Mild SLE:
• Fever
• Arthralgia or arthritis
• Rash, headache
• Mild pericarditis or mild pericardial effusion
• Mild pleural effusion.
Severe SLE:
• Massive pleural effusion
• Massive pericardial effusion
• Renal involvement
• CNS involvement
• Acute vasculitis
• Myocarditis
• Lupus pneumonitis
• Hemolytic anemia
• Thrombocytopenic purpura.
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• Fever
• Arthralgia or arthritis
• Rash, headache
• Mild pericarditis or mild pericardial effusion
• Mild pleural effusion.
Severe SLE:
• Massive pleural effusion
• Massive pericardial effusion
• Renal involvement
• CNS involvement
• Acute vasculitis
• Myocarditis
• Lupus pneumonitis
• Hemolytic anemia
• Thrombocytopenic purpura.
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In Systemic Sclerosis"SScl":
-ANA is positive in about 70%.
-About 30% of patients with "diffuse" dcSScl have antibodies to topoisomerase 1 (Scl70).
-About 60% of patients with "limited" lcSScl syndrome have anticentromere antibodies.
Bosentan
MOA: endothelin-1 antagonist.
Uses: treating ischaemic digital ulcers in severe Raynaud’s syndrome in SScl.
Also early treatment of Progressive pulmonary hypertension.
"Watermelon stomach"
Recurrent occult upper gastrointestinal bleeding may indicate it (antral vascular ectasia; up to 20% of patients with systemic sclerosis).
Pneumatosis cystoides intestinalis, in which there is radiolucent cyst or streaks in the wall of small intestine due to air in the intestinal wall can occur.
The patient presents with severe abdominal pain.
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-ANA is positive in about 70%.
-About 30% of patients with "diffuse" dcSScl have antibodies to topoisomerase 1 (Scl70).
-About 60% of patients with "limited" lcSScl syndrome have anticentromere antibodies.
Bosentan
MOA: endothelin-1 antagonist.
Uses: treating ischaemic digital ulcers in severe Raynaud’s syndrome in SScl.
Also early treatment of Progressive pulmonary hypertension.
"Watermelon stomach"
Recurrent occult upper gastrointestinal bleeding may indicate it (antral vascular ectasia; up to 20% of patients with systemic sclerosis).
Pneumatosis cystoides intestinalis, in which there is radiolucent cyst or streaks in the wall of small intestine due to air in the intestinal wall can occur.
The patient presents with severe abdominal pain.
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In SLE:
-The most common respiratory complication of SLE is PLEURISY.
-Most common muscloskeltal manifastation of SLE
is ARTHRALGIA 100٪.
-Most common renal complication of SLE is diffuse lupus.Also most severe.
-The most common haematologic features of SLE is lekupenia/lymphopenia.
-The most common cause of death in SLE is the renal impairment.
-Most common dermatologic manifastations or characteristic of SLE is MALAR RASH.
-The most common cardiac complication of SLE is PERICARDITIS.
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-The most common respiratory complication of SLE is PLEURISY.
-Most common muscloskeltal manifastation of SLE
is ARTHRALGIA 100٪.
-Most common renal complication of SLE is diffuse lupus.Also most severe.
-The most common haematologic features of SLE is lekupenia/lymphopenia.
-The most common cause of death in SLE is the renal impairment.
-Most common dermatologic manifastations or characteristic of SLE is MALAR RASH.
-The most common cardiac complication of SLE is PERICARDITIS.
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•Gingival overgrowth is a common side effect of phenytoin.
Other causes:
-Anticonvulsants (such as phenytoin, phenobarbital, vigabatrin, ethosuximide, topiramate and primodone NOT common for valproate)
-Calcium channel blockers (antihypertensives such as nifedipine, amlodipine, and verapamil).
-The dihydropyridine derivative isradipidine can replace nifedipine and does not induce gingival overgrowth.
-Cyclosporine, an immunosuppressant.
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Other causes:
-Anticonvulsants (such as phenytoin, phenobarbital, vigabatrin, ethosuximide, topiramate and primodone NOT common for valproate)
-Calcium channel blockers (antihypertensives such as nifedipine, amlodipine, and verapamil).
-The dihydropyridine derivative isradipidine can replace nifedipine and does not induce gingival overgrowth.
-Cyclosporine, an immunosuppressant.
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•Imatinib
-In ALL and CML with philadelphia chromosome.
-Common side effects include vomiting, diarrhea, muscle pain, headache, and rash. Severe side effects may include fluid retention, gastrointestinal bleeding, bone marrow suppression, liver problems, and heart failure.
