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1.
PLoS One ; 15(12): e0242670, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33264333

RESUMO

BACKGROUND: Despite their importance in population health among children and adolescents, our understanding of how individual items mutually interact within and between pediatric health-related quality of life (HRQOL) and school social capital is limited. METHODS: We employed network analysis in a general population sample of 7759 children aged 9-15 years to explore the network structure of relations among pediatric HRQOL and school social capital items measured using validated scales. Furthermore, network centrality was examined to identify central items that had stronger and more direct connections with other items in the network than others. Network structure and overall strength of connectivity among items were compared between groups (by sex and age). RESULTS: Our analysis revealed that the item related to school/academic functioning and the item related to shared enjoyment among students had the highest strength centrality in the network of HRQOL and school social capital, respectively, underpinning their critical roles in pediatric HRQOL and school social capital. Additionally, the edge connecting "I trust my friends at school" and "trouble getting along with peers" had the strongest negative edge weight among ones connecting school social capital and pediatric HRQOL constructs. Network comparison test revealed stronger overall network connectivity in middle schoolers compared to elementary schoolers but no differences between male and female students. CONCLUSION: The network approach elucidated the complex relationship of mutually influencing items within and between pediatric HRQOL and school social capital. Addressing central items may promote children's perceived health and school social capital.

2.
Autism Res ; 2020 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-33251760

RESUMO

There is relatively little information about prospectively reported developmental milestones from caregivers of children who go on to be diagnosed with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD). The current study examined rates of early skill attainment in 5-year-old children who participated in a comprehensive in-person assessment for NDDs in Hirosaki in Japan. Developmental milestone data were extracted from their Maternal and Child Health Handbook (MCHH), a booklet distributed to all pregnant women as part of universal health care. Seven hundred and twenty children underwent the assessment, among whom 455 received one or more NDD diagnoses (ASD: n = 124, non-ASD NDD: n = 331). Developmental skills were organized into four domains (motor, social interaction, communication, self-help), and the cumulative number of potential delays in each domain was calculated for each participant within three different age ranges (by 12 months, by 24 months, and by 36 months). Even by age 12 months, children with ASD/NDDs showed more potential delays across domains compared to those who received no NDD diagnosis. However, differences between those with ASD and those with non-ASD NDDs were not apparent until 24 months for social interaction and communication, and 36 months for self-help. These findings provide insights into specific behaviors that could be used to screen for ASD and other NDDs. In addition, the present study indicates the potential utility of the MCHH as a broadband screening tool to educate parents about what to look for in charting their child's early development. LAY SUMMARY: The present study examined prospectively charted developmental milestones from home-based records used as part of universal health care in 720 5-year-old children from Hirosaki, Japan. All children participated in a comprehensive evaluation to determine if they met criteria for a neurodevelopmental disorder (NDD), including autism spectrum disorder (ASD). Compared to those who received no NDD diagnosis, children with NDDs exhibited higher rates of potential delays across developmental domains, including social interaction, communication, and self-help. For some children, these delays were apparent before the age of 12 months. Differences between diagnostic groups became even more pronounced by 24 and 36 months, well before the average age of diagnosis. This suggests that home-based records can be useful tools to educate caregivers about what to look for in charting their child's early development and could assist with early screening efforts.

