scholarly journals Two Paediatric Patients with Encephalopathy and Concurrent COVID-19 Infection: Two Sides of the Same Coin?

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Katerina Vraka ◽  
Dipak Ram ◽  
Siobhan West ◽  
Wei Yen Evelyn Chia ◽  
Praveen Kurup ◽  
...  
Keyword(s):  
Common Type ◽  
Typical Case ◽  
Diagnostic Tools ◽  
Contrasting Cases ◽  
Laboratory Findings ◽  
Csf Analysis ◽  
Paediatric Patients ◽  
First Case ◽  
Mog Antibodies ◽  
Two Sides

There is increasing evidence that SARS-CoV-2 has neurotropic potential. We report on two paediatric patients who presented with encephalopathy during COVID-19 illness. Both patients had ADEM-like changes in their neuroimaging, negative SARS-CoV-2 RNA PCR in CSF, and paucity of PIMS-TS laboratory findings. However, the first patient was positive for serum MOG antibodies with normal CSF analysis, and the second had negative MOG antibodies but showed significant CSF lymphocytic pleocytosis. We concluded that the first case was a typical case of demyelination, which could have been triggered by different cofactors. In the second case, however, we postulated that the encephalopathic process was triggered by SARS-CoV-2, as no other cause was identified. With these two contrasting cases, we provide evidence that SARS-CoV-2-associated encephalitis can show ADEM-like changes, which can present during the postinfectious phase of COVID-19 illness. As ADEM is a relatively common type of postinfectious encephalitis in children, the distinguishing line between the two conditions of encephalitis and ADEM can be relatively fine. The development of more reliable diagnostic tools (e.g., anti-SARS-CoV-2 antibodies in CSF) might play an assisting role in the differentiation of these encephalopathic processes.

Extremely Elevated Cerebrospinal Fluid Protein and Glucose Level in a Neonate with Hypernatremic Dehydration

2020 ◽  
Author(s):  
Arti Maria ◽  
Tapas Bandyopadhyay
Keyword(s):  
Cerebrospinal Fluid ◽  
Neurodevelopmental Outcome ◽  
Neurological Sequelae ◽  
Glucose Levels ◽  
Csf Analysis ◽  
First Case ◽  
Time Of Admission ◽  
Cerebrospinal Fluid Protein ◽  
Hypernatremic Dehydration

AbstractWe describe the case of a term newborn who presented with hypernatremic dehydration on day 19 of life. The baby was otherwise hemodynamically stable with no evidence of focal or asymmetric neurological signs. The laboratory tests at the time of admission were negative except for hypernatremia and the extremely elevated levels of cerebrospinal fluid (CSF) protein (717 mg/dL) and glucose levels (97 mg/dL). The hypernatremic dehydration was corrected as per the unit protocol over 48 hours. Repeat CSF analysis done after 5 days showed normalization of the protein and glucose levels. Serial follow-up and neuroimaging showed no evidence of neurological sequelae. Unique feature of our case is this is the first case reporting such an extreme elevation of CSF protein and glucose levels that have had no bearing on neurodevelopmental outcome at 1 month and 3 months of follow-up.

scholarly journals Case report: a 5-year-old with new onset nephrotic syndrome in the setting of COVID-19 infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kelsi M. Morgan ◽  
Peace D. Imani
Keyword(s):  
Nephrotic Syndrome ◽  
Case Report ◽  
Pediatric Patient ◽  
Corticosteroid Therapy ◽  
Clinical Remission ◽  
Laboratory Findings ◽  
Case Presentation ◽  
The Third ◽  
First Case ◽  
New Onset

Abstract Background This is a case report of an asymptomatic SARS-CoV-2 infection associated with new-onset nephrotic syndrome in a pediatric patient. This is the third case of new-onset nephrotic syndrome in children associated with SARS-CoV-2 infection, but is the first case report describing a new-onset nephrotic syndrome presentation in a patient who had asymptomatic COVID-19 infection. Case presentation This is a case of a previously healthy 5 year old female who presented with new-onset nephrotic syndrome in the setting of an asymptomatic COVID-19 infection. She presented with progressive edema, and laboratory findings were significant for proteinuria and hypercholesterolemia. She was treated with albumin, diuretics, and corticosteroid therapy, and achieved clinical remission of her nephrotic syndrome within 3 weeks of treatment. Though she was at risk of hypercoagulability due to her COVID-19 infection and nephrotic syndrome, she was not treated with anticoagulation, and did not develop any thrombotic events. Conclusions Our case report indicates that SARS-CoV-2 infection could be a trigger for nephrotic syndrome, even in the absence of overt COVID-19 symptoms.

