A potential role for cytomegalovirus in a facial ulcer in a renal transplant recipient.

Cytomegalovirus infection (CMV) is a well-known consequence of immunosuppression and one of the expected pathogens in recipients of solid organs such as renal transplant recipients (RTRs). Infection by CMV in immunocompromised settings can be life-threatening since many organs are involved and affected. Skin involvement has been rarely reported. In this report, we present a highly immunosuppressed RTR with CMV infection manifested as ulcerative skin lesions on the face, along with allograft dysfunction diagnosed by biopsy of the skin and the renal allograft, in addition to the presence of viral DNA in the tissue and antigenemia, which resolved following antiviral treatment. To the best of our knowledge, this is the first report in the literature of facial skin involvement induced by CMV in an RTR. This report emphasizes the value of early biopsy in RTRs with skin lesions and highlights CMV infection as a possible etiology.

Anti-inflammatory effects of 5-HT receptor antagonist, tropisetron on experimental colitis in rats.

BACKGROUND: There is a pressing need for research that will lead to the development of new therapeutic approaches for treating inflammatory bowel disease (IBD). The aim of this study was to investigate the effects of tropisetron, a 5-Hydroxytryptamine (5-HT)-3 receptor antagonist with anti-inflammatory properties in a model of experimental colitis in rat. MATERIALS AND METHODS: Acetic acid model of colitis in rats was used. Colitis was induced by intracolonal instillation of 4% (v/v) acetic acid. One hour after induction of colitis, intraperitoneal (IP) or intrarectal (IR) tropisetron (2 mg kg(-1), either route) or dexamethasone (1 mg kg(-1), either route) was administered. The severity of colitis was assessed 24 h later using macroscopic and microscopic changes of damaged colon, measurement of inflammatory cytokines interleukin-1beta, interleukin-6 and tumour necrosis factor-alpha levels and oxidative stress markers myeloperoxidase (MPO) and malondialdehyde (MDA) in colonic tissues. RESULTS: Tropisetron decreased colonic macroscopic and microscopic damage scores. This was associated with significant reduction in both neutrophil infiltration indicated by decreased colonic MPO activity and lipid peroxidation measured by MDA content, as well as a decreased colonic inflammatory cytokines. IR tropisetron decreased colonic damage that was associated with decreased neutrophil infiltration, lipid peroxidation and colonic inflammatory cytokines. Beneficial effects of tropisetron were lower than those of dexamethasone. No significant differences were observed between IP and IR administration with the exception of MDA level more diminished by IP tropisetron and dexamethasone. CONCLUSIONS: Tropisetron exert beneficial effects in experimental rat colitis and therefore might be useful in the treatment of IBD.

Systemic lupus erythematosus arising in a patient with epidermodysplasia verruciformis.

Few cases have been published relating systemic lupus erythematosus (SLE) and epidermodysplasia verruciformis (EV). We describe a patient with this association. A 22-year-old female with classical skin lesions of EV since childhood together with systemic lupus erythematosus (SLE) which developed 10 years later. According to the knowledge of the authors, this case is the third report of association of EV and SLE and the first report of a patient with EV who developed SLE several years after initiation of EV.

Ascites as a presenting feature of relapsed multiple myeloma. Report of a case diagnosed by aspiration cytology.

A 68-year-old woman with IgG-type multiple myeloma (MM) in remission and a chief complaint of ascites was found to have peritoneal fluid involvement by myeloma cells on cytologic study. There are only a few reports describing the cytologic features in patients presenting with ascites as the first manifestation of relapsed MM. IgG myeloma, however, is one of the rarest types. The patient had had pancreatic involvement months before her presentation with ascites, which itself is a rare manifestation of relapsed MM. Cytologic smears of ascitic fluid showed isolated and incoherent groups of cells with plasmacytoid features. To recognize myeloma as a cause of ascites is important because it may respond well to therapy. Aspiration cytologic study can be considered a useful method for follow-up and diagnosis of MM relapse even without a biopsy.