Immune System Diseases Commons^™

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

Interstitial Lung Disease Associated With Certolizumab Pegol Monotherapy In Psoriatic Arthritis, Tan T. Tran, Raesham Bukhari, Mahmood Danishwar, Mohammad Abu Tineh, Syed Jaleel

Tower Health Research Day

No abstract provided.

Remitting Seronegative Symmetrical Synovitis With Pitting Edema (Rs3pe) - A Hidden Inflammation Unveiled, Tirumala Nischal Jasty, Jon Nesfeder

Tower Health Research Day

No abstract provided.

Examining The Matrix: A Case Of Anti-Nuclear Matrix Protein 2 (Nxp-2) Positive Dermatomyositis, Victoria Cuello, Ramiro Oquita, Emilia Dulgheru

Research Symposium

Background: Dermatomyositis is a disease characterized by proximal muscle weakness, elevated muscle enzymes and cutaneous skin findings including heliotrope rash, periungual erythema, Gottron’s papules/sign and shawl-sign. Myositis-specific autoantibodies (MSA) can be used to predict disease manifestations, response to therapy and prognosis. Specifically, patients with dermatomyositis with positive anti-nuclear matrix protein (NXP-2) typically present with classical skin findings, subcutaneous edema, profound muscle weakness, severe dysphagia and hypophonia.

Case Presentation: A 21-year-old Hispanic lady presented to the hospital for severe muscle weakness. She reported soreness in her thighs for three months prior to presentation followed by arm soreness. She also developed a …

A True Bloody Emergency: An Unusual Case Of Thrombotic Thrombocytopenic Purpura, Joshua M. Ninan

Research Symposium

Background: Thrombotic thrombocytopenic purpura (TTP) is a primary thrombotic microangiopathy that is classically characterized by thrombocytopenia and microangiopathic hemolytic anemia (MAHA). Although rare with an annual incidence of 3.7 cases per one million adults, it is considered a true hematological emergency due to its fatality rate of almost 100% if appropriate treatment is not initiated immediately. This makes it vitally important to identify and treat patients with TTP, a task that becomes unusually challenging in the absence of the disorder’s other characteristically diagnostic clinical features such as mucosal bleeding, fever, or presence of schistocytes.

Case Presentation: A 30-year-old gentleman with …

Image-Based Multiplex Immune Profiling Of Cancer Tissues: Translational Implications. A Report Of The International Immuno-Oncology Biomarker Working Group On Breast Cancer., Chowdhury Arif Jahangir, David B. Page, Glenn Broeckx, Claudia A. Gonzalez, Caoimbhe Burke, Clodagh Murphy, Jorge S. Reis-Filho, Amy Ly, Paul Harms, Shahin Sayed

Pathology, East Africa

Recent advances in the field of immuno-oncology have brought transformative changes in the management of cancer patients. The immune profile of tumours has been found to have key value in predicting disease prognosis and treatment response in various cancers. Multiplex immunohistochemistry and immunofluorescence have emerged as potent tools for the simultaneous detection of multiple protein biomarkers in a single tissue section, thereby expanding opportunities for molecular and immune profiling while preserving tissue samples. By establishing the phenotype of individual tumour cells when distributed within a mixed cell population, the identification of clinically relevant biomarkers with high-throughput multiplex immunophenotyping of tumour …

Avaren-Fc, A Novel Immunotherapeutic, Recruits Nk Cells In B16f10 Melanoma Tumor Tissue, Sreevatsa Vemuri, Katarina Mayer, Nobuyuki Matoba

Posters-at-the-Capitol

Melanoma is the fifth most common cancer in the US, with limited effective immunotherapeutic options available for patients. Avaren-Fc (AvFc) is a novel experimental immunotherapeutic agent with a unique “lectibody” property. It is capable of targeting cancer cells through the selective recognition of high mannose glycans, which are aberrantly overrepresented on the surface of malignant cells. AvFc can interact with circulating effector immune cells equipped with Fc receptors, such as natural killer (NK) cells to induce antibody-dependent cell-mediated cytotoxicity (ADCC) and kill cancer cells. Previous work has shown that AvFc effectively induces ADCC activity against B16F10 cancer cells in vitro …