scholarly journals Human Babesiosis in Europe

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1165
Author(s):  
Anke Hildebrandt ◽  
Annetta Zintl ◽  
Estrella Montero ◽  
Klaus-Peter Hunfeld ◽  
Jeremy Gray
Keyword(s):  
Clinical Management ◽  
Diagnostic Tools ◽  
Genetic Characteristics ◽  
Susceptibility To Infection ◽  
First Case ◽  
The Usa ◽  
Life Threatening ◽  
History Of ◽  
Etiological Agents ◽  
Human Babesiosis

Babesiosis is attracting increasing attention as a worldwide emerging zoonosis. The first case of human babesiosis in Europe was described in the late 1950s and since then more than 60 cases have been reported in Europe. While the disease is relatively rare in Europe, it is significant because the majority of cases present as life-threatening fulminant infections, mainly in immunocompromised patients. Although appearing clinically similar to human babesiosis elsewhere, particularly in the USA, most European forms of the disease are distinct entities, especially concerning epidemiology, human susceptibility to infection and clinical management. This paper describes the history of the disease and reviews all published cases that have occurred in Europe with regard to the identity and genetic characteristics of the etiological agents, pathogenesis, aspects of epidemiology including the eco-epidemiology of the vectors, the clinical courses of infection, diagnostic tools and clinical management and treatment.

scholarly journals Image of Motherland: Justification and Approbation of Diagnostic Tools

2020 ◽  
Vol 13 (4) ◽  
pp. 205-219
Author(s):  
M.V. Tarasov
Keyword(s):  
Human Mind ◽  
The State ◽  
Research Interest ◽  
Diagnostic Tools ◽  
Nature And Culture ◽  
First Case ◽  
The Status ◽  
Patriotic Education ◽  
Education Today ◽  
The Subject

The topic of patriotic consciousness and patriotic education today claims to the status of a nationwide idea, so the research interest in this issue is unusually high. The study of patriotic consciousness should begin with an analysis of the subject which the patriotic feelings of citizens are directed on. This subject is the motherland and its image in the minds of citizens. The article gives an overview of the data, which is used for the semantic deferential method «Image of Motherland» and the procedure of studying of the image of the Motherland based on this method. The sample was 165 respondents. Based on the results obtained, it is concluded that the use of this methodology is a tool, which lets us to determine social ideas about the image of the Motherland. It has been proved that the image of the Motherland in consciousness reflects the ideas about the country and the state in which the respondents were born and raised, it is not associated with a so-called “Small homeland”, but with a certain commonality of territory, nature and culture. There is reason to believe that the image of the Motherland in the human mind can be viewed as an image “for oneself” and an image “for others”: in the first case, the Motherland is perceived as big and strong, interesting for life and comfortable, simple and cultural; Motherland “for others” is bold and friendly, strong and kind.

Neurological Presentation of Severe Dengue in Children From a Colombian Hyperendemic Area

2020 ◽  
Author(s):  
Jaime E. Castellanos ◽  
Paula Esteban ◽  
Juanita Panqueba-Salgado ◽  
Daniela Benavides-del-Castillo ◽  
Valentina Pastrana ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Hypovolemic Shock ◽  
University Hospital ◽  
Severe Dengue ◽  
Laboratory Findings ◽  
Dengue Disease ◽  
Neurological Signs ◽  
Csf Analysis ◽  
Neurological Patients ◽  
The University

Abstract Objective: Dengue transmission is sustained in Colombia with increasing prevalence mainly in children. This work was aimed to describe a cases series of children diagnosed with dengue presenting neurological disease in the Huila province of Colombia. Eleven pediatric febrile patients confirmed to dengue disease and presenting neurological signs were studied in the University Hospital of Neiva, Huila province. Clinical and laboratory findings, CSF cytochemical analysis, neurology images, and serology and molecular studies were performed. Results. Viral RNA was detected in all patients’ sera by RT-PCR. Nine out of 11 were primary infections. Tonic-clonic seizures (73%), consciousness alterations (27%), irritability (27%) and ataxia (18%) were the most frequent neurological signs. None of the patients had plasma leakage, hypovolemic shock or liver disease, confirming the encephalitis diagnosis. Diagnostic images did not show abnormal findings neither bacterial or fungal infections were detected in CSF analysis. All patients survived without sequelae except in one patient that presented ataxia for months. In conclusion, we described a group of children with neurological signs during severe dengue disease as the main finding, indicating the importance of include dengue as a differential diagnosis in neurological patients from endemic areas.

