Andrea Péter

Recurrent Arterial Thrombosis Associated With the Antithrombin Basel Variant and Elevated Lipoprotein(a) Plasma Level in an Adolescent Patient

Both myocardial infarction and ischemic stroke are rare in the young. Yet a 15-year-old male patient suffered a myocardial infarction and later an ischemic stroke despite uninterrupted antiplatelet therapy. His medical history involved the surgical correction of an incomplete atrioventricular canal defect at the age of 13 years. No cardiovascular risk factors other than elevated lipoprotein(a) level could be identified. His antithrombin (AT) activity was decreased and DNA sequence analysis revealed heterozygosity for AT Basel (p.Pro41Leu), a variant with impaired heparin binding. This report supports a possible additional pathophysiological role for AT Basel and elevated lipoprotein(a) level in arterial thrombogenesis.

[Anti-NXP2-positive dermatomyositis associated with ulcerative colitis and celiac disease].

The authors discuss a rare case of a 25-year-old female patient having dermatomyositis associated with celiac disease and ulcerative colitis. The idiopathic inflammatory myopathies are systemic, chronic, immune-mediated diseases characterized by proximal, symmetrical muscle weakness. Many examples from the literature refer that celiac disease occurs more often in patients with myositis than in the general population, but its association with ulcerative colitis is a real rarity in the international literature.A szerzők az idiopathias inflammatorikus myopathia ritka, colitis ulcerosaval es coeliakiaval tarsult esetet mutatjak be egy altaluk kezelt, 25 eves dermatomyositises nőbeteg kortorteneten keresztul. Az idiopathias inflammatorikus myopathiak szisztemas, kronikus, immunmedialt megbetegedesek, amelyeket a proximalis vegtagizmok szimmetrikus gyengesege jellemez. Irodalmi peldak utalnak ra, hogy a coeliakia gyakrabban jelentkezik myositisben, mint az atlagpopulacioban. Colitis ulcerosaval valo asszociacioja azonban irodalmi ritkasagnak szamit. Orv. Hetil., 2014, 155(26), 1033–1038.

Transient Long QT Development in a Patient with Takotsubo Cardiomyopathy

Abstract QT interval prolongation on the electrocardiogram is considered a precursory sign for imminent, potentially lethal ventricular arrhythmias. Beside the inherited condition of long QT syndrome, numerous drugs, certain electrolyte disturbances and early transmural ischemia have been identified to induce reversible prolongation of the QT interval, collectively called as acquired long QT syndrome. Herein we describe a case of a patient with transient QT prolongation and Takotsubo cardiomyopathy, a rather infrequent cause of long QT development. Serial changes of the repolarization pattern were documented to demonstrate progression and resolution of the abnormal QT interval.

The association of colitis ulcerosa and coeliakia with idiopathic inflammatory myopathy

The authors discuss a rare case of a 25-year-old female patient having dermatomyositis associated with celiac disease and ulcerative colitis. The idiopathic inflammatory myopathies are systemic, chronic, immune-mediated diseases characterized by proximal, symmetrical muscle weakness. Many examples from the literature refer that celiac disease occurs more often in patients with myositis than in the general population, but its association with ulcerative colitis is a real rarity in the international literature.A szerzők az idiopathias inflammatorikus myopathia ritka, colitis ulcerosaval es coeliakiaval tarsult esetet mutatjak be egy altaluk kezelt, 25 eves dermatomyositises nőbeteg kortorteneten keresztul. Az idiopathias inflammatorikus myopathiak szisztemas, kronikus, immunmedialt megbetegedesek, amelyeket a proximalis vegtagizmok szimmetrikus gyengesege jellemez. Irodalmi peldak utalnak ra, hogy a coeliakia gyakrabban jelentkezik myositisben, mint az atlagpopulacioban. Colitis ulcerosaval valo asszociacioja azonban irodalmi ritkasagnak szamit. Orv. Hetil., 2014, 155(26), 1033–1038.

