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HIV Associated Multiple Mononeuropathies

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Cryoglobulinemic Vasculitis Masquerading as Bilateral Carpal Tunnel Syndrome.

Oyintayo Ajiboye, Ishaan Vohra, Bashar Attar, Vatsala Katiyar, Benjamin Mba,

Cryoglobulinemic vasculitis (CV) is a systemic inflammatory syndrome involving small- to medium-sized vessels. Almost half of hepatitis C-infected patients have detectable cryoglobulins levels, but only very few develop clinical manifestations. In this case report, we bring forth a diagnostic challenge of CV. A 52-year-old man with untreated hepatitis C (high viral ... Read more >>

Cureus (Cureus)
[2019, 11(12):e6423]

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Multiple Neurologic Deficits and Cognitive Decline in a Young Woman.

Arunmozhimaran Elavarasi, Jacob George, Mehar Chand Sharma, Kalpana Kumari, Ajay Garg, Awadh Kishor Pandit, Abhishek Satapathy, Vinay Goyal,

We present the clinicopathologic conference of a 34-year-old lady with history of facial palsy 14 years ago who developed new deficits of mononeuritis multiplex, maculopapular rash, pancytopenia, splenomegaly, lung involvement and cognitive decline rapidly over three years. Investigations revealed pancytopenia, reversal of albumin globulin ratio, mediastinal adenopathy, ANA positivity, low ... Read more >>

Ann Indian Acad Neurol (Annals of Indian Academy of Neurology)
[2019, 22(4):506-512]

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Development of Central Nervous System Vasculitis in a Patient with Waldenstrom Macroglobulinemia: A Rare Presentation with Poor Prognosis.

Tahir Muhammad Abdullah Khan, Yusra Ansari, Abdul Hasan Siddiqui, Saad Ali Ansari, Faraz Siddiqui,

Waldenstrom macroglobulinemia (WM) is a rare lymphoproliferative disorder characterized by the presence of monoclonal immunoglobulin M in serum. WM may present with neurologic complications involving the peripheral and central nervous systems (CNS) though CNS complications associated with WM are rare. We present a case of a 72-year-old male with an ... Read more >>

Cureus (Cureus)
[2019, 11(10):e6039]

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Vasculitis: A Checklist to Approach and Treatment Update for Dermatologists.

Prabhakar M Sangolli, Dammaningala Venkataramaiah Lakshmi,

Vasculitis poses a great diagnostic, investigative and therapeutic challenge to the treating physician. The classification of vasculitides itself still eludes universal acceptance. Comprehensive management comprises establishing the diagnosis of true vasculitis after ruling out vasculitis mimics, finding the etiology if feasible, assessing the caliber of the vessels involved, deciphering the ... Read more >>

Indian Dermatol Online J (Indian Dermatology Online Journal)
[2019, 10(6):617-626]

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A Review of Primary Vasculitis Mimickers Based on the Chapel Hill Consensus Classification.

Farah Zarka, Charles Veillette, Jean-Paul Makhzoum,

Primary systemic vasculitides are rare diseases that may manifest similarly to more commonly encountered conditions. Depending on the size of the vessel affected (large vessel, medium vessel, or small vessel), different vasculitis mimics must be considered. Establishing the right diagnosis of a vasculitis mimic will prevent unnecessary immunosuppressive therapy. ... Read more >>

Int J Rheumatol (International journal of rheumatology)
[2020, 2020:8392542]

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Cutaneous polyarteritis nodosa in a 7-year-old boy: difficulties in diagnosis.

Izabela Dybowska-Gołota, Magdalena Krajewska-Włodarczyk, Zbigniew Żuber,

Vasculitides are a diverse group of diseases. The potential diversity of their clinical symptoms requires the exclusion of other systemic connective tissue diseases, infectious diseases or malignancies. Due to similar clinical manifestations, comprehensive differential diagnosis is needed. This paper presents the case of a boy in whom polyarteritis nodosa, early ... Read more >>

Reumatologia (Reumatologia)
[2019, 57(5):301-305]

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How we treat neurological toxicity from immune checkpoint inhibitors.

