scholarly journals Chest pain in a mid-aged woman, not simply myopericarditis: a case report of anti-Ku positive polymyositis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Weiping Tan ◽  
Bin Dong ◽  
Jincui Gu ◽  
Yang Peng ◽  
Ruicong Xue
Keyword(s):  
Chest Pain ◽  
Rare Case ◽  
Cardiac Involvement ◽  
Inflammatory Myopathy ◽  
Proximal Muscle ◽  
Comprehensive Understanding ◽  
Case Presentation ◽  
Aged Woman ◽  
Negative Findings

Abstract Background Anti-Ku is a rare antibody which can be positive in some rheumatic diseases and it might be related to cardiac involvement. Polymyositis is an inflammatory myopathy, and its cardiac involvement seldom presents as myopericarditis and anti-Ku positive. Case presentation In this case, we report a mid-aged woman with chest pain, upper limbs weakness and fever unrelated with infection. The diagnosis of this case was unquestionably myopericarditis supported by ECG, cardiac MRI and negative findings in coronary arteries. Diagnosis of polymyositis was further clarified by the evidence of persistently increased CK, degeneration of proximal muscle in MRI, muscular dystrophy with lymphocytes infiltration in muscle biopsy. In the analysis of autoantibodies, we surprisingly discovered positive anti-Ku. Glucocorticoid and mycophenolate mofetil were then prescribed for polymyositis. Patient follow-up indicated remission of both myopericarditis and polymyositis. We finally clarified this rare case as a positive anti-Ku polymyositis with myopericarditis as cardiac involvement. Conclusion This report presents a rare case with anti-Ku positive polymyositis and the cardiac involvement of polymyositis was manifested as myopericarditis. Therefore, positive anti-Ku might explain the myopericarditis as cardiac involvement in polymyositis. More cases and longer duration of follow-up is required for the comprehensive understanding of the disease.

A case of statin-induced liver injury with positive rechallenge with a second statin. Is there a class effect?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Giovanna Onfiani ◽  
Fabio Nascimbeni ◽  
Francesca Carubbi
Keyword(s):  
Liver Injury ◽  
Clinical Symptoms ◽  
High Risk Population ◽  
Drug Induced ◽  
Case Presentation ◽  
Drug Induced Liver Injury ◽  
Aged Woman ◽  
Cardiovascular Morbidity And Mortality ◽  
Middle Aged Woman

Abstract Objectives Statins have proved to reduce cardiovascular morbidity and mortality in high-risk population and are generally well tolerated, although adverse events can occur. Up to 3% of patients develop aminotransferases elevation, which usually normalizes with continued treatment and hardly is associated with clinical symptoms. Serious statin-related liver injury is exceedingly rare. Furthermore, literature regarding rechallenge with a second statin is extremely poor. Some authors caution that re-exposure to these drugs is associated with a more serious liver injury but safe switching to a second statin after drug-induced liver injury (DILI) is also reported. Case presentation We describe a case of a middle-aged woman who developed hepatocellular liver injury after simvastatin dose escalation; a rechallenge with low dose rosuvastatin caused rapid recurrence of DILI. Conclusions In our opinion, clinicians should be very cautious upon rechallenge and closely follow-up patients who experienced statin-induced liver injury when trying re-exposure to another statin.

A rare case of spontaneous haemothorax in patient with haemophilia A

2021 ◽  
Vol 14 (4) ◽  
pp. e242412
Author(s):  
Suthaphong Tripoppoom ◽  
Nophol Leelayuwatanakul
Keyword(s):  
Chest Pain ◽  
Rare Case ◽  
Rare Event ◽  
Haemophilia A ◽  
Minor Trauma ◽  
Conservative Approach ◽  
Pleuritic Chest Pain ◽  
Good Clinical Outcome ◽  
History Of

Haemorrhage in patients with haemophilia is common after minor trauma but may occur spontaneously. Despite the diversity of bleeding sites, spontaneous haemothorax, on a non-traumatic basis, is an exceedingly rare event and only a few cases had been reported. We present a case of a 43-year-old man with a history of haemophilia A who had pleuritic chest pain for 1 day without significant history of trauma. Diagnostic thoracentesis showed bloody pleural fluid in which neither abnormal cell nor organism was found. He was treated by cryoprecipitate replacement and therapeutic thoracentesis for releasing haemothorax. After discharge, the patient returned for follow-up with complete radiological resolution. Regarding the consequences of retained haemothorax from conservative approach and the procedure-related bleeding of given therapeutic intervention in haemothorax making its management in patients with haemophilia to be more challenging. Our case illustrates a conservative treatment of spontaneous haemothorax in patient with haemophilia resulting in a good clinical outcome.

scholarly journals Anti-OJ (Anti-isoleucyl-tRNA Synthetase) Autoantibody- Positive Anti-synthetase Syndrome: a Case Report

