Presentation
We present a case of a 62 year-old-male who presented with altered liver function tests, anemia and unintentional weight loss. Initial laboratories revealed anemia and a cholestatic pattern. [ncbi.nlm.nih.gov]
Entire Body System
- Fever
Sweet's syndrome is characterized by fever, neutrophilia, erythematous skin lesions, and a diffuse dermal infiltrate of mature neutrophils. There are sets of associations that we will discuss in this article between OS and Sweet's syndrome. [ncbi.nlm.nih.gov]
Low-grade fever. Raynaud phenomenon (reduced blood flow to the fingers, toes, ears, and nose, causing sensitivity, numbness, and loss of color in these areas). [my.clevelandclinic.org]
[…] treatment of Juvenile Idiopathic Arthritis, Systemic Lupus Erythematosus, Mixed Connective Tissue Disease, Juvenile Dermatomyositis, Morphea/Scleroderma, vasulitis (Wegener’s/GPA, MPA, Churg-Strauss, Henoch-Schonlein Purpura, Takayasu’s Arteritis), periodic fever [floatinghospital.org]
During his stay in the ward, his urine out-put ranged between 200-400 ml/24 hrs., his edema feet increased, he had persistent fever upto 39°C. [jpgmonline.com]
In practical terms, if a patient is on either drug, they must go immediately to the hospital if they develop a fever. For cyclosporine, this is to make sure that they do not have one of many possible infections. [aamds.org]
- Swelling of the Finger
She had a thin body habitus, acanthosis nigricans in multiple body folds ( Fig 2A ), hypertrichosis on the face and shoulders, and swelling of the finger tips (Raynauds phenomenon). [pediatrics.aappublications.org]
Respiratoric
- Cough
In contrast, an older patient with a history of tobacco smoking with chronic cough and dyspnea with evidence of fixed obstruction would favor a diagnosis of COPD. [mdedge.com]
Symptoms of ACOS are likely to include: labored breathing wheezing coughing, with or without mucus tightness in the chest Symptoms vary from day to day and typically includes flare-ups. [healthline.com]
It has been long recognised that features of asthma and COPD may co-exist in patients who present with airflow limitation and symptoms of cough and/or dyspnoea [ 4 ]. [erj.ersjournals.com]
Plasma Substance P levels in patients with persistent cough. Respiration 2011; 82:431–438. https://doi.org/10.1159/000330419 pmid:21846969 View Article PubMed/NCBI Google Scholar 31. Metz M, Krull C, Hawro T, Saluja R, Groffik A, Stanger C et al. [journals.plos.org]
Gastrointestinal
- Abdominal Pain
Clinically, the patient reported no jaundice, dark urine, nausea or abdominal pain, fatigue or anorexia suggestive of acute viral hepatitis. [healio.com]
Abdominal pain. Neuropathy (nerve disorders) affecting the trigeminal nerve in the face. Hearing loss. The "classic" symptoms of MCTD are: Raynaud phenomenon (see description above). [my.clevelandclinic.org]
pain, or were investigated for elevated liver enzymes. [acgcasereports.gi.org]
Skin
- Eczema
People with asthma often have allergies and the skin condition eczema. If you only have COPD, symptoms usually start after age 40. Symptoms can vary from day to day, but they’re chronic and progressive, even with treatment. [healthline.com]
These variables will include diagnosis, GP visits, and prescriptions related to asthma and COPD, as well as history of allergy (including atopic eczema/dermatitis, food allergy, allergic rhinitis, and anaphylaxis) and smoking history (see Table 1 ). [nature.com]
Musculoskeletal
- Arthritis
Learn more about Raynaud's Phenomenon Rheumatoid Arthritis Rheumatoid Arthritis (RA) is a chronic inflammatory autoimmune disease which can overlap with Myositis. [understandingmyositis.org]
Programs + Services | Doctors + Care Team | Research + Clinical Trials | News Programs + Services Rheumatology The Pediatric Rheumatology Division at Floating Hospital in Boston provides expert arthritis and inflammatory disorder diagnosis and treatment [floatinghospital.org]
Overlap syndromes typically have elements of systemic lupus erythematosus, rheumatoid arthritis, and progressive systemic sclerosis, among other illnesses. View Full Glossary [lupusresearch.org]
However, there are few reported cases of SSc-rheumatoid arthritis (RA) overlap-associated interstitial pneumonia. [ncbi.nlm.nih.gov]
Arthritis Rheum. 2009, 60: 1112-1118. 10.1002/art.24409. [arthritis-research.biomedcentral.com]
- Arthralgia
A clinical examination revealed Raynaud phenomenon, arthralgia, distal skin sclerosis, and microbleeds in the nailfold capillaries. An anti-Ku antibody test was positive. A muscle biopsy revealed inflammatory myopathy with rimmed vacuoles (RVs). [ncbi.nlm.nih.gov]