3.
Yonsei Med J ; 61(11): 909-922, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33107234

RESUMO

Through this meta-analysis, we sought to examine the prevalence of, risks for, and factors associated with bullying involvement (victimization, perpetration, perpetration-victimization) among students with autism spectrum disorder (ASD). Additionally, we attempted to examine sources of variance in the prevalence and effect sizes of bullying in students with ASD across studies. Systematic database and literature review identified 34 relevant studies (31 for Western countries, three for Eastern countries). Pooled prevalence estimates for victimization, perpetration, and perpetration-victimization in general were 67%, 29%, and 14%, respectively. The risk of victimization in students with ASD was significantly higher than that in typically developing students and students with other disabilities. Further, deficits in social interaction and communication, externalizing symptoms, internalizing symptoms, and integrated inclusive school settings were related to higher victimization, and externalizing symptoms were related to higher perpetration. Finally, moderation analyses revealed significant variations in the pooled prevalences thereof depending on culture, age, school settings, and methodological quality and in the pooled effect sizes according to publication year and methodological quality. Our results highlight needs for bullying intervention for students with ASD, especially those who are younger, are in an inclusive school setting, and have higher social difficulties and externalizing/internalizing symptoms; for intensive research of bullying experiences among students with ASD in Eastern countries; and for efforts to improve the methodological quality of such research.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Bullying/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Comparação Transcultural , Estudantes/psicologia , Adolescente , Transtorno do Espectro Autista/etnologia , Transtorno do Espectro Autista/psicologia , Bullying/psicologia , Criança , Pré-Escolar , Vítimas de Crime/psicologia , Feminino , Humanos , Relações Interpessoais , Masculino , Prevalência , Estudantes/estatística & dados numéricos , Adulto Jovem
4.
J Autism Dev Disord ; 2020 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-33040268

RESUMO

In the present study, we employed network analysis that conceptualizes internet addiction (IA) as a complex network of mutually influencing symptoms in 108 adolescents with autism spectrum disorder (ASD) to examine the network architecture of IA symptoms and identify central/influential symptoms. Our analysis revealed that defensive and secretive behaviors and concealment of internet use were identified as central symptoms in this population, suggesting that mitigating these symptoms potentially prevent the development and/or maintenance of IA in adolescents with ASD. Providing adolescents and their caregivers with psychoeducation on the role of central symptoms above in IA can be a salient intervention. Doing so may facilitate nonconflicting conversations between them about adolescents' internet use and promote more healthy adolescents' internet use behavior.

6.
Clin Rheumatol ; 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32974835

RESUMO

Eosinophilic fasciitis (EF) is a rare connective tissue disease that causes inflammation and fibrosis of the fascia, inducing pain and motor dysfunction. Characteristic skin manifestations, such as edema, erythema, induration, peau d'orange appearance, and the groove sign, are of diagnostic significance and observed in the majority of patients with EF. We herein report a case of EF without these characteristic skin manifestations. A 66-year-old Japanese woman developed progressive limb pain and motor dysfunction. No skin changes were observed. We diagnosed the patient with EF based on the clinical course, magnetic resonance imaging, and en bloc biopsy containing fascia and muscle. Oral prednisolone therapy markedly attenuated limb pain and motor dysfunctions. Through a systemic search of the medical literature, we retrieved 4 juvenile cases and 8 adult cases of EF without characteristic skin manifestations during the clinical course. We herein present a systemic review on EF without skin manifestations and discuss differences between the two proposed sets of diagnostic criteria of EF.

7.
J Autism Dev Disord ; 2020 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-32705394

RESUMO

Despite increasing attention to internet addiction (IA) in both clinical practice and research, our understanding of longitudinal changes of IA status is limited. In the present study, we employed latent transition analysis to investigate patterns of transitions and the stability of IA status among 5483 students (aged 9-12 years) over the two-year study periods. Additionally, we examined whether neurodevelopmental traits predicted certain transition patterns. The stability rate of IA class membership and the conversion rate from non-IA to IA status across the 2 years were 47% and 11%, respectively. The regression model revealed that autistic traits predicted the persisting IA pattern and that inattention traits predicted both the persisting and converting (from non-IA to IA status) patterns.

8.
Artigo em Inglês | MEDLINE | ID: mdl-32529540

RESUMO

The aims of this study were to identify sensory processing profiles specific to preschoolers with DCD in a community sample and examine the association of sensory processing problems with motor coordination difficulties in these children. Sixty-three 5-year-old children with DCD and without other neurodevelopmental disorders and 106 age-matched typically developing children participated in this study. Sensory processing problems were assessed using the Sensory Profile. Our results demonstrated problems in wide sensory processing patterns (low registration, sensitivity and avoiding) and areas (auditory, vestibular, touch and oral) in children with DCD compared with typically developing children. Additionally, the association of problems in sensory processing patterns (sensitivity and avoiding) and areas (touch and auditory) with motor coordination difficulties were identified in children with DCD alone. Our findings indicate that sensory processing abnormalities may contribute to the pathophysiology of DCD, suggesting the importance of assessing sensory processing functions in children with DCD.

