Although involvement of the reticuloendothelial system in systemic lupus erythematosus (SLE) is a well-recognised concomitant of the disease, spontaneous splenic rupture is an unusual occurrence. We observed a 54-year-old woman with SLE who had spontaneous splenic rupture during the late course of the disease and showed some changes histopathologically. The courses and the clinical characteristics of such patients are reviewed, and the diagnosis and treatment of these cases are discussed. Early evaluation for SLE patients with spontaneous splenic rupture should be considered and included in the differential diagnosis of acute abdomen, as it may affect follow-up and treatment, although the condition is rare.
Objective. Periodontitis is a highly prevalent oral infectious disease and has been increasingly associated with H. pylori infection, gastric inflammation, and gastric cancer but little is known about epigenetic machinery underlying this potentially bidirectional association. The present study is aimed at identifying key deregulated miRNA, their associated genes, signaling pathways, and compounds linking periodontitis with H. pylori-associated peptic ulcer disease. Methods. miRNA expression datasets for periodontitis-affected and H. pylori-associated peptic ulcer disease-affected tissues were sought from the GEO database. Differentially expressed miRNA (DEmiRNAs) were identified and the overlapping, shared-DEmiRNA between both datasets were determined. Shared-DEmiRNA-target networks construction and functional analyses were constructed using miRNet 2.0, including shared-DEmiRNA-gene, shared-DEmiRNA-transcription factor (TF), and shared-DEmiRNA-compound networks. Functional enrichment analysis for shared DEmiRNA-gene and shared DEmiRNA-TF networks was performed using the KEGG, Reactome, and Geno Ontology (GO) pathways. Results. 11 shared-DEmiRNAs were identified, among which 9 showed similar expression patterns in both diseases, and 7 were overexpressed. miRNA hsa-hsa-mir-155-5p and hsa-mir-29a-3p were top miRNA nodes in both gene and TF networks. The topmost candidate miRNA-deregulated genes were PTEN, CCND1, MDM2, TNRC6A, and SCD while topmost deregulated TFs included STAT3, HIF1A, EZH2, CEBPA, and RUNX1. Curcumin, 5-fluorouracil, and the gallotanin 1,2,6-Tri-O-galloyl-beta-D-glucopyranose emerged as the most relevant linkage compound targets. Functional analyses revealed multiple cancer-associated pathways, PI3K pathways, kinase binding, and transcription factor binding among as enriched by the network-associated genes and TFs. Conclusion. Integrative analysis of deregulated miRNAs revealed candidate molecular mechanisms comprising of top miRNA, their gene, and TF targets linking H. pylori-infected peptic ulcer disease with periodontitis and highlighted compounds targeting both diseases. These findings provide basis for directing future experimental research.
Epidermal growth factor receptor (EGFR) inhibitors, as a first-line drug treatment in the EGFRsensitive mutation of advanced non-small-cell lung cancer (NSCLC), has been used in a wide variety of malignancies. These therapies have various troublesome side effects including diarrhea, stomatitis, mucositis, rash, dry skin and paronychia which may impact a patient's clinical outcome in addition to their beneficial effects. Here, we report a rare case of a 69-year-old male having advanced NCSLC treated with gefitinib, who developed EGFR tyrosine kinase inhibitor (TKI)-related multiple ulcers accompanied by bleeding.After a detailed examination and multidisciplinary discussion, we have learnt that early identification of gastrointestinal (GI) bleeding and blood in urine is due to targeted drugs rather than other causes such as ulcer and stones. Good results have also been achieved by reducing drug dosage under close observation.So far, the patient has been followed up for 15 months, and his condition remained stable. Up to now, there is no case of such severe side effect having been found, and no guidelines recommended for handling such adverse events. Through clinical case sharing, early recognition and proactive management are particularly important in order to minimize appropriately the effect of these adverse events. The whole course of a disease can be vividly illustrated through a case report, so as to provide more effective guiding principles for clinicians.
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