Managing mechanical ventilation in patient with bronchopleural fistula with coexisting acute respiratory distress syndrome is a challenging situation for the intensivist. We are reporting a case of a pregnant patient with systemic lupus erythematosus on immunosuppressive medications who developed methicillin-resistant Staphylococcus aureus necrotizing pneumonia complicated by bronchopleural fis...

Joint pain is a common presenting symptom seen in the outpatient setting. Accurate diagnosis is imperative for providing optimal patient care. Our patient is a 50 year old male who presented with many years of joint pain affecting multiple joints. He was diagnosed with seronegative Rheumatoid arthritis. Despite treatment with immunosuppressive medications, his joint symptoms persisted and he de...

Theprognosis for patients with systemic lupus erythematosus (SLE) has improved over the past several decades (1). In some studies, 10-year survival estimates of >90%have been reported. This improvement has likely been the result of more judicious use of immunosuppressive medications including corticosteroids and immunosuppressants and the availability of better treatment for the organ damage th...

Although statin drugs can have adverse effects on muscles and the liver, these effects are uncommon. Caution is warranted in patients at higher risk, ie, those who are elderly, frail, or small; have multisystem disease; are receiving immunosuppressive drugs or other medications that interact with statins; or are receiving higher doses of a statin.

WS Historically, we have treated inflammatory bowel disease (IBD) using small molecules such as prednisone, budesonide, and mesalamine, along with immunosuppressive drugs such as azathioprine, 6-mercaptopurine, and methotrexate. Until infliximab (Remicade, Janssen) was approved in 1998, the treatment of IBD was entirely based on small molecules. Since that time, virtually all new medications ap...

BACKGROUND About 80% to 90% of children with steroid-sensitive nephrotic syndrome (SSNS) have relapses. Of these children, around half relapse frequently, and are at risk of adverse effects from corticosteroids. Non-corticosteroid immunosuppressive medications are used to prolong periods of remission in these children; however, these medications have significant potential adverse effects. Curre...

OBJECTIVES Thus far, there is no active treatment for BK virus-associated nephropathy after a kidney transplant that has proven to be effective. We sought to assess the effectiveness of treatment with leflunomide, intravenous immunoglobulin, and ciprofloxacin on graft outcome after 1 year compared with a historical group treated with reduced immunosuppressive medications strategy. MATERIALS A...

Pruritus is a common problem following a kidney transplant and is usually attributable to new medications related to transplantation. We present an unusual case of pruritus that began several months after kidney transplantation. After changing several immunosuppressive medications, numerous clinical visits and consideration by the patient of stopping immunosuppression, scabies was diagnosed as ...

BACKGROUND Pemphigus vulgaris (PV) patients receiving immunosuppressive therapy may develop nail alterations resulting from infection, skin disorder, or drug regimen. OBJECTIVE This study aims to describe nail changes in PV female patients receiving immunosuppressive therapy and to report the frequency of associated fungal and bacterial growth in the patients' nails. METHODS Twenty-five fem...