MyMedR

Fulltext Extrapulmonary sarcoidosis: unusual cause of epiphora

Ramlee N, Ramli N, Liza-Sharmini AT

Singapore Med J, 2007 Jun;48(6):e168-70.

Sarcoidosis is a multisystemic granulomatous disease of unknown aetiology mainly affecting African-Americans, Scandinavians, and the Irish. However, individuals of other races and ethnicities are still not immune. The clinical presentations vary widely with most patients having some respiratory problems. Though extrapulmonary sarcoidosis is no longer rare, sarcoidosis involving the lacrimal sac is an infrequently-reported problem. We present a case of sarcoidosis involving the lacrimal sac in a 42-year-old Malay woman who presented with epiphora. She was successfully treated with steroids and dacryocystorhinostomy. There was no evidence of systemic involvement. It is suggested that in an unusual presentation of sarcoidosis, a thorough search should be made for localisation of other sites, lungs in particular, even in the absence of respiratory complaints.

Matched MeSH terms: Prednisolone/therapeutic use

Steroid-induced diabetes mellitus in systemic lupus erythematosus patients: analysis from a Malaysian multi-ethnic lupus cohort

Shaharir SS, Gafor AH, Said MS, Kong NC

Int J Rheum Dis, 2015 Jun;18(5):541-7.

PMID: 25294584 DOI: 10.1111/1756-185X.12474

OBJECTIVE:
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and glucocorticoid is the mainstay of treatment in SLE. The reported incidence of steroid-induced diabetes mellitus (SDM) ranged between 1-53%. We sought to investigate the prevalence and associated factors of SDM in patients with SLE.

METHODOLOGY:
A total of 100 SLE patients attending the Nephrology/SLE and Rheumatology Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) who received corticosteroid treatment were recruited. The diagnosis of diabetes mellitus was based on the 2010 American Diabetes Association's criteria. Prevalent cases of SDM were also included. Statistical analysis was performed to determine the factors associated with SDM.

RESULTS:
Thirteen of them (13%) developed SDM, with the median onset of diagnosis from commencement of glucocorticoid treatment being 8 years (range 0.5-21 years). Although only seven Indians were recruited into the study, three of them (42.9%) had SDM compared to Malays (9.3%) and Chinese (12.8%) (P ≤ 0.05). Univariate and multivariate analysis showed that higher numbers of system or organ involvement in SLE, abdominal obesity, hypertriglyceridemia and daily prednisolone of ≥ 1 mg/kg/day were the important associated factors of SDM (P ≤ 0.05). Meanwhile, hydroxychloroquine (HCQ) use was associated with reduced SDM prevalence (P < 0.05).

CONCLUSION:
The prevalence of SDM among SLE patients was 13% and Indians were more prone to develop SDM compared to other races. Higher numbers of system involvement, abdominal obesity, hypertriglyceridemia and the use of oral prednisolone of ≥ 1 mg/kg/day were associated with SDM, while HCQ use potentially protects against SDM.

© 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

KEYWORDS:
SLE drug treatment; clinical aspects; systemic lupus erythematous

Matched MeSH terms: Prednisolone/adverse effects*; Prednisolone/therapeutic use*

Hemorrhagic Descemet Membrane Detachment Following Syphilitic Interstitial Keratitis

Höllhumer R, Zairani Mz A, Watson S

Cornea, 2016 Sep;35(9):1255-6.

PMID: 27227396 DOI: 10.1097/ICO.0000000000000889

PURPOSE: Syphilitic interstitial keratitis is a stromal inflammatory disease with characteristic secondary vascularization. This case illustrates a late complication of hemorrhagic Descemet membrane detachment.

METHODS: Case report.

RESULTS: The patient presented with painless sudden visual loss and progressive shallowing of the anterior chamber caused by hemorrhagic Descemet membrane detachment. She had corneal neovascularization and a positive syphilis serology. Owing to the risk of pupil block glaucoma, the patient had surgical drainage of the blood via an ab externo approach.

CONCLUSIONS: This case illustrates a previously unreported complication of syphilitic interstitial keratitis. The patient recovered good visual acuity and had residual pigment deposits in the pre-Descemet interface.

Matched MeSH terms: Prednisolone/analogs & derivatives; Prednisolone/therapeutic use

Fulltext Pemphigus vulgaris in a pregnant woman and her neonate

Ibrahim SB, Yashodhara BM, Umakanth S, Kanagasabai S

BMJ Case Rep, 2012;2012.

PMID: 22744241 DOI: 10.1136/bcr.02.2012.5850

A 23-year-old pregnant woman in her second trimester of pregnancy presented with blisters on the face, abdomen and the leg. Based on the clinical presentation and skin biopsy (histopathology and direct immunofluorescence) the diagnosis of pemphigus vulgaris was established. The child born to this patient also had similar skin lesions. The lesions in the mother and the child improved after treatment. The authors report a rare case of pemphigus vulgaris in a pregnant lady and neonatal pemphigus in her child, both of whom were treated successfully.