scholarly journals Still's Disease in a Pediatric Patient after Liver Transplantation

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Juan-Carlos Meza ◽  
Evelyn Muñoz-Buitrón ◽  
Fabio Bonilla-Abadía ◽  
Carlos Alberto Cañas ◽  
Gabriel J. Tobón
Keyword(s):  
Liver Transplantation ◽  
Immunosuppressive Therapy ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Still’S Disease ◽  
High Grade Fever ◽  
Acute Phase Reactants ◽  
Laboratory Findings ◽  
Still's Disease ◽  
First Case

Still's disease (SD) is a multisystemic inflammatory disease characterized by persistent arthritis and in many cases with fever of unknown origin. Diagnosis of SD is challenging because of nonspecific characteristics and especially in the case of a patient with solid organ transplantation and immunosuppressive therapy where multiple causes of fever are possible. There is no diagnostic test for SD, even though some useful diagnostic criteria or laboratory findings, such as serum ferritin levels, have been proposed, and useful imaging studies for the diagnosis or followup of SD have not been developed. We report the case of a 9-year-old child who presented with high grade fever associated with joint pain after a history of liver transplantation and immunosuppressive therapy. Laboratory tests showed increased acute phase reactants, elevated ferritin, and leukocytosis. An 18 F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) was performed identifying abnormal hypermetabolic areas localized in spleen, transplanted liver, and bone marrow secondary to inflammatory process. All infectious, autoimmune, and malignant causes were ruled out. A diagnosis of SD was performed and a steroid-based regimen was initiated with adequate response and no evidence of recurrence. To our knowledge this is the first case of SD following a solid organ transplant.

Improvements in Rupture Prediction of Abdominal Aortic Aneurysms Using Local Mechanical Property Estimation Obtained From ECG-Gated Computed Tomography

2010 ◽  
Author(s):  
Áine Tierney ◽  
Anthony Callanan ◽  
Tim M. McGloughlin
Keyword(s):  
Computed Tomography ◽  
Abdominal Aortic Aneurysms ◽  
Common Type ◽  
Aortic Aneurysms ◽  
Diagnostic Tools ◽  
The Past ◽  
Property Estimation ◽  
Abdominal Aortic ◽  
The Us ◽  
Local Mechanical Property

Cardiovascular disease concerns any disease which affects the heart or blood vessels. Aneurysms account for a significant portion of these cardiovascular diseases. The most common type of aneurysm is abdominal aortic aneurysm (AAA) which affects up to 5% of the population over the age of 55. AAA is a focal balloon like dilation of the terminal aorta that occurs gradually over a span of years [1]. There are approximately 200,000 patients in the US and 500,000 patients worldwide diagnosed with AAA each year [2]. The incidences of AAA’s has increased largely during the past two decades due in part to the aging demographic, the rise in the number of smokers, the introduction of screening programmes and improved diagnostic tools [3].

scholarly journals SAT-069 Advantages of Next Generation Sequencing (NGS) in Hypophosphatemic Disorders Diagnosis. First Case of SLC9A3R1 Gene Pathogenic Variant Detected in a Pediatric Patient

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Pablo Ramirez, Biochemist ◽  
Isabel Di Palma ◽  
Gisela Viterbo ◽  
Natalia Isabel Perez-Garrido, Biochemist ◽  
Matias Pujana, Biochemist ◽  
...  
Keyword(s):  
Pediatric Patient ◽  
Pathogenic Variant ◽  
Hypophosphatemic Rickets ◽  
Inherited Disorders ◽  
Molecular Alteration ◽  
Vitamin D Metabolism ◽  
Laboratory Findings ◽  
Long Term Outcome ◽  
First Case ◽  
Phex Gene

