Adult haemophagocytic syndrome

[1]  M. Barnes,et al.  Gene-expression signatures differ between different clinical forms of familial hemophagocytic lymphohistiocytosis. , 2013, Blood.

[2]  A. Filipovich,et al.  Salvage therapy of refractory hemophagocytic lymphohistiocytosis with alemtuzumab , 2013, Pediatric blood & cancer.

[3]  H. Imran,et al.  Sensitivity and specificity of bone marrow hemophagocytosis in hemophagocytic lymphohistiocytosis. , 2012, Annals of clinical and laboratory science.

[4]  F. Gherlinzoni,et al.  Familial Hemophagocytic Lymphohistiocytosis May Present during Adulthood: Clinical and Genetic Features of a Small Series , 2012, PloS one.

[5]  B. Chetaille,et al.  Protection from Inflammatory Organ Damage in a Murine Model of Hemophagocytic Lymphohistiocytosis Using Treatment with IL-18 Binding Protein , 2012, Front. Immun..

[6]  M. Murakami,et al.  Characterization of Epstein–Barr virus (EBV) BZLF1 gene promoter variants and comparison of cellular gene expression profiles in Japanese patients with infectious mononucleosis, chronic active EBV infection, and EBV‐associated hemophagocytic lymphohistiocytosis , 2012, Journal of medical virology.

[7]  Yongmin Tang,et al.  Diagnostic accuracy of a specific cytokine pattern in hemophagocytic lymphohistiocytosis in children. , 2012, The Journal of pediatrics.

[8]  S. Ikuyama,et al.  Oral low-dose tacrolimus therapy for refractory hemophagocytic syndrome associated with systemic lupus erythematosus , 2012, Modern rheumatology.

[9]  M. Hendricks,et al.  Serum Ferritin is a Cost-effective Laboratory Marker for Hemophagocytic Lymphohistiocytosis in the Developing World , 2012, Journal of pediatric hematology/oncology.

[10]  S. Ehl,et al.  A prospective evaluation of degranulation assays in the rapid diagnosis of familial hemophagocytic syndromes. , 2012, Blood.

[11]  W. Wilson,et al.  EBV-associated lymphomas in adults. , 2012, Best practice & research. Clinical haematology.

[12]  M. Jordan,et al.  Hemophagocytic lymphohistiocytosis: updates and evolving concepts , 2012, Current opinion in pediatrics.

[13]  Min Chen,et al.  Critical role for perforin and Fas-dependent killing of dendritic cells in the control of inflammation. , 2012, Blood.

[14]  E. Behrens,et al.  Not all hemophagocytes are created equally: appreciating the heterogeneity of the hemophagocytic syndromes , 2012, Current opinion in rheumatology.

[15]  A. Filipovich The expanding spectrum of hemophagocytic lymphohistiocytosis , 2011, Current opinion in allergy and clinical immunology.

[16]  J. Meller,et al.  Hypomorphic mutations in PRF1, MUNC13-4, and STXBP2 are associated with adult-onset familial HLH. , 2011, Blood.

[17]  S. Kugathasan,et al.  Association of Crohn's disease, thiopurines, and primary epstein-barr virus infection with hemophagocytic lymphohistiocytosis. , 2011, The Journal of pediatrics.

[18]  A. Filipovich,et al.  How I treat hemophagocytic lymphohistiocytosis. , 2011, Blood.

[19]  Q. Jiang,et al.  Recombinant activated factor VII in hemophagocytic lymphohistiocytosis with disseminated intravascular coagulation. , 2011, Chinese medical journal.

[20]  M. Jordan,et al.  Perforin is a critical physiologic regulator of T-cell activation. , 2011, Blood.

[21]  J. Aliberti,et al.  Hemophagocytosis causes a consumptive anemia of inflammation , 2011, The Journal of experimental medicine.

[22]  G. Koretzky,et al.  Repeated TLR9 stimulation results in macrophage activation syndrome-like disease in mice. , 2011, The Journal of clinical investigation.

[23]  Chung-Wu Lin,et al.  Causes, clinical symptoms, and outcomes of infectious diseases associated with hemophagocytic lymphohistiocytosis in Taiwanese adults. , 2011, Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi.

