Presentation
We describe a case of IgG4-RSD initially presenting as a submandibular mass and subsequently presenting two years later with secondary infiltration of the kidney causing tubulointerstitial nephritis. [ncbi.nlm.nih.gov]
Generalised pruritus and cutaneous vasculitis are more common cutaneous presentations where an underlying systemic disease may be present and will influence management. [racgp.org.au]
Entire Body System
- Malnutrition
Karlock and Miller cite malnutrition and anemia for their affects on wound healing. Drs. Karlock and Schlanger also cite nicotine abuse. [podiatrytoday.com]
Table|Download (.pdf) TABLE 290e-1Common Systemic Disorders and their Associated Cardiac Manifestations Systemic Disorder Common Cardiac Manifestations Chapter Diabetes mellitus CAD, atypical angina, CMP, systolic or diastolic CHF 417 Protein-calorie malnutrition [accesspharmacy.mhmedical.com]
They also may be present in patients with nephrotic syndrome, liver disease, and malnutrition. 9 Children and active adults commonly have one or more white lines or spots on one or more nails; this condition is known as leukonychia ( Figure 7 ). [aafp.org]
Koilonychia can be idiopathic or associated with a variety of conditions such as iron deficiency anemia (Plummer Vinson syndrome), malnutrition, hemochromatosis, coronary disease, thyroid disorders, Upper gastrointestinal malignancy, traumatic injury, [idoj.in]
- Congestive Heart Failure
These local manifestations may be followed by secondary systemic sequelae like congestive heart failure. [ncbi.nlm.nih.gov]
This appearance was first reported to be associated with liver disease and has also been reported with congestive heart failure, type II diabetes and aging. [handcare.assh.org]
heart failure, left ventricular hypertrophy, and renal impairment.13 The benefits of a fundoscopic examination are its ability to predict underlying systemic disease (typically cardiovascular in nature) and its ability to assess the need for initiating [uspharmacist.com]
- Weight Gain
Prednisone has proven very effective in treating this condition but also leads to side effects such as weight gain, osteoporosis, high blood pressure and diabetes. [massgeneral.org]
The results do provide a clear positive association between weight gain and new cases of periodontitis. [link.springer.com]
gain, and lethargy, while cutaneous manifestations include dry skin and hair. [292] On the other hand, common manifestations of hyperthyroid include heat intolerance, abdominal pain, weight loss, and tachycardia, while cutaneous manifestations include [emedicine.medscape.com]
- Abdominal Obesity
Metabolic syndrome (MetS) is a clustering of multiple atherosclerotic risk factors, including abdominal obesity, dyslipidaemia, hyperglycaemia and hypertension, which identifies a 5-fold increase in risk for developing type 2 diabetes.18 Currently, evidence [nature.com]
They reported that the risk of obesity, abdominal obesity, and high percentage of body fat was higher in individuals with a lower daily frequency of tooth brushing and usage of secondary oral products. 6 This supports an earlier study finding significant [lifeextension.com]
Gastrointestinal
- Abdominal Pain
Three patients, all with marked weight loss, who presented with jaundice, abdominal pain, and/or diarrhea were found to have a pancreatic mass at first presentation. [ncbi.nlm.nih.gov]
Patients present with abdominal pain, bloody diarrhea, fever and weight loss. [clinicaladvisor.com]
Pain]. 61 Schadow C...Meyer F 28282682 2017 19 Eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome) as a differential diagnosis of hypereosinophilic syndromes. 61 Santos YA...Lopes AJ 28337408 2017 20 Acute coronary [malacards.org]
GERD has a prevalence of 18-28% in the United States. [17] The etiology of GERD varies among individuals, but it may be due to slackening of the lower esophageal sphincter, increased intra-abdominal pressure, or delayed gastric emptying. [emedicine.medscape.com]
Jaw & Teeth
- Strawberry Tongue
Oral manifestations of systemic diseases Systemic infections Measles see Koplik's spots Scarlet fever Strawberry tongue Rubella Petechial lesions on the palate and uvula Whooping cough Traumatic ulceration of the lingual fraenum Varicella (chickenpox) [med-college.de]