2021 ◽  
Author(s):  
Ji-Na Gu ◽  
Wang Yan ◽  
Qiao-Ling Gao ◽  
Lin Chen
Keyword(s):  
Joint Pain ◽  
Rare Case ◽  
Clinical Symptoms ◽  
Inflammatory Myopathy ◽  
Trna Synthetase ◽  
Systemic Autoimmune Diseases ◽  
Case Presentation ◽  
Recurrent Hepatocellular Carcinoma ◽  
Atypical Manifestations ◽  
One Year

Abstract Background: Anti-OJ (anti-isoleucyl-tRNA synthetase) autoantibody-positive anti-synthetase syndrome(ASS) is a rare systemic autoimmune diseases that manifest as an inflammatory myopathy and interstitial lung diseas.Case presentation: We present a case of anti-OJ antibody-positive ASS with recurrent joint pain, fever, significantly elevated inflammatory markers, occult myositis but no interstitial pneumonia in a 75-year-old male patient. The patient was misdiagnosed for more than one year. Recurrent hepatocellular carcinoma (HCC) was confirmed after 1 year of the diagnosis of ASS, and the clinical symptoms were relieved after surgical resection. Conclusion: We report this rare case of anti-OJ antibody-positive ASS with atypical manifestations to raise awareness of the disease for clinicians.

scholarly journals Corneal erforation casused by eyelid margin trichilemmal carcinoma: A case report

2019 ◽  
Author(s):  
Liying Zhang ◽  
Zhirong Lin ◽  
Huping Wu
Keyword(s):  
Rare Case ◽  
The Elderly ◽  
Corneal Perforation ◽  
Slit Lamp ◽  
Blurred Vision ◽  
Eyelid Margin ◽  
Case Presentation ◽  
Adnexal Tumor ◽  
History Of

Abstract Background: Trichilemmal carcinoma (TLC) is a rare malignant adnexal tumor predominantly affecting the scalp, eyelids, neck and face of the elderly. Here, we firstly report a rare case of corneal perforation caused by TLC grown in eyelid margin. Case presentation: A 68-year-old female presented with two months history of unprovoked redness, pain and blurred vision in the left eye. On slit-lamp examination, a 1×2mm aseptic corneal perforation embedded by iris prolapsed was noted. After excluding other causes through examinations and case history inquiry, we speculated that the severe MGD and subsequent BKC might be the cause. In order to prevent the ulcer enlargement and intraocular infection, the patient was treated with penetrating keratoplasty immediately. However, a terrible phenomenon has aroused our concern that several small nodules gradually developed on the eyelid margin, accompanied with bleeding, burst and madarosis postoperatiely. The biopsy revealed the eyelid was involved by TLC and then the lesionectomy was performed immediately. There was no evidence of local recurrence and metastasis during 1 year follow-up. Conclusions: The involvement of eyelid margin by TLC, and subsequent BKC and corneal perforation were very rare and it has not been reported yet. The concomitant BKC can be gradually healed after rectifying eyelid margin by total excision of TLC. It is very important to offer careful follow-up to all patients.

scholarly journals A rare Bochdalek hernia in an adult: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi-Min Gu ◽  
Xiao-Yang Li ◽  
Wen-Ping Wang ◽  
Long-Qi Chen
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Chest Pain ◽  
Respiratory Distress ◽  
Rare Case ◽  
Acute Chest Pain ◽  
Bochdalek Hernia ◽  
Case Presentation ◽  
Developmental Abnormalities

Abstract Background Symptomatic Bochdalek hernias are found mainly in infants in respiratory distress and occur rarely in adults. Case presentation We report a rare case of Bochdalek hernia associated with developmental abnormalities in an adult who exhibited acute chest pain and dyspnea on exertion. Conclusions This case highlights the importance of the differential diagnosis of acute left-sided chest pain and antenatal examination.

scholarly journals Arginine-Restricted Therapy Resistant Bilateral Macular Edema Associated with Gyrate Atrophy

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Sibel Doguizi ◽  
Mehmet Ali Sekeroglu ◽  
Mustafa Alpaslan Anayol ◽  
Pelin Yilmazbas
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Peripheral Zone ◽  
Restricted Diet ◽  
Comprehensive Understanding ◽  
Gyrate Atrophy ◽  
Case Presentation ◽  
Corrected Visual Acuity

Introduction. Gyrate atrophy is a rare genetical metabolic disorder affecting vision. Here, we report a 9-year-old boy with gyrate atrophy associated with bilateral macular edema at the time of diagnosis and the effect of long term metabolic control on macular edema.Case Presentation. A 9-year-old boy presented with a complaint of low visual acuity (best corrected visual acuity: 20/80 in both eyes, refractive error: −12.00 D). Dilated fundus examination revealed multiple bilateral, sharply defined, and scalloped chorioretinal atrophy areas in the midperipheral and peripheral zone. Spectral-domain optical coherence tomography revealed bilateral cystoid macular edema in both eyes. Serum ornithine level was high (622 μmol/L). An arginine-restricted diet reduced serum ornithine level (55 μmol/L). However, visual findings including macular edema remained unchanged in 2 years of follow-up.Conclusion. Arginine-restricted diet did not improve macular edema in our patient with gyrate atrophy. A more comprehensive understanding of the underlying factors for macular edema will lead to the development of effective therapies.

