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Nocardia Lymphadenitis and Encephalitis in Immunocompromised Patient: A Case Report 免疫功能低下患者的诺卡菌淋巴结炎和脑炎1例报告

Q4 Medicine

Open Neurology Journal

Pub Date : 2023-10-30 DOI: 10.2174/011874205x254011230922043119

Rizaldy Taslim Pinzon, Tillandsia Filli Folia Primastuti

Background: Nocardiosis-related HIV usually appears in immunocompromised patients, which is caused by Nocardia sp. Although a number of reports describe pulmonary forms of nocardiosis in HIV-positive patients, lymphadenitis and encephalitis due to this organism are rare entities. Our preliminary search has only found a few cases reported in the literature. Unless investigations like gram stain and culture for Nocardia are specifically done, the infection is often mistaken for tuberculosis. We have herein reported a case of Nocardia lymphadenitis and encephalitis in an HIV-positive patient. Case Presentation: A 33-year-old male presented fever, progressive weakness in the right side of the body, multiple lesions on the oral cavity, and left colli lesions. Physical examination found GCS as E4 M6 V uncounted, hypertonic and increased physiology reflexes on the right extremity without pathologic reflexes, meningeal signs, and all cranial nerves as normal. The laboratory test result was HIV-positive with CD4+ 7 cells/μL and Nocardia sp. on histopathology. A plain head computed tomography (CT) scan showed a hypodense lesion in the fronto-temporo-parieto-occipital sinistra region, and vasogenic edema. The patient was administered antiretroviral (ARV) therapy and antibiotics for nocardiosis lymphadenitis. Conclusion: A rare case of Nocardia lymphadenitis has been reported in this paper, and the physician must be aware of nocardiosis in HIV patients with neurological deficits.

背景:诺卡菌病相关的HIV通常出现在免疫功能低下的患者中，这是由诺卡菌引起的。尽管许多报告描述了诺卡菌病在HIV阳性患者中的肺部形式，但由该生物体引起的淋巴结炎和脑炎是罕见的。我们的初步调查只发现文献中报道的少数病例。除非进行革兰氏染色和诺卡菌培养等专门检查，否则这种感染经常被误认为是结核病。我们在此报告了诺卡菌淋巴结炎和脑炎在一个hiv阳性病人的情况。病例介绍:33岁男性，发热，右侧进行性虚弱，口腔多处病变，左侧结肠病变。体格检查发现GCS为E4 M6 V未计数，右肢生理反射增高，无病理性反射，脑膜征，所有脑神经正常。实验室检测结果为hiv阳性，CD4+ 7细胞/μL，组织病理学检查为诺卡菌感染。头部CT平扫显示额-颞-顶-枕窦区低密度病变，血管源性水肿。患者接受抗逆转录病毒(ARV)治疗和诺卡菌性淋巴结炎抗生素治疗。结论:本文报道了一例罕见的诺卡菌性淋巴结炎病例，医生必须注意诺卡菌性淋巴炎伴神经功能缺损的HIV患者。

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引用次数: 0

Epidemiology and Clinical Course of Chronic Autoimmune Neuropathies During the SARS-CoV-2 Pandemic in Latvia 拉脱维亚SARS-CoV-2大流行期间慢性自身免疫性神经病变的流行病学和临床病程

Q4 Medicine

Open Neurology Journal

Pub Date : 2023-06-23 DOI: 10.2174/1874205x-v17-230619-2022-14

Ieva Glāzere, Marija Luīze Kalniņa, Dmitrijs Rots, Marija Roddate, Linda Gailīte, Nataļja Kurjāne, Viktorija Ķēniņa

