. "12"^^ . . "Vnit\u0159n\u00ED l\u00E9ka\u0159stv\u00ED" . . "RIV/00209805:_____/12:#0000383" . "\u0158eh\u00E1k, Zden\u011Bk" . "Interleukin-1 receptor blockade with anakinra provided cessation of fatigue, reduction in inflammation markers and regression of retroperitoneal fibrosis in a patient with Erdheim-Chester disease \u2013 case study and a review of literature"@en . "Blok\u00E1da receptoru pro interleukin-1 prepar\u00E1tem anakinra vedla u pacienta s Erdheimovou-Chesterovou nemoc\u00ED k vymizen\u00ED patologick\u00E9 \u00FAnavy, k poklesu marker\u016F z\u00E1n\u011Btu a \u00FAstupu fibr\u00F3zy v retroperitoneu - popis p\u0159\u00EDpadu a p\u0159ehled liter\u00E1rn\u00EDch \u00FAdaj\u016F" . . "4" . . "anakinra; interleukin-1 receptor blocker; Erdheim; Chester disease; juvenile xantogranuloma; fatigue; autoinflammatory diseases"@en . "125285" . "RIV/00209805:_____/12:#0000383!RIV13-MZ0-00209805" . . "[42974EC48350]" . . "6"^^ . . . . . "0042-773X" . . "Adam, Zden\u011Bk" . . . "Koukalov\u00E1, Renata" . . "58" . "Blok\u00E1da receptoru pro interleukin-1 prepar\u00E1tem anakinra vedla u pacienta s Erdheimovou-Chesterovou nemoc\u00ED k vymizen\u00ED patologick\u00E9 \u00FAnavy, k poklesu marker\u016F z\u00E1n\u011Btu a \u00FAstupu fibr\u00F3zy v retroperitoneu - popis p\u0159\u00EDpadu a p\u0159ehled liter\u00E1rn\u00EDch \u00FAdaj\u016F"@cs . "http://www.prolekare.cz/vnitrni-lekarstvi-clanek/blokada-receptoru-pro-interleukin-1-preparatem-anakinra-vedla-u-pacienta-s-erdheimovou-chesterovou-nemoci-k-v-37722" . . "Blok\u00E1da receptoru pro interleukin-1 prepar\u00E1tem anakinra vedla u pacienta s Erdheimovou-Chesterovou nemoc\u00ED k vymizen\u00ED patologick\u00E9 \u00FAnavy, k poklesu marker\u016F z\u00E1n\u011Btu a \u00FAstupu fibr\u00F3zy v retroperitoneu - popis p\u0159\u00EDpadu a p\u0159ehled liter\u00E1rn\u00EDch \u00FAdaj\u016F"@cs . "CZ - \u010Cesk\u00E1 republika" . . "Popisujeme pacienta s Erdheimovou-Chesterovou nemoc\u00ED. V r\u00E1mci inici\u00E1ln\u00ED l\u00E9\u010Dby byla pou\u017Eita chemoterapie obsahuj\u00EDc\u00ED 2-chlorodeoxyadenosin. Tato l\u00E9\u010Dba v\u0161ak u popisovan\u00E9ho pacienta nevedla k poklesu akumulace fluorodeoxygluk\u00F3zy v patologick\u00FDch lo\u017Eisc\u00EDch. Pacient m\u011Bl trvale zv\u00FD\u0161en\u00E9 hodnoty CRP 17\u201320 mg/l. Nemoc d\u00E1le zp\u016Fsobovala subfebrilie a v\u00FDraznou patologickou \u00FAnavu, kter\u00E1 nutila nemocn\u00E9ho tr\u00E1vit v\u011Bt\u0161inu dne na l\u016F\u017Eku. Pro trvale zv\u00FD\u0161en\u00E9 markery z\u00E1n\u011Btu jsme se rozhodli zah\u00E1jit l\u00E9\u010Dbu prepar\u00E1tem anakinra, kter\u00FD se s \u00FAsp\u011Bchem pod\u00E1v\u00E1 u n\u011Bkter\u00FDch chorob ze skupiny autoinflamatorn\u00EDch nemoc\u00ED (nap\u0159. Schnitzler\u016Fv syndrom). Nyn\u00ED hodnot\u00EDme prvn\u00EDch 6 m\u011Bs\u00EDc\u016F t\u00E9to l\u00E9\u010Dby. Ihned po zah\u00E1jen\u00ED denn\u00ED aplikace prepar\u00E1tu anakinra (KineretTM 100 mg denn\u011B) ve form\u011B podko\u017En\u00EDch injekc\u00ED poklesly hodnoty CRP na norm\u00E1ln\u00ED \u00FArove\u0148, vymizely subfebrilie, a hlavn\u011B signifikantn\u011B poklesla intenzita patologick\u00E9 \u00FAnavy. Signifikantn\u011B se prodlou\u017Eil interval, kter\u00FD byl pacient schopen tr\u00E1vit mimo l\u016F\u017Eko. Objektivn\u00ED l\u00E9\u010Debnou odpov\u011B\u010F jsme hodnotili m\u011B\u0159en\u00EDm m\u00EDry akumulace fluorodeoxygluk\u00F3zy v patologick\u00FDch kostn\u00EDch lo\u017Eisc\u00EDch. PET-CT vy\u0161et\u0159en\u00ED bylo provedeno p\u0159ed zah\u00E1jen\u00EDm aplikace anakinry a po 3 m\u011Bs\u00EDc\u00EDch l\u00E9\u010Dby. Intenzita akumulace fluorodeoxygluk\u00F3zy se zat\u00EDm po prvn\u00EDch 3 m\u011Bs\u00EDc\u00EDch l\u00E9\u010Dby signifikantn\u011B nezm\u011Bnila, p\u0159i kontrole po 6. m\u011Bs\u00EDci m\u00EDrn\u011B poklesla. Kontroln\u00ED CT b\u0159i\u0161n\u00ED dutiny bylo provedeno ke konci 6. m\u011Bs\u00EDce l\u00E9\u010Dby. P\u0159i srovn\u00E1n\u00ED CT obrazu p\u0159ed aplikac\u00ED KineretuTM a po 6 m\u011Bs\u00EDc\u00EDch l\u00E9\u010Dby byl z\u0159eteln\u00FD \u00FAstup fibrotick\u00FDch zm\u011Bn v retroperitoneu, jak dokl\u00E1daj\u00ED publikovan\u00E9 obr\u00E1zky. Denn\u00ED aplikace anakinry pacientovi s aktivn\u00ED Erdheimovou-Chesterovou nemoc\u00ED signifikantn\u011B sn\u00ED\u017Eila intenzitu patologick\u00E9 \u00FAnavy, a zlep\u0161ila tak kvalitu \u017Eivota, vedla k poklesu marker\u016F z\u00E1n\u011Btu a vedla k \u00FAstupu fibrotizace retroperitonea." . "Interleukin-1 receptor blockade with anakinra provided cessation of fatigue, reduction in inflammation markers and regression of retroperitoneal fibrosis in a patient with Erdheim-Chester disease \u2013 case study and a review of literature"@en . . . "2"^^ . . "P(NT11154), P(NT12130), P(NT12215), S, Z(MSM0021622434), Z(MZ0MOU2005)" . "We describe a case of an Erdheim-Chester disease patient. First line chemotherapy treatment with 2-chlorodeoxyadenosine did not reduce fluorodeoxyglucose accumulation in pathological lesions. The patient had continuously increased CRP values of 17\u201320 mg/l. The disease continued to cause subfebrile temperatures and significant fatigue that made the patient to spend most of the daytime in bed. To manage the permanently increased inflammation markers, we decided to start treatment with anakinra, successfully used in some other autoinflammatory diseases (e.g. Schnitzler syndrome). We have now been able to evaluate the first 6 months of treatment. Daily subcutaneous administration of anakinra (KineretTM 100 mg daily) led to normalization of CRP values, cessation of subfebrile temperatures and, importantly, significant reduction of fatigue. Time periods the patient was able to spend out of the bed increased significantly. Objective treatment response was assessed by measuring the degree of fluorodeoxyglucose accumulation in pathological bone lesions. PET-CT was performed before and 3 and 6 months after anakinra initiation. Intensity of accumulation did not change significantly after the first 3 months of therapy but decreased after 6 month therapy. Follow up CT of abdominal cavity was performed at the end of the 6th month of treatment. Presented CT images from before and 6 months after the treatment evidence an obvious reduction in fibroid changes in the retroperitoneum. Daily administration of anakinra to a patient with active Erdheim-Chester disease significantly reduced intensity of fatigue and improved quality of life, led to a reduction in inflammatory markers and regression in retroperitoneal fibrotization."