Case 17-2019: A 44-Year-Old Man with Joint Pain, Weight Loss, and Chest Pain

2019 ◽  
Vol 380 (22) ◽  
pp. 2157-2167 ◽  
Author(s):  
Sheila L. Arvikar ◽  
Sara R. Schoenfeld ◽  
Andrew S. Fox ◽  
Varsha K. Tanguturi ◽  
Lena D. Stuart
Keyword(s):  
Weight Loss ◽  
Chest Pain ◽  
Joint Pain

scholarly journals Pain in Patients with Panic Disorder: Relation to Symptoms, Cognitive Characteristics and Treatment Outcome

2002 ◽  
Vol 7 (3) ◽  
pp. 134-141 ◽  
Author(s):  
Norman B Schmidt ◽  
Helen T Santiago ◽  
John H Trakowski ◽  
J Michael Kendren
Keyword(s):  
Treatment Outcome ◽  
Chest Pain ◽  
Panic Disorder ◽  
Joint Pain ◽  
Behavioural Therapy ◽  
Depression Symptoms ◽  
Diagnostic And Statistical Manual ◽  
Cognitive Behavioural ◽  
Stomach Pain ◽  
Pain Symptoms

OBJECTIVE:Although there has been a link between certain types of pain, notably chest pain, and panic disorder, the relation between pain and panic disorder has not been systematically evaluated. In the present study, the relation between pain symptoms (headache, chest pain, stomach pain, joint pain) and the clinical presentation of patients with panic disorder was evaluated.HYPOTHESES:Pain was generally hypothesized to be related to increased symptoms of anxiety, panic-relevant cognitive domains and treatment outcome. In terms of specific pain domains, headache and chest pain were expected to be more closely related to anxiety-related symptoms.PARTICIPANTS AND METHODS:Patients (n=139) meeting the criteria of theDiagnostic and Statistical Manual of Mental Disorders - Fourth Editionfor panic disorder completed a set of standardized clinician-rated and self-reported measures. Moderator analyses were used in a subset of these patients completing a treatment outcome study.RESULTS:Approximately two-thirds of the participants endorsed at least one current pain symptom. The hypotheses were partially supported, with pain being associated with higher levels of anxiety and depression symptoms, as well as panic frequency. Pain was also related to several cognitive features, including anxiety sensitivity and panic appraisals. Headache and chest pain were more highly associated with anxiety symptoms than was joint pain. Cognitive measures did not mediate the relation between anxiety and pain, and pain did not significantly moderate outcome in response to cognitive-behavioural therapy.CONCLUSIONS:Co-occurring pain symptoms appear to be more highly related to phenomenology than to treatment response in patients with panic disorder.

scholarly journals A Rare Cause of Dysphagia and Weight Loss

2018 ◽  
Vol 12 (3) ◽  
pp. 640-645 ◽  
Author(s):  
Janelle B. Gyorffy ◽  
Johanna Marowske ◽  
John Gancayco
Keyword(s):  
Weight Loss ◽  
Connective Tissue ◽  
Joint Pain ◽  
Marked Improvement ◽  
Esophageal Manometry ◽  
Biologic Therapy ◽  
Connective Tissue Disorder ◽  
Barium Swallow ◽  
Systemic Lupus Erythematous ◽  
Imaging Studies

Mixed connective tissue disease (MCTD) is a rare connective tissue disorder with clinical features that overlap with systemic lupus erythematous, systemic sclerosis, and polymyositis. We report the case of a patient who presented with dysphagia, 25-lb weight loss, difficulty opening her mouth, and joint pain. Dysphagia workup showed a normal barium swallow and normal-appearing EGD but esophageal manometry consistent with severe dysmotility. Through further laboratory and imaging studies, the patient met the diagnostic criteria for MCTD. She had marked improvement in her dysphagia with steroids, biologic therapy, and intravenous immunoglobulin.

scholarly journals A CLINICAL STUDY OF MALIGNANT MESOTHELIOMA

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Ankit Agarwal ◽  
Abhishek Padhiar ◽  
Arun Pandey ◽  
Giriraj Prajapati
Keyword(s):  
Weight Loss ◽  
Chest Pain ◽  
Malignant Mesothelioma ◽  
Asbestos Exposure ◽  
Symptom Duration ◽  
Karnofsky Performance Score ◽  
Survival Times ◽  
Aggressive Tumor ◽  
Histopathological Type ◽  
Diagnosis Date

