zithromax and Autoimmune-Diseases

The recognition of the five criteria for PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) by Swedo et al established a homogenous subgroup of children with childhood onset obsessive-compulsive disorder (OCD) and/or tic disorders. The five clinical characteristics that define the PANDAS subgroup are the presence of OCD and/or tic disorder, prepubertal age of onset, abrupt onset and relapsing-remitting symptom course, association with neurological abnormalities during exacerbations (adventitious movements or motoric hyperactivity), and a temporal association between symptom exacerbations and a Group-A beta-hemolytic streptococcal (GAS) infection. These five criteria have been used for the purpose of systematic research on the phenomenology and unique therapies for the PANDAS subgroup as well as studies of the pathophysiology of post-streptococcal OCD and tic disorders. The etiology of OCD and tics in the PANDAS subgroup is unknown, but is theorized to occur as a result of post-streptococcal autoimmunity in a manner similar to that of Sydenham's chorea. The working hypothesis for the pathophysiology begins with a GAS infection in a susceptible host that incites the production of antibodies to GAS that crossreact with the cellular components of the basal ganglia, particularly in the caudate nucleus and putamen. The obsessions, compulsions, tics, and other neuropsychiatric symptoms seen in these children are postulated to arise from an interaction of these antibodies with neurons of the basal ganglia.

Topics: Antibiotic Prophylaxis; Autoimmune Diseases; Azithromycin; Basal Ganglia; Child; Child, Preschool; Chorea; Double-Blind Method; Forecasting; Frontal Lobe; Humans; Immunoglobulins, Intravenous; Infant; Models, Neurological; Neurons; Obsessive-Compulsive Disorder; Penicillins; Plasma Exchange; Randomized Controlled Trials as Topic; Research; Rheumatic Fever; Streptococcal Infections; Streptococcus pyogenes; Tic Disorders

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Antibodies, Monoclonal, Humanized; Antirheumatic Agents; Arthritis, Rheumatoid; Autoimmune Diseases; Azithromycin; Biological Products; COVID-19; COVID-19 Drug Treatment; Enzyme Inhibitors; Female; Glucocorticoids; Hospitalization; Humans; Hydroxychloroquine; Immunomodulation; Immunosuppressive Agents; Inflammatory Bowel Diseases; Intensive Care Units; Janus Kinase Inhibitors; Male; Middle Aged; Respiration, Artificial; Sarcoidosis; SARS-CoV-2; Surveys and Questionnaires; Tumor Necrosis Factor Inhibitors; Young Adult

Topics: Acute Disease; Anti-Bacterial Agents; Autoimmune Diseases; Azithromycin; Behavior Therapy; Child; Diagnosis, Differential; Humans; Male; Obsessive-Compulsive Disorder; Penicillins; Streptococcal Infections

To describe clinical characteristics of patients with rheumatic and musculoskeletal diseases (RMDs) and immunosuppressive therapies with Coronavirus disease 2019 (COVID-19) at an academic rheumatology center in Madrid and to identify baseline variables associated with a severe infection requiring hospitalization.. We identified SARS-CoV-2 positive cases by polymerase chain reaction performed at our center within an updated RMDs database in our clinic. Additional RMDs patients were identified when they contacted the clinic because of a positive infection. Data extraction included diagnosis, demographics, immunosuppressive treatment, comorbidities, and laboratory tests. Comparisons between patients with or without hospitalization were performed. Multivariate logistic regression was used to analyze associations between baseline variables and need for hospitalization.. A total of 62 patients with COVID-19 and underlying RMDs were identified by April 24, 2020. Median age was 60.9 years, and 42% men. Forty-two patients required hospitalization; these were more frequently men, older and with comorbidities. There were no statistically significant between-group differences for rheumatologic diagnosis and for baseline use of immunosuppressive therapy except for glucocorticoids that were more frequent in hospitalized patients. Total deaths were 10 (16%) patients. In multivariate analysis, male sex (odds ratio [OR], 8.63; p = 0.018), previous lung disease (OR, 27.47; p = 0.042), and glucocorticoids use (> 5 mg/day) (OR, 9.95; p = 0.019) were significantly associated to hospitalization.. Neither specific RMD diagnoses or exposures to DMARDs were associated with increased odds of hospitalization. Being male, previous lung disease and exposure to glucocorticoids were associated with higher odds of hospitalization in RMDs patients.

Topics: Aged; Anti-Bacterial Agents; Antibodies, Monoclonal, Humanized; Antirheumatic Agents; Antiviral Agents; Arthritis, Psoriatic; Arthritis, Rheumatoid; Autoimmune Diseases; Azithromycin; Betacoronavirus; Comorbidity; Coronavirus Infections; COVID-19; COVID-19 Drug Treatment; Drug Combinations; Female; Glucocorticoids; Hospitalization; Humans; Hydroxychloroquine; Immunosuppressive Agents; Logistic Models; Lopinavir; Lung Diseases; Lupus Erythematosus, Systemic; Male; Middle Aged; Multivariate Analysis; Pandemics; Pneumonia, Viral; Retrospective Studies; Ritonavir; SARS-CoV-2; Severity of Illness Index; Sex Factors; Spain

Linear immunoglobulin A (IgA) bullous dermatosis (LABD) is a rare autoimmune disorder characterized by vesiculobullous mucocutaneous eruptions. LABD also has been reported as a drug-induced reaction. Idiopathic LABD and drug-induced LABD are clinically indistinguishable and can resemble bullous pemphigoid, dermatitis herpetiformis, or bullous erythema multiforme. LABD is diagnosed with direct immunofluorescence (DIF), and idiopathic LABD can be distinguished from drug-induced LABD with a careful medication history. We present the case of a 54-year-old man with drug-induced LABD after ingestion of rimantadine, zanamivir, and azithromycin for presumed influenza. The patient's bullous eruption resolved with discontinuation of the offending medications and treatment with prednisone and pentoxifylline.

Topics: Anti-Infective Agents; Autoimmune Diseases; Azithromycin; Diagnosis, Differential; Drug Eruptions; Fluorescent Antibody Technique, Direct; Humans; Immunoglobulin A; Male; Middle Aged; Rimantadine; Skin; Skin Diseases, Vesiculobullous; Stevens-Johnson Syndrome; Zanamivir