Background: Chronic autoimmune neuropathies are a group of rare neurological disorders caused by the immune response to autoantigens in the peripheral nervous system. Objective: This study aimed to report epidemiological data in Latvia on the most common chronic autoimmune neuropathies and evaluate SARS-CoV-2 infections or vaccinations’ impact on our patient’s clinical course of the disease. Methods: A single-center observational study was performed, which included all patients diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN) in Latvia since 2015. Prevalence and incidence were calculated by using population data from the corresponding time of the Central Statistics Bureau of Latvia. Detailed clinical evaluation and re-assessment of diagnostic criteria were performed in the whole study group. All patients underwent telephone interviews regarding their SARS-CoV-2 vaccination or infection status. Results: This study included 23 CIDP and 8 MMN patients. The point prevalence and incidence of CIDP were 1.21 per 100 000 people and 1.16 per 100 000 people, respectively. The point prevalence and incidence of MMN were 0.42 per 100 000 individuals and 0.40 per 100 000 individuals, respectively. Most of the patients involved in this study (90%, n=28) with CIDP or MMN were vaccinated against SARS-CoV-2 infection, and none of the patients experienced fluctuations or relapse regarding autoimmune polyneuropathy. Conclusion: The incidence and prevalence of CIDP and MMN in Latvia are similar to previously reported European studies. In our study group, vaccination against SARS-CoV-2 was safe and did not negatively affect the clinical course of CIDP and MMN patients.

背景:慢性自身免疫性神经病是由周围神经系统对自身抗原的免疫反应引起的一组罕见的神经系统疾病。目的:本研究旨在报告拉脱维亚最常见的慢性自身免疫性神经病变的流行病学数据，并评估SARS-CoV-2感染或疫苗接种对患者临床病程的影响。方法:采用单中心观察性研究，纳入拉脱维亚2015年以来诊断为慢性炎症性脱髓鞘性多神经病变(CIDP)和多灶性运动神经病变(MMN)的所有患者。患病率和发病率是利用拉脱维亚中央统计局相应时间的人口数据计算的。在整个研究组中进行详细的临床评估和诊断标准的重新评估。所有患者都接受了关于其SARS-CoV-2疫苗接种或感染状况的电话访谈。结果:本研究纳入23例CIDP和8例MMN患者。点患病率和发病率分别为1.21 / 10万人和1.16 / 10万人。MMN的点患病率和发病率分别为0.42 / 10万和0.40 / 10万。本研究涉及的大多数CIDP或MMN患者(90%，n=28)接种了SARS-CoV-2感染疫苗，没有患者出现自身免疫性多神经病变的波动或复发。结论:拉脱维亚的CIDP和MMN的发病率和流行程度与先前报道的欧洲研究相似。在我们的研究组中，接种SARS-CoV-2疫苗是安全的，并且对CIDP和MMN患者的临床病程没有负面影响。

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引用次数: 0

Post-COVID-19 Sydenham Chorea: A Case Report 后covid -19西德汉姆舞蹈病:一例报告

Q4 Medicine

Open Neurology Journal

Pub Date : 2023-04-07 DOI: 10.2174/1874205x-v17-e230403-2022-13

José Augusto Camargo, Stéfani Augustoli Morcillo

Background: Sydenham chorea, or rheumatic chorea, is a movement disorder that is more prevalent among young people, with a mean age at symptom onset between 8 and 9 years. The condition is more common in females. Sydenham chorea is associated with rheumatic fever and is considered the most common cause of acute chorea in children. We believe that the present case is worth reporting since the occurrence of Sydenham chorea as a post-COVID-19 sequela has not been described in Brazil. Case Presentation: We report here the case of a 14-year-old girl with symptoms of acute chorea that emerged 15 days after treatment resolution of COVID-19 (SARS-CoV-2 or severe acute respiratory syndrome coronavirus 2). Brain computed tomography (CT) and magnetic resonance imaging scans showed no changes, and the laboratory tests revealed no signs of an active infectious process. In contrast, neurological positron-emission tomography/CT showed mild glycolytic hypometabolism in the bilateral mesial frontal region. Administration of an oral anticonvulsant resulted in a marked improvement in her symptoms. Conclusion: Despite major efforts of the scientific community for discovering treatments, preventive methods, mechanisms of action, and possible sequelae of SARS-CoV-2, there is still a long way to go to better understand this devastating pathological agent that has affected the global population.

