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Association of Age with Risk of Adverse Pathological Findings in Men Undergoing Delayed Radical Prostatectomy Following Active Surveillance.

Urology 2021 Jun 9. Epub 2021 Jun 9.

Department of Urology, UCSF - Helen Diller Comprehensive Cancer Center, University of California, San Francisco, CA, USA. Electronic address:

Objectives: To determine if older men with Gleason grade group (GG) 1 prostate cancer have a higher risk of having adverse pathology at radical prostatectomy after initially being managed with active surveillance (AS).

Methods: A total of 365 patients with GG1 prostate cancer initially managed with AS followed by delayed radical prostatectomy were identified. The primary outcome was adverse pathology after delayed radical prostatectomy in the men that were <65 years versus men ≥65 years at the initiation of AS. Read More

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Clinico-microbiological description and evaluation of rapid lateral flow immunoassay and PCR for detection of Burkholderia pseudomallei from patients hospitalized with sepsis and pneumonia: A twenty-one months study from Odisha, India.

Acta Trop 2021 Jun 9:105994. Epub 2021 Jun 9.

Department of Community and Family Medicine, AIIMS, Bhubaneswar. Electronic address:

Establishing a diagnosis of melioidosis based on clinical grounds is difficult in hospitalized patients with sepsis or community acquired pneumonia (CAP). We aimed to ascertain the prevalence, clinico-epidemiological and laboratory profile of melioidosis in hospitalized patients with sepsis or CAP, and to evaluate the diagnostic utility of rapid lateral flow immunoassay (LFI) and PCR in comparison with culture. In all patients with sepsis or CAP, blood, sputum/throat swab, and urine sample were subjected to culture along with other samples based on clinical presentation. Read More

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A hungry Histiocyte, altered immunity and myriad of problems: Diagnostic challenges for Pediatric HLH.

Int J Lab Hematol 2021 Jun 12. Epub 2021 Jun 12.

Division of Pediatric Hematology/Oncology, Department of Pediatrics, VMMC and Safdarjung Hospital, New Delhi, India.

Introduction: Hemophagocytic lymphohistiocytosis (HLH) is an immune deregulation disorder with varied clinical presentation which clinically overlaps with widespread tropical infections.

Methods: We conducted a retrospective chart review of children diagnosed with HLH at our center from February-2017 to October-2020.

Results: Out of the nine diagnosed patients, genetic predisposition was present in three children; two had identified infectious triggers. Read More

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Inter-center agreement of mRECIST in transplanted patients for hepatocellular carcinoma.

Eur Radiol 2021 Jun 12. Epub 2021 Jun 12.

Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum - University of Bologna, Bologna, Italy.

Objectives: To evaluate the inter-observer reliability of modified Response Evaluation Criteria In Solid Tumours (mRECIST) of patients with hepatocellular carcinoma (HCC) undergoing neo-adjuvant treatments before liver transplant (LT). The agreement of tumor number, size, transplant criteria, and the radiological-pathological concordance were also assessed.

Methods: A total of 180 radiological studies before/after neo-adjuvant therapies performed on 90 patients prior to LT were reviewed from three expert centers. Read More

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Comprehensive aptamer-based screen of 1317 proteins uncovers improved stool protein markers of colorectal cancer.

J Gastroenterol 2021 Jun 12. Epub 2021 Jun 12.

Department of Biomedical Engineering, University of Houston, Houston, USA.

Background: To screen and validate novel stool protein biomarkers of colorectal cancer (CRC).

Methods: A novel aptamer-based screen of 1317 proteins was used to uncover elevated proteins in the stool of patients with CRC, as compared to healthy controls (HCs) in a discovery cohort. Selected biomarker candidates from the discovery cohort were ELISA validated in three independent cross-sectional cohorts comprises 76 CRC patients, 15 adenoma patients, and 63 healthy controls, from two different ethnicities. Read More

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PHKA2 variants expand the phenotype of phosphorylase B kinase deficiency to include patients with ketotic hypoglycemia only.

Am J Med Genet A 2021 Jun 12. Epub 2021 Jun 12.

Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.

Idiopathic ketotic hypoglycemia (IKH) is a diagnosis of exclusion with glycogen storage diseases (GSDs) as a differential diagnosis. GSD IXa presents with ketotic hypoglycemia (KH), hepatomegaly, and growth retardation due to PHKA2 variants. In our multicenter study, 12 children from eight families were diagnosed or suspected of IKH. Read More

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Comparison and validation of FDG-PET/CT scores for polymyalgia rheumatica.

