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1.
Cureus ; 15(7): e42667, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37525862

RESUMO

Takayasu arteritis (TA) is a rare, chronic, inflammatory vasculitis that primarily affects large arteries, causing significant morbidity and mortality. This review provides an overview of the pathophysiology, diagnosis, and management of TA based on current advances in the field. TA is characterized by autoimmune-mediated inflammation, vascular remodeling, and endothelial dysfunction. The disease progresses through three stages (active, chronic, and healing phase) each presenting distinct clinical features. Diagnosis of TA can be challenging due to non-specific clinical manifestations and the lack of specific diagnostic tests. Various imaging modalities, such as angiography, ultrasound, and Doppler techniques, play a crucial role in the diagnosis of TA by visualizing arterial involvement and assessing disease extent. Management of TA involves a multidisciplinary approach, with disease-modifying anti-rheumatic drugs (DMARDs) as the cornerstone of medical therapy. Synthetic and biologic DMARDs are used to induce remission, control inflammation, and prevent complications. Non-pharmacologic interventions, such as resistance exercises and curcumin supplementation, show potential benefits. Invasive interventions, including endovascular therapy and open surgery, are used for managing vascular lesions. However, challenges remain in disease understanding and management, including the heterogeneity of disease presentation and the lack of standardized treatment guidelines. The future of TA management lies in precision medicine, utilizing biomarkers and molecular profiling to personalize treatment approaches and improve patient outcomes. Further research is needed to unravel the underlying mechanisms of TA and develop targeted therapies.

2.
Cureus ; 15(7): e42504, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37637651

RESUMO

Acute myeloid leukemia (AML) is a hematologic cancer that is characterized by unchecked myeloid precursor cell growth in the bone marrow and peripheral circulation, which results in an overabundance of immature myeloid cells. The 22-year-old man featured in this case report had a fever, tiredness, and easy bruising. Pancytopenia was discovered through laboratory testing, and an AML diagnosis was confirmed by a bone marrow biopsy, with myeloid blasts making up 85% of the nucleated cells. FLT3-ITD and NPM1 mutations were found by genetic testing. After receiving induction chemotherapy using the drugs daunorubicin and cytarabine, the patient experienced complete remission after just one cycle of treatment. He then had an allogeneic stem cell transplant and was still in remission during follow-up. This example highlights the significance of early AML diagnosis and detection, as well as the function of molecular profiling and risk stratification in directing treatment choices. It emphasizes the requirement for continued study to produce novel treatments and enhance results for AML patients. In general, this case study advances knowledge of AML and its management techniques. For AML patients to experience the best results, early diagnosis, risk assessment, and individualized therapy plans based on molecular profiling are essential. AML patients' prognosis and quality of life can be improved by the development of targeted medicines, which require ongoing study to better understand the disease.

3.
Cureus ; 15(7): e41947, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37461430

RESUMO

Primary cardiac angiosarcoma is a rare and aggressive malignancy originating from the endothelial lining of cardiac blood vessels. This review covers various aspects of the disease, including its pathogenesis, clinical presentation, diagnosis, treatment, and prognosis. The primary characteristic of cardiac angiosarcoma is the rapid growth of abnormal blood vessels that invade the heart muscle, leading to the destruction of healthy tissue. Due to its infiltrative nature and early spread, diagnosing and treating cardiac angiosarcoma present significant challenges. Transesophageal echocardiography (TEE) plays a crucial role in diagnosing cardiac tumors such as angiosarcoma due to its high sensitivity. Additional imaging techniques such as computed tomography (CT) and cardiac magnetic resonance imaging (MRI) help assess tumor anatomy and identify metastases. Histopathological examination and immunohistochemistry are essential for confirming the diagnosis, as they reveal distinct histological features and specific endothelial markers associated with primary cardiac angiosarcoma. Targeted therapies directed at the angiogenic mechanisms and molecular abnormalities hold promise for improving treatment outcomes. Early detection of primary cardiac angiosarcoma remains challenging due to its rarity, and the prognosis is generally poor due to advanced disease at the time of diagnosis. The review emphasizes the importance of a multidisciplinary approach and collaboration among different specialties to optimize the diagnosis, treatment, and follow-up care of patients with primary cardiac angiosarcoma. The ultimate goal is to enhance diagnostic methods and therapeutic approaches by advancing knowledge and promoting further research into this aggressive malignancy.

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