[24]  Kejian Zhang,et al.  Gene expression profiling of peripheral blood mononuclear cells from children with active hemophagocytic lymphohistiocytosis. , 2011, Blood.

[25]  M. Machaczka,et al.  Malignancy-associated hemophagocytic lymphohistiocytosis in adults: a retrospective population-based analysis from a single center , 2011, Leukemia & lymphoma.

[26]  M. Ziol,et al.  Prevalence and Clinical Significance of Küpffer Cell Hyperplasia With Hemophagocytosis in Liver Biopsies , 2011, The American journal of surgical pathology.

[27]  C. Tabata,et al.  Prominent granulomas in bone marrow in disseminated lymphoma with hemophagocytic syndrome , 2011, Annals of Hematology.

[28]  C. Kozinetz,et al.  Rate of decline of ferritin in patients with hemophagocytic lymphohistiocytosis as a prognostic variable for mortality , 2011, Pediatric blood & cancer.

[29]  T. Heike,et al.  Subtypes of Familial Hemophagocytic Lymphohistiocytosis in Japan Based on Genetic and Functional Analyses of Cytotoxic T Lymphocytes , 2010, PloS one.

[30]  W. Paul,et al.  Sustained IL-4 exposure leads to a novel pathway for hemophagocytosis, inflammation, and tissue macrophage accumulation. , 2010, Blood.

[31]  Y. Bryceson,et al.  Alemtuzumab treatment for hemophagocytic lymphohistiocytosis , 2010, Nature Reviews Clinical Oncology.

[32]  J. Sánchez,et al.  Perivascular Hemophagocytosis: Report of 2 Cases and Review of the Literature , 2010, The American Journal of dermatopathology.

[33]  Je-Jung Lee,et al.  Clinical significance of clonality and Epstein‐Barr virus infection in adult patients with hemophagocytic lymphohistiocytosis , 2010, American journal of hematology.

[34]  M. Strout,et al.  Alemtuzumab as a bridge to allogeneic SCT in atypical hemophagocytic lymphohistiocytosis , 2010, Nature Reviews Clinical Oncology.

[35]  M. Rybojad,et al.  Critical care management of patients with hemophagocytic lymphohistiocytosis , 2010, Intensive Care Medicine.

[36]  C. Lebbé,et al.  Reactive haemophagocytic syndrome in 58 HIV-1-infected patients: clinical features, underlying diseases and prognosis , 2010, AIDS.

[37]  H. Ogawa,et al.  [Aggressive NK-cell leukemia with sustained relapse-free survival after allogeneic peripheral blood stem cell transplantation]. , 2010, [Rinsho ketsueki] The Japanese journal of clinical hematology.

[38]  S. Jang,et al.  Establishment of a reference interval for natural killer cell activity through flow cytometry and its clinical application in the diagnosis of hemophagocytic lymphohistiocytosis , 2010, International journal of laboratory hematology.

[39]  K. McClain,et al.  Hemophagocytic lymphohistiocytosis in Texas: Observations on ethnicity and race , 2010, Pediatric blood & cancer.

[40]  C. Lebbé,et al.  Frequency, clinical features and prognosis of cutaneous manifestations in adult patients with reactive haemophagocytic syndrome , 2010, The British journal of dermatology.

[41]  H. Albrecht,et al.  Viral infections associated with haemophagocytic syndrome , 2010, Reviews in medical virology.

[42]  J. V. van Dissel,et al.  Fever, shock, and pancytopenia in a patient treated with alemtuzumab. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[43]  K. Ohashi,et al.  High incidence of haemophagocytic syndrome following umbilical cord blood transplantation for adults , 2009, British journal of haematology.

[44]  E. Jaffe,et al.  Epstein-Barr virus-associated lymphoproliferative disease in non-immunocompromised hosts: a status report and summary of an international meeting, 8-9 September 2008. , 2009, Annals of oncology : official journal of the European Society for Medical Oncology.

[45]  J. Raemaekers,et al.  The role of rituximab in a case of EBV-related lymphoproliferative disease presenting with haemophagocytosis. , 2009, The Netherlands journal of medicine.