Lavinia Spain, Zayd Tippu, James M Larkin, Aisling Carr, Samra Turajlic,

Neurological adverse events from immune checkpoint inhibition are increasingly recognised, especially with combination anti-cytotoxic T-lymphocyte antigen 4 (CTLA4) and anti-programmed death receptor 1 (anti-PD-1) therapies. Their presenting symptoms and signs are often subacute and highly variable, reflecting the numerous components of the nervous system. Given the risk of substantial morbidity ... Read more >>

ESMO Open (ESMO open)
[2019, 4(Suppl 4):e000540]

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Neurological disorders in HIV in Africa: a review.

William P Howlett,

Background:Neurological disorders in HIV infection are a common cause of morbidity and mortality. The aim of this paper is to provide a narrative overview of up to date information concerning neurological disorders affecting HIV infected persons in Africa. Methods:Seminal research concerning neurological disorders among HIV-infected adults in sub-Saharan Africa from ... Read more >>

Afr Health Sci (African health sciences)
[2019, 19(2):1953-1977]

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Multiple Cranial Neuropathies in a Patient with Diabetes Mellitus.

Jomal Mathew, Madhukar Mohan, Ashok Menon,

Ann Indian Acad Neurol (Annals of Indian Academy of Neurology)
[2019, 22(3):353-355]

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The Diagnosis and Treatment of Idiopathic Facial Paresis (Bell's Palsy).

Josef Georg Heckmann, Peter Paul Urban, Susanne Pitz, Orlando Guntinas-Lichius, Ildikό Gágyor,

BACKGROUND:Peripheral facial nerve palsy is the most com- mon functional disturbance of a cranial nerve. 60-75% of cases are idiopathic. METHODS:This review is based on a selective literature search proceeding from the current, updated German-language guideline on the diagnosis and treatment of idiopathic facial nerve palsy. RESULTS:The recommended drug treatment ... Read more >>

Dtsch Arztebl Int (Deutsches Arzteblatt international)
[2019, 116(41):692-702]

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Peripheral nerve disease secondary to systemic conditions in children.

Jo M Wilmshurst, Robert A Ouvrier, Monique M Ryan,

This review is an overview of systemic conditions that can be associated with peripheral nervous system dysfunction. Children may present with neuropathic symptoms for which, unless considered, a causative systemic condition may not be recognized. Similarly, some systemic conditions may be complicated by comorbid peripheral neuropathies, surveillance for which is ... Read more >>

Ther Adv Neurol Disord (Therapeutic advances in neurological disorders)
[2019, 12:1756286419866367]

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Risk factors for cytomegalovirus infection in patients with antineutrophil cytoplasmic antibody-associated vasculitis.

Michiko Morishita, Ken-Ei Sada, Yoshinori Matsumoto, Keigo Hayashi, Yosuke Asano, Sumie Hiramatsu Asano, Keiji Ohashi, Yoshia Miyawaki, Eri Katsuyama, Haruki Watanabe, Tomoko Kawabata, Jun Wada,

AIMS:Cytomegalovirus (CMV) infection under immunosuppression sometimes causes death. This study aimed to elucidate risk factors for CMV infection in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). METHODS:Patients with AAV who underwent remission induction treatment at Okayama University Hospital between 2006 and 2016 were retrospectively analyzed. The primary outcome was the ... Read more >>

PLoS ONE (PloS one)
[2019, 14(7):e0218705]

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Non-infectious aortic and mitral valve vegetations in a patient with eosinophilic granulomatosis with polyangiitis.

Kamalesh Karthikeyan, Sudarshan Balla, Martin A Alpert,

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare form of vasculitis characterised by atopic manifestations, inflammation of small-sized to medium-sized arteries and veins, hypereosinophilia and tissue infiltration with eosinophils. Cardiac complications occur most commonly in the absence of antineutrophil cytoplasmic antibodies. Cardiac complications include coronary arteritis (rare), pericarditis, myocarditis, endocardial ... Read more >>

BMJ Case Rep (BMJ Case Reports)
[2019, 12(5):]

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Anterior hypopituitarism secondary to biopsy-proven IgG4-related hypophysitis in a young man.