背景:西德纳姆舞蹈病或风湿病舞蹈病是一种运动障碍，在年轻人中更为普遍，症状发作的平均年龄在8至9岁之间。这种情况在女性中更为常见。西德纳姆舞蹈病与风湿热有关，被认为是儿童急性舞蹈病的最常见原因。我们认为，目前的病例值得报告，因为在巴西尚未报道过西德纳姆舞蹈病作为covid -19后后遗症的发生。病例介绍:我们在此报告一名14岁女孩，在COVID-19 (SARS-CoV-2或严重急性呼吸综合征冠状病毒2)治疗消退15天后出现急性舞蹈病症状。脑计算机断层扫描(CT)和磁共振成像扫描未显示任何变化，实验室检查未显示活跃感染过程的迹象。相反，神经正电子发射断层扫描/CT显示双侧内侧额叶区轻度糖酵解代谢低下。口服抗惊厥药使她的症状明显好转。结论:尽管科学界为发现SARS-CoV-2的治疗方法、预防方法、作用机制和可能的后遗症做出了重大努力，但要更好地了解这种影响全球人口的破坏性病理因子，还有很长的路要走。

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引用次数: 0

Post-COVID-19 Sydenham Chorea: A Case Report 后covid -19西德汉姆舞蹈病:一例报告

Q4 Medicine

Open Neurology Journal

Pub Date : 2023-04-07 DOI: 10.2174/1874205X-v17-230223-2022-13

José Augusto Camargo, Stéfani Augustoli Morcillo

Sydenham chorea, or rheumatic chorea, is a movement disorder that is more prevalent among young people, with a mean age at symptom onset between 8 and 9 years. The condition is more common in females. Sydenham chorea is associated with rheumatic fever and is considered the most common cause of acute chorea in children. We believe that the present case is worth reporting since the occurrence of Sydenham chorea as a post-COVID-19 sequela has not been described in Brazil. We report here the case of a 14-year-old girl with symptoms of acute chorea that emerged 15 days after treatment resolution of COVID-19 (SARS-CoV-2 or severe acute respiratory syndrome coronavirus 2). Brain computed tomography (CT) and magnetic resonance imaging scans showed no changes, and the laboratory tests revealed no signs of an active infectious process. In contrast, neurological positron-emission tomography/CT showed mild glycolytic hypometabolism in the bilateral mesial frontal region. Administration of an oral anticonvulsant resulted in a marked improvement in her symptoms. Despite major efforts of the scientific community for discovering treatments, preventive methods, mechanisms of action, and possible sequelae of SARS-CoV-2, there is still a long way to go to better understand this devastating pathological agent that has affected the global population.

西德纳姆舞蹈病或风湿病舞蹈病是一种运动障碍，在年轻人中更为普遍，症状发作的平均年龄在8至9岁之间。这种情况在女性中更为常见。西德纳姆舞蹈病与风湿热有关，被认为是儿童急性舞蹈病的最常见原因。我们认为，目前的病例值得报告，因为在巴西尚未报道过西德纳姆舞蹈病作为covid -19后后遗症的发生。我们在此报告一名14岁女孩，在COVID-19 (SARS-CoV-2或严重急性呼吸综合征冠状病毒2)治疗消退15天后出现急性舞蹈病症状。脑计算机断层扫描(CT)和磁共振成像扫描未显示任何变化，实验室检查未显示活跃感染过程的迹象。相反，神经正电子发射断层扫描/CT显示双侧内侧额叶区轻度糖酵解代谢低下。口服抗惊厥药使她的症状明显好转。尽管科学界为发现SARS-CoV-2的治疗方法、预防方法、作用机制和可能的后遗症做出了重大努力，但要更好地了解这种影响全球人口的破坏性病理因子，还有很长的路要走。

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引用次数: 1

An immunological analysis of dystroglycan subunits: lessons learned from a small cohort of non-congenital dystrophic patients. 糖营养不良亚基的免疫学分析:非先天性营养不良患者小队列的经验教训。

Q4 Medicine

Open Neurology Journal

Pub Date : 2011-01-01 Epub Date: 2011-10-20 DOI: 10.2174/1874205X01105010068

Ernesto Pavoni, Francesca Sciandra, Giorgio Tasca, Roberta Tittarelli, Manuela Bozzi, Bruno Giardina, Enzo Ricci, Andrea Brancaccio

