Pearls &amp; Oy-sters: Neuro-Sweet disease presenting as ischemic stroke and aseptic meningitis

Das, Alvin S; Conway, Steve; Unizony, Sebastian; Bouffard, Marcel; Rost, Natalia S.; Venna, Nagagopal

doi:10.1212/wnl.0000000000006628

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…Lymphoid interstitial lung disease has been reported in association with TINU [11], where the pulmonary lesion proved steroid responsive but flared after initially remitting. Other disorders, including hypoparathyroidism [12], immunoglobulin A nephropathy [5], immunoglobulin G4-related disease [13], cytoplasmic anti-neutrophil cytoplasmic antibodies positive [14], nephrogenic fibrosing dermopathy [15], Crohn’s disease [16], and neuro-Sweet disease [17], have been reported to be associated with TINU.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Relevant to Tubulointerstitial Nephritis with Late-Onset Uveitis Superimposed by Thrombotic Microangiopathy: A Case Report and Review of the Literature

Zhao

Yang

et al. 2020

Kidney Dis

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Background: The syndrome of tubulointerstitial nephritis and uveitis (TINU) is an uncommon and multisystemic autoimmune disorder. This review reports a rare case of TINU being superimposed on thrombotic microangiopathy (TMA) and, by comparing with the available literature, also summarizes the clinical features, associated conditions, treatment, and outcome of patients with TINU. Summary: Herein, we report the case of a 37-year-old male patient with acute kidney injury (AKI) clinicopathologically identified as malignant hypertension-induced TMA superimposed by acute tubulointerstitial nephritis, which was suspected to be related to drug hypersensitivity. After treatment with oral prednisone combined with a renin-angiotensin system inhibitor, the patient achieved partial renal recovery and was withdrawn from hemodialysis. Recurrent AKI concomitant with new-onset asymptomatic uveitis was detected during routine clinical follow-up after cessation of prednisone. TINU was then diagnosed, and prednisone followed by cyclophosphamide was prescribed. The patient achieved better renal recovery than in the first round of treatment and maintained stable renal function afterward. By reviewing the literature, 36 cases were reported as TINU superimposed on other conditions, including thyroiditis, osteoarthropathy, and sarcoid-like noncaseating granulomas. Key messages: TINU could be complicated by many other conditions, among which TMA is very rare. When presented as AKI, kidney biopsy is important for differential diagnosis. The case also shows that recurrent AKI with concomitant uveitis after prednisone withdrawal strongly suggested the need for long-term follow-up and elongated prednisone therapy for TINU syndrome.

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Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Relevant to Tubulointerstitial Nephritis with Late-Onset Uveitis Superimposed by Thrombotic Microangiopathy: A Case Report and Review of the Literature

Zhao

Yang

et al. 2020

Kidney Dis

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Protean Neurologic Manifestations of Two Rare Dermatologic Disorders: Sweet Disease and Localized Craniofacial Scleroderma

Wallach

Magro

Franks

et al. 2019

Curr Neurol Neurosci Rep

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Evaluation of the Therapeutic Response by 11C-Methionine PET in a Case of Neuro-Sweet Disease

Mitamura¹,

Yamamoto²,

Norikane³

et al. 2020

Clin Nucl Med

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Sweet disease is a multisystem inflammatory disorder characterized by fever, cutaneous erythematous plaques, and aseptic neutrophilic infiltration of various organs. Neuro-Sweet disease is a known rare central nervous system complication of Sweet disease. A 67-year-old Japanese woman who was diagnosed with neuro-Sweet disease underwent 11C-methionine (11C-MET) PET. 11C-MET PET revealed increased accumulation in the affected brain tissues. After steroid therapy, she became asymptomatic, and a follow-up 11C-MET PET scan showed disappearance of the abnormal uptake of 11C-MET.

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Pearls & Oy-sters: Neuro-Sweet disease presenting as ischemic stroke and aseptic meningitis

Cited by 3 publications

References 7 publications

Acute Kidney Injury Relevant to Tubulointerstitial Nephritis with Late-Onset Uveitis Superimposed by Thrombotic Microangiopathy: A Case Report and Review of the Literature

Acute Kidney Injury Relevant to Tubulointerstitial Nephritis with Late-Onset Uveitis Superimposed by Thrombotic Microangiopathy: A Case Report and Review of the Literature

Protean Neurologic Manifestations of Two Rare Dermatologic Disorders: Sweet Disease and Localized Craniofacial Scleroderma

Evaluation of the Therapeutic Response by 11C-Methionine PET in a Case of Neuro-Sweet Disease

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