Rheumatology (Oxford) 2021 Jun 12. Epub 2021 Jun 12.

Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Objectives: To compare and validate the diagnostic accuracy of FDG-PET/CT scores for polymyalgia rheumatica (PMR); and to explore their relationship with clinical factors.

Methods: This retrospective study included 39 consecutive patients diagnosed with PMR and 19 PMR comparators. The final clinical diagnosis was established after 6 months follow-up. Read More

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Quantifying Bone Marrow Fat Fraction and Iron by MRI for Distinguishing Aplastic Anemia from Myelodysplastic Syndromes.

J Magn Reson Imaging 2021 Jun 11. Epub 2021 Jun 11.

Radiology Department, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Background: Bone marrow of patients with aplastic anemia (AA) is different from that of patients with myelodysplastic syndrome (MDS) and is difficult to identify by blood examination. IDEAL-IQ (iterative decomposition of water and fat with echo asymmetry and least-squares estimation) imaging might be able to quantify fat fraction (FF) and iron content in bone tissues.

Purpose: To determine if IDEAL-IQ measurements of bone marrow FF and iron content can distinguish between patients with AA and MDS. Read More

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Distinguishing swept-source optical coherence tomography findings in active toxoplasmic retinochoroiditis.

Eye (Lond) 2021 Jun 11. Epub 2021 Jun 11.

Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia.

Objective: To define the swept-source optical coherence tomography (SS-OCT) features which distinguish ocular toxoplasmosis (OT) from other forms of retinochoroiditis.

Methods: This is a prospective diagnostic study enrolling 43 eyes of 43 patients with active toxoplasmic (TOXO) retinochoroiditis matched to 54 eyes (54 lesions) with non-TOXO retinochoroiditis evaluated by structural SS-OCT.

Results: The finding of retinal hyper-reflective round deposits, sub-lesional choroidal thickening, and sub-lesional retinal pigment epithelium elevation were more likely to be found in TOXO lesions with a positive likelihood ratio of 45. Read More

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Oncostatin-M Does Not Predict Treatment Response in Inflammatory Bowel Disease in a Pediatric Cohort.

J Pediatr Gastroenterol Nutr 2021 Jun 10. Epub 2021 Jun 10.

Divisions of Pediatric Gastroenterology Pathology Nemours Biomedical Research, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA Division of Pediatric Gastroenterology, Inova Children's Hospital, Fairfax, VA, USA Division of Pediatric Gastroenterology, Pediatric Specialists of Virginia, Fairfax, VA, USA.

Objectives: This study aimed to determine whether mRNA expression of oncostatin-M (OSM) and its receptor (OSMR) in initial, pre-treatment intestinal biopsies is predictive of response to tumor necrosis factor antagonists (antiTNF) in a pediatric inflammatory bowel disease (IBD) cohort. Secondary outcomes correlated OSM and OSMR expression with demographic variables; IBD type, extent, phenotype, and severity; laboratory values; and endoscopic findings.

Methods: A retrospective chart review was conducted on 98 pediatric patients. Read More

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Severe multisystem pathology, metabolic acidosis, mitochondrial dysfunction, and early death associated with an X-linked variant.

Cold Spring Harb Mol Case Stud 2021 Jun 11;7(3). Epub 2021 Jun 11.

Greenwood Genetic Center, Greenwood, South Carolina 29646, USA.

Variants in the X-linked gene (apoptosis-inducing factor mitochondria-associated 1) are associated with a highly variable clinical presentation that encompasses motor neuropathy, ataxia, encephalopathies, deafness, and cognitive impairment. encodes a mitochondrial flavin adenine dinucleotide (FAD)-dependent nicotinamide adenine dinucleotide (NADH) oxidoreductase, with roles in the regulation of respiratory complex assembly and function, production of reactive oxygen species, and the coordination of a caspase-independent type of apoptosis known as parthanatos. In this report, we describe a missense variant (absent in reference population databases; c. Read More

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Balanced Growth project: a protocol of a single-centre observational study on the involvement of the vestibular system in a child's motor and cognitive development.

BMJ Open 2021 Jun 11;11(6):e049165. Epub 2021 Jun 11.

Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium.

