Intestinal lymphangiectasia is a pathological dilation of enteric lymphatic vessels resulting in lymph leakage to the intestinal lumen. This chronic lymph leakage leads to a state of immunosuppression secondary to the loss of humoral and cellular components of the immune system and represents a potential risk factor for opportunistic infections. We report a case of protein-losing enteropathy in a seemingly immunocompetent patient. An intestinal histopathological study revealed the unusual association...
Tue Apr 21, 2020 12:05
Primary dural lymphoma (PDL) is an extranodal non-Hodgkin lymphoma that accounts for less than 1% of all central nervous system lymphomas. Primary dural lymphoma grows from the dura mater, and it is often diagnosed as meningioma or acute subdural hematoma due to its radiological characteristics. Surgery is the gold standard of therapy; in many patients, PDL is relatively benign with good outcome. Authors report their experience in three patients affected by extranodal non-Hodgkin lymphoma (PDL) mimicking...
Tue Apr 21, 2020 12:05
The present report describes the case of a 56-year-old African American man experiencing progressive disequilibrium, lower extremity weakness, difficulty walking, and hearing loss. Brain magnetic resonance imaging showed leptomeningeal enhancement. Initial differential diagnosis was broad, including malignant, infectious, and inflammatory etiologies. The cerebrospinal fluid analyses demonstrated lymphocytic pleocytosis, hypoglycorrhachia, and hyperproteinorrachia but no other abnormalities. An extensive...
Tue Apr 21, 2020 08:35
Acute Motor Sensory Axonal Neuropathy (AMSAN) is a rare and severe variant of Guillain-Barré syndrome (GBS) that has a prolonged recovery course. GBS is often suspected due to ascending muscle weakness, sensation difficulties, respiratory compromise, and antecedent diarrhea. The diagnosis of GBS is supported by cerebrospinal fluid analysis showing albuminocytologic dissociation. Electromyogram and nerve conduction study confirm the diagnosis and allow for further classification by variant. Treatment...
Mon Apr 20, 2020 11:50
Elephantiasis nostras verrucosa (ENV) is a unique, chronic condition found in patients with obesity and chronic secondary lymphedema. It develops due to chronic inflammation and recurrent infection, most commonly on gravity-dependent sites. Progressive tissue enlargement, deformity, and disability necessitate intervention. First, clinicians should explore the etiology of patients’ secondary lymphedema, as this is paramount in determining treatment for ENV. The fundamental goal is alleviating lymphatic...
Thu Apr 16, 2020 20:05
Lethal congenital contracture syndrome type 7 (LCCS7) and congenital hypomyelinating neuropathy type 3 (CHN3) are rare autosomal recessive diseases, characterized by severe neonatal hypotonia, polyhydramnios, arthrogryposis, facial diplegia, and severe motor paralysis, leading to death in early infancy. They are related to mutations in the CNTNAP1 (contactin associated protein 1) gene, playing an important role in myelination. Recent studies have shown that both diseases could present with a wide...
Mon Apr 13, 2020 18:05
Glycogen hepatopathy (GH) is a rare complication of type 1 diabetes mellitus that leads to an abnormal accumulation of glycogen in the hepatocytes. The exact mechanism of GH remains unknown, but fluctuations in blood glucose and insulin levels play important roles in promoting glycogen accumulation. We report a case of a 16-year-old female diagnosed with poorly controlled type 1 diabetes mellitus with hepatomegaly and elevated liver enzymes. The patient experienced multiple admissions for diabetic...
Mon Apr 13, 2020 17:50
Background. Heparin-induced thrombocytopenia (HIT) is a transient, antibody-mediated thrombocytopenia syndrome that usually follows exposure to unfractioned heparin (UFH) or low-molecular-weight heparin (LMWH). In contrast to other pathological conditions which lead to thrombocytopenia and bleeding complications, HIT results in a paradoxical prothrombotic state. It is caused by antibodies directed to complexes containing UFH or LMWH and a self-platelet protein: the platelet factor 4 (PF4). The heparin-PF4...