Abstract Background: Hereditary hypophosphatemic rickets (HHR) is a group of inherited disorders characterized by hypophosphatemia due to renal-phosphate wasting and impairment of vitamin D metabolism, rickets and disproportioned short stature. Different genetic defects are known to cause HHR, but similar clinical and biochemical features were reported. Dominant-X-linked HR (XLHR) is the most frequent form, with an incidence of 1 in 20.000, although dominant and recessive autosomal forms are also described. XLHR is caused by inactivating mutations in the PHEX gene (located at Xp22.1), encoding a endopeptidase which regulates the phosphaturic secretion. Affected individuals present with a broad phenotypic spectrum, ranging from isolated hypophosphatemia up to severe symptoms of rickets. Therefore NGS studies represent an useful tool for molecular diagnosis characterization Aim: to develop a reliable NGS diagnostic tool for HHR and related disorders. Patients and Methods: we develop a NGS panel including 13 genes related with HHR or other hypophosphatemic disorders, using Illumina TruSeq Custom Amplicon technology. We analyzed 12 patients which have been sent to our laboratory for molecular genetic testing under suspicion of HHR based on clinical phenotype and laboratory studies but with no proven mutation in PHEX gene by Sanger sequencing or MLPA analysis or other hypophosphatemic disorder. Results: A previously reported pathogenic variant (p.Arg153Gln) was found in SLC9A3R1 gene encoding NHERF1cotransporter, which interact with phosphate and sodium renal transporter NaPi2a in a 13 months old girl. There are only 5 reported cases with alterations in this gene and all of them were adult patients with nephrolithiasis. The patient was referred to our hospital due to hypercalcemia. She had poor weight gain and laboratory findings showed high serum calcium (16,6 mg/dl), mild serum phosphate (3.9 mg/dl), very low parathyroid hormone (PTH) (< 3 ng/ml), normal 25OHvit D (40 ng/ml) levels, and elevated urinary calcium/ creatinine rate (2), and low phosphate tubular reabsorption (85%). Ultrasound showed nephrolithiasis. Since she had hypophosphatemia and renal phosphate wasting with symptomatic severe PTH independent hypercalcemia probably secondary to excessive calcitriol production with hypercalciuria, a molecular alteration of CYP24A1 or SLC34A1genes was suspected. Conclusion: NGS allowed to report for the first time the identification of a mutation in the SLC9A3R1 gene in a pediatric patient. An early diagnosis might improve long term outcome starting the right therapy to avoid progression of nephrolithiasis and nephrocalcinosis and chronic renal failure.

scholarly journals Imported bancroftian filariasis discovered in a patient infected with Plasmodium falciparum: First case of concomitant parasitism in the Al-Buraimi Governorate, Oman

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Muhammad Muqeet Ullah ◽  
Ahmed Yar Mohammed Dawood Al Balushi ◽  
Nader Rahid Salim Al Aliyani ◽  
Biju Kalarikkal ◽  
Reeher Ian C. Miranda ◽  
...  
Keyword(s):  
Wuchereria Bancrofti ◽  
Sub Saharan Africa ◽  
Global Burden ◽  
Bancroftian Filariasis ◽  
African Region ◽  
Laboratory Findings ◽  
Anopheles Species ◽  
First Case ◽  
Nigerian Woman ◽  
Sub Saharan

Malaria and lymphatic filariasis (LF) are endemic in tropical and subtropical regions of sub-Saharan Africa, Asia, and Central and South America. Ninety-two percent (200 million) of malaria cases in 2017 were detected in the WHO African Region. This accounts for approximately 30% of the global burden of LF disease and includes 405.9 million people at risk in 39 out of 46 member countries. Anopheles species of mosquitoes transmit Wuchereria bancrofti in most parts of Africa. Our case of a 23-year-old Nigerian woman highlights incidental laboratory findings showing the first malaria/filariasis coinfection in the governorate (province). This coinfection was ascertained during the usual medical screening before recruitment in Oman, which is routinely conducted for every expatriate.

scholarly journals Case Report: Sickle Cell Anemia; First Case Reported from Egypt

Blood ◽  
1951 ◽  
Vol 6 (6) ◽  
pp. 555-558 ◽  
Author(s):  
A. S. ABBASY
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Mediterranean Area ◽  
Laboratory Studies ◽  
Laboratory Findings ◽  
Rheumatic Arthritis ◽  
Points Of Interest ◽  
First Case ◽  
Paternal Uncle ◽  
The Family

Abstract Rheumatic fever, rheumatic arthritis, acholuric jaundice were excluded in this case on the clinical and laboratory findings. The history, physical examination and the laboratory studies all supported the diagnosis of sickle cell anemia. This case presents certain points of interest. It is the first case of sickle cell anemia reported from Egypt. The disease was found in the patient and her father and excluded in the other members of the family. It is, however, possible that the paternal uncle had also suffered and died from the disease. The patient is a white girl and admixture of Negro blood was reasonably excluded through 6 ancestral generations. This case, therefore, adds to those already described in subjects of the white race from the Mediterranean area. It will be noticed that the patient’s family originates from Algeria, where 3 cases were diagnosed in natives by Smith19 on the basis of the anatomical changes observed in the spleen.

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