ACUTE DISSEMINATED ENCEPHALOMYELITIS (ADEM): A CASE REPORT OF A FAVOURABLE RESPONSE TO DELAYED ADMINISTRATION OF ORAL PREDNISOLONE FOLLOWING POOR RESPONSE TO TREATMENT WITH INTRAVENOUS IMMUNOGLOBULINS (IVIG)

2006 ◽  
Vol 37 (S 1) ◽  
Author(s):  
GS Chng ◽  
T Thomas ◽  
V Ganesan
Keyword(s):  
Case Report ◽  
Poor Response ◽  
Oral Prednisolone ◽  
Acute Disseminated Encephalomyelitis ◽  
Intravenous Immunoglobulins ◽  
Response To Treatment ◽  
Favourable Response

scholarly journals All that glitters is not gold: When motor and vocal tics in a child do not match Tourette syndrome: A case report

2016 ◽  
Vol 10 (3) ◽  
pp. 251-253 ◽  
Author(s):  
Raquel Quimas Molina da Costa ◽  
Rogério Paysano Marrocos ◽  
Marco Antonio Araujo Leite ◽  
Fabio Henrique Gobbi Porto
Keyword(s):  
Case Report ◽  
Tourette Syndrome ◽  
Poor Response ◽  
Extrapyramidal Symptoms ◽  
Response To Treatment ◽  
Pantothenate Kinase ◽  
Atypical Form ◽  
Psychiatric Problems ◽  
Vocal Tics

ABSTRACT The atypical form of Pantothenate Kinase-Associated Neurodegeneration (PKAN) tends to present at around the age of 14 years, has a heterogeneous presentation with extrapyramidal symptoms, and approximately one third of patients exhibit psychiatric problems. This paper reports the case of a patient with apparent typical symptoms of Tourette syndrome. However, the severity and poor response to treatment led to further investigation and the diagnosis of PKAN as a secondary cause of Tourettism was reached.

scholarly journals Nodular Scleritis Associated with Herpes Zoster Virus: An Infectious and Immune-Mediated Process

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Mónica Loureiro ◽  
Renata Rothwell ◽  
Sofia Fonseca
Keyword(s):  
Poor Response ◽  
Oral Prednisolone ◽  
Viral Disease ◽  
Response To Treatment ◽  
Pcr Analysis ◽  
Clinical Resolution ◽  
Varicella Zoster ◽  
Immune Mediated ◽  
Polymerase Chain ◽  
The Right

Purpose.To describe a case of anterior nodular scleritis, preceded by an anterior hypertensive uveitis, which was primarily caused by varicella zoster virus (VZV).Case Report. A 54-year-old woman presented with anterior uveitis of the right eye presumably caused by herpetic viral disease and was successfully treated. Two months later, she developed a nodular scleritis and started oral nonsteroidal anti-inflammatory without effect. A complete laboratory workup revealed positivity for HLA-B27; the infectious workup was negative. Therapy was changed to oral prednisolone and an incomplete improvement occurred. Therefore, a diagnostic anterior paracentesis was performed and the polymerase chain reaction (PCR) analysis revealed VZV. She was treated with valacyclovir and the oral prednisolone began to decrease; however, a marked worsening of the scleritis occurred with the reduction of the daily dose; subsequently, methotrexate was introduced allowing the suspension of the prednisolone and led to clinical resolution of the scleritis.Conclusion.This report of anterior nodular scleritis caused by VZV argues in favor of an underlying immune-mediated component, requiring immunosuppressive therapy for clinical resolution. The PCR analysis of the aqueous humor was revealed to be a valuable technique and should be considered in cases of scleritis with poor response to treatment.

