scholarly journals Lymphomatoid papulosis in a patient treated with glatiramer acetate and the glatiramoid Glatopa for multiple sclerosis: A case report

2021 ◽  
Vol 13 ◽  
pp. 117957352110537
Author(s):  
Afsaneh Shirani ◽  
Scott R Dalton ◽  
Eric J Avery ◽  
Lakshman Arcot Jayagopal ◽  
Christina Meyer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Glatiramer Acetate ◽  
Lymphoproliferative Disorder ◽  
Skin Lesions ◽  
T Cell Differentiation ◽  
Caucasian Woman ◽  
Lymphomatoid Papulosis ◽  
The Past ◽  
History Of

A 48-year-old Caucasian woman with history of multiple sclerosis (MS) presented with erythematous papulonodular lesions in her extremities and trunk. She was being treated with glatiramer acetate (GA) for the past 10 years and the glatiramoid, Glatopa, for 2 years prior to this presentation. A skin biopsy showed CD30+ lymphoproliferative disorder consistent with lymphomatoid papulosis (LyP). Three weeks after stopping Glatopa, her skin lesions were improved. It remains unclear whether GA’s or Glatopa’s capability to alter T-cell differentiation, may have a link with LyP. This case report is a reminder to be vigilant for skin lesions in patients with MS.

It is not always COVID-19: Case report about an undiagnosed HIV man with dyspnea

2021 ◽  
Vol 19 ◽  
Author(s):  
Michela Pontolillo ◽  
Katia Falasca ◽  
Jacopo Vecchiet ◽  
Claudio Ucciferri
Keyword(s):  
Case Report ◽  
Diagnostic Assays ◽  
Radiological Features ◽  
The Past ◽  
Undiagnosed Hiv ◽  
History Of ◽  
Clinical Conditions ◽  
Diagnostic Thinking ◽  
Diagnostic Delays ◽  
Analyze Data

Background: The current COVID-19 pandemic has attracted great attention from the medical world. In the past year, there have been reports of missed or delayed treatments for conditions that mimic COVID-19. The main symptoms caused by SARS-CoV-2, such as fever and cough, belong to different clinical conditions. It is of the utmost importance that the diagnostic thinking used to analyze data and information to reach a COVID-19 diagnosis does not overlook the plethora of different diagnoses related to these symptoms. Case report: The aim of this work is to present the clinical case of a patient having unrecognized HIV infection with a 4-week history of fever, cough, and hypoxia. When tests were allowed to highlight HIV-related immunodeficiency status, a CMV assay was performed in order to evaluate opportunistic pneumonia. Through this, diagnosis of HIV combined with CMV pneumonia was made, thus excluding COVID-19 respiratory insufficiency. Conclusion: The diagnosis of the two conditions in the COVID-19 era is challenging due to overlapping clinical and radiological features and limitations of current diagnostic assays. This causes clinical implications due to diagnostic delays.

scholarly journals Case Report: Combining Dalfampridine with Multicomponent Exercise and Gait Training in a Person with Multiple Sclerosis

2018 ◽  
Vol 20 (5) ◽  
pp. 238-243
Author(s):  
Prudence Plummer ◽  
Corinne J. Bohling ◽  
L. Ellese Nickles ◽  
Alexis A. Williams ◽  
Amy Thomas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Dual Task ◽  
Gait Speed ◽  
Gait Training ◽  
Important Change ◽  
Relapsing Remitting ◽  
History Of ◽  
Task Conditions ◽  
Clinically Important Change