Her review of systems was unremarkable, with no chronic fatigue, anorexia, abdominal pain, arthralgias or other symptoms suggestive of autoimmune disorders. [healio.com]
Simultaneously, occurrence of painful intraoral (buccal mucosa, palate/tongue) ulcers, swelling of both hands, arthralgia/myalgia and listlessness, ocular (watering, burning, and reddening) complaints, and loss of hearing made her seek dermatological [e-ijd.org]
Dryness of eyes and mouth, chronic fatigue, and arthralgias are the most common features of this disease, which may appear solely, as primary SS, or together with other rheumatic disease as secondary SS. [jcp.bmj.com]
- Proximal Muscle Weakness
SSc patients with serum CK more than 2 times upper limit, myalgia, and proximal muscle weakness were analyzed for the presence of polymyositis with electromyography (EMG) and muscle biopsy. [arthritis-research.biomedcentral.com]
- Morning Stiffness
stiffness朝のこわばり n necrotizing angiitis壊死性血管炎 neovascularization新生血管形成 nodule小[結]節 nonsteroidal anti-inflammatory drugs (NSAIDs)非ステロイド性抗炎症剤 o oligosialia唾液減少[症] osteoarthritis (OA)変形性関節症 overlap syndrome重複(オーバーラップ)症候群〈膠原病の〉 p pancreas膵臓、膵 peak [expiratory [tokyo-med.ac.jp]
Neurologic
- Neglect
Sleep Disordered Breathing is one of the most underdiagnosed and neglected disorders directly affecting both the quality and quantity of life for our COPD patients. [aarc.org]
This stimulated basic scientific research aimed at obtaining a better understanding of both diseases, particularly COPD that had been neglected. [um.edu.mt]
- Gowers Sign
The child had typical Gower's sign. He was unable to climb stairs or raise his arms above head and had a very poor grip. There was no obvious wasting but he had generalised hypotonia even of neck and back muscles with absent deep tendon reflexes. [jpgmonline.com]
Workup
Metabolic workup documented elevated cerebrospinal fluid lactate. Initial genetic analyses excluded the three most common LHON mutations. Subsequently, Sanger sequencing of the entire mitochondrial DNA (mtDNA) genome was performed. [ncbi.nlm.nih.gov]
The workup for other causes of liver disease including hepatitis B, HIV, Wilson disease, and α-1-antitrypsin phenotype was negative, and there was no history of drug or alcohol use. An abdominal ultrasound showed normal liver size and echogenicity. [journals.lww.com]
The data collection contains information of symptoms, physical examination, laboratory workup, as well as annually performed pulmonary-function test results, echocardiography, right-heart catheterization, and high-resolution computed tomography (HRCT) [arthritis-research.biomedcentral.com]
X-Ray
- Esophageal Motility Disorder
motility disorder(食道機能異常)、sclerodactyly(強指症)、telangiectasia(毛細血管拡張)〉 crystal arthritis結晶性関節炎 cyclosporineサイクロスポリン cytokineサイトカイン d deep venous thrombosis (DVT)深在静脈血栓症 dermatomyositis (DM)皮膚筋炎 diffuse scleroderma汎発(全身)強(硬)皮症 discoid lupus erythematosus [tokyo-med.ac.jp]
Treatment
Before treatment, HCV RNA was 36,100 IU/mL, with AST 124 U/L and ALT 171 U/L. She was a rapid responder to the treatment with undetectable HCV RNA after 4 weeks of treatment (Fig. 2). She completed 48 weeks of antiviral treatment and achieved SVR. [journals.lww.com]
The treatment recommendation for patients, whose differential diagnosis is equally balanced between asthma and COPD, is to start treatment for asthma until further investigations are performed. [northeast.devonformularyguidance.nhs.uk]
Andrew Schorr: …for treatment. Dr. Daver: …we had the Jakafi for treatment. [patientpower.info]
Currently, the most effective treatment for ACOS is unknown and omalizumab for ACOS has not yet been reported. We report our experience with anti-IgE, omalizumab treatment on 3 patients with ACOS as a retrospective case study. [ncbi.nlm.nih.gov]
Many questions remain, however, with regard to disease definition, prognosis, and optimal treatment. Treatment currently consists of continuous positive airway pressure, and oxygen as needed. [rc.rcjournal.com]
Prognosis
Patients with antisynthetase syndrome are generally considered to have a poor prognosis, with mortality 3 times greater than that of myositis without antisynthetase syndrome. [online.epocrates.com]
Interstitial pneumonia is a common and major comorbidity affecting the prognosis of patients with systemic sclerosis (SSc). However, there are few reported cases of SSc-rheumatoid arthritis (RA) overlap-associated interstitial pneumonia. [ncbi.nlm.nih.gov]