[…] of papillae on the surface of the tongue (strawberry tongue) and intense erythema of the mucosal surfaces. [140] Ulceration in the oral cavity is a common presenting sign. [141] The labia may appear cracked, cherry-red, swollen, or hemorrhagic. [127] [emedicine.medscape.com]
Cardiovascular
- Heart Failure
The woman whose physical activity is limited to some extent because it causes undue fatigue, shortness of breath, heart palpitation, or heart pain, but who has never experienced heart failure, will seldom suffer heart failure if she follows a strict regimen [britannica.com]
failure 113 Pheochromocytoma Hypertension, palpitations, CHF 407 Acromegaly Systolic or diastolic heart failure 401e Rheumatoid arthritis Pericarditis, pericardial effusions, coronary arteritis, myocarditis, valvulitis 380 Seronegative arthropathies [accesspharmacy.mhmedical.com]
Hepatomegaly is frequent in moderately severe heart failure. Cardiac cirrhosis is a rare complication.... Access to the complete content on Oxford Medicine Online requires a subscription or purchase. [oxfordmedicine.com]
These local manifestations may be followed by secondary systemic sequelae like congestive heart failure. [ncbi.nlm.nih.gov]
Acromegaly Macroglossia Myxoedema Macroglossia see Addison's disease Bronze discolouration of tongue (melanin deposit) Haemochromatosis Dark-brown tongue (iron pigment deposit) Cardiovascular diseases Right-sided heart failure Congested tongue (purple [med-college.de]
Fetus
- Hydrops Fetalis
fetalis in utero, scarring and deformities, hemolytic anemia, corneal scarring, and blindness. [emedicine.medscape.com]
Eyes
- Periorbital Edema
edema with a violaceous hue (heliotrope). [clevelandclinicmeded.com]
Musculoskeletal
- Joint Swelling
There is some tenderness on palpation of the joints and muscles but no joint swelling, warmth, or effusion. There is no rash and the neurologic examination is intact except for a delay in the relaxation phase of the deep tendon reflexes. [rheumatology.org]
Common symptoms include: severe fatigue joint pain joint swelling headaches a rash on the cheeks and nose, which is called a “butterfly rash” hair loss anemia blood-clotting problems fingers turning white or blue and tingling when cold, which is known [healthline.com]
Skin
- Palpable Purpura
Hepatitis C Virus–Associated Skin Disorders Leukocytoclastic vasculitis (cutaneous small vessel vasculitis) (Fig. 26) associated with circulating type II cryoglobulins, usually yields palpable purpura on the lower extremities. [clevelandclinicmeded.com]
purpura and urticarial vasculitis. [126] In SS, saliva can be thick, ropey, and mucinous, or it may be altogether absent. [127] Oral mucosal changes are those typical of xerostomia. [emedicine.medscape.com]
- Eczema
Cutaneous manifestations of Hodgkin lymphoma include cutaneous Hodgkin disease, eczema, pruritus, and erythema nodosum. [71] Oral manifestations of Hodgkin disease are uncommon, although they may develop secondary to chemotherapeutics. [emedicine.medscape.com]
Face, Head & Neck
- Malar Rash
rash (do not count if malar discoid) Bullous lupus Toxic epidermal necrolysis variant of SLE Maculopapular lupus rash Photosensitive lupus rash in the absence of dermatomyositis OR subacute cutaneous lupus (nonindurated psoriasiform and/or annular polycyclic [emedicine.medscape.com]
Neurologic
- Irritability
Furthermore, patients were investigated regarding patient-reported outcomes for pSS (EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI)) and irritable bowel syndrome (IBS)-like symptoms according to the Rome III criteria. [ncbi.nlm.nih.gov]
Anti-irritant and anti-inflammatory effects of glycerol and xylitol in sodium lauryl sulphate-induced acute irritation. J Eur Acad Dermatol Venereol. 2015;29(12):2333-41. Haghgoo R, Afshari E, Ghanaat T, et al. [lifeextension.com]
Differential diagnosis includes psoriasis, atopic dermatitis, allergic or irritant contact dermatitis, and dermatophyte (tinea) infections. [clevelandclinicmeded.com]
It is more frequently associated with diverse local conditions such as trauma, psoriasis, fungus, and contact irritant reactions (nail cosmetics) than systemic disease. [idoj.in]
A clinicopathologic study of 24 cases of systemic mastocytosis involving the gastrointestinal tract and assessment of mucosal mast cell density in irritable bowel syndrome and asymptomatic patients. Am J Surg Pathol. 2014 Jun. 38 (6):832-43. [emedicine.medscape.com]
Workup
