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Case Reports 2016; 37(3): 169-173 PubMed PMID: 27179580 Citation  Keywords:  Acidosis, Renal Tubular:complications, Adult, DNA:immunology, Female, Humans, Hyperthyroidism:complications, Kidney Tubules, Distal:pathology, Lupus Erythematosus, Systemic:complications, Lupus Nephritis:complications,.   

: A case of a 42-year-old female with hyperthyroidism was subsequently diagnosed to have systemic lupus erythematosus with distal RTA. The clinical examination on admission showed swelling of the knee joints and the urinalysis showed pH 6.5, pro 3+. Her blood routine results were as follows: white blood cells 1.85×109/L, platelets 100×109/L, erythrocyte 3.06×1012/L. The serum potassium was 3.11 mmol/L, 24 hour urinary electrolyte: K 68.87 mmol/24 H, antinuclear antibodies (ANA) 1:1 000, speckled pattern. The anti-double stranded DNA antibody (anti-dsDNA), anti SS-A(52) antibody and anti SS-A(60) antibody were positive. The light microscopy and immunofluorescence showed diffuse proliferative lupus nephritis. These data were compatible with the diagnosis of systemic lupus erythematosus. The diagnosis of hyperthyroidism and distal RTA is clear. This report showed that other autoimmune disease in the diagnosis of hyperthyroidism should not be ignored....

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Journal Article 2015; 36(Suppl 1): 133-140 PubMed PMID: 26757116 Citation  Keywords:  Animals, Carps:blood, Catalase:drug effects, Gills:drug effects, Glutathione Reductase:drug effects, Hematocrit, Hemoglobins:drug effects, Insecticides:toxicity, Kidney:drug effects, Liver:drug effects, Nitriles:toxicity, Oxidative Stress:drug effects, Py.   

OBJECTIVES: The aim of this study is to evaluate effects of the insecticide Decis Mega (DM; active substance deltamethrin 50 g.L(-1)) on common carp on the basis of haematological profile, oxidative stress, antioxidant enzymes and histopathology.

DESIGN: Fish were exposed two concentrations of DM 6.56 μg.L(-1) (1DM) and 65.6 μg.L(-1) (2DM) for 96 h. Then the remaining fish were transferred into DM-free water for depuration for another period of 96 h.

RESULTS: Exposure to 1DM and 2DM proved effect on enzymatic activity of superoxide dismutase, catalase, glutathione reductase and on oxidative damage of cells in gills, liver and kidney (p<0.05, p<0.01). Exposure to 1DM showed differences (p<0.05, p<0.01) in hematocrit and hemoglobin in blood. Histopathological changes were observed after acute exposure to DM as well as to DM-free water in gills, liver and kidney.

CONCLUSION: This study concludes that deltamethrin has influence on the haematological parameters, activity of antioxidant enzymes and caused oxidative damage, and histopathological changes in the fish. However, antioxidant balance in the body was restored after placing the fish in clean water for 4 days, however, this time was not sufficient complete regeneration....

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Case Reports 2013; 34(6): 508-513 PubMed PMID: 24378452 Citation  Keywords:  ADAM Proteins:genetics, ADAMTS13 Protein, Fatal Outcome, Female, Humans, Male, Platelet Aggregation:genetics, Pregnancy, Pregnancy Complications, Hematologic:genetics, Pregnancy Outcome, Purpura, Thrombotic Thrombocytopenic:genetics, Twins, Young Adult,.   

OBJECTIVE: The primary pathologic reason for thrombotic thrombocytopenic purpura (TTP) lies in the systemic formation of platelet aggregations in association with endothelial cells damage. Endothelial damage is a result of an abnormal synthesis and metabolism of unusually large von Willebrand Factor (ULvWF) multimers. In normal conditions vWF cleaving metalloprotease, known as ADAMTS-13 (A Disintegrin And Metalloproteinase with Thrombospondin type-1 motif, member 13) prevents the ULvWF entrance in the circulation. It already has been proven that thrombotic thrombocytopenic purpura is strongly correlated with severe congenital or acquired deficiency of ADAMTS-13. Congenital ADAMTS-13 deficiency is known as Upshaw-Schulman Syndrome and it accounts for only 2-4% of all TTP cases. It is conditioned by genetic variants of the ADAMTS-13 gene causing reduced ADAMTS-13 synthesis and shows an autosomal recessive type of inheritance.

