Personal non-commercial use only

ABSTRACT. Autoimmune thyroid disease (AITD) is an inflammatory thyroiditis that in some cases is characterized by lymphocytic infiltration of the thyroid gland, also referred to as chronic lymphocytic thyroiditis or Hashimoto thyroiditis. Hashimoto thyroiditis is one of the commonest causes of hypothyroidism. Hypothyroidism has been associated with osteoarthritis (OA) and inflammatory forms of arthritis and with several well defined connective tissue diseases, which in turn can cause arthritis. The presence of arthritis in patients with AITD with normal thyroid function is now being increasingly recognized. There is also considerable evidence to suggest that AITD is highly associated with fibromyalgia syndrome. We review the current literature on the rheumatologic manifestations of AITD and describe the features in its presentation that set it apart from other forms of autoimmune arthritis. (J Rheumatol First Release April 15 2012; doi:3899/jrheum.120022

Secretion of beta-human chorionic gonadotropin by non-small cell lung cancer: a case report

<p>Abstract</p> <p>Introduction</p> <p>We describe a case of non-small cell lung cancer that was found to stain positive for beta-human chorionic gonadotropin on immunohistochemistry. Only a few case reports have described lung cancers that secrete beta-human chorionic gonadotropin.</p> <p>Case presentation</p> <p>A 68-year-old Caucasian man presented with symptoms of weakness, fatigue and weight loss for the past two months. On examination, he was found to have generalized lymphadenopathy, and radiologic workup revealed numerous metastases in the lungs, liver and kidneys. Biopsy of the supraclavicular lymph node revealed metastatic large cell lung cancer with beta-human chorionic gonadotropin hormone positivity. The serum beta-human chorionic gonadotropin level was 11,286 mIU/ml (upper limit of normal, 0.5 mIU/ml in non-pregnant females). He was diagnosed with stage 4 lung non-small cell lung cancer. The patient refused chemotherapy. He was discharged home with hospice care.</p> <p>Conclusion</p> <p>The markedly elevated serum values of beta-human chorionic gonadotropin initially prompted the medical team to investigate germinal tumors. In the presence of a negative testicular ultrasound, workup was performed to find an extratesticular source of the tumor. Finally, the diagnosis was made with a tissue biopsy. This case illustrates that atypical markers can be seen in many cancers, emphasizing the role of immunohistochemistry and tissue biopsy in establishing the diagnosis.</p

Efficacy and safety of fezakinumab (an IL-22 monoclonal antibody) in adults with moderate-to-severe atopic dermatitis inadequately controlled by conventional treatments: a randomized, double-blind, phase 2a trial

BACKGROUND: IL-22 promotes epidermal hyperplasia and inhibits skin barrier function. OBJECTIVE: Evaluate IL-22 blockade in adults with moderate-to-severe atopic dermatitis (AD). METHODS: Randomized, double-blind, placebo-controlled trial with intravenous fezakinumab monotherapy every 2wks for 10wks, with follow-up assessments until 20wks. SCORAD change from baseline at 12wks served as primary endpoint. RESULTS: At 12wks, mean SCORAD decline was 13·8±2·7 (fezakinumab) vs. 8·0±3·1 (placebo) for the entire population (p=0·134). In severe patients (baseline SCORAD≥50), SCORAD decline was significantly stronger in drug vs. placebo at 12wks (21·6±3·8 vs. 9·6±4·2, p=0.029) and 20wks (27·4±3·9 vs. 11·5±5·1, p=0·010). At 12wks, improvements were significantly stronger in drug vs. placebo (12·4%±2·4 vs. 6·2%±2·7; p=0·009) for BSA in the entire population, and for IGA in severe patients (0·7±0·2 vs. 0·3±0·1; p=0·034). All scores showed progressive improvements after last dosing (10wks) until end of study (20wks). Common adverse events were upper respiratory tract infections. LIMITATIONS: Limited sample size, lack of EASI and numerical rating scale (NRS) pruritus assessments; significance primarily obtained in severe AD. CONCLUSION: Fezakinumab was well-tolerated, with sustained clinical improvements after last drug dosing