Abstract:
UNLABELLED:To describe a case of complete remission of thrombotic microangiopathy after treatment with eculizumab in a patient with non-Shiga toxin-associated bacterial enteritis. CASE REPORT:Medical/surgical intensive care unit (ICU) of a university teaching hospital.A 62-year-old man presented to a local hospital with mucous and bloody stool persisting for 1 month and worsening abdominal pain for 2 weeks. He had thrombocytopenia and renal dysfunction and was admitted with a diagnosis of sepsis due to intraabdominal infection. However, he did not respond to antimicrobial therapy, and after 7 days he was transferred to the Chiba University Hospital ICU.Antimicrobial therapy was continued, and continuous hemodiafiltration was initiated on ICU day 3, but the patient's condition deteriorated and he became anuric. Plasma exchange (PE) was initiated on ICU day 11, but anuria and thrombocytopenia persisted. Intravenous eculizumab therapy was initiated on day 26 and resulted in quick recovery of urine output and platelet count and successful discontinuation of renal support.The diagnosis of thrombotic microangiopathy was established by the presence of schistocytes on the peripheral blood smear on ICU day 9. A plasma sample collected prior to initiation of PE showed a disintegrin-like and metalloproteinase with thrombospondin type 1 motifs member 13 (ADAMTS13) activity level of >10% (25.1%). The absence of both Shiga-toxin producing E coli in feces and anti-Shiga-toxin antibody in blood led to suspicion of atypical hemolytic uremic syndrome (aHUS). Genetic test identified a nonsynonymous mutation (p.Ala311Val) in the membrane cofactor protein gene (MCP).Although the pathological significance is currently unknown, this mutation may have been the cause of adult-onset aHUS in our patient. In this case, eculizumab was successfully introduced and discontinued, and the patient remained relapse-free after 1 year of follow-up. The duration of eculizumab therapy for patients with aHUS should be determined on a case-by-case basis and possibly according to the causative genetic mutation, even though discontinuation of eculizumab therapy once initiated is not generally recommended.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Omura T,Watanabe E,Otsuka Y,Yoshida Y,Kato H,Nangaku M,Miyata T,Oda Sdoi
10.1097/MD.0000000000004104subject
Has Abstractpub_date
2016-07-01 00:00:00pages
e4104issue
27eissn
0025-7974issn
1536-5964pii
00005792-201607050-00054journal_volume
95pub_type
杂志文章相关文献
MEDICINE文献大全abstract::The porphyrias are a group of rare metabolic disorders. The incidence and prevalence are low because the acute intermittent porphyria (AIP) is rare. Our aim was to assess the use of anthropometric and quality-of-life parameters in porphyric patients in order to identify predictor factors that might help in characteriz...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000001023
更新日期:2015-07-01 00:00:00
abstract::Although obesity is an established risk factor of primary stroke, the association between obesity and post-stroke mortality remains unclear. The aim of this study was to investigate the association between dynamic obesity status and mortality in survivors of their first stroke in China.Of 775 patients with first-ever ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000022243
更新日期:2020-09-18 00:00:00
abstract:RATIONALE:We report on a patient with a positron emission tomography/computed tomography scans (PET/CT)-negative malignant spine tumor, which had even caused a pathologic fracture, and was eventually confirmed on surgical biopsy. PATIENT CONCERNS:A 67-year-old man visited our emergency department with sudden onset of ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000013374
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The aim of the study was to retrospectively investigate the changes in pulmonary function and its influencing factors in patients with adolescent idiopathic scoliosis (AIS) undergoing preoperative brace treatment or not. METHODS:Total 237 AIS patients (43 boys, 194 girls) who underwent operations and had a ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000005088
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:In addition to the physical burden, the quality of life and survival in patients with cancer may also be reduced because of psychological distress, such as spiritual crisis, anxiety, and depression. Many studies have verified that spirituality could reduce anxiety and depression and improve quality of life a...
journal_title:Medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MD.0000000000011948
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:The prophylactic efficacy of statin pretreatment for the prevention of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) remains controversial. The aim of the study was to perform a meta-analysis of randomized controlled trials (R...