Abstract Background: Dalfampridine extended release (D-ER) improves gait speed in some people with multiple sclerosis (MS), but many patients who take D-ER demonstrate only small improvements of questionable clinical significance. Physical therapy (PT) may augment the treatment effects of D-ER on the nervous system and improve clinical outcomes. This case report describes the successful use of D-ER combined with multicomponent PT in a patient who did not have a clinically important change in gait speed with D-ER alone. Methods: A 59-year-old woman with a 6-year history of relapsing-remitting MS was prescribed D-ER by her neurologist. After 3 weeks of D-ER therapy (10 mg twice daily), she demonstrated only a 7.1% improvement in the Timed 25-Foot Walk test. She then commenced PT consisting of two 40-minute sessions per week for 6 weeks while continuing D-ER therapy. Training focused on gait, balance, coordination, functional strengthening, and dual-task performance. Results: After 6 weeks of D-ER + PT, she had a further 14.6% improvement in Timed 25-Foot Walk gait speed, for a total improvement of 20.7%, which elevated her above the clinically meaningful threshold of 20%. Similar patterns of improvement were also observed for self-selected gait speed in single- and dual-task conditions. Improvements in fast and dual-task gait speed were retained 3 weeks later. Conclusions: For this patient, combining PT with D-ER therapy improved gait speed more than the use of D-ER alone. Further investigation of D-ER + PT or PT as an alternative to D-ER in patients with submeaningful medication response is warranted.

Quinacrine Hydrochloride-Induced Yellow Discoloration of the Skin in Children

PEDIATRICS ◽  
1982 ◽  
Vol 69 (2) ◽  
pp. 232-233
Author(s):  
Ronald J. Sokol ◽  
Philip K. Lichtenstein ◽  
Michael K. Farrell
Keyword(s):  
Case Report ◽  
Drug Administration ◽  
Side Effect ◽  
Common Side Effect ◽  
Clinical Method ◽  
The Past ◽  
Drug Of Choice ◽  
Bowel Movements ◽  
Alternative Drug ◽  
History Of

The drug of choice for treatment of giardiasis in children has changed over the past several years. Metronidazole (Flagyl) has been found to be carcinogenic in mice and mutagenic in bacteria,1 and is, therefore, no longer approved by the Food and Drug Administration for the treatment of giardiasis. Thus, quinacrine hydrochloride (Atabrine) is the recommended alternative drug for the treatment of giardiasis in children. The purpose of this report is to remind physicians of a common side effect of quinacrine hydrochloride and to call attention to a simple clinical method for its confirmation. CASE REPORT S.W., a 3-year-old white boy, had a three-week history of three to six loose, watery bowel movements per day.

scholarly journals Muir-Torre Syndrome: case report and molecular characterization

2014 ◽  
Vol 132 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Carolina Alejandra Rios ◽  
Ricardo Villalon ◽  
Jorge Munoz ◽  
Monica Acuna ◽  
Lucia Cifuentes
Keyword(s):  
Case Report ◽  
Autosomal Dominant ◽  
Treatment Options ◽  
Skin Lesions ◽  
Molecular Techniques ◽  
Causative Mutation ◽  
Colorectal Tumors ◽  
History Of ◽  
Repair Genes ◽  
Microsatellite Instability Analysis

CONTEXT: Muir-Torre syndrome is a rare autosomal dominant genodermatosis caused by mutations in the mismatch repair genes. It is characterized by the presence of sebaceous skin tumors and internal malignancies, affecting mainly the colon, rectum and urogenital tract. Awareness of this syndrome among physicians can lead to early diagnosis of these malignancies and a better prognosis. CASE REPORT: We report the case of a Chilean patient who, over the course of several years, had multiple skin lesions, endometrial cancer and colon cancer. The syndrome was diagnosed using molecular techniques such as microsatellite instability analysis, immunohistochemistry and DNA sequencing, which allowed us to find the causative mutation. CONCLUSION: Molecular diagnostics is a highly useful tool, since it allows clinicians to confirm the presence of mutations causing Muir-Torre syndrome. It is complementary to the analysis of the clinical data, such as dermatological presentation, presence of visceral malignancies and family history of colorectal tumors, and it provides important knowledge to help physicians and patients choose between treatment options.