A Rare Case Of Iga Vasculitis In An Adult Patient With Mssa Bacteremia And Prostate Abscess, Maria E Mesalles, Erinolaoluwa F Araoye, Anees Siddiqi, Adrien Janvier

Journal of Community Hospital Internal Medicine Perspectives

IgA vasculitis, previously known as Henoch Schönlein Purpura (HSP), is a disease more common in children and occurs when IgA1 immune complexes attach to the walls of small blood vessels causing inflammation. This case report is of an adult male who presented with a purpuric rash affecting both legs, microhematuria, and knee pain. Blood cultures were positive for Methicillin-sensitive Staphylococcus aureus (MSSA). Computed tomography of the pelvis revealed a prostate abscess. Skin biopsy demonstrated IgA and C3 in the dermal vessels. To our knowledge, this is the first report of IgA vasculitis associated with MSSA bacteremia due to a prostate …

An Atypical Presentation Of Systematic Lupys Erythematosus (Sle), Devante Shootes, Jeremiah Ling, Omer Farooq

Gulf Coast Division Research Day 2024

No abstract provided.

Mycophenolate Associated Progressive Multifocal Leukoencephalopathy In A Woman With Systemic Lupus Erythematosus, Zaur Komachkov, Yacoub Khatab

Gulf Coast Division Research Day 2024

No abstract provided.

Thoracic Spine Lesion With Paralysis: A Rare Presentation Of Plasmacytoma, Daniel Khashchuk, Natarajan Venkatayan

Gulf Coast Division Research Day 2024

No abstract provided.

Quantification Of Antiviral Drug Tenofovir (Tfv) By Surface-Enhanced Raman Spectroscopy (Sers) Using Cumulative Distribution Functions (Cdfs), Marguerite R. Butler, Jana Hrncirova, Meredith Clark, Sucharita Dutta, John B. Cooper

Chemistry & Biochemistry Faculty Publications

Surface-enhanced Raman spectroscopy (SERS) is an ultrasensitive spectroscopic technique that generates signal-enhanced fingerprint vibrational spectra of small molecules. However, without rigorous control of SERS substrate active sites, geometry, surface area, or surface functionality, SERS is notoriously irreproducible, complicating the consistent quantitative analysis of small molecules. While evaporatively prepared samples yield significant SERS enhancement resulting in lower detection limits, the distribution of these enhancements along the SERS surface is inherently stochastic. Acquiring spatially resolved SERS spectra of these dried surfaces, we have shown that this enhancement is governed by a power law as a function of analyte concentration. Consequently, by definition, …

A Retrospective Study On The Effect Of Raas Pathway Inhibitors At Decreasing The Risk Of Acute Coronary Syndrome In Hypertensive Patients With Rheumatoid Arthritis As Compared To Other Antihypertensives, Yousuf Sherwani, Asad Risvi, Senthil Thambidorai

North Texas Research Forum 2024

Rheumatoid arthritis (RA) is a chronic multi-system inflammatory disease of which is characterized by articular and extra-articular involvement. Patients with RA have a higher risk of mortality when compared with the general population, which is due predominantly to increased cardiovascular disease. Due to the higher incidence of CVD and MI in RA patients it has been postulated that enhanced systemic inflammation plays an important role in the pathogenesis of CVD in RA patients. Previous studies have shown that ant inflammatory medication such as systemic steroids and immune blockers have been shown to decrease the risk of MI in patients with …

Case Report: Unilateral Internuclear Ophthalmoplegia As First Manifestation In Multiple Sclerosis, Imaad Zaman, Tyler Adame, Steven Do, Kien Nham, Azeem Muhammad

North Texas Research Forum 2024

Multiple Sclerosis is an inflammatory disorder of the central nervous system secondary to myelin degeneration. The disease is mediated by reactive lymphocytes where the spinal cord, brain and optic nerves are attacked. Diagnosis of MS is made clinically and confirmed via MRI with T2 hyperintensities. On presentation, a 26-year-old female with no significant past medical history presented with frequent headaches and blurry vision. There was right eye nystagmus on L lateral gaze with CN III deficits with absent medial rotation. MRI Head presented with a classic presentation of T2 hyperintensities in the subcortical and deep white matter. Further confirmed with …

Bridging The Gap For Hiv Education In Primary Care Setting, Oregon Mcdiarmid, Lindsay Porter

North Texas Research Forum 2024

No abstract provided.

