A case of urticarial vasculitis in a female patient with lupus: Mycoplasma pneumoniae infection or lupus reactivation?

Diplomatico, Mario; Gicchino, Maria Francesca; Ametrano, Orsola; Marzuillo, Pierluigi; Olivieri, Alma Nunzia

doi:10.1007/s00296-016-3626-9

Cited by 10 publications

(9 citation statements)

References 16 publications

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“…However, the IgG level showed an increasing trend after 2 weeks, indicating temporal changes in IgA, IgM, and IgG levels differ after MP infection. In several studies, the serum IgA, IgM, and IgG levels of critically ill children were significantly higher than in mildly ill children, indicating the humoral immunity becomes increasingly compromised with the progression of MP infection 2 . In several studies, the serum total IgE levels were higher in the atopic patients than in the nonatopic patients with increased IgE levels 22,23 …”

Section: Discussionmentioning

confidence: 99%

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Serum amyloid a, C‐reactive protein, and procalcitonin levels in children with Mycoplasma pneumoniae infection

Jiang

Wang

Zhang

et al. 2022

Clinical Laboratory Analysis

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Background Mycoplasma pneumoniae (MP) is a common pathogen of community‐acquired pneumonia in children. In the present study, serum amyloid A (SAA), C‐reactive protein (CRP), and procalcitonin (PCT) levels in children with MP infection were analyzed and the differential diagnoses of MP evaluated. Methods The study included 152 children with MP infection hospitalized in Tai’an Central Hospital in Shandong Province and 50 healthy children as controls. SAA, CRP, and PCT, as well as serum immunoglobulins and T lymphocyte subsets were analyzed during the acute and convalescent phases. Among the MP‐infected children, 30 cases were selected to monitor the SAA, immunoglobulins, and T lymphocyte subset levels for a week. Results The SAA, CRP, PCT, IgA, and IgM levels were significantly higher in the MP‐infected group than in the control group (F(SAA) = 83.91, p < 0.05; F(CRP) = 40.79, p < 0.05; F(PCT) = 60.58, p < 0.05; F(IgA) = 43.45, p < 0.05; F(IgM) = 233.88, p < 0.05). In addition, the levels of these factors were significantly higher in the acute phase than in the convalescent phase (p < 0.05). However, significant difference was not observed in the IgG level between these two groups (p > 0.05). The CD3+ and CD4+ levels in the MP‐infected group were lower than in the control group ( F(CD3+)= 60.58, P < 0.05; F(CD4+) = 89.05, p < 0.05), and the CD8+ level was higher than in the control group ( F(CD8+)= 96.96, p < 0.05). The CD3+, CD4+, and CD8+ levels were significantly different between the acute phase and the convalescent phase (CD3+: acute phase vs. convalescent phase, q = 2.79, p < 0.05; CD4+: acute phase vs. convalescent phase, q = 2.83, p < 0.05; CD8+: acute phase vs. convalescent phase, q = 3.15, p < 0.05). The changes in serum SAA levels in the MP‐infected group positively correlated with the changes in IgA, IgM, and CD8+ levels and negatively correlated with CD3+, CD4+, and CD4+/CD8+. Conclusion SAA, CRP, and PCT were specific markers for diagnosing early MP infection in children. These findings are important in the differential diagnosis of MP infection and clinical guidance for MP treatment.

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Section: Discussionmentioning

confidence: 99%

“…Mycoplasma pneumoniae (MP) is a common pathogen of community‐acquired pneumonia in children 1 . When MP infection occurs in infants and young children, it causes inflammation of respiratory tracts and immune system disorders 2 such as arthritis, myocarditis, and thrombosis. Multiple organ failure might occur in severe cases 3 .…”

Section: Introductionmentioning

confidence: 99%

Serum amyloid a, C‐reactive protein, and procalcitonin levels in children with Mycoplasma pneumoniae infection

Jiang

Wang

Zhang

et al. 2022

Clinical Laboratory Analysis

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“…As in other autoimmune conditions, both innate and adaptive immunity play a role in disease pathogenesis [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

