J T Lie

University of California, Davis, Davis, California, United States

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Publications (67)306.53 Total impact

  • Rheumatology 01/2000; 38(12):1285-9. · 4.21 Impact Factor
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    ABSTRACT: The rare clinicopathological entity 'disseminated visceral giant cell arteritis' (DVGCA) was first described in 1978. It is characterized by widespread small-vessel giant cell angitis and extravascular granulomas. A normal and healthy 7-month-old boy who presented unexpectedly with sudden infant death syndrome (SIDS) is reported. Histological examination at autopsy revealed giant cell angitis of the aorta, common carotid, coronary, pulmonary, celiac, mesenteric and common iliac arteries. There were also granulomas in the tracheal wall and liver. To our knowledge, this is the first documented case of DVGCA occurring in an infant younger than 12 months of age. A review of the literature on DVGCA is presented in this report, and the differential diagnosis is discussed.
    Pathology International 04/1999; 49(3):226-30. · 1.72 Impact Factor
  • J T Lie
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    ABSTRACT: Takayasu arteritis is usually defined as a chronic, progressive, inflammatory, occlusive disease of the aorta and its branches. However, we should remind Takayasu arteritis as a systemic disease. Here I describe nonclassical and catastrophic manifestations of the Takayasu arteritis, which often go unrecognized until after the event. Especially I stress that we should focus on cardiopulmonary complications in Takayasu arteritis.
    International Journal of Cardiology 11/1998; 66 Suppl 1:S11-21. · 6.18 Impact Factor
  • J T Lie
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    ABSTRACT: Buerger's disease is a non-arteriosclerotic, segmental, progressive, inflammatory vaso-occlusive disease of unknown etiology. Buerger's disease occurs almost exclusively in susceptible young men who are habitual tobacco users; usually with onset of symptoms before the age of 40 years. Buerger's disease affects both arteries and veins of principally lower and upper limbs and, rarely, of the viscera. To date, only 16 confirmed cases of visceral-intestinal Buerger's disease have been reported in the English-language literature; and all 16 patients were men. We describe here, for the first time, two young women with intestinal Buerger's disease who died of complications of ischemic bowel disease.
    International Journal of Cardiology 11/1998; 66 Suppl 1:S249-56. · 6.18 Impact Factor
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    ABSTRACT: We analyzed the clinical and laboratory characteristics of 50 patients with catastrophic antiphospholipid syndrome (APS) (5 from our clinics and 45 from a MEDLINE computer-assisted review of the literature from 1992 through 1996). Thirty-three (66%) patients were female and 17 (34%) were male. Twenty-eight (56%) patients had primary APS, 15 (30%) had defined systemic lupus erythematosus (SLE), 6 (12%) had "lupus-like" syndrome, and 1 (2%) had rheumatoid arthritis. Mean age of patients in this series was 38 +/- 14 years (range, 11-74 yr). Three (6%) patients developed the clinical picture of catastrophic APS under the age of 15 years, and 11 (22%) were 50 years old or more. In 11 (22%) patients, precipitating factors contributed to the development of catastrophic APS (infections in 3, drugs in 3, minor surgical procedures in 3, anticoagulation withdrawal in 2, and hysterectomy in 1). The presentation of the acute multi-organ failure was usually complex, involving multiple organs simultaneously or in a very short period of time. The majority of patients manifested microangiopathy--that is, occlusive vascular disease affecting predominantly small vessels of organs, particularly kidney, lungs, brain, heart, and liver--with a minority of patients experiencing only large vessel occlusions. Thrombocytopenia was reported in 34 (68%) patients, hemolytic anemia in 13 (26%), disseminated intravascular coagulation in 14 (28%), and schistocytes in 7 (14%). The following antibodies were detected: lupus anticoagulant (94%), anticardiolipin antibodies (94%), anti-dsDNA (87% of patients with SLE), antinuclear antibodies (58%), anti-Ro/SS-A (8%), anti-RNP (8%), and anti-La/SS-B (2%). Anticoagulation was used in 70% of the patients, steroids in 70%, plasmapheresis in 40%, cyclophosphamide in 34%, intravenous gammaglobulins in 16%, and splenectomy in 4%. Most patients, however, received a combination of nonsurgical therapies. Death occurred in 25 of the 50 (50%) patients. In most, cardiac problems seemed to be the major cause of death. In several of these, respiratory failure was also present, usually due to acute respiratory distress syndrome and diffuse alveolar hemorrhage. Among the 20 patients who received the combination of anticoagulation, steroids, and plasmapheresis or intravenous gammaglobulins, recovery occurred in 14 (70%) patients. The use of ancrod and defibrotide appeared to be effective in the 2 respective patients in whom they were used.
    Medicine 06/1998; 77(3):195-207. · 4.23 Impact Factor
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    ABSTRACT: Segmental mediolytic arteriopathy, a rare, noninflammatory arterial disease, is fundamentally a variant of fibromuscular dysplasia. The characteristic angiographic findings of segmental mediolytic arteriopathy include the "string of beads" and microaneurysms which are indistinguishable from those of vasculitis, and the correct diagnosis can be made only after histopathologic evaluation of the arterial lesions. Thrombosis, arterial wall hemorrhage, and dissection are among the complications of segmental mediolytic arteriopathy. We describe herein a patient with segmental mediolytic arteriopathy who presented with hemoperitoneum. The patient underwent urgent surgical repair of a ruptured hepatic artery aneurysm. The postoperative visceral arteriography findings led to a clinical diagnosis of polyarteritis nodosa, and immunosuppressive therapy was initiated. This treatment was stopped as soon as the correct biopsy diagnosis of segmental mediolytic arteriopathy was obtained through outside consultation. The patient recovered without drug treatment and was spared the potentially life-threatening complications of immunosuppression.