[46]  Yini Wang,et al.  Early diagnostic value of low percentage of glycosylated ferritin in secondary hemophagocytic lymphohistiocytosis , 2009, International journal of hematology.

[47]  Jingshi Wang,et al.  [Significance of hemophagocytosis in diagnosis of hemophagocytic lymphohistiocytosis]. , 2009, Zhongguo shi yan xue ye xue za zhi.

[48]  F. Torti,et al.  Ferritin for the clinician. , 2009, Blood reviews.

[49]  A. Vinks,et al.  Severe neurologic side effects in patients being treated for hemophagocytic lymphohistiocytosis , 2009, Pediatric blood & cancer.

[50]  J. Carcillo,et al.  Secondary hemophagocytic lymphohistiocytosis and severe sepsis/ systemic inflammatory response syndrome/multiorgan dysfunction syndrome/macrophage activation syndrome share common intermediate phenotypes on a spectrum of inflammation. , 2009, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[51]  H. Hirasawa,et al.  Continuous hemodiafiltration in the treatment of reactive hemophagocytic syndrome refractory to medical therapy. , 2009, Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis.

[52]  J. Maruyama,et al.  Cyclosporin rapidly diminished a severe lupus-associated macrophage association syndrome refractory to pulsed methylprednisolone and intravenous immunoglobulin , 2009, Scandinavian journal of rheumatology.

[53]  Yini Wang,et al.  [Diagnostic significance of glycosylated ferritin for patients with secondary hemophagocytic lymphohistiocytosis]. , 2008, Zhongguo shi yan xue ye xue za zhi.

[54]  M. Kawamura,et al.  Increased serum monocyte chemoattractant protein‐1, macrophage inflammatory protein‐1β, and interleukin‐8 concentrations in hemophagocytic lymphohistiocytosis , 2008, Pediatric blood & cancer.

[55]  T. Koike,et al.  Clinical features of haemophagocytic syndrome in patients with systemic autoimmune diseases: analysis of 30 cases. , 2008, Rheumatology.

[56]  É. Nicand,et al.  Syndrome confusionnel et anémie hémolytique au retour d'outre-mer , 2008 .

[57]  R. Arceci When T cells and macrophages do not talk: the hemophagocytic syndromes , 2008, Current opinion in hematology.

[58]  Je-Jung Lee,et al.  Treatment Outcomes with CHOP Chemotherapy in Adult Patients with Hemophagocytic Lymphohistiocytosis , 2008, Journal of Korean medical science.

[59]  É. Azoulay,et al.  Understanding organ dysfunction in hemophagocytic lymphohistiocytosis , 2008, Intensive Care Medicine.

[60]  C. Teng,et al.  Primary splenic lymphoma associated with hemophagocytic lymphohistiocytosis complicated with splenic rupture. , 2008, Journal of the Chinese Medical Association : JCMA.

[61]  Á. G. Franco,et al.  Hemophagocytic lymphohistiocytosis secondary to Calmette-Guèrin bacilli infection. , 2008, European journal of internal medicine.

[62]  S. Banno,et al.  Successful use of etanercept in the treatment of acute lupus hemophagocytic syndrome , 2008, Modern rheumatology.

[63]  M. Abdelhaleem,et al.  The role of hemophagocytosis in bone marrow aspirates in the diagnosis of hemophagocytic lymphohistiocytosis , 2008, Pediatric blood & cancer.

[64]  Jian Huang,et al.  Clinical characteristics of T-cell lymphoma associated with hemophagocytic syndrome: Comparison of T-cell lymphoma with and without hemophagocytic syndrome , 2008, Leukemia & lymphoma.

[65]  N. Rouphael,et al.  Infections associated with haemophagocytic syndrome , 2007, The Lancet Infectious Diseases.

[66]  J. Won,et al.  [A case of therapy-related acute monocytic leukemia following low-dose of etoposide treatment for hemophagocytic lymphohistiocytosis]. , 2007, The Korean journal of laboratory medicine.

