Publications by authors named "Y L Matthews"

33 Publications

Pseudotumor cerebri syndrome in childhood: incidence, clinical profile and risk factors in a national prospective population-based cohort study.

Arch Dis Child 2017 08 29;102(8):715-721. Epub 2017 Mar 29.

Clinical Neurosciences, Faculty of Medicine, University of Southampton, University Hospital Southampton, Southampton, UK.

Aim: To investigate the epidemiology, clinical profile and risk factors of pseudotumor cerebri syndrome (PTCS) in children aged 1-16 years.

Methods: A national prospective population-based cohort study over 25 months. Newly diagnosed PTCS cases notified via British Paediatric Surveillance Unit were ascertained using classical diagnostic criteria and categorised according to 2013 revised diagnostic criteria. We derived national age, sex and weight-specific annual incidence rates and assessed effects of sex and weight categories.

Results: We identified 185 PTCS cases of which 166 also fulfilled revised diagnostic criteria. The national annual incidence (95% CI) of PTCS in children aged 1-16 years was 0.71 (0.57 to 0.87) per 100 000 population increasing with age and weight to 4.18 and 10.7 per 100 000 in obese boys and girls aged 12-15 years, respectively. Incidence rates under 7 years were similar in both sexes. From 7 years onwards, the incidence in girls was double that in boys, but only in overweight (including obese) children. In children aged 12-15 years, an estimated 82% of the incidence of PTCS was attributable to obesity. Two subgroups of PTCS were apparent: 168 (91%) cases aged from 7 years frequently presented on medication and with headache and were predominantly female and obese. The remaining 17 (9%) cases under 7 years often lacked these risk factors and commonly presented with paralytic squint.

Conclusions: This uniquely large population-based study of childhood PTCS will inform the design of future intervention studies. It suggests that weight reduction is central to the prevention of PTCS.
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http://dx.doi.org/10.1136/archdischild-2016-312238DOI Listing
August 2017

Intraductal tubulopapillary neoplasm of pancreas with associated invasive carcinoma, lymph node, rectal and hepatic metastases.

Pathology 2015 Feb;47(2):169-71

1Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown 2Douglass Hanly Moir Pathology, Macquaire Park 3Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown 4Central Clinical School, University of Sydney, Camperdown, Sydney, NSW, Australia.

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http://dx.doi.org/10.1097/PAT.0000000000000228DOI Listing
February 2015

Microchimerism in the transfused obstetric population.

Vox Sang 2014 Nov 16;107(4):428-30. Epub 2014 Jul 16.

Blood Systems Research Institute, San Francisco, CA, USA.

Microchimerism (MC), the coexistence of allogeneic populations of cells within a host, is well described in pregnancy and blood transfusion. To date, transfusion-associated MC (TA-MC) appears unique to patients transfused after severe traumatic injury. We sought to determine whether transfusion in the peripartum period results in enduring, high-level TA-MC. We conducted a prospective cohort study of 22 women who were newly transfused within 48 h of delivery. Two subjects showed evidence of transient TA-MC; however, MC was not detected at 6 weeks and 6 months. The negative findings suggest that enduring TA-MC does not occur in this population.
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http://dx.doi.org/10.1111/vox.12177DOI Listing
November 2014

Response regarding CLIPPERS.

J Cutan Pathol 2014 Sep 30;41(9):761. Epub 2014 Jun 30.

Department of Dermatopathology, Skin and Cancer Foundation Australia, Sydney, Australia.

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http://dx.doi.org/10.1111/cup.12360DOI Listing
September 2014

Neurotropic T-cell lymphocytosis: a cutaneous expression of CLIPPERS.

J Cutan Pathol 2014 Aug 21;41(8):657-62. Epub 2014 May 21.

Department of Dermatology, Prince of Wales Hospital, Randwick, NSW, Australia.

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is an inflammatory disease of the central nervous system that predominantly involves the pons and cerebellum and that improves with immunosuppressive treatment. Only recently described, the etiology is unknown, diagnosis is difficult and long-term neurological sequelae may occur without aggressive treatment. Herein, we describe a 59-year-old woman who presented with subcutaneous nodules affecting her face, trunk, limbs and an indurated annular erythematous lesion on her forearm. This was associated with marked dysesthesia of her skin, refractory to treatment. There was a 4-year history of dysequilibrium, vertigo, truncal and gait ataxia with progressive neurological symptoms. Skin biopsy of the annular nodular lesion showed a lymphohistiocytic infiltrate in dermis and subcutis with a striking lymphocyte-dominant infiltrate that was perineural and formed a nodular collection extending along a prominent subcutaneous nerve. Immunophenotyping indicated a marked predominance of T cells that were CD3 positive with a 2 : 1 CD4 : CD8 ratio. Scattered histiocytes were present but no well-formed granulomas or vasculitis. Magnetic resonance imaging studies showed changes in the pontine, brain stem and cerebellar region, which subsequently were defined as characteristic for CLIPPERS, but no brain biopsy was pursued. The marked neural skin symptoms and the cutaneous histopathological findings indicate that the skin may be an additional target organ in CLIPPERS, and the immune response may be directed against a common neural antigen. In radiologically typical CLIPPERS, identification of clinical skin lesions particularly subcutaneous nodules and biopsy may potentially form a basis for tissue diagnosis in this syndrome.
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http://dx.doi.org/10.1111/cup.12344DOI Listing
August 2014
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