scholarly journals Neuroleptic malignant syndrome as part of an akinetic crisis associated with sepsis in a patient with Lewy body disease

2019 ◽  
Vol 12 (2) ◽  
pp. bcr-2018-227216 ◽  
Author(s):  
Saki Manabe ◽  
Hidetaka Yanagi ◽  
Hideki Ozawa ◽  
Atsushi Takagi
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Lewy Body ◽  
Cardiopulmonary Arrest ◽  
Lewy Body Disease ◽  
Kidney Injury ◽  
Spontaneous Circulation ◽  
Japanese Woman ◽  
Old Japanese ◽  
History Of ◽  
Tentative Diagnosis

A 65-year-old Japanese woman with Parkinson’s disease, later diagnosed with Lewy body disease, presented with a 2-day history of systemic tremors. She also had fever without rigidity or creatine kinase (CK) elevation. She was diagnosed with sepsis caused by pyelonephritis with acute kidney injury and parkinsonism exacerbation. Although antibiotic and fluid therapy improved her pyuria and renal function, her fever and tremors persisted. On the fourth day, her symptoms worsened and resulted in cardiopulmonary arrest; however, quick resuscitation allowed the return of spontaneous circulation. Simultaneously, hyperthermia, altered consciousness, extrapyramidal symptoms, dysautonomia and CK elevation were noted. Thus, dantrolene administration was initiated with a tentative diagnosis of neuroleptic malignant syndrome (NMS). This caused her fever to subside, and her symptoms gradually improved. It was difficult to distinguish between parkinsonism exacerbation associated with sepsis and NMS. Physicians should consider NMS early on, even if the patient does not fulfil the diagnostic criteria.

Delirium prior to dementia as a clinical phenotype of Lewy body disease: an autopsied case report

2016 ◽  
Vol 29 (4) ◽  
pp. 687-689 ◽  
Author(s):  
Hiroshige Fujishiro ◽  
Ito Kawakami ◽  
Kenichi Oshima ◽  
Kazuhiro Niizato ◽  
Shuji Iritani
Keyword(s):  
Lewy Body ◽  
Clinical Phenotype ◽  
Lewy Bodies ◽  
Lewy Body Disease ◽  
Japanese Woman ◽  
Visual Hallucinations ◽  
Limited Information ◽  
Lewy Body Pathology ◽  
Old Japanese ◽  
The Relationship

ABSTRACTAlthough delirium shares clinical characteristics with dementia with Lewy bodies (DLB), there is limited information regarding the relationship between delirium and Lewy body pathology. Here, we report an 89-year-old Japanese woman with an episode of delirium who was pathologically confirmed to have limbic-type Lewy body disease (LBD). Although she exhibited transient visual hallucinations during the delirium, she had no overt dementia. She developed no core clinical features of DLB and died of pneumonia at the age of 90 years. This autopsied case suggests that delirium may be one of the clinical phenotypes of LBD prior to the onset of dementia.

scholarly journals Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuki Yamauchi ◽  
Hiraku Kameda ◽  
Kazuno Omori ◽  
Michio Tani ◽  
Kyu Yong Cho ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Cushing’S Disease ◽  
Cardiopulmonary Arrest ◽  
Severe Infection ◽  
Japanese Woman ◽  
The Body ◽  
Cushing's Disease ◽  
Old Japanese ◽  
Subclinical Cushing’S Disease ◽  
Physical Features

Abstract Background Subclinical Cushing’s disease (SCD) is defined by corticotroph adenoma-induced mild hypercortisolism without typical physical features of Cushing’s disease. Infection is an important complication associated with mortality in Cushing’s disease, while no reports on infection in SCD are available. To make clinicians aware of the risk of infection in SCD, we report a case of SCD with disseminated herpes zoster (DHZ) with the mortal outcome. Case presentation An 83-year-old Japanese woman was diagnosed with SCD, treated with cabergoline in the outpatient. She was hospitalized for acute pyelonephritis, and her fever gradually resolved with antibiotics. However, herpes zoster appeared on her chest, and the eruptions rapidly spread over the body. She suddenly went into cardiopulmonary arrest and died. Autopsy demonstrated adrenocorticotropic hormone-positive pituitary adenoma, renal abscess, and DHZ. Conclusions As immunosuppression caused by SCD may be one of the triggers of severe infection, the patients with SCD should be assessed not only for the metabolic but also for the immunodeficient status.