Chronic Subdural Hematoma in the Elderly: A Case Report

1996 ◽  
Vol 9 (2) ◽  
pp. 100-101 ◽  
Author(s):  
Michel Elie ◽  
Francois Primeau ◽  
Martin G. Cole
Keyword(s):  
Elderly Patient ◽  
Weight Loss ◽  
Case Report ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Poor Response ◽  
The Elderly ◽  
Response To Treatment ◽  
Pharmacologic Treatment ◽  
Paranoid Symptoms

A previously healthy 82-year-old male presented with depressive and paranoid symptoms of 3 months' duration. Physical examination and cognitive functions were normal. Poor response to treatment and continuing weight loss lead to medical investigations that ultimately showed a large, left frontoparietal, chronic subdural hematoma. Following drainage, the patient showed some improvement in paranoid features but still required pharmacologic treatment for depression. The psychiatric features of chronic subdural hematoma as well as the management of this neurologic condition in the elderly patient are reviewed and discussed.

scholarly journals Vogt-Koyanagi-Harada with Unilateral Clinical Presentation: A Case Report

2020 ◽  
Author(s):  
Seyedeh Maryam Hosseini ◽  
Maryam Dourandish ◽  
Marjan Mazouchi
Keyword(s):  
Case Report ◽  
Clinical Manifestations ◽  
Oral Prednisolone ◽  
Response To Treatment ◽  
Systemic Involvement ◽  
Optic Disc Swelling ◽  
Characteristic Features ◽  
The Right ◽  
Visual Blurring ◽  
Vkh Disease

Purpose: To report a case of acute Vogt-Koyanagi-Harada (VKH) disease with unilateral clinical manifestations followed by late fellow eye involvement. Case Report: This case report reviews the 12-month follow-up observation of a 44-year old woman who presented to the emergency department with unilateral progressive and painless visual blurring. Ophthalmoscopic findings, best-corrected visual acuity (BCVA), fluorescein angiography (FAG), enhanced-depth optical coherence tomography (EDIOCT), indocyanine green angiography, and response to treatment were evaluated. Her BCVA was 20/50 (logMAR: 0.4) in the right eye and 20/20 (logMAR: 0) in the left eye. Eye examination revealed optic disc swelling and multiple serous retinal detachments in the right eye and a normal left eye. She had headache, dysacusia, and mild hearing problems. Her past ocular and drug histories were unremarkable. Retinal imaging revealed characteristic features of VKH in the right eye. All laboratory testing results were inconclusive. VA and OCT findings significantly improved following the treatment with methylprednisolone 1 g/day continued by tapering dose of oral prednisolone. Two months after the presentation and during prednisolone tapering, VA of the left eye decreased and fundus examination revealed multiple serous retinal detachments in this eye. Conclusion: Ophthalmologists should recognize unilateral and asymmetrical VKH disease with subtle systemic involvement.

Primary Malignant Lymphoma Cutis in an Infant: Case Report and Review of Literature

PEDIATRICS ◽  
1979 ◽  
Vol 64 (4) ◽  
pp. 478-482
Author(s):  
Pardeep Bhanot ◽  
A. Joseph Brough ◽  
Y. Ravindranath ◽  
Jeanne Lusher
Keyword(s):  
Case Report ◽  
Malignant Lymphoma ◽  
Intensive Therapy ◽  
Poor Response ◽  
Lymphoid Hyperplasia ◽  
Cutaneous Lymphoma ◽  
Response To Treatment ◽  
Review Of Literature ◽  
Histologic Differentiation ◽  
Infant Case

A 6-month-old infant with primary malignant cutaneous lymphoma is presented. The histologic differentiation between benign cutaneous lymphoid hyperplasia and cutaneous malignant lymphoma is discussed. Intensive therapy is warranted at the onset because of early dissemination and poor response to treatment after dissemination.

