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1.
Clin Lab ; 65(7)2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31307165

RESUMO

BACKGROUND: We report a case that presented as fever with positive Epstein-Barr Virus (EBV) IgM antibody combined with subcutaneous nodules on lower extremities and cervical lymphadenopathy firstly misdiagnosed as infectious mononucleosis, which was proven as subcutaneous panniculitis-like T-cell lymphoma by subcutaneous nodule biopsies. METHODS: Appropriate serum and bacteriological laboratory tests were carried out for the cause of fever. An ultrasound and subcutaneous nodule biopsies were performed. RESULTS: EBV IgM antibody was positive. An ultrasound revealed multiple subcutaneous nodules, which were prone to be lipoma on lower extremities and cervical lymphadenopathy. Subcutaneous nodule biopsies were firstly misdiagnosed as lipoma, while pathology consultation for the subcutaneous nodule biopsies diagnosed subcutaneous panniculitis-like T-cell lymphoma. CONCLUSIONS: When patients have persistent fever with positive EBV IgM antibody combined other system involvements, especially lymphadenopathy and multiple subcutaneous nodules, it should differentiate lymphoma from infectious diseases.


Assuntos
Febre/diagnóstico , Imunoglobulina M/imunologia , Mononucleose Infecciosa/diagnóstico , Extremidade Inferior/patologia , Linfadenopatia/diagnóstico , Linfoma de Células T/diagnóstico , Paniculite/diagnóstico , Tela Subcutânea/patologia , Adulto , Anticorpos Antivirais/imunologia , Biópsia , Diagnóstico Diferencial , Feminino , Febre/etiologia , Herpesvirus Humano 4/imunologia , Herpesvirus Humano 4/fisiologia , Humanos , Mononucleose Infecciosa/complicações , Mononucleose Infecciosa/virologia , Extremidade Inferior/virologia , Linfadenopatia/etiologia , Linfoma de Células T/complicações , Pescoço , Paniculite/complicações , Encaminhamento e Consulta , Tela Subcutânea/virologia
3.
J Med Case Rep ; 13(1): 169, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31142349

RESUMO

BACKGROUND: Pleomorphic dermal sarcoma is the cutaneous variant of undifferentiated pleomorphic sarcoma. It is a rare malignancy of unclear histogenesis; it is a diagnosis of exclusion that requires extensive use of immunohistochemistry to rule out other malignancies. Pleomorphic dermal sarcoma typically presents as a solitary tumor in sun-exposed areas and may have unpredictable clinical behavior, with some tumors associated with metastasis and death. CASE PRESENTATION: We present an unusual case of multifocal pleomorphic dermal sarcoma arising in the areas of alpha-1-antitrypsin deficiency panniculitis in a lung transplant patient. Our patient was a 58-year-old white woman whose initial presentation was consistent with alpha-1-antitrypsin deficiency panniculitis. She then developed extensive multifocal, bleeding, and ulcerated nodules in the areas of the panniculitis. A skin biopsy was consistent with a diagnosis of pleomorphic dermal sarcoma. Her immunosuppressive regimen was decreased, and she was treated with liposomal doxorubicin 40 mg/m2 every 3 weeks with some initial improvement in the size of her tumors. However, soon after beginning therapy, she developed pneumonia and septic shock and ultimately died from multi-organ failure. CONCLUSIONS: We hypothesize that chronic, multifocal inflammation in the skin in the setting of immunosuppression led to simultaneous, malignant transformation in numerous skin lesions. We discuss the challenges of diagnosing pleomorphic dermal sarcoma, therapeutic options, and stress the need for multidisciplinary management of these cases.


Assuntos
Imunossupressores/efeitos adversos , Transplante de Pulmão , Neoplasias Primárias Múltiplas/diagnóstico , Paniculite/imunologia , Sarcoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Feminino , Rejeição de Enxerto/prevenção & controle , Humanos , Inflamação , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/imunologia , Neoplasias Primárias Múltiplas/patologia , Paniculite/complicações , Doença Pulmonar Obstrutiva Crônica/etiologia , Doença Pulmonar Obstrutiva Crônica/cirurgia , Enfisema Pulmonar/etiologia , Enfisema Pulmonar/cirurgia , Sarcoma/imunologia , Sarcoma/patologia , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/patologia , Deficiência de alfa 1-Antitripsina/complicações
6.
Plast Reconstr Surg ; 143(4): 1211-1219, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30676508

