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Reports, Volume 7, Issue 4 (December 2024) – 2 articles

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8 pages, 2953 KiB  
Case Report
Tuberculosis-Induced Immune-Mediated Necrotizing Myopathy: A Challenging Case Scenario in a Non-Endemic Country
by Agnese Colpani, Davide Astorri, Andrea De Vito, Giordano Madeddu, Sandro Panese and Nicholas Geremia
Reports 2024, 7(4), 82; https://doi.org/10.3390/reports7040082 - 24 Sep 2024
Viewed by 357
Abstract
Background: Tuberculosis (TB) poses a significant global health challenge; although low–middle income countries carry the heaviest burden, its diagnosis and treatment can be challenging in any country. The clinical picture can be complex and vary from person to person, with autoimmune complications [...] Read more.
Background: Tuberculosis (TB) poses a significant global health challenge; although low–middle income countries carry the heaviest burden, its diagnosis and treatment can be challenging in any country. The clinical picture can be complex and vary from person to person, with autoimmune complications that can hinder TB diagnosis and treatment. Case Presentation: We report the case of a 38-year-old man from Bangladesh who had recently arrived in Italy through the Balkan route. He presented with TB in the cervical lymph nodes and long-standing chronic myalgias. While a wide range of TB-triggered autoimmune entities can be found in the literature, this case is the first to describe immune-mediated necrotizing myopathy (IMNM) triggered by active TB. Conclusions: IMNM has been previously associated only with other infections like SARS-CoV-2 and Dengue. The successful diagnosis and management of TB-induced IMNM was achieved through a collaborative, multidisciplinary approach involving rheumatologists, immunologists, and infectious diseases specialists, showcasing an innovative treatment strategy and adding new insights into the complexities of TB and IMNM. Full article
(This article belongs to the Collection Health Threats of Climate Change)
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6 pages, 2340 KiB  
Case Report
Endoscopic Guided Dilations without Intralesional Corticosteroid Injections: Pediatric Crohn’s Patients Case Series
by Leo Fawaz, Yousif Slim and Peter N. Freswick
Reports 2024, 7(4), 81; https://doi.org/10.3390/reports7040081 - 24 Sep 2024
Viewed by 442
Abstract
Background: The treatment for pediatric Crohn’s disease (CD) has shifted over the years from steroids and immunomodulators to biologics with the goal of histological and clinical remission. Endoscopic balloon dilation (EBD) has been utilized for stricturing disease, even in the pediatric population. EBD [...] Read more.
Background: The treatment for pediatric Crohn’s disease (CD) has shifted over the years from steroids and immunomodulators to biologics with the goal of histological and clinical remission. Endoscopic balloon dilation (EBD) has been utilized for stricturing disease, even in the pediatric population. EBD has been shown to be effective and minimally invasive, though historically, has been performed on patients with persistent mucosal inflammation. As such, intralesional corticosteroid (ILC) injections have been traditionally utilized during EBD. However, intralesional corticosteroid efficacy among pediatrics patients in deep endoscopic remission is unknown. Case Presentation: We report four patients that demonstrated at least initial successful dilations without intralesional steroid injections. Conclusions: The use of ILC injections during routine EBDs in pediatric patients should be further explored in randomized control trials. Full article
(This article belongs to the Section Gastroenterology)
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