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Diagnostic Criteria for Chronic Neutrophilic Leukemia (CNL)

Chronic neutrophilic leukemia (CNL) is a rare, often aggressive myeloproliferative neoplasm (MPN) defined by persistent mature neutrophilic leukocytosis, bone marrow granulocyte hyperplasia, and frequent hepatosplenomegaly. The seminal discovery of oncogenic driver mutations in colony-stimulating factor 3 receptor (CSF3R) in the majority of patients with CNL in 2013 anchored a new scientific framework, deepening our understanding of its molecular pathogenesis, providing a diagnostic biomarker, and rationalizing the use of pharmacological targeting. Continue reading “Diagnostic Criteria for Chronic Neutrophilic Leukemia (CNL)”

Accelerated Phase Criteria for Chronic Myeloid Leukemia (CML)

The chronic myeloid leukemia (CML) is classically staged into chronic phase (CP, most patients at presentation), accelerated phase (AP) and blast phase (BP). Many definitions have been used for these stages, but all the data generated from the tyrosine kinase inhibitor (TKI) studies has used the historically standard definition where AP is defined by the presence of one or more of the following: ≥15% blasts in PB/BM, ≥20% basophils in PB, platelets <100,000/µL unrelated to treatment or the development of cytogenetic evolution. Blast phase is defined by the presence of ≥30% blasts in the peripheral blood or bone marrow, the presence of clusters of blasts in marrow or the presence of extramedullary disease with immature cells (i.e., a myeloid sarcoma). Continue reading “Accelerated Phase Criteria for Chronic Myeloid Leukemia (CML)”

Criteria for Acute Myocardial Infarction in the Left Bundle Branch Block

In the Emergency Department, the diagnosis of acute myocardial infarction (AMI) relies initially on a patient’s history and the 12-lead electrocardiogram (ECG). Establishing the diagnosis of AMI in the left bundle branch block (LBBB) is difficult and can result in delay of definitive treatment. In 1996, Sgarbossa found 3 ECG criteria to evaluate for AMI in patients with LBBB. Continue reading “Criteria for Acute Myocardial Infarction in the Left Bundle Branch Block”

Diagnostic Criteria for Hypersensitivity Pneumonitis

Hypersensitivity pneumonitis (HP), also called extrinsic allergic alveolitis, is a respiratory syndrome involving the lung parenchyma and specifically the alveoli, terminal bronchioli, and alveolar interstitium, due to a delayed allergic reaction. Such reaction is secondary to a repeated and prolonged inhalation of different types of organic dusts or other substances to which the patient is sensitized and hyper responsive, primarily consisting of organic dusts of animal or vegetable origin, more rarely from chemicals. Continue reading “Diagnostic Criteria for Hypersensitivity Pneumonitis”

EULAR/ACR New Classification Criteria for Systemic Lupus Erythematosus (SLE)

The new EULAR/ACR classification criteria use anti-nuclear antibodies (ANA) as an entry criterion. (Non-infectious) fever is the one new criterion. All criteria items now have individual weights (from 2 to 10) and are structured in domains, within which only the highest item is counted. There is one common attribution rule, counting criteria only if there is no more likely alternative explanation. Ten points are sufficient for classification. The new criteria have reached a sensitivity of 96.1% and a specificity of 93.4%. Continue reading “EULAR/ACR New Classification Criteria for Systemic Lupus Erythematosus (SLE)”

ACR Revised Criteria for Early Diagnosis of Knee Osteoarthritis (OA)

Osteoarthritis (OA) is cartilage failure resulting in joint pain and loss of joint functions. Knee OA is the OA of knee that mechanical forces have major effect on initiation and progression of it. Knee OA is the most common disease of knee especially in the middle to old ages. The most common findings in the history and physical examination of the patients with knee OA are mechanical knee pain, gelling knee pain, crepitus on knee motion, bony tenderness and bony enlargement in the joint line. During the flare up of Osteoarthritis, knee can show swelling due to joint effusion called “Hydrarthrosis” that is a mechanical type of synovial fluid. Continue reading “ACR Revised Criteria for Early Diagnosis of Knee Osteoarthritis (OA)”

Clinical Diagnostic Criteria of IgG4-Related Sclerosing Cholangitis (IgG4-SC)

Sclerosing cholangitis (SC) is defined as a condition with progressive stenosis and destruction of the bile ducts due to diffuse inflammation and fibrosis and currently includes three categories: primary sclerosing cholangitis (PSC), secondary cholangitis, and IgG4-related sclerosing cholangitis (IgG4-SC). SC categories share similar clinical features, such as cholestasis. Patients with SC present with cholestatic symptoms, including jaundice and pruritus, and blood tests reveal elevation of cholestatic enzymes. Continue reading “Clinical Diagnostic Criteria of IgG4-Related Sclerosing Cholangitis (IgG4-SC)”

Diagnostic Criteria for IgG4-Related Kidney Disease (IgG4-RKD)

IgG4-related disease is characterized by a high level of serum IgG4 and dense infiltration of IgG4-positive plasma cells into multiple organs, with the kidney being one representative target. Although several sets of diagnostic criteria for autoimmune pancreatitis (AIP) are available and renal lesion is recognized as an extrapancreatic manifestation of AIP, it is difficult to differentiate IgG4-related tubulointerstitial nephritis (TIN) without
AIP from other types of TIN. Continue reading “Diagnostic Criteria for IgG4-Related Kidney Disease (IgG4-RKD)”

International Consensus Diagnostic Criteria for Autoimmune Pancreatitis (AIP)

Autoimmune pancreatitis is a distinct form of pancreatitis characterized clinically by frequent presentation with obstructive jaundice with or without a pancreatic mass, histologically by a lymphoplasmacytic infiltrate and fibrosis and therapeutically by a dramatic response to steroids. Continue reading “International Consensus Diagnostic Criteria for Autoimmune Pancreatitis (AIP)”

Classification Criteria for IgG4-Related Disease

Immunoglobulin G4-related disease is an immune mediated condition resulting in disease in various organs of the body such as the pancreas, kidneys, salivary glands, lung, liver, lymph nodes, biliary tract and orbits of the eyes. The disease is recognized by a characteristic pattern of pathological, serological or clinical features shared amongst the organs system that are involved. In some cases, IgG4-RD can mimic malignant, infectious or inflammatory disorders and therefore distinguishing the disease is crucial. Continue reading “Classification Criteria for IgG4-Related Disease”

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