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Children (Basel) 2022 Jun 15;9(6). Epub 2022 Jun 15.

Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, 70124 Bari, Italy.

Parathyroid hormone-related peptide (PTHrP) is expressed at a wide range of sites in the body and performs different functions including vasodilation, relaxation of smooth muscle cells, and regulation of bone development. PTHrP also mediates hypercalcemia related to neoplastic diseases. However, reference ranges specific method and age were not evaluated. Read More

Postgrad Med J 2022 Jun 23. Epub 2022 Jun 23.

NIHR Health Protection Unit for Emerging and Zoonotic Infection, Liverpool, UK

Encephalitis describes inflammation of the brain parenchyma, typically caused by either an infectious agent or through an autoimmune process which may be postinfectious, paraneoplastic or idiopathic. Patients can present with a combination of fever, alterations in behaviour, personality, cognition and consciousness. They may also exhibit focal neurological deficits, seizures, movement disorders and/or autonomic instability. Read More

Pan Afr Med J 2022 29;41:257. Epub 2022 Mar 29.

Service d'Hématologie Clinique, Centre Hospitalier Universitaire Mohammed VI Marrakech, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech, Maroc.

Malignant hypercalcaemia is a metabolic emergency. Its association with solid tumors is common, whereas it has been rarely described in patients with malignant hemopathies other than multiple myeloma and T-cell leukemias/T-cell lymphomas associated with lymphotropic virus type I (HTLV-I). We here report the case of a female patient with acute lymphoblastic leukemia revealed by malignant hypercalcaemia and pathological fracture of the humerus. Read More

Neurol Neuroimmunol Neuroinflamm 2022 Sep 21;9(5). Epub 2022 Jun 21.

From the Department of Neurology (S.F., C.W., L.T., K.M.B., S.V.), University of Texas Southwestern Medical Center, Dallas, TX; and Department of Neurology (R.N.), Barrow Neurological Institute, Phoenix, AZ.

Background And Objectives: Anti-N-methyl d-aspartate receptor (NMDAR) encephalitis classically affects women of childbearing age, producing a disproportionate number of pregnant women with anti-NMDAR encephalitis. The typical presentation includes progressive neuropsychiatric symptoms, seizures, and alterations in consciousness, all of which present potential risks to the fetus. First-line and second-line treatments similarly pose teratogenic potential; therefore, randomized studies with supportive data on pregnancy and fetal outcomes are lacking. Read More

Neurol Neuroimmunol Neuroinflamm 2022 Jul 21;9(4). Epub 2022 Jun 21.

From the Neuromuscular Diseases Unit (D.R.-L., R.R.-G., J.T.-S., L.Q., M.O., R.Á.-V., M.C.-Á., Á.C., A.V.-C., I.I., E.C.-V.), Department of Neurology, Hospital de la Santa Creu i Sant Pau, "Departament de Medicina," Universitat Autònoma de Barcelona; Neuromuscular Diseases Lab (D.R.-L., R.R.-G., J.T.-S., L.Q., M.O., R.Á.-V., M.C.-Á., Á.C., A.V.-C., I.I., E.G., E.C.-V.), Institut de Recerca Hospital de la Santa Creu i Sant Pau (IIB-Sant Pau), Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (D.R.-L., F.P.-J., R.R.-G., J.T.-S., L.Q., M.O., R.Á.-V., M.C.-Á., Á.C., I.I., E.G., E.C.-V.), Valencia; Unidad de Enfermedades Infecciosas (J.L.-C., P.D.), Servicio de Medicina Interna, Hospital de la Santa Creu i Sant Pau; and Department of Immunology (E.M., E.L.-P.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Spain.

Background And Objectives: Evidence regarding the safety and efficacy of messenger RNA (mRNA) vaccines in patients with myasthenia gravis (MG) after immunosuppressive therapies is scarce. Our aim is to determine whether the mRNA-1273 vaccine is safe and able to induce humoral and cellular responses in patients with MG.

Methods: We performed an observational, longitudinal, prospective study including 100 patients with MG of a referral center for MG in our country, conducted from April 2021 to November 2021 during the vaccination campaign. Read More

J Vis Exp 2022 Jun 2(184). Epub 2022 Jun 2.

ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona;

Over the last 15 years, a new category of antibody-mediated diseases of the central nervous system (CNS) has been characterized and is now defined as "autoimmune encephalitis" (AE). There are currently 17 known AE syndromes, and all are associated with antibodies against the neuronal cell surface or synaptic proteins. The clinical syndromes are complex and vary according to the type of associated antibody. Read More

Front Immunol 2022 1;13:913703. Epub 2022 Jun 1.

Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China.

Objective: To develop a fusion model combining clinical variables, deep learning (DL), and radiomics features to predict the functional outcomes early in patients with adult anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in Southwest China.

Methods: From January 2012, a two-center study of anti-NMDAR encephalitis was initiated to collect clinical and MRI data from acute patients in Southwest China. Two experienced neurologists independently assessed the patients' prognosis at 24 moths based on the modified Rankin Scale (mRS) (good outcome defined as mRS 0-2; bad outcome defined as mRS 3-6). Read More

BMC Neurol 2022 Jun 18;22(1):224. Epub 2022 Jun 18.

Emergency Department, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a common type of autoimmune encephalitis. Patients with this condition are frequently very ill but are often misdiagnosed in the Emergency Department (ED). The objective of this study was to analyze the clinical characteristics of anti-NMDAR patients in the ED and to identify any associations with a diagnosis of anti-NMDAR encephalitis. Read More

Lancet Glob Health 2022 Jul;10(7):e989-e1002

National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.

Background: Encephalitis is a worldwide public health issue, with a substantially high burden among children in southeast Asia. We aimed to determine the causes of encephalitis in children admitted to hospitals across the Greater Mekong region by implementing a comprehensive state-of-the-art diagnostic procedure harmonised across all centres, and identifying clinical characteristics related to patients' conditions.

Methods: In this multicentre, observational, prospective study of childhood encephalitis, four referral hospitals in Cambodia, Vietnam, Laos, and Myanmar recruited children (aged 28 days to 16 years) who presented with altered mental status lasting more than 24 h and two of the following minor criteria: fever (within the 72 h before or after presentation), one or more generalised or partial seizures (excluding febrile seizures), a new-onset focal neurological deficit, cerebrospinal fluid (CSF) white blood cell count of 5 per mL or higher, or brain imaging (CT or MRI) suggestive of lesions of encephalitis. Read More

BMC Neurol 2022 Jun 17;22(1):222. Epub 2022 Jun 17.

Department of Rheumatology and Immunology, Tianjin Medical University General Hospital, No.154 Anshan Road, Tianjin, 300052, China.

Background: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune inflammatory disease predominantly found in women of child-bearing age. Neurogenic pulmonary edema (NPE) is a recalcitrant complication that occurs after injury to the central nervous system and has an acute onset and rapid progression. Limbic encephalitis is an inflammatory encephalopathy caused by viruses, immune responses, or other factors involving the limbic system. Read More

J Int Med Res 2022 Jun;50(6):3000605211053703

Department of Emergency, The Second Affiliated Hospital of Fujian Medical University, Quanzhou City, Fujian Province, P. R. China.

Objective: Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder. Recent studies report that long non-coding RNAs (lncRNAs) play vital roles in the pathogenesis of various diseases. This study explored the molecular mechanism of lncRNA growth arrest specific 5 (GAS5) in regulating the T helper 17 (Th17)/regulatory T (Treg) cell balance in MG. Read More

PLoS One 2022 15;17(6):e0269621. Epub 2022 Jun 15.

Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, PR China.

Objectives: Malnutrition, defined according to Nutritional risk screening (NRS 2002), is commonly observed in patients of Myasthenia gravis (MG), a neuromuscular disorder manifested by varied degrees of skeletal muscle weakness. Because biochemical composition of saliva changes in correspondence to alterations in nutritional status, we tested our hypothesis that a certain saliva component(s) might serve as a biomarker(s) for nutrition status of MG, particularly for those MG patients with high risk of malnutrition.

Materials And Methods: 60 MG patients and 60 subjects belonging to the healthy control group (HCG) were enrolled in this case-control study. Read More

Case Rep Oncol 2022 May-Aug;15(2):507-514. Epub 2022 May 9.

