scholarly journals Evaluation of the Clinical, Laboratory, and Radiological Findings and Treatment of 19 Cases of Pancreatic Echinococcosis

2020 ◽  
Vol 7 (5) ◽  
Author(s):  
Li Gou ◽  
Feng Gao ◽  
Maijudan Tiheiran ◽  
Hui Guo
Keyword(s):  
Cyst Wall ◽  
Rural Areas ◽  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Enzyme Linked Immunosorbent Assay ◽  
Imaging Features ◽  
Test Results ◽  
Radiological Findings ◽  
Abdominal Ct ◽  
Imaging Characteristics

Abstract Background Hydatid disease is a severe health problem in endemic areas. In recent years, the incidence of this disease in China has been increasing. As the imaging characteristics of pancreatic echinococcosis (PE) are similar to those of cystic diseases, such as cysts, tuberculosis, and tumors, PE is often misdiagnosed and mistreated. Methods The clinical manifestations, laboratory tests, radiological findings, and treatment of 19 patients with PE between January 2006 and December 2018 in 2 hospitals were retrospectively analyzed. Results The mean age of the patients was 38 years, and the ratio of women to men was 2. All patients came from rural areas. Clinical manifestations included cholestatic jaundice, mass, nausea, pain, and swelling. Hemagglutination inhibition test results were positive for all patients. Enzyme-linked immunosorbent assay test results were positive in 17 cases (89.5%). Foci in the pancreas were head in 52.6%, body in 26.3%, body and tail in 15.8%, tail in 5.3%. The size of lesions’ diameter ranged from 1 to 12 cm (mean, 6.5 cm). The imaging features of PE included the presence of (a) daughter cysts on abdominal computed tomography (CT) and/or magnetic resonance imaging (MRI); (b) internal cyst wall dissection and ribbon sign on abdominal CT and/or MRI; (c) typical eggshell cyst wall calcification on abdominal CT. Conclusions For patients with cystic lesions on CT and/or MRI combined with epidemiological history and positive echinococcosis serology, doctors can correctly diagnose PE earlier. Surgical treatment combined with drugs can reduce the mortality of PE, leading to a better prognosis.

scholarly journals Subacute Thyroiditis After Sars-COV-2 Infection

2020 ◽  
Vol 105 (7) ◽  
pp. 2367-2370 ◽  
Author(s):  
Alessandro Brancatella ◽  
Debora Ricci ◽  
Nicola Viola ◽  
Daniele Sgrò ◽  
Ferruccio Santini ◽  
...  
Keyword(s):  
Neck Pain ◽  
Thyroid Function ◽  
Inflammatory Markers ◽  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Subacute Thyroiditis ◽  
Imaging Features ◽  
Free Triiodothyronine ◽  
First Case ◽  
Oropharyngeal Swab

Abstract Context Subacute thyroiditis (SAT) is a thyroid disease of viral or postviral origin. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China, has spread rapidly worldwide and Italy has been severely affected by this outbreak. Objectives The objective of this work is to report the first case of SAT related to SARS-CoV-2 infection. Methods We describe the clinical, laboratory, and imaging features of an 18-year-old woman who came to our attention for fever, neck pain radiated to the jaw, and palpitations occurring 15 days after a SARS-CoV-2–positive oropharyngeal swab. Coronavirus disease 2019 (COVID-19) had been mild and the patient had completely recovered in a few days. Results At physical examination the patient presented with a slightly increased heart rate and a painful and enlarged thyroid on palpation. At laboratory exams free thyroxine and free triiodothyronine were high, thyrotropin undetectable, and inflammatory markers and white blood cell count elevated. Bilateral and diffuse hypoechoic areas were detected at neck ultrasound. One month earlier, thyroid function and imaging both were normal. We diagnosed SAT and the patient started prednisone. Neck pain and fever recovered within 2 days and the remaining symptoms within 1 week. Thyroid function and inflammatory markers normalized in 40 days. Conclusions We report the first case of SAT after a SARS-CoV-2 infection. We alert clinicians to additional and unreported clinical manifestations associated with COVID-19.

scholarly journals Clinical and Imaging Features of Patients With Encephalitic Symptoms and Myelin Oligodendrocyte Glycoprotein Antibodies