[67]  D. Teachey,et al.  Use of rituximab in conjunction with immunosuppressive chemotherapy as a novel therapy for Epstein Barr virus-associated hemophagocytic lymphohistiocytosis. , 2007, Journal of pediatric hematology/oncology.

[68]  K. Kawa,et al.  Nationwide Survey of Hemophagocytic Lymphohistiocytosis in Japan , 2007, International journal of hematology.

[69]  K. Hara,et al.  Epstein-Barr virus-associated post-transplant lymphoproliferative disorder presenting with skin involvement after CD34-selected autologous peripheral blood stem cell transplantation. , 2007, European journal of dermatology : EJD.

[70]  Sarah Park,et al.  Lymphoma-associated hemophagocytic syndrome: clinical features and treatment outcome , 2007, Annals of Hematology.

[71]  H. Ohno,et al.  Rituximab alone was effective for the treatment of a diffuse large B-cell lymphoma associated with hemophagocytic syndrome , 2007, International Journal of Clinical Oncology.

[72]  M. Aricò,et al.  HLH‐2004: Diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis , 2007, Pediatric blood & cancer.

[73]  M. Çivilibal,et al.  CONTROL OF BLEEDING ASSOCIATED WITH HEMOPHAGOCYTIC SYNDROME IN CHILDREN: An Audit of the Clinical use of Recombinant Activated Factor VII , 2007, Pediatric hematology and oncology.

[74]  Y. Kodera,et al.  [Successful salvage therapy with cladribine and rituximab for a patient with a relapsed Asian variant of intravascular large B-cell lymphoma]. , 2006, [Rinsho ketsueki] The Japanese journal of clinical hematology.

[75]  P. Brastianos,et al.  Tuberculosis-associated haemophagocytic syndrome. , 2006, The Lancet. Infectious diseases.

[76]  M. Makuuchi,et al.  Hemophagocytic syndrome after adult-to-adult living donor liver transplantation. , 2006, Transplantation proceedings.

[77]  J. Piette,et al.  Characteristics and Long-Term Outcome of 15 Episodes of Systemic Lupus Erythematosus-Associated Hemophagocytic Syndrome , 2006, Medicine.

[78]  E. Ok,et al.  High-dose immunoglobulin therapy in renal transplant recipients with hemophagocytic histiocytic syndrome. , 2006, Journal of nephrology.

[79]  H. Mitsuya,et al.  PERIPHERAL HEMOPHAGOCYTOSIS: AN EARLY INDICATOR OF ADVANCED SYSTEMIC INFLAMMATORY RESPONSE SYNDROME/HEMOPHAGOCYTIC SYNDROME , 2006, Shock.

[80]  T. Miyamoto,et al.  Success with infliximab in treating refractory hemophagocytic lymphohistiocytosis , 2006, American journal of hematology.

[81]  N. Siddiqui,et al.  Haemophagocytic syndrome associated with hepatitis-B virus infection responding to etoposide. , 2005, Clinical and laboratory haematology.

[82]  C. Dinarello,et al.  Severe imbalance of IL-18/IL-18BP in patients with secondary hemophagocytic syndrome. , 2005, Blood.

[83]  K. Neftel,et al.  Haemophagocytic syndromes in adults: current concepts and challenges ahead. , 2005, Swiss medical weekly.

[84]  M. Kurrer,et al.  Soluble hemoglobin–haptoglobin scavenger receptor CD163 as a lineage‐specific marker in the reactive hemophagocytic syndrome , 2005, European journal of haematology.

[85]  Y. Shoenfeld,et al.  Intravenous immunoglobulin and the kidney--a two-edged sword. , 2004, Seminars in arthritis and rheumatism.

[86]  Sa A. Wang,et al.  Hemophagocytosis exacerbated by G‐CSF/GM‐CSF treatment in a patient with myelodysplasia , 2004, American journal of hematology.

[87]  E. Hahn,et al.  Multifactorial risk analysis of bone marrow histiocytic hyperplasia with hemophagocytosis in critically ill medical patients—A postmortem clinicopathologic analysis , 2004, Critical care medicine.

[88]  S. Bae,et al.  Copyright � The Korean Academy of Medical Sciences Adult-onset Still's Disease with Disseminated Intravascular Coagulation , 2002 .