Matched MeSH terms: Prednisolone/therapeutic use

Polymyositis and dermatomyositis in Sarawak: a profile of patients treated in the Sarawak General Hospital

Teh CL, Wong JS, Soo HH

Rheumatol Int, 2012 Jan;32(1):265-8.

PMID: 21243497 DOI: 10.1007/s00296-010-1745-2

We performed a cross-sectional study of the demography, clinical and laboratory features of patients with polymyositis and dermatomyositis followed up in our centre from 2006 to 2009. There were 12 cases, with the majority of them (58.3%) being woman. They have a mean age of 57.8 years and mean disease duration of 11.83 (SD 9.92) months. Our patients comprised of multi-ethnic groups with predominantly Chinese (83.3%), Sarawak natives (8.3%) and Malays (8.3%). They have a mean lag time to diagnosis of 3.67 (SD 4.27) months. Nine (75%) patients had dermatomyositis and 3(25%) had polymyositis. The common clinical manifestations found in our patients were proximal myopathy (100%), neck weakness (33.3%), dysphagia (33.3%) and interstitial lung disease (33.3%). For the nine patients with dermatomyositis, the most common dermatological manifestations were shawl sign (88.9%) and V sign (88.9%). Muscle enzymes were raised in 91.7% of patients. Electromyographies were carried out in four patients, and only one of our patients had muscle biopsy. Only 41.7% of our patients have positive ANA. The majority received prednisolone (100%) and hydroxychloroquine (58.3%). Malignancy occurred in five (three nasopharyngeal carcinomas, one sigmoid colon cancer and one lung cancer) out of the nine dermatomyositis patients but none in the polymyositis group. The mortality rate in our group was 4(33.3%) over the 4-year period. This study demonstrated the rarity of PM/DM in our centre with considerable lag time to diagnosis in our patients. Despite lack of muscle biopsy in our centre, our centre achieved appropriate diagnosis and management of PM/DM.

Matched MeSH terms: Prednisolone/therapeutic use

Fulltext Pulmonary haemosiderosis with juvenile idiopathic arthritis in a Malaysian child

Wong AR, Noor AS, Rasool AH, Quah BS, Roberton D

Med J Malaysia, 2007 Oct;62(4):352-4.

PMID: 18551948 MyJurnal

A rare case of childhood pulmonary haemosiderosis with juvenile idiopathic arthritis is discussed, with particular reference to treatment with hydroxychloroquine and sildenafil for pulmonary hypertension which occurs secondary to this disease.

Matched MeSH terms: Prednisolone/therapeutic use

Acute retinal necrosis by cytomegalovirus in an immunocompetent adult: case report and review of the literature

Tajunisah I, Reddy SC, Tan LH

Int Ophthalmol, 2009 Apr;29(2):85-90.

PMID: 18026692

A rare case of acute retinal necrosis caused by cytomegalovirus in an immunocompetent adult, diagnosed by polymerase chain reaction of vitreous aspirate, with good visual outcome after intravitreal and intravenous ganciclovir and oral prednisolone therapy, is reported. A 50-year-old healthy lady presented with redness and diminution of vision in her right eye of 10 days duration. She had anterior chamber inflammation, marked vitritis, and anterior retinal necrosis in the right eye. Blood and other investigations did not reveal any infectious diseases and HIV testing was negative. The retinal lesions and panuveitis resolved with treatment. Two months later she developed retinal detachment which was treated successfully. The best-corrected vision was 6/12 in the right eye. Seven cases of cytomegalovirus ocular infection in immunocompetent healthy adults, reported in the literature, were reviewed. The different presentations of this disease and the importance of suspecting this causative agent are highlighted.

Matched MeSH terms: Prednisolone/administration & dosage

A case of mixed connective tissue disease with pseudo-pseudo Meigs' syndrome (PPMS)-like features

Cheah CK, Ramanujam S, Mohd Noor N, Gandhi C, D Souza BA, Gun SC

Lupus, 2016 Feb;25(2):214-6.

PMID: 26377236 DOI: 10.1177/0961203315606441

Pseudo-pseudo Meigs' syndrome (PPMS) has been reported to be a rare presentation of patients with systemic lupus erythematosus (SLE). However, such a presentation is not common in other forms of connective tissue disease. We presented a case of gross ascites, pleural effusion, and marked elevation of CA-125 level (PPMS-like features) that led to a diagnosis of MCTD. The patient responded to systemic steroid therapy.