A case report of a boy suffering from type 1 diabetes mellitus and familial Mediterranean fever

et al. 2021

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Background Type 1 diabetes mellitus could be associated with other autoimmune diseases, such as autoimmune thyroid disease, celiac disease, but the association with Familial Mediterranean Fever is rare, we describe a case of a boy with type 1 Diabetes Mellitus associated with Familial Mediterranean Fever (FMF). Case presentation A 13 year old boy already suffering from Diabetes Mellitus type 1 since the age of 4 years, came to our attention because of periodic fever associated with abdominal pain, chest pain and arthralgia. The fever appeared every 15–30 days with peaks that reached 40 °C and lasted 24–48 h. Laboratory investigation, were normal between febrile episodes, but during the attacks revealed an increase in inflammatory markers. Suspecting Familial Mediterranean Fever molecular analysis of MEFV gene, was performed. The genetic analysis showed homozygous E148Q mutation. So Familial Mediterranean Fever was diagnosed and colchicine treatment was started with good response. Conclusion Familial Mediterranean Fever could be associated with other autoimmune diseases such as Ankylosing Spondylitis, Rheumatoid Arthritis, Polyarteritis Nodosa, Behcet disease, Systemic Lupus, Henoch-Schönlein Purpura, and Hashimoto’s Thyroiditis. Association of type 1 Diabetes Mellitus and Familial Mediterranean Fever has been newly reported in the medical literature, this is the third association of these two diseases described in the medical literature so far.

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“…Vasculitis etiologic factors are diverse and include infectious agents (15-20%), inflammatory conditions (15-20%), medications (10-15%) and neoplasms (5%), with 45-55% of cases not having an etiologic diagnosis 5,[18][19][20] .In tertiary care referral centers, SLE-associated vasculitides occur more often in adult patients 21 . Vasculitis clinical diagnosis must be confirmed by anatomopathological study, where loss of vascular architecture is observed, caused by wall infiltration by neutrophils, lymphocytes or histiocytes; the presence of fibrinoid necrosis is characteristic 22 .…”

Section: Introductionmentioning

confidence: 99%

Etiology of cutaneous vasculitis: utility of a systemic approach

Chanussot-Deprez¹,

Vega‐Memije²,

Flores‐Suárez³

et al. 2023

GMM

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Cutaneous vasculities (CV) represents a diagnostic challenge, occurs as primary cutaneous disorder or as a manifestation of other entities. Objective: To search the cause of CV. Methods: Patients with CV were prospectively evaluated. In all patients, skin biopsies were drawn, and direct immunofluorescence was done in most of the patients. American College of Rheumatology (ACR) and Chapel Hill Consensus Conference Criteria (CHCC) were used for classification. Results: 32 patients were studied. There was female predominance (71.8%). Children presented drug-associated CV or Schönlein-Henoch purpura (SHP). Adults presented more frequently SHP, systemic lupus erythematosus or paraneoplastic vasculitis, other diagnosis as polyarteritis nodosa, microscopic polyangiitis, thrombotic vasculitis (post-puerperal), antiphospholipid syndrome, Churg-Strauss syndrome, and drug-associated CV were presented. Using the ACR and CHCC criteria, 50% of cases were classified. Discussion: In our institution, during this work the etiologic diagnostic of CV increased more than twice. However, in the case of HSV and SHP none of the proposed criteria had high specificity; other parameters were used to discern between both. Six patients remained as not classified. In our view, cryoglobulins and hepatitis serology do not seem useful unless patient's history supports they need to be done. Unclassified patients were followed-up closely for 2 years.

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A case of urticarial vasculitis in a female patient with lupus: Mycoplasma pneumoniae infection or lupus reactivation?

Cited by 10 publications

References 16 publications

Serum amyloid a, C‐reactive protein, and procalcitonin levels in children with Mycoplasma pneumoniae infection

Serum amyloid a, C‐reactive protein, and procalcitonin levels in children with Mycoplasma pneumoniae infection

A case report of a boy suffering from type 1 diabetes mellitus and familial Mediterranean fever

Etiology of cutaneous vasculitis: utility of a systemic approach

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