-Use during pregnancy may result in harm to the fetus.
-Imatinib works by stopping the Bcr-Abl tyrosine-kinase.
-This can slow growth or result in programmed cell death of certain types of cancer cells.
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-In ALL and CML with philadelphia chromosome.
-Common side effects include vomiting, diarrhea, muscle pain, headache, and rash. Severe side effects may include fluid retention, gastrointestinal bleeding, bone marrow suppression, liver problems, and heart failure.
-Use during pregnancy may result in harm to the fetus.
-Imatinib works by stopping the Bcr-Abl tyrosine-kinase.
-This can slow growth or result in programmed cell death of certain types of cancer cells.
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•What are the myeloproliferative disorder?
Group of disease consisting of:
-Chronic myelocytic leukemia
-Myelofibrosis
-Polycythemia rubra vera
-Essential thrombocythemia.
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Group of disease consisting of:
-Chronic myelocytic leukemia
-Myelofibrosis
-Polycythemia rubra vera
-Essential thrombocythemia.
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-Loss of chromosome 17p or mutation in the TP53 gene, which resides at this genetic locus, is a powerful prognostic marker and predictor of response to therapy in patients with CLL.
-A mutation in TP53 is present in < 10% of patients at presentation but rises to 30% of cases at relapse. This test
should be performed in all patients prior to the initiation of therapy.
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-A mutation in TP53 is present in < 10% of patients at presentation but rises to 30% of cases at relapse. This test
should be performed in all patients prior to the initiation of therapy.
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In HL:
-A normochromic, normocytic anaemia or lymphopenia is present, this is a poor prognostic factor.
-An eosinophilia or a neutrophilia may be present.
-Bulky disease (> 10 cm in a single node mass) is an adverse prognostic feature.
-LDH measurements showing raised levels are an adverse prognostic feature.
-ABVD chemotherapy can cause cardiac and pulmonary toxicity, due to doxorubicin and bleomycin, respectively.
-The incidence of infertility and secondary myelodysplasia/AML is low with the above regimen.
-Brentuximab vedotin is an antibody–drug conjugate directed against CD30 on the Reed–Sternberg cell surface. Can produce good responses in patients who have failed, or are not suitable for, an autologous transplant and can be a ‘bridge’ to an allogeneic transplant.
-Reed-Sternberg cell is the hallmark of Hodgkin’s disease. Rarely, found in:
1-Infectious mononucleosis,
2-Recurrent Burkitt’s lymphoma and
3-CLL.
-High alkaline phosphatase (biliary obstruction) indicates involvement of lymph nodes in porta hepatis.
-Adriamycin = doxorubicin.
-Hasenclever prognostic index for advanced HL. "Quiz"
-Differences between HL&NHL." Writing "
-Indications of chemo /radiotherapy."Writing"
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-A normochromic, normocytic anaemia or lymphopenia is present, this is a poor prognostic factor.
-An eosinophilia or a neutrophilia may be present.
-Bulky disease (> 10 cm in a single node mass) is an adverse prognostic feature.
-LDH measurements showing raised levels are an adverse prognostic feature.
-ABVD chemotherapy can cause cardiac and pulmonary toxicity, due to doxorubicin and bleomycin, respectively.
-The incidence of infertility and secondary myelodysplasia/AML is low with the above regimen.
-Brentuximab vedotin is an antibody–drug conjugate directed against CD30 on the Reed–Sternberg cell surface. Can produce good responses in patients who have failed, or are not suitable for, an autologous transplant and can be a ‘bridge’ to an allogeneic transplant.
-Reed-Sternberg cell is the hallmark of Hodgkin’s disease. Rarely, found in:
1-Infectious mononucleosis,
2-Recurrent Burkitt’s lymphoma and
3-CLL.
-High alkaline phosphatase (biliary obstruction) indicates involvement of lymph nodes in porta hepatis.
-Adriamycin = doxorubicin.
-Hasenclever prognostic index for advanced HL. "Quiz"
-Differences between HL&NHL." Writing "
-Indications of chemo /radiotherapy."Writing"
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•Amantadine
Side effects include restlessness, confusion, depression, skin rashes, edema, nausea, constipation, anorexia, postural hypotension, and disturbances of cardiac rhythm.
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Side effects include restlessness, confusion, depression, skin rashes, edema, nausea, constipation, anorexia, postural hypotension, and disturbances of cardiac rhythm.
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