2021 ◽  
Vol 12 ◽  
Author(s):  
Jingsi Wang ◽  
Zhandong Qiu ◽  
Dawei Li ◽  
Xixi Yang ◽  
Yan Ding ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Brain Mri ◽  
Age At Onset ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Outcome Data ◽  
Periventricular White Matter ◽  
Imaging Features ◽  
Progressive Dementia ◽  
Imaging Characteristics ◽  
Progressive Course

BackgroundMyelin oligodendrocyte glycoprotein-antibody (MOG-ab)-associated disease (MOGAD) has highly heterogenous clinical and imaging presentations, in which encephalitis is an important phenotype. In recent years, some atypical presentations in MOG-ab-associated encephalitis (MOG-E) have been increasingly reported but have not yet been described well. The aim of the study was to describe the clinical and imaging features of patients with MOG-E in our center. Atypical phenotypes would be reported, which is expected to expand the spectrum of MOGAD.MethodsWe reviewed medical records of 59 patients with MOGAD diagnosed in our center and identified cases who had ever experienced encephalitic symptoms. Three hundred ten patients with autoimmune encephalitis (AE) were also reviewed, and cases with positive MOG-ab were identified. Besides, patients with chronically progressive encephalitis were identified from 13 MOG-E and 310 AE patients. We collected demographic, clinical, laboratory, radiological, and outcome data to explore clinical and imaging characteristics in MOG-E, especially in the atypical phenotype of chronically progressive encephalitis.ResultsWe identified 13 patients (7 males, 6 females) with MOG-E. The median age at onset was 33 years (range 13~62 years). Most (9/13, 69.2%) of patients showed acute or subacute onset of encephalitic symptoms. Brain MRI abnormalities were observed in all patients. The most common lesion locations on MRI were cortical/subcortical (11/13, 84.6%), deep/periventricular white matter (10/13, 76.9%) and corpus callosum (4/13, 30.8%). Brain MRI patterns were categorized into four phenotypes. The most common pattern was cortical encephalitis with leptomeningeal enhancement/brain atrophy (10/13, 76.9%). Eight (8/13, 61.5%) patients had a good response to immunotherapy. Four (4/13, 30.8%) patients with chronically progressive course were identified from MOG-E cohort. They showed leukodystrophy-like pattern, multifocal hazy lesions, or cortical encephalitis on MRI. With immunotherapy, they only showed mild or no improvement. We also identified four (4/310, 1.3%) patients with chronically progressive course from AE cohort. They had better outcomes than counterparts in MOG-E.ConclusionsThis study demonstrates that encephalitic presentations in MOGAD had complex clinical patterns. Chronically progressive encephalitis may be a new phenotype of MOGAD. We recommend to test MOG-ab in subacute and chronic progressive dementia with leukodystrophy-like MRI lesions.

scholarly journals Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Alfonso J. Rodriguez-Morales ◽  
Jaime A. Cardona-Ospina ◽  
Estefanía Gutiérrez-Ocampo ◽  
Rhuvi Villamizar-Peña ◽  
Yeimer Holguin-Rivera ◽  
...  
Keyword(s):  
Observational Studies ◽  
Clinical Laboratory ◽  
Case Reports ◽  
Meta Analysis ◽  
Fatal Outcome ◽  
Clinical Manifestations ◽  
Clinical Infectious Disease ◽  
Imaging Features ◽  
Pooled Prevalence ◽  
Quantitative Analyses

Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) begun in December 2019 in China, causing a Public Health Emergency of International Concern. Among raised questions, clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews have been published on this matter. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of confirmed cases of COVID-19. All the observational studies, and also case reports, were included and analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). Measures of heterogeneity were estimated and reported. Results: 660 articles were retrieved. After screening by abstract and title, 27 articles were selected for full-text assessment. Of them, 19 were finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 40.8-74.4%) and dyspnea (45.6%, 10.9-80.4%) were the most prevalent clinical manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), with 32.8% presenting acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock and 13.9% (95%CI 6.2-21.5%) with a fatal outcome. Discussion: COVID-19 is a new clinical infectious disease, causing considerable compromise, especially in patients with comorbidities, requiring ICU in at least a fifth of them and sometimes with fatal outcomes. Additional research is needed to elucidate factors that may mediate the pathogenesis of the severe and fatal associated disease.

scholarly journals Confirmation Value of Western Blotting in Detecting Anti-treponema Pallidum Specific Antibodies With Suspicious Results

