Autoimmune diseases are rarely the cause of stroke even in the young age group in association with cervical artery dissection and collagen vascular diseases. Takayasu arteritis is a chronic, idiopathic, inflammatory disease that primarily affects large vessels, such as the aorta and its main branches. Takayasu arteritis rarely coexists with systemic lupus erythematosus, and only few cases have been reported in association with the presence of antiphospholipid antibodies. We describe a young patient with right internal carotid artery dissection and subsequent stroke who presented with all three syndromes. Although this patient met the diagnostic criteria for each syndrome, systemic lupus erythematosus, Takayasu arteritis and the antiphospholipid antibody syndrome, it remains unlikely that the three disorders are not related. We suggest a single disimmune disorder may have led to carotid artery dissection.
The first case report of leukopenia with neutropenia due to the new glycopeptide antibiotic teicoplanin is described. The side effect occurred in a 73-year-old man hospitalized because of subacute bacterial endocarditis caused by Streptococcus faecalis. Leukopenia with neutropenia (white blood cells 2000/mm3, neutrophils 46%) developed after 20 days of teicoplanin therapy. After stopping teicoplanin white blood cell and neutrophil counts reverted to normal, but dropped again on rechallenge. A review of 1500 records of patients treated with teicoplanin alone or in combination with other drugs was also performed. Five cases were found in which leukopenia was possibly (four cases) or probably (one case) related to teicoplanin therapy. From these preliminary data the incidence of leukopenia related to teicoplanin seems to be low.
Oesophageal motor function was clinically and manometrically investigated by means of a low-compliance system in 24 nonselected rheumatoid arthritis (RA) patients and 15 healthy controls. Dysphagia was referred by 37.5% of RA patients. Oesophageal motor abnormalities were discovered to be significantly present in a high percentage (62.5%) of patients with RA. However, there was no correlation between oesophageal motor abnormalities and any disease characteristic. It is concluded that a high percentage of RA patients have an oesophageal motor dysfunction, even in the absence of dysphagic symptoms.
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