Immunochemistry in the work‐up of mesothelioma and its differential diagnosis and mimickers

2021 ◽  
Author(s):  
Wadad S. Mneimneh ◽  
Yuying Jiang ◽  
Aparna Harbhajanka ◽  
Claire W. Michael
Keyword(s):  
Differential Diagnosis ◽  
Work Up

scholarly journals Neonate born with ischemic limb to a COVID-19 positive mother: management and review of literature

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shahana Perveen ◽  
Karmaine A. Millington ◽  
Suchitra Acharya ◽  
Amit Grag ◽  
Vita Boyar
Keyword(s):  
Differential Diagnosis ◽  
Compartment Syndrome ◽  
Upper Extremity ◽  
Preterm Neonate ◽  
Review Of Literature ◽  
Case Presentation ◽  
Ischemic Limb ◽  
History Of ◽  
Hand Amputation ◽  
Work Up

AbstractObjectivesTo describe challenges in diagnosis and treatment of congenital neonatal gangrene lesions associated with history of maternal coronavirus disease 2019 (COVID-19) infection.Case presentationA preterm neonate was born with upper extremity necrotic lesions and a history of active maternal COVID-19 infection. The etiology of his injury was challenging to deduce, despite extensive hypercoagulability work-up and biopsy of the lesion. Management, including partial forearm salvage and hand amputation is described.ConclusionsNeonatal gangrene has various etiologies, including compartment syndrome and intrauterine thromboembolic phenomena. Maternal COVID-19 can cause intrauterine thrombotic events and need to be considered in a differential diagnosis.

scholarly journals Pulvinar sign in a case of anti-HU paraneoplastic encephalitis

2016 ◽  
Vol 29 (6) ◽  
pp. 436-439 ◽  
Author(s):  
Pierre-Luc Gamache ◽  
Maude-Marie Gagnon ◽  
Martin Savard ◽  
François Émond
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Clinical Manifestations ◽  
Resonance Imaging ◽  
Paraneoplastic Encephalitis ◽  
Jakob Disease ◽  
Magnetic Resonance Imaging Mri ◽  
Work Up

This article reports the case of a 68-year-old patient with anti-HU antibodies paraneoplastic encephalitis. The clinical manifestations were atypical and the paraclinical work-up, notably the magnetic resonance imaging (MRI) showing bilateral posterior thalamic hyperintensities (pulvinar sign), misleadingly pointed towards a variant Creutzfeld–Jakob disease. After presenting the case, the differential diagnosis of the pulvinar sign is discussed along with other important diagnostic considerations.

scholarly journals Metastatic adrenal pheochromocytoma to the thoracic spine

2010 ◽  
Vol 9 (3) ◽  
pp. 343-346 ◽  
Author(s):  
Michael T. Scalfani ◽  
Paul M. Arnold ◽  
Karen K. Anderson
Keyword(s):  
Differential Diagnosis ◽  
Surgical Intervention ◽  
Hepatic Metastases ◽  
Posterior Fixation ◽  
Original Diagnosis ◽  
Average Survival ◽  
Progression Of Disease ◽  
Adrenal Pheochromocytoma ◽  
History Of ◽  
Work Up

To report on a case of pheochromocytoma metastases to the spine occurring more than 20 years after initial diagnosis. A 34-year-old female with a history of metastatic pheochromocytoma diagnosed at age 12 presented with weakness, heart palpitations, and circumferential back pain of five months duration. The patient had undergone multiple laparatomies for abdominal and hepatic metastases. Work-up revealed a destructive lesion at T9. After two weeks of preoperative phenoxybenzamine to control her hypertension, she underwent decompression, posterior fixation and fusion. Surgical intervention was followed by radiation therapy, zoledronic acid, and only one cycle of chemotherapy due to intolerance of side effects. The patient survived 25 years after original diagnosis, which far exceeds the average survival of less than 15 years. The patient died 26 months postoperatively due to progression of disease. Pheochromocytoma with spine metastases occurring more than 20 years after diagnosis is very uncommon, and should be considered in the differential diagnosis of a patient with a history of pheochromocytoma.