2021 ◽  
Author(s):  
Siqi Xu ◽  
hongsheng Li ◽  
xiaoyan Wu ◽  
jianwei Guo ◽  
jiaoli Zhang ◽  
...  
Keyword(s):  
Western Blotting ◽  
Clinical Laboratory ◽  
Treponema Pallidum ◽  
Antibody Detection ◽  
Enzyme Linked Immunosorbent Assay ◽  
Test Results ◽  
Chi Square ◽  
Confirmation Test ◽  
Chi Square Test ◽  
The Difference

Abstract ObjectiveThis study aimed to evaluate the necessity of Western blotting (WB) in samples with inconsistent results in detecting anti-treponema pallidum (TP) antibodies by enzyme-linked immunosorbent assay (ELISA) and Treponema pallidum granule agglutination assay (TPPA). MethodsSpecific anti-TP test results in our clinical laboratory were retrospectively analyzed. The specimens with a positive or a negative result, but with colored ELISA plates, were retested by TPPA. WB was used to confirm the suspicious results between ELISA and TPPA. The chi-square test was used to analyze whether the difference was statistically significant. ResultsA total of 106,757 anti-TP specimens were screened by ELISA from August 2018 to December 2019; 3972 were retested by TPPA, and 3809 were positive by TPPA. ELISA and TPPA showed different results in 163 specimens. Among them, 29 specimens were negative and 134 were positive by ELISA; 76 were negative, 23 were positive, and 64 were “reserve” by TPPA; 93 were negative, 31 were positive, and 39 were suspicious by the WB confirmation test. Compared with WB, the difference in the results of ELISA and TPPA was statistically significant. ConclusionsTPPA is an effective retest method for anti-TP antibody detection. If the results of anti-TP antibodies by ELISA and TPPA are inconsistent, it is necessary to use WB for confirmation.

scholarly journals Evaluation Of Clinical, Laboratory And Radiological Findings In Pediatric Covid-19 Cases And Their Relation With RT-PCR Result

2021 ◽  
Author(s):  
Muhammet Asena ◽  
ilyas yolbaş ◽  
murat Kanğın
Keyword(s):  
Computed Tomography ◽  
Respiratory Distress ◽  
Clinical Laboratory ◽  
Age Groups ◽  
Age Group ◽  
Test Results ◽  
Rt Pcr ◽  
Radiological Findings ◽  
Laboratory Findings ◽  
Pcr Test

Background: The pandemic of the new coronavirus disease (COVID-19) continues to be a major health problem globally. In this study, clinical findings, radiological findings, laboratory findings and polymerase chain reaction (PCR) test results were evaluated according to age groups in pediatric patients with COVID-19. Methods: In this study, PCR (+) and PCR (-) 278 cases diagnosed with COVID-19 between March 15, 2020 and September 30, 2020 were assessed considering clinical symptoms, radiological and laboratory findings and RT-PCR test results. Results: 43.9% of the cases consisted of RT-PCR (+) and 56.1% of RT-PCR (-) cases. Fever was observed at the rate of 64.7%, cough 53.2%, respiratory distress 12.2%, myalgia 24.5%, diarrhea 12.9%, chest X-ray findings 48.2% and computed tomography findings 43.6%. Diarrhea and cough, alanine aminotransferase, aspartate aminotransferase, leukocyte and lymphocyte elevation were determined as significantly higher in younger age group cases, while high myalgia and neutrophilia was observed in older age group children (p <0.05). Fever, high CRP, leukocytosis frequency, high neutrophil, were significantly higher in PCR(-) cases and the frequency of respiratory distress, high lymphocyte and chest computed tomography findings in PCR(+) cases (p <0.05). Conclusion: COVID-19 infection may indicate different nonspecific clinical, laboratory and radiological findings in children according to both adults and pediatric age groups. In addition, the results of the PCR test may give erroneous results in cases due to conditions such as fever, respiratory distress, high CRP, leukocytosis, high neutrophil and CT finding. Keywords: pediatric, COVID-19, RT-PCR

Clinical Characteristics of Pediatric Patients with Ocular Toxocariasis in China

2016 ◽  
Vol 235 (2) ◽  
pp. 97-105 ◽  
Author(s):  
Yalu Liu ◽  
Qi Zhang ◽  
Jing Li ◽  
Xunda Ji ◽  
Yu Xu ◽  
...  
Keyword(s):  
Rural Areas ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Age Of Onset ◽  
Age Groups ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Enzyme Linked Immunosorbent Assay ◽  
Ocular Toxocariasis