    Arthritis & Rheumatology 06/1998; 41(5):935-8. · 7.48 Impact Factor
  • J.T. Lie
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    ABSTRACT: Rheumatoid arthritis has a multitude of extra-articular manifestations, of which systemic vasculitis is a clinically significant co-morbidity and co-mortality determinant in the prognosis of the disease. Rheumatoid vasculitis may occur in the early stage of the disease but, more commonly, in patients who have had seropositive rheumatoid arthritis for 10 years or longer. Rheumatoid vasculitis has a wide variety of histopathologic expressions and it may affect blood vessels of all sizes (from vasa nervorum or vasa vasorum to the aorta; and occasionally veins and venules). The diagnosis ideally requires biopsy or autopsy tissue confirmation, which is discussed and illustrated in this review.
    Cardiovascular Pathology. 01/1998;
  • J T Lie
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    ABSTRACT: There are many different and diverse causes of central nervous system (CNS) vasculitis, and many nonvasculitic disorders that often mimic CNS vasculitis. CNS vasculitis is usually suspected clinically with compatible or suggestive angiographic findings, but a definitive diagnosis is not possible without biopsy confirmation, especially with CNS vasculitis mimickers. Primary CNS vasculitis, although relatively uncommon, is most important because of its overall unfavorable prognosis. Secondary CNS vasculitis occurs in association with a long list of systemic vasculitic and nonvasculitic disorders with variable brain biopsy findings. Because of the focal and segmental distribution of CNS vasculitis, a positive biopsy is diagnostic for the disease demonstrated, but a single isolated negative biopsy does not necessarily exclude primary or secondary CNS vasculitis.
    Neurologic Clinics 12/1997; 15(4):805-19. · 1.34 Impact Factor
  • J.T. Lie, MD
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    ABSTRACT: Angiodysplasia is a unifying concept and designation for all developmental vascular anomalies currently known in the medical literature as angiomatosis, arteriovenous malformation, congenital arteriovenous fistula, congenital hemangioma or lymphangiomatosis, telangiectasia, vascular hamartoma, and all those clinical disorders identified by eponyms, such as Klippel-Tranaunay syndrome and Rendu-Osler-Weber syndrome. A new classification is proposed to catalog the histomorphologic spectrum of angiodysplasia likely to be found in each individual case with the caveat that virtually all angiodysplastic lesions will have mixed histomorphology although one type may predominate. Examples of the most commonly encountered angiodysplastic lesions are described and illustrated in this review.
    Cardiovascular Pathology. 09/1997;
  • Arthritis & Rheumatology 08/1997; 40(7):1189-201. · 7.48 Impact Factor
  • J T Lie
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    ABSTRACT: A definitive diagnosis of virtually all vasculitides requires histological documentation. Although each major type of systemic vasculitis may have its own unique features, variability and overlaps still exist, and histopathological specificity is rarely an absolute discriminator. The interpretation of biopsies for the diagnosis of vasculitis remains more an art than a science, and it requires full and complete correlation with historical, clinical, laboratory, and angiographic findings.
    Baillière s Clinical Rheumatology 06/1997; 11(2):219-36.
  • J.T Lie, MD, J.Alan Sanders
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    ABSTRACT: Kawasaki disease is an acute, self-limited illness of young children (most commonly under 4 years of age) that may result in significant cardiovascular sequelae in about 20% of the patients 10 to 20 years later, mostly from occlusive coronary artery disease and myocardial infarction. Early mortality occurs in about 2% of children under the age of 2 years as the result of acute coronary vasculitis, with or without myocarditis, and of complications from coronary aneurysms. To our knowledge, fatal late sequelae of “healed” or “regressed” coronary aneurysms with occlusive intimal fibrocellular proliferation occurring in children under 1 year of age, have not been reported. We describe one such rare example in an 11-month-old infant.
    Cardiovascular Pathology. 01/1997;
  • La Revue de Médecine Interne 01/1997; 18. · 0.90 Impact Factor
  • J T Lie
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    ABSTRACT: Whether the vasculopathy in APS is thrombosis or vasculitis is more than a mere academic interest; the distinction is important not only for unravelling the pathogenesis of vascular injuries in APS but also for selecting the appropriate choice of drug treatment. A diagnosis of vasculitis would call for treatment with corticosteroids and cytotoxic agents which are not without serious side effects and drug toxicity. The same powerful but potentially dangerous drugs are clearly quite ineffectual in treating or preventing thrombosis associated with APS which has been known to respond in the lowly and inexpensive aspirin. The vasculopathy of APS remains almost exclusively thrombotic in nature according to our current state of knowledge, even if one were to accept capillaritis as a bona fide member in the family of vasculitides, the 'microangiitis'. Vasculitis secondary to an independent underlying disease, such as SLE, may coexist with APS in a patient. In the management of APS patients, the distinction between a true vasculitis coincidental with and one that is causally related to APS affects clinical decision making, and not just a matter of semantics or an academic curiosity. In vasculopathy of APS, thrombosis is the culprit and vasculitis, when present, is the consort. This is still true until newer and more convincing evidence emerges and proves to be contrary.