The dystroglycan (DG) expression pattern can be altered in severe muscular dystrophies. In fact, some congenital muscular dystrophies (CMDs) and limb-girdle muscular dystrophies (LGMDs) are caused by point mutations identified in six glycosyltransferase genes which are likely to target different steps along the posttranslational "O-glycosylation route" leading to a fully decorated and functional α-DG subunit. Indeed, hypoglycosylation of α-DG is thought to represent a major pathological event, in that it could reduce the DG's ability to bind the basement membrane components, thus leading to sarcolemmal instability and necrosis. In order to set up an efficient standard immunological protocol, taking advantage of a wide panel of antibodies, we have analyzed the two DG subunits in a small cohort of adult dystrophic patients, whom an extensive medical examination had already clinically classified as affected by LGMD (5), Miyoshi (1) or distal (1) myopathy. Immunofluorescence analysis of skeletal muscle tissue sections revealed a proper sarcolemmal localization of the DG subunits in all the patients analyzed. However, Western blot analysis of lectin enriched skeletal muscle samples revealed an abnormal glycosylation of α-DG in two patients. Our work reinforces the notion that a careful immunological and biochemical analysis of the two DG subunits should be always considered as a prerequisite for the identification of new putative cases of dystroglycanopathy.

肌营养不良蛋白(DG)的表达模式在严重肌营养不良症中可以改变。事实上，一些先天性肌营养不良症(CMDs)和肢带状肌营养不良症(LGMDs)是由6个糖基转移酶基因的点突变引起的，这些基因可能靶向翻译后“o -糖基化途径”的不同步骤，从而导致α-DG亚基的完全修饰和功能。事实上，α-DG的低糖基化被认为是一个主要的病理事件，因为它可以降低DG结合基底膜成分的能力，从而导致肌层不稳定和坏死。为了建立一个有效的标准免疫方案，利用广泛的抗体面板，我们分析了两个DG亚基在一个小队列的成人营养不良患者，广泛的医学检查已经被临床分类为LGMD (5)， Miyoshi(1)或远端(1)肌病的影响。骨骼肌组织切片的免疫荧光分析显示，在所有分析的患者中，DG亚基都有适当的肌上皮定位。然而，对富含凝集素的骨骼肌样本进行Western blot分析，发现两例患者α-DG糖基化异常。我们的工作强化了这样一种观念，即对两种DG亚基进行仔细的免疫学和生化分析应始终被视为识别新的假定糖营养不良病例的先决条件。

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引用次数: 0

Pregnant women with epilepsy in a developing country. 发展中国家的癫痫孕妇。

Q4 Medicine

Open Neurology Journal

Pub Date : 2011-01-01 Epub Date: 2011-10-20 DOI: 10.2174/1874205X01105010063

Silvia Kochen, Constanza Salera, Josef Seni

This is the first prospective study carried out in Argentina and Latin America to provide the impact of epilepsy throughout the childbearing years life of women, and pregnancy outcome in a population of pregnant women with diagnosis of epilepsy and antiepileptics drugs (AEDs). Ninety-four women were studied prospectively at the Epilepsy Center, the largest in Argentina. Of the 94 women examined in this study only 10% planned their pregnancy and received folic acid before conception.More than half of women in our study were on monotherapy, with the most frequently prescribed drugs being carbamazepine and valproic acid. In all, 90.4% of the women had a normal pregnancy and delivery. There were 8.5% spontaneous abortions. Major congenital malformations (MCM) was detected in 10.6% of newborns at birth; in the general population it varies between 1.6-3.2%. The results from this study are helpful in the highlighting correct gaps in knowledge in this population group.

这是在阿根廷和拉丁美洲开展的第一项前瞻性研究，旨在提供癫痫在整个育龄期对妇女生活的影响，以及诊断为癫痫和抗癫痫药物(aed)的孕妇人群的妊娠结局。94名女性在阿根廷最大的癫痫中心接受了前瞻性研究。在这项研究中接受调查的94名女性中，只有10%的人计划怀孕，并在受孕前服用了叶酸。在我们的研究中，超过一半的女性接受单一疗法，最常用的处方药是卡马西平和丙戊酸。总的来说，90.4%的妇女正常怀孕和分娩。自然流产率为8.5%。10.6%的新生儿出生时检出严重先天性畸形(MCM);在一般人群中，这一比例在1.6-3.2%之间变化。这项研究的结果有助于突出这一人群中正确的知识差距。

引用次数: 18

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全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

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