scholarly journals Age-related aspects of differential diagnosis of acute cough in children and adults

2018 ◽  
Vol 28 (4) ◽  
pp. 461-468
Author(s):  
I. V. Leshchenko ◽  
S. A. Tsar’kova ◽  
A. D. Zherebtsov
Keyword(s):  
Differential Diagnosis ◽  
Anatomical Location ◽  
Pathological Changes ◽  
Review Of Literature ◽  
Acute Cough ◽  
Age Related ◽  
Common Causes ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Cough is one of the most common causes of seeking the primary medical care, especially during the autumn and the spring. This article is a review of literature  aimed at differential diagnosis of possible causes of acute cough in children and  adults. Given a vast majority of diseases associated with cough, differential diagnosis  have to consider several issues. The key issue is cough duration and possible  anatomical location of the pathological changes. An algorithm of differential diagnosis  of acute cough in children and adults and description of most common diseases  associated with acute cough are given in the review. Further diagnostic work-up  should be driven by the duration of cough as soon as the acute cough could be first  manifestation of a chronic disease.

Diffuse alveolar haemorrhage: a rare complication of clopidogrel use

2021 ◽  
Vol 14 (8) ◽  
pp. e244314
Author(s):  
Rachelle Soriano ◽  
Saud Al-Rawaf ◽  
Khalil Diab
Keyword(s):  
Differential Diagnosis ◽  
Native American ◽  
Rare Complication ◽  
American Woman ◽  
Alveolar Haemorrhage ◽  
High Dose ◽  
Diffuse Alveolar Haemorrhage ◽  
Carotid Artery Stent ◽  
Hypoxic Respiratory Failure ◽  
Work Up

Diffuse alveolar haemorrhage (DAH) has been reported as a rare complication of clopidogrel use and is usually a diagnosis of exclusion. We describe the case of an 88-year-old Native American woman who presented with acute hypoxic respiratory failure with CT scan of the chest showing diffuse bilateral ground-glass opacities. She had been on clopidogrel for 6 months for a carotid artery stent. Bronchoscopy with bronchoalveolar lavage and transbronchial biopsies revealed DAH. Infectious and autoimmune work-up were all negative. Clopidogrel was stopped and high-dose steroids were started. Her symptoms gradually improved until she was discharged from the hospital. The differential DAH is broad. Anticoagulant-induced DAH should be part of the differential diagnosis, and is usually a diagnosis of exclusion.

Abstract 108: Additional Value of Intracranial Vessel Wall Imaging to Determine the Etiology of Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Joanna D Schaafsma ◽  
David J Mikulis ◽  
Jonathan Coutinho ◽  
Cheryl S Jaigobin ◽  
Daniel M Mandell
Keyword(s):  
Differential Diagnosis ◽  
Ischemic Stroke ◽  
Vessel Wall ◽  
Stroke Work ◽  
Standard Work ◽  
Additional Information ◽  
Stroke Etiology ◽  
Additional Value ◽  
Work Up ◽  
Wall Imaging

Objective: High-resolution MR-imaging of the intracranial arterial wall is a promising technique for diagnosis of intracranial arteriopathies in patients with ischemic stroke. We aimed to evaluate the additional value of vessel wall imaging (VWI) to the standard work-up of ischemic stroke patients. Methods: We selected all patients with ischemic stroke who had intracranial VWI at our institute to evaluate possible intracranial arteriopathy, such as atherosclerosis, dissection, vasculitis, or reversible cerebral vasoconstriction syndrome. Two observers, who were blinded to the VWI, first determined the most likely stroke etiology based on the standard work-up (clinical history, brain parenchyma imaging, vessel lumen imaging, laboratory results, and cardiac work-up). Then VWI was reviewed to assess whether this would change the suspected stroke etiology or whether the differential diagnosis could be narrowed down. Results: Between 2006 and 2014, 199 patients with ischemic stroke, mean age 55 (IQ-range: 44-67) had VWI. VWI provided additional information to the standard stroke work-up in 128 patients (64%). In 38/199 patients (19%) the conclusion on stroke etiology was altered based on VWI and in 90/199 patients (45%) the differential diagnosis was further narrowed after VWI. VWI did not have additional value when the most likely stroke etiology based on the standard work-up remained the same (50/199 patients; 25%), when the differential diagnosis could not be narrowed down (16/199; 8%), or in case of poor image quality (5/199 patients; 3%). Patients under the age of 46 benefited more often from VWI than older adults (Odds Ratio 3.5; 95%CI: 1.7-7.6). Conclusion: VWI provided additional information to the conventional stroke work-up in almost two-thirds of patients suspected to have intracranial arteriopathy. Next step is to determine how frequently this additional information resulted in altered therapy.