[89]  E. Thervet,et al.  Hemophagocytic syndrome in renal transplant recipients: report of 17 cases and review of literature , 2004, Transplantation.

[90]  J. Piette,et al.  Reactive hemophagocytic syndrome in adult systemic disease: report of twenty-six cases and literature review. , 2003, Arthritis and rheumatism.

[91]  T. Nakao,et al.  Treatment of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in young adults: a report from the HLH study center. , 2003, Medical and pediatric oncology.

[92]  E. Iannitto,et al.  Bone marrow biopsy in hemophagocytic syndrome , 2002, Virchows Archiv.

[93]  J. Harlé,et al.  Severe hemophagocytic syndrome after intravesical BCG instillation. , 2002, The American journal of medicine.

[94]  C. Haioun,et al.  [Intravascular large cell lymphoma revealed by diffuse telangiectasia and cauda equina syndrome]. , 2002, Annales de dermatologie et de venereologie.

[95]  K. Neftel,et al.  Intravenous immunoglobulin for hemophagocytic lymphohistiocytosis? , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[96]  A. Morimoto,et al.  Quantitative Analysis of Cell-free Epstein-Barr Virus Genome Copy Number in Patients with EBV-associated Hemophagocytic Lymphohistiocytosis , 2002, Leukemia & lymphoma.

[97]  S. Nakamura,et al.  A Clinicopathological Study of 20 Patients With T/Natural Killer (NK)-Cell Lymphoma-Associated Hemophagocytic Syndrome With Special Reference to Nasal and Nasal-Type NK/T-Cell Lymphoma , 2001, International journal of hematology.

[98]  L. Moretta,et al.  Pathogenesis of haemophagocytic lymphohistiocytosis , 2001, British journal of haematology.

[99]  E. Ashihara,et al.  Clinical characteristics of B-cell lymphoma-associated hemophagocytic syndrome (B-LAHS): comparison of CD5+ with CD5- B-LAHS. , 2001, Internal medicine.

[100]  N. Takahashi,et al.  A Clinical Analysis of 52 Adult Patients With Hemophagocytic Syndrome: The Prognostic Significance of the Underlying Diseases , 2001, International journal of hematology.

[101]  C. Copie-Bergman,et al.  Bone Marrow Involvement in Lymphomas With Hemophagocytic Syndrome at Presentation: A Clinicopathologic Study of 11 Patients in a Western Institution , 2001, The American journal of surgical pathology.

[102]  M. Kato,et al.  Requirement for etoposide in the treatment of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[103]  D. Valla,et al.  Hepatic manifestations of hemophagocytic syndrome: a study of 30 cases , 2001, American Journal of Gastroenterology.

[104]  F. Demirkan,et al.  Hemophagocytic Syndrome Associated with Inappropiate Secretion of Antidiuretic Hormone in Lymphoma and Acute Myeloblastic Leukemia: Report of Two Cases , 2001, Leukemia & lymphoma.

[105]  A. Baruchel,et al.  [Intravenously administered gamma-globulins in reactive hemaphagocytic syndrome. Multicenter study to assess their importance, by the immunoglobulins group of experts of CEDIT of the AP-HP]. , 2000, Annales de medecine interne.

[106]  T. Kodera,et al.  Angiotropic B-cell lymphoma with hemophagocytic syndrome associated with syndrome of inappropriate secretion of antidiuretic hormone , 2000, Annals of Hematology.

[107]  Wan Ariffin Bin Abdullah,et al.  Med Pediatr Oncol , 1999 .

[108]  K. Ohshima,et al.  Clinicopathological findings of virus‐associated hemophagocytic syndrome in bone marrow: Association with Epstein‐Barr virus and apoptosis , 1999, Pathology international.

[109]  A. Majluf-Cruz,et al.  Hemophagocytic syndrome associated with hematological neoplasias. , 1998, Leukemia research.

[110]  H. Tsuda The use of cyclosporin-A in the treatment of virus-associated hemophagocytic syndrome in adults. , 1997, Leukemia & lymphoma.