scholarly journals Treatment of Fraley’s syndrome by upper-pole nephrectomy

2007 ◽  
Vol 125 (6) ◽  
pp. 354-355
Author(s):  
Thaís Bandeira Cerqueira ◽  
Natalia Bacellar Costa Lima ◽  
Romeu Magno Baptista Neto ◽  
José Cohim Moreira Filho ◽  
Luiz Eduardo Café
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Emergency Care ◽  
Lumbar Pain ◽  
Vascular Compression ◽  
The Past ◽  
Renal Arteriography ◽  
History Of ◽  
The Right

CONTEXT: Fraley’s syndrome is characterized by vascular compression on the superior infundibulum with secondary dilatation of the upper pole calyx, mostly located on the right side. CASE REPORT: We present the case of a 22-year-old woman with vascular compression of the upper-pole infundibulocalyceal system (Fraley’s syndrome). The patient had a history of frequent hospitalizations for emergency care due to lumbar pain over the past twelve months. The diagnosis was obtained following renal arteriography. Since the surgical treatment by means of upper-pole nephrectomy, the patient has not had any further symptoms.

scholarly journals Multicentric Cutaneous Crohn's Disease: A Case Report and Review of Literature

1990 ◽  
Vol 4 (2) ◽  
pp. 59-63 ◽  
Author(s):  
Robert Prokopetz ◽  
J Barrie Ross ◽  
Peter Smith ◽  
Joseph J Sidorov
Keyword(s):  
Crohn’S Disease ◽  
Case Report ◽  
Crohn's Disease ◽  
Erythema Nodosum ◽  
Skin Lesions ◽  
Review Of Literature ◽  
Histological Features ◽  
The Past ◽  
Common Skin ◽  
Skin Conditions

A patient presented with skin lesions at sites not contiguous with Crohn's disease of the bowel and with specific histological features of Crohn's disease occurring two weeks from the onset of bowel symptoms. Currently a number of nonspecific skin conditions such as erythema nodosum, pyoderma gangrenosum and erythema multiforme are accepted as being the most common skin manifestations of Crohn's disease. It is likely, however, that specific lesions of Crohn's disease in the skin have been underdiagnosed either because of lack of biopsy or misinterpretation of the histology. Twenty-three cases with specific Crohn's disease in the skin have been recorded in the past 25 years, since the condition has been recognized. Sarcoidosis has been a common misdiagnosis. The literature relating to multicentric Crohn's disease is reviewed and attention drawn to its protean and masquerading features. An argument is made for the use of the term 'multicentric' rather than 'metastatic' in relation to cutaneous Crohn's disease.

scholarly journals Non allergic simple eosinophilic pneumonia: Löffler syndrome: A case report study

2008 ◽  
Vol 61 (11-12) ◽  
pp. 643-646 ◽  
Author(s):  
Ivana Meta-Jevtovic ◽  
Miroslav Tomovic ◽  
Slavica Mojsilovic ◽  
Marina Petrovic
Keyword(s):  
Case Report ◽  
Bronchial Asthma ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Eosinophilic Pneumonia ◽  
Unknown Etiology ◽  
Caucasian Woman ◽  
Low Grade ◽  
Radiographic Findings ◽  
Therapy Regimen ◽  
History Of

