Possibility Of Autoimmune Disease Research Articles

Systemic sclerosis (positive anti-Ro 52 and anti-centromere antibodies) in a patient after COVID-19 infection: a rare case report

Introduction and importance: The SARS-CoV-2 is the source of COVID-19, a respiratory disease. It typically manifests as restricted pulmonary symptoms, but autoimmune dysfunction might occasionally show up. A COVID-19 infection may cause a multi-system connective tissue disease known as systemic sclerosis (SSc). In patients who recovered from COVID-19, autoimmunity may have multiple underlying causes. Case presentation: The authors report the case of a 68-year-old female who, 1 month after contracting COVID-19, complained of dyspnoea and muscle exhaustion. The patient was treated for post-COVID syndrome. She developed symptoms of chronic dyspnoea, pale fingers, pursed lips, trouble chewing and swallowing, and muscle weakness after 7 weeks. A chest high-resolution computerised tomography (HRCT) scan suggested interstitial lung disease. Clinical characteristics and an autoantibody profile containing anti-Ro 52 and anti-centromere antibodies pointed towards SSc. She was treated with azathioprine and prednisolone at a reduced dosage, and she is now stable with monthly follow-ups. Clinical discussion: COVID-19 might induce cytokine storms and immunological dysregulation, ultimately culminating in autoimmune manifestations. Several autoantibodies are observed in autoimmune illnesses in post-COVID-19 infection patients. Our situation is distinct because SSc following a COVID-19 infection is not commonly seen as an autoimmune illness. Conclusion: The number of patients with rare autoimmune diseases, like SSc, following COVID-19 has been rising. Therefore, we should consider the possibility of autoimmune disease when looking into a patient who presents strangely or has developed new symptoms after COVID and should contact the patient’s management immediately.

AN UNILATERAL SCLEROMALACIA PERFORANS IN YOUNG PATIENT MANAGED BY MYOCONJUNCTIVAL ENUCLEATION AND DERMIS FAT GRAFT

Introduction : Scleromalacia perforans is a disease that might compromise vision and globe integrity. The possible associations of systemic disease are autoimmune diseases such as rheumatoid arthritis, lupus, and Wegener's granulomatosis. Determining the underlying etiology in such cases also possess a great challenge to treat disease, especially in this case.
 Case Illustration : A 19-year-old female with a progressed protrusion of the left eye since she was 1 year old. Six years ago, she had redness, worsen protrusion, photophobia, tearing, and pain, but resolved without treatment. Her cousin had the same condition but refused to continue the examination. Visual acuityof the left eye was no light perception with 4x4 mm of corneal leukoma, and 360 degrees of anterior scleral ectasia covered with conjunctival neovascularization. USG showed posterior vitreous detachment and 28,9 mm axial length. Systemic examination found ANA test and HLA B27 were normal, positive hypermobility joint, and Rheumatologists ruled out the possibility of autoimmune disease. Myoconjuctival enucleation was performed with a dermis fat graft for cosmesis, and pathological examination showed nonspecific chronic inflammation.
 Discussion : A childhood-onset scleromalacia perforans with positive family history and hypermobility joints might be a sign of connective tissue disorder. Possible autoimmune diseases were ruled out by a rheumatologist. The genetic examinations may be necessary to establish the diagnosis.
 Conclusion : Scleromalacia perforans is rare yet it is strongly believed to have an association with systemic disease. Collaboration between ophthalmologists, rheumatologists, and geneticist is essential to manage this kind of case.