H Joshi, M Hikmat, A P Devadass, S O Oyibo, S V Sagi,

IgG4-related disease (IgG4-RD) is an immune-mediated fibro-inflammatory condition which can affect various organs including the pituitary gland. The true annual incidence of this condition remains widely unknown. In addition, it is unclear whether IgG4 antibodies are causative or the end result of a trigger. With no specific biomarkers available, the ... Read more >>

Endocrinol Diabetes Metab Case Rep (Endocrinology, diabetes & metabolism case reports)
[2019, 2019:]

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Biomarkers in Vasculitides of the Nervous System.

Daniel Strunk, Antje Schmidt-Pogoda, Carolin Beuker, Lennart S Milles, Catharina Korsukewitz, Sven G Meuth, Jens Minnerup,

Besides being affected by the rare and severe primary angiitis of the central nervous system (PACNS) the nervous system is also affected by primary systemic vasculitides (PSV). In contrast to PACNS, PSV affect not only the central but also the peripheral nervous system, resulting in a large array of potential ... Read more >>

Front Neurol (Frontiers in Neurology)
[2019, 10:591]

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Spontaneous Retroperitoneal Hematoma: A Rare Presentation of Polyarteritis Nodosa.

Asad Ullah, Asghar Marwat, Krithika Suresh, Ahmed Khalil, Saba Waseem,

Spontaneous retroperitoneal hematoma is a rare clinical entity that is most commonly caused by renal tumors and vascular disease. In this article, we present a case of spontaneous retroperitoneal hemorrhage caused by polyarteritis nodosa in a patient who presented with severe left flank pain. He underwent computed tomography angiography of ... Read more >>

J Investig Med High Impact Case Rep (Journal of Investigative Medicine High Impact Case Reports)
[2019, 7:2324709619858120]

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Atypical Lyme Neuroborreliosis, Guillain-Barré Syndrome or Conversion Disorder: Differential Diagnosis of Unusual Neurological Presentations.

Tomás Teodoro, Renato Oliveira, Pedro Afonso,

Nervous system Lyme disease and Guillain-Barré syndrome are common neurological conditions that may present with unusual symptoms rendering differential diagnosis difficult. We report the case of a 62-year-old woman presenting with asymmetrical tetraparesis and hyporeflexia. Initially the presumed diagnosis of Guillain-Barré syndrome with a possible functional component was suspected and ... Read more >>

Case Rep Neurol (Case reports in neurology)
[2019, 11(1):142-147]

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Cost of peripheral neuropathy in patients receiving treatment for multiple myeloma: a US administrative claims analysis.

Xue Song, Kathleen L Wilson, Jerry Kagan, Sumeet Panjabi,

Background:Peripheral neuropathy (PN) is a common consequence of multiple myeloma (MM) among those commonly treated with older-generation proteasome inhibitors (PIs). In this study, we evaluated the economic burden attributable to PN among MM patients in real-world practice settings in the US. Methods:Adults diagnosed with MM and first treated (index event) ... Read more >>

Ther Adv Hematol (Therapeutic advances in hematology)
[2019, 10:2040620719839025]

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A Rare Case of HIV-Induced Inflammatory Demyelinating Polyneuropathy.

Abin Sajan, Soombal Zahid, Jordan Stumph, Daniel Griepp, Sami Saba, Nazish Ilyas, Isabel M McFarlane,

Background:Acute inflammatory demyelinating polyneuropathy (AIDP) is an uncommon form of neuropathy in HIV-infected patients that can cause pain, sensory disturbance, and motor weakness. Case presentation:A 23-year-old African American male with past medical history of Guillain-Barre Syndrome (GBS), Lyme disease, and sexually transmitted infections including syphilis and chlamydia presented with acute ... Read more >>

Am J Med Case Rep (American journal of medical case reports)
[2019, 7(1):5-8]

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PD-1 Inhibitors-Related Neurological Toxicities in Patients with Non-Small-Cell Lung Cancer: A Literature Review.