Anti-NXP2-pozitív dermatomyositis társulása colitis ulcerosával és coeliakiával@@@The association of colitis ulcerosa and coeliakia with idiopathic inflammatory myopathy

The authors discuss a rare case of a 25-year-old female patient having dermatomyositis associated with celiac disease and ulcerative colitis. The idiopathic inflammatory myopathies are systemic, chronic, immune-mediated diseases characterized by proximal, symmetrical muscle weakness. Many examples from the literature refer that celiac disease occurs more often in patients with myositis than in the general population, but its association with ulcerative colitis is a real rarity in the international literature.A szerzők az idiopathias inflammatorikus myopathia ritka, colitis ulcerosaval es coeliakiaval tarsult esetet mutatjak be egy altaluk kezelt, 25 eves dermatomyositises nőbeteg kortorteneten keresztul. Az idiopathias inflammatorikus myopathiak szisztemas, kronikus, immunmedialt megbetegedesek, amelyeket a proximalis vegtagizmok szimmetrikus gyengesege jellemez. Irodalmi peldak utalnak ra, hogy a coeliakia gyakrabban jelentkezik myositisben, mint az atlagpopulacioban. Colitis ulcerosaval valo asszociacioja azonban irodalmi ritkasagnak szamit. Orv. Hetil., 2014, 155(26), 1033–1038.

Anti-NXP2-pozitív dermatomyositis társulása colitis ulcerosával és coeliakiával

The authors discuss a rare case of a 25-year-old female patient having dermatomyositis associated with celiac disease and ulcerative colitis. The idiopathic inflammatory myopathies are systemic, chronic, immune-mediated diseases characterized by proximal, symmetrical muscle weakness. Many examples from the literature refer that celiac disease occurs more often in patients with myositis than in the general population, but its association with ulcerative colitis is a real rarity in the international literature.A szerzők az idiopathias inflammatorikus myopathia ritka, colitis ulcerosaval es coeliakiaval tarsult esetet mutatjak be egy altaluk kezelt, 25 eves dermatomyositises nőbeteg kortorteneten keresztul. Az idiopathias inflammatorikus myopathiak szisztemas, kronikus, immunmedialt megbetegedesek, amelyeket a proximalis vegtagizmok szimmetrikus gyengesege jellemez. Irodalmi peldak utalnak ra, hogy a coeliakia gyakrabban jelentkezik myositisben, mint az atlagpopulacioban. Colitis ulcerosaval valo asszociacioja azonban irodalmi ritkasagnak szamit. Orv. Hetil., 2014, 155(26), 1033–1038.

Biological therapy in idiopathic inflammatory myopathies

Idiopathic inflammatory myopathies are systemic, immune-mediated diseases characterized by proximal, symmetrical, progressive muscle weakness. The aim of this work is to give an overview of the biological therapy used in the treatment of idiopathic inflammatory myopathies. The authors also focus on novel results in the therapy directed against the B- and T-cells. They emphasize the importance of new trials in these diseases which may lead to the introduction of novel therapeutic options in these disorders.

Wall motion changes in myocardial infarction in relation to the time elapsed from symptoms until revascularization

Objective Wall motion abnormalities during acute ST-segment elevation myocardial infarction (STEMI) and the improvement after recanalization depend on the conditions of the coronary occlusion. Methods Fifty-seven patients with first-ever STEMI due to one-artery occlusion, treated with primary PCI, were evaluated. Area at risk and left ventricular wall motion abnormalities were localized with coronary angiography and echocardiography and then compared in relation to the time elapsed from the onset of symptoms at the time of infarction and at 3 months. Left ventricular diameters and ejection fractions were evaluated in relation to the ischemic time. Results Three hundred forty-one affected left ventricular segments were detected with angiography, while echocardiography showed 206 segments with motion abnormality. No correlation was found between the regional wall motion index in the area at risk and the time elapsed from the beginning of symptoms. However, the improvement in wall motion abnormalities at the follow-up was dependent on the ischemic time (r=-0.29, p<0.03). The early subgroup showed significant improvement in left ventricular ejection fraction at follow-up (p=0.03), whereas in the late subgroup, a significant increase in left ventricle diameters was observed. Conclusion Our results first demonstrate in humans that in the early hours from the occlusion of the coronary artery, the extent and severity of the wall motion abnormalities inside the area at risk show large variability without relation to the elapsed time since the onset of symptoms. On the other hand, the results of follow-up echocardiography proved that the wall motion improvement was highly dependent on the ischemic time.