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Fulltext IgG4-related disease: an atypical presentation of steroid-responsive renal mass

Ng SH, Tay JS, Lai EL

BMJ Case Rep, 2021 May 24;14(5).
PMID: 34031075 DOI: 10.1136/bcr-2020-240611

IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disease characterised by dense lymphoplasmacytic infiltration rich in IgG4-positive plasma cells, storiform fibrosis and obliterative phlebitis. Serum IgG4 levels are typically elevated but half of the patients had normal serum IgG4 levels. IgG4-RD represents a spectrum of diseases that involve various organs such as the pancreas, liver, kidneys, and salivary glands often manifesting as diffuse organ enlargement or a mass-like lesion mimicking cancer. An increased incidence of malignancy among patients with IgG4-RD has been reported. Thus, differentiating malignancy from IgG4-RD manifestation is important as the treatment differs. Glucocorticoids are considered first-line therapy and should be started early to prevent fibrosis. Patients usually have an excellent clinical response to steroids, and poor steroid response is indicative of an alternative diagnoses such as malignancy. This case report describes a case of IgG4-RD with renal mass in a young man that resolved with glucocorticoid therapy alone.

Matched MeSH terms: Phlebitis*
Retinal phlebitis associated with autoimmune hemolytic anemia

Chew FL, Tajunisah I

Ocul Immunol Inflamm, 2009 Nov-Dec;17(6):394-5.
PMID: 20001258 DOI: 10.3109/09273940903260204

To describe a case of retinal phlebitis associated with autoimmune hemolytic anemia.

Matched MeSH terms: Phlebitis/diagnosis; Phlebitis/etiology*; Phlebitis/therapy
Fulltext Infusion phlebitis assessment method used in paediatric setting: a systematic review of literature

Li Tsu Chong, Deena Clare Thomas, Renie Martha Joanes, Rose A Nain

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):62-0.
MyJurnal

Introduction: Phlebitis may localise to the insertion site or travel along the vein. The risk of phlebitis is higher in children as they have thin and weak blood vessels and move continuously due to the pain associated with insertion. Therefore, regular assessment of the risk of developing phlebitis is crucial. This review aimed to identify infusion phlebitis assessment tool used in the paediatric setting. Methods: Electronic databases used were Scopus, ProQuest, ScienceDirect, and Google Scholar. A total of ten studies which assess the development of infusion phlebitis on hos- pitalised children included in this reviewed. Study findings were discussed and concluded with a recommendation for clinical practice and future studies. Results: Phlebitis development rate was the primary outcome measures in ten studies. Of ten studies, six provided no actual definition of phlebitis. Eight reported phlebitis incidence and/or severity, eight used a scale and two used a definition alone in assessing the development of phlebitis. This review identified five different phlebitis assessment scales. Conclusion: Although there are applicable phlebitis scales can be used for paediatric setting, Limited studies have been conducted on infusion phlebitis assessment method in chil- dren. Therefore, it is suggested that more studies and vigorous test needed to identify applicable assessment tools in paediatric setting.

Matched MeSH terms: Phlebitis
Fulltext Two cases of retinal vasculitis in ocular tuberculosis involving different parts of the vascular system

Kok, Howe Sen, Tara, Mary Georg, Mae-Lynn, Catherine Bastion, Muhaya Hj Mohamad

Medicine & Health, 2006;1(1):91-93.
MyJurnal

Two case reports of retinal vasculitis in presumptive ocular tuberculosis are presented. Case 1 is a 26-year-old Malay woman who had phlebitis with choroidal lesions and case 2 is a 27 year old Malay woman who had occlusive arteritis. Both subjects had positive Mantoux tests with negative systemic screen. Both responded clinically to anti-tuberculous therapy within days of commencing therapy. There was however concurrent increase in vitritis which decreased following anti-inflammatory doses of oral corticosteroids. These two cases represent a rare mode of presentation of ocular tuberculosis for which a high index of suspicion is needed. Multidrug anti-tuberculous therapy should be combined with oral corticosteroids for effective treatment.

Matched MeSH terms: Phlebitis
Fulltext Incidence of phlebitis among adult patients with peripheral intravenous catheter in an east coast hospital Malaysia

Azlina Daud, Fatimah Mohamad, Siti Noorkhairina Sowtali

International Journal of Care Scholars, 2018;1(2):5-8.
MyJurnal

Objective: This study aims to determine the incidence rate of phlebitis among patients with peripheral intravenous catheter. Methods: An observational study was conducted in one of the hospitals in East Coast Malaysia. There were 321 data collected among patients who had peripheral intravenous catheter in medical, gynecology and orthopedic wards. The incidence of phlebitis was evaluated using modified Visual Infusion Phlebitis score checklist. Results: The incidence of phlebitis, was found out to be 36.1% (n=116/321). Most patients who developed phlebitis had visual infusion phlebitis, with a score of two (34.9%) and the rest developed phlebitis with a score of three (1.2%). Conclusion: This high incidence of phlebitis indicated a worrying outcome. Therefore, the study findings suggested that a specific guideline on post insertion management of peripheral intravenous catheter should be revised which may help in reducing more incidence of phlebitis, subsequently reduce infection in ward, and provide more safety environment in hospital and reducing cost in managing infection control.

Matched MeSH terms: Phlebitis
Blurring of vision due to VLM

Kamala D, Rohela M, Khairul Anuar A, Jamaiah I

JUMMEC, 1999;4:115-116.