Cochlear fistula found in a naturally healed tympanic cavity

1991 ◽  
Vol 105 (8) ◽  
pp. 656-658 ◽  
Author(s):  
Mamoru Suzuki ◽  
Isao Nishida ◽  
Katsuhiro Hirakawa ◽  
Masafumi Nikaido ◽  
Yasuo Harada
Keyword(s):  
Semicircular Canal ◽  
Posterior Wall ◽  
Japanese Woman ◽  
Mastoid Cavity ◽  
Tympanic Cavity ◽  
Ear Canal ◽  
Horizontal Semicircular Canal ◽  
Old Japanese ◽  
History Of ◽  
Exploratory Surgery

AbstractA cochlear fistula found in a naturally healed mastoid cavity is reported. The patient is a 53-year-old Japanese woman who was complaining of unsteadiness. She hada long history of otorrhoea in childhood. Her tympanic and mastoid cavities were widely open and were covered by thin epithelium. The posterior wall of the ear canal was missing. She had no hearing in the ear but responded to electrical promontory testing. Exploratory surgery was indicated at which fistulae of the basal turn of the cochlea and the horizontal semicircular canal were found. These fistulae were sealed by pieces of bone andmuscle.

scholarly journals Tissue Hypoperfusion, Hypercoagulopathy, and Kidney and Liver Dysfunction after Ingestion of a Naphazoline-Containing Antiseptic

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Yuko Ono ◽  
Nozomi Ono ◽  
Kazuaki Shinohara
Keyword(s):  
Liver Dysfunction ◽  
Laboratory Data ◽  
Japanese Woman ◽  
Over The Counter ◽  
Tissue Hypoperfusion ◽  
First Case ◽  
Old Japanese ◽  
History Of ◽  
History Of Depression ◽  
Adrenergic Receptor Agonist

Naphazoline is a peripheral α2-adrenergic receptor agonist commonly used as a topical decongestant. In Japan, over-the-counter antiseptics often contain naphazoline to effect local hemostasis. We present the first case involving the development of hypercoagulopathy, with kidney and liver dysfunction, following a naphazoline overdose. A 22-year-old Japanese woman with a history of depression ingested 160 mL of a commercially available antiseptic containing 0.1% naphazoline. Three days later, she was brought to the emergency department because of general fatigue, nausea, and vomiting. Physical examination revealed cool, pale extremities. Laboratory data showed evidence of severe kidney and liver dysfunction (creatinine, 9.2 mg/dL; alanine aminotransferase, 2948 IU/L), hypercoagulation (D-dimers, 58.3 μg/mL), and thrombocytopenia (platelet count, 90,000/μL). After infusion of normal saline, intravenous administration of alprostadil, and hemodiafiltration, her organ function completely recovered. Because both the kidney and liver express α2-adrenergic receptors, their failure was likely associated with naphazoline overdose-induced hypoperfusion. The most plausible causes of hypercoagulation are peripheral low perfusion and subsequent microthrombus formation. This case illustrates that severe organ dysfunction can occur following over-the-counter antiseptic ingestion and serves as a caution for both drug manufacturers and healthcare professionals.

scholarly journals Dermoscopic Features of Pigmented Bowen's Disease in a Japanese Female Mimicking Malignant Melanoma

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Takayuki Inoue ◽  
Ken Kobayashi ◽  
Mizuki Sawada ◽  
Sumiko Ishizaki ◽  
Haruo Ito ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Skin Lesions ◽  
Japanese Woman ◽  
Bowen’S Disease ◽  
Seborrheic Keratosis ◽  
Bowen's Disease ◽  
Pathologic Features ◽  
Old Japanese ◽  
History Of ◽  
Pigmented Skin Lesions

Various structures have been reported for dermoscopic features of pigmented Bowen's disease (BD), which could be a mimic of various pigmented skin lesions. A 79-year-old Japanese woman presented with a 3-year history of brown-black macule on her right upper arm without symptom. Dermoscopic examination demonstrated irregular flossy streaks, irregular brown dots/globules, blue-whitish regression structures, and overlaying whitish scaly areas. We suspected pigmented skin lesions including seborrheic keratosis, pigmented eccrine poroma, and malignant melanoma and excised completely with a 5 mm margin. Histopathological features were consistent with a diagnosis of pigmented BD. Although similar dermoscopic features might be revealed in pigmented skin lesions and it may occasionally be difficult to distinguish between pigmented BD and other pigmented skin lesions, dermoscopy would be useful in speculating pathologic features of pigmented BD.