@en . . . "Popisujeme pacienta s Erdheimovou-Chesterovou nemoc\u00ED. V r\u00E1mci inici\u00E1ln\u00ED l\u00E9\u010Dby byla pou\u017Eita chemoterapie obsahuj\u00EDc\u00ED 2-chlorodeoxyadenosin. Tato l\u00E9\u010Dba v\u0161ak u popisovan\u00E9ho pacienta nevedla k poklesu akumulace fluorodeoxygluk\u00F3zy v patologick\u00FDch lo\u017Eisc\u00EDch. Pacient m\u011Bl trvale zv\u00FD\u0161en\u00E9 hodnoty CRP 17\u201320 mg/l. Nemoc d\u00E1le zp\u016Fsobovala subfebrilie a v\u00FDraznou patologickou \u00FAnavu, kter\u00E1 nutila nemocn\u00E9ho tr\u00E1vit v\u011Bt\u0161inu dne na l\u016F\u017Eku. Pro trvale zv\u00FD\u0161en\u00E9 markery z\u00E1n\u011Btu jsme se rozhodli zah\u00E1jit l\u00E9\u010Dbu prepar\u00E1tem anakinra, kter\u00FD se s \u00FAsp\u011Bchem pod\u00E1v\u00E1 u n\u011Bkter\u00FDch chorob ze skupiny autoinflamatorn\u00EDch nemoc\u00ED (nap\u0159. Schnitzler\u016Fv syndrom). Nyn\u00ED hodnot\u00EDme prvn\u00EDch 6 m\u011Bs\u00EDc\u016F t\u00E9to l\u00E9\u010Dby. Ihned po zah\u00E1jen\u00ED denn\u00ED aplikace prepar\u00E1tu anakinra (KineretTM 100 mg denn\u011B) ve form\u011B podko\u017En\u00EDch injekc\u00ED poklesly hodnoty CRP na norm\u00E1ln\u00ED \u00FArove\u0148, vymizely subfebrilie, a hlavn\u011B signifikantn\u011B poklesla intenzita patologick\u00E9 \u00FAnavy. Signifikantn\u011B se prodlou\u017Eil interval, kter\u00FD byl pacient schopen tr\u00E1vit mimo l\u016F\u017Eko. Objektivn\u00ED l\u00E9\u010Debnou odpov\u011B\u010F jsme hodnotili m\u011B\u0159en\u00EDm m\u00EDry akumulace fluorodeoxygluk\u00F3zy v patologick\u00FDch kostn\u00EDch lo\u017Eisc\u00EDch. PET-CT vy\u0161et\u0159en\u00ED bylo provedeno p\u0159ed zah\u00E1jen\u00EDm aplikace anakinry a po 3 m\u011Bs\u00EDc\u00EDch l\u00E9\u010Dby. Intenzita akumulace fluorodeoxygluk\u00F3zy se zat\u00EDm po prvn\u00EDch 3 m\u011Bs\u00EDc\u00EDch l\u00E9\u010Dby signifikantn\u011B nezm\u011Bnila, p\u0159i kontrole po 6. m\u011Bs\u00EDci m\u00EDrn\u011B poklesla. Kontroln\u00ED CT b\u0159i\u0161n\u00ED dutiny bylo provedeno ke konci 6. m\u011Bs\u00EDce l\u00E9\u010Dby. P\u0159i srovn\u00E1n\u00ED CT obrazu p\u0159ed aplikac\u00ED KineretuTM a po 6 m\u011Bs\u00EDc\u00EDch l\u00E9\u010Dby byl z\u0159eteln\u00FD \u00FAstup fibrotick\u00FDch zm\u011Bn v retroperitoneu, jak dokl\u00E1daj\u00ED publikovan\u00E9 obr\u00E1zky. Denn\u00ED aplikace anakinry pacientovi s aktivn\u00ED Erdheimovou-Chesterovou nemoc\u00ED signifikantn\u011B sn\u00ED\u017Eila intenzitu patologick\u00E9 \u00FAnavy, a zlep\u0161ila tak kvalitu \u017Eivota, vedla k poklesu marker\u016F z\u00E1n\u011Btu a vedla k \u00FAstupu fibrotizace retroperitonea."@cs . "Blok\u00E1da receptoru pro interleukin-1 prepar\u00E1tem anakinra vedla u pacienta s Erdheimovou-Chesterovou nemoc\u00ED k vymizen\u00ED patologick\u00E9 \u00FAnavy, k poklesu marker\u016F z\u00E1n\u011Btu a \u00FAstupu fibr\u00F3zy v retroperitoneu - popis p\u0159\u00EDpadu a p\u0159ehled liter\u00E1rn\u00EDch \u00FAdaj\u016F" . . . . . .