RESUMO

BACKGROUND: The safety of concurrent panniculectomy during ventral hernia repair remains a widely debated topic. This study aims to compare outcomes in obese patients who undergo ventral hernia repair with concurrent panniculectomy versus ventral hernia repair alone. METHODS: An 8-year retrospective cohort study was performed on obese patients who underwent ventral hernia repair. Patients were divided into those who underwent concurrent panniculectomy and those who did not. Postoperative complications were compared between these groups. RESULTS: A total of 223 patients were analyzed: 122 in the ventral hernia repair with concurrent panniculectomy group and 101 in the ventral hernia repair-only group. Median follow-up duration was 141 days. Patients in the ventral hernia repair with concurrent panniculectomy group had more surgical-site occurrences (57 percent versus 40 percent; p = 0.012). Both groups had similar rates of surgical-site occurrences that required an intervention (39 percent versus 31 percent; p = 0.179) and similar rates of hernia recurrence (23 percent versus 29 percent; p = 0.326). Multivariate analysis showed that concurrent panniculectomy increased the risk of surgical-site occurrences by two-fold; however, it did not increase the risk of surgical-site occurrences that required an intervention. CONCLUSIONS: The addition of a panniculectomy to ventral hernia repair increases surgical-site occurrences but does not increase complications that require an intervention. As such, ventral hernia repair with concurrent panniculectomy can be considered in obese patients with a symptomatic panniculus who wish to have a single-stage operation and the lifestyle benefits of a panniculectomy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.


Assuntos
Abdominoplastia/métodos , Hérnia Ventral/cirurgia , Herniorrafia/métodos , Obesidade/complicações , Paniculite/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hérnia Ventral/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Paniculite/complicações , Complicações Pós-Operatórias/etiologia , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
7.
Int J Hematol ; 109(2): 187-196, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30547418

RESUMO

Subcutaneous panniculitis-like T-cell lymphoma (SPTL) is a rare form of cytotoxic T-cell lymphoma. It is believed that SPTL in patients without hemophagocytic syndrome (HPS) follows an indolent course; in contrast, SPTL in patients with HPS has been associated with unfavorable survival. To provide more clinical data on SPTL in Asian populations and to identify optimal therapeutic strategies for SPTL, we assessed the clinicopathological features and long-term follow-up data of 10 Taiwanese SPTL patients diagnosed at a single center. Our study demonstrates a group of patients with high incidence of HPS (50%), rather aggressive courses, and early progression. A total of eight patients underwent hematopoietic stem cell transplant (HSCT), including one autologous HSCT and seven allogeneic HSCT. Seven of eight patients receiving HSCT achieved durable remission and maintained in remission for over 30 months (range 30-132 months). There was no difference in 3-year survival of patients with HPS (80%) compared with patients without HPS (80%). Of long-term survivors in the HPS group, three of four received HSCT (autologous HSCT, n = 1; allogeneic HSCT, n = 2). Our study indicated that HSCT is a curative option for eligible SPTL patients with HPS.


Assuntos
Transplante de Células-Tronco Hematopoéticas/métodos , Linfoma de Células T/terapia , Paniculite/terapia , Adulto , Grupo com Ancestrais do Continente Asiático , Feminino , Humanos , Linfo-Histiocitose Hemofagocítica/mortalidade , Linfo-Histiocitose Hemofagocítica/terapia , Linfoma de Células T/complicações , Linfoma de Células T/mortalidade , Masculino , Pessoa de Meia-Idade , Paniculite/complicações , Paniculite/mortalidade , Indução de Remissão , Análise de Sobrevida
8.
Diabetes Metab ; 45(4): 341-346, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30189343

