Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Diagnosis and Assessment of Takayasu Arteritis and Ulcerative Colitis

Takayasu arteritis (TA) and ulcerative colitis (UC), both immune-mediated inflammatory diseases, rarely occur together. This report describes TA in a 29-year old female patient who was being treated for UC for three years. As she had left-side neck pain and headache, she was diagnosed with TA and her response to tumor necrosis factor (TNF) inhibitor was assessed by fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT). Positive responses to the TNF inhibitor were seen by PET/CT for the TA and by endoscopy for the UC. We conclude that TNF inhibitors are effective treatments for both TA and UC. We found that PET/CT is a useful for diagnosing and assessing TA.

Genetic polymorphisms of interleukin-10 and transforming growth factor-β1 and antituberculosis drugs-induced liver injury

PURPOSE: Drug-induced liver injury is one of the serious adverse reactions resulting in severe morbidity and discontinuation of medications. Previously, IL-10 gene polymorphism has been reported to be associated with diclofenac-induced hepatitis. In this study, we aimed to investigate the associations between genetic polymorphisms of immune-regulating cytokines (IL-10 and TGF-β1) with antituberculosis drugs (ATD)-induced liver injury. METHODS: We enrolled 80 patients with ATD-induced liver injury and 238 ATD-tolerant controls. Two single nucleotide polymorphisms (SNP) of IL-10 (-1082A>G, rs1800896; -819T>C, rs1800871) and one promoter SNP of TGF-β1 gene (-509C>T, rs1800469) were genotyped in both groups. Genotype frequencies of these SNPs were compared between case and control groups. RESULTS: In 2 promoter SNPs of IL-10 gene, there was no significant difference of genotype frequencies between patients with ATD-induced liver injury and controls. In addition, the genotype frequency of TGF-β1 -509C>T SNP in ATD-induced liver injury patients were not different from those of controls. CONCLUSION: In conclusion, there was no significant association between IL-10 and TGF-β1 gene polymorphisms and ATD-induced liver injury. These findings suggest that IL-10 and TGF-β1 do not play important role in the development of ATD-induced liver injury.

Atypical Femoral Fracture in a Patient with Rheumatoid Arthritis / 대한내과학회지

Atypical femoral fractures are characterized by a subtrochanteric or diaphyseal location. Recent studies have suggested that long-term treatment with bisphosphonates might be associated with the occurrence of atypical femoral fractures. The present report describes a case involving a 60-year-old woman with left buttock pain that was unassociated with trauma. Her hip pain was initially considered to be a symptom of her underlying rheumatoid arthritis, but a plain radiography, bone scintigraphy, and magnetic resonance imaging revealed an insufficiency fracture in the lateral shaft of the left proximal femur. She had been treated with a bisphosphonate for 4.5 years because of a previous vertebral fracture. Her chronic, long-term rheumatoid arthritis and history of bisphosphonate administration were considered to be associated with the development of her atypical femoral fracture.

A Case of Lesch-Nyhan Syndrome Manifesting Only Chronic Gouty Arthritis without Neurologic Symptom

Deficiency of hypoxanthine-guanine phosphoribosyltransferase is a purine nucleotide disorder and is the most common genetic cause of uric acid overproduction. This disease has a wide range of spectrum with regard to neurological features depending on the extent of the enzymatic deficiency. Complete deficiency of hypoxanthine-guanine phosphoribosyltransferase, called Lesch-Nyhan syndrome, is presented with hyperuricemia and characteristic neurological manifestation and self-mutilation. Partial hypoxanthine-guanine phosphoribosyltransferase--deficient patients are presented with a various intensities of the aforementioned symptoms, from almost normal neurologic manifestation to a severe form along with hyperuricemia. We report a twenty-year-old man with complete hypoxanthine-guanine phosphoribosyltransferase mutation and Lesch-Nyhan sydrome, who manifested gouty arthritis without neurologic symptom.