Background: Malignant Mesothelioma (MM) is a rare but rapidly fatal and aggressive tumor of the pleura and peritoneum with limited knowledge of its natural history. Methods: 100 patients with histopathological MM diagnosis were included. The data obtained from patient files were recorded on standard forms, prepared in advance. Age, gender, hometown, residence, asbestos usage history, latent period between asbestos exposure and diagnosis, symptoms, symptom duration, diagnosis date, diagnostic method, localization, histopathological type, routine laboratory results, stage, karnofsky performance score (KPS), treatment regimen, pleurodesis, treatment response, date of death and survival times of patients were all recorded on the forms. Results: The mean age of patients 52.31±12.36 Yrs. 62 patients were male and 38 female. Environmental asbestos exposure was determined in 75.00% of patients At diagnosis, 76.00% patients had dyspnea; 71.00% weight loss; and 64.00% chest pain. A total of 48.00% patients were smokers. Mean survival time was found to be 9.3 months in our study. Conclusion: MM related to asbestos exposure is seen frequently in Southern Rajastan. Patients present with the typical clinical features of dyspnea, weight loss, and chest pain. Keywords: MM, Absestos, Dyspnea.

Differential diagnosis of common presentations

2019 ◽  
pp. 863-890
Author(s):  
Punit S. Ramrakha ◽  
Kevin P. Moore ◽  
Amir H. Sam
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Back Pain ◽  
Chest Pain ◽  
Muscle Weakness ◽  
Joint Pain ◽  
Nausea And Vomiting ◽  
Cutaneous Manifestations ◽  
Internal Malignancy

This chapter explores the differential diagnosis of common presentations, including abdominal pain and distension, back pain, blackouts and collapse, breathlessness and dyspnoea, chest pain, confusion, constipation, cough, cutaneous manifestations of internal malignancy, diarrhoea, dysphagia, falls, fever, fits and seizures, haematemesis and melaena, haematuria, haemoptysis, headache, hemiparesis, hoarseness, itching and pruritus, joint pain and swelling, leg swelling, muscle weakness, nausea and vomiting, palpitations, tremor, unconsciousness and reduced consciousness, weak legs, and wheeze.

Weight loss supplement causing acute heart block in a child

2020 ◽  
Vol 30 (1) ◽  
pp. 131-133 ◽  
Author(s):  
Daniel R. O’Brien ◽  
Vivian Szymczuk ◽  
Cecilia A. Albaro
Keyword(s):  
Weight Loss ◽  
Chest Pain ◽  
Side Effects ◽  
Heart Block ◽  
Acute Onset ◽  
Digoxin Toxicity ◽  
Herbal Supplements ◽  
St Segments ◽  
Aleurites Moluccana ◽  
Degree Heart Block

AbstractA 16-year-old male was admitted to the paediatric ICU with acute onset of vomiting, somnolence, and chest pain, and electrocardiogram showing 2nd degree heart block after ingesting an Aleurites moluccana (Candlenut) seed as a herbal weight loss supplement. Electrocardiogram showed progressively worsening heart block with down-sloping of the ST segments, resembling digoxin toxicity. After 2 days of ICU observation, his symptoms began to improve and eventually resolved. The side effects of herbal supplements are often unknown but by analysing cases such as these, physicians can develop a better understanding of these substances to help guide management.

scholarly journals Fever, Weight Loss, Cough, and Chest Pain in a HIV-Positive Man

2005 ◽  
Vol 36 (11) ◽  
pp. 696-699
Author(s):  
Asim Diab ◽  
Rita Gander ◽  
Debra Grant ◽  
Dominick Cavuoti ◽  
Paul Southern
Keyword(s):  
Weight Loss ◽  
Chest Pain ◽  
Hiv Positive

A 21-Year-Old Male with Productive Cough, Hemoptysis, Chest Pain, and Weight Loss

Respiration ◽  
2007 ◽  
Vol 74 (6) ◽  
pp. 706-709 ◽  
Author(s):  
N.D. Bakan ◽  
G. Camsari ◽  
A. Gur ◽  
G. Ozkan ◽  
M. Bayram ◽  
...  
Keyword(s):  
Weight Loss ◽  
Chest Pain ◽  
Productive Cough

scholarly journals A dangerous surgical masquerade - medial arcuate ligament syndrome as acute coronary syndrome: a case report