Matched MeSH terms: Methylprednisolone/administration & dosage; Prednisolone/administration & dosage

Autoimmune thrombocytopenia and neutropenia after autologous peripheral blood stem cell transplantation

Wahid FS, Cheong SK, Sivagengei K

Acta Haematol., 2002;107(4):237-8.

PMID: 12053154

Matched MeSH terms: Prednisolone/therapeutic use

Bullous pemphigoid--management of a patient with oral and skin lesions

Ali TB, Zain RB, Adam BA

Singapore Dent J, 1994 Jan;19(1):18-21.

PMID: 9582679

A case of bullous pemphigoid with extra-oral and intraoral lesions in a 60-year-old female is reported. Diagnosis is based on histopathology and direct immunofluorescence, and the treatment regime described included oral prescription of prednisolone and topical application of a mixture of fluocinonide ointment and triamcinolone acetonide in Orabase on the oral lesions.

Matched MeSH terms: Prednisolone/administration & dosage

Inhibition of rats adjuvant arthritis by a bradykinin antagonist Hoe 140 and its influence on kallikreins

Sharma JN, Wirth KJ

Gen. Pharmacol., 1996 Jan;27(1):133-6.

PMID: 8742510

1. This study examines the effect of Hoe 140, a bradykinin (BK) 2 receptor antagonist, indomethacin and prednisolone on chronic adjuvant arthritis of the knee in rats. We also evaluated the influence of Hoe 140 on BK-forming enzymes in the synovial and paw tissues. 2. Adjuvant arthritis was induced in male Sprague-Dawley rats in the right knee by injecting 0.05 ml of a fine suspension of heat-killed Mycobacterium tubercle bacilli in liquid paraffin (5 mg/ml). 3. Hoe 140 (1.5 mg/kg i.p.), indomethacin (2.5 mg/kg orally) and prednisolone (3.0 mg/kg orally) administration for 9 days resulted in significant suppression of knee joint swelling. Plasma and tissue kallikrein levels were raised (P < 0.01) in the synovial and paw tissues of adjuvant arthritic rats. Hoe 140 treatment reduced (P < 0.05) tissue kallikrein but increased (P < 0.01) plasma kallikrein levels in synovial tissue. 4. Hoe 140 treatment did not alter (P > 0.05) the raised plasma and tissue kallikrein levels in the paw tissue. The findings indicate that Hoe 140 may be a useful anti-inflammatory agent and BK plays a major role in this adjuvant-induced arthritis model.

Matched MeSH terms: Prednisolone/pharmacology

Role of Angiography in Systemic Lupus Erythematosus-Induced Choroiditis

Lee KR, Peng LY, Iqbal TB, Subrayan V

Ocul Immunol Inflamm, 2018;26(8):1146-1149.

PMID: 28362518 DOI: 10.1080/09273948.2017.1298821

PURPOSE: To report a case of systemic lupus erythematosus-induced choroidal vasculitis.

METHODS: A 34-year-old woman with a long-standing history of systemic lupus erythematosus had a sudden painless loss of vision in the right eye over 12 hours. Ocular examination revealed a visual acuity of counting fingers of 1 foot on the right eye and 20/20 on the left. There was a relative afferent pupillary defect on the right side with a pink, distinct optic disk margin.

RESULTS: Optical coherence tomography of the macula and fundus fluorescein angiogram for the eyes were normal. The MRI brain and orbit with the cerebral MRA did not show signs of optic neuritis or occipital vasculitic changes. However, the indocyanine green angiography revealed patches of ill-defined areas of choroidal hypofluorescence in the early- to mid-phase in the macula region.

CONCLUSION: ICGA becomes the crucial tool in unmasking the presence of choroidal vasculitis.

Matched MeSH terms: Methylprednisolone/therapeutic use; Prednisolone/therapeutic use

Fulltext Rechallenge of ponatinib in chronic myeloid leukaemia after hepatotoxicity

Boo YL, Liam CCK, Toh SG, Lim SM

Hong Kong Med J, 2019 04;25(2):162-163.

PMID: 30971509 DOI: 10.12809/hkmj187420

Matched MeSH terms: Prednisolone/administration & dosage

"Mummy, my eyelids are heavy": A case series of juvenile myasthenia gravis

Krishna L, Abdul Jalil NF, Lott PW, Singh S, Choo MM

Eur J Ophthalmol, 2021 Mar;31(2):NP119-NP122.

PMID: 31390886 DOI: 10.1177/1120672119867605

PURPOSE: To report three cases of juvenile myasthenia gravis aged between 18 and 24 months with ocular symptoms as their first presentation.

METHOD: A case series.