journal_title:Medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MD.0000000000007384
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The digestive tract malignancies are a series of malignant tumor with high morbidity and mortality. Traditional Chinese medicine (TCM) combined with chemotherapy drugs interventions have been applied for the treatment of malignant tumors in Asian countries for dacades. This study aimed to assess the effectiv...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000019480
更新日期:2020-04-01 00:00:00
abstract:RATIONALE:Pleomorphic rhabdomyosarcoma (PRMS) is a rare soft tissue malignancy which is frequently misdiagnosed and associated with metastasis to the lungs, lymph nodes, and bone marrow. Case studies are needed to improve the awareness of the disease and our understanding of it. PATIENT CONCERNS:In this study, we pres...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000013648
更新日期:2018-12-01 00:00:00
abstract::In 23 adult women having uncomplicated recurrent urinary tract infections treated with 10 days of appropriate antibiotic for each infection, the following findings were noted. 1. The attack rate was 0.17 infections per month. 2. 94% of infections has associated symptoms. 3. 73% of symptomatic episodes had an associate...
journal_title:Medicine
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract:RATIONALE:Metastatic involvement of the gastrointestinal tract is an uncommon scenario encountered in the clinical practice. Our case represents a gastric outlet obstruction (GOO) as a consequence of distant Transitional cell carcinoma (TCC) metastasis without any lymph node involvement in association with inflammatory...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000007059
更新日期:2017-06-01 00:00:00
abstract::Venous thromboembolism (VTE) is a common vascular disorder with high mortality and morbidity. Clinical nurses are a pivotal group that can serve as first-line health care providers. Lack of knowledge about VTE is an important barrier to effective nursing performance. This study aimed to determine nurses' knowledge of ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000010338
更新日期:2018-04-01 00:00:00
abstract::This study is to investigate the computed tomography (CT) image quality of the low- tube-voltage protocol with low contrast agent dose.CT portography was performed in 118 cirrhosis patients with body mass index (BMI) less than 25 kg/m under 2 protocols: Protocol A, tube voltage of 90 kVp/395 mAs and contrast agent dos...
journal_title:Medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/MD.0000000000013141
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:To assess the efficacy and safety of tranexamic acid (TA) in reducing blood loss and lowering transfusion needs for patients undergoing caesarean section (CS) or vaginal delivery (VD). METHODS:An electronic literature search of PubMed, EMBASE, OVID, Cochrane library, Scopus, Central, and Clinical trials.gov...
journal_title:Medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MD.0000000000005653
更新日期:2017-01-01 00:00:00
abstract::Osteopetrosis, also known as marble bone disease, is a clinically rare genetic disease, which represents a heterogeneous group of rare, inherited bone dysplasias that share the hallmark of abnormally increased bone density caused by osteoclast dysfunction. Hereby, the authors describe a case of osteopetrosis that show...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000000929
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:There is presently no clear evidence on the effect of combined treatment for non-cystic fibrosis (non-CF) bronchiectasis with inhaled corticosteroid (ICS) and long-acting β2-adrenergic agonist (LABA). The objective of this study is to assess the efficacy and safety of salmeterol-fluticasone com...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000005116
更新日期:2016-10-01 00:00:00
abstract:RATIONALE:Apatinib is an oral tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor-2. It has been shown that apatinib is effective and safe for treatment of multiple solid tumors, including gastric cancer, liver cancer, non-small-cell lung cancer, and breast cancer. However, there is currentl...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000018382
更新日期:2019-12-01 00:00:00
abstract::The aim of this study was to compare the effectiveness and safety of 2 surgical techniques that are used to treat proximal femoral fractures.A systematic literature search (up to December 2014) was conducted in Medline, Embase, PubMed, and The Cochrane Central Register of Controlled Trials to screen for studies compar...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000003168
更新日期:2016-04-01 00:00:00
abstract:RATIONALE:Some patients with pulmonary arteriovenous malformation (PAVM) present with hypoxemia and life-threatening complications, including stroke and cerebral abscess. Catheter embolization is currently the preferred treatment for PAVM. However, previous studies have revealed that the incidence of PAVM recanalizatio...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000018694
