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Postgraduate Medical Journal Feb 2002Subacute sclerosing panencephalitis (SSPE) is a progressive neurological disorder of childhood and early adolescence. It is caused by persistent defective measles virus.... (Review)
Review
Subacute sclerosing panencephalitis (SSPE) is a progressive neurological disorder of childhood and early adolescence. It is caused by persistent defective measles virus. Brain biopsies or postmortem histopathological examination show evidence of astrogliosis, neuronal loss, degeneration of dendrites, demyelination, neurofibrillary tangles, and infiltration of inflammatory cells. Patients usually have behavioral changes, myoclonus, dementia, visual disturbances, and pyramidal and extrapyramidal signs. The disease has a gradual progressive course leading to death within 1-3 years. The diagnosis is based upon characteristic clinical manifestations, the presence of characteristic periodic EEG discharges, and demonstration of raised antibody titre against measles in the plasma and cerebrospinal fluid. Treatment for SSPE is still undetermined. A combination of oral isoprinosine (Inosiplex) and intraventricular interferon alfa appears to be the best effective treatment. Patients responding to treatment need to receive it life long. Effective immunisation against measles is the only solution presently available to the problem of this dreaded disease.
Topics: Antiviral Agents; Brain; Diagnosis, Differential; Electroencephalography; Female; Humans; Magnetic Resonance Imaging; Male; Measles; Pregnancy; Pregnancy Complications; Prognosis; SSPE Virus; Subacute Sclerosing Panencephalitis; Virus Latency
PubMed: 11807185
DOI: 10.1136/pmj.78.916.63 -
European Review For Medical and... May 2021Increased calprotectin (S100A8/A9) levels have been demonstrated in many acute and chronic inflammatory processes. Subacute thyroiditis is an inflammatory disease of the...
OBJECTIVE
Increased calprotectin (S100A8/A9) levels have been demonstrated in many acute and chronic inflammatory processes. Subacute thyroiditis is an inflammatory disease of the thyroid gland. In our study, we investigated the value of this inflammation marker in the diagnosis and follow-up of subacute thyroiditis.
PATIENTS AND METHODS
Patients with subacute thyroiditis admitted to our clinic between November 2018 and January 2020 were included in the study. In the acute phase of the disease, fT4 (free thyroxin), TSH (Thyroid Stimulant Hormone), CRP (C Reactive Protein), ESR (Erythrocyte Sedimentation Rate), ALT (Alanine Aminotransferase), AST (Aspartate Aminotransferase), Creatinine, WBC (White Blood Cell), Absolute Lymphocyte and Neutrophil Count (ALC, ANC) parameters were detected and recorded. After complete resolution of the disease, the same laboratory parameters and acute phase reactants were again detected. Additionally, Calprotectin determination was performed in the acute phase and recovery period. Persistent hypothyroidism was determined by 6th-month TSH levels.
RESULTS
Thirty-six patients were included in the study. Along with the classical acute phase reactants and ANC, there was a significant increase in the Calprotectin levels in the acute inflammatory phase of the disease compared to the recovery period (96. 92-37.98, p<0.001). Neither classical acute phase reactants and nor calprotectin were found to have a significant effect on the development of permanent hypothyroidism. Calprotectin did not correlate with other acute phase reactants, absolute neutrophil count and TSH levels in both the acute phase and resolution period.
CONCLUSIONS
Calprotectin appears to be an important marker in the diagnosis and follow-up of subacute thyroiditis.
Topics: Adult; Blood Sedimentation; C-Reactive Protein; Female; Humans; Leukocyte Count; Leukocyte L1 Antigen Complex; Male; Middle Aged; Neutrophils; Severity of Illness Index; Thyroiditis, Subacute; Thyroxine
PubMed: 34109583
DOI: 10.26355/eurrev_202105_25942 -
Human Vaccines & Immunotherapeutics Dec 2021Subacute thyroiditis is the most common cause of painful thyroiditis, which usually occurs after an acute viral upper respiratory tract infection. Rare cases of subacute...
Subacute thyroiditis is the most common cause of painful thyroiditis, which usually occurs after an acute viral upper respiratory tract infection. Rare cases of subacute thyroiditis have been reported after administration of viral vaccines. Here, we report four cases of subacute thyroiditis after administration of the COVID-19 mRNA vaccine (Pfizer/BioNTech®). We describe the clinical, laboratory and imaging features of five cases of subacute thyroiditis after COVID-19 mRNA vaccine (Pfizer/BioNTech®). COVID-19 mRNA vaccine (Pfizer/BioNTech®)-associated subacute thyroiditis may present with clinical findings typical of classic subacute thyroiditis such as fever, neck pain, weakness, and tremor within a few days following vaccination. Subacute thyroiditis may be focal or may progress with diffuse bilateral involvement. Depending on the extent of subacute thyroiditis involvement, significant increases in acute-phase reactants can be observed. COVID-19 mRNA vaccine (Pfizer/BioNTech®) associated subacute thyroiditis responds quite well to non-steroidal anti-inflammatory therapy. Clinicians should be aware of the risk of developing subacute thyroiditis after vaccination.