Objective: The aim of the study was to analyze the clinical characteristics of pediatric patients with ocular toxocariasis. Methods: Ocular toxocariasis was diagnosed and treated in 46 children from Shanghai and surrounding provinces. The diagnosis of ocular toxocariasis was confirmed immunologically by performing an enzyme-linked immunosorbent assay on serum and/or intraocular fluid. All pediatric patients and their guardians completed a questionnaire concerning their cases and living habits. Results: The mean age of onset was 6 ± 3 years. Most children (85%) resided in rural areas, and 91% of the children had contact with adult dogs or puppies. At the first visit, visual acuity (VA) was <20/200 in 36 cases, and we detected peripheral granuloma in 36 patients. In our study, the most common signs were vitritis, vitreous strands, and tractional retinal detachment. The Optomap 200Tx device detected granuloma with an 85% sensitivity, which is much higher than that of other techniques. We treated 40 cases (87%) with topical corticosteroids, while 28 patients (61%) were treated with systemic corticosteroids. Only 18 children (39%) required surgical intervention. All patients were examined and treated by the same ophthalmologists. Conclusions: Preschool children in China are more often affected by toxocariasis compared with other age groups. The most common signs included unilateral granuloma and ocular inflammation. In our study, clinical manifestations were severe and complicated. At the first visit, VA was <20/200 in most patients. Ocular toxocariasis was diagnosed on the basis of clinical signs and symptoms; the diagnosis was confirmed by immunological testing. Techniques using the Optomap 200Tx device can facilitate the early detection and lead to better visual prognosis.

scholarly journals Two case reports of COVID-19: A 6-year-old boy and his 66-year-old grandmother

2020 ◽  
Author(s):  
Wanwan Yi ◽  
Hengwei Fan ◽  
Zhong Wei Lv ◽  
Xuan Long ◽  
hengmei zhu
Keyword(s):  
Clinical Manifestations ◽  
The Elderly ◽  
Imaging Features ◽  
Test Results ◽  
Imaging Diagnosis ◽  
Case Presentation ◽  
Global Pandemic ◽  
Family Aggregation ◽  
Multiple Detection ◽  
Acid Test

Abstract Background: Currently, COVID-19 is a global pandemic disease that has caused a large number of infections worldwide. Reports of COVID-19 cases are not uncommon, but there is no report that SAMS-CoV-2 RNA test results for grandma and grandchildren in family aggregation infections are completely different.Case presentation: A 6-year-old boy's chest CT indicated lung infection, but SAMS-CoV-2 RNA test was negative. His grandmother's imaging showed lung inflammation absorption, and nucleic acid test was positive. Conclusions: Children and the elderly people have different clinical manifestations during the course of SAMS-CoV-2 infection, it is challenging to identify whether they are infectious. Therefore, the diagnosis of COVID-19 requires a combination of multiple detection measures, including clinical features, imaging features, and SAMS-CoV-2 RNA test results.Keywords: COVID-19; SAMS-CoV-2 RNA test; Imaging diagnosis; Case report

scholarly journals Radiologic evaluation of discharge quality in patients with COVID-19

2020 ◽  
Author(s):  
Jingwen Li ◽  
Xi Long ◽  
Fang Fang ◽  
Xuefei Lv ◽  
Dandan Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Case Series ◽  
High Sensitivity ◽  
Imaging Features ◽  
Radiologic Evaluation ◽  
Discharged Patients ◽  
Novel Coronavirus ◽  
Discharge Criteria ◽  
Progressive Stage