RESULTS: We present a case series of juvenile myasthenia gravis in a tertiary centre in Malaysia. Two of the three cases consist of a pair of twins who presented with ptosis of bilateral eyes; the first twin presented 4 months later than the second twin. These two cases were positive for anti-acetylcholine receptor antibodies and had generalized myasthenia gravis, whereas the other case was negative for receptor antibodies and was purely ocular myasthenia gravis.

CONCLUSION: Juvenile myasthenia gravis is relatively rare in toddlers. Early diagnosis and commencement of treatment is important to slow the progression of the disease and avoiding life-threatening events.

Matched MeSH terms: Prednisolone/therapeutic use

Eosinophilic granulomatosis with polyangiitis and mononeuritis multiplex responded to induction cyclophosphamide

Mohammad N, Wan Ghazali WS

BMJ Case Rep, 2017 May 27;2017.

PMID: 28551593 DOI: 10.1136/bcr-2016-218252

We report a case of 28-year-old Malay woman who initially presented with multiple joints pain with underlying poorly controlled asthma since her childhood. She was treated as seronegative arthritis. However, the involvement of joints, asthma and high-eosinophil counts raised suspicion of Churg-Strauss syndrome. This disease is undoubtedly rare in Malaysians or even in Asian populations. After appropriate therapy was delivered for the correct diagnosis her clinical condition improved. She is currently receiving maintenance treatment.

Matched MeSH terms: Prednisolone/therapeutic use*

Fulltext The atypical presentation of rheumatoid arthritis in an elderly woman: a case report

Devaraj NK

Ethiop J Health Sci, 2019 Jan;29(1):957-958.

PMID: 30700964 DOI: 10.4314/ejhs.v29i1.18

The diagnosis of rheumatologic problem can be difficult, especially if not all the diagnostic criteria or typical clinical features are seen. This includes conditions such as rheumatoid arthritis which needs early diagnosis to start disease modifying drugs (DMARDs) which can improve the prognosis and prevent further joint erosion and organ damage. This case report focused on a similar scenario in an elderly woman initially thought to have osteoarthritis but was diagnosed later with rheumatoid arthritis which brought much relief to her current predicament.

Matched MeSH terms: Prednisolone/therapeutic use

Kawasaki disease following coronavirus disease 2019 with prolonged fecal viral shedding

Uda K, Okita K, Soneda K, Taniguchi K, Horikoshi Y

Pediatr Int, 2021 05;63(5):597-599.

PMID: 33278321 DOI: 10.1111/ped.14452

Matched MeSH terms: Prednisolone/therapeutic use

Fulltext Electrocardiographic case--electrocardiographic clinical diagnosis in a patient with post-chemotherapy emesis and oliguria

Fadilah SS

Singapore Med J, 1999 Aug;40(8):553-5.

PMID: 10572501

Matched MeSH terms: Prednisolone/administration & dosage

Fulltext Puerperal acquired factor VIII inhibitor causing a von Willebrand-like syndrome in a patient with anti-DNA antibodies

Jackson N, Hashim ZA, Zainal NA, Jamaluddin N

Singapore Med J, 1995 Apr;36(2):230-1.

PMID: 7676276

A 30-year-old Malay lady, with no previous or family history of bleeding, presented with severe gum bleeding 25 days post-partum. The factor VIII:c was 0.03 iu/ml with evidence of a slow-acting factor VIII inhibitor. Von Willebrand factor antigen (VWF:age) varied from less that 0.05 to 0.17 iu/ml, and there was absent ristocetin-induced platelet aggregation. Anti-nuclear and anti-DNA antibodies were present, but there were no other features of systemic lupus erythematosus. There was some clinical response to cryoprecipitate and tranexamic acid, and slight improvement with corticosteroid. Fifteen months later, the patient has no active bleeding problem, and her VWF-ag is increasing spontaneously. However, factor VIII:c is less than 0.01 iu/ml and her factor VIII inhibitor titre is still > 20 Bethesda units/ml.

Matched MeSH terms: Prednisolone/therapeutic use

Fulltext Sarcoidosis: a review of cases seen at the University Hospital, Kuala Lumpur

Liam CK, Menon A

Singapore Med J, 1993 Apr;34(2):153-6.

PMID: 8266159

Fourteen cases of sarcoidosis consisting of 7 male and 7 female patients with a mean age of 42.4 years were seen at the University Hospital from 1972 to 1990. There were 10 Indians, 2 Malays, and 2 Chinese. Twelve patients had thoracic involvement. The other common disease manifestations included weight loss, arthralgia, hepatomegaly, erythema nodosum, peripheral lymphadenopathy, and hypercalcaemia. At initial presentation, the disease was in radiographic stage I, II, and III in 8, 3 and one patient respectively. The Kveim test was positive in 7 out of 9 patients. Eight patients required steroid therapy.

Matched MeSH terms: Prednisolone/therapeutic use

Displaying publications 81 - 100 of 141 in total