CASE PRESENTATION: We present an interesting case of a 20 year old patient, primigravida, nulliparous, in 28th gestational week of twin pregnancy with undiagnosed Upshaw-Schulman Syndrome. The patient was transferred from the district hospital to the Tertiary Perinatal Care Center because of thrombocytopenia and suspicion of hemolytic-uremic syndrome. Genetic analysis performed 5 years after patient's death (before 2008 that kind of genetic analysis had not been available in Poland) showed a homozygotic mutation in the ADMTS13 gene (4143insA) which confirmed the diagnosis of Upshaw-Schulman Syndrome.

CONCLUSIONS: 1. TTP, especially hereditary Upshaw-Schulman Syndrome, is extremely rare and complicates the course of pregnancy. It is usually very sudden and dramatic; 2. Differential diagnosis of this disease is difficult and treatment strategy very burdensome for the patient. For this reason, diagnosis of micro-angiopathic disorders need to be simultaneously based on both clinical symptoms and laboratory findings; 3. Genetic diagnosis that confirms exact recognition of Upshaw-Schulman Syndrome is not commonly available; 4. The described case was a huge diagnostic challenge, and actually the final diagnosis was published until five years after the patient's death. Before 2008, that type of genetic analysis had not been available in Poland; 5. Despite the enormous progress in medical knowledge and experience, the exact diagnosis of TTP, including Upshaw-Schulman Syndrome, of this condition remains very difficult....

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Case Reports 2013; 34(5): 343-346 PubMed PMID: 23922039 Citation  Keywords:  Aged, Anticoagulants:adverse effects, Cerebral Amyloid Angiopathy:complications, Cerebral Hemorrhage:chemically induced, Hematoma:complications, Humans, Male,.   

: The incidence of anticoagulant treatment (AT)-related intracerebral hemorrhage (AT-ICH) is increasing in consequence of the increased incidence of ischemic stroke due to an aging population. AT-ICH is associated with a risk of ongoing bleeding, death, or disability. Cerebral amyloid angiopathy (CAA), a common pathological finding among the elderly that is associated with macro- and microscopic hematoma development, might increase the risk of ICH. We report a rare case of contralateral delayed hematoma in the context of CAA secondary to acute ICH after AT for intracerebral ischemic stroke....

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Comparative Study 2012; 33(Suppl 3): 66-71 PubMed PMID: 23353846 Citation  Keywords:  Aminobenzoates:toxicity, Anesthetics:pharmacology, Animals, Aquaculture:methods, Blood Proteins:metabolism, Clove Oil:pharmacology, Erythrocyte Count, Esocidae:blood, Ethylene Glycols:pharmacology, Etomidate:pharmacology, Hematocrit, Perches:blood,.   

OBJECTIVES: The objectives of the study were to compare the effects of Propiscin, 2-phenoxyethanol, clove oil and tricaine methane sulphonate (MS 222), anaesthetics frequently used in aquaculture.

DESIGN: The haematological and biochemical blood profiles of pikeperch (Sander lucioperca L.) anesthetized with Propiscin (1.5 ml L-1), 2-phenoxyethanol (0.3 ml L-1), clove oil (33 mg L-1), MS 222 (150 mg L-1) and non-anesthetized control group were tested. Each tested group was divided into two subgroups, the first subgroup was sampled in anaesthesia 10 min after application of the anaesthetic and the second one live on 24h.

RESULTS: The erythrocyte count and haematocrit was significantly decreased in 2-phenoxyethanol (24 h) compared with control group (CG). The mean corpuscular haemoglobin concentration was significantly increased in 2-phenoxyethanol (10 min), Propiscin (10 min and 24 h) compared to CG. The 2-phenoxyethanol (10 min and 24 h), MS 222 (24 h), clove oil (24 h), and Propiscin (10 min and 24 h) showed significantly lower leukocyte count compared with CG. The level of glucose was significantly (p<0.05) elevated with MS 222 (10 min) and clove oil (10 min) compared with CG. The 2-phenoxyethanol (10 min and 24 h), MS 222 (24 h), clove oil (24 h), and Propiscin (24 h) showed significantly lower (p<0.01) ammonia levels compared with CG. The triacylglycerols was significantly decreased (p<0.01) with Propiscin (10 min and 24 h), MS 222 (24 h), clove oil (24 h) and with 2-phenoxyethanol (24 h) compared with CG. After 24 hours MS 222 (24 h) and Propiscin (24 h) anaesthesia, fish showed significantly lower (p<0.01) concentration of inorganic phosphate compared with CG.