Introduction: The involvement of the vestibular system in the motor and higher (cognitive) performances of typically developing or vestibular-impaired children is currently unknown or has only scarcely been explored. Interestingly, arguments for an interaction between vestibular, motor and cognitive functions in children can also be supported by research on children known for their difficulties in motor and/or cognitive processing (eg, children with neurodevelopmental disorders (NDD)), as they often present with vestibular-like characteristics. Therefore, in order to elucidate this interaction, and to increase the understanding of the pathophysiology and symptomatology of vestibular disorders and NDD in children, the Balanced Growth project was developed. Read More

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Symptomatic Val122del mutated hereditary transthyretin amyloidosis: Need for early diagnosis and prioritization for heart and liver transplantation.

Hepatobiliary Pancreat Dis Int 2021 May 27. Epub 2021 May 27.

Institute for Experimental and Clinical Research (IREC), Catholic University of Louvain (UCL), Avenue Hippocrate 55, Brussels 1200, Belgium. Electronic address:

Background Hereditary transthyretin (ATTRv) amyloidosis is an autosomal dominant disease linked to transthyretin gene mutations which cause instability of the transthyretin tetramer. After dissociation and misfolding they reassemble as insoluble fibrils (i.e. Read More

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Therapeutic potential of targeting Tfr/Tfh cell balance by low-dose-IL-2 in active SLE: a post hoc analysis from a double-blind RCT study.

Arthritis Res Ther 2021 Jun 11;23(1):167. Epub 2021 Jun 11.

Department of Rheumatology & Immunology, Peking University People's Hospital, Beijing, 100044, China.

Objective: To investigate the regulation of T follicular regulatory (Tfr) and T follicular (Tfh) cell subtypes by low-dose IL-2 in systemic lupus erythematosus (SLE) in a randomized, double-blind, placebo-controlled clinical trial.

Methods: A post hoc analysis was performed in a randomized cohort of SLE patients (n=60) receiving low-dose IL-2 therapy (n=30) or placebo (n=30), along with the standard of care treatment. The primary endpoint was the attainment of SLE responder index-4 (SRI-4) at week 12 in the trial. Read More

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Interstitial lung disease associated with adjuvant and neoadjuvant chemotherapy in early breast cancer.

World J Surg Oncol 2021 Jun 11;19(1):169. Epub 2021 Jun 11.

Department of Medical Oncology, Izumi City General Hospital, 4-5-1 Wake, Izumi, Osaka, 594-0073, Japan.

Background: Interstitial lung disease (ILD) is a rare adverse event in patients receiving adjuvant or neoadjuvant chemotherapy (NAC) for breast cancer. Few studies have reported the frequency of ILD in detail, and only small numbers of cases have been described in the literature. Given these previous findings concerning ILD, we retrospectively examined the clinicopathological characteristics of five cases of ILD who had received epirubicin and cyclophosphamide (EC) and compared their findings with non-ILD cases. Read More

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Distal Tibial Reconstruction in the Management of Primary Bone Tumors in Children and Adolescents.

Foot Ankle Int 2021 Jun 11:10711007211012690. Epub 2021 Jun 11.

Department of Oncology and Surgical Oncology for Children and Youth, Institute of Mother and Child, Warsaw, Poland.

Background: Distal tibial primary bone tumors are rare, and options for limb salvage surgery are limited and challenging. Importantly, local control has shown to be crucial and necessary for cure, and radical surgery is one of the most important components of therapy for some bone sarcomas. We investigated the feasibility and functional and oncological outcomes of distal tibial reconstruction using endoprosthesis in children with malignant bone tumors. Read More

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Late morbidity and mortality following revascularization surgery for moyamoya disease in the pediatric population.

J Neurosurg Pediatr 2021 Jun 11:1-6. Epub 2021 Jun 11.

Objective: There are limited reports on long-term morbidity in pediatric patients who have undergone surgical revascularization for moyamoya disease (MMD). Here, the authors report long-term morbidity and mortality in a population of pediatric patients who underwent pial synangiosis for MMD from 1988 through 2016.

Methods: A single-center retrospective review of the hospital and personal operative databases of the senior authors was carried out to identify all patients who were treated for MMD at Boston Children's Hospital between 1988 and 2016, and who experienced any episode of late morbidity or mortality, which the authors defined as an event resulting in significant neurological deficit or death occurring more than 1 year after revascularization surgery. Read More

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Association between vaginal microbiota and risk of early pregnancy miscarriage.