Evaluating Chatgpt As an Adjunct for Analyzing Challenging Case

Introduction Despite the rapid development of medicine, clinicians still faced with many challenging cases in practice. For challenging cases, most inexperienced doctors are unable to make a clear diagnosis in the first place, resulting in misdiagnosis and delayed disease. Recently, OpenAI released a new Chatbot model, called ChatGPT (Generation Pre training Converter), which is an artificial intelligence (AI) system that uses reinforcement learning model based on human feedback for training. There have been many research reports on the application of ChatGPT in the medical field, and it has been proven to have a wide range of clinical applications. In our study, we aimed to assess the accuracy and reliability of ChatGPT in diagnosing and treating challenging case. Methods We provided 2 challenging cases. Case 1 provided a medical history and auxiliary test results for ChatGPT, and then ChatGPT answered the possible diagnosis, diagnostic basis, further auxiliary examination and treatment. Case 2 provides negative symptoms and auxiliary test results for ChatGPT, which answers all possible diagnoses. Conduct a comprehensive evaluation and scoring of the results of ChatGPT responses by 5 senior physicians. A score of 10 is the perfect score. Results The analysis results of 2 challenging cases by ChatGPT were comprehensively evaluated by senior experienced professional doctors and scored 9 points. We found that ChatGPT's analysis of challenging case is comprehensive. Especially for the diagnosis and treatment of diseases, ChatGPT analyzes all possible diagnoses and provides accurate treatment plans through the provided medical history, auxiliary examination results, and treatment processes. ChatGPT can directly interpret the auxiliary examination results, such as high level of procalcitonin (PCT), abnormal kidney function, and with negative results can rule out certain diseases, such as ANA, ENA, and ANCA negative, ruling out the possibility of autoimmune diseases. ChatGPT can summarize all the diagnoses including rare diseases, based on the results of an auxiliary test, and explain the cause of the disease and the pathogenesis in detail. Conclusions Our study shows that ChatGPT can provide important reference value as an adjunct to clinicians in challenging case analysis. In particular, it can assist inexperienced doctors in remote areas and underdeveloped medical conditions to make clear diagnosis and treatment as soon as possible, avoid unnecessary referral to higher-level hospitals, reduce medical burden, and reduce waste of medical resources. In the medical field, ChatGPT needs more research to evaluate in clinical applications and become a better adjunct tool in clinical work.

MPO-ANCA Associated Vasculitis Following COVID-19 Vaccination – A Case Report

Whether autoimmune or rheumatic disease can be precipitated after vaccination is controversial. Only epidemiological studies or clinical trials with an extremely large sample size can allow for a consistent assessment of the relative risk of vaccine-related incidence. Studies with such large sample sizes are complex, difficult to perform, and costly, which limit their administration. There exists no minimum criteria for diagnosing vaccine-related autoimmune diseases, this question must be analyzed on a case-by-case basis. Although our report does not prove a causal association between vaccination and vasculitis, it seems possible that in rare cases, vaccination might induce vasculitic disease. While the possibility of autoimmune disease is very real, without vaccinations the SARS-CoV-2 pandemic will spread unchecked, bringing with it a slew of multisystem disorders, including autoimmune diseases both in the present and future (<em><strong>Table 1, Figures 1, 2</strong></em>).

Association Kikuchi disease with Hashimoto thyroiditis: a case report and literature review.

Kikuchi-Fujimoto disease (KFD) is a benign and self-limited disease characterized by fever and lymphadenopathy. The etiology of KFD is unknown, but an autoimmune cause has been suggested. Hashimoto thyroiditis is the most common autoimmune thyroid disorder in children and is known to be associated with other autoimmune diseases. Only a few cases of Hashimoto thyroiditis associated with KFD have been documented. We report a case of a 16-year-old girl who was first diagnosed with KFD and developed Hashimoto thyroiditis 2 years and 6 months later during her follow-up period. Physicians of patients with KFD should consider the possibility of autoimmune diseases like Hashimoto’s thyroiditis.

A CASE OF MULTIPLE GASTRIC CANCER WITH HIGH GRADE FEVER

We report a case of gastric cancer with high serum levels of IL-6 and G-CSF. A 76-year-old man was admitted to the hospital presented with high grade fever. Although biochemical tests indicated an inflammatory reaction (WBC 11, 800/mm3, CRP 13.9mg/dl) and consequently infection, no other evidence of infection was odtained upon further clinical examinations. Furthermore, a possibility of autoimmune disease was ruled out based on the laboratory data and physical findings. Endoscopic examination, prompted by occult blood in the stool, identified two separate gastric cancer lesions in the antrum and body of the stomach. The fever was resistant to various antibiotics, but administration of Naproxen at a dose of 600mg per day p.o. was effective. We reasoned that the fever was in some way associated with the gastric cancer. After a distal partial gastrectomy was performed, a dramatic crisis, involving rapid reduction of fever and a simultaneous decrease in the levels of IL-6 and G-CSF, occurred. Immunohistochemical stainings for both IL-6 and G-CSF on surgical specimens were negative. We believe that the high serum IL-6 and G-CSF levels were the result of immunoreaction to gastric cancer rather than direct secretion from the cancer cells.