scholarly journals Granulomatous Pancreas: A Case Report of Pancreatic Sarcoid

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Tatiana Bihun ◽  
Yanet Diaz ◽  
Seth Wenig
Keyword(s):  
Disease Process ◽  
Unknown Etiology ◽  
Frozen Sections ◽  
Gi Tract ◽  
Quadrant Pain ◽  
Pancreatic Involvement ◽  
Pancreatic Masses ◽  
Fresh Frozen ◽  
History Of ◽  
Head Of The Pancreas

Sarcoidosis is a chronic, systemic, noncaseating granulomatous disease process of unknown etiology. Sarcoidosis most commonly manifests in the lungs; however, gastrointestinal manifestations can occur. If in the GI tract, it is almost always found in the liver. Solitary pancreatic lesions are extremely rare, with less than 50 documented cases found in the literature. We present a case of a 61-year-old female, with a past medical history of sarcoidosis, who presented to the ER with unexpected weight loss, scleral icterus, right upper quadrant pain, and epigastric and back pain. US and MRI found a dilated common bile duct and mild dilation of the pancreatic duct, as well as a focal prominence in the head of the pancreas surrounded by areas of atrophy. A pancreaticoduodenectomy procedure was performed and fresh frozen sections were taken. The pathologist made a diagnosis of nonnecrotizing granulomatous pancreatitis. Pancreatic sarcoid is often asymptomatic and a benign finding on autopsy; however, clinicians should be mindful of pancreatic involvement when working up differential diagnosis for pancreatic masses.

A Rare Nonmalignant Mass of the Pancreas: Case Report and Review of Pancreatic Sarcoidosis

2010 ◽  
Vol 76 (1) ◽  
pp. 79-84
Author(s):  
Martin Wijkstrom ◽  
Rabih I. Bechara ◽  
Juan M. Sarmiento
Keyword(s):  
Signs And Symptoms ◽  
Whipple Procedure ◽  
Unknown Etiology ◽  
Benign Condition ◽  
Pancreatic Malignancy ◽  
First Case ◽  
Pancreatic Involvement ◽  
Positron Emission ◽  
History Of ◽  
High Index Of Suspicion

Sarcoidosis is a systemic granulomatous disease of unknown etiology affecting patients from all genetic backgrounds. Pancreatic involvement is rare; the first case was described on autopsy in 1937. We present a case of pancreatic sarcoidosis without a history of the disease presenting as biliary obstruction mimicking pancreatic malignancy. We also review the literature with respect to management and outcomes of similar cases. The patient described here presented with all the signs and symptoms of a pancreatic malignancy, which was confirmed on a CT scan; the positron emission tomography scan and the CA 19-9 level were also confirmatory of the suspected diagnosis. In this setting, if the mass looks resectable, a Whipple procedure would be the next logical step. However, such strategy would be aggressive management for a benign condition that could be palliated with diverting rather than resective procedures without changing the outlook of the disease. We suggest keeping a high index of suspicion in patients with a history of the disease if demographic concordance exists.

scholarly journals Pancreatic Tuberculosis mimicking Cystic Neoplasm

2017 ◽  
Vol 20 (1) ◽  
pp. 35-37
Author(s):  
Anamika Jha
Keyword(s):  
Young Patients ◽  
Pancreatic Head ◽  
Young Male ◽  
Cystic Neoplasm ◽  
Histopathological Study ◽  
Head Region ◽  
Pancreatic Involvement ◽  
Pancreatic Masses ◽  
History Of ◽  
Pancreatic Origin

Tuberculosis is endemic in our part of the world and may have uncommon presentations like pancreatic involvement. A young male presented to the OPD with recent history of pain in epigastric region and was subsequently diagnosed with a multi-loculated cystic neoplasm in pancreatic head region on ultrasonography and CT scan. The pancreatic origin was confirmed on surgery while the histopathological study revealed tuberculous nature. This case report highlights the importance of considering tuberculosis in the differential diagnosis in pancreatic masses, especially, with atypical appearances, in young patients or with background predisposing to TB and the need for histological diagnosis.  

The Concepts of Prevalence and Incidence as Applied to the Study of Development and Duration of Disease

1968 ◽  
Vol 7 (02) ◽  
pp. 111-117 ◽  
Author(s):  
M. Kashgahian
Keyword(s):  
Mass Screening ◽  
Disease Process ◽  
Incidence Data ◽  
Disease States ◽  
History Of ◽  
Duration Of Disease ◽  
Process Methodology

The proper use of prevalence and incidence data can result in an effective way to study the history of the disease process. Methodology is given whereby the progression, duration and transition of diseases can be elucidated. Prevalence and incidence have been redefined and used in an unconventional way in view of new types of data which are being generated by mass screening projects for disease which are able to discover presymptomatic and preclinical disease states.

Corticosteroids in Inflammatory Bowel Disease patients: a practical guide for physicians.

