scholarly journals Rhabdomyosarcoma in a child with nephrotic syndrome treated with cyclosporine: a case report with literature review

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Huai-Chueh Gem Wu ◽  
Chao-Neng Cheng ◽  
Jiann-Shiuh Chen ◽  
Yuan-Yow Chiou
Keyword(s):  
Nephrotic Syndrome ◽  
Case Report ◽  
Immunosuppressive Therapy ◽  
Female Child ◽  
Magnetic Resonance Imaging Scan ◽  
Creatinine Ratio ◽  
Resonance Imaging ◽  
Urine Protein ◽  
Case Presentation ◽  
Frequently Relapsing Nephrotic Syndrome

Abstract Background In patients with frequently relapsing nephrotic syndrome, immunosuppressive therapy such as cyclosporine are often required to maintain remission. Cyclosporine has been noted to have tumorgenesis effects. In this case report, we present a child with relapsing nephrotic syndrom developed a rhabdomyosarcoma on her tongue after adout 4 years of continual immunosuppressive therapy. Case presentation A 2-year-old female child had nephrotic syndrome (urine protein-creatinine ratio 749.1 mg/mg; blood urea nitrogen 11 mg/dL; serum creatinine 0.3 mg/dL; and serum albumin 1.8 g/dL.) Proteinuria resolved on treatment with daily prednisolone for 4 weeks at the dose of 45 mg (2.5 mg/kg/day) but recurred with taper from 25 mg/day to 10 mg/day. At least five more episodes of relapse occurred within about a 3-year period. After the third relapse, she was treated with prednisolone and cyclosporine (at initial dose of 50 mg/day [1.7 mg/kg/day]) for immunosuppression. About 4 years after the diagnosis of nephrotic syndrome had been made, an embryonal rhabdomyosarcoma developed on her tongue. The cancer was treated with TPOG-RMS-LR protocol, with vincristine, actinomycin, and cyclophosphamide. Magnetic resonance imaging scan, performed about 3 years after the start of TPOG-RMS-LR therapy, revealed complete remission of the cancer. Conclusions Although treatment with cyclosporine cannot be conclusively implicated as the cause the rhabdomyosarcoma in this patient, the association should prompt consideration of its use in the treatment of frequently relapsing nephrotic syndrome in children.

scholarly journals Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Interventional Radiology ◽  
Case Report ◽  
Magnetic Resonance ◽  
Thoracic Duct ◽  
Rare Case ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Thoracostomy Tube ◽  
Magnetic Resonance Imaging Mri

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.

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 Isolated nausea and vomiting as the cardinal presenting symptoms of clozapine-induced myocarditis: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
M. Z. van der Horst ◽  
F. van Houwelingen ◽  
J. J. Luykx
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Clinical Symptoms ◽  
Early Recognition ◽  
Nausea And Vomiting ◽  
Resonance Imaging ◽  
Treatment Resistant ◽  
Laboratory Examination ◽  
Case Presentation ◽  
Presenting Symptoms

Abstract Background Clozapine is an atypical antipsychotic proven to be superior in the treatment of treatment-resistant schizophrenia. Myocarditis is a rare, but well-known complication of treatment with clozapine. Only few cases have been reported in which nausea and vomiting were prominent symptoms. This is the first described report in which nausea and vomiting were the only presenting symptoms of clozapine-induced myocarditis. Case presentation We report a case of a 58-year-old woman, suffering from schizoaffective disorder, who is being treated with clozapine. Two weeks after initiation of clozapine, she developed nausea and vomiting, in absence of any other clinical symptoms. Laboratory examination and magnetic resonance imaging confirmed the diagnosis of clozapine-induced myocarditis. Clozapine was discontinued and the patient recovered fully. Conclusions This case emphasizes the importance of recognizing myocarditis as a cause of isolated nausea and vomiting in patients treated with clozapine. Early recognition improves clinical outcome and reduces mortality.

scholarly journals A Giant Solitary Solid Hemangioblastoma: A Case Report and Review of The Literature