A 59-Year-Old Man with Progressive Difficulties with Balance and Weight Loss

2016 ◽  
Author(s):  
Jeffrey A. Cohen ◽  
Justin J. Mowchun ◽  
Victoria H. Lawson ◽  
Nathaniel M. Robbins
Keyword(s):  
Weight Loss ◽  
Differential Diagnosis ◽  
Peripheral Neuropathy ◽  
Cerebral Spinal Fluid ◽  
Treatment Options ◽  
Peripheral Neuropathies ◽  
Serum Antibodies ◽  
Paraneoplastic Neuropathy ◽  
Work Up ◽  
Paraneoplastic Antibody

Paraneoplastic peripheral neuropathies are rare but important to consider in the evaluation of subacute peripheral neuropathy. The clinical and electrophysiological pattern as well as antibody evaluation is essential order to identify a specific paraneoplastic neuropathy. A positive paraneoplastic antibody in the cerebral spinal fluid is not required to make the diagnosis, but is helpful to consider if the serum antibodies are negative. This chapter emphasizes the importance of differential diagnosis and work up. Treatment options are described. Immunotherapy is also an important consideration.

scholarly journals A RARE CASE OF STATIN-INDUCED NECROTIZING AUTOIMMUNE MYOPATHY

2020 ◽  
Vol 6 (2) ◽  
pp. e86-e89
Author(s):  
Shirley Shuster ◽  
Sara Awad
Keyword(s):  
Differential Diagnosis ◽  
Statin Therapy ◽  
Alternative Therapy ◽  
Pcsk9 Inhibitors ◽  
Pcsk9 Inhibitor ◽  
Lipid Panel ◽  
Exposed Individual ◽  
Necrotizing Autoimmune Myopathy ◽  
Autoimmune Myopathy ◽  
Work Up

Objective: Necrotizing autoimmune myopathy (NAM) is a rare side-effect of statin therapy. We report the case of a patient who developed statin-induced NAM with a review of the clinical presentation and management of this rare entity. The case illustrates the importance of including NAM in the differential diagnosis of persistent myopathy in a statin-exposed individual. Methods: A 74-year-old male was referred to endocrinology for hypercholesterolemia management in the context of a statin contraindication. He previously developed myositis and rhabdomyolysis secondary to statin therapy, but continued to have persistent proximal lower limb muscle weakness despite statin discontinuation. Rheumatologic and metabolic work-up were negative and neurologic work-up was negative except for a myopathic pattern in the glutei found on electromyography. Results: Due to the persistence of proximal myopathy despite statin discontinuation and myopathic pattern seen on electromyography, NAM was suspected and antibodies against 3-hydroxy-3-methylglutaryl-coenzyme A reductase were sent and came back positive. The patient was treated with the immunosuppressant azathioprine, which resulted in clinical improvement. The patient was started on a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolucumab for hypercholesterolemia, which resulted in significant improvement in his lipid panel. Conclusion: The case illustrates the presentation and management of statin-induced NAM. We demonstrate the necessity for prompt diagnosis and timely management, as statin therapy is contraindicated and immunosuppressive therapy is warranted. Statin-induced NAM is rare however, it should be included in the differential diagnosis of persistent myopathy despite statin discontinuation. PCSK9 inhibitors are the only alternative therapy for hypercholesterolemia management in patients with statin-induced NAM.

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