ABSTRACT
Laryngeal involvement in systemic lupus erythematosus (SLE) is rare. It can range from mild ulcerations, vocal cord paralysis, and edema to necrotizing vasculitis with airway obstruction. The causes of vocal cord paralysis included vasculitis of the vasa nervorum, neuritis, thromboembolic effect on recurrent laryngeal nerves, and compression of the left recurrent laryngeal nerve by an enlarged left pulmonary artery. Few cases on the association of vocal cord palsy and pulmonary hypertension in SLE patient have been reported. We report a case of left vocal cord palsy and pulmonary hypertension in a patient with SLE who experienced improvement of vocal cord palsy and dyspnea after steroid pulse therapy.
Subject(s)
Humans , Airway Obstruction , Dyspnea , Edema , Hypertension, Pulmonary , Lupus Erythematosus, Systemic , Neuritis , Pulmonary Artery , Recurrent Laryngeal Nerve , Ulcer , Vasa Nervorum , Vasculitis , Vocal Cord Paralysis , Vocal CordsABSTRACT
BACKGROUND AND OBJECTIVES: Along with intracoronary stenting, medications, such as Ca++ channel blocker, nitric oxide and some platelet aggregation inhibitors, have contributed to the reduction of coronary restenosis. However, restenosis still remains as a challenging dilemma, with a frequency of 20-50%. Aspirin and ticlopidine are known as a standard anti-platelet regimen following PCI, but cilostazol is a comparably effective drug, which has a different mechanism to that of ticlopidine. It is unknown if the triple combination of aspirin, ticlopidine and cilostazol could further reduce adverse events and restenosis. SUBJECTS AND METHODS: The clinical and angiographic data, which had been collected after PCIs at Wallace Memorial Baptist Hospital, between Jan. 2000 and Dec. 2001, were retrospectively analyzed. The patients had taken either aspirin+ ticlopidine or aspirin+ticlopidine+cilostazol, and the clinical observation and follow-up angiography was completed for 6 months. There were 111 (66 males) and 87 (male:57) in the aspirin+ticlopidine and aspirin+ ticlopidine+cilostazol groups, respectively. The rates of major adverse cardiovascular events (MACE) and restenosis were compared during the follow-up period. RESULTS: The frequency of MACE was similar, without a significant increase in the side effects during the follow-up period. The restenosis and target lesion revascularization (TLR) rates were significantly decreased in the triple combination therapy group (37.2% vs. 21.9%, p=0.006, 29.8% vs. 14.1%, p=0.008). CONCLUSION: This study showed that this triple combination of platelet aggregation inhibitors is a good combination therapy for the reduction of restenosis. It is suggested that these effects were probably due to more potent platelet inhibition by the multi-directional mechanism in addition to coronary vasodilation effect.
Subject(s)
Humans , Angiography , Aspirin , Blood Platelets , Coronary Restenosis , Follow-Up Studies , Nitric Oxide , Platelet Aggregation Inhibitors , Platelet Aggregation , Protestantism , Retrospective Studies , Stents , Ticlopidine , VasodilationABSTRACT
Malignancy may cause variable musculoskeletal symptoms which resemble connective tissue disorder. This symptoms as a fine sign of hidden neoplasm can precede the diagnosis of underlying malignancy. But only one case of stomach cancer associated with cancer arthritis was reported in the world. This fact is very interesting in Asia which has high prevalence of stomach cancer. We experienced one case of gastric adenocarcinoma with oligoarthritis involving both knee and right elbow. A 48-year-old man was diagnosed stomach cancer by gastric endoscope and biopsy. After then, he complained pain, tenderness, heating sensation, swelling of both knee and right elbow with high fever. Both knee MRI showed abundant synovial effusion and soft tissue edema. Full dose of nonsteroidal anti-inflammatory drug was not effective to control fever and arthritis. But fever and arthritis were gone after resection of tumor.
Subject(s)
Humans , Middle Aged , Adenocarcinoma , Arthritis , Asia , Biopsy , Connective Tissue , Diagnosis , Edema , Elbow , Endoscopes , Fever , Heating , Hot Temperature , Knee , Magnetic Resonance Imaging , Prevalence , Sensation , Stomach NeoplasmsABSTRACT
A case of Mycobacterium avium arthritis in a 39-year-old female patient with mixed connective tissue disease (MCTD) was reported. An extra-articular abscess had formed outside the knee joint and extended down the calf. A culture was taken of the abscess and synovial fluid disclosed Mycobacteriun avium. This was resistant to most anti-tuberculosis agents. A combination of anti-tuberculosis drugs followed a total resection of the abscess. We concluded that M avium septic arthritis could insidiously develop into an extra-articular abscess. A combination of anti-tuberculosis drugs with a total resection of the abscess was an effective treatment.
Subject(s)
Adult , Female , Humans , Antitubercular Agents/therapeutic use , Arthritis, Infectious/microbiology , Knee Joint/microbiology , Mixed Connective Tissue Disease/complications , Mycobacterium avium/drug effects , Mycobacterium avium-intracellulare Infection/complicationsABSTRACT
Streptococcal myositis is an extremely uncommon infectious disease caused by Group A streptococcus (GAS). GAS infection spreads rapidly and diffusely through the muscle, resulting in edema and necrosis. Consequently, it results in streptococcal toxic shock syndrome having extremely high mortality. We report a 42 year-old female patient with systemic lupus erythematosus accompanying with streptococcal myositis who initially presented with fever, severe pain, and tenderness on the calf. Her systemic toxic symptoms were aggravated and finally she died of the disease in spite of aggressive management.