[111]  Y. Minamino,et al.  Successful treatment with cyclosporine in a case of hemophagocytic syndrome manifesting as severe liver dysfunction. , 1997, The American journal of the medical sciences.

[112]  M. Tulliez,et al.  Role of hemophagocytic histiocytosis in the etiology of thrombocytopenia in patients with sepsis syndrome or septic shock. , 1997, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[113]  M. Yoshida,et al.  Prognostic factors of hemophagocytic syndrome in adults: analysis of 34 cases , 1997, European journal of haematology.

[114]  M. Takei,et al.  [Successful treatment with intermittent administration of etoposide for an adult case with recurrent hemophagocytic syndrome, developed in association with chronic EB virus infection related lymphoid hyperplasia in the small intestine]. , 1997, [Rinsho ketsueki] The Japanese journal of clinical hematology.

[115]  R. Egeler,et al.  HLH-94: a treatment protocol for hemophagocytic lymphohistiocytosis. HLH study Group of the Histiocyte Society. , 1997, Medical and pediatric oncology.

[116]  B. Quesnel,et al.  Successful treatment of juvenile rheumatoid arthritis associated haemophagocytic syndrome by cyclosporin A with transient exacerbation by conventional-dose G-CSF. , 1997, British journal of haematology.

[117]  H. Tsuda,et al.  Serum lipids in adult patients with hemophagocytic syndrome , 1996, American journal of hematology.

[118]  Y. Sakiyama,et al.  ETOPOSIDE (VP‐16) INHIBITS EPSTEIN‐BARR VIRUS DETERMINED NUCLEAR ANTIGEN (EBNA) SYNTHESIS , 1995, British journal of haematology.

[119]  M. Bell,et al.  Fatal virus-associated hemophagocytic syndrome in a young adult producing nontraumatic splenic rupture. , 1992, Journal of forensic sciences.

[120]  P. Nilsson-ehle,et al.  Lipoprotein Alterations and Plasma Lipoprotein Lipase Reduction in Familial Hemophagocytic Lymphohistiocytosis , 1991, Acta paediatrica Scandinavica.

[121]  A. Öst,et al.  Incidence in Sweden and Clinical Features of Familial Hemophagocytic Lymphohistiocytosis , 1991, Acta paediatrica Scandinavica.

[122]  A. Öst,et al.  DIAGNOSTIC GUIDELINES FOR HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS , 1991 .

[123]  H. Balfour,et al.  Virus‐associated hemophagocytic syndrome A benign histiocytic proliferation distinct from malignant histiocytosis , 1979, Cancer.

[124]  C. Tabata,et al.  Possible prediction of underlying lymphoma by high sIL-2R/ferritin ratio in hemophagocytic syndrome , 2011, Annals of Hematology.

[125]  K. Oshimi,et al.  Analysis of triglyceride value in the diagnosis and treatment response of secondary hemophagocytic syndrome. , 2009, Internal medicine.

[126]  I. Nakamura,et al.  [A case of dengue fever with viral-associated hemophagocytic syndrome]. , 2009, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases.

[127]  S. Rubio Barbón,et al.  [Hemophagocytic syndrome. Study of 16 cases]. , 2009, Medicina clinica.

[128]  C. Teng,et al.  Occult subcutaneous panniculitis-like T-cell lymphoma with initial presentations of cellulitis-like skin lesion and fulminant hemophagocytosis. , 2007, Journal of the Formosan Medical Association = Taiwan yi zhi.

[129]  T. Yoshino,et al.  Hemophagocytic syndrome associated with fatal veno-occlusive disease in the liver. , 2007, Internal medicine.

[130]  N. Kececioglu,et al.  Is there any effect of compliance on clinical parameters of renal transplant recipients? , 2004, Transplantation proceedings.

[131]  A. Cariou,et al.  Plasmapheresis for the treatment of acute pancreatitis induced by hemophagocytic syndrome related to hypertriglyceridemia , 2003, Journal of clinical apheresis.

[132]  H. Fujimura,et al.  [An autopsy case of malignant lymphoma who showed hearing loss and cavernous sinus syndrome in the first stage and hemophagocytic syndrome]. , 2000, Rinsho shinkeigaku = Clinical neurology.