Mouth and genital ulcers with inflamed cartilage (MAGIC) syndrome refers to a condition in which features of Behcet’s disease (BD) and relapsing polychondritis (RP) occur in the same individual. The existence of MAGIC syndrome suggests a potential common etiology for BD and RP. However, connecting these two diseases and referring to this condition as MAGIC syndrome might have been premature, as there is currently insufficient knowledge on BD and RP. In this critical review, we argue that these two clinical entities could possibly be unique disease processes rather than two ends of the same disease spectrum. Distinguishing the clinical difference between BD and RP is critical for the management of patients diagnosed with MAGIC syndrome, as biological therapeutic approaches for BD and RP differ. Also, inaccurate perception regarding the relationship of these two diseases could mislead researchers in their endeavors to unravel the pathophysiological mechanisms behind these two diseases.
Injection drug users are at high risk of contracting human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) due to parenteral exposure. Hepatitis A virus (HAV) is classically thought to be transmitted through the fecal-oral route, but injection drug use is increasingly recognized as a risk factor. It is well documented that there is a high prevalence of total antibodies to HAV in injection drug users, although there is limited data about the prevalence of acute HAV in injection drug users. Acute viral hepatitis is most often due to HAV, HBV, or hepatitis E virus (HEV), and it is rare to have acute co-infection with these viruses. We report a case of acute viral hepatitis due to co-infection with both HAV and HBV in an injection drug user.
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