CONCLUSIONS: On the basis of this experiment, it appears that clove oil was associated with the lowest effects in pikeperch and therefore would be recommended as an alternative to MS 222, while Propiscin and 2-phenoxyethanol are not suitable for manipulation with pikeperch in aquaculture....

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Case Reports 2011; 32(4): 425-427 PubMed PMID: 21876498 Citation  Keywords:  Adenocarcinoma:immunology, Breast Neoplasms:immunology, Carcinoma, Ductal:immunology, Carcinoma, Squamous Cell:immunology, Female, Humans, Immunocompromised Host, Immunosuppressive Agents:adverse effects, Lupus Erythematosus, Discoid:complications, Middle.   

: A case of metachronous presentation of two malignancies, invasive mammary ductal adenocarcinoma and later invasive keratinizing squamous cell vulvar carcinoma, complicating a 20 years long course of disseminated discoid lupus erythematosus is described. The authors underline a potential role of long-standing immunotherapy as a factor responsible for inducing secondary neoplasia....

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Journal Article 2011; 32(3): 334-339 PubMed PMID: 21670728 Citation  Keywords:  Adult, Aspirin:pharmacology, Cesarean Section, Drug Resistance, Female, Fetal Distress:epidemiology, Humans, Infant, Newborn, Infant, Small for Gestational Age, Lupus Erythematosus, Systemic:blood, Obstetric Labor, Premature:epidemiology, Parity, Platelet.   

OBJECTIVE: Verify that resistance to aspirin may have an impact on pregnancy and neonatal outcome.

METHODS: We enrolled 43 pregnant women, aged 30.7 ± 4.0 years regularly taking 75 mg of aspirin daily and 32 (aged 30.8 ± 4 years) pregnant women not receiving aspirin who served as control group. Laboratory tests were performed at 18 to 22 weeks of gestation, 28 to 32 weeks of gestation and 16 to 32 weeks after delivery. Resistance to aspirin was defined as urinary 11-dehydrothromboxane B2 (u11-dTXB2) concentrations in the highest quartile and additionally, as the resistance index (RI) calculated for each woman, defined as the difference between u11-dTXB2 concentration of each woman treated with aspirin and the median value at the same time point measured in the control group.

RESULTS: Women taking aspirin in the highest quartile of u11-dTXB2 delivered prematurely (35.8±3.4 vs 38.1±1.7 weeks, p=0.02). Delivery of small for gestational age (SGA) newborns (p=0.003) as well as fetal distress (p=0.014) and preeclampsia (p=0.003) occured more frequently in aspirin-resistant women. Resistance to aspirin based on the RI value was also associated with higher prevalence of preeclampsia (p=0.02) and SGA newborns delivery (p=0.01). The two groups resistant to ASA designed on the basis of both (RI and u11-dTXB2 urine levels) methods compared with ASA sensitive group differed in frequency of SLE prevalence.

CONCLUSION: Aspirin resistance may be associated with increased risk of adverse pregnancy outcomes including preeclampsia, premature delivery and delivery of SGA newborns....

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Case Reports 2011; 32(1): 4-6 PubMed PMID: 21407162 Citation  Keywords:  Adjuvants, Immunologic:administration & dosage, Adult, Female, Humans, Interferon beta-1b, Interferon-beta:administration & dosage, Lupus Erythematosus, Systemic:chemically induced, Multiple Sclerosis, Relapsing-Remitting:drug therapy, Time Factors,.   

: Drug-induced systemic lupus erythematosus (SLE) is a rare complication of therapies with some drugs. Breaking out after months or years of therapy with a certain drug, its occurrence is likely to increase with the duration of the medication and the cumulative quantity of the drug. The symptoms of this syndrome include, in particular, arthralgia, myalgia, fever, serositis, skin exanthema and production of antinuclear (ANA) antibodies. In contrast to SLE, its symptoms gradually abate after discontinuation of the inducing agent. The authors describe the case of a 43-year-old patient suffering from multiple sclerosis who experienced drug-induced SLE after 8-year application of interferon (IFN) beta-1b....

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