Abstract Background Worldwide spread of the novel coronavirus disease 2019 (COVID-19) has made hundreds of thousands people sick and fortunately many of them have been treated and discharged. However, it remains unclear how well the discharged patients were recovering. Chest CT scan, with demonstrated high sensitivity to COVID-19, was used here to examine clinical manifestations in patients at discharge.Methods This study registered retrospectively single-center case series of 180 discharged patients, all confirmed with COVID-19 at Wuhan Red Cross Hospital in Wuhan, China. Epidemiological, demographic, clinical, laboratory and treatment data were collected. CT imaging features of absorption vs progressive stage were compared and analyzed.Results Five pulmonary lobes were affected in 54 (30%) of the 180 patients at the absorption stage, comparing to 66% of them at the progressive stage (P=1.45×10-11). Forty five (25%) patients had pleural effusion on admission and 13 of them still carried hydrothorax when discharged as per standard discharge criteria(P=4.48×10-6). Besides, compared with those at progressive stage, 97 (54%) discharged patients had interlobular thickening (P=6.95×10-3) and 43% of them still presented adjacent pleura thickening (P=5.58×10-5). The median total CT score of discharged patients at absorption stage was lower than progressive stage (3 vs 12.5 ). The median total CT score recovery rate was 67% (range, 0-100%) and 139 (77%) patients showed less than 90% improvement at discharge.Conclusions A majority (77%) of the discharged patients had not recovered completely. The current discharge criteria may need to include 90% or higher CT score-based recovery rate.Authors Jingwen Li, Xi Long, Fang Fang, and Xuefei Lv contributed equally to this work.Authors Zhicheng Lin and Nian Xiong are joint last coauthors.

Steroid Cell Tumours: Rare Ovarian Tumours that Cause Hyperandrogenaemia in Postmenopausal Women

2020 ◽  
Author(s):  
xiaodan zhu ◽  
linyu zhou ◽  
jian jiang ◽  
Tian'an Jiang
Keyword(s):  
Postmenopausal Women ◽  
Clinical Manifestations ◽  
Case Series ◽  
Resistance Index ◽  
Cell Tumor ◽  
Imaging Features ◽  
Ovarian Steroid ◽  
Clinical Recurrence ◽  
Imaging Characteristics ◽  
Ovarian Tumours

Abstract Background Diagnosing hyperandrogenemia in postmenopausal women is very difficult, because it occasionally manifests as excessive hair growth or no clinical manifestations, so it is often misdiagnosed or missed diagnosis. Ovarian steroid cell tumours that cause hyperandrogenaemia in women account for approximately 0.1% of all ovarian tumours. Due to the low incidence, corresponding imaging reports are rare, so ovarian steroid cell tumours lacks typical imaging findings to differentiate it from other ovarian tumours. Therefore, we summarized its clinical and imaging characteristics through this case series ,and we also elaborated on the differential diagnosis of steroid cell tumors. We hope to help clinicians have a deeper understanding of ovarian steroid cell tumours.Case presentation we report three cases of postmenopausal women with hyperandrogenaemia.Only 1 patient showed virilization symptoms, the other two patients were completely asymptomatic. All patients underwent total hysterectomy + bilateral adnexectomy. Histological results showed one case of leyding cell tumor (case 1) and two cases of benign non-specific steroid cell tumor (case 2 and case 3). After the operation, the androgen levels of all patients returned to normal, and there was no clinical recurrence since follow-up.Conclusions Through this series of cases, we found that although virilization caused by increased serum testosterone levels is an important clinical feature of ovarian steroid cell tumors, complete asymptomatic is also one of its features. A solid, slightly hypoechoic, round or oval mass with uniform internal echo, richer blood flow in the solid part and low resistance index are typical imaging features of ovarian steroid cell tumors. Diagnosis of ovarian steroid cell tumours after menopause is challenging, but surgery can be used for both diagnosis and clear treatment.

scholarly journals Differences in Clinical Features among Different Onset Patterns in Moyamoya Disease

2021 ◽  
Vol 10 (13) ◽  
pp. 2815
Author(s):  
Yudai Hirano ◽  
Satoru Miyawaki ◽  
Hideaki Imai ◽  
Hiroki Hongo ◽  
Yu Teranishi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Moyamoya Disease ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Age At Onset ◽  
Imaging Features ◽  
Radiological Findings ◽  
Severe Stenosis ◽  
Imaging Characteristics ◽  
Internal Carotid Arteries

Moyamoya disease is characterized by severe stenosis at the ends of the bilateral internal carotid arteries and the development of collateral circulation. The disease is very diverse in terms of age at onset, onset patterns, radiological findings, and genetic phenotypes. The pattern of onset is mainly divided into ischemic and hemorrhagic onsets. Recently, the opportunity to identify asymptomatic moyamoya disease, which sometimes manifests as nonspecific symptoms such as headache and dizziness, through screening with magnetic resonance imaging has been increasing. Various recent reports have investigated the associations between the clinical features of different onset patterns of moyamoya disease and the corresponding imaging characteristics. In this article, we have reviewed the natural history, clinical features, and imaging features of each onset pattern of moyamoya disease.

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