2017 ◽  
Vol 14 (2) ◽  
pp. 47-50
Author(s):  
Rajeev Bhandari ◽  
Gopal R Sharma ◽  
Prakash Bista ◽  
Rajiv Jha ◽  
Rajendra Shrestha ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Case Report ◽  
Vascular Tumor ◽  
Posterior Cranial Fossa ◽  
Magnetic Resonance Imaging Scan ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Cranial Fossa ◽  
Resonance Imaging Scan

We present a case of solitary vascular tumor on posterior cranial fossa in a 15-year-old female who had a complaint of headache on/off for six months with associated dizziness, nausea, vomiting and vertigo. Well circumscribed solid vascular mass was localized on posterior fossa by computed tomography along with magnetic resonance imaging scan. Furthermore, the diagnosis was confirmed by surgical findings and histological examinations.Nepal Journal of Neuroscience, Vol. 14, No. 2,  2017 Page: 47-50 

scholarly journals A Novel Homozygous Mutation in the COL4A4 Gene (Gly1436del) Causing Alport Syndrome Exposed by Pregnancy: A Case Report and Review of the Literature

2022 ◽  
Vol 2022 ◽  
pp. 1-5
Author(s):  
Ulrich Jehn ◽  
Cornelie Müller-Hofstede ◽  
Barbara Heitplatz ◽  
Veerle Van Marck ◽  
Stefan Reuter ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Case Report ◽  
Alport Syndrome ◽  
Kidney Biopsy ◽  
Novel Mutation ◽  
Basement Membranes ◽  
Homozygous Mutation ◽  
Lamina Densa ◽  
Case Presentation ◽  
Hereditary Defect

Background. Alport syndrome results from a hereditary defect of collagen IV synthesis. This causes progressive glomerular disease, ocular abnormalities, and inner ear impairment. Case Presentation. Herein, we present a case of Alport syndrome in a 28-year-old woman caused by a novel mutation (Gly1436del) in the COL4A4 gene that was not unveiled until her first pregnancy. Within the 29th pregnancy week, our patient presented with massive proteinuria and nephrotic syndrome. Light microscopic examination of a kidney biopsy showed typical histological features of segmental sclerosis, and electron microscopy revealed extensive podocyte alterations as well as thickness of glomerular basement membranes with splitting of the lamina densa. One and a half years after childbirth, renal function deteriorated to a preterminal stage, whereas nephrotic syndrome subsided quickly after delivery. Conclusion. This case report highlights the awareness of atypical AS courses and emphasizes the importance of genetic testing in such cases.

scholarly journals Assessment of Proteinuria in Nephrotic Syndrome in Children by Using Spot Urinary Protein/Creatinine Ratio

2018 ◽  
Vol 42 (3) ◽  
pp. 108-111
Author(s):  
Delowar Hossain ◽  
Zahiruddin ◽  
Monimul Hoque
Keyword(s):  
Nephrotic Syndrome ◽  
Total Protein ◽  
Mean Value ◽  
Urinary Protein ◽  
Urine Collection ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Spot Urine ◽  
Protein Excretion ◽  
The Mean

Background: Quantification of proteinuria is usually predicted upon 24-hour urine collection. Multiple factors influence urine collection and the rate of protein and creatinine excretion. A spot urine protein-creatinine (P-C) ratio has been shown over the years to be a reliable alternative to the 24-hour collection for detection and follow up of proteinuria. The objective of the study was to evaluate the accuracy of urine protein creatinine ratio (UP/UC) in a spot sample for quantitative measurement of proteinuria in comparison with 24 hours urinary protein excretion in children of nephrotic syndrome having normal Glomerular Filtration Rate (GFR). Methodology: This was a prospective study conducted in the department of paediatrics, Sir Salimullah Medical College & Mitford Hospital Dhaka over a period of six months from January 2003. Fifty cases of Nephrotic syndrome were included who were on initial attack and relapse cases noted down into the proforma with respect to history, examination and investigation. All the patients were advised regarding 24 hours urine collection. They were asked to give a 24 hours urine sample starting at 9.00 am for total protein excretion rate. A spot urine sample was obtained and urine protein/creatinine ratio was calculated. The data was analyzed by linear regression and by calculating the correlation coefficient between urinary protein/ creatinine ratio and 24-hour urinary protein. Results: Sample size was fifty. Urine total protein in a timed 24-hour sample of nephrotic syndrome patients was in the range of 300-3150mg/m2/hour with the mean value of 1725 mg/m2/hour. While as U(Pr/Cr) ratio ranged from 3.1-27.5 with the mean value of 15.2. A significant correlation was found between timed 24-hour urinary protein and UP/UC ratio (r=0.622, p=<.001.) Conclusions: Spot urine protein-creatinine ratio is highly reliable and rapid test for quantification of proteinuria in children with nephrotic syndrome. Bangladesh J Child Health 2018; VOL 42 (3) :108-111