Topics: COVID-19; COVID-19 Vaccines; Humans; SARS-CoV-2; Thyroiditis, Subacute; Vaccines, Synthetic; mRNA Vaccines
PubMed: 34893014
DOI: 10.1080/21645515.2021.2013083 -
Tidsskrift For Den Norske Laegeforening... Oct 2021Subacute thyroiditis is a clinical condition usually seen 1-2 weeks after a viral infection in the upper respiratory tract, and has also been reported following...
BACKGROUND
Subacute thyroiditis is a clinical condition usually seen 1-2 weeks after a viral infection in the upper respiratory tract, and has also been reported following infection with COVID-19. Cases of subacute thyroiditis following a seasonal influenza vaccination have been described, and recent case reports have reported clinical symptoms and signs typical of subacute thyroiditis following vaccination with mRNA SARS-CoV-2 vaccine.
CASE PRESENTATION
A young, healthy female underwent surgery with left-side lobectomy for papillary thyroid carcinoma. Hashimoto's thyroiditis was revealed as an additional histological finding. Six days prior to complementary thyroidectomy of the right lobe the patient received mRNA SARS-CoV-2 vaccine. The histological slides showed features consistent with extensive subacute thyroiditis throughout the entire lobe.
INTERPRETATION
As no other aetiology could account for the subacute thyroiditis, the vaccination against COVID-19 is seen as a plausible source.
Topics: COVID-19; COVID-19 Vaccines; Female; Humans; SARS-CoV-2; Thyroid Neoplasms; Thyroiditis, Subacute; Vaccination
PubMed: 34641650
DOI: 10.4045/tidsskr.21.0554 -
Developmental Medicine and Child... Oct 2010Subacute sclerosing panencephalitis (SSPE) is a chronic encephalitis occurring after infection with measles virus. The prevalence of the disease varies depending on... (Review)
Review
Subacute sclerosing panencephalitis (SSPE) is a chronic encephalitis occurring after infection with measles virus. The prevalence of the disease varies depending on uptake of measles vaccination, with the virus disproportionally affecting regions with low vaccination rates. The physiopathology of the disease is not fully understood; however, there is evidence that it involves factors that favour humoral over cellular immune response against the virus. As a result, the virus is able to infect the neurons and to survive in a latent form for years. The clinical manifestations occur, on average, 6 years after measles virus infection. The onset of SSPE is insidious, and psychiatric manifestations are prominent. Subsequently, myoclonic seizures usually lead to a final stage of akinetic mutism. The diagnosis is clinical, supported by periodic complexes on electroencephalography, brain imaging suggestive of demyelination, and immunological evidence of measles infection. Management of the disease includes seizure control and avoidance of secondary complications associated with the progressive disability. Trials of treatment with interferon, ribavirin, and isoprinosine using different methodologies have reported beneficial results. However, the disease shows relentless progression; only 5% of individuals with SSPE undergo spontaneous remission, with the remaining 95% dying within 5 years of diagnosis.
Topics: Antibodies, Viral; Antiviral Agents; Apoptosis; Brain; Demyelinating Diseases; Disease Progression; Drug Therapy, Combination; Electroencephalography; Epilepsies, Myoclonic; Female; Gliosis; Humans; Inosine Pranobex; Interferon-alpha; Magnetic Resonance Imaging; Male; Measles; Measles Vaccine; Measles virus; Ribavirin; Severity of Illness Index; Sex Factors; Subacute Sclerosing Panencephalitis; Time Factors; Virion
PubMed: 20561004
DOI: 10.1111/j.1469-8749.2010.03717.x -
Neurologic Clinics Aug 2007Rapidly progressive dementias (RPDs) are neurologic conditions that develop subacutely over weeks to months or, rarely, acutely over days. In contrast to most dementing... (Review)
Review
Rapidly progressive dementias (RPDs) are neurologic conditions that develop subacutely over weeks to months or, rarely, acutely over days. In contrast to most dementing conditions that take years to progress to death, RPD quickly can be fatal. It is critical to evaluate patients who have RPD without delay, usually in a hospital setting, as they may have a treatable condition. This review discusses a differential diagnostic approach to RPD, emphasizing neurodegenerative, toxic and metabolic, infectious, autoimmune, neoplastic, and other conditions to consider.