9.
Mol Autism ; 11(1): 35, 2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32410700

RESUMO

BACKGROUNDS: Whether there is a true increase in autism spectrum disorder (ASD) frequency or not remains unclear. Additionally, the rates of co-existing neurodevelopmental disorders (NDD) in a total population sample has not been fully examined before. Therefore, using a total population sample in Japan, we aimed to estimate the prevalence and cumulative incidence of autism spectrum disorder (ASD) annually, to determine whether there is a true increase in ASD prevalence by estimating the cumulative incidence of ASD annually, and to examine the rates of co-existing neurodevelopmental disorders (NDD). METHOD: In this cross-sectional sequential design study, all 5-year-old children in the catchment area underwent the screening annually from the year 2013-2016. Screen-positive children were invited to participate in a comprehensive assessment, including child and parent interview, behavioral observation, and cognitive and motor function testing. All cases were reviewed by a multidisciplinary research team. RESULTS: Caregivers of 3954 children returned the screening, among which 559 children underwent the assessment with 87 children receiving an ASD diagnosis. Adjusted ASD prevalence was 3.22% (95% confidence interval (CI) 2.66-3.76%). The male to female ratio of the crude prevalence was 2.2:1. The cumulative incidence of ASD up to 5 years of age for the total study years was 1.31% (95% CI 1.00-1.62%). A generalized linear model revealed no significant linear trends in 5-year cumulative incidence over the study years. Only 11.5% of children had ASD alone; the remaining 88.5% were found to have at least one co-existing NDD. LIMITATIONS: Modest sample size for a total population study. CONCLUSIONS: Our findings demonstrate the stability of the 5-year cumulative incidence of ASD, implying no true rise in ASD incident cases over the 4-year study period in the study catchment area. High rates of co-existing NDDs reflect the importance of investigating broad developmental challenges in children with ASD.

10.
Space Sci Rev ; 216(3): 43, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32280148

RESUMO

Recent observations have suggested that circumstellar disks may commonly form around young stellar objects. Although the formation of circumstellar disks can be a natural result of the conservation of angular momentum in the parent cloud, theoretical studies instead show disk formation to be difficult from dense molecular cores magnetized to a realistic level, owing to efficient magnetic braking that transports a large fraction of the angular momentum away from the circumstellar region. We review recent progress in the formation and early evolution of disks around young stellar objects of both low-mass and high-mass, with an emphasis on mechanisms that may bridge the gap between observation and theory, including non-ideal MHD effects and asymmetric perturbations in the collapsing core (e.g., magnetic field misalignment and turbulence). We also address the associated processes of outflow launching and the formation of multiple systems, and discuss possible implications in properties of protoplanetary disks.

11.
J Autism Dev Disord ; 50(4): 1210-1220, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31897854

RESUMO

Irritability and aggression (IA) are highly prevalent in individuals with autism spectrum disorder (ASD). Although clinical correlates of IA in this population have been previously examined, findings from existing studies capturing symptoms as a set of latent variables do not fully explain meaningful associations between the symptoms themselves. In the present study, we conducted network analysis which conceptualizes mental health difficulties as a complex network of directly associated symptoms in 2612 individuals who were diagnosed with ASD through rigorous diagnostic assessment and who were enrolled in the Simons Simplex Collection. Using the Aberrant Behavior Checklist, a validated scale, we investigated the network structure of IA and tried to identify bridge symptoms that link IA and other symptom domains. In our analysis, irritability symptoms had stronger and more direct associations with other nodes than aggression symptoms did. Additionally, depressed mood and oppositionality were identified to function as bridge symptoms. The network structures did not differ between individuals with and without intellectual disability. Our findings indicate that addressing these bridge symptoms through integrated care combining different modalities of treatment could ease the complicated symptom network and thereby reduce IA symptoms in individuals with ASD.


