Show simple item record

dc.contributor.authorYourison, Isaac
dc.date.accessioned2016-03-25T23:46:53Zen
dc.date.available2016-03-25T23:46:53Zen
dc.date.issued2016-03-25
dc.identifier.urihttp://hdl.handle.net/10150/603686
dc.descriptionA Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.en
dc.description.abstractBACKGROUND AND SIGNIFICANCE: Sarcoidosis is a granulomatous disease of unknown etiology. Coccidioidomycosis is a granulomatous fungal infection due to Coccidioides immitis and Coccidioides Posadasii endemic to the Southwestern United States and the majority of the cases are reported from Arizona. The cause of sarcoidosis has been studied for over a hundred years without establishing an etiology. Establishing the cause of sarcoid would be a significant contribution to the understanding of an important multisystem disease. RESEARCH QUESTIONS: Based on clinical observations a group of patients with two granulomatous diseases – sarcoidosis and coccidioidomycosis led to the hypothesis for this Scholarly Project – can sarcoidosis be caused by the fungus Coccidioides? METHODS: A literature review was performed which resulted in 5 patient case reports, a medical record review was conducted of patients with sarcoidosis between 2004‐2014 at Maricopa Medical Center with a case‐control comparison to 68 matched patients, and PCR analysis of 34 sarcoid biopsy specimens from the 68 sarcoid patients identified from the medical record. Also, two main patients with sarcoidosis were studied, one prospectively and the other retrospectively, both patients had their diagnosis of sarcoidosis made in Arizona and both develop sarcoidosis. There was no evidence of an etiology for their sarcoidosis at the time of diagnosis, specifically no evidence of coccidioidomycosis. The prospective patient was followed for eight years before he developed coccidioidomycosis. Predicting correctly that a patient diagnosed with sarcoid in Arizona would eventually develop coccidioidomycosis provides strong evidence for an etiologic relationship between Coccidioides and sarcoidosis. INCOMPLETE STUDIES: There is one major study for this Project that has not been completed: 1. Genetic studies on patients with both sarcoidosis and coccidioidomycosis to determine if there is a genetic predisposition to disseminated coccidioidomycosis
dc.language.isoen_USen
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.subject.meshCoccidioidomycosisen
dc.subject.meshSarcoidosisen
dc.subject.meshArizonaen
dc.titleCoccidioidomycosis as a Cause of Sarcoid in Arizonaen_US
dc.typetext; Electronic Thesisen
dc.contributor.departmentThe University of Arizona College of Medicine - Phoenixen
dc.description.collectioninformationThis item is part of the College of Medicine - Phoenix Scholarly Projects 2016 collection. For more information, contact the Phoenix Biomedical Campus Library at pbc-library@email.arizona.edu.en_US
dc.contributor.mentorKuberski, Timen
html.description.abstractBACKGROUND AND SIGNIFICANCE: Sarcoidosis is a granulomatous disease of unknown etiology. Coccidioidomycosis is a granulomatous fungal infection due to Coccidioides immitis and Coccidioides Posadasii endemic to the Southwestern United States and the majority of the cases are reported from Arizona. The cause of sarcoidosis has been studied for over a hundred years without establishing an etiology. Establishing the cause of sarcoid would be a significant contribution to the understanding of an important multisystem disease. RESEARCH QUESTIONS: Based on clinical observations a group of patients with two granulomatous diseases – sarcoidosis and coccidioidomycosis led to the hypothesis for this Scholarly Project – can sarcoidosis be caused by the fungus Coccidioides? METHODS: A literature review was performed which resulted in 5 patient case reports, a medical record review was conducted of patients with sarcoidosis between 2004‐2014 at Maricopa Medical Center with a case‐control comparison to 68 matched patients, and PCR analysis of 34 sarcoid biopsy specimens from the 68 sarcoid patients identified from the medical record. Also, two main patients with sarcoidosis were studied, one prospectively and the other retrospectively, both patients had their diagnosis of sarcoidosis made in Arizona and both develop sarcoidosis. There was no evidence of an etiology for their sarcoidosis at the time of diagnosis, specifically no evidence of coccidioidomycosis. The prospective patient was followed for eight years before he developed coccidioidomycosis. Predicting correctly that a patient diagnosed with sarcoid in Arizona would eventually develop coccidioidomycosis provides strong evidence for an etiologic relationship between Coccidioides and sarcoidosis. INCOMPLETE STUDIES: There is one major study for this Project that has not been completed: 1. Genetic studies on patients with both sarcoidosis and coccidioidomycosis to determine if there is a genetic predisposition to disseminated coccidioidomycosis


Files in this item

Thumbnail
Name:
Yourison_Thesis.pdf
Size:
291.5Kb
Format:
PDF
Thumbnail
Name:
Yourison_Poster.pdf
Size:
69.54Kb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record