Topics: Algorithms; Brain Diseases; Creutzfeldt-Jakob Syndrome; Diagnosis, Differential; Humans; Practice Guidelines as Topic
PubMed: 17659190
DOI: 10.1016/j.ncl.2007.04.001 -
The International Journal of... Feb 2022To assess (1) global longitudinal strain (GLS) by feature tracking cardiac magnetic resonance (CMR) in the sub-acute and chronic phases after ST-elevation infarction... (Clinical Trial)
Clinical Trial
To assess (1) global longitudinal strain (GLS) by feature tracking cardiac magnetic resonance (CMR) in the sub-acute and chronic phases after ST-elevation infarction (STEMI) and compare to GLS in healthy controls, and (2) the evolution of GLS and regional longitudinal strain (RLS) over time, and their relationship to infarct location and size. Seventy-seven patients from the CHILL-MI-trial (NCT01379261) who underwent CMR 2-6 days and 6 months after STEMI and 27 healthy controls were included for comparison. Steady state free precession (SSFP) long-axis cine images were obtained for GLS and RLS, and late gadolinium enhancement (LGE) images were obtained for infarct size quantifications. GLS was impaired in the sub-acute (- 11.8 ± 3.0%) and chronic phases (- 14.3 ± 2.9%) compared to normal GLS in controls (- 18.4 ± 2.4%; p < 0.001 for both). GLS improved from sub-acute to chronic phase (p < 0.001). GLS was to some extent determined by infarct size (sub-acute: r = 0.2; chronic: r = 0.2, p < 0.001). RLS was impaired in all 6 wall-regions in LAD infarctions in both the sub-acute and chronic phase, while LCx and RCA infarctions had preserved RLS in remote myocardium at both time points. Global longitudinal strain is impaired sub-acutely after STEMI and improvement is seen in the chronic phase, although not reaching normal levels. Global longitudinal strain is only moderately determined by infarct size. Regional longitudinal strain is most impaired in the infarcted region, and LAD infarctions have effects on the whole heart. This could explain why LAD infarcts are more serious than the other culprit vessel infarctions and more often cause heart failure.
Topics: Contrast Media; Gadolinium; Humans; Magnetic Resonance Imaging, Cine; Myocardium; Predictive Value of Tests; ST Elevation Myocardial Infarction; Ventricular Function, Left
PubMed: 34482507
DOI: 10.1007/s10554-021-02391-0 -
Enfermedades Infecciosas Y... 2022
Topics: COVID-19; COVID-19 Vaccines; Humans; Thyroiditis, Subacute; Vaccination
PubMed: 35680353
DOI: 10.1016/j.eimce.2021.12.009 -
Acta Medica Portuguesa 2000Subacute sclerosing panencephalitis is a slowly progressive neurodegenerative disorder occurring in childhood and adolescence and is characterised by dementia, ataxia,... (Review)
Review
Subacute sclerosing panencephalitis is a slowly progressive neurodegenerative disorder occurring in childhood and adolescence and is characterised by dementia, ataxia, myoclonias and other neurological focal signs, with an invariably fatal outcome. The author reviews the subject, focussing on epidemiology, clinical features, measles virus behaviour, host immune reactions, measles prophylaxis and treatment proposals.
Topics: Antiviral Agents; Child; Female; Humans; Inosine Pranobex; Interferons; Male; Measles; Measles virus; Prevalence; Subacute Sclerosing Panencephalitis
PubMed: 11155486
DOI: No ID Found -
Discovery Medicine Sep 2018Tumor necrosis factor alpha (TNF-α) regulates the expression of proinflammatory cytokines and apoptosis in thyroids. miR-155-5p is upregulated in circulating...
Tumor necrosis factor alpha (TNF-α) regulates the expression of proinflammatory cytokines and apoptosis in thyroids. miR-155-5p is upregulated in circulating microvesicles in patients with autoimmune thyroiditis. However, the function and molecular mechanisms of TNF-α and miR-155-5p in the initiation and progression of subacute thyroiditis are largely unknown. Herein, we determined serum TNF-α levels in subacute thyroiditis patients and normal healthy controls by ELISA assay. Proliferation and apoptosis of rat thyroid follicle FRTL-5 cells were determined by MTT, TUNEL, and annexin V staining assays. Protein levels and phosphorylation status were assessed by immunoblotting. miR-155-5p expression was determined by the real-time quantitative PCR. Serum TNF-α was significantly upregulated in patients with subacute thyroiditis compared to that in normal healthy controls. In rat thyroid follicle FRTL-5 cells, TNF-α treatment led to a reduction of cell proliferation and an induction of apoptosis. It also increased IL-6 expression and phosphorylation of JAK2 and STAT3. Importantly, we demonstrated that serum miR-155-5p was upregulated in subacute thyroiditis patients and TNF-α stimulated the expression of miR-155-5p in FRTL-5 cells. We found that miR-155-5p inhibited the proliferation and induced apoptosis of FRTL-5 cells and increased the expression of IL-6 in FRTL-5 cells. Our results demonstrated that serum TNF-α and miR-155-5p were upregulated in patients with subacute thyroiditis, and TNF-α inhibited proliferation and induced apoptosis of rat thyroid follicle FRTL-5 cells via modulating the IL-6-JAK2/STAT3 pathway and miR-155-5p signaling. Our findings suggest that miR-155-5p might be a novel biomarker of subacute thyroiditis.
Topics: Adult; Animals; Biomarkers; Case-Control Studies; Cells, Cultured; Female; Gene Expression Regulation; Humans; Male; MicroRNAs; Middle Aged; Rats; Spheroids, Cellular; Thyroid Epithelial Cells; Thyroid Gland; Thyroiditis, Subacute; Tumor Necrosis Factor-alpha; Up-Regulation
PubMed: 30399324
DOI: No ID Found