A Bullous Eruption In An 81-Year-Old Male, Garrett S. Furth, Christian J. Scheufele, Carlos S. Bahrami, Stephen E. Weis

North Texas Research Forum 2024

INTRODUCTION: When a patient presents with a blistering rash arriving at the diagnosis can seem overwhelming. Bullous Pemphigoid (BP) is the most common autoimmune blistering disease and tends to affect older individuals, with a mean age of presentation of eighty. It is caused by antibodies targeting the basement membrane zone, the structure between epidermis and dermis, specifically affecting the BP180 (Type-XVII collagen) and BP230 (a plakin) proteins. Antibody-antigen complexes lead to complement activation and destruction of these transmembrane proteins, causing separation of the epidermis and dermis, and formation of tense, subepidermal blisters and bullae. Identification of key clinical features and …

Thymoma With Paraneoplastic Myasthenia Gravis, Dallin Beus, Sherwin Thomas, Amnah Andrabi

North Texas Research Forum 2024

Background: Myasthenia gravis is an autoimmune neuromuscular disorder characterized by muscle weakness and fatigue. Paraneoplastic myasthenia gravis, a rare manifestation of this condition, is often associated with underlying malignancies, such as thymic tumors. We present the case of a 51-year-old female patient with a mediastinal mass who developed paraneoplastic myasthenia gravis, highlighting the diagnostic challenges and therapeutic considerations in such cases. Case Description: A 51-year-old female presented with a one-month history of progressive muscle weakness, diplopia, and dysphagia. Clinical examination and serological tests led to the diagnosis of myasthenia gravis. Computed tomography (CT) imaging revealed a 6 cm mediastinal mass, …

Fungal Empyema Thoracis, A Rare But An Emerging Entity: A Retrospective Case Series From Pakistan, Nousheen Iqbal, Akbar Shoukat Ali, Aqusa Zahid, Kauser Jabeen, Muhammad Irfan

Section of Pulmonary & Critical Care

Background and objective: Fungal empyema is a rare entity which is associated with high mortality. It is mostly seen in immune-compromised hosts. However, there is limited data available on fungal empyema from developing countries regarding risk factors, treatment, and outcome. This study was conducted to determine the risk factors, clinical features, treatment, and outcome of fungal empyema.
Methods: A retrospective observational study was performed on proven fungal empyema cases, admitted at Aga Khan University Hospital, Karachi, Pakistan during January 2018 to May 2021. We excluded all those patients with polymicrobial bacterial and fungal empyema or with negative pleural fluid cultures. …

Lifestyle And Dietary Modifications For Reducing Psoriatic Disease Activity: A Comprehensive Review, Andrea Nguyen, Jessica Garner

Pacific Journal of Health

Abstract: Psoriasis is a prevalent, immune-medication disorder affecting millions of individuals in the United States, leading to substantial healthcare costs (Armstrong, 2021; Brenzinski, 2015). Psoriasis has an established correlation with comorbidities such as hypertension, coronary artery disease, obesity, dyslipidemia, and metabolic syndrome (Al-Mutairi, 2010). Due to the substantial socioeconomic burden psoriatic disease poses on modern day society, significant benefit could be derived from identifying nonprescription strategies for patients to adopt in order to reduce disease activity. This comprehensive review includes 33 publications from 2008 to 2023, evaluating non-prescription therapeutic strategies including lifestyle modification and anti-inflammatory dietary changes. The analysis suggests …

Multisystem Inflammatory Syndrome In Children (Mis-C): Is There A Relationship To Typhus?, Juliana Hager, Juliana Hager, Jacob Smith

Research Colloquium

The United Kingdom first reported in April 2020 a group of eight previously healthy children with a link to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that presented with systemic inflammation and multi-organ involvement, now named multisystem inflammatory syndrome in children (MIS-C). The Centers of Disease Control and Prevention (CDC) have reported over 1000 cases since the primary discovery as of October 2020 with 20 total deaths. [1] The clinical features of MIS-C have been previously compared to inflammatory syndromes including Kawasaki disease (KD) and toxic shock syndrome (TSS). We describe the clinical presentation and management for 3 pediatric cases with …

