Seyed Farshad Allameh
Vol 7 No 1 (2022): January-February
Kikuchi disease is a benign, self-limited, and rare condition presented mainly by lymphadenopathy and fever. Kikuchi disease is more common in women, especially women under 40. We report a 63-year-old Iranian woman presenting with long-term fever, constitutional symptoms, and cervical lymphadenopathy. A lymph node biopsy was done for her, and the diagnosis of Kikuchi disease was confirmed. Kikuchi disease is a self-limited condition with a good prognosis that can resolve with no specific treatment within a few weeks. Still, some patients are at risk of recurrence and development of SLE and Lymphoma. Our patient was treated with a low dose of glucocorticoids. On 6 month follow-up, she had no signs and symptoms of recurrence and no evidence of SLE development. The interesting point of this case is the clinical picture and her age of presentation.
Gastrointestinal complications are common in chemotherapy patients. Although most patients’ abdominal symptoms can be due to mild chemotherapy adverse reactions, severe or life-threatening complications might occur. Typhlitis or neutropenic enterocolitis is a severe bowel wall inflammation in leukemia or solid tumor chemotherapy in neutropenic patients and may contribute to necrosis and colon perforation. Patients undergoing chemotherapy rarely experience colitis that has no standard typhlitis trait. This ischemic colitis-induced chemotherapy had conducted in patients receiving taxane-based agents. Our study presented ischemic colitis in patients receiving 5-fluorouracil, Leucovorin, and Irinotecan for sigmoid cancer that affected the transverse colon alone, unlikely for both typhlitis and chemotherapy-induced ischemic colitis. Given these findings; it is prominent to consider that life-threatening gastrointestinal complications may develop with these agents, and then surgical intervention is needed
Chronic Granulomatous Disease (CGD) is a rare inherited primary immune deficiency disorder with defective respiratory burst activity in phagocytes, resulting in recurrent pyogenic infections. In this study, we described two CGD patients who had done bone marrow transplantation (BMT). As Bone marrow transplantation (BMT) is the definitive treatment of the disease, we evaluated the function of their lungs before and after BMT. In both patients, the BMT was from their siblings. In case 1, the patient’s pulmonary function (PFT) before BMT was: FEV1: 34, FVC: 40, FEV1 / FVC: 72%, and after BMT was: FEV1: 66, FVC: 40 by 49, FEV1 / FVC: 64%. In case 2, the patient’s PFT before BMT was: FEV1: 22, FVC: 36, FEV1 / FVC: 41%, and after BMT was: FEV1: 47, FVC: 33, FEV1/FVC: 43%. BMT significantly improved their Pulmonary Problems and Preclinical (PFT). In addition, after BMT, both patients’ well-tolerated clinical signs and the infection rate, and the number of hospitalizations in both patients decreased.
Anaphylaxis is a severe allergic reaction characterized by life-threatening airway, breathing, and hemostatic problems. There has been an established association between cerebral infarction following wasp or bee sting in the literature. A 54-year-old female was admitted to the hospital for acute anaphylaxis due to bleach exposure and developed a new-onset left-sided weakness. Head computed tomography demonstrated midline frontal calcifications but was negative for acute ischemia or hemorrhage. Magnetic resonance imaging multifocal infarcts of the internal capsule’s right temporal and posterior limb. The patient was started on aspirin 81 mg, atorvastatin 40 mg daily for secondary prevention of stroke, and physical, occupational, and speech therapies. Although exceedingly rare, decreased cerebral blood flow may occur secondary to anaphylaxis due to an abrupt drop in blood pressure leading to ischemic injury. The case characterizes a unique association between bleach anaphylaxis and ischemic stroke, which has not been previously reported.
Variations of Monteggia fractures are uncommon in the pediatric population and demand a high suspicion for early recognition and treatment. The involvement of the radial head in these types of injury isn’t well documented, but literary reports are growing. We report a case of a poorly documented variant of a Monteggia Equivalent Fracture with a Salter-Harris II fracture of the radial head with medial displacement and propose a new approach to the Bado classification in the pediatric population based on a literature review.