    Lupus 11/1996; 5(5):368-71. · 2.78 Impact Factor
  • J T Lie
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    ABSTRACT: Primary cutaneous granulomatous phlebitis (PCGP) is distinctly unusual. The entity was first described in 1954 and, to date, the only four known reported cases of PCGP occurred in two men and two women, all under 40 years of age. The arm and/or leg veins were affected in three patients and mesenteric veins in one; all were diagnosed by means of excisional biopsy specimens. The first three patients presented with a febrile illness, and two of them had elevated erythrocyte sedimentation rates but little else indicative of a systemic disease. Three of the four patients received no immunosuppressive drug treatment. The fourth patient presented with a segmental infarction of the ileum that required a bowel resection. We now describe four new cases of PCGP, in women aged 26, 62, 76, and 38 years, one black, one Hispanic, and two white. The diagnosis of PCGP was made by means of biopsy specimens in two patients, at autopsy in one, and from a below-knee amputation specimen in one. Despite the obvious limited global experience of this rare form of phlebitis, there is ground for uneasiness that PCGP may not be as innocuous a curiosity in surgical pathology as was thought at first sight but a more sinister, little-known villain among the vasculitides that is only now beginning to show its true color.
    Modern Pathology 08/1996; 9(7):719-24. · 5.25 Impact Factor
  • J T Lie
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    ABSTRACT: Involvement of the pulmonary arteries is common in systemic Takayasu arteritis and, in nearly all of the reported cases, the diagnosis has been based solely on clinical and angiographic evaluations of the patients. Isolated pulmonary Takayasu arteritis occurs rarely and can be diagnosed only after histologic examination of the appropriate tissue specimens; five such patients are described herein. The patients were two men and three women. Their age at diagnosis ranged from 25 to 66 years. The initial clinical diagnosis was thromboembolism in two patients, and primary pulmonary hypertension, pulmonary granulomatosis, or pulmonary tumor or sarcoidosis in the remaining three patients, respectively. All five patients underwent surgery for lung resection (three patients) or for reconstruction/bypass of the obstructed pulmonary arteries (two patients). Three types of vascular lesions were observed in the surgical specimens: the classic large-vessel granulomatous giant cell arteritis, a peculiar type of organized thrombus with prominent recanalization and neoangiogenesis, and plexogenic arteriopathy. Thus, the histopathologic findings of pulmonary Takayasu arteritis is distinctive and differs in many aspects from that of systemic Takayasu arteritis. Moreover, the vascular lesions of pulmonary Takayasu arteritis are distinguishable from those of pulmonary hypertension, sarcoidosis, and other types of pulmonary angiitis and granulomatosis.
    Modern Pathology 06/1996; 9(5):469-74. · 5.25 Impact Factor
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    ABSTRACT: We describe a 24-year old Caucasian man with gangrene of small bowels and intestinal resection due to mesenteric inflammatory veno-occlusive disease (MIVOD) who later developed deep vein thrombosis in his left leg. He had no clinical evidence of an underlying symptomatic connective tissue disease or Behçet's disease. An IgG anticardiolipin antibody titre above 60 GPL unit/mL and thrombocytopenia confirmed the diagnosis of primary antiphospholipid syndrome (APS). This is the first known case of APS associated with MIVOD.
    Clinical Rheumatology 04/1996; 15(2):207-10. · 2.04 Impact Factor
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    ABSTRACT: Giant cell arteritis (GCA) of the female genital tract has been described as an incidental finding, but associated temporal arteritis (TA) has been rarely reported. We describe a case of female genital tract GCA associated with occult giant cell TA, which in the absence of cranial symptoms was confirmed by a random temporal artery biopsy. The patient remains asymptomatic at 12 month followup after treatment with prednisolone and azathioprine.
    The Journal of Rheumatology 03/1996; 23(2):393-5. · 3.26 Impact Factor
  • Arthritis & Rheumatology 02/1996; 39(1):9-22. · 7.48 Impact Factor
  • J T Lie, R K Dixit
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    ABSTRACT: Not all arteritides of the temporal arteries are giant cell temporal arteritis (Horton's disease). We describe an unusual case of etodolac (Lodine) nonsteroidal antiinflammatory drug (NSAID) induced hypersensitivity vasculitis of the temporal artery clinically simulating giant cell temporal arteritis. NSAID are common drugs and their gastrointestinal and renal side effects are well known. Ours is the first known documentation of NSAID induced hypersensitivity vasculitis isolated to the involvement of a temporal artery.
    The Journal of Rheumatology 02/1996; 23(1):183-5. · 3.26 Impact Factor

