ABSTRACT
Bevacizumab is a recombinant humanised monoclonal antibody directed against the vascular endothelial growth factor (VEGF). The drug, alone or in combination with other anticancer agents, has been shown to be effective against several types of neoplasms. We report a case of a woman with a history of severe psoriasis who developed psoriatic arthritis during a course of bevacizumab, which was administered for a malignant glioma.
ABSTRACT
BACKGROUND: Most of the data currently available on early psoriatic arthritis (EPsA) derive from studies performed in rheumatological settings. However, in recent years, there has been an increase in the amount of data from dermatologic centres. OBJECTIVES: To describe the prevalence, clinical, laboratory and imaging characteristics of psoriatic patients with EPsA seen at a dermatological outpatient psoriasis centre. METHODS: From January 2007 to May 2010, all patients with psoriasis who visited the psoriasis centre were asked about inflammatory joint involvement. A diagnosis of psoriatic arthritis was made on the basis of clinical, laboratory and imaging studies. The patients were diagnosed with early PsA (EPsA) if their inflammatory articular symptoms had been present for ≤ 1 year. RESULTS: We diagnosed EPsA in 33 patients. Joint involvement was polyarticular (>5 joints involved) in 20 patients (60.6%) and oligoarticular (≤5 joints involved) in the remaining 13 patients. Quality of life due to skin involvement and the degree of functional impairment due to joint inflammation were only mildly affected, as measured by DLQI and HAQ, respectively. A direct correlation between the number of tender joints (ACR 68) and HAQ was found (r = 0.36; P = 0.04). Imaging studies showed that in spite of the absence of radiologic findings of peripheral joint damage, ultrasonography and contrast enhanced ultrasonography showed signs of articular inflammation in all patients. CONCLUSIONS: A diagnosis of EPsA can be correctly performed in a dermatologic outpatient facility. To do so, a close collaboration among dermatologists, rheumatologists and radiologists is necessary.
Subject(s)
Ambulatory Care/organization & administration , Arthritis, Psoriatic/diagnosis , Early Diagnosis , Female , Humans , MaleABSTRACT
The occurrence of sarcoidosis during anti-TNF-alpha therapy has occasionally been published. We report the case of a psoriasis patient who developed pulmonary sarcoidosis during a cycle of therapy with infliximab.
Subject(s)
Antibodies, Monoclonal/adverse effects , Antirheumatic Agents/adverse effects , Arthritis, Psoriatic/drug therapy , Sarcoidosis, Pulmonary/chemically induced , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Adult , Antibodies, Monoclonal/administration & dosage , Antirheumatic Agents/administration & dosage , Humans , Infliximab , Infusions, Intravenous , MaleABSTRACT
BACKGROUND: Radiographic examination (Rx) is still the best method to obtain an accurate diagnosis of psoriatic arthritis (PsA). Nevertheless, ultrasound (US) examination of the potentially involved joints has started to play a leading role. The sensitivity and specificity of a scan can be determined by contrast enhancement in the diagnosis of arthritis during PsA in comparison with basal US with MRI. METHODS: Our study was made on 22 uninformed patients showing clinical suspicion of PsA. The patients were submitted to clinical evaluation, Rx, US with and without contrast enhancement and MRI. The parameters evaluated by basal US were effusion, synovial hypertrophy, positiveness to color power Doppler signals and bone erosion. RESULTS: Contrast-enhanced US (CEUS) seems to amplify small alterations previously detected by US and, moreover, increases the diagnostic confidence in cases of suspected symptomatology with a negative diagnosis. Finally, CEUS appears to have a concordance of almost 100% with the results of MRI with contrast enhancement. CONCLUSION: US appears to be an effective method for detecting the alterations in bone outline and soft tissues, such as synovitis. Furthermore, US provides useful information concerning the evolution of vascularization and the dynamic behavior of tendons.
Subject(s)
Arthritis, Psoriatic/diagnostic imaging , Contrast Media , Ultrasonography, Doppler, Color/methods , Adult , Aged , Arthritis, Psoriatic/pathology , Early Diagnosis , Female , Humans , Italy , Joints/diagnostic imaging , Magnetic Resonance Imaging/methods , Male , Middle Aged , Radiography , Sensitivity and Specificity , Synovitis/diagnosisABSTRACT
Vesiculodeferentography was used in the past to evaluate suspected cases of obstruction of the seminal ducts. Over the years, numerous attempts have been made to improve the technique used to perform this examination and to render it less invasive. Its use is currently indicated in selected cases, where it is combined with functional studies like seminal tract washout and followed by immediate interventions to correct the alterations revealed. Vesiculodeferentography includes collection of the contents of the seminal vesicles, which can later be used in vitro assisted fertilization procedures.
SommarioLa vesciculodeferentografia, esame utilizzato in passato nei casi di sospette ostruzioni delle vie seminali, è stato negli anni oggetto di numerosi studi allo scopo di migliorarne la tecnica di esecuzione e renderla meno invasiva. Attualmente è indicata solo in casi selezionati, in associazione a un'indagine funzionale quale il Seminal Tract Washout e prevedendo un contemporaneo o in via subordinata, successivo atto terapeutico.Ovviamente, peraltro, la procedura ipso facto prevede il prelievo di materiale dalla seminale e ciò può consentire una successiva procedura di fecondazione assistita in vitro.