Family history of dementia is a risk factor for Lewy body disease

Neurology ◽  
2006 ◽  
Vol 66 (12) ◽  
pp. 1949-1950 ◽  
Author(s):  
B. K. Woodruff ◽  
N. R. Graff-Radford ◽  
T. J. Ferman ◽  
D. W. Dickson ◽  
M. W. DeLucia ◽  
...  
Keyword(s):  
Risk Factor ◽  
Family History ◽  
Lewy Body ◽  
Lewy Body Disease ◽  
History Of

Disseminated neurenteric cyst

2008 ◽  
Vol 9 (4) ◽  
pp. 382-386 ◽  
Author(s):  
Muneyoshi Yasuda ◽  
Hiroshi Nakagawa ◽  
Hiroaki Ozawa ◽  
Chikage Inukai ◽  
Takeya Watabe ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Japanese Woman ◽  
Neurenteric Cyst ◽  
Cerebrospinal Fluid Circulation ◽  
Unsteady Gait ◽  
Old Japanese ◽  
History Of ◽  
Cyst Membrane ◽  
Upper Thoracic ◽  
Cyst Fenestration

This case report presents the unusual holospinal dissemination of a neurenteric cyst, which was successfully treated by fenestration and placement of a subarachnoid-peritoneal (SP) shunt. The patient was a 46-year-old Japanese woman with a history of fourth ventricle neurenteric cysts, which were managed with cyst fenestration in 1996 and 2005. She had been doing well until January 2006, when she developed dizziness and an unsteady gait. A neurological examination revealed a disturbance in the deep sensation of the feet. A neuroimaging evaluation demonstrated multiple cystic lesions in the whole spinal canal, which significantly distorted the spinal cord. Because the spinal cord distortion was the most severe in the lower cervical to upper thoracic areas, a unilateral osteoplastic laminotomy with an endoscopic cyst fenestration was performed in these areas, followed by placement of an SP shunt. The pathological diagnosis was a disseminated neurenteric cyst. There was no malignancy, and the patient has been well, with an improved gait and no signs of peritoneal dissemination, for > 1 year. The present case showed a unique extent of dissemination, which was most likely a secondary characteristic. Neurenteric cysts are well known for their tendency to recur, and total removal is usually difficult because of adhesion of the cyst membrane to important structures. The lesion also compromises cerebrospinal fluid circulation. Cyst fenestration combined with SP shunt placement might be a treatment option in such a case.

scholarly journals Amyloidosis in the Palpebral Conjunctiva Mimicking Lymphoproliferative Lesion

2021 ◽  
pp. 73-76
Author(s):  
Shinjiro Kono ◽  
Patricia Ann L. Lee ◽  
Hirohiko Kakizaki ◽  
Yasuhiro Takahashi
Keyword(s):  
Differential Diagnosis ◽  
Japanese Woman ◽  
Soft Tissue Lesion ◽  
Palpebral Conjunctiva ◽  
Biopsy Specimens ◽  
Body Sensation ◽  
Old Japanese ◽  
History Of ◽  
The Right ◽  
Conjunctival Lesion

A 47-year-old Japanese woman presented with a 1-year history of foreign body sensation in the right eye. Upon examination, a linear soft tissue lesion in the lower conjunctival fornix was noted. The mass resembled a conjunctival lymphoproliferative lesion but was pinkish-yellow rather than salmon pink in color. Histopathology of the biopsy specimens revealed amyloidosis. Systemic workup showed no other lesions. The conjunctival lesion did not recur at 3 months postoperatively. Since conjunctival amyloidosis mimics conjunctival lymphoproliferative lesions, it is important to keep conjunctival amyloidosis as a differential diagnosis in the diagnosis of a pinkish conjunctival lesion.

scholarly journals Coincidence of Large Adrenal Cyst and Prominent Hyporeninemic Hyperaldosteronism

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Takaaki Sakaue ◽  
Yosuke Okuno ◽  
Kosuke Mukai ◽  
Shingo Fujita ◽  
Junji Kozawa ◽  
...  
Keyword(s):  
Japanese Woman ◽  
Vascular Endothelial ◽  
Abdominal Ct ◽  
Adrenal Cyst ◽  
Old Japanese ◽  
Resected Tumor ◽  
History Of ◽  
Endothelial Cyst ◽  
Stage Renal Disease ◽  
End Stage

A 67-year-old Japanese woman who had end-stage renal disease was referred to our hospital for kidney transplantation. Abdominal CT revealed a large adrenal mass with inhomogeneity. She had a history of hospitalization for stroke and heart failure and exhibited prominent hyporeninemic hyperaldosteronism. Histological examination of the resected tumor with anti-CYP11B2 antibody indicated that she had a vascular endothelial cyst with primary aldosteronism (PA) due to multiple adrenocortical micronodules. This report implicates the pathological interaction between adrenal vascular cysts and PA-mediated vascular damage of the adrenal vein.

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