Assuntos
Agressão/fisiologia , Agressão/psicologia , Transtorno do Espectro Autista/psicologia , Humor Irritável/fisiologia , Adolescente , Transtorno do Espectro Autista/diagnóstico , Criança , Pré-Escolar , Feminino , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/psicologia , Masculino
12.
J Autism Dev Disord ; 49(11): 4515-4522, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31410697

RESUMO

Internet addiction (IA) has been reported as prevalent in adolescents with autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD). However, the course of IA in this population has not been elucidated. The authors performed a 2-year follow-up study including 89 out of 132 adolescents with ASD and/or ADHD in a psychiatric clinical setting who participated in the original cross-sectional study assessing IA prevalence. Within this sample of participants from both the original and the follow-up study, results showed a 2-year IA remission and incidence rate of 60% and 5%, respectively. Our findings imply that the course of IA in psychiatric populations with ASD and/or ADHD might be similar to reports from previous studies with general adolescent populations.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Espectro Autista/psicologia , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/psicologia , Adolescente , Criança , Progressão da Doença , Feminino , Seguimentos , Humanos , Incidência , Internet , Japão/epidemiologia , Masculino , Prevalência , Indução de Remissão , Fatores de Tempo
14.
Psychiatry Clin Neurosci ; 73(2): 84-89, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30471156

RESUMO

AIM: Data pertaining to child and adolescent psychiatry (CAP) training systems are limited as extant research has mostly been derived from one-time data collection. This 5-year follow-up survey collects updated information on CAP training systems in the Far East, allowing for the tracking of system changes over the past 5 years. METHODS: Data were obtained from 18 countries, or functionally self-governing areas, in the Far East, 17 of which were also included in the original study. An online questionnaire was completed by leading CAP professionals in each country. Questions were expanded in the present study to capture the contents of CAP training. RESULTS: When compared to data from the original study, there has been progress in CAP training systems in the last 5 years. Specifically, there has been an increase in the number of countries with CAP training programs and national guidelines for the training. In addition, the number of CAP departments/divisions affiliated with academic institutions/universities has increased. Findings from 12 of 18 countries in the present study provide data on clinical contents. All informants of the present study reported the need for more child and adolescent psychiatrists and allied professionals. CONCLUSION: Despite progress in CAP training systems over the last 5 years, the need for more professionals in child and adolescent mental health care in all the relevant areas in this region have yet to be adequately addressed. Continued national efforts and international collaborations are imperative to developing and sustaining new CAP training systems while facilitating improvements in existing programs.


Assuntos
Psiquiatria do Adolescente/educação , Psiquiatria do Adolescente/estatística & dados numéricos , Psiquiatria Infantil/educação , Psiquiatria Infantil/estatística & dados numéricos , Médicos/estatística & dados numéricos , Extremo Oriente , Seguimentos , Humanos , Sociedades Médicas
15.
Soc Psychiatry Psychiatr Epidemiol ; 53(12): 1349-1359, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30255383

RESUMO

PURPOSE: Pathological Internet use has been predominantly studied in junior high/middle school-aged or older children; data from elementary/primary school-aged children, however, are scarce. The current study aimed to examine the prevalence of problematic Internet use, including pathological and maladaptive Internet use, in elementary and junior high school-aged children and the relationships between problematic Internet use and mental health problems and health-related quality of life. METHODS: The survey was conducted among children who attend national and public elementary and junior high schools in a medium-sized city in Japan; data were received from 3845 elementary school-aged and 4364 junior high school-aged children. RESULTS: Based on the Young's Diagnostic Questionnaire score, the prevalence of pathological and maladaptive Internet use was 3.6% and 9.4% and 7.1% and 15.8% in elementary and junior high school-aged children, respectively. The prevalence of problematic Internet use, including pathological and maladaptive Internet use, consistently increased from the 4th grade to the 8th grade. In addition, the prevalence sharply increased between the 7th grade and the 8th grade. Our study revealed that children with pathological and maladaptive Internet use exhibited more severe depression and decreased health-related quality of life than those with adaptive Internet use. CONCLUSIONS: Our results demonstrated that pathological Internet use is not uncommon even in elementary school-aged children and that those with pathological and maladaptive Internet use have severe mental health problems and decreased health-related quality of life, supporting the importance of providing these children with educational and preventive interventions against problematic Internet use and associated risk factors.