Aurora Mirabile, Elena Brioschi, Monika Ducceschi, Sheila Piva, Chiara Lazzari, Alessandra Bulotta, Maria Grazia Viganò, Giovanna Petrella, Luca Gianni, Vanesa Gregorc,

The advent of immune checkpoint inhibitors gave rise to a new era in oncology and general medicine. The increasing use of programmed death-1 (PD-1) inhibitors in non-small cell lung cancer and in other malignancies means clinicians have to face up to new challenges in managing immune-related adverse events (irAEs), which ... Read more >>

Cancers (Basel) (Cancers)
[2019, 11(3):]

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Sporadic late onset nemaline myopathy (SLONM) in an adult presenting with progressive muscle weakness.

Shereen Paramalingam, Jason M Dyke, Johannes C Nossent,

Sporadic late onset nemaline myopathy (SLONM) is a rare, intractable acquired myopathy that is characterised by progressive muscle weakness and the presence of nemaline rods in myofibres. Unlike the congenital form of nemaline myopathy (NM), there are only few case reports and series on SLONM in the scientific literature. We ... Read more >>

Eur J Rheumatol (European journal of rheumatology)
[2019, 6(2):105-107]

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A 17-Year-Old Girl With Unilateral Headache and Double Vision.

Larissa G Rodriguez-Homs, Mark Goerlitz-Jessen, Samrat U Das,

Tolosa-Hunt syndrome is characterized by a painful ophthalmoplegia secondary to a granulomatous inflammation in or adjacent to the cavernous sinus. Magnetic resonance imaging will show enhancement of the cavernous sinus and/or the orbital apex. Although this syndrome is extremely rare in children, it should be a diagnostic consideration in patients ... Read more >>

J Investig Med High Impact Case Rep (Journal of Investigative Medicine High Impact Case Reports)
[2019, 7:2324709619838309]

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The clinical significance of single or double bands in cerebrospinal fluid isoelectric focusing. A retrospective study and systematic review.

Harald Hegen, Anne Zinganell, Michael Auer, Florian Deisenhammer,

BACKGROUND:The presence of ≥3 oligoclonal bands (OCB) in the cerebrospinal fluid (CSF) without corresponding bands in serum represents a definite pathological pattern, whereas the clinical significance of 1-2 CSF bands (borderline pattern) is poorly investigated. METHODS:We screened 1986 consecutive CSF and serum samples which were collected over a four-year time ... Read more >>

PLoS ONE (PloS one)
[2019, 14(4):e0215410]

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Mononeuritis multiplex: an uncommon neurological manifestation of cytomegalovirus reactivation in an HIV-infected patient.

Pedro Palma, Andreia Costa, Raquel Duro, Nélia Neves, Cândida Abreu, António Sarmento,

BACKGROUND:Cytomegalovirus (CMV) reactivation with neurological involvement in patients with acquired immunodeficiency syndrome (AIDS) is increasingly rare since the introduction of antiretroviral therapy (ART). Manifestations include encephalitis, myelitis, polyradiculopathy and, less commonly, mononeuritis multiplex (MNM). We report a case of disseminated CMV disease with gastrointestinal and peripheral and central nervous system ... Read more >>

BMC Infect. Dis. (BMC infectious diseases)
[2018, 18(1):554]

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Peripheral and central nervous system involvement in a patient with primary Sjögren's syndrome: a case report.

Kathi Ging, Marie-Luise Mono, Mathias Sturzenegger, Martin Zbinden, Sabine Adler, Vera Genitsch, Franca Wagner,

BACKGROUND:Primary Sjögren's syndrome is the second most common rheumatological disorder after rheumatoid arthritis. It typically presents as xerophthalmia and xerostomia in postmenopausal women. Involvement of the central nervous system has been recognized, although its pathogenesis and characteristics are poorly understood. Central nervous system complications are a diagnostic challenge and emphasize ... Read more >>

J Med Case Rep (Journal of medical case reports)
[2019, 13(1):165]

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