A Very Di-Still-Ed Diagnosis- Adult-Onset Still’S Disease Presenting In A Middle-Aged Hispanic Patient, Christine E. Loftis, Juan Naranjo, Shadi Jafari-Esfahani, Andrew Guerra, Emilia C. Dulgheru

Research Symposium

Background: Adult-Onset Still’s Disease (AOSD) is a systemic inflammatory disorder characterized by daily high fevers, arthritis, evanescent rash, and leukocytosis (1). Patients can present without typical manifestations and pose a challenging differential. We present a case of a 52-year-old gentleman with a one-year history of recurring fever, lymphadenopathy, and weight loss diagnosed with AOSD. This case highlights the diagnostic challenge that AOSD poses and the strategies to help aid in the diagnosis.

Case Presentation: A 52-year-old gentleman presented to the ED for a 2-week history of fever associated with chills and bone pain. He reported that he has been having …

The Importance Of A Broad Differential Diagnosis: Hepatitis C Virus Associated Cryoglobulinemic Vasculitis, Shadi Jafari-Esfahani, Christine E. Loftis, Juan Naranjo, Emilia Dulgheru

Research Symposium

Introduction: Mixed cryoglobulinemia syndrome (MCS) is a systemic inflammatory syndrome affecting small-medium sized vessels due to the presence of type II or III cryoglobulins in the serum. MSC can manifest as systemic vasculitis with symptoms varying from weakness, arthralgia, palpable purpura, peripheral neuropathy, and renal involvement. The most common cause of MCS includes lymphoproliferative disorders, autoimmune diseases and viral infections, with hepatitis C virus (HCV) being the most common etiology.

Case Presentation: A 60-year-old lady was referred to our office for evaluation of rheumatoid arthritis. She reported history of bilateral thumb pain, bilateral knee pain associated with episodes of swelling, …

Granulomatous Mastitis: A Rare Or An Underdiagnosed Disease?, Shadi Jafari-Esfahani, Juan Naranjo, Christine E. Loftis, Emilia Dulgheru

Research Symposium

Introduction:Granulomatous mastitis (GM) is a benign chronic inflammatory breast disease that is poorly understood, with no universal agreement on underlying etiologies and treatment protocol. The proposed etiologies include trauma, metabolic processes, hormonal changes, autoimmune disorders, and infections. This entity commonly presents with unilateral painful firm and erythematous breast mass, and less frequently with areolar retraction, fistula formation and ulceration. The disease is more common in Hispanic and Asian population. Due to its inflammatory nature, the mainstay of treatment includes a tapered course of high-dose corticosteroid, and methotrexate has proven to be effective in some cases.

Case Presentation: A 47-year-old …

Clinical Characteristics And Risk Factors For Mortality During The 'First Wave' Of Covid-19 In Reynosa, Tamaulipas, Luis G. Vargas Garcia, Francisco E. Díaz Cisneros, Antonio Gutiérrez Sierra, Juan Rosales Martínez, Manlio F. Lara Duck, Netzahualcoyotl Mayek Pérez

Research Symposium

Background: The COVID-19 pandemic has impacted public health in Mexico. As of February 2020, there have been at least four "waves" of contagion that resulted in 5.82 million positive cases and more than 325 thousand deaths. At the beginning of the COVID-19 pandemic, hospital and population-based information was available, frequently with non-specific symptoms. Little was known about the risk factors for mortality in specific conditions. We described the clinical characteristics of patients with COVID-19 in Reynosa, Tamaulipas during 2020 and identified the risk factors for mortality.