Medical Oncology Department, University Hospital of Salamanca, Salamanca, Spain.

Autoimmune haemolytic anaemia (AIHA) is an acquired disorder in which antibodies are produced against self-erythrocyte antigens. We distinguish those produced by cold antibodies (IgM), which may be associated with lymphoproliferative syndromes, infectious diseases, other autoimmune phenomena, as well as drugs or solid tumours. We report a case of AIHA due to cold antibodies as a paraneoplastic syndrome (PNS) in a patient with metastatic renal carcinoma. Read More

Chemotherapy 2022 Jun 14:1-5. Epub 2022 Jun 14.

Medical Oncology Department, Centre Oscar Lambret, Lille, France.

Paraneoplastic neurological syndrome (PNS) is uncommon and not well known. PNS can reveal cancer, but its role in seminomas has not been described explicitly. We report the case of a 36-year-old man with unremarkable medical history and no comorbidities who was diagnosed with a retroperitoneal metastatic seminoma. Read More

Cureus 2022 May 11;14(5):e24913. Epub 2022 May 11.

Hematology/Oncology, Columbus Oncology Associates, Columbus, USA.

Paraneoplastic syndromes (PNS) are rare and can be challenging to diagnose and treat. The uniqueness of PNS lies in the complexity of presentation, the importance of early diagnosis, and the role of multidisciplinary care in managing those patients to mitigate long-term neurologic complications. We describe a patient with metastatic renal cell carcinoma who presented with a complex constellation of neurological symptoms (progressive global ataxia and sensory changes) that did not resolve following nephrectomy. Read More

Ital J Pediatr 2022 Jun 13;48(1):94. Epub 2022 Jun 13.

Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, 300134, China.

Background: Autoimmune encephalitis (AE) is a type of encephalopathy mediated by an antigenic immune response in the central nervous system. Most research related to autoimmune encephalitis (AE) is focused on early diagnosis, treatment and prognosis analysis; there has been little research conducted on the characteristics of immune function, and the relationship between immune function and prognoses of patients with autoimmune encephalitis needs to be studied further.

Methods: A total of 33 children with autoimmune encephalitis were identified through the clinic database and inpatient consults at Tianjin Children's Hospital from January 2013 to January 2021. Read More

Actas Dermosifiliogr 2022 05 20;113(5):514-515. Epub 2021 Sep 20.

Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España. Electronic address:

J Obstet Gynaecol Can 2022 Jun;44(6):700-702

Department of Obstetrics & Gynecology, University of Montréal, Montréal, QC; Division of Gynecologic Oncology, Maisonneuve-Rosemont Hospital, Montréal, QC. Electronic address:

Background: Paraneoplastic dermatomyositis following a diagnosis of ovarian cancer is rare. There are very few cases reported on the management of severe forms.

Case: We report the case of a 50-year-old woman diagnosed with stage IIIC high-grade serous ovarian cancer and a severe form of paraneoplastic dermatomyositis requiring mechanical ventilation. Read More

BMC Surg 2022 Jun 11;22(1):226. Epub 2022 Jun 11.

Department of Thoracic Surgery, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.

Background: Ectopic Cushing syndrome (ECS) is a sporadic condition. Even uncommon is an ECS that derives from a carcinoid tumor of the thymus. These tumors may pose several diagnostic and therapeutic conundrums. Read More

Med Trop Sante Int 2021 12 11;1(4). Epub 2021 Nov 11.

CHU Yalgado Ouédraogo de Ouagadougou, Unité de formation et de recherches des sciences de la santé, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso.

Introduction: Certain differences in the epidemiological, clinical, paraclinical and evolution profiles of autoimmune myasthenia gravis (AIMG) are increasingly described in patients according to geographic origins. The present study was carried out in order to help characterize the socio-demographic, clinical and paraclinical profile of AIMG in Ouagadougou, Burkina Faso.