scholarly journals A Rare Case of Cranial Nerve VII Neuropraxia Associated with Alveolar Nerve Blocks

2021 ◽  
Vol 2 (5) ◽  
pp. 273-274
Author(s):  
Stephen Allegra ◽  
Richard Church ◽  
Veera Sudireddy
Keyword(s):  
Cranial Nerve ◽  
Rare Case ◽  
Oral Corticosteroid ◽  
Dental Procedure ◽  
Nerve Blocks ◽  
Case Presentation ◽  
Dental Anesthesia ◽  
Antiviral Medications ◽  
Uncommon Complication

Case Presentation: A 26-year-old male presented to our emergency department for six days of right-sided facial myasthenia and parasthesias following a dental procedure using anesthetic nerve blocks. Discussion: Iatrogenic cranial nerve VII neuropraxia, a peripheral nerve injury, is an uncommon complication of alveolar nerve blocks with few documented cases specifically due to dental anesthesia. Treatment usually involves use of oral corticosteroid and/or antiviral medications along with close follow-up in clinic with a neurologist and/or otolaryngologist.

scholarly journals Two giant connected retroperitoneal schwannomas: A rare case report

2020 ◽  
Author(s):  
Tao Yang ◽  
Lanqing Cao ◽  
Wei Li ◽  
Kai Zhang ◽  
Yuecheng Zhu ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Rare Case ◽  
Low Density ◽  
Soft Tissue Density ◽  
Case Presentation ◽  
Benign Schwannoma ◽  
Rare Case Report ◽  
Retroperitoneal Schwannoma ◽  
Specific Symptoms

Abstract Background：There are few reports of large retroperitoneal schwannomas and few guidelines for the diagnosis and surgical treatment.Case presentation：A 40-year-old female came to our department due to abdominal pain for 1 day and there are no other specific symptoms. There were no abnormalities in the patient's tumor markers. Plain computer tomography (CT) scan of the whole abdomen revealed two mass soft tissue density shadows behind the peritoneum, with uneven internal density, cystic low-density shadows and patchy calcification shadows. The larger mass was about 12.0 cm × 12.3 cm in size. Then tumors were completely excised by a reasonable surgical approach while the surrounding organs closely related to the tumor were preserved. Postoperative pathology confirmed that the tumor was benign schwannoma. In the 18-month follow-up, the patient had no recurrences and was asymptomatic.Conclusion：We summarize the diagnosis and treatment of a rare giant retroperitoneal schwannoma. Laparotomy for the management of retroperitoneal giant schwannomas may be a safe and effective method.

scholarly journals A Rare Case of Cardiogenic Shock following Severe Multivessel Coronary Vasospasm

2019 ◽  
Author(s):  
Reza Rahmani ◽  
Amirfarhangh Zand Parsa ◽  
Alborz Sherafati ◽  
Rouzbeh Kosari ◽  
Vahid Mohhamadi ◽  
...  
Keyword(s):  
Chest Pain ◽  
Cardiac Death ◽  
Rare Case ◽  
Recurrent Attack ◽  
St Segment Elevation ◽  
St Segment ◽  
Life Threatening ◽  
Vascular Beds ◽  
Typical Chest Pain

Prinzmetal’s angina occurs following spasms in a single or multiple vascular beds, resulting in a typical chest pain and an ST-segment elevation in electrocardiography (ECG). It can lead to life-threatening arrhythmias and sudden cardiac death. We describe a 37-year-old woman who was admitted with a typical chest pain and hypotension. Her initial ECG showed an ST-segment elevation in the inferior and precordial leads. She was transferred to the catheterization unit, where coronary angiography illustrated multivessel spasms. The spasms were relieved with a nitroglycerin injection. She was discharged with stable hemodynamics 7 days later, and at 1 month’s follow-up, no recurrent attack was detected.

Hiccups Induced by Aripiprazole Combined With Sertraline in An Adolescent With Olfactory Reference Disorder: A Case Report

2021 ◽  
Author(s):  
Zhe Li ◽  
Yang Li ◽  
Zhenzhen Xiong ◽  
Zhixiong Li ◽  
Yiwen Yuan ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Medication Compliance ◽  
Acute Administration ◽  
Case Presentation

Abstract Background Hiccup can cause significant distress to patients and affect medication compliance. Individuals with olfactory reference disorder (ORD) who might develop persistent hiccups when treated with a combination of antidepressant and antipsychotic, leading to significant distress and impairment. Case presentation We report a rare case of an adolescent with ORD who was treated with aripiprazole combined with sertraline and who began to hiccup persistently after 6 days on this treatment. He stopped hiccupping after the aripiprazole had been suspended for 12 h. After discharge, the patient continued on sertraline alone and reported no hiccupping at one-month follow-up. Conclusions Clinicians should consider that the combination of aripiprazole and sertraline can induce hiccups during the acute administration period in adolescents with ORD.

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