The authors identified 2 cases of AL amyloidosis confirmed by mass spectrometry localized to the conjunctiva and without evidence of systemic disease as determined by thorough systemic workup. [ncbi.nlm.nih.gov]
Q: When patients present with a chronic, non-healing wound, what workup do you perform to rule out a systemic cause? A: For patients with lower extremity ulcers and non-healing wounds, Dr. Schlanger orders a multi-stage workup. [podiatrytoday.com]
Ideally, early recognition of the characteristic mucocutaneous melanosis would lead to a thorough medical workup and the diagnosis of PJS. [clinicaladvisor.com]
[…] associated with nail involvement. [22],[35] Hence, nail findings may not only be window to a plethora of possible systemic associations, but also a window of opportunity as a profound knowledge of the associations may be useful in a complete and targeted workup [idoj.in]
Serum
- Hyperglycemia
Associated signs include hyperglycemia, diarrhea, weight loss, and atrophic glossitis. Treatment is rmoval of the tumor. [clevelandclinicmeded.com]
Temporal sequence of the bidirectional relationship between hyperglycemia and periodontal disease: a community-based study of 5,885 Taiwanese aged 35-44 years (KCIS no. 32). Acta Diabetol. 2015;52(1):123–31. doi: 10.1007/s00592-014-0612-0. [link.springer.com]
Treatment
CONCLUSION: Treatment with rituximab led to prompt clinical and serologic improvement in these patients with refractory IgG4-RSD, and is a viable treatment option for this condition. [ncbi.nlm.nih.gov]
Prognosis
Because these extra-pulmonary manifestations of COPD are common and/or may have significant implications for the patient wellbeing and prognosis, they warrant systematic screening and appropriate management in order to provide optimal medical care. [ncbi.nlm.nih.gov]
The prognosis of amyloidosis depends on which organs are involved and the extent of the deposition. For example, protein accumulation in the heart and kidney can result in organ failure. [clinicaladvisor.com]
As you might expect, rheumatoid arthritis patients with systemic complications tend to do worse than those without such complications (i.e. prognosis is worse with systemic involvement). [verywell.com]
Etiology
In the pediatric population, oral changes can be related to rare cancers, such as Langerhans cell histiocytosis, or infectious etiologies, such as Kawasaki disease. [ncbi.nlm.nih.gov]
Epidemiology
The present era of international travel poses a new diagnostic and epidemiologic challenge that demands increased awareness to the possibility of an exotic tropical infectious disease. [ncbi.nlm.nih.gov]
[…] disease and non-celiac gluten sensitivity Clinical Review State of the Art Review BMJ 2015 ; 351 doi: https://doi.org/10.1136/bmj.h4347 (Published 05 October 2015) Cite this as: BMJ 2015;351:h4347 Benjamin Lebwohl, assistant professor of medicine and epidemiology [doi.org]
The results of these recent MR studies suggest that the epidemiological association between obesity and periodontitis may be confounded. [link.springer.com]
One mechanism that may explain these epidemiologic observations is the association of hyperhomocysteinemia with increased intake of meats and decreased intake of vitamin B6, vitamin B12, and folate. [humpath.com]
Pathophysiology
In this review, the authors highlight the main clinical features, electrographic abnormalities, histopathological aspects and treatment, as well as the current, but still incomplete understanding of the pathophysiological mechanisms involved. [ncbi.nlm.nih.gov]
Prevention
System biology will allow in depth understanding of complex diseases like CKD and will set the stage for predictive, preventive and personalized medicine, a long-standing dream of doctors and patients alike. © 2014 S. Karger AG, Basel. [ncbi.nlm.nih.gov]
B 33 – 38 Based on one meta-analysis of herpes simplex virus prevention with acyclovir; two meta-analyses of mucositis prevention with chlorhexidine; one RCT and one randomized crossover trial examining mucositis prevention with chlorhexidine and oral [aafp.org]
Dietary fiber, or roughage, resulting in increased fecal bulk, has a preventive effect against diverticulosis of the colon. [humpath.com]
“Although you clean your mouth every day at home, regular checkups to the dentist will prevent additional disease that can likely cause you to be sick.” [padental.org]