Criteria positive and criteria negative anaphylaxis, with a focus on undifferentiated somatoform idiopathic anaphylaxis: A review and case series

2020 ◽  
Vol 41 (6) ◽  
pp. 436-441 ◽  
Author(s):  
Daniel A. Rosloff ◽  
Kunal Patel ◽  
Paul J. Feustel ◽  
Jocelyn Celestin
Keyword(s):  
Diagnostic Criteria ◽  
Statistical Significance ◽  
Case Series ◽  
Poor Response ◽  
Response To Treatment ◽  
Fisher Exact Test ◽  
Subjective Symptoms ◽  
Significant Difference ◽  
Physical Findings ◽  
Idiopathic Anaphylaxis

Background: Undifferentiated somatoform (US) idiopathic anaphylaxis (IA) is considered a psychogenic disorder characterized by a lack of observable physical findings and poor response to treatment. Although failure to diagnose true anaphylaxis can have disastrous consequences, identification of US-IA is crucial to limit unnecessary expenses and use of health care resources. Objective: To better define the presentation and understand the potential relationship between US-IA and underlying psychiatric comorbidities. Methods: We retrospectively reviewed 110 visits by 107 patients to our institution for evaluation and management of anaphylaxis over a 1-year period. The patients were classified as having either criteria positive (CP) or criteria negative (CN) anaphylaxis based on whether they met Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium criteria for the clinical diagnosis of anaphylaxis. Patient characteristics, including objective and subjective signs and symptoms, and the presence of psychiatric diagnoses were collected and analyzed. Statistical significance was assessed by using the Fisher exact test. A literature review of US-IA and other psychogenic forms of anaphylaxis was performed. Results: Patients with CP anaphylaxis were more likely to present with hypotension, wheezing, urticaria, and vomiting than were patients with CN anaphylaxis. The patients with CN anaphylaxis were more likely to present with subjective symptoms of sensory throat tightness or swelling compared with patients with CP anaphylaxis. No significant difference was detected in the prevalence of psychiatric conditions between the two groups. Conclusion: Patients who met previously established diagnostic criteria for anaphylaxis were more likely to present with objective physical findings than those who did not meet criteria for true anaphylaxis. CN patients who presented for treatment of anaphylaxis were more likely to present with subjective symptoms. Formal diagnostic criteria should be used by clinicians when evaluating patients with suspected anaphylaxis.

scholarly journals Predictive Factors of the Responses to Treatment of Mycoplasma pneumoniae Pneumonia

2021 ◽  
Vol 10 (6) ◽  
pp. 1154
Author(s):  
Eun Lee ◽  
Yun Young Lee
Keyword(s):  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Predictive Factors ◽  
Respiratory Virus ◽  
Clinical Laboratory ◽  
Poor Response ◽  
Response To Treatment ◽  
Slow Response ◽  
Response Group ◽  
Time Of Admission

The prevalence of refractory Mycoplasma pneumoniae (MP) pneumonia is increasing. The present study aimed to identify the predictive factors of responses to treatment of MP pneumonia in children. A total of 149 children were diagnosed with MP pneumonia, of whom 56 were included in the good response group, 75 children in the slow response group, and 18 children in no response or progression group. Data on the clinical, laboratory, and radiologic features were retrospectively obtained through medical chart reviews. The severity of pneumonia, based on the extent of pneumonic lesions on chest x-ray (adjusted odds ratio (aOR), 10.573; 95% confidence intervals (CIs), 2.303−48.543), and lactate dehydrogenase (LDH) levels (aOR, 1.002; 95% CIs, 1.000–1.004) at the time of admission were associated with slow response to treatment of MP pneumonia. Pleural effusion (aOR, 5.127; 95% CIs, 1.404–18.727), respiratory virus co-infection (aOR, 4.354; 95% CIs, 1.374–13.800), and higher LDH levels (aOR, 1.005; 95% CIs, 1.002–1.007) as well as MP-specific IgM titer (aOR, 1.309; 95% CIs, 1.095–1.564) were associated with no response or progression of MP pneumonia. The area under the curve for the prediction of no or poor response in MP pneumonia using pleural effusion, respiratory virus co-infection, LDH levels, and MP-specific IgM titer at the time of admission was 0.8547. This study identified the predictive factors of responses to treatment of MP pneumonia in children, which would be helpful in establishing a therapeutic plan and predicting the clinical course of MP pneumonia in children.

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