Publication Stats

4k Citations
306.53 Total Impact Points

Institutions

  • 1993–1999
    • University of California, Davis
      • • Department of Plant Pathology
      • • School of Medicine
      Davis, California, United States
  • 1998
    • Harvard Medical School
      Boston, Massachusetts, United States
  • 1993–1998
    • CSU Mentor
      Long Beach, California, United States
  • 1997
    • Lawrence Memorial Hospital
      Medford, Massachusetts, United States
    • California State University, Sacramento
      Sacramento, California, United States
  • 1990–1997
    • Cleveland Clinic
      Cleveland, Ohio, United States
    • University of Kentucky
      Lexington, Kentucky, United States
    • Stanford University
      Palo Alto, California, United States
    • Massachusetts General Hospital
      Boston, Massachusetts, United States
  • 1996
    • Istanbul University
      • Department of Family Medicine (Istanbul Medical Faculty)
      İstanbul, Istanbul, Turkey
    • Prince of Wales Hospital, Hong Kong
      Chiu-lung, Kowloon City, Hong Kong
  • 1995
    • Hospital Clínic de Barcelona
      • Servicio de Enfermedades Autoinmunes y Sistémicas
      Barcelona, Catalonia, Spain
  • 1994
    • Reykjavík University
      Reikiavik, Capital Region, Iceland
  • 1991
    • Mayo Clinic - Rochester
      Rochester, Minnesota, United States