2020 ◽  
Vol 15 ◽  
Author(s):  
Maria Carla Di Paolo ◽  
Cristiano Pagnini ◽  
Maria Giovanna Graziani
Keyword(s):  
Severe Disease ◽  
Unknown Etiology ◽  
History Of Disease ◽  
Bowel Diseases ◽  
Literature Evidence ◽  
History Of ◽  
Inflammatory Bowel ◽  
Favorable Safety ◽  
Pass Metabolism

: Inflammatory bowel diseases (IBDs) are chronic conditions characterized by unknown etiology and pathogenesis with deregulation of mucosal immunity. Among possible treatments, corticosteroids, already available from the 50’, are still the mainstay of treatment for moderate-severe disease. Nonetheless, the use of steroids is still largely empirical and solid evidence about therapeutic schemes are lacking. Moreover, due to the important side-effects and for the unsatisfactory impact on long-term natural history of disease, the steroid sparing has become an important therapeutic goal in IBD management. Besides conventional steroids, the so called “low bioavailability” steroids, which are steroids with high affinity for peripheral receptors and elevated hepatic first-pass metabolism, have demonstrated efficacy and more favorable safety profile. In the present review of the literature evidence of efficacy and safety of conventional and low bioavailability steroids in IBD patients are evaluated, and practical suggestions for a correct use in clinical practice are presented according to the current clinical guidelines.

‘Do not Do’ Recommendations in Hemophilia

2020 ◽  
Vol 20 (3) ◽  
pp. 168-174
Author(s):  
Hortensia De la Corte-Rodriguez ◽  
E. Carlos Rodriguez-Merchan ◽  
M. Teresa Alvarez-Roman ◽  
Monica Martin-Salces ◽  
Victor Jimenez-Yuste
Keyword(s):  
Improve Patient Safety ◽  
Health Resources ◽  
Fresh Frozen Plasma ◽  
Factor Ix ◽  
Levels Of Care ◽  
Fresh Frozen ◽  
History Of ◽  
Improve Patient ◽  
Different Levels ◽  
Frozen Plasma

Background: It is important to discard those practices that do not add value. As a result, several initiatives have emerged. All of them try to improve patient safety and the use of health resources. Purpose: To present a compendium of "do not do recommendations" in the context of hemophilia. Methods: A review of the literature and current clinical guidelines has been made, based on the best evidence available to date. Results: The following 13 recommendations stand out: 1) Do not delay the administration of factor after trauma; 2) do not use fresh frozen plasma or cryoprecipitate; 3) do not use desmopressin in case of hematuria; 4) do not change the product in the first 50 prophylaxis exposures; 5) do not interrupt immunotolerance; 6) do not administer aspirin or NSAIDs; 7) do not administer intramuscular injections; 8) do not do routine radiographs of the joint in case of acute hemarthrosis; 9) Do not apply closed casts for fractures; 10) do not discourage the performance of physical activities; 11) do not deny surgery to a patient with an inhibitor; 12) do not perform instrumental deliveries in fetuses with hemophilia; 13) do not use factor IX (FIX) in patients with hemophilia B with inhibitor and a history of anaphylaxis after administration of FIX. Conclusions: The information mentioned previously can be useful in the management of hemophilia, from different levels of care. As far as we know, this is the first initiative of this type regarding hemophilia.

SMAD4 juvenile polyposis syndrome and hereditary haemorrhagic telangiectasia presenting in a middle-aged man as a large fungating gastric mass, polyposis in both upper and lower GI tract and iron deficiency anaemia, with no known family history

2020 ◽  
Vol 13 (12) ◽  
pp. e236855
Author(s):  
Wendy Chang ◽  
Patricia Renaut ◽  
Casper Pretorius
Keyword(s):  
Family History ◽  
Autosomal Dominant ◽  
Signs And Symptoms ◽  
Juvenile Polyposis ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Gi Tract ◽  
Juvenile Polyposis Syndrome ◽  
Polyposis Syndrome ◽  
History Of ◽  
Gastric Mass

Juvenile polyposis syndrome (JPS) and hereditary haemorrhagic telangiectasia (HHT) are rare autosomal dominant diseases, where symptoms manifest at childhood. A 32-year-old man with no family history of JPS or HHT with SMAD4 gene mutation who developed signs and symptoms only at the age of 32, when he was an adult. In this article, we highlight the steps taken to diagnose this rare pathology, explain its pathophysiology and management.

Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽  
2021 ◽  
pp. 273250162110050
Author(s):  
Samuel Ruiz ◽  
Rizal Lim
Keyword(s):  
Pediatric Population ◽  
Rare Complication ◽  
Disease Process ◽  
Rare Condition ◽  
External Drainage ◽  
Direct Extension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

scholarly journals p-HYDROQUINONE AND p-BENZOQUINONE AS HISTOCHEMICAL REAGENTS I. A NEW TETRAZOLIUM METHOD FOR AMINO GROUPS, AND THE MECHANISM OF FORMAZAN STAINING OF PARAFFIN AND FRESH FROZEN SECTIONS