Comp Immunol Microbiol Infect Dis 2021 May 10;77:101669. Epub 2021 May 10.

Shanghai Key Laboratory of Embryo Original Diseases, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China. Electronic address:

Approximately 15 % of clinically recognized pregnancies end in miscarriage. To explore the vaginal microbiota profile in women diagnosed with early pregnancy miscarriage (including missed miscarriage [M] or empty-sac miscarriage [E]), the microbial community structure in vaginal fluid was evaluated by Illumina MiSeq sequencing of the 16S rRNA gene V4 region and compared with that in women with normal pregnancy (P). Taxa identified in samples from the P, E, and M groups formed distinct clusters. Read More

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A higher percentage of leukemic blasts with vacuoles predicts unfavorable outcomes in patients with acute myeloid leukemia.

Leuk Res 2021 Jun 6;109:106638. Epub 2021 Jun 6.

Department of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, People's Republic of China. Electronic address:

Cytoplasmic vacuoles, which are a morphological feature of dysplasia, can be observed under a microscope at initial diagnosis. Recently, this typical morphological feature has been found to be associated with impaired survival. To investigate the clinical significance of the grading of blasts with vacuoles in acute myeloid leukemia (AML), we retrospectively studied 152 patients newly diagnosed with non-M3 AML. Read More

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New ratio as a useful marker for early diagnosis of proximal urea cycle disorders.

Clin Chim Acta 2021 Jun 8. Epub 2021 Jun 8.

Expanded Newborn Screening Laboratory, Referral Center for Inherited Metabolic Disorders, Pediatric Clinical, University-Hospital "Gaspare Rodolico - San Marco", Catania, Italy; Clinical and Experimental Medicine Department, University of Catania, Catania, Italy.

Background And Aims: Proximal urea cycle disorders (PUCDs) are not included in most newborn screening programs due to the lack of adequate markers to monitor. Failure to alter citrulline and glutamine levels, the prognostic markers commonly used, can results in high false negative. Therefore, new biomarkers, prognostic of PUCDs, are strongly desirable. Read More

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Line-field confocal optical coherence tomography for actinic keratosis and squamous cell carcinoma: a descriptive study.

Clin Exp Dermatol 2021 Jun 11. Epub 2021 Jun 11.

Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.

Background: Early and accurate diagnosis of cutaneous squamous cell carcinoma (SCC) and actinic keratosis (AK) is fundamental to reduce their morbidity and to select the correct treatment. Line-field confocal optical coherence tomography (LC-OCT) is a new imaging device that can characterize healthy skin and basal cell carcinoma, but no large studies are available on keratinocyte cell tumours.

Objectives: To identify and describe LC-OCT criteria associated with SCC and AK and to compare LC-OCT findings in these tumours. Read More

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TNF-alpha inhibition in the setting of undiagnosed HIV infection: a call for enhanced screening guidelines.

AIDS 2021 Jun 10. Epub 2021 Jun 10.

Department of Medicine, University of California, San Francisco, CA, USA Division of Hospital Medicine, University of California, San Francisco, CA, USA Department of Pathology, University of California, San Francisco, CA, USA Division of Gastroenterology, University of California, San Francisco, CA, USA Division of Infectious Diseases, University of California, San Francisco, CA, USA Division of Experimental Medicine, University of California, San Francisco, CA, USA Division of HIV, Infectious Diseases, and Global Medicine University of California, San Francisco, CA, USA.

Background: Despite the risks of immunosuppression, recommendations regarding screening for HIV infection prior to initiation of biologic therapies targeting common rheumatologic disorders, including inflammatory bowel disease (IBD) and inflammatory arthritides, are limited. Few cases of patients started on biologics while living with undiagnosed HIV infection have been reported.

Methods: We report 3 cases of patients initiated on biologics in the absence of recent or concurrent HIV screening who developed refractory disease or unanticipated complications and were later found to have undiagnosed chronic HIV infection. Read More

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Complications associated with myocardial bridging in four children without underlying cardiac disease: a case series.

Paediatr Int Child Health 2021 Jun 11:1-7. Epub 2021 Jun 11.

Department of Life Sciences and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Myocardial bridging is largely considered to be a benign, symptomless congenital anomaly of the coronary arteries in which the intramyocardial coronary course is partially 'tunnelled' and leads to vessel compression during ventricular systole. There are few data regarding children. To report on myocardial bridging observed in children seeking medical help in the paediatric emergency room. Read More

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Hyperferritinemia: A Diagnostic Marker for Disseminated Neonatal Herpes Simplex Virus Infection?