Patients And Methods: This was a cross-sectional, descriptive, multicenter, hospital study carried out in Ouagadougou (Burkina Faso), over a period of 5 years 6 months, from March 2015 to September 2019. Read More

Zhonghua Xue Ye Xue Za Zhi 2022 Apr;43(4):311-315

Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

To evaluate the clinical characteristics, treatment, and prognosis of patients with paraneoplastic neurological syndrome (PNS) associated with lymphoma. Between January 2012 and May 2021, the clinical data of 11 patients with lymphoma complicated with PNS treated at Peking Union Medical College Hospital were retrospectively reviewed. Among the 11 patients (8 male and 3 female) , the median onset age was 61 (range, 33-78) years. Read More

Neurocase 2022 Apr 7;28(2):239-245. Epub 2022 Jun 7.

Department of Child Neurology, Faculty of Medicine, Ege University, Izmir, Turkey.

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune entity in psychiatry literature that occurs when antibodies attack NMDA-type glutamate receptors in the brain. Principle clinical features include a neurological domain such as seizure, orofacial dyskinesia, dystonia, and choreic-like movements of extremities. Also the psychiatric manifestations of this form of encephalitis may vary from psychotic-like symptoms to mood symptoms like depression or mania. Read More

BMJ Case Rep 2022 Jun 7;15(6). Epub 2022 Jun 7.

Internal Medicine, PGIMER, Chandigarh, India

Neuromyelitis optica spectrum disorder (NMOSD) is a demyelinating disease of the central nervous system characterised by longitudinal extensive transverse myelitis and involvement of the optic nerve and is associated with many autoimmune disorders. The index case, a known case of Hashimoto's thyroiditis, presented with quadriparesis and tea-coloured urine. Investigations revealed ongoing rhabdomyolysis related to autoimmune myositis and autoimmune haemolytic anaemia leading to pigment-induced acute kidney injury. Read More

BMJ Case Rep 2022 Jun 6;15(6). Epub 2022 Jun 6.

Department of Medicine, University of California San Francisco, San Francisco, California, USA

Giant cell myositis (GCM) is a rare inflammatory myopathy associated with myasthenia gravis and thymoma. Here, we report on a woman in her late 50s with a history of myasthenia gravis, systemic lupus erythematosus and stage IV thymoma with pleural metastases, who presented with proximal weakness, neuromuscular respiratory failure and hypercalcaemia. She was diagnosed with GCM via muscle biopsy and screened for myocarditis but showed no evidence of myocardial involvement. Read More

Medicine (Baltimore) 2022 Jun 3;101(22):e29480. Epub 2022 Jun 3.

Front Immunol 2022 19;13:864664. Epub 2022 May 19.

Department of Neurology, Tongde Hospital of Zhejiang Province, Hangzhou, China.

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune-mediated idiopathic inflammatory demyelinating disease with a typical clinical presentation of optic neuritis, acute myelitis, and area postrema syndrome. Most NMOSD patients are seropositive for disease-specific and pathogenic aquaporin-4 (AQP4) antibodies, which are key markers for the NMOSD diagnosis. Herein, we report an atypical case of a 41-year-old man who complained of intractable hiccups and vomiting at disease onset, followed by fever, headache, back pain, progressive paresthesia, and weakness of extremities later on. Read More

Clin Biochem 2022 May 31. Epub 2022 May 31.

IRCCS Ospedale Policlinico San Martino, Genova, Italy. Electronic address:

Biomed Res Int 2022 24;2022:8587273. Epub 2022 May 24.

Department of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning, China 530021.

Background: Myasthenia gravis (MG) is an autoimmune disease that severely affects the life quality of patients. This study explores the differences in immune cell types between MG and healthy control and the role of immune-related genes in the diagnosis of MG.

Methods: The GSE85452 dataset was downloaded from the Gene Expression Omnibus (GEO) database and analyzed using the limma package to determine differentially expressed genes (DEGs) between patients with MG and the control group. Read More

Eur J Dermatol 2022 Jan;32(1):150-153

Front Oncol 2022 16;12:892539. Epub 2022 May 16.

Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.

Paraneoplastic neurological syndromes (PNSs) are a group of neurological disorders triggered by an underlying remote tumor. Ovarian teratoma (OT) is the most common histologic type of germ cell tumor in females. The most common PNSs associated with OT is anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Read More