Thyroid malignant neoplasms are the most prevalent cancer of the endocrine system, and their concurrence with parathyroid neoplasms is extremely rare. We report a 69-year-old woman presenting with hypercalcemia and thyroid nodule, which histologic examination revealed bilateral papillary thyroid carcinoma with different variants coincident with parathyroid adenoma. Awareness of concomitant parathyroid and thyroid diseases may help manage patients with hypercalcemia history. So, we recommended a preoperative calcium check in a patient with a thyroid nodule.
Presacral tumors are a rare group of tumors located posterior to the rectum in the retrorectal or presacral space. Due to the lack of specific symptoms and difficult anatomic localization, they present a diagnostic and management challenge for the surgeons. We present a case of retrorectal schwannoma in a young female who was initially misdiagnosed as a uterine fibroid on ultrasound and taken up for myomectomy. The tumor was later successfully excised by a combined abdominosacral approach. The clinical features and management of presacral tumors are discussed in this article.
A unicornuate uterus with a non-communicating rudimentary horn has always been a notorious uterine malformation threatening normal pregnancy continuation. Pregnancy in the rudimentary horn of the uterus is rare, but it plays an essential role in maternal morbidity and mortality. Early detection of rudimentary horn pregnancy is vital because poor musculature can lead to the dangerous complication of uterine rupture. When a Rudimentary horn pregnancy is diagnosed, surgical treatment to excision the horn with ipsilateral salpingectomy is recommended because of its high risk of rupture in the second trimester. We present a case of non-communicating rudimentary horn pregnancy that was terminated, and the rudimentary horn was resected.
The spread of Lassa Fever (LF) cases across international borders call for cross-board management and collaboration. This case report describes a laboratory-confirmed index case of LF in Kwara state, Nigeria. The case of LF in Kwara state was a 30-year-old woman who presented with a history of fever, headache, and abdominal pain and had been treated for malaria. On 13th February 2020, the Kwara State Ministry of Health was notified of a suspected case of LF. The case visited health facilities in Kwara state, Nigeria, and the Republic of Benin during her illness. Blood samples were obtained from her, and she was confirmed a positive LF case in the Republic of Benin. Although LF diagnosis is challenging, multisectoral collaboration and effective community engagement within the framework of the International Health Regulations is required to control the LF outbreak promptly.
Cervical dystonia is a common malaise in the doctor's office. It is a movement disorder characterized by sustained involuntary muscle contractions and abnormal postures: the patient ehibits involuntary left head and neck turning. It can recognize various more or less severe conditions as etiologicals agents and still remains a difficult disorder to treat. We reviewed a clinical case, analyzing both the moments of differential diagnostics and the therapeutic choices, with particular interest in cerebral electrostimulation.
This case describes a female with long-term primary infertility, labelled with polycystic ovarian syndrome, who showed no response to the given treatments. Hysterosalpingography, performed as part of the in vitro Fertilisation (IVF) preparation, showed Asherman syndrome and calcified lymph nodes. Subsequently, further evaluations confirmed tuberculosis. The case highlights the necessity and importance of the proper assessment of the patients presenting with infertility for early detection of genital TB to prevent end-stage disease.
Introduction: Cystic meningioma is an unusual shape of meningioma, and the imaging manifestations and site of the solid/cystic components of the mass increase our difficulties in making a diagnosis.
Case report: We report a case of a 78-year-old right-handed woman who presented with right-sided hemiparesis, urinary incontinency, and Broca aphasia. A large left-sided frontal region cystic extra-axial mass with a suspicious small solid nodule and adjacent bony erosion was detected on non-contrast CT of the brain. Brain Magnetic resonance imaging (MRI) with gadolinium depicted the cystic and solid components exactly. A probable diagnosis of cystic meningioma was made and subsequently confirmed by histological study after surgical resection of the tumor. To confirm the category and subtypes of the tumor, a histopathological examination of the tumor cells should be done.
Conclusion: Cystic or solid cystic intracranial lesions have several differential diagnoses making the final diagnosis difficult in some cases. There are four types of cystic meningiomas according to the Nauta classification that was revised by Jung et al. Determination of the type of cystic meningioma is crucial for surgical planning. To confirm the category and subtypes of the tumor, a histopathological examination of the tumor cells should be done. Our case was a type IV cystic meningioma with a small mural enhancing solid nodule but an associated adjacent bony invasion.
Seyed Farshad Allameh
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