2020 ◽  
Vol 7 (6) ◽  
pp. 2016
Author(s):  
Preethi Subramanian ◽  
Rajan Vaithianathan
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Chest Pain ◽  
Celiac Artery ◽  
Sudden Onset ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Coronary Syndrome ◽  
Arcuate Ligament ◽  
Focal Stenosis

Median arcuate ligament syndrome is an uncommon cause for abdominal pain and weight loss, caused by median arcuate ligament compressing the celiac plexus or artery. Median arcuate ligament is the continuation of the posterior diaphragm which passes superior to celiac artery and surrounds the aorta. In this case report, A 67 year old male presented with complaints of sudden onset chest pain and loss of weight for the past 6 months. CECT thorax and abdomen it showed features of focal stenosis of coeliac axis and post stenotic dilation of the coeliac trunk suggesting median arcuate ligament syndrome. Laparoscopic median arcuate ligament release was done to relieve the patient from symptoms. Diagnosis of median arcuate ligament syndrome should be considered in a patient presenting with chest pain and weight loss with normal cardiac status and unexplained etiology.

scholarly journals Long COVID symptoms and duration in SARS-CoV-2 positive children — a nationwide cohort study

2022 ◽  
Author(s):  
Luise Borch ◽  
Mette Holm ◽  
Maria Knudsen ◽  
Svend Ellermann-Eriksen ◽  
Soeren Hagstroem
Keyword(s):  
Cohort Study ◽  
Chest Pain ◽  
Muscle Weakness ◽  
Joint Pain ◽  
Response Rate ◽  
Small Sample Size ◽  
Small Sample ◽  
Control Group ◽  
Respiratory Problems

AbstractMost children have a mild course of acute COVID-19. Only few mainly non-controlled studies with small sample size have evaluated long-term recovery from SARS-CoV-2 infection in children. The aim of this study was to evaluate symptoms and duration of ‘long COVID’ in children. A nationwide cohort study of 37,522 children aged 0–17 years with RT-PCR verified SARS-CoV-2 infection (response rate 44.9%) and a control group of 78,037 children (response rate 21.3%). An electronic questionnaire was sent to all children from March 24th until May 9th, 2021. Symptoms lasting > 4 weeks were common among both SARS-CoV-2 children and controls. However, SARS-CoV-2 children aged 6–17 years reported symptoms more frequently than the control group (percent difference 0.8%). The most reported symptoms among pre-school children were fatigue Risk Difference (RD) 0.05 (CI 0.04–0.06), loss of smell RD 0.01 (CI 0.01–0.01), loss of taste RD 0.01 (CI 0.01–0.02) and muscle weakness RD 0.01 (CI 0.00–0.01). Among school children the most significant symptoms were loss of smell RD 0.12 (CI 0.12–0.13), loss of taste RD 0.10 (CI 0.09–0.10), fatigue RD 0.05 (CI 0.05–0.06), respiratory problems RD 0.03 (CI 0.03–0.04), dizziness RD 0.02 (CI 0.02–0.03), muscle weakness RD 0.02 (CI 0.01–0.02) and chest pain RD 0.01 (CI 0.01–0.01). Children in the control group experienced significantly more concentration difficulties, headache, muscle and joint pain, cough, nausea, diarrhea and fever than SARS-CoV-2 infected. In most children ‘long COVID’ symptoms resolved within 1–5 months.Conclusions: Long COVID in children is rare and mainly of short duration. What is Known:• There are increasing reports on ‘long COVID’ in adults.• Only few studies have evaluated the long-term recovery from COVID-19 in children, and common for all studies is a small sample size (median number of children included 330), and most lack a control group. What is New:• 0.8% of SARS-CoV-2 positive children reported symptoms lasting >4 weeks (‘long COVID’), when compared to a control group.• The most common ‘long COVID’ symptoms were fatigue, loss of smell and loss of taste, dizziness, muscle weakness, chest pain and respiratory problems.• These ‘long COVID’ symptoms cannot be assigned to psychological sequelae of social restrictions.• Symptoms such as concentration difficulties, headache, muscle- and joint pain as well as nausea are not ‘long COVID’ symptoms.• In most cases ‘long COVID’ symptoms resolve within 1-5 months.

scholarly journals Adolescent With Vomiting, Profound Weight Loss, and Chest Pain

2021 ◽  
Vol 77 (1) ◽  
pp. 47-90
Author(s):  
Amani Sanchez ◽  
Huy D. Tran ◽  
Shabana Yusuf
Keyword(s):  
Weight Loss ◽  
Chest Pain
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