scholarly journals Atypical Presentation of Systemic Arthritis in a Toddler with Down Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Emily Worley ◽  
Weijie Li ◽  
Jordan T. Jones
Keyword(s):  
Down Syndrome ◽  
Case Report ◽  
Broad Spectrum ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Chronic Inflammatory Disease ◽  
Atypical Presentation ◽  
Increased Risk ◽  
Macular Rash ◽  
Life Threatening ◽  
Atypical Presentations

Systemic juvenile idiopathic arthritis (sJIA) is a chronic, inflammatory disease of childhood, which is characterized by the combination of arthritis, serositis, daily, high-spiking fevers, and evanescent macular rash and can present with the life-threatening complication of macrophage activation syndrome (MAS). Children with Down syndrome (DS) have complex medical challenges related to abnormalities in their immune system, which can cause a broad spectrum of disease manifestations, which can occur atypically. Children with DS are at increased risk for arthritis and interstitial lung disease (ILD) associated with sJIA that has high mortality. This case report outlines an atypical presentation of sJIA in a 21-month-old male with DS in which fever was not part of the initial presentation of sJIA and then later developed MAS and ILD. Due to broad spectrum of disease and atypical presentation in children with DS, this case report was created to increase awareness of atypical presentations of rheumatic disease in children with DS.

scholarly journals LGI1 positive paraneoplastic limbic encephalitis: A case report of atypical presentation

2021 ◽  
Vol 26 (4) ◽  
pp. 865-867
Author(s):  
Chien-Chung Cheng ◽  
Jia-Ying Sung ◽  
Chih-Shan Huang
Keyword(s):  
Case Report ◽  
Temporal Lobe ◽  
Rectal Carcinoma ◽  
Medial Temporal Lobe ◽  
Limbic Encephalitis ◽  
Memory Loss ◽  
Atypical Presentation ◽  
Paraneoplastic Limbic Encephalitis ◽  
Sensory Aphasia ◽  
Atypical Presentations

Limbic encephalitis is a rare disorder mainly affecting the medial temporal lobe and is classically paraneoplastic. Autoimmune etiologies also exist, such as antibodies against leucine-rich glioma activated 1 (LGI1). Most cases of anti-LGI1 encephalitis are not associated with tumors. Subacute memory loss is the predominant feature, and most patients develop focal seizures, especially faciobrachial dystonic seizures (FBDSs). Immunotherapies usually show a good response, but are less effective in paraneoplastic cases. We report a case of steroid-responsive anti-LGI1 encephalitis with atypical presentations of sensory aphasia during relapse from rectal carcinoma, an atypical site.

scholarly journals Idarucizumab to revert the anticoagulant effect of dabigatran in traumatic acute subdural haematoma: a case report of first use in Latin America

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Raúl Izaguirre Ávila ◽  
José Eduardo Bahena López ◽  
Evelyn Cortina de la Rosa ◽  
Miguel Ángel Hernández Márquez
Keyword(s):  
Latin America ◽  
Case Report ◽  
Emergency Surgery ◽  
Subdural Haematoma ◽  
Vitamin K Antagonists ◽  
Attractive Alternative ◽  
Venous Disease ◽  
First Case ◽  
Increased Risk ◽  
Life Threatening

Abstract Background  Direct oral anticoagulants (DOAC) are an attractive alternative over vitamin K antagonists. They have several advantages in primary and secondary prevention of thromboembolisms due to atrial fibrillation, as well as in prevention and treatment of thromboembolic venous disease. They have fast onset action, do not need laboratory controls in patients with normal renal function, and they have practically no interference with the patient’s diet or medications. The strongest objection to their use was the lack of reversal agents that could be used in case of life-threatening haemorrhage or the need for emergency surgery. Dabigatran was the first DOAC to have its own specific reversal agent: idarucizumab, a monoclonal antibody. Case summary  We report here the case of a patient undergoing treatment with dabigatran that suffered an expansive subdural haematoma secondary to a cranial injury. The condition was life-threatening and required emergency surgery. Anticoagulation was successfully reversed with idarucizumab. Discussion  Emergency surgery in patients in treatment with DOAC is associated with an increased risk of bleeding. With the use of a specific antidote to block the action of the anticoagulant, as in the case of idarucizumab with dabigatran, the risk of complications during and after emergency surgery is reduced. This is the first case report with which the successful use of idarucizumab in Latin America is documented.

scholarly journals Isolated Sacrococcygeal Tuberculosis, A Case Report Of A Rare Atypical Presentation

2019 ◽  
Vol 1 (4) ◽  
Author(s):  
Daksh Gadi ◽  
Saket Nigam ◽  
Deepti Gupta ◽  
Akanksha Sinha
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Clinical Suspicion ◽  
Atypical Presentation ◽  
Rare Entity ◽  
Hematogenous Spread ◽  
Major Health Problem ◽  
Major Health ◽  
Rare Case Report ◽  
Atypical Presentations