Methods: The COVID-19 cases registered from March to November 2020 in Reynosa were divided …

Acute Eosinophilic Pneumonia In A Patient With Long Standing Behcet’S Syndrome, Juan C. Naranjo, Shadi J. Estefahani, Christine E. Loftis, Emilia Dulgheru

Research Symposium

Background: Behcet’s syndrome (BS) is a multisystemic disease that frequently manifests as oral and genital ulcers. Pulmonary involvement occurs in approximately 18% of patients and can have complex clinical manifestations, including vascular disease, hemorrhage, infarctions, and organizing pneumonia. Broad-spectrum radiological findings like loss of lung volume, lung opacities, and indistinct nodular or reticular lesions have been described. There is little data on the association between Behcet’s disease and eosinophilic pneumonitis; the latest is usually characterized by eosinophilic infiltration of the lung parenchyma caused by a hypersensitivity reaction to an inhaled antigen. Patients usually present with nonproductive cough, dyspnea, fever, and …

That Which Keeps On Giving - A Case Of Class Iv Diffuse Proliferative Lupus Nephritis In A Hispanic Woman With Underlying Systemic Lupus Erythematosus, Josenny L. Rodriguez-Paez, Christine E. Loftis, Rosa White-Guedez

Research Symposium

Background: Glomerulonephritis is the primary cause of morbidity and mortality of systemic lupus erythematosus (SLE). Lupus nephritis is characterized by immune complex deposition in the mesangium leading to complement activation and hypocomplementemia. Studies show that up to 60% of adults with lupus develop renal involvement and it has been well established that Hispanic patients show poorer outcomes than Caucasians despite advances in treatment. Preserved kidney function with new-onset proteinuria should raise clinical suspicion for acute lupus nephritis. Further evaluation with a kidney biopsy is paramount in establishing a diagnosis, helping to define treatment strategy, and determining response to treatment.

Case …

Individual Difference Correlates Of Being Sexually Unrestricted Yet Declining An Hiv Test, Nicholas S. Holtzman, Stephen W. Carden, Stacy W. Smallwood, Janice Steirn, S. Mason Garrison

Department of Mathematical Sciences Faculty Publications

Which individual differences accurately predict one’s decision to get tested for human immunodeficiency virus (HIV), and do individuals who have regular short-term sex get tested at higher rates? Two studies—one lab study (total valid N = 69, with n = 20 who were tested) and one involving a student health center (valid N = 250, n = 4 who were tested)—involved participants (total valid N = 319, with n = 24 who got tested) taking a number of personality and individual difference measures, including the dark triad (Machiavellianism, narcissism, and psychopathy). Then, in both studies, participants had the opportunity to …

Objectivity, Practicality, And Significance Of Practice Guidelines For The Practicing Neurologists: What We Learnt From Consensus Criteria In Cidp, Myasthenia Gravis And Inflammatory Myopathies, Marinos C. Dalakas

Department of Neurology Faculty Papers

The value of practice guidelines in the three most common autoimmune neuromuscular disorders, namely Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), Myasthenia Gravis (MG) and Autoimmune Inflammatory Myopathies (AIM), has been extensively debated regarding their usefulness in clinical practice, objectivity and universal value considering that guidelines are also established regionally in certain countries. This commentary highlights common concerns on how guidelines are presently generated, pointing out: (a) non-sufficient diversity among Task-Force members to identify and address not only routine clinical and electrophysiology issues but also immunology, imaging, pathology, biomarkers, epidemiology or treatment economics; (b) Task-Force being often comprised by the same or …

A Tale Of Two Situations: A Case Report Of The Merger Between Dermatology Outcomes And Prescription Drug Access, Kara Ye, Yasseen Amellal, Will Evans, Theresa Rohr-Kirchgraber

Cooper Rowan Medical Journal

This case report illustrates a case of guttate psoriasis in a young adult and the logistical role dermatologists can play in patients acquiring their prescriptions and improving the quality of their care.

Role Of Circular Rna Asph In Macrophage Polarization And Response In Sepsis, Tan Ze Wang

Electronic Thesis and Dissertation Repository

Circular RNAs (circRNAs), a novel non-coding RNA species generated by back-splicing, has been shown to participate in gene regulation of leukocytes. Our previous RNA sequencing results show circular RNA ASPH (circASPH) to be highly expressed in peripheral blood mononuclear cells of sepsis patients at the start of intensive care. Macrophages, as ubiquitous innate immune cells, are responsible for the recruitment of other immune cells at sepsis onset. This work investigates the role of circASPH in the regulation of macrophage polarization in sepsis. Using an in vitro THP-1 cell model, it was found that circASPH levels peaked after 24 h of …