Recovery from Alopecia Universalis after Bilateral Lung Transplantation

 

Abstract

Alopecia areata (AA) is an immune-mediated form of hair loss that occurs in all ethnic groups, ages, and both sexes, with an estimated lifetime risk of 1.7% among the general population. Approximately 15-25% of all AA cases progress to Alopecia universalis (AU), which is a complete loss of scalp and body hair. Complete recovery from AU is rare (<10%). We report a case of AU in a patient who was referred to us for lung transplantation due to advanced bronchiectasis. The patient recovered from AU within three months of bilateral lung transplant using standard triple immunosuppressive therapy. To our knowledge, this is the first case report of AU recovery with standard immunosuppression use after lung transplantation. 

 

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Whole Exome Sequencing Identifies Two Mutations in an Indian Patient with KBG Syndrome

 

Abstract

KBG syndrome is a condition characterised by macrodontia, neurological disturbance, short stature, a distinct cranio-facial appearance, and also the skeletal anomalies. The authors describe what appears to be the first case of KBG syndrome with mutation in two different gene reported from the Indian subcontinent. Meticulous evaluation of the patients helps to classify such cases which may otherwise remain undiagnosed. Further research is reasonable to regulate the classic and the variant presentations of this condition, with the follow-up of the patients that provides the valuable data insights into its natural history and long-term prognosis. As per database these variants have been not reported till date, we found two variants in an Indian patient.

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Clinical, Radiographic, and Histologic Outcomes of Ankle Arthrodesis in a Diabetic Patient using a Biphasic Calcium Phosphate Bone Graft with a Novel Submicron Needle-shaped Surface Topography

 

Abstract

Patients with diabetes mellitus who sustain ankle fractures are at increased risk of complications including non-union, malunion, wound dehiscence, soft tissue infection, osteomyelitis, deterioration to Charcot arthropathy, and amputation [1-3]. Multiple publications have evaluated treatment options for diabetic patients with ankle fractures; management options include non-surgical treatment and immobilization, open reduction internal fixation, arthrodesis of the tibiotalar joint, arthrodesis of the tibiotalocalcaneal joints, external fixation, and amputation [4-7]. It is important to identify an effective bone graft for these cases, as well as to understand the science behind the bone graft selected. In recent years, the study of osteoimmunology has confirmed the reciprocal interaction of bone forming mesenchymal stem cells and immune cells on bone growth. This report describes an adult female patient with a late presenting ankle fracture dislocation, initially treated with ankle arthrodesis using a novel bone graft with submicron needle-shaped surface topography. The patient developed Charcot arthropathy and was revised to a tibiotalocalcaneal (TTC) nail. During revision, a biopsy was taken of a solidly fused segment and sent for histology. Radiographic, clinical, and histological data were tracked and showed solid fusion at 6 weeks radiographically, which was confirmed via histology and surgical exploration at 12 weeks, indicating notable results in this challenging arthrodesis case using a novel bone graft with submicron needle-shaped surface topography.

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