A thirty two year old taxi driver presented with cotnplaints of headache, nausea, vomiting and blurring of vision of the left eye of two days duration. He was found to have an acute anterior uveities and secondary glaucoma. On further examination patient was also found to have a neuroretinitis and phlebitis in the same eye. A worm was found in the anterior chamber and it was removed via a limbal incision under local anaesthesia. The worm-like structure sent to the Department of Parasitology was identified as Gnathostoma spinigerum. he patient was treated with topical eye drops and oral steroids at the same time to reduce the inflammation. No neurological symptoms were seen. The patient was not available for further evaluation and followup. KEYWORDS: Blurring of vision, Gnathostomiasis

Matched MeSH terms: Phlebitis
Cisplatin and vinorelbine in the treatment of locally advanced and metastatic non-small cell lung cancer

Wong CMM, Lim KH, Liam CK

JUMMEC, 2001;6:20-23.

From August 1999 to January 2001, twelve chemotherapy naive patients with locally advanced and metastatic non-small cell lung cancer (NSCLC) in our hospital received vinorelbine and cisplatin. Ten patients had stage IV disease while two had stage HI disease. Patients' performance status (PS) were as follows: four had PS 1, six had PS 2, and one each PS 3 and 4. A total of 46 cycles were given as scheduled. Only major haematological toxicities were noted; one patient each with Grade 3 anaemia, Grade 3 and Grade 4 leucopenia, two had Grade 3 neutropenia and 5 had Grade 4 neutropenia without associated mortality. Three patients had Grade 3 alopecia and one had Grade 3 phlebitis. After three cycles, three patients demonstrated partial response and two had stable disease. For the four patients who completed 6 cycles, two demonstrated stable disease and two partial response. Symptom improvement was reported in all but one patient. Performance status was better in four, stable in six but declined in two patients. In conclusion, in patients with locally advanced and metastatic NSCLC, vinorelbine/cisplatin is a well-tolerated and active regimen, offering symptom palliation and improved performance status in a significant proportion of patients. KEYWORDS; Vinorelbine, lung cancer, chemotherapy.

Matched MeSH terms: Phlebitis
Fulltext Complications of temporary transvenous pacing

Chin K, Singham KT, Anuar M

Med J Malaysia, 1985 Mar;40(1):28-30.
PMID: 3831729

The complications of temporary transvenous endocardial pacing as performed in the University Hospital Kuala Lumpur, from 1971 to 1979 were reviewed. 125 temporary pacings were performed in 111 patients. Different routes of temporary pacing
were used: namely percutaneous subclavian vein and femoral vein puncture and acutecubital vein cutdown. The latter route was associated with a higher incidence of dislodgement and infection. Other common complications encountered were ventricular arrhythymia and generator failure.

Matched MeSH terms: Phlebitis/etiology*
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: Phlebitis
Perceptions of risk factors for phlebitis among Malaysian nurses

Ying CX, Yusuf A, Keng SL

Br J Nurs, 2020 Jan 23;29(2):S18-S23.
PMID: 31972104 DOI: 10.12968/bjon.2020.29.2.S18

BACKGROUND: Intravenous therapy is an integral part of professional nursing practice. Nurses have a responsibility to recognise risk factors for phlebitis.
AIMS: To investigate nurses' perceptions of risk factors for phlebitis in a tertiary teaching hospital in north-east Peninsular Malaysia.
METHODS: A cross-sectional study of 199 randomly selected nurses were surveyed for their perceptions of risk factors for phlebitis using a self-administered questionnaire.
FINDINGS: More than half of the nurses (56.8%) had a good perception levels of risk factors for phlebitis. There was a significant association between the clinical area and nurses' perceptions of risk factors for phlebitis (p=0.04). Nurses working in medical, orthopaedic, and surgical areas had slightly better perceptions than nurses working in multidisciplinary and oncology areas.
CONCLUSION: These findings suggest that nurses need to continually improve their knowledge about risk factors for phlebitis to ensure safer nursing practice.

Matched MeSH terms: Phlebitis/nursing*
Fulltext Peripheral intravenous canula (PIVC) assessment skills among pediatric nurses: audit-based approach study

Deena C T, Li Tsu Chong, Drina Dalie, Rose A Nain, Renie M Joanes, CheristyTumbil

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):4-0.
MyJurnal

Introduction: Peripheral Intravenous Cannula (PIVC) placement can cause undesirable effects, such as phlebitis. Poor PIVC care can irritate tunica intima layers of the superficial vein. The incidence of phlebitis had become a national nursing indicator, with a standard of less than 0.9%. The standard care of the patient with intravenous in- cludes a routine PIVC assessment. However, what the assessment should be based on remained unclear. The objec- tive of this study is to assess nurses’ skill in performing PIVC assessment. Methods: This is a descriptive study using an audit-based approach. It is conducted in a pediatric hospital. Nine pediatric wards were identified via stratified sampling methods. A total of 86 registered nurses consented to participate in this study. A validated research instru- ments (α = 0.83), PIVC Assessment Skill (PIVC-AS) checklist is used to audit nurses in performing PIVC assessment. PIVC-AS consists of nine audit criteria (AC), AC1: communication skill, AC2 until AC7: PIVC assessment skill, AC8: documentation skill and AC9: PIVC management. Results: Nurses communication skills to patient as in AC1 shows compliance rate of seventy six percent. The compliance rate can be explained that this study was done in the pedi- atric setting. Participants may skip this communication due to handling with a pediatric patient. More than eighty eight percent nurses comply with AC2 to AC6 which indicated their excellent skill in performing PIVC assessment every shift. However, in the AC7, only sixty seven percent comply to palpate PIVC area for any evidence of venous cord and warmth. Conclusion: This study concludes that communication between nurses and pediatric patients prior to PIVC assessment often missed out by nurses. The palpation techniques also not been carried out as compared to observation technique in pediatrics setting. Palpation technique is crucial to detect ‘warmth to touch’ because it differentiates between the early and medium stage of phlebitis.

Matched MeSH terms: Phlebitis