ABSTRACT
Angioedema has been observed in a few cases secondary to systemic lupus erythematosus (SLE). Herein, we report a rare case where a young healthy male initially presented with angioedema, lymphadenopathy and parotitis and later on developed neuropsychiatric manifestations at the very onset of his SLE disease. This case illustrates the importance of prompt clinical consideration of lupus with unusual and atypical preceding manifestations.
Subject(s)
Angioedema/etiology , Histiocytic Necrotizing Lymphadenitis/etiology , Lupus Erythematosus, Systemic/complications , Lupus Vasculitis, Central Nervous System/etiology , Parotitis/etiology , Adult , Angioedema/diagnosis , Angioedema/drug therapy , Angioedema/immunology , Biopsy , Histiocytic Necrotizing Lymphadenitis/diagnosis , Histiocytic Necrotizing Lymphadenitis/drug therapy , Histiocytic Necrotizing Lymphadenitis/immunology , Humans , Immunosuppressive Agents/therapeutic use , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/immunology , Lupus Vasculitis, Central Nervous System/diagnosis , Lupus Vasculitis, Central Nervous System/drug therapy , Lupus Vasculitis, Central Nervous System/immunology , Male , Parotitis/diagnosis , Parotitis/drug therapy , Parotitis/immunology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Interstitial granulomatous dermatitis with arthritis (IGDA) is a rare idiopathic skin disorder with variable cutaneous expression, typically associated with a seronegative arthritis. Histopathology of this disorder reveals a granulomatous infiltrate with foci of collagen degeneration in the deep reticular dermis. We present a case of IGDA in a 56-year-old man with diffuse large B-cell lymphoma, exacerbated by the administration of anakinra.
Subject(s)
Arthritis/etiology , Dermatitis , Granuloma , Interleukin 1 Receptor Antagonist Protein/adverse effects , Lymph Nodes/pathology , Lymphoma, Large B-Cell, Diffuse , Antineoplastic Agents/administration & dosage , Antineoplastic Combined Chemotherapy Protocols , Arthritis/immunology , Arthritis/therapy , Biopsy , Dermatitis/etiology , Dermatitis/immunology , Dermatitis/pathology , Dermatitis/therapy , Disease Progression , Humans , Interleukin 1 Receptor Antagonist Protein/administration & dosage , Lymphoma, Large B-Cell, Diffuse/drug therapy , Lymphoma, Large B-Cell, Diffuse/pathology , Lymphoma, Large B-Cell, Diffuse/physiopathology , Male , Middle Aged , Monitoring, Immunologic/methods , Neck , Treatment Outcome , Withholding TreatmentABSTRACT
OBJECTIVE: The development and application of a questionnaire that eventually could be used as a management tool and a means of promoting the quality of care provided in 'P. & A. Kyriakou' Children's Hospital. DESIGN: Parents' survey; during treatment of their children. SETTING: 'P. & A. Kyriakou' Children's Hospital, Athens, Greece. PARTICIPANTS: Sample of 240 parents. MAIN OUTCOME MEASURE: Parent satisfaction. RESULTS: The most important finding of the study, although normative statements cannot be made, appears to be signalling of low satisfaction with care. The general mean observed (45 on a scale of 100) is not close to the mean (76) derived from a systematic review of 221 satisfaction studies. Moreover, satisfaction appears to be very low (14/100) for the procedures of the hospital, low for the outpatient dimension (42/100) and rather satisfactory for the inpatient dimension (61/100). CONCLUSION: Data-based feedback as a management tool has been associated with improved organizational functioning. However, systematic use of this intervention within Greek hospitals has been limited. Therefore, the next phase of the project will be used as feedback to the Governing Board and the personnel of the hospital. Finally, a study will be planned to investigate the effects of implementing changes based on parents' ratings of staff performance.
