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March 2015

Volume 1 Issue 1
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Case Report
Acute Eosinophilic Pneumonia in a Patient with Inflammatory Bowel Disease

Jacqueline N. Chu*, BA and Errol Ozdalga, MD

Acute eosinophilic pneumonia (AEP) is an uncommon respiratory disease characterized by increased eosinophilis in bronchoalveolar lavage fluid. It may be triggered by a drug, infection, or dust. The etiology may also be idiopathic, in which case the patient is usually a young, previously healthy smoker. We report a case of AEP in an elderly non-smoking patient with ulcerative colitis, treated with a total colectomy one decade prior to presentation. Though cases of AEP have been reported in association with anti-metabolite therapy for inflammatory bowel disease, our patient was not taking any such medications. He also did not have exposure to any other known triggers of AEP, and did not fit the usual clinical picture of idiopathic AEP. Therefore, we suspect that this case of AEP was a complication of the patient’s inflammatory bowel disease itself.

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Case Report

What can Comprehensive Cognitive Behavioural Therapy Achieve in People with Spider Phobia? – A Case Series

Barry Wright*, Juliette Kennedy, Sophie Bennett, Laura Manea, Heather Tomlinson, Lucy Tindall, Ben Alderson-Day

This study evaluated the effectiveness of an optimised and comprehensive cognitive behavioural therapy (CBT) course for spider phobia using the most up-to-date, evidence-based techniques combined into a treatment programme.              

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Case Report

Improvement of Knee Joint and Laboratory Markers of a Rheumatoid Arthritis Patient Treated with Tocilizumab

Wataru Shimada, Yasunori Itoh, Osamu Matsuo and Hiraku Kikuchi*

Here, we report on the case of 27-year-old women with rheumatoid arthritis [RA] whose symptoms improved after the administration of tocilizumab [TCZ] following long-term biological disease-modifying anti-rheumatic drugs treatment. The clinical changes in her signs and symptoms were confirmed by radiographic analysis of the affected knee joint and laboratory markers including C-reactive protein, matrix metalloproteinase-3, amino-terminal telopeptides of type 1 collagen [NTX], osteocalcin, interleukin-6, anti-cyclic citrullinated peptide, carboxy-terminal telopeptides od type 2 collagen [CTX-2], Dikkopf-1 [DKK-1], and osteoprotegerin [OPG] levels.

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Case Report

A Rare Case of ST Segment Elevation in Anterior Leads Due to Transient Acute Marginal Branch Occlusion During Right Coronary Artery Stenting

Musuraca G*, Agostoni P, Terraneo C, Di Matteo I, Boldi E, Albiero R

Isolated right ventricular infarction is an extremely rare phenomenon which may be difficult to recognize. Also, it is rare to observe ST segment elevation in anterior leads caused by isolated, transient acute marginal branch occlusion. We described the case of a patient suffering Acute coronary syndrome with transient ST segment elevation in precordial leads from V1 to V4, due to isolated right side branch occlusion during right coronary artery stenting.

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Case Report

Acute Diffuse Alveolar Hemorrhage following Intravesical Bacille Calmette-Guérin Immunotherapy for Superficial Bladder Cancer
Antonielli E*, Pieralli F, Mancini A, Sammicheli L, Mari A, Nozzoli C, Lapini A

Hypersensitivity pneumonitis (HP) is an immunologically mediated lung disease caused by repeated exposition to organic antigens. Among many other and more common etiologies, intravesicaladministration of Bacille Calmette-Guérin (BCG) has been rarely described as a cause of HP. Moreover, HP rarely is so grave to cause widespread damage of the alveolocapillary membrane, an anatomical-clinical condition known as diffuse alveolar haemorrhage (DAH). DAH is a very severe syndrome that is burdened by high mortality despite aggressive treatment, and nowadays no cases of DAH following intravesical BCG administration have been reported in medical literature. Herein, we report the first case of HP associated with DAH caused by intravesical BCG administration for the treatment of superficial bladder cancer.

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