This is a necessary starting point from which to design studies to investigate the clinical features, aetiology, pathophysiology and prognosis of these patients, and ultimately determine treatment strategies. [um.edu.mt]
Etiology
While the etiology of connective tissue diseases remains unknown, the classification of individual cases will continue to depend on identifying certain patterns of clinical and laboratory features. [ncbi.nlm.nih.gov]
Current Opinion in Rheumatology. 3(6):995–1000, DEC 1991 PMID: 1772755 Issn Print: 1040-8711 Publication Date: 1991/12/01 Checking for direct PDF access through Ovid Abstract While the etiology of connective tissue diseases remains unknown, the classification [doi.org]
Later, etiologies included prion, autoimmune disease, and various toxic etiologies ( Antelmi et al 2015 ). The content you are trying to view is available only to logged in, current MedLink Neurology subscribers. [medlink.com]
B, Enlarged ovaries with multiple ovarian cysts; left ovary, 21.6 cm3, right ovary, 25.3 cm3 A fasting study to understand the etiology of her hypoglycemia was performed in a supervised clinical environment ( Table 2 ). [pediatrics.aappublications.org]
Epidemiology
Epidemiology and survival of systemic sclerosis-systemic lupus erythematosus overlap syndrome [published online July 15, 2018]. J Rheumatol. doi:10.3899/jrheum.170953 [rheumatologyadvisor.com]
This is a cross-sectional study with a community-based sample of 1298 participants (mean age, 59.7 ± 6.7) from the cohort of Korean Genomic and Epidemiologic Study during 2013 to 2014. [insights.ovid.com]
Our primary aim was to identify prevalence and predictors of the overlap syndrome in Koreans.This is a cross-sectional study with a community-based sample of 1298 participants (mean age, 59.7 ± 6.7) from the cohort of Korean Genomic and Epidemiologic [ncbi.nlm.nih.gov]
Little is known about the epidemiology, clinical characteristics, and survival of SSc-SLE overlap. We evaluated the prevalence of SSc-SLE overlap and differences in SSc characteristics, and compared survival with SSc without SLE. [jrheum.org]
This article will review the identification, epidemiology, diagnostic evaluation, and basic treatment strategy for ACOS. This information should assist the primary care physician (PCP) in his or her approach to this condition. [mdedge.com]
Pathophysiology
We report 3 cases of patients with COPD in a stable clinical condition, referred to the Department of Respiratory Pathophysiology at the "Mariano Santo" Hospital in Cosenza, due to possible symptoms suggestive of obstructive sleep apnea, and who were [ncbi.nlm.nih.gov]
This is a necessary starting point from which to design studies to investigate the clinical features, aetiology, pathophysiology and prognosis of these patients, and ultimately determine treatment strategies. [um.edu.mt]
It is acknowledged that within this description of ACOS will lie a number of phenotypes that may in due course be identified by more detailed characterization on the basis of clinical, pathophysiological and genetic identifiers. [goldcopd.org]
McNicholas WT: Chronic obstructive pulmonary disease and obstructive sleep apnea: overlaps in pathophysiology, systemic inflammation, and cardiovascular disease. Am J Respir Crit Care Med 2009; 180: 692–700. [karger.com]
Prevention
CPAP alone may not fully correct hypercapnia or hypoxemia, so non-invasive ventilation (NIV) treatment and/or supplemental oxygen may increase the clinical benefit to the patient. 18 NIV therapy can theoretically rest overloaded respiratory muscles, prevent [resmed.com]
Keep reading: 5 diet tips for people with COPD » As far as researchers know, there is no way to prevent asthma, but you can lower your risk of developing COPD. It’s unclear if lowering your risk of COPD also lowers your risk of developing ACOS. [healthline.com]
A perceptive diagnostic approach toward these diseases is critical, and early diagnosis and treatment are needed to prevent dystrophic calcinosis. [ncbi.nlm.nih.gov]
COPD is defined by the Global Initiative for Chronic Obstructive Lung disease (GOLD) as: A preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients. [sleepapnea.org]
This approach recognises the pivotal role of inhaled corticosteroids in preventing morbidity and even death in patients with uncontrolled asthma symptoms, for whom even seemingly 'mild' symptoms (compared to those of moderate or severe COPD) might indicate [northeast.devonformularyguidance.nhs.uk]