Introduction L?ffler syndrome is an acute, pneumonia of unknown etiology. This disease is not often associated with bronchial asthma. In its asymptomatic form, this disease is reversible, transient, self-limited with no requests for specific therapy regimen. In the symptomatic form, as well as during its progression, treatment with steroids is very effective. Furthermore, in both acute eosinophilic and idiopathic chronic eosinophilic form, this kind of therapy ensures survival. Case report The case of a 53-year-old Caucasian woman was presented with 2-month history of low grade fever, shortness of breath, cough and reduced exercise tolerance. Although she had an allergic accident on insects in history, non allergy reactions as well as an obstructive disease with that kind of origin were not detected on admission. The diagnosis of simple eosinophilic pneumonia (SEP) (L?ffler's syndrome) was confirmed by transbronchial biopsy and by sternal testing. The peripheral blood eosinophilia with pulmonary eosinophilic infiltrates on X ray chest radiography were observed during clinical examination. Biopsy specimen of the lung parenchym showed changes associated with L?ffler's syndrome. The diagnosis was, also, confirmed according to the radiographic findings of unilateral migratory infiltrates consistent pneumonia. Discussion Churg Strauss syndrome (CSS) has to be considered in this differential diagnosis. Frequently, this disease has extrinsic bronchial asthma with eosinophilic pneumonia in history; asthma is often associated with allergic bronchopulmonary aspergillosis. In the reported case, treatment with steroids resulted in a marked clinical improvement compared to nonsteroid therapy.

scholarly journals Case Report: Migrainous Infarct without Aura

2017 ◽  
Vol 9 (3) ◽  
pp. 241-251
Author(s):  
Kamesh Gupta ◽  
Anurag  Rohatgi ◽  
Shivani Handa
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Report ◽  
Rare Case ◽  
Case Presentation ◽  
The Past ◽  
Need To Evaluate ◽  
History Of ◽  
Complicated Migraine ◽  
Full Investigation

Background: Stroke in a migraine with aura has been documented in several cases, even deserving the merit of a classification as complicated migraine. Herein, we present a rare case of migrainous infarct without aura. The diagnosis was challenging due to lack of risk factors. The patient was unique in not having any other comorbidities. Case Presentation: The case is of a 21-year-old female presenting with right-sided hemiplegia and facial drooping. She had had an index presentation of throbbing headaches for the past 2 years, typical of a migraine but not preceded by any aura symptoms. However, in the current episode, the pain became excessively severe and accompanied by right-sided hemiplegia and facial drooping. A full investigation workup using MRI revealed evidence of infarct in the left temporoparietal and basal ganglion region. Conclusion: Our case highlights the need to evaluate silent ischemic stroke in case of prolonged headache with a history of migraine as well as the need for precaution to avoid the use of triptans or opioids in such a case. It also highlights the conditions that need to be excluded before labeling it as a migrainous infarct.

scholarly journals Untreated Active Tuberculosis in Pregnancy with Intraocular Dissemination: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Shadi Rezai ◽  
Stephen LoBue ◽  
Daniel Adams ◽  
Yewande Oladipo ◽  
Ramses Posso ◽  
...  
Keyword(s):  
Case Report ◽  
Developed Countries ◽  
Physiological Changes ◽  
Review Of The Literature ◽  
X Ray ◽  
Delay In Diagnosis ◽  
The Past ◽  
History Of ◽  
Chest X Ray ◽  
Patient Refusal

Background.Tuberculosis (TB) is a disease that affects hundreds of millions of people across the world. However, the incidence in developed countries has decreased over the past decades causing physicians to become unfamiliar with its unspecific symptoms. Pregnant individuals are especially difficult because many symptoms of active TB can mimic normal physiological changes of pregnancy. We present a case report of a 26-year-old multiparous woman, G4P3003, at 38-week gestation with a history of positive PPD who emigrated from Ghana 6 years ago. She came to the hospital with an initial complaint of suprapubic pain, pressure, and possible leakage of amniotic fluid for the past week. Patient also complained of a productive cough for the past 3 to 4 months with a decrease in vision occurring with the start of pregnancy. Visual acuity was worse than 20/200 in both eyes. Definitive diagnosis of active TB was delayed due to patient refusal of chest X-ray. Fortunately, delay in diagnosis was minimized since patient delivered within 24 hours of admission. Active TB was confirmed with intraocular dissemination. Patient had optic atrophy OS (left eye) and papillitis, choroiditis, and uveitis OD (right eye) due to TB infiltration. Fetus was asymptomatic and anti-TB therapy was started for both patients.

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