Δευτέρα 15 Μαΐου 2017
Score of Toxic Epidermal Necrosis Predicts the Outcomes of Pediatric Epidermal Necrolysis
Abstract
Background/Objectives
Epidermal necrolysis (Stevens–Johnson syndrome and toxic epidermal necrolysis) includes immune-mediated, life-threatening inflammatory blistering disorders that can affect children. The Score of Toxic Epidermal Necrosis (SCORTEN) tool has accurately predicted the outcome of these disorders in adults but has not been tested in children.
Methods
We performed a retrospective chart review to compare the accuracy of the adult SCORTEN tool with that of two modifications tailored to children in predicting disease outcome.
Results
The longer the patient's median length of hospital stay was, the higher the adult and two proposed pediatric SCORTENs were. In addition, all patients who died had SCORTENs greater than 4.
Conclusion
The pediatric-modified tools were not superior to the adult SCORTEN, which accurately predicted outcome.
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Positive clinical outcome in a patient with recalcitrant bullous pemphigoid treated with rituximab and intravenous immunoglobulin
Summary
A 41-year-old white man was treated for bullous pemphigoid (BP) for 4 years, using high-dose prednisone as well as ciclosporin and mycophenolate mofetil. Sustained clinical improvement was not observed. He suffered several serious side effects. Consequently, he was treated with a combination of rituximab (RTX) and intravenous immunoglobulin (IVIg). He received 12 infusions of RTX in 6 months and monthly IVIg until the end of the therapy. Within 5 weeks of this therapy, appearance of new lesions ceased. Within 8 weeks, all previous lesions resolved and previous medications were discontinued. No hospitalizations, relapses, infections or other serious adverse events occurred. The high levels of pathogenic autoantibody decreased and have remained undetectable. After three infusions of RTX, CD19+ B cells were undetectable and returned to normal levels within 18 months. The patient remains in complete clinical remission off all systemic therapy and free of disease for a 20-month follow-up.
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A rounded opacity silhouetting the left heart border and hilum
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
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Fwd: Space Medicine & Medical Engineering, Year 2017, Issue 01 -New Issue Alert.
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A rounded opacity silhouetting the left heart border and hilum
A 73-year-old woman with hypertension and atrial fibrillation presented with head and neck injury after mechanical fall. During workup, chest X-ray anteroposterior view (figure 1) revealed a rounded opacity silhouetting the left heart border and hilum. Subsequent contrast-enhanced CT of the chest showed single, 6.4 cm, rounded, well-defined, thin-walled, non-enhanced, low attenuated (–20 and 20 Hounsfield Unit) and homogenous cyst-like structure at the left mediastinum connected to pericardial recesses and not attached to adjacent structures (figure 2A–C). Transthoracic echocardiogram ruled out left ventricular aneurysm, aortic aneurysm, solid tumour and outflow tracts obstruction. Although bronchogenic cyst, oesophageal duplication cyst, thymic tumour and mediastinal lymphoma were considered as possible differentials, radiological features such as CT appearance, homogenous attenuation, unrelated to the underlying structures favoured pericardial cyst. Since patient was asymptomatic, patient and family member were unwilling to undergo surgical removal and pathological confirmation. Follow-up with non-enhanced CT of...
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A rounded opacity silhouetting the left heart border and hilum
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Fwd: Cancer Research on Prevention and Treatment, Year 2017, Issue 01 -New Issue Alert.
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Fwd: Neuroscience Bulletin, Year 2017, Issue 02 -New Issue Alert.
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Fwd: Journal of International Neurology and Neurosurgery, Year 2016, Issue 06 -New Issue Alert.
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Fwd: Journal of Clinical Radiology, Year 2016, Issue 12 -New Issue Alert.
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Fwd: Chinese Journal of Neuroanatomy, Year 2017, Issue 01 -New Issue Alert.
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Fwd: Journal of Oncology, Year 2017, Issue 02 -New Issue Alert.
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