1967 ◽  
Vol 15 (7) ◽  
pp. 404-408 ◽  
Author(s):  
G. G. CARMICHAEL ◽  
STEPHANIE T. K. MANDER
Keyword(s):  
Electron Acceptor ◽  
Thermal Shrinkage ◽  
Frozen Sections ◽  
Amino Groups ◽  
Paraffin Sections ◽  
Tetrazolium Bromide ◽  
Acid Ph ◽  
Reduction System ◽  
Oxidation Reduction ◽  
Fresh Frozen

The staining of amino groups by formazan when dehydrated paraffin sections are incubated in a mixture of hydroquinone and 3-(4,5-dimethyl thiazolyl-2)-2 ,5-diphenyl-2H-tetrazolium bromide at an acid pH is reported. The mechanism of this reaction and of the cytoplasmic deposition of formazan in fresh frozen sections incubated under similar conditions is investigated. It is shown that the oxidation of hydroquinone to semiquinone is responsible for the reaction, the tetrazole acting as electron acceptor. The tissue amino groups, exposed by dehydration and thermal shrinkage, and the nitrogen groupings of phosphobipid behave as "catalysts." The relevant properties of the hydroquinone-benzoquinone oxidation-reduction system are described, and the reactions between benzoquinone and tissue constituents are reviewed.

Evidence that iron accelerates Alzheimer’s pathology: a CSF biomarker study

2017 ◽  
Vol 89 (5) ◽  
pp. 456-460 ◽  
Author(s):  
Scott Ayton ◽  
Ibrahima Diouf ◽  
Ashley Ian Bush
Keyword(s):  
Disease Process ◽  
Threshold Value ◽  
Simulation Modelling ◽  
Longitudinal Changes ◽  
Accelerated Depreciation ◽  
History Of ◽  
Amyloid Aβ ◽  
Β Amyloid ◽  
Using Data ◽  
Alzheimer’S Pathology

ObjectiveTo investigate whether cerebrospinal fluid (CSF) ferritin (reporting brain iron) is associated with longitudinal changes in CSF β-amyloid (Aβ) and tau.MethodsMixed-effects models of CSF Aβ1-42 and tau were constructed using data from 296 participants who had baseline measurement of CSF ferritin and annual measurement of CSF tau and Aβ1-42 for up to 5 years.ResultsIn subjects with biomarker-confirmed Alzheimer’s pathology, high CSF ferritin (>6.2 ng/mL) was associated with accelerated depreciation of CSF Aβ1-42 (reporting increased plaque formation; p=0.0001). CSF ferritin was neither associated with changes in CSF tau in the same subjects, nor longitudinal changes in CSF tau or Aβ1-42 in subjects with low baseline pathology. In simulation modelling of the natural history of Aβ deposition, which we estimated to occur over 31.4 years, we predicted that it would take 12.6 years to reach the pathology threshold value of CSF Aβ from healthy normal levels, and this interval is not affected by CSF ferritin. CSF ferritin influences the fall in CSF Aβ over the next phase, where high CSF ferritin accelerated the transition from threshold preclinical Aβ levels to the average level of Alzheimer’s subjects from 18.8 to 10.8 years.ConclusionsIron might facilitate Aβ deposition in Alzheimer’s and accelerate the disease process.

Comorbid depression and ulcerative colitis – is there a connection?

2017 ◽  
Vol 41 (S1) ◽  
pp. S534-S534
Author(s):  
A. Melada ◽  
I. Krišto-Mađura ◽  
A. Vidović
Keyword(s):  
Ulcerative Colitis ◽  
Psychiatric Treatment ◽  
Psychiatric Symptoms ◽  
Specific Treatment ◽  
Unknown Etiology ◽  
Suicidal Thoughts ◽  
Symptoms Of Depression ◽  
Bidirectional Communication ◽  
History Of ◽  
Competing Interest

Ulcerative colitis (UC) is a subset disorder of inflammatory bowel disease (IBD) with chronic course and symptoms such as fatigue, gastrointestinal pain, fever, etc. IBD is associated with psychological manifestations including depression and anxiety. There is an increased number of studies trying to link these comorbidities. The gut-brain axis is regulated by intestinal microbiota and this bidirectional communication including immune, neural, endocrine and metabolic mechanisms may bring us closer to the answer. The following case concerns a 56-year-old patient with history of major depressive disorder who was in continuous psychiatric care and treated with antidepressants. Several years after the beginning of psychiatric treatment, he was hospitalized for diagnostic examination due to subfebrility of unknown etiology, but with no final somatic diagnosis. After two years he was referred to our department and at administration the patient showed symptoms of depression, anxiety, lack of motivation and suicidal thoughts and tendencies. Subfebrility was still present at that time. His psychopharmacotherapy was revised and there was a slight improvement in mood and behaviour. During outpatient follow-ups the symptoms of depression were still prominent and remission was not achieved even with modulation of antidepressant pharmacotherapy. The following year the patient was diagnosed with UC and started specific treatment after he presented with diarrhea in addition to subfebrility. Subsequently his mood improved, suicidal thoughts were diminished and ultimately remission was achieved. This case suggests that only after UC was being treated the psychiatric symptoms also withdrew which implicates that inflammatory mediators were involved in pathogenesis of depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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