RESUMO

AIM: Type 1 innate lymphoid cells (ILC1s) play a major role in regulating systemic inflammatory diseases. However, the relationship between ILC1s and type 2 diabetes (T2D) remains unclear. Thus, the present study investigated the relationship between ILC1s and glucose homoeostasis in humans. METHODS: A total of 37 newly diagnosed T2D patients and 32 subjects with normal glucose tolerance (NGT), matched for age and body mass index (BMI), were enrolled in the study. Flow cytometric analysis of ILC1s derived from peripheral blood mononuclear cells (PBMCs) and omental adipose tissue was performed. RESULTS: T2D patients displayed greater numbers and frequencies of circulating and adipose tissue ILC1s (P < 0.05) compared with NGT subjects, and the two types of ILC1s correlated positively with each other. Circulating ILC1s were positively associated with glycated haemoglobin (HbA1c), fasting plasma glucose (FPG), homoeostasis model assessment for insulin resistance (HOMA-IR), adipose tissue insulin resistance index (Adipo-IR) and serum free fatty acids (FFAs). A logistic regression model revealed that patients with higher ILC1 levels exhibited a 13.481-fold greater risk of developing T2D. CONCLUSION: This study is the first to provide evidence that ILC1 abnormalities are involved in the development of diabetes. The data also suggest a potential role of ILC1s as therapeutic indicators in the treatment of T2D.


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Imunidade Inata/fisiologia , Linfócitos/fisiologia , Tecido Adiposo/imunologia , Adulto , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/imunologia , Feminino , Teste de Tolerância a Glucose , Humanos , Inflamação/etiologia , Inflamação/imunologia , Resistência à Insulina/fisiologia , Linfócitos/classificação , Masculino , Pessoa de Meia-Idade , Paniculite/complicações , Paniculite/imunologia , Fatores de Risco
9.
Reumatismo ; 70(4): 268-269, 2018 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-30570247

RESUMO

Hashimoto's encephalopathy (HE) is an autoimmune form of encephalopathy, associated with autoimmune thyroiditis. Its prevalence is estimated to be 2:100,000. HE is characterized by behavioral changes, mental confusion, dysarthria, ataxia, psychosis, paranoia, convulsions, hallucinations, headache and hyperthermia. Elevated thyroid antibodies are necessary for diagnosis and the disease responds dramatically to glucocorticoid therapy. We describe a patient with HE and panniculitis, an association reported twice in the literature.


Assuntos
Encefalite/complicações , Doença de Hashimoto/complicações , Paniculite/complicações , Idoso , Humanos , Masculino
11.
BMJ Case Rep ; 20182018 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-30219783

RESUMO

Pancreatitis, panniculitis and polyarthritis syndrome (PPP syndrome) is a rare and complex manifestation of pancreatitis that is currently reported in few cases. We present this case regarding a 77-year-old man who presented unusually with a 6-week history of bilateral lesions on his lower limbs. During this time, he experienced increasing fatigue, joint pain, and reported fevers and significant weight loss. An incidental serum amylase was found to be significantly elevated and remained elevated throughout his 2-month hospital stay. He never complained of abdominal pain or other typical symptoms of pancreatitis. Histological examination of the leg lesions reported evidence of fat necrosis and changes consistent with pancreatic panniculitis. An abdominal CT scan revealed a well-defined lesion posterior to the neck of the pancreas. Further examination by endoscopic ultrasound revealed chronic inflammatory changes. The patient experienced a long admission and was managed supportively until he was well enough to be discharged home.


Assuntos
Artralgia/etiologia , Artrite/complicações , Necrose Gordurosa/etiologia , Pancreatite/complicações , Paniculite/complicações , Idoso , Articulações dos Dedos , Humanos , Perna (Membro) , Masculino , Síndrome
12.
BMC Infect Dis ; 18(1): 467, 2018 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-30223775

RESUMO

BACKGROUND: Legionellosis is a well-known cause of pneumonia. Primary cutaneous and subcutaneous infection caused by Legionella pneumophila is rare and the diagnosis is challenging. CASE PRESENTATION: A 38-year-old Thai woman with systemic lupus erythematosus and myasthenia gravis treated with prednisolone and azathioprine presented to our hospital with low-grade fever, diarrhea, and indurated skin lesions on both thighs. Initial examination showed plaques on both inner thighs. Magnetic resonance imaging showed myositis and swelling of the skin and subcutaneous tissue. Diagnosis of panniculitis due to L. pneumophila was carried out by histopathology, Gram stain, and 16S rRNA gene sequencing method of tissue biopsy from multiple sites on both thighs. Myocarditis was diagnosed by echocardiography. The final diagnosis was disseminated extrapulmonary legionellosis. Treatment comprised intravenous azithromycin for 3 weeks and the skin lesions, myositis and myocarditis resolved. Oral azithromycin and ciprofloxacin were continued for 3 months to ensure eradication of the organism. The patient's overall condition improved. CONCLUSIONS: To our knowledge, we report the first case of L. pneumophila infection manifesting with panniculitis, possible myositis, and myocarditis in the absence of pneumonia. The diagnosis of extrapulmonary Legionella infection is difficult, especially in the absence of pneumonia. A high index of suspicion and appropriate culture with special media or molecular testing are required. Initiation of appropriate treatment is critical because delaying therapy was associated with progressive infection in our patient.


Assuntos
Legionella pneumophila , Doença dos Legionários/patologia , Paniculite/patologia , Dermatopatias Bacterianas/patologia , Adulto , Feminino , Humanos , Legionella pneumophila/isolamento & purificação , Doença dos Legionários/complicações , Doença dos Legionários/diagnóstico , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/microbiologia , Paniculite/complicações , Paniculite/microbiologia , Dermatopatias Bacterianas/complicações , Dermatopatias Bacterianas/microbiologia
14.
J Endocrinol ; 238(1): 61-75, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29743341

RESUMO

The etiopathogenesis of type 1 diabetes (T1D) remains poorly understood. We used the LEW1.WR1 rat model of Kilham rat virus (KRV)-induced T1D to better understand the role of the innate immune system in the mechanism of virus-induced disease. We observed that infection with KRV results in cell influx into visceral adipose tissue soon following infection prior to insulitis and hyperglycemia. In sharp contrast, subcutaneous adipose tissue is free of cellular infiltration, whereas ß cell inflammation and diabetes are observed beginning on day 14 post infection. Immunofluorescence studies further demonstrate that KRV triggers CD68+ macrophage recruitment and the expression of KRV transcripts and proinflammatory cytokines and chemokines in visceral adipose tissue. Adipocytes from naive rats cultured in the presence of KRV express virus transcripts and upregulate cytokine and chemokine gene expression. KRV induces apoptosis in visceral adipose tissue in vivo, which is reflected by positive TUNEL staining and the expression of cleaved caspase-3. Moreover, KRV leads to an oxidative stress response and downregulates the expression of adipokines and genes associated with mediating insulin signaling. Activation of innate immunity with Poly I:C in the absence of KRV leads to CD68+ macrophage recruitment to visceral adipose tissue and a decrease in adipokine expression detected 5 days following Poly (I:C) treatment. Finally, proof-of-principle studies show that brief anti-inflammatory steroid therapy suppresses visceral adipose tissue inflammation and protects from virus-induced disease. Our studies provide evidence raising the hypothesis that visceral adipose tissue inflammation and dysfunction may be involved in early mechanisms triggering ß cell autoimmunity.


Assuntos
Tecido Adiposo/patologia , Tecido Adiposo/fisiopatologia , Diabetes Mellitus Tipo 1/virologia , Inflamação/complicações , Paniculite/complicações , Parvovirus/fisiologia , Tecido Adiposo/imunologia , Tecido Adiposo/virologia , Animais , Células Cultivadas , Diabetes Mellitus Tipo 1/imunologia , Diabetes Mellitus Tipo 1/patologia , Diabetes Mellitus Tipo 1/fisiopatologia , Feminino , Imunidade Inata/fisiologia , Inflamação/patologia , Inflamação/virologia , Macrófagos/fisiologia , Masculino , Paniculite/imunologia , Paniculite/patologia , Paniculite/virologia , Parvovirus/imunologia , Ratos , Transdução de Sinais/imunologia
15.
Pediatrics ; 141(Suppl 5): S496-S500, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29610179

RESUMO

We report on 4 children who presented with aseptic panniculitis associated with inherited immunodeficiency. Three patients had a B-cell immunodeficiency resulting from mutations in the TRNT1 and NF-κb2 genes (no mutation was found in the third patient), and 1 had a T-cell deficiency (mutation in the LCK gene). Panniculitis occurred before the age of 2 years in the 4 patients and preceded the onset of recurrent infections because of immunodeficiency in 2. It presented either as nodules, which resolved spontaneously within 1 to 2 weeks (3 patients), or chronic ulcerative lesions (1 patient) associated with unexplained fever and elevated acute phase reactants, without evidence of infection or high-titer autoantibodies. Febrile nodules relapsed in 2 patients, and recurrent attacks of unexplained fever (without relapse of panniculitis) occurred in the third. Skin biopsy revealed predominantly lympho-histiocytic or septal neutrophilic panniculitis in 1 and 3 patients, respectively. Panniculitis was associated with dermal involvement in the 4 patients. Patients with B-cell deficiency received monthly intravenous immunoglobulin replacement. Two patients who underwent bone marrow transplant died of bone marrow transplant-related complications. The 2 remaining patients had persistent, mild autoinflammatory disease, which did not require specific treatment. In these cases, the need for careful immunologic evaluation of patients who present with unexplained panniculitis, especially early-onset panniculitis before the age of 2 years, is highlighted.


Assuntos
Síndromes de Imunodeficiência/complicações , Síndromes de Imunodeficiência/genética , Paniculite/complicações , Paniculite/imunologia , Linfócitos B/imunologia , Transplante de Medula Óssea/efeitos adversos , Pré-Escolar , Feminino , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Síndromes de Imunodeficiência/terapia , Lactente , Proteína Tirosina Quinase p56(lck) Linfócito-Específica/genética , Masculino , Mutação , Subunidade p52 de NF-kappa B/genética , Nucleotidiltransferases/genética , Complicações Pós-Operatórias , Linfócitos T/imunologia
16.
J Eur Acad Dermatol Venereol ; 32(8): 1352-1359, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29524269

RESUMO

BACKGROUND: Panniculitis occurring in dermatomyositis is uncommon, with only a few cases described in the literature, most of them as case reports. OBJECTIVE: This report describes the clinicopathological and immunohistochemical findings in a series of 18 patients with panniculitis associated with dermatomyositis. METHODS: In each patient, we collected the clinical data of the cutaneous lesions as well as the characteristic clinical and laboratory findings. A series of histopathologic findings was recorded in the biopsy of each patient. A panel of antibodies was used in some cases to investigate the immunophenotype of the infiltrate. Data of treatment and follow-up were also collected. RESULTS: Of the 18 patients, 13 were female and 5 were male, ranging in age from 13 to 74 years (median, 46.4 years). In addition to panniculitis, all patients presented pathognomonic cutaneous findings of DM and reported proximal muscle weakness prior to the diagnosis of panniculitis. Muscle biopsy was performed in 17 patients and MRI in one, all with the diagnosis of inflammatory myopathy. None of the patients presented any associated neoplasia. Panniculitis lesions were located in the upper or lower limbs. Histopathology showed a mostly lobular panniculitis with lymphocytes as the main component of the infiltrate. Most cases showed also numerous plasma cells and lymphocytes surrounding necrotic adipocytes (rimming) were frequently seen. Lymphocytic vasculitis and abundant mucin interstitially deposited between collagen bundles of the dermis were also frequent findings. Late-stage lesions showed hyaline necrosis of the fat lobule and calcification. Immunohistochemistry demonstrated that most lymphocytes of the infiltrate were T-helper lymphocytes, with some B lymphocytes in the lymphoid aggregates and small clusters of CD-123-positive plasmacytoid dendritic cells in the involved fat lobule. CONCLUSION: Panniculitis in dermatomyositis is rare. Histopathologic findings of panniculitis dermatomyositis are identical to those of lupus panniculitis. Therefore, the final diagnosis requires clinic-pathologic correlation.


Assuntos
Dermatomiosite/metabolismo , Dermatomiosite/patologia , Paniculite/metabolismo , Paniculite/patologia , Adolescente , Adulto , Idoso , Linfócitos B/patologia , Biópsia , Células Dendríticas/metabolismo , Células Dendríticas/patologia , Dermatomiosite/complicações , Feminino , Humanos , Subunidade alfa de Receptor de Interleucina-3/metabolismo , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Paniculite/complicações , Linfócitos T Auxiliares-Indutores/patologia , Adulto Jovem
17.
J Am Coll Cardiol ; 71(4): 414-425, 2018 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-29389358

RESUMO

BACKGROUND: Recent studies suggested that perivascular components, such as perivascular adipose tissue (PVAT) and adventitial vasa vasorum (VV), play an important role as a source of various inflammatory mediators in cardiovascular disease. OBJECTIVES: The authors tested their hypothesis that coronary artery spasm is associated with perivascular inflammation in patients with vasospastic angina (VSA) using 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). METHODS: This study prospectively examined 27 consecutive VSA patients with acetylcholine-induced diffuse spasm in the left anterior descending artery (LAD) and 13 subjects with suspected angina but without organic coronary lesions or coronary spasm. Using CT coronary angiography and electrocardiogram-gated 18F-FDG PET/CT, coronary PVAT volume and coronary perivascular FDG uptake in the LAD were examined. In addition, adventitial VV formation in the LAD was examined with optical coherence tomography, and Rho-kinase activity was measured in circulating leukocytes. RESULTS: Patient characteristics were comparable between the 2 groups. CT coronary angiography and ECG-gated 18F-FDG PET/CT showed that coronary PVAT volume and coronary perivascular FDG uptake significantly increased in the VSA group compared with the non-VSA group. Furthermore, optical coherence tomography showed that adventitial VV formation significantly increased in the VSA group compared with the non-VSA group, as did Rho-kinase activity. Importantly, during the follow-up period with medical treatment, both coronary perivascular FDG uptake and Rho-kinase activity significantly decreased in the VSA group. CONCLUSIONS: These results provide the first evidence that coronary spasm is associated with inflammation of coronary adventitia and PVAT, where 18F-FDG PET/CT could be useful for disease activity assessment. (Morphological and Functional Change of Coronary Perivascular Adipose Tissue in Vasospastic Angina [ADIPO-VSA Trial]; UMIN000016675).


Assuntos
Túnica Adventícia/diagnóstico por imagem , Angina Pectoris/diagnóstico por imagem , Vasoespasmo Coronário/complicações , Vasoespasmo Coronário/diagnóstico por imagem , Paniculite/complicações , Paniculite/diagnóstico por imagem , Tecido Adiposo , Idoso , Angina Pectoris/etiologia , Estudos de Casos e Controles , Angiografia Coronária , Feminino , Fluordesoxiglucose F18 , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Estudos Prospectivos , Compostos Radiofarmacêuticos
19.
Ter Arkh ; 90(5): 55-60, 2018 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-30701890

RESUMO

AIM: The study of the course and outcomes of panniculitis (PN) in modern rheumatology practice. MATERIALS AND METHODS: We observed 209 patients (pts) (f-185, m-24 in age 17 to 80 years) with the input diagnosis "Erythema nodosum? Undifferentiated panniculitis?" and duration of illness in from 1 week to 25 years, observed in V.A. Nasonova Research Institute of Rheumatology in 2009-2016 years. Along with the general clinical examination, serological, immunological histological and immunohistochemical studies, CT scan of the chest, Doppler (Doppler ultrasound) of the veins of the lower extremities, tuberculin tests and consultations with doctors of other specialties were conducted. Outcomes were assessed after 1-6 years. RESULTS: In 23 pts a secondary character of PN was identified and discovered non-rheumatic underlying disease. Of the remaining 186 cases, the most frequent were pts with erythema nodosum (EN) (n=121), lipodermatosclerosis (LDS) (n=38) and panniculitis of Weber-Christian (PWCh)(n=18). For EN average age (AA) amounted to 38.9±12.6 years, the nodes the nodes were located symmetrically in 93% of cases on all surfaces of the lower and upper extremities (LUE). For LDS AA of the pts was 54±13 years, 68% of the pts noted the increase in the average body mass index (BMI), 79% - showed signs of chronic venous insufficiency (CVI). In 60% of the pts the items were located asymmetrically, localized mainly in the medial (92%) of the surface of the tibia (s). For PWCh AA amounted to 48.4 ± 17.6 years, seals were located on all surfaces of LUE and in 14 cases - on the trunk. CONCLUSION: To clarify the nature of PN it is necessary to conduct a comprehensive survey. The EN is characterized by symmetric defeat of all surfaces LUE more common in people of young age. A distinctive feature of LDS is asymmetrical lesions of the lower extremities in patients with increased BMI and signs of CVI. For PWCh seals are often localized on the trunk.


Assuntos
Paniculite , Adulto , Idoso , Idoso de 80 Anos ou mais , Eritema Nodoso/complicações , Humanos , Pessoa de Meia-Idade , Paniculite/complicações , Paniculite/diagnóstico , Paniculite/terapia , Reumatologia/tendências , Esclerodermia Localizada/complicações , Insuficiência Venosa/complicações , Adulto Jovem
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