Deutsche medizinische Wochenschrift
-
ATP-Citrate-Lyase is a key enzyme of cholesterol biosynthesis. Its liver-specific inhibition by the bempedoic acid opens new possibilities to effectively escalate a cholesterol-lowering therapy while avoiding muscle-related side effects. Herein, we present the properties of this new first-in-class pharmaceutical agent and discuss potential consequences for pharmacotherapy.
-
Dtsch. Med. Wochenschr. · Apr 2021
[West-Nile-Virus Infection acquired in Germany in a Kidney Transplant Recipient].
West-Nile-Virus (WNV) is a widely distributed flavivirus that is mainly transmitted between birds through different mosquito species (e. g. Culex, Aedes), but may also be transmitted to mammals including humans. WNV causes a spectrum of disease, ranging from asymptomatic infection to encephalitis in a minority of cases. Risk factors for severe disease are older age, cardiovascular disease and an immunocompromised state. ⋯ This case highlights the need to consider rarer causes of illness like WNV-infection particularly in risk groups for more severe outcomes of infectious disease. WNV may be detected by PCR in the blood and cerebrospinal fluid early in the course of infection but it is also excreted for a prolonged period of time in the urine. Seroconversion to anti WNV IgG and IgM may be shown but serologic cross-reactivity among members of the flaviviridae family must be considered.
-
Dtsch. Med. Wochenschr. · Apr 2021
[Old and depressed and/or demented? - Pseudodepression vs. pseudodementia].
Many elderly patients suffer from both, depressive symptoms and cognitive deficits. Clinically, it oftentimes appears unclear whether the affective or the cognitive problems are primary or secondary. ⋯ A careful history and clinical investigations are necessary to identify the underlying diseases, but they do not always offer sufficient therapeutic guidance. If in doubt, the condition should always be considered as potentially reversible and treated emphatically (but with age-appropriate caution).
-
Dtsch. Med. Wochenschr. · Apr 2021
Case Reports[First Cases of Multisystem Inflammatory Syndrome following SARS-CoV-2 infection in Adults in Germany].
Multisystem Inflammatory Syndrome is a rare condition that affects multiple organs following SARS-CoV-2 infection. It was first observed in children, however few cases of adults with Multisystem Inflammatory Syndrome (MIS-A) were published in the US and the UK. We present two cases of Multisystem Inflammatory Syndrome in adults which occurred in Germany. ⋯ Multisystem Inflammatory Syndrome presents as a chameleon of symptoms. In the context of the ongoing SARS-CoV-2 pandemic, rising numbers of cases in adults can be expected. In patients with fever, increased inflammation parameters and lack of other explanations, Multisystem Inflammatory Syndrome must be considered. Due to the potential severity of clinical courses and possible cardiac involvement, a therapy with hydrocortisone, ASS and immunoglobulins should be considered early.
-
Dtsch. Med. Wochenschr. · Apr 2021
Case Reports[De novo thombotic microangiopathy (TMA) after incompatible AB0 renal transplantation].
We report a 57-year-old patient admitted to our hospital for planned AB0-incompatible living kidney transplantation. ⋯ It has to be discussed whether an early use of eculizumab in cases of suspected de novo TMA is a safe way to prevent graft dysfunction and thus to improve the poor prognosis for graft and recipient described in the literature.