Granulomatosis

Interferon gamma-lb (Imukin ) is used to reduce the incidence of infections in the treatment of chronic granulomatosis. 

PA S1 S01.134 Myeloblastin Antigen against which the autoimmunity of Wegener s granulomatosis is directed... 

Wegener granulomatosis or small 3 51% Proteinase-3 (cANCA) silica, solvents... 

Nuyts, G.D. et al., Wegener granulomatosis is associated to exposure to silicon compounds A case-control study, Nephrol. Dial. Transplant., 10, 1162, 1995. 

Pillinger, M.. and Staud, R., Wegener s granulomatosis in a patient receiving propylthiouracil for Graves disease, Semin. Arthritis Rheum., 28, 124, 1998. 

Chronic granulomatous disease (CGD) is a recently-described disorder, first reported some 40 or so years ago as fatal granulomatosis of childhood ,... 

Weller RW, Crellin AJ. 1953. Pulmonary granulomatosis following extensive use of paradichlorobenzene. Arch Intern Med 91 408-413. 

Toxieology. Exposure to compounds of beryllium may cause dermatitis, acute pneumonitis, and chronic pulmonary granulomatosis (berylliosis) in humans. The compounds are carcinogenic in experimental animals and considered to be suspected human carcinogens. 

Miscellaneous Epistaxis dry nose or mouth transient chest pain (rarely persists after discontinuation) vasculitis (including Wegener s granulomatosis) anemia lymphadenopathy edema tinnitus hearing impairment weight loss. 

Azathioprine also has applications in certain disorders with autoimmune components, most commonly rheumatoid arthritis. It is as effective as cyclophosphamide in the treatment of Wegener s granulomatosis. It has largely been replaced by cyclosporine in immunosuppressive therapy. Relative to other cytotoxic agents, the better oral absorption of azathioprine is the reason for its more widespread clinical use. 

H. Other considerations Enbrel has been designated an orphan product for use in the treatment of juvenile rheumatoid arthritis and Wegener s granulomatosis. 

Cyclophosphamide is active against rheumatoid arthritis when given orally at dosages of 2 mg/kg/d but not when given intravenously. It is used regularly to treat systemic lupus erythematosus, vasculitis, Wegener s granulomatosis, and other severe rheumatic diseases. 

Cyclosporine is approved for use in rheumatoid arthritis and retards the appearance of new bony erosions. Its usual dosage is 3-5 mg/kg/d divided into two doses. Anecdotal reports suggest that it may be useful in systemic lupus erythematosus, polymyositis and dermatomyositis, Wegener s granulomatosis, and juvenile chronic arthritis. 

MMF is effective for the treatment of renal disease due to systemic lupus erythematosus and may be useful in vasculitis and Wegener s granulomatosis. Although MMF is occasionally used at a dosage of 2 g/d to treat rheumatoid arthritis, there are no well-controlled data regarding its efficacy in this disease. 

Other rheumatic diseases in which the corticosteroids potent anti-inflammatory effects may be useful include vasculitis, systemic lupus erythematosus, Wegener s granulomatosis, psoriatic arthritis, giant cell arteritis, sarcoidosis, and gout. 

Enzyme deficiency causing chronic granulomatosis hydroxyl radicals. Myeloperoxidase is an important enzyme in this pathway. A genetic defect in NADPH oxidase causes chronic granulomatosis, a disease characterized by severe, persistent, chronic pyogenic infections. 

Erban SB, Sokas RK. Kaposi s sarcoma in an elderly man with Wegener s granulomatosis treated with cyclophosphamide and corticosteroids. Arch Intern Med 1988 148(5) 1201-3. 

Lapiere CM, Pierard GE, Hermanns JF, Lefebvre P. Unusual extensive granulomatosis after long-term use of plastic syringes for insulin injections. Dermatologica 1982 165(6) 580-90. 

The adverse effects associated with methylphenidate are generally mild and short-lived, with the most common effects being insomnia, decreased appetite, stomach ache, headache, and jitteriness. Although methylphenidate has been abused, the problem of abuse is generally seen in adults who use multiple substances or in adolescents experimenting with medications (28). Sweden withdrew methylphenidate from its market in 1968 because some adults dissolved tablets and injected the solution, leading to serious cases of talc granulomatosis (38). However, most cases of methylphenidate abuse apparently have led to less serious consequences (28). 

Although the most common methotrexate dosing regimens for the treatment of rheumatoid arthritis are 15 or 17.5 mg weekly, there is an increased effect up to 30 or 35 mg weekly. The drug decreases the rate of appearance of new erosions. Evidence supports its use in juvenile chronic arthritis, and it has been used in psoriasis, psoriatic arthritis, polymyositis, dermatomyositis, Wegener s granulomatosis, giant cell arteritis, subacute lupus erythematosus, and vasculitis. 

Chen W-J, Monnat RJJ, Chen M, et al. 1978. Aluminum induced pulmonary granulomatosis. Hum Pathol 9 705-711. 

De Vuyst P, Dumortier P, Schandene L, et al. 1987. Sarcoidlike lung granulomatosis induced by aluminum dusts. Am Rev Respir Dis 135 493-497. 

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