هاني محمد عثمان المعلم

Isolated eosinophilic mesenteric vasculitis with extensive thrombosis and splenic infarction in a 13-year-old boy

 Authors: Amal Abdulwahab¹, Hani Almoallim² and Nasim Khan¹

Affiliation:
(1)Alnoor Specialist Hospital, Makkah, Saudi Arabia

(2) Department of Medicine, University of Umm Alqura, Makkah, Saudi Arabia

 Published in: Clinical Rheumatology, Volume 26, Number 2 / February, 2007

Abstract

  There are no generally accepted diagnostic criteria for primary systemic vasculitis, and the application of classification as diagnostic criteria is not feasible and may even be misleading. We report a case of a 13-year-old boy with acute abdomen who was found to have isolated eosinophilic mesenteric vasculitis with extensive thrombosis and splenic infarction. All serological tests were negative, including antineutrophil cytoplasmic antibody. The vasculitis had been successfully controlled with surgical intervention, steroid, and cyclophosphamide therapy. This may be an atypical presentation of Churg–Strauss syndrome.

URL: http://www.springerlink.com/content/71kq5n28l5531v5w/

Delayed diagnosis of systemic lupus erythematosus due to lack of competency skills in musculoskeletal examination

Authors: Hani Almoallim, Emad Khojah, Riyadh Allehebi and Abdulsalam Noorwali

Affiliation: Internal Medicine Department, Medical College, Umm Alqura University, Makkah, Saudi Arabia

Published in: Clinical Rheumatology, Volume 26, Number 1 / January, 2007

Abstract

Deficiencies in musculoskeletal (MSK) examination skills among internal medicine residents can cause serious outcomes. We report a case of systemic lupus erythematosus with active arthritis where the diagnosis was delayed for 7 days after hospital admission due to the lack of basic skills in MSK examination.

URL: http://www.springerlink.com/content/m84u137767l862l5

The High Clinic: a pilot project of a new model for an outpatient, community-based teaching clinic in heumatology

Authors: Hani Almoallim; Andrew Chalmers; Gordon Page

Affiliation: UBC Division of Rheumatology, Vancouver, BC, Canada

Published in: Medical Teacher, Volume 28, Issue 8 December 2006 , pages 713 – 716

Abstract: The objectives were to develop an outpatient, community-based clinical education experience for second-year rheumatology fellows based on sound education principles, and to pilot the program to test its practicability and assess student perception of its educational efficacy. The outpatient clinical education experience consisted of four steps. In Step 1 second-year rheumatology fellows assessed patients and reviewed their cases with two supervisors. Step 2 entailed each fellow presenting a brief summary of each case to their colleagues and supervisors for discussion and analysis of learning issues. In Step 3 each fellow conducted a literature search of the learning issues identified in Step 2. Step 4 occurred in the days following the clinic and entailed a seminar discussion of the literature search results with fellow colleagues. At the end of this outpatient clinical education program, questionnaires were given to participating fellows to assess its effectiveness. All participants judged this new clinical education program to be practical and effective; outcomes were positive for all skills specified as objectives for the clinic. This model of outpatient community-based clinical teaching, named ‘The High Clinic’ is a new and effective model for a teaching clinic in rheumatology, featuring augmented patient exposure, increased interactions with supervisors and a case-based learning. The pilot test of the clinic was implemented successfully. Participants in the clinic were satisfied with their achievement of stated objectives. This model is applicable to other specialties.

URL: http://www.informaworld.com/smpp/content?content=10.1080/01421590601102956

Laser Induced Chrysiasis: Disfiguring Hyperpigmentation Following Q-Switched Laser Therapy in a Woman Previously Treated with Gold

HANI ALMOALLIM, ALICE V. KLINKHOFF, ANNE B. ARTHUR, JASON K. RIVERS, and ANDREW CHALMERS

J Rheumatol 2006;33:620–1

ABSTRACT

We describe a 40-year-old woman with rheumatoid arthritis and a history of 2 previous courses of intramuscular gold who developed disfiguring hyperpigmentation immediately after Q-switched laser therapy. This is the third case report of localized chrysiasis induced by laser therapy

URL: http://www.jrheum.com/abstracts/abstracts06/620.html

Microscopic polyangiitis sparing the kidneys in a long-term survivor after allogenic bone marrow transplantation and graft-versus-host disease

Clinical Rheumatology, Volume 24, Number 2 / April, 2005

Hani Almoallim¹ and A. Caroline Patterson²

1 Department of Medicine, Medical College, Umm Alqura University Makkah

2 Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada

We report an unusual case of microscopic polyangiitis sparing the kidneys in a long-term survivor of allogenic bone marrow transplantation. Clinical and pathologic studies revealed cutaneous leukocytoclastic vasculitis and isolated pulmonary capillaritis. Serological studies revealed “double positive”: perinuclear antineutrophil cytoplasmic (p-ANCA) antibody testing with anti-myeloperoxidase (MPO) activity and anti-glomerular basement membrane (anti-GBM) antibody. The vasculitis has been successfully controlled with prednisone and cyclophosphamide.

URL: http://www.springerlink.com/content/h709gulxfpxxgbrl

Longterm Outcome of Treatment of Felty’s Syndrome with Intramuscular Gold: Case Reports and Recommendations for Management

HANI ALMOALLIM and ALICE KLINKHOFF

Division of Rheumatology, University of British Columbia, Vancouver, British Columbia, Canada

J Rheumatol 2005;32:20-6

ABSTRACT
OBJECTIVE: To evaluate the incidence, complications, and course of Felty’s syndrome (FS) in patients treated with intramuscular (IM) gold. METHODS: Retrospective chart review of all FS cases (1979 to 2003) was conducted in the Mary Pack Arthritis Centre (MPAC) gold clinic. FS was diagnosed if patients had rheumatoid arthritis (RA; American College of Rheumatology criteria) and persistent leukopenia [white blood cell (WBC) count < 4] in the absence of other known causes of leukopenia. Splenomegaly was not part of the inclusion criteria. RESULTS: Thirteen patients with FS were identified in the gold clinic population. The mean age at diagnosis of FS was 58.7 years and the mean duration of RA at time of diagnosis was 6.9 years. The weekly dose of gold ranged from 10 mg to 50 mg depending on tolerability. Gold therapy resulted in normalization of the WBC count in 9 of 13 patients. The mean time to normalization of the WBC was 40 weeks. Only one patient with FS had experienced recurrent infectious complications from FS, and this did not recur after gold treatment was initiated. No patient had vasculitis. CONCLUSION: In our gold clinic population FS is a mild disease and is rarely associated with infectious complications. Gold is an effective treatment of FS

URL: http://www.jrheum.com/abstracts/abstracts05/20.html