Spontaneous Resolution of Chiari I Malformation and Syringomyelia: Case Report and Review of the Literature

Neurosurgery ◽  
2001 ◽  
Vol 48 (3) ◽  
pp. 664-667 ◽  
Author(s):  
Jörg Klekamp ◽  
Giorgio Iaconetta ◽  
Madjid Samii
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Case Report ◽  
Foramen Magnum ◽  
Chiari I Malformation ◽  
Spontaneous Resolution ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Chiari I ◽  
Resonance Imaging Scan

Abstract OBJECTIVE AND IMPORTANCE Indications for surgery and the surgical technique of foramen magnum decompression for patients with Chiari I malformation and syringomyelia are controversial issues. This case report supports the view that observation may be adequate for patients without progressive symptoms or with mild clinical symptoms. CLINICAL PRESENTATION A 37-year-old woman presented with a 3-month history of burning dysesthesias and hypesthesia in her right arm. A neurological examination revealed hypesthesia in the right trigeminal distribution. A magnetic resonance imaging scan revealed a Chiari I malformation with syringomyelia between C2 and T2. No hydrocephalus was observed. CLINICAL COURSE Because the patient's symptoms regressed spontaneously, surgery was not performed. Thirty-two months after her initial examination, the patient was asymptomatic. A second magnetic resonance imaging scan was obtained, which demonstrated complete spontaneous resolution of the Chiari I malformation and syringomyelia. CONCLUSION We attribute the regression of the patient's symptoms to spontaneous recanalization of cerebrospinal fluid pathways at the foramen magnum, which most likely was due to rupture of the arachnoid membranes that had obstructed cerebrospinal fluid flow.

Anatomical variation of internal carotid artery presenting as pharyngeal mass

2009 ◽  
Vol 123 (4) ◽  
Author(s):  
S C Leong ◽  
D A Luff
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Incidental Finding ◽  
Anatomical Variation ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Pharyngeal Wall ◽  
Resonance Imaging Scan

AbstractObjective:We describe a case of an internal carotid artery loop presenting as an oropharyngeal mass.Method:Case report and review of current literature.Case report:A 71-year-old woman presented with an asymptomatic oropharyngeal mass. This was an incidental finding by her general practitioner and was urgently referred as a suspicious lesion. A magnetic resonance imaging scan revealed an internal carotid artery tonsillar kink indenting into the pharyngeal wall. No further treatment was necessary.Conclusion:The internal carotid kink is an important anatomical variation which ENT surgeons should be aware of, as there are significant complications if blind biopsy is undertaken prior to appropriate imaging.

Plasma Cell Granuloma of the Middle Ear and Mastoid

1992 ◽  
Vol 101 (1) ◽  
pp. 92-94 ◽  
Author(s):  
Nick C. Benton ◽  
Harold W. Korol ◽  
Lawrence T. Smyth
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Plasma Cell ◽  
Middle Ear ◽  
Plasma Cell Granuloma ◽  
Magnetic Resonance Imaging Scan ◽  
Vascular Compression ◽  
Resonance Imaging ◽  
First Case ◽  
Resonance Imaging Scan

We present the case of a 37-year-old man with plasma cell granuloma affecting the middle ear and mastoid. At magnetic resonance imaging scan, the lesion appeared as a homogeneously enhancing mass of soft tissue replacing the majority of the mastoid bone and causing vascular compression. After surgