Displaying publications 21 - 40 of 49 in total

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  1. Conidiobolomycosis in a young Malaysian woman showing chronic localized fibrosing leukocytoclastic vasculitis: a case report and meta-analysis focusing on clinicopathologic and therapeutic correlations with outcome
    Choon SE, Kang J, Neafie RC, Ragsdale B, Klassen-Fischer M, Carlson JA
    Am J Dermatopathol, 2012 Jul;34(5):511-22.
    PMID: 22728716 DOI: 10.1097/DAD.0b013e31823db5c1
    Conidiobolomycosis (also known as rhinoentomophthoramycosis) is a rare cutaneous/mucosal fungal infection seen mainly in the tropical rain forest regions of the world that can be associated with disfiguring facial elephantiasis, and rarely, death.
    Matched MeSH terms: Vasculitis, Leukocytoclastic, Cutaneous/diagnosis; Vasculitis, Leukocytoclastic, Cutaneous/drug therapy; Vasculitis, Leukocytoclastic, Cutaneous/microbiology; Vasculitis, Leukocytoclastic, Cutaneous/pathology*
  2. Fulltext Deep vein thrombosis as a rare presentation in a female with anti-neutrophil cytoplasmic antibodies-associated vasculitis
    Wan Ghazali WS, Mohammad N, Ismail AM
    Arch Rheumatol, 2017 Jun;32(2):171-174.
    PMID: 30375559 DOI: 10.5606/ArchRheumatol.2017.6108
    This article aims to report a case of a young female patient with anti-neutrophil cytoplasmic antibodies-associated vasculitis complicated with pulmonary renal syndrome, multiple relapses, and who later developed venous thromboembolism. Pulmonary renal syndrome is a well- recognized and lethal complication; however, incidence of venous thromboembolism has not been well-described. In this article, we described a 38-year-old Malay female patient admitted in 2008 with three-month history of peripheral neuropathy of lower limbs and right ankle ulcers. Initial inflammatory markers were high and perinuclear Anti-Neutrophil Cytoplasmic Antibodies were positive. She was diagnosed as anti-neutrophil cytoplasmic antibodies-associated vasculitis and started on intravenous methylprednisolone with methotrexate. She presented with relapse of skin vasculitis complicated with pulmonary renal syndrome after being stable for one year. She was intubated and proceeded with plasmapheresis and hemodialysis. She completed six cycles of cyclophosphamide. Renal biopsy revealed chronic changes consistent with end stage renal disease. She further relapsed in 2011 with nasal blockage, epistaxis, and nasal deviation. Chest X-ray revealed lung nodules. Prednisolone was increased, her symptoms settled, and she was discharged with azathioprine. She was readmitted at the end of the same year due to two-day history of right deep vein thrombosis and she later succumbed to methicillin-resistant Staphylococcus aureus sepsis.
    Matched MeSH terms: Vasculitis*; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
  3. Fulltext ANCA-associated vasculitis - revisited, and its association with autoimmune thyroid disease
    Lai Y, Nik Yahya NH, Ong SG
    Med J Malaysia, 2014 Apr;69(2):98-100.
    PMID: 25241822
    Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of uncommon diseases. Given its rarity and multisystem clinical presentation which are usually serious and potentially fatal, prompt recognition and early treatment are of utmost importance. We report a case of AAV that presented with digital infarcts, cutaneous vasculitis, rapidly progressive glomerulonephritis, mononeuritis multiplex, eosinophilia and positive myeloperoxidase (MPO)-ANCA antibody. Apart from renal damage, there was complete recovery in other systems following intravenous cyclophosphamide and high-dose glucocorticoids albeit the response was delayed. This response obviates the need for second-line therapy with newer agent such as rituximab (anti-CD20 monoclonal antibody). We would also like to highlight that this is the first case of AAV that is associated with autoimmune thyroid disease to be reported from Malaysia.
    Matched MeSH terms: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
  4. Human Hendra virus infection causes acute and relapsing encephalitis
    Wong KT, Robertson T, Ong BB, Chong JW, Yaiw KC, Wang LF, et al.
    Neuropathol. Appl. Neurobiol., 2009 Jun;35(3):296-305.
    PMID: 19473296 DOI: 10.1111/j.1365-2990.2008.00991.x
    To study the pathology of two cases of human Hendra virus infection, one with no clinical encephalitis and one with relapsing encephalitis.
    Matched MeSH terms: Vasculitis/immunology; Vasculitis/pathology; Vasculitis/virology
  5. Fulltext Case series of ocular tuberculosis; the great masquerader
    Loh, Ui Lyn, Nadras, Indira, Yeong, Choo Mee, Nadarajah, Gaayathri, Fazilawati Qamarruddin, Shelina Oli Mohamed, et al.
    Journal of Biomedical and Clinical Sciences, 2018;3(2):1-5.
    MyJurnal
    Tuberculosis, an ancient disease, still thrives today as the leading infection caused by Mycobacterium tuberculosis. Diagnosis of ocular tuberculosis poses a great challenge due to the varied clinical presentations. We report 3 cases of primary ocular tuberculosis with varied presentations: conjunctival abscess, sclera-uveitis and occlusive vasculitis. There were no symptoms suggestive of pulmonary tuberculosis in all cases. All patients presented with acute, unilateral painful red eye. The first case had good visual acuity (VA) OD (6/9) with a swollen upper lid, localized perilimbal-hemorrhagic conjunctival swelling superiorly, keratic precipitates and mild anterior chamber reaction. The posterior segment was normal. The second case had a VA of 6/60 OD. There was presence of conjunctival injection, keratic precipitates, posterior synechiae and anterior chamber reaction of 1+. A few days later, there was a progression to vitritis OU and hyperemic optic disc OD with choroidal folds, cystoid macula edema and a positive T sign on B scan ultrasonography. The third case had VA of 6/6 OU, AC reaction of 2+ OD. There was multiple peripheral choroiditis with peripheral vasculitis seen in the posterior segment OU. Fundus fluorescein angiography (FFA) showed peripheral periphlebitis in all 4 quadrants OU. All 3 cases had positive Tuberculin Skin Test (Mantoux test) results which were more than 20mm. Anti-tuberculous treatment was promptly started and all patients showed significant clinical improvement. This case series highlights the diverse clinical presentations of ocular tuberculosis. A high clinical index of suspicion led to prompt initiation of anti-tuberculous therapy which resulted in good clinical outcomes for all cases.
    Matched MeSH terms: Vasculitis
  6. Fulltext Shrinking lung syndrome – a rare cause of recurrent dyspnoea in SLE
    Baharuddin H, Mohd Zim MA, Rosman A, Mohd Zain M
    Journal of Clinical and Health Sciences, 2017;2(1):35-38.
    Here we present a 24-year-old lady with systemic lupus erythematosus (SLE) whom we diagnosed with shrinking lung syndrome (SLS), a rare manifestation of SLE. The initial SLE manifestation was alopecia, thrombocytopenia, serositis and vasculitis. Anti-nuclear antibody (ANA), anti-double stranded DNA (dsDNA) antibody, anti-ribonucleic (RNP) and anti-Ro antibody were positive. A year after diagnosis, she started to develop intermittent dyspnea and was hospitalised on three occasions. Lung examinations revealed reduced breath sounds at both bases and dullness at the right base. Multiple chest radiographs showed bilateral raised hemi-diaphragms. Other investigations including CT pulmonary angiogram, high resolution CT of the thorax, ventilation-perfusion scan and echocardiogram were not significant. On the third hospital admission, we noticed bilateral small lung volumes in the previous high resolution CT scan. Inspiratory and expiratory chest radiographs were performed and showed minimal change in lung volumes and a diagnosis of shrinking lung syndrome (SLS) was made. Her SLE remained active with lupus nephritis despite multiple immunosuppression and she passed away two years later due to sepsis with multi-organ failure.
    Matched MeSH terms: Vasculitis
  7. Sudden cardiac death in a young adult man due to spontaneous coronary artery dissection
    Subramaniam K, Siew SF, Mahmood MS
    Malays J Pathol, 2019 Apr;41(1):51-54.
    PMID: 31025638
    Spontaneous coronary artery dissection is a rare event and commonly associated with pregnancy and female gender. This condition can reduce or completely obstruct the blood flow to the heart, causing a myocardial ischaemia, abnormalities in heart rhythm or sudden death. We present a case of a 28-year-old Indian male with no previous medical illness who complained sudden onset of chest pain prior to his death. Autopsy revealed a left anterior descending coronary artery dissection associated with plaque rupture. The anterior wall of left ventricle showed contraction band necrosis. There was also atheroma present in the right coronary artery which was insignificant. Histologically, dissection was associated with atherosclerosis. There was no evidence of vasculitis. The cause of death was given as coronary artery dissection due to coronary artery atherosclerosis.
    Matched MeSH terms: Vasculitis
  8. Fulltext Nipah virus encephalitis — a review
    Tan, C.T., Chua, K.B., Wong, K.T.
    ASM Science Journal, 2009;3(1):91-96.
    MyJurnal
    The Nipah virus was first discovered in 1999, following a severe outbreak of viral encephalitis among pig farm workers in Malaysia. The virus was thought to have spread from Pteropus bats to pigs, then from infected pigs to humans by close contact. Mortality of the disease was high at about 40%. The main necropsy finding was disseminated microinfarction associated with vasculitis and direct neuronal involvement. Relapsed encephalitis was seen in approximately 10% of those who survived the initial illness. Since its first recorded emergence in peninsular Malaysia, 10 outbreaks of Nipah virus encephalitis have been reported in Bangladesh and West Bengal in India. The outbreaks occurred from January to May, with Pteropus giganteus as the reservoir of the virus. In Bangladesh, evidence indicated that the virus transmitted directly from bats to human, with human to human transmission as an important mode of spread. The mortality of the illness was higher in Bangladesh which stood at around 70%. This was likely to be due to genetic variation of the virus.
    Matched MeSH terms: Vasculitis
  9. Fulltext Endovascular therapy versus surgery in adult with coarctation of the aorta
    Abdulgani, Hafil Budianto, Oemar, Hamed
    Medical Health Reviews, 2009;2009(1):43-58.
    MyJurnal
    Coarctation of the aorta is a congenital anomaly presented by the combination of upper body hypertension and weak or absent femoral pulses. Increased morbidity and shortened life span of infants born with coarctation suggest that the malformation should be treated early in life. Surgical intervention has been recognized as the gold standard of treatment for children born with this defect. Unfortunately, studies in many institutions have shown that the diagnosis of coarctation of the aorta is often missed. As a consequence, many patients with coarctation of the aorta are not detected until adult life. Long-term follow-up of adult patients following surgical intervention for coarctation of the aorta reveals ongoing risks; hence, less invasive endovascular therapy becomes an alternative approach. Literature’s review was performed to compare the results of endovascular therapy (stenting and angioplasty) with surgical techniques to repair adult with coarctation of the aorta. The immediate improvement in hypertension and the morbidity were similar. Although stenting can be expected to show superiority to balloon angioplasty alone, that was not apparent when comparing these two endovascular approaches. The morbidity, mortality, and repeat intervention rates were just as high for stenting as they were for angioplasty or for a combination of both modalities. The majority of surgical complications were minor (i.e., vasculitis, bleeding), whereas the majority of endovascular complications could be considered more severe (i.e., dissection, traumatic aneurysm, stroke). Surgical therapy was associated with a very low risk of restenosis and recurrence, whereas endovascular therapy had a much higher incidence of restenosis and the need for repeat interventions. In conclusion, surgical therapy is superior compared to other modes of interventional therapy for adult with coarctation of the aorta, and it shall remain as current mode of therapy for adult with coarctation of the aorta.
    Matched MeSH terms: Vasculitis
  10. Fulltext Parkinsonism and brain MRI findings in a relapsed culture-proven salmonella typhi infection: a case report in Malaysia
    Ng, Y.M., Cheng, J.T.
    JUMMEC, 2016;19(1):1-2.
    MyJurnal
    Typhoid fever is a systemic infection caused by Salmonella typhi, which may be associated with extra-intestinal
    complications. Neurological manifestations, particularly Parkinsonism, are rarely reported. We report a
    17-year-old patient with relapsed culture-proven Salmonella typhi infection who developed septic shock and
    subsequently Parkinsonism. Lumbar puncture revealed acellular cerebrospinal fluid with raised protein level.
    Magnetic resonance imaging revealed cerebral petechial haemorrhages resulted from small vessels vasculitis.
    His symptoms resolved spontaneously after 3 months.
    Matched MeSH terms: Vasculitis
  11. Fulltext Gastrointestinal involvement in Henoch Schonlein purpura: a case report
    Siti Kamariah CM, Rohaizan Y
    International Medical Journal Malaysia, 2009;8(2):37-38.
    MyJurnal
    Henoch-Schonlein purpura or anaphylactoid purpura is a systemic vasculitis of unknown cause that affects small vessels and mainly involves the skin, joints, gastrointestinal tract and kidneys. Gastrointestinal involvement occurs in more than half of patients and is thought to be related to edema and intramural haemorrhage. Radiologically the gastrointestinal findings are mainly those of bowel ischemia with thumbprinting and bowel wall oedema. Although this disease is usually treated conservatively, aggressive intervention is occasionally performed because of acute abdominal symptoms due to complications, such as perforation, intussusception and obstruction. This report illustrates a case of Henoch-Schonlein purpura with acute abdominal symptoms due to intussusception.
    Matched MeSH terms: Systemic Vasculitis
  12. Fulltext Non-alcoholic fatty liver disease, vascular inflammation and insulin resistance are exacerbated by TRAIL deletion in mice
    Cartland SP, Harith HH, Genner SW, Dang L, Cogger VC, Vellozzi M, et al.
    Sci Rep, 2017 05 15;7(1):1898.
    PMID: 28507343 DOI: 10.1038/s41598-017-01721-4
    Non-alcoholic fatty liver disease (NAFLD) incorporates steatosis, non-alcoholic steato-hepatitis (NASH) and liver cirrhosis, associating with diabetes and cardiovascular disease (CVD). TNF-related apoptosis-inducing ligand (TRAIL) is protective of CVD. We aimed to determine whether TRAIL protects against insulin resistance, NAFLD and vascular injury. Twelve-week high fat diet (HFD)-fed Trail -/- mice had increased plasma cholesterol, insulin and glucose compared to wildtype. Insulin tolerance was impaired with TRAIL-deletion, with reduced p-Akt, GLUT4 expression and glucose uptake in skeletal muscle. Hepatic triglyceride content, inflammation and fibrosis were increased with TRAIL-deletion, with elevated expression of genes regulating lipogenesis and gluconeogenesis. Moreover, Trail -/- mice exhibited reduced aortic vasorelaxation, impaired insulin signaling, and >20-fold increased mRNA expression for IL-1β, IL-6, and TNF-α. In vitro, palmitate treatment of hepatocytes increased lipid accumulation, inflammation and fibrosis, with TRAIL mRNA significantly reduced. TRAIL administration inhibited palmitate-induced hepatocyte lipid uptake. Finally, patients with NASH had significantly reduced plasma TRAIL compared to control, simple steatosis or obese individuals. These findings suggest that TRAIL protects against insulin resistance, NAFLD and vascular inflammation. Increasing TRAIL levels may be an attractive therapeutic strategy, to reduce features of diabetes, as well as liver and vascular injury, so commonly observed in individuals with NAFLD.
    Matched MeSH terms: Vasculitis/complications*; Vasculitis/metabolism; Vasculitis/pathology
  13. Periodic lateralized epileptiform discharges (PLEDs) in cerebral lupus correlated with white-matter lesions in brain MRI and reduced cerebral blood flow in SPECT
    Aye SM, Lim KS, Ramli NM, Tan CT
    Lupus, 2013 Apr;22(5):510-4.
    PMID: 23358870 DOI: 10.1177/0961203312474705
    This is a case report on an uncommon correlation between periodic lateralized epileptiform discharges (PLEDs) and white-matter lesions in cerebral lupus, and with a reduced cerebral blood flow (CBF) in single-photon emission computed tomography (SPECT). A 47-year-old woman with a long-term history of systemic lupus erythematosus (SLE) presented with a seizure followed by frontal lobe dysfunction clinically. An electroencephalogram (EEG) showed bilateral independent PLEDs in the frontal region. A magnetic resonance image of the brain showed white-matter changes in the frontal periventricular region. Cerebral angiogram did not reveal any evidence of vasculitis. A cerebral SPECT with tracer injected during the EEG showing PLEDs showed a reduction in CBF in the frontal regions. Clinical recovery was observed with intravenous immunoglobulin. This case shows that PLEDs can be seen with white-matter changes in SLE.
    Matched MeSH terms: Lupus Vasculitis, Central Nervous System*
  14. Outcome of immunosuppression in children with IgA vasculitis-related nephritis
    Rohner K, Marlais M, Ahn YH, Ali A, Alsharief A, Novak AB, et al.
    Nephrol Dial Transplant, 2024 Jul 31;39(8):1299-1309.
    PMID: 38211969 DOI: 10.1093/ndt/gfae009
    BACKGROUND: Immunoglobulin A vasculitis with nephritis (IgAVN) is the most common vasculitis in children. Due to a lack of evidence, treatment recommendations are based on expert opinion, resulting in variation. The aim of this study was to describe the clinical presentation, treatment and outcome of an extremely large cohort of children with biopsy-proven IgAVN in order to identify prognostic risk factors and signals of treatment efficacy.

    METHODS: Retrospective data were collected on 1148 children with biopsy-proven IgAVN between 2005 and 2019 from 41 international paediatric nephrology centres across 25 countries and analysed using multivariate analysis. The primary outcome was estimated glomerular filtration rate (eGFR) and persistent proteinuria at last follow-up.

    RESULTS: The median follow-up was 3.7 years (interquartile range 2-6.2). At last follow-up, 29% of patients had an eGFR <90 mL/min/1.73 m2, 36% had proteinuria and 3% had chronic kidney disease stage 4-5. Older age, lower eGFR at onset, hypertension and histological features of tubular atrophy and segmental sclerosis were predictors of poor outcome. There was no evidence to support any specific second-line immunosuppressive regimen being superior to others, even when further analysing subgroups of children with reduced kidney function, nephrotic syndrome or hypoalbuminemia at onset. Delayed start of immunosuppressive treatment was associated with a lower eGFR at last follow-up.

    CONCLUSION: In this large retrospective cohort, key features associated with disease outcome are highlighted. Importantly, there was no evidence to support that any specific immunosuppressive treatments were superior to others. Further discovery science and well-conducted clinical trials are needed to define accurate treatment and improve outcomes of IgAVN.

    Matched MeSH terms: Vasculitis/drug therapy
  15. Fulltext A plasmid-encoded peptide from Staphylococcus aureus induces anti-myeloperoxidase nephritogenic autoimmunity
    Ooi JD, Jiang JH, Eggenhuizen PJ, Chua LL, van Timmeren M, Loh KL, et al.
    Nat Commun, 2019 07 29;10(1):3392.
    PMID: 31358739 DOI: 10.1038/s41467-019-11255-0
    Autoreactivity to myeloperoxidase (MPO) causes anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), with rapidly progressive glomerulonephritis. Here, we show that a Staphylococcus aureus peptide, homologous to an immunodominant MPO T-cell epitope (MPO409-428), can induce anti-MPO autoimmunity. The peptide (6PGD391-410) is part of a plasmid-encoded 6-phosphogluconate dehydrogenase found in some S. aureus strains. It induces anti-MPO T-cell autoimmunity and MPO-ANCA in mice, whereas related sequences do not. Mice immunized with 6PGD391-410, or with S. aureus containing a plasmid expressing 6PGD391-410, develop glomerulonephritis when MPO is deposited in glomeruli. The peptide induces anti-MPO autoreactivity in the context of three MHC class II allomorphs. Furthermore, we show that 6PGD391-410 is immunogenic in humans, as healthy human and AAV patient sera contain anti-6PGD and anti-6PGD391-410 antibodies. Therefore, our results support the idea that bacterial plasmids might have a function in autoimmune disease.
    Matched MeSH terms: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/blood; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/immunology
  16. Paediatric rheumatology clinic population in Southeast Asia: are we different?
    Arkachaisri T, Tang SP, Daengsuwan T, Phongsamart G, Vilaiyuk S, Charuvanij S, et al.
    Rheumatology (Oxford), 2017 03 01;56(3):390-398.
    PMID: 27994096 DOI: 10.1093/rheumatology/kew446
    Objectives: To examine the descriptive epidemiology of the patient population referred to paediatric rheumatology centres (PRCs) in Southeast Asia (SEA) and to compare the frequency of conditions encountered with other PRC populations.

    Methods: A web-based Registry for Childhood Onset Paediatric Rheumatic Diseases was established in 2009 and seven PRCs in four SEA countries, where paediatric rheumatologists are available, participated in a prospective 24 month data collection (43 months for Singapore).

    Results: The number of patients analysed was 4038 (788 from Malaysia, 711 from the Philippines, 1943 from Singapore and 596 from Thailand). Over 70% of patients evaluated in PRCs in Malaysia, the Philippines and Thailand had rheumatic diseases (RDs), as compared with one-half of the proportion seen in Singaporean PRCs, which was similar to the Western PRC experience. Among RDs diagnosed (n = 2602), JIA was the most common disease encountered in Malaysia (41%) and Thailand (61%) as compared with systemic vasculitides in the Philippines (37%) and Singapore (35%) among which Henoch-Schönlein purpura was the most prevalent. SLE and related diseases were more common, but idiopathic pain syndrome and abnormal immunological laboratory tests were rarer than those seen in the West. JIA subtype distributions were different among countries. Among non-RDs (n = 1436), orthopaedic and related conditions predominated (21.7-59.4%).

