Tag Archives: immunology

VA Resident Report: How many recent instances of Acute Rheumatic Fever in the United States?

The Bottom Line: Acute rheumatic fever is no longer a nationally notifiable disease in the United States, and its annual incidence in the continental United States declined in the late 20th century to approximately 0.04–0.06 cases per 1,000 children. Exceptions … Continue reading

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VA Resident Report: Is there an increased risk for patients with Terminal Complement Deficiency and HIV?

The Bottom Line: The Advisory Committee on Immunization Practices has previously recommended routine vaccination of persons aged ≥2 months who have certain medical conditions that increase risk for meningococcal disease, including persons who have persistent deficiencies in the complement pathway … Continue reading

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EUHM Resident Report: What is the rate of lymphogranuloma venerum developing in the distal rectum and causing painful bleeding?

Anorectal LGV is a common cause of acute proctitis and proctocolitis among HIV-infected MSM who practice unprotected anal sex, and it is frequently associated with other rectal STDs. The implementation of routine screening and prompt diagnosis of these rectal infections … Continue reading

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What is the clinical presentation associated with various drugs that incite drug rash with eosinophilia and systemic symptoms (DRESS)?

Bottom line: Typically presents with fever, rash, and solid organ involvement. Commonly associated drugs include aromatic anticonvulsants and sulfonamides. Walsh SA, et al. Drug reaction with eosinophilia and systemic symptoms (DRESS): a clinical update and review of current thinking. Clin … Continue reading

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Is there a danger in supplementing vitamin D in the setting of sarcoidosis?

The Bottom Line: In this first published RCT of vitamin D supplementation in sarcoidosis, it was found that patients with sarcoidosis and 25OHD <50 nmol/L, vitamin D supplements did not alter average serum calcium or urine calcium, but had no benefit on surrogate markers … Continue reading

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When is plasma exchange used as a therapy in Guillain-Barre syndrome?

The Bottom Line: Patients who receive PE are typically older, and have higher complication rates including respiratory failure. Reference: Alshekhlee A, Hussain Z, Sultan B, Katirji B.  Immunotherapy for Guillain-Barré syndrome in the US hospitals. J Clin Neuromuscul Dis. 2008 Sep;10(1):4-10.    Summary: In this large US cohort, it was discovered that patients … Continue reading

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What are the etiologies of P-ANCA, C-ANCA and atypical ANCA results?

WHAT IS ANCA? In: Neuromuscular Case Studies, 1st ed. [MDConsult]. This table (63-1) summarizes diseases associated with C-anca, P-anca, and X-anca and the antigens MPO (myeloperoxidase), BPI (bactericidal/permeability-increasing), PR3 (proteinase 3), elastase, cathepsin-G, lysosomal and lactoferrin jkn 2/16

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