Assuntos
Comportamento Aditivo/epidemiologia , Depressão/epidemiologia , Internet/estatística & dados numéricos , Qualidade de Vida , Estudantes/psicologia , Adolescente , Comportamento Aditivo/psicologia , Criança , Depressão/psicologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Prevalência , Fatores de Risco , Instituições Acadêmicas , Inquéritos e Questionários
16.
Res Dev Disabil ; 80: 1-12, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29879612

RESUMO

BACKGROUND: Existing reviews of screening tools for Autism Spectrum Disorder (ASD) focus on young children, and not all screening tools have been examined against validated diagnostic procedures. AIMS: To examine the validity of screening tools for ASD in non-young children and adults to provide clinical recommendations about the use of these tools in a variety of clinical settings. METHODS AND PROCEDURES: Electronic databases, including MEDLINE, EMBASE, PsychINFO, Cochrane Library and CINAHL, were searched through March 2017. Studies examining the validity of ASD screening tools against the Autism Diagnostic Observation Schedule and/or the Autism Diagnostic Interview - Revised in non-young children (age 4 or above) and adults were included. Three authors independently reviewed each article for data extraction and quality assessment. OUTCOMES AND RESULTS: 14 studies met the inclusion criteria, of which 11 studies were with children (4-18 years of age) and 3 studies included adults only (19 years of age and above). Included studies were conducted in a general population/low-risk sample (N = 3) and a clinically referred/high-risk sample (N = 11). In total 11 tools were included. CONCLUSIONS AND IMPLICATIONS: Only three screening tools (the Autism-Spectrum Quotient, the Social Communication Questionnaire, and the Social Responsiveness Scale) were examined in more than 2 studies. These tools may assist in differentiating ASD from other neurodevelopmental and psychiatric disorders or typically developed children. In young adult populations, the paucity of the existing research in this group limits definitive conclusion and recommendations.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Programas de Rastreamento , Reprodutibilidade dos Testes , Adulto Jovem
17.
Intern Med ; 57(18): 2747-2752, 2018 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-29780126

RESUMO

Hemophagocytic syndrome (HPS) associated with systemic lupus erythematosus (SLE), dubbed acute lupus hemophagocytic syndrome (ALHS), is an intractable complication of SLE. A 24-year-old man who had been diagnosed with SLE three months previously, presented with fever, rash, hallucination, and pancytopenia accompanied with hyperferritinemia and bone marrow hemophagocytosis. He was diagnosed with ALHS and neuropsychiatric (NP)-SLE. Although 4 courses of methylprednisolone pulse therapy and 1 course of intravenous cyclophosphamide (IVCY) improved his NP-SLE, his ALHS did not respond. However, the addition of cyclosporine A (CsA) led to a rapid remission from ALHS. This suggests the usefulness of CsA in the treatment of intractable, corticosteroid- and IVCY-resistant ALHS.


Assuntos
Ciclosporina/uso terapêutico , Imunossupressores/uso terapêutico , Vasculite Associada ao Lúpus do Sistema Nervoso Central/complicações , Linfo-Histiocitose Hemofagocítica/complicações , Linfo-Histiocitose Hemofagocítica/tratamento farmacológico , Administração Intravenosa , Corticosteroides/uso terapêutico , Ciclofosfamida/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Humanos , Vasculite Associada ao Lúpus do Sistema Nervoso Central/tratamento farmacológico , Masculino , Metilprednisolona/uso terapêutico , Adulto Jovem
18.
Mod Rheumatol ; 28(3): 383-408, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29409370

RESUMO

OBJECTIVES: The objective of this study is to develop clinical practice guideline (CPG) for Sjögren's syndrome (SS) based on recently available clinical and therapeutic evidences. METHODS: The CPG committee for SS was organized by the Research Team for Autoimmune Diseases, Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW), Japan. The committee completed a systematic review of evidences for several clinical questions and developed CPG for SS 2017 according to the procedure proposed by the Medical Information Network Distribution Service (Minds). The recommendations and their strength were checked by the modified Delphi method. The CPG for SS 2017 has been officially approved by both Japan College of Rheumatology and the Japanese Society for SS. RESULTS: The CPG committee set 38 clinical questions for clinical symptoms, signs, treatment, and management of SS in pediatric, adult and pregnant patients, using the PICO (P: patients, problem, population, I: interventions, C: comparisons, controls, comparators, O: outcomes) format. A summary of evidence, development of recommendation, recommendation, and strength for these 38 clinical questions are presented in the CPG. CONCLUSION: The CPG for SS 2017 should contribute to improvement and standardization of diagnosis and treatment of SS.


