Acute Encephalopathy, Streptococcal Infection, and Cryoglobulinemia

Hodson, A.; Doughty, Robert A.; Norman, Michael E.

doi:10.1001/archneur.1978.00500250047011

Cited by 22 publications

(11 citation statements)

References 9 publications

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“…Type III cryoglobulinemia can develop secondary to malignancies, infections (especially Hepatitis B and C), and connective tissue diseases such as APS (Hanly and Smith 2000;Beddhu et al 2002). Mixed cryoglobulinemia has been associated with Streptococcal infections (Hodson et al 1978), with RF demonstrating Streptococcal antigen cross-reactivity (Schroder and Christensen 1988). In our patient, elevated ASO and anti-DNase B titers may represent an antecedent group A Streptococcus infection or a hypergammaglobulinemic state.…”

Section: Discussionmentioning

confidence: 68%

Type III Mixed Cryoglobulinemia and Antiphospholipid Syndrome in a Patient With Partial DiGeorge Syndrome

Chang

Tachdjian

Gallagher

et al. 2006

Journal of Immunology Research

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We studied a 14 year-old boy with partial DiGeorge syndrome (DGS), status post complete repair of Tetralogy of Fallot, who developed antiphospholipid syndrome (APS) and type III mixed cryoglobulinemia. He presented with recurrent fever and dyspnea upon exertion secondary to right pulmonary embolus on chest computed tomography (CT). Coagulation studies revealed homozygous methylene tetrahydrofolate reductase 677TT mutations, elevated cardiolipin IgM antibodies, and elevated β2-glycoprotein I IgM antibodies. Infectious work-up revealed only positive anti-streptolysin O (ASO) and anti-DNAse B titers. Autoimmune studies showed strongly positive anti-platelet IgM, elevated rheumatoid factor (RF), and positive cryocrit. Renal biopsy for evaluation of proteinuria and hematuria showed diffuse proliferative glomerulonephritis (DPGN) with membranoproliferative features consistent with cryoglobulinemia. Immunofixation showed polyclonal bands. Our patient was treated successfully with antibiotics, prednisone, and mycophenolate mofetil (MMF). This is the first report of a patient with partial DGS presenting with APS and type III mixed cryoglobulinemia possibly due to Streptococcal infection.

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Section: Discussionmentioning

confidence: 68%

Type III Mixed Cryoglobulinemia and Antiphospholipid Syndrome in a Patient With Partial DiGeorge Syndrome

Chang

Tachdjian

Gallagher

et al. 2006

Journal of Immunology Research

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“…Although hypertensive encephalopathy can arise in patients with conditions in which there is acute systemic hypertension alone, it most commonly occurs in patients with conditions in which there is also preexisting endothelial dysfunction or damage, such as systemic lupus erythematosus (3,9), cryoglobulinemia (20), or hemolytic uremic syndrome (9,21), and in patients undergoing cyclosporine (22) and cisplatin (23) therapy. Investigators in studies in which single photon emission computed tomography (SPECT) (3) and diffusion-weighted MR imaging (8,9) have demonstrated that the brain edema in patients with hypertensive encephalopathy does not represent cytotoxic edema.…”

Section: Discussionmentioning

confidence: 99%

Preeclampsia-Eclampsia: Clinical and Neuroradiographic Correlates and Insights into the Pathogenesis of Hypertensive Encephalopathy

et al. 2000

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“…Although hypertensive encephalopathy is described in malignant hypertension alone, the similar clinical and radiological manifestations can be seen more common in patients with comorbid conditions, such as systemic lupus [6], cryoglobulinemia [7], or hemolytic-uremic syndrome [8], and in patients treated with cyclosporine [9] or cisplatin [10]. …”

Section: Discussionmentioning

confidence: 99%

Isolated Brainstem Involvement in a Patient with Hypertensive Encephalopathy

Osman

Imam

Salem

et al. 2013

Case Reports in Neurological Medicine

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Hypertensive encephalopathy typically presents with headache, confusion, and bilateral parietooccipital vasogenic edema. Brainstem edema in hypertensive encephalopathy usually occurs in association with typical supratentorial parieto-occipital changes and is usually asymptomatic. We report here a patient with hypertensive encephalopathy, with isolated brain stem involvement on magnetic resonance imaging (MRI). Rapid treatment of hypertension resulted in clinical and radiological improvement. Prompt recognition of the condition and aggressive treatment of hypertension in such patients is crucial to relieve edema and prevent life-threatening progression.

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Acute Encephalopathy, Streptococcal Infection, and Cryoglobulinemia

Cited by 22 publications

References 9 publications

Type III Mixed Cryoglobulinemia and Antiphospholipid Syndrome in a Patient With Partial DiGeorge Syndrome

Type III Mixed Cryoglobulinemia and Antiphospholipid Syndrome in a Patient With Partial DiGeorge Syndrome

Preeclampsia-Eclampsia: Clinical and Neuroradiographic Correlates and Insights into the Pathogenesis of Hypertensive Encephalopathy

Isolated Brainstem Involvement in a Patient with Hypertensive Encephalopathy

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