Tuberculosis is a major health problem in India and in view of rise in the MDR tuberculosis atypical presentations are getting commoner these days and are difficult to diagnose. Musculoskeletal tuberculosis is very common among the  hematogenous spread cases of pulmonary tuberculosis involving thoracic spine the most. Involvement of sacrum and coccyx is rarest of  the possibility and isolated sacrococcygeal tuberculosis thus is very rare. Being a rare entity a high index of clinical suspicion is required to diagnose it. We hereby report a very rare case report of sacrococcygeal tuberculosis.

scholarly journals Giant Squamous Cell Carcinoma on Chronic Lichen Planus on the Ankle - A Case Report and Short Literature Review

2019 ◽  
Vol 7 (18) ◽  
pp. 3061-3063 ◽  
Author(s):  
Uwe Wollina ◽  
Claudia Krönert ◽  
Jacqueline Schönlebe ◽  
Aleksandra Vojvodic ◽  
Torello Lotti
Keyword(s):  
Squamous Cell Carcinoma ◽  
Case Report ◽  
Literature Review ◽  
Cell Carcinoma ◽  
Lichen Planus ◽  
Squamous Cell ◽  
Caucasian Woman ◽  
Increased Risk ◽  
Life Threatening ◽  
Threatening Situation

BACKGROUND: Cutaneous squamous cell carcinoma (SCC) is the second most common malignancy of skin. Although a major risk factor is a chronic exposure to ultraviolet radiation, preexistent chronic inflammatory disorders may also possess an increased risk for SCC. That is not the case for cutaneous lichen planus in contrast to oral lichen planus and oral SCC.  CASE REPORT: We report the case of an 87-year-old Caucasian woman presenting with a giant verrucous tumour on the left ankle. She suffered from long-standing disseminated lichen planus. Histology confirmed the diagnosis of SCC on partly verrucous lichen planus. The course was complicated due to sepsis. An emergency transfemoral amputation became necessary. The patients survived and could be released into her nursery. A literature review underlined the rarity of SCC on lichen planus of the skin. Most of these rare cases were in patients in their second half of life on the lower legs. Hypertrophic lichen plnaus was overrepresented.   CONCLUSIONS: Although very rare by number, SCC can complicate lichen planus and lead to the life-threatening situation. Atypical verrucous lesions on lichen planus warrant a histologic analysis. Surgery is the treatment of choice for cutaneous SCC.

scholarly journals Syncope: A Very Atypical Presentation of COVID-19

2020 ◽  
Vol 2 (6) ◽  
Author(s):  
Richard D. Shih ◽  
Paul M. Louis ◽  
Scott M. Alter ◽  
Patrick G. Hughes ◽  
Joshua J. Solano ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Risk Factor ◽  
Case Report ◽  
Personal Protective Equipment ◽  
Unusual Case ◽  
Protective Equipment ◽  
Atypical Presentation ◽  
Shortness Of Breath ◽  
Atypical Presentations

Possible COVID-19 patients have presented commonly to United States Emergency Departments. Patients presenting with cough, fever and shortness of breath are easy to identify as suspected cases. Unfortunately, not all COVID-19 patients present this way. Atypical presentations are a risk factor for healthcare worker (HCW) transmission of this disease. In this case report we describe the unusual case of COVID-19 presenting as syncope without any other risk factors. HCWs need to be aware of atypical COVID-19 presentations and to maintain proper use of personal protective equipment.

scholarly journals Tranexamic Acid in a Case Report of Life-threatening Nontraumatic Hemorrhage in Immune Thrombocytopenic Purpura

2020 ◽  
Vol 4 (3) ◽  
pp. 421-423
Author(s):  
Melanie Randall ◽  
Jason Nurse ◽  
Karan Singh
Keyword(s):  
Case Report ◽  
Tranexamic Acid ◽  
Immune Thrombocytopenic Purpura ◽  
The Body ◽  
Thrombocytopenic Purpura ◽  
Increased Risk ◽  
Life Threatening ◽  
Traditional Therapies ◽  
Effective Adjunct ◽  
Uncontrolled Bleeding

Introduction: Immune thrombocytopenic purpura (ITP) is an autoimmune-mediated disorder in which the body produces antibodies that destroy platelets, causing an increased risk of bleeding and bruising. Tranexamic acid (TXA) is a medication that prevents clot breakdown and is used to treat uncontrolled bleeding. Case Report: We present the case of an 11-year-old female with significant epistaxis and hypotension in the emergency department. Traditional therapies were initiated; however, the patient continued to have bleeding and remained hypotensive, so intravenous TXA was given. The patient’s bleeding then resolved. Conclusion: TXA may be a safe and effective adjunct to traditional therapies for the treatment of life-threatening hemorrhage in ITP patients.