    Conclusion: The frequencies of RDs seen by SEA PRCs were different from those in the West. Systemic vasculitides and SLE were common in addition to JIA. Paediatric rheumatologist availability and healthcare accessibility partially explain these observed discrepancies.

    Study site: multination + Selayang Hospital, Malaysia
    Matched MeSH terms: Systemic Vasculitis; Systemic Vasculitis/epidemiology*
  17. Fulltext A young patient with history of Kawasaki disease presenting with triple vessel disease
    Lim AL, Lam HY, Kareem BA, Kamarulzaman MH
    Med J Malaysia, 2012 Apr;67(2):219-21.
    PMID: 22822650 MyJurnal
    Kawasaki disease is primarily a condition that affects young children and it is associated with cardiac morbidity and mortality. This disease has been known to cause coronary artery aneurysms which occurs as a sequelae of vasculitis. The progression of triple vessel disease in adult which results from cardiac complications from Kawasaki disease is rare. We report a case of a young man with history of Kawasaki disease at infancy presenting with triple vessel disease requiring cardiac bypass surgery at the age of 20 years old.
    Matched MeSH terms: Vasculitis
  18. Fulltext Ocular Tuberculosis Initially Presenting as Central Retinal Vein Occlusion
    Mahyudin M, Choo MM, Ramli NM, Omar SS
    Case Rep Ophthalmol, 2010 Aug 02;1(1):30-35.
    PMID: 21116342
    A 23-year-old man presented with central retinal vein occlusion. The retinal haemorrhages worsened and signs of retinal vasculitis appeared later as vision dropped from 6/60 to Counting Fingers. No signs of systemic disease were observed. Routine Mantoux test and chest radiograph were negative for tuberculosis. Fundus flourescein angiogram confirmed presence of retinal vasculitis. Both systemic and topical corticosteroid therapy were ineffective. Polymerase chain reaction analysis of vitreous fluid showed presence of Mycobacterium tuberculosis. A full 6-month course of antituberculosis therapy was given and inflammation subsided. Vision improved to 3/60. This is a rare case of ocular tuberculosis without evidence of systemic infection, presenting first as a central retinal vein occlusion.
    Matched MeSH terms: Retinal Vasculitis
  19. Periodic lateralized epileptiform discharges in neuropsychiatric lupus: association with cerebritis in magnetic resonance imaging and resolution after intravenous immunoglobulin
    Lim KS, Cheong KL, Tan CT
    Lupus, 2010 May;19(6):748-52.
    PMID: 20133346 DOI: 10.1177/0961203309351539
    A 13-year-old girl with a known diagnosis of systemic lupus erythematosus presented with seizures and psychosis. An electroencephalogram (EEG) revealed continuous, non-evolving periodic lateralized epileptiform discharges (PLEDs) in the left temporal region, which did not resolve with benzodiazepine. A magnetic resonance imaging (MRI) brain scan demonstrated a focal hyperintensity in the left medial temporal and left occipital lobes, left thalamus and bilateral cerebellar white matter, with evidence of vasculitis in the magnetic resonance angiography. Intravenous immunoglobulin was given because of failed steroid therapy, which resulted in a full resolution of clinical, EEG and MRI abnormalities. Lupus cerebritis should be considered as a possible aetiology in PLEDs, and immunoglobulin can be effective in neuropsychiatric lupus.
    Matched MeSH terms: Lupus Vasculitis, Central Nervous System
  20. Fulltext Silent occlusive retinal vasculitis in a patient with pulmonary tuberculosis
    Nadia Yaacob, Adil Hussein, Maizan Yaakob, Zuraidah Mustari
    Journal of Biomedical and Clinical Sciences, 2018;3(1):31-34.
    MyJurnal
    The presence of retinal vasculitis in patients with pulmonary tuberculosis is not uncommon. However, asymptomatic presentations are quite rare. Here, we present a case of 25-year-old Malay gentleman with pulmonary tuberculosis, who was referred for an eye assessment following initiation of anti-tuberculosis drugs. His vision was good; he had no other symptoms despite having retinal neovascularization, pre-retinal haemorrhages and healed choroiditis at the fundus of the left eye. Fundus fluorescein angiography showed multiple areas of capillary fallouts at the superotemporal quadrant of the left eye with leakage from the retinal neovascularization. He was treated with laser retinal photocoagulation and oral steroids for 6 weeks, while the anti-tuberculosis drugs were continued for 9 months. Subsequent follow-ups showed regression of the neovascularization. He has remained asymptomatic since his initial visit to the eye clinic.
    Matched MeSH terms: Retinal Vasculitis
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