Mon Apr 13, 2020 16:05
Splenic abscess is a very rare complication of laparoscopic sleeve gastrectomy (LSG). Clinical presentation includes fever, leucocystosis, and abdominal pain. CT SCAN is a must for diagnosis. The preferred treatment is either conservative, with intravenous antibiotics and percutaneous drainage, or splenectomy. We report the thirteen case of a splenic abscess after LSG. In our patient, the abscess occurred three weeks after LSG in a 21-year-old man, and it was successfully treated conservatively.
Mon Apr 13, 2020 10:05
Portal vein thrombosis is a major complication associated with liver cirrhosis. In cirrhotic patients, a decrease in procoagulant and anticoagulant factors and an unstable balance between them is observed, and a relative decrease in the activation of anticoagulant drivers is one of the main causes of portal vein thrombosis (PVT). Herein, we report a case of acute portal thrombosis associated with liver cirrhosis and treated with a recombinant form of soluble thrombomodulin (thrombomodulin alpha,...
Mon Apr 13, 2020 09:35
Lymphangiomas are benign tumours of lymphatic vessels which are not linked with the normal lymphatic vessels. Their symptoms usually depend on their location and size as they can compress or block adjacent organs. We present a 9-month-old girl with isolated cavernous lymphangiomas of the spleen, a rare variable of lymphangiomas, with no symptoms. She had an isolated anaemia which could only be explained by the hypersplenism caused by the lymphangiomas. Such a presentation has been very rarely reported...
Mon Apr 13, 2020 09:20
We report a case of myopathy in a chronic alcoholic patient with scurvy who presented with generalized weakness, myalgias, and arthralgia. Our case raises awareness regarding rare interaction between vitamin C deficiency and myopathy which is seen more commonly in patients with history of chronic alcoholism and low socioeconomic status. Early treatment with vitamin C replacement is helpful in treatment of the disease and its complications.
Thu Apr 09, 2020 03:20
Presentation of Case. Dr. Xavier Guell (Medicine): A 24-year-old man was transferred to this hospital because of fever, fatigue, cough, and dyspnea. The patient had been well until 5 days before this presentation, when fatigue, malaise, fever, chills, and cough that was productive of terra…
Thu Apr 16, 2020 03:00
Presentation of Case. Dr. Sarimer Sanchez (Medicine): A 37-year-old man was admitted to this hospital because of a facial droop, dysarthria, and kidney failure. The patient had been well until 1 week before admission, when weakness of the right arm and hand developed, along with difficulty with…
Thu Apr 09, 2020 03:00
Disseminated intravascular coagulation is a critical complication of advanced clear cell renal cell carcinoma, despite the rarity of the occurrence of disseminated intravascular coagulation in such tumors. The...
Tue Apr 21, 2020 03:00
Osteosarcoma is a common malignancy of bone that usually occurs in individuals in the age range of 0–24 years. Extraskeletal osteosarcoma is a rare tumor presentation which originates in non-bony tissues. Extr...
Mon Apr 20, 2020 03:00
Melioidosis is a potentially fatal bacterial infection caused by Burkholderia pseudomallei. The existence of melioidosis in Sri Lanka was once unheard of, and entertaining it as a diagnosis in clinical practice w...
Sat Apr 18, 2020 03:00
The increasing incidence of allergies and allergic reactions among children and adults has become a major public health concern. The etiology of allergic reactions can often be confirmed based on a detailed hi...
Fri Apr 17, 2020 03:00
Lyme disease is the most common tick-borne illness in the USA, Canada, and Europe. Clinical manifestations vary greatly, with localized skin findings functioning as early signs of the disease, followed by diss...
Thu Apr 16, 2020 03:00
Hydralazine is a common vasodilator which has been used for the treatment of hypertension and heart failure. Hydralazine can induce antineutrophil cytoplasmic antibody-associated vasculitis due to its auto-imm...
Wed Apr 15, 2020 03:00
Fasciotomy is a life-saving procedure to treat acute compartment syndrome, a surgical emergency. As fasciotomy dramatically improves wound pain, it should be performed as soon as possible. Moreover, delays in ...
Tue Apr 14, 2020 03:00
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