Pediatr Ann 2021 Jun 1;50(6):e264-e267. Epub 2021 Jun 1.

Although the prognosis of neonatal herpes simplex virus (HSV) infection has improved with intravenous acyclovir, the morbidity and mortality of disseminated disease remains high. Transaminitis and thrombocytopenia have been reported to be sensitive markers of neonatal HSV disease; however, early diagnosis remains a challenge due to a lack of specific clinical and laboratory indicators for this disease process. Ferritin, an acute phase reactant known for its use in diagnosing hemophagocytic lymphohistiocytosis, has recently been reported as extremely elevated in neonates with disseminated HSV due to its high inflammatory nature. Read More

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What sound sources trigger misophonia? Not just chewing and breathing.

J Clin Psychol 2021 Jun 11. Epub 2021 Jun 11.

Department of Psychology, The Ohio State University, Columbus, Ohio, USA.

Objectives: Misophonia is a highly prevalent yet understudied condition characterized by aversion toward particular environmental sounds. Oral/nasal sounds (e.g. Read More

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Optical Coherence Tomography Angiography Findings of Iris Ischemia and Reperfusion in Cytomegalovirus Panuveitis.

Ocul Immunol Inflamm 2021 Jun 11:1-4. Epub 2021 Jun 11.

Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Milan, Italy.

: To report a case of iris ischemia in an eye affected by Cytomegalovirus (CMV)-related Chronic Retinal Necrosis (CRN) with partial reperfusion after antiviral therapy demonstrated by optical coherence tomography angiography (OCTA).: Retrospective case report. Multimodal imaging was performed at each follow-up visits. Read More

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Body composition and risk of major gynecologic malignancies: Results from the UK Biobank prospective cohort.

Cancer Med 2021 Jun 10. Epub 2021 Jun 10.

Department of Endocrinology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.

Objective: To evaluate the association between body composition and subsequent risk of the major gynecologic malignancies.

Methods: This is a prospective analysis of participants from the UK Biobank. We measured baseline body composition and confirmed cancer diagnosis through linkage to cancer and death registries. Read More

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Comparison of Clinical Features and Outcomes between Intrahepatic Cholangiocarcinoma and Hepatocellular Carcinoma in the United States.

Hepatology 2021 Jun 11. Epub 2021 Jun 11.

Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Background & Aims: Intrahepatic cholangiocarcinoma (iCCA) and hepatocellular carcinoma (HCC) are the most common primary liver cancers. Differences in their clinical features and outcomes have not been investigated in a large-scale study. We aim to investigate the differences in clinical features and outcomes between iCCA and HCC. Read More

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Major genetic discontinuity and novel toxigenic species in taxonomy.

Elife 2021 Jun 11;10. Epub 2021 Jun 11.

School of Biomedical Sciences, University of Western Australia, Nedlands, Australia.

infection (CDI) remains an urgent global One Health threat. The genetic heterogeneity seen across underscores its wide ecological versatility and has driven the significant changes in CDI epidemiology seen in the last 20 years. We analysed an international collection of over 12,000 genomes spanning the eight currently defined phylogenetic clades. Read More

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Expert Perspective: Management of Microvascular and Catastrophic Antiphospholipid Syndrome.

Authors:
Doruk Erkan

Arthritis Rheumatol 2021 Jun 11. Epub 2021 Jun 11.

Barbara Volcker Center for Women and Rheumatic Diseases, Hospital for Special Surgery; Weill Cornell Medicine, New York, NY, USA.

A 50-year-old male with antiphospholipid syndrome (APS) presents to your office for the first time with a three-month history of worsening dyspnea, dry cough, and early morning blood-tinged sputum. His APS diagnosis was based on an unprovoked left lower extremity deep vein thrombosis, four years prior to the presentation, with persistent (multiple occasions) triple antiphospholipid antibody (aPL)-positivity, defined as lupus anticoagulant (LA) test positive performed while off anticoagulation, high titer [≥80 U] IgG anticardiolipin antibodies (aCL), and high titer IgG anti-β -glycoprotein-I (aβ GPI). He has no other past medical history; and he is on warfarin with a target international normalized ratio (INR) of 2. Read More

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