scholarly journals Multiple renal infarctions in a patient caused by granulomatosis with polyangiitis

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097744
Author(s):  
Xiao Lu ◽  
ChengYing Yuan ◽  
RongShan Li
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Small Vessel Vasculitis ◽  
High Dose ◽  
Nasal Discharge ◽  
Renal Infarction ◽  
Cross Sectional ◽  
Computed Tomography Images ◽  
Contrast Enhanced ◽  
Increased Risk ◽  
Enhanced Computed Tomography

Granulomatosis with polyangiitis (GPA) is a small-vessel vasculitis that is highly associated with anti-neutrophil cytoplasmic antibodies. GPA carries an increased risk of organ infarction, but renal infarction is rare. We herein describe a case of multiple renal infarctions caused by GPA. A 66-year-old man presented with hearing loss, nasal discharge, fatigue, and weight loss for several months. Cross-sectional contrast-enhanced computed tomography images revealed multiple low-attenuation areas in both kidneys. He subsequently developed fever and impaired renal function. Blood serum was positive for cytoplasmic anti-neutrophil cytoplasmic antibody and a renal biopsy showed granulomatous necrotizing vasculitis. He was diagnosed with GPA and treated with high-dose corticosteroids, plasma exchange, and cyclophosphamide. The patient ultimately entered clinical remission.

Granulomatosis with polyangiitis presenting as pancreatic disease

2021 ◽  
Vol 14 (3) ◽  
pp. e241033
Author(s):  
Jessie Jia Tao ◽  
Arnav Agarwal ◽  
Ari Benjamin Cuperfain ◽  
Christian Pagnoux
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Epigastric Pain ◽  
Delayed Diagnosis ◽  
Pancreatic Disease ◽  
Small Vessel Vasculitis ◽  
High Dose ◽  
Rapid Progression ◽  
Radiographic Evidence ◽  
High Index Of Suspicion ◽  
Parenchymal Lung

Granulomatosis with polyangiitis (GPA) is a rare necrotising small vessel vasculitis typically associated with oronasal, pulmonary and renal manifestations. Pancreatic disease is an exceedingly rare initial presentation and is associated with delayed diagnosis and rapid progression. We discuss a 66-year-old woman presenting with epigastric pain, elevated lipase and radiographic evidence of focal pancreatitis. She had no relevant medical history and no lithiasis seen on imaging. Pertinent findings include strawberry gingivitis, positive proteinase-antineutrophil cytoplasm antibody (98% specificity) and focal nodular parenchymal lung lesions on CT chest—all of which are consistent with a diagnosis of GPA. She was promptly started on high-dose steroids which resulted in significant clinical and biochemical improvement. Cyclophosphamide was added once biopsy confirmed the absence of malignancy. In order to optimise the clinical outcomes of GPA, physicians must keep a wide differential and high index of suspicion in the setting of unexplained pancreatitis with systemic features.

High-dose contrast-enhanced computed tomography (CECT) with iopamidol in the detection of cerebral metastases

1989 ◽  
Vol 31 (2) ◽  
pp. 148-150 ◽  
Author(s):  
M. Leonardi ◽  
A. Lavaroni ◽  
E. Biasizzo ◽  
G. Fabris ◽  
T. Penco ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cerebral Metastases ◽  
High Dose ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

scholarly journals Nasopharyngeal Polyp in a Cat: Clinical Assessment

2021 ◽  
Author(s):  
Emre Yanar Kerim
Keyword(s):  
Computed Tomography ◽  
Invasive Procedure ◽  
Clinical Findings ◽  
Nasal Discharge ◽  
Runny Nose ◽  
Contrast Enhanced ◽  
Mixed Breed ◽  
Precise Diagnosis ◽  
Increased Sensitivity ◽  
Enhanced Computed Tomography

The case report describes diagnosis and surgical treatment of nasopharyngeal polyp in a 3-months-old mixed breed female cat with sneezing, runny nose, lack of appetite and change of voice Serous tear discharge, mucopurulent nasal discharge and increased sensitivity in trachea were detected at clinical examination of the cat Following inspection of the oral cavity, it was observed that the soft palate was bulged and had a different appearance from the normal anatomical structure Significant alterations were not determined in the haematological, biochemical and radiographic examinations However, nasopharyngeal polyp was determined following the contrast-enhanced computed tomography examination After the polyp was removed by a simple invasive procedure, clinical findings of the cat started to improve as from the second day One month after the operation, the she was completely cured and became healthy In conclusion, nasopharyngeal polyp has to be considered for cats with lack of appetite, sneezing, runny nose and change of voice, and collaboration between oropharyngeal examination and transversal shots of the computed tomography would constitute a reliable approach for a precise diagnosis and preoperative planning for feline nasopharyngeal polyps.

Miscellaneous Lesions of the Mediastinum

Chest Imaging ◽  
2019 ◽  
pp. 505-510
Author(s):  
Brett W. Carter
Keyword(s):  
Clinical History ◽  
Extramedullary Hematopoiesis ◽  
Vascular Lesions ◽  
Esophageal Hiatus ◽  
Malignant Neoplasms ◽  
Cross Sectional ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Enhanced Computed Tomography ◽  
Omental Fat

A group of several miscellaneous lesions may arise within one or more of the mediastinal compartments that are distinct from benign or malignant neoplasms, cysts, lymphadenopathy, and vascular lesions. Such entities cannot be classified as one specific disease type, and include extramedullary hematopoiesis and multiple types of herniations, specifically hiatal, paraesophageal and Morgagni hernias. Extramedullary hematopoiesis typically manifests as paravertebral masses that may exhibit fat attenuation or signal. Hiatal and paraesophageal hernias are common abnormalities in which the stomach herniates into the thorax through the esophageal hiatus. Morgagni hernias occur through an anterior diaphragmatic defect and typically contain omental fat but may also contain liver and bowel. As with other abnormalities of the mediastinum, these lesions may first be identified on chest radiography. However, correlation with pertinent clinical history and cross-sectional imaging, typically contrast-enhanced computed tomography, is necessary for definitive diagnosis.

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