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Low-dose methotrexate in Rheumatology: A reinvented drug.
J R Coll Physicians Edinb
January 2025
Department of Rheumatology, Centre for Rheumatology, Calicut, Kerala, India.
Low-dose methotrexate (LD-MTX) is the anchor drug used in the treatment of various rheumatological illnesses. There are a lot of misconceptions associated with the long-term use of MTX in the minds of practitioners. The origin of most of these myths stems from the ill effects associated with high-dose MTX used in cancer chemotherapy.
View Article and Find Full Text PDFTherapeutic Dilemmas Arising From a Serpentine Thrombus Across a Patent Foramen Ovale in a Patient With Dilated Cardiomyopathy.
Cureus
December 2024
Cardiology/Internal Medicine, Luton and Dunstable University Hospital, Luton, GBR.
A thrombus straddling a patent foramen ovale (TSPFO) is a rare condition that presents significant health risks, including stroke or myocardial infarction, and can be life-threatening if not promptly addressed. We report the case of a 42-year-old female with morbid obesity who presented with sudden shortness of breath due to a bilateral pulmonary embolism. Imaging revealed a thrombus extending from the right atrium to the left atrium through the patent foramen ovale (PFO).
View Article and Find Full Text PDFAmyopathic Dermatomyositis with a Rapidly Progressing Interstitial Pneumonia.
Eur J Case Rep Intern Med
November 2024
Department of Lung Diseases and Thoracic Surgery, Pauls Stradins Clinical University Hospital, Riga, Latvia.
Background: Clinically amyopathic dermatomyositis (CADM) is a rare subtype of idiopathic inflammatory myositis often linked with the presence of autoantibodies targeting melanoma differentiation-associated protein 5 (MDA5). Patients with CADM are at increased risk of developing rapidly progressing interstitial lung disease, which significantly increases both morbidity and mortality compared to other forms of inflammatory myopathies. While there is no standardized treatment regimen, current therapeutic strategies are generally focused on combination immunosuppressive therapies.
View Article and Find Full Text PDFAnaemia of Inflammation Preceding Dyspnoea, Dry Cough and Weight Loss in Primary Pulmonary Lymphoma.
Eur J Case Rep Intern Med
December 2024
The Faculty of Medicine, Hebrew University and Hadassah Medical School, Jerusalem, Israel.
Introduction: There is little information in the literature on the early, sub-clinical stage and laboratory test results in patients with primary mucosa-associated lymphoid tissue (MALT) lymphoma of the lung, a rare disease.
Case Description: In a 75-year-old man, an open lung biopsy-confirmed diagnosis of primary pulmonary lymphoma was preceded by almost six months of anaemia of inflammatory disease and monocytosis without any pulmonary symptoms. When he developed a dry cough, increasing dyspnoea and marked weight loss, these changes deepened and became associated with reactive thrombocytosis; markedly increased ferritin and C-reactive protein (positive acute-phase reactants), as well as reduced albumin and transferrin (negative acute-phase reactants).
Evaluation of a Patient With a Severe Systemic Inflammatory Response to Nitrofurantoin.
HCA Healthc J Med
December 2024
Trident Medical Center, Charleston, SC.
Background: Nitrofurantoin is a prevalent antibiotic used to treat urinary tract infections. Despite nitrofurantoin's general safety, it can cause serious side effects, including acute pulmonary toxicity, fulminant hepatitis, and severe systemic inflammatory responses, which may mimic conditions such as ischemia and infection. However, reports of acute systemic inflammatory response syndrome after nitrofurantoin ingestion are uncommon in medical literature.
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