Assuntos
Guias de Prática Clínica como Assunto , Padrões de Prática Médica/normas , Síndrome de Sjogren/diagnóstico , Gerenciamento Clínico , Humanos , Japão , Síndrome de Sjogren/terapia
19.
Mod Rheumatol ; 28(2): 300-307, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28722506

RESUMO

OBJECTIVE: To compare parotid diffusion-weighted images (DWIs) taken before and after abatacept therapy in patients with Sjögren's syndrome (SS) associated with rheumatoid arthritis (RA) and to examine the utility in evaluation and prediction of response to therapy. METHODS: DWIs of the parotid glands taken at baseline and 52 weeks after initiation of abatacept were analyzed in nine SS patients with RA using relative standard deviation (RSD) of the entire glands and signal intensity ratio (SIR) within the residual parenchyma. The correlation between changes in RSD and SIR and changes in salivary secretion based on Saxon's test was examined. Furthermore, baseline characteristics were compared in patients with increased and decreased salivary secretion after treatment. The predictive power of the parameter at baseline was examined using receiver operating characteristic (ROC) analysis. RESULTS: Abatacept improved salivary secretion from 2076 ± 1535 at baseline to 2857 ± 1431 mg/2 min at 52 weeks (n = 9, p = .05). Increase of salivary secretion was significantly higher in patients with decreased RSD (n = 6) than increased RSD (n = 3) (1241 ± 713, -137 ± 142 mg/2 min, p = .02). The increase and decrease in RSD completely accorded with those of salivary secretion. Furthermore, SIR was the only parameter that was significantly different between patients with posttreatment increase and decrease in salivary secretion (p = .04). ROC analysis showed the sensitivity and specificity of SIR at baseline of ≥13.0 × 10-2 for the prediction of the response to abatacept were 75.0% and 83.3%, respectively. CONCLUSIONS: Parotid DWI seems to be useful for evaluating and predicting the response in salivary secretion to abatacept in SS patients with RA.


Assuntos
Abatacepte/uso terapêutico , Antirreumáticos/uso terapêutico , Artrite Reumatoide/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Glândula Parótida/diagnóstico por imagem , Síndrome de Sjogren/diagnóstico por imagem , Adulto , Idoso , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/patologia , Feminino , Humanos , Imagem por Ressonância Magnética/normas , Pessoa de Meia-Idade , Glândula Parótida/patologia , Sensibilidade e Especificidade , Síndrome de Sjogren/complicações , Síndrome de Sjogren/tratamento farmacológico
20.
Intern Med ; 56(24): 3373-3377, 2017 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-29021444

RESUMO

Kikuchi-Fujimoto disease (KFD) is a benign disease of unknown etiology characterized by lymphadenopathy and a fever. For the majority of patients with KFD, the course is self-limited; however, the optimum method of managing recurrent cases has not yet been established. We herein report a case of a 42-year-old Japanese woman with KFD (confirmed by a lymph node biopsy). Although high-dose prednisolone (PSL) rapidly induced remission, she experienced four recurrences on treatment tapering. Concomitant use of hydroxychloroquine (HCQ) with low-dose PSL induced continuous remission. This is the first case to suggest the effectiveness of HCQ for recurrent KFD in a Japanese patient.


Assuntos
Linfadenite Histiocítica Necrosante/tratamento farmacológico , Hidroxicloroquina/uso terapêutico , Imunossupressores/uso terapêutico , Prednisolona/uso terapêutico , Adulto , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Feminino , Humanos , Hidroxicloroquina/administração & dosagem , Imunossupressores/administração & dosagem , Prednisolona/administração & dosagem , Recidiva
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