Cardiac Tamponade: atypical presentations after cardiac surgery Ravikirti & R Karadi

2012 ◽  
Vol 11 (2) ◽  
pp. 93-96
Author(s):  
◽  
Rangaprasad Karadi ◽  
Keyword(s):  
Cardiac Surgery ◽  
Cardiac Tamponade ◽  
High Index ◽  
Atypical Presentation ◽  
Diagnosis And Management ◽  
Early Access ◽  
Life Threatening ◽  
Atypical Presentations ◽  
High Index Of Suspicion

We present two cases of cardiac tamponade presenting in the aftermath of cardiac surgery. We have briefly discussed the aetiology, presentation, diagnosis and management of the condition with emphasis on its atypical presentation in postoperative patients. A high index of suspicion and early access to echocardiography is necessary for prompt recognition and treatment of this life threatening emergency.

Asymptomatic cardiac tumour with premature ventricular contraction in an athlete: case report

2021 ◽  
pp. 1-4
Author(s):  
Deniz Eriş ◽  
Feyza Ayşenur Paç
Keyword(s):  
Case Report ◽  
Primary Tumour ◽  
Premature Ventricular Contraction ◽  
Competitive Sports ◽  
Premature Ventricular Contractions ◽  
Low Cardiac Output ◽  
Cardiac Tumours ◽  
Cardiology Department ◽  
Increased Risk ◽  
Life Threatening

Abstract Cardiac fibromas are the second most common benign primary tumour of the heart in the children; the clinical features include chest pain, arrhythmia, low cardiac output due to outflow tract obstruction, and sudden cardiac death. Sports are associated with an increased risk for sudden death in athletes who are affected by cardiovascular conditions predisposing to life-threatening arrhythmias. We present a case report of 10-year-old asymptomatic boy who was referred to the paediatric cardiology department by his general practitioner for cardiac examination before participation in competitive sports. The electrocardiogram showed premature ventricular contractions originated from inferior of left ventricle. A mass was detected by 2D transthoracic echocardiography, and it was found to be compatible with fibroma on MRI. In some cases, cardiac tumours are asymptomatic as in our patient. Electrocardiogram abnormalities require detailed cardiac imaging with echocardiogram, and if necessary CT/MRI. In this article, we emphasise that detailed cardiac examination of individuals before participating in competitive sports is vital.

scholarly journals Deep Venous Thrombosis and Bilateral Pulmonary Embolism Revealing Silent Celiac Disease: Case Report and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Igor Dumic ◽  
Scott Martin ◽  
Nadim Salfiti ◽  
Robert Watson ◽  
Tamara Alempijevic
Keyword(s):  
Celiac Disease ◽  
Case Report ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Deficiency Anemia ◽  
Increased Risk ◽  
Disease Case ◽  
Wide Range ◽  
Life Threatening ◽  
Work Up

Celiac disease (CD) is a systemic, chronic autoimmune disease that occurs in genetically predisposed individuals following dietary gluten exposure. CD can present with a wide range of gastrointestinal and extraintestinal manifestations and requires lifelong adherence to a gluten-free diet [GFD]. Venous thromboembolism (VTE) as a presentation of celiac disease is unusual and rarely reported. We present a case of a 46-year-old man who was admitted for shortness of breath and pleuritic chest pain and was found to have iron deficiency anemia, deep venous thrombosis, and bilateral pulmonary emboli (PE). After work-up for his anemia, the patient was diagnosed with CD. Comprehensive investigation for inherited or acquired prothrombotic disorders was negative. It is becoming increasingly recognized that CD is associated with an increased risk for VTE. PE, however, as a presentation of CD is exceedingly rare and to the best of our knowledge this is the third case report of such an occurrence and the only case report of a patient from North America. It is important to recognize that the first symptoms or signs of celiac disease might be extraintestinal. Furthermore, VTE as a presentation of CD is rare but life-threatening.

scholarly journals Incidental Abdominal Aortic Aneurysm in the Psoriasis Patient: A Case Report and Review of Literature

2018 ◽  
Vol 7 ◽  
pp. e1168
Author(s):  
Neda Akhoundi ◽  
Taraneh Faghihi Langroudi ◽  
Kiarash Shafizadeh ◽  
Mohamad Javad Jabbarzadeh ◽  
Sepehr Talebi
Keyword(s):  
Case Report ◽  
Aortic Aneurysm ◽  
Large Scale ◽  
Psoriasis Patient ◽  
Chronic Inflammatory Disease ◽  
Turnover Time ◽  
Review Of Literature ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Epidermal Turnover

Background: Psoriasis is defined as a chronic inflammatory disease involving keratinocytes hyperproliferation of the epidermis with the acceleration in the epidermal turnover time, which is affected by various factors including genetic, immunologic, and environmental factors. There is a high risk for the development of premature cardiovascular diseases among patients with psoriasis as well as one of the life-threatening events is an aortic aneurysm (AA). Case Report: We report a 60-year-old man with the diagnosed psoriatic disease that an enlargement of the abdominal AA was incidentally found by annual check-up. Conclusion: Further large-scale studies are needed to find the prevalence of abdominal AA in psoriasis and the appropriate screening time of that in this disease. [GMJ.2018;7:e1168]

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