm.39.4.62
I. E. Uluisik, M. Sonkaya, N. Dokuzeylul Gungor
Glanzmann thrombasthenia (GT), which has an autosomal inheritance pattern, is a hemorrhagic disorder mostly complicated by mucocutaneous bleeding. The severity of this bleeding disorder varies from mild bruising to frequent severe bleeding. Prepartum, peripartum and postpartum bleeding risks are increased in these patients. In addition to the hemorrhagic complications that endanger maternal and fetal well-being, the risk of miscarriage is increased due to maternal antibodies to the platelets found on conceptus-derived trophoblast (placental) cells. In this case report, we report a patient who had a miscarriage in 7+1 week. Our patient had GT, low ovarian reserve, HPV positivity, bilateral dermoid cyst and was complicated by infertility.
{"title":"Miscarriage in a patient with Glanzmann Thrombasthenia and low ovarian reserve: A case report","authors":"I. E. Uluisik, M. Sonkaya, N. Dokuzeylul Gungor","doi":"10.52142/omujecm.39.4.62","DOIUrl":"https://doi.org/10.52142/omujecm.39.4.62","url":null,"abstract":"Glanzmann thrombasthenia (GT), which has an autosomal inheritance pattern, is a hemorrhagic disorder mostly complicated by mucocutaneous bleeding. The severity of this bleeding disorder varies from mild bruising to frequent severe bleeding. Prepartum, peripartum and postpartum bleeding risks are increased in these patients. In addition to the hemorrhagic complications that endanger maternal and fetal well-being, the risk of miscarriage is increased due to maternal antibodies to the platelets found on conceptus-derived trophoblast (placental) cells. In this case report, we report a patient who had a miscarriage in 7+1 week. Our patient had GT, low ovarian reserve, HPV positivity, bilateral dermoid cyst and was complicated by infertility.","PeriodicalId":38819,"journal":{"name":"Tokai Journal of Experimental and Clinical Medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78051961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-29DOI: 10.52142/omujecm.39.4.12
Murat Önal, M. Kavrut, N. Dokuzeylül Güngör, T. Gürbüz
{"title":"The effects of sperm parameters and sperm DNA damage on pregnancy outcomes of women undergoing intrauterine insemination","authors":"Murat Önal, M. Kavrut, N. Dokuzeylül Güngör, T. Gürbüz","doi":"10.52142/omujecm.39.4.12","DOIUrl":"https://doi.org/10.52142/omujecm.39.4.12","url":null,"abstract":"","PeriodicalId":38819,"journal":{"name":"Tokai Journal of Experimental and Clinical Medicine","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81854426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-29DOI: 10.52142/omujecm.39.4.51
A. Asik, S. Bolu
{"title":"An evaluation of IGF-1 and IGFBP-3 levels in patients receiving growth hormone therapy and these parameters therapeutic efficacy","authors":"A. Asik, S. Bolu","doi":"10.52142/omujecm.39.4.51","DOIUrl":"https://doi.org/10.52142/omujecm.39.4.51","url":null,"abstract":"","PeriodicalId":38819,"journal":{"name":"Tokai Journal of Experimental and Clinical Medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79507202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Change in GFR in relation to pulse rate, dipping blood pressure, anti-hypertensives, NLR and PLR in patients with chronic kidney disease","authors":"Hüseyin Duru","doi":"10.52142/omujecm.39.4.3","DOIUrl":"https://doi.org/10.52142/omujecm.39.4.3","url":null,"abstract":"","PeriodicalId":38819,"journal":{"name":"Tokai Journal of Experimental and Clinical Medicine","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86477514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-29DOI: 10.52142/omujecm.39.4.44
Fulya Köse, Bülent Güngörer, H. Arslan, A. S. Girişgin, Z. D. Dündar, Merve Güven
{"title":"Significance of tissue oxygenation in patients connected to a mechanical ventilator","authors":"Fulya Köse, Bülent Güngörer, H. Arslan, A. S. Girişgin, Z. D. Dündar, Merve Güven","doi":"10.52142/omujecm.39.4.44","DOIUrl":"https://doi.org/10.52142/omujecm.39.4.44","url":null,"abstract":"","PeriodicalId":38819,"journal":{"name":"Tokai Journal of Experimental and Clinical Medicine","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84704219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-29DOI: 10.52142/omujecm.39.4.64
Emre Demirel, E. Tahir, H. Albayrak, N. Yener, S. Atmaca
the event of upper airway edema. A previously undetected subcutaneous emphysema in the patient’s submandibular region and anterior thoracic wall was found. We used a syringe to drain subcutaneous emphysema. In the presence of imminent respiratory failure, we performed elective endotracheal intubation using direct laryngoscopy without incident. The child was transported to the pediatric intensive care unit and placed on mechanical ventilation. On the first day of his hospitalization, he had a fever
{"title":"Management of subcutaneous emphysema due to penetrating oropharyngeal trauma","authors":"Emre Demirel, E. Tahir, H. Albayrak, N. Yener, S. Atmaca","doi":"10.52142/omujecm.39.4.64","DOIUrl":"https://doi.org/10.52142/omujecm.39.4.64","url":null,"abstract":"the event of upper airway edema. A previously undetected subcutaneous emphysema in the patient’s submandibular region and anterior thoracic wall was found. We used a syringe to drain subcutaneous emphysema. In the presence of imminent respiratory failure, we performed elective endotracheal intubation using direct laryngoscopy without incident. The child was transported to the pediatric intensive care unit and placed on mechanical ventilation. On the first day of his hospitalization, he had a fever","PeriodicalId":38819,"journal":{"name":"Tokai Journal of Experimental and Clinical Medicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90431115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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