更新日期:2020-01-01 00:00:00
abstract::School sandplay group therapy is a useful clinical treatment method for adolescents who cannot adapt to school due to various emotional and behavioral problems. In this study, we conducted 10 weeks of group therapy in 70 adolescents referred to as maladjustment behavior problem in the school. The purpose of this study...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000023272
更新日期:2020-12-11 00:00:00
abstract::Although published studies have reported the association between MTHFR C677T (rs 1801133), A1298C (rs 1801131), and MTRR A66G (rs1801394) polymorphisms and male infertility in Asian populations, the results are conflicting. In order to accurately evaluate the relevance, a meta-analysis was performed.We searched for po...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000014283
更新日期:2019-02-01 00:00:00
abstract::Cell and animal experiments have found that in addition to being a retinol transporter, Stimulated by Retinoic Acid 6 (STRA6) also functions as a surface signaling receptor by which retinol regulates insulin responses. Several studies revealed that the STRA6 gene may contribute to the pathogenesis of type 2 diabetes m...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000014885
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:This study will examine the effects of oxymatrine on the proliferation of human liver cancer Bel-7404 cells (HLCBC). METHODS:This study will search electronic bibliographic databases available in PUBMED, EMBASE, Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature, China Biolog...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000020181
更新日期:2020-06-05 00:00:00
abstract::Informed consent has now become common in medical practice. However, a gap still exists between doctors and patients in the understanding of clinical conditions. We designed medical comics about "subarachnoid hemorrhage" and "intracerebral hemorrhage" to help doctors obtain informed consent intuitively, quickly, and c...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000001077
更新日期:2015-07-01 00:00:00
abstract:RATIONALE:Abdominal wall defects are common after tumor resection. PATIENT CONCERNS:We report an 83-year-old male patient with recurrent tumors in his abdomen, and who had an incision wound that could not be directly closed. Mesh was not suitable because the wound was infected. DIAGNOSES:Abdominal wall defect result ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000009993
更新日期:2018-03-01 00:00:00
abstract::This study aimed to investigate the correlation of microRNA (miR)-206, vascular endothelial growth factor (VEGF) and miR-206/VEGF axis at different gestational ages with fetal growth retardation (FGR) risk in pregnancies.Eight hundred twenty pregnancies were consecutively recruited and their plasma samples were collec...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000018897
更新日期:2020-02-01 00:00:00
abstract::Immune cells contribute to determining the prognosis of gastric cancer. However, their exact role is less clear. We determined the prognostic significance of different immune cells in intratumoral tissue (T), stromal tissue (S), and adjacent normal tissue (N) of 166 gastric cancer cases and their interactions, includi...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000001631
更新日期:2015-09-01 00:00:00
abstract::The purpose of this study was to develop and validate a finite element (FE) model to predict vertebral bone strength in vitro using multidetector computed tomography (MDCT) images in multiple myeloma (MM) patients, to serve as a complementing tool to assess fracture risk. In addition, it also aims to differentiate MM ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000005825
更新日期:2017-01-01 00:00:00
abstract::Categorical syndromes such as schizophrenia may represent complexes of many continuous psychological structural phenotypes along several dimensions of personality development/degeneration. The present study investigated the heritability and familiality of Neuroticism-Extraversion-Openness to experience (NEO) personali...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000009858
更新日期:2018-02-01 00:00:00
abstract::By retrieving records from Taiwan's National Health Insurance (NHI) system's database, the current study aimed to investigate the impacts of hysterosalpingography (HSG) to patients after ectopic pregnancy (EP) operations in Taiwan.In this retrospective cohort study, insurance claims data from 1997 to 2013, derived fro...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000007263
更新日期:2017-06-01 00:00:00
abstract:RATIONALE:The diagnosis of anaplastic lymphoma kinase (ALK)-negative inflammatory myofibroblastic tumors (IMT) remains challenging because of their morphological resemblance with spindle cell sarcoma with myofibroblastic characteristics. PATIENT CONCERNS:A 69-year-old female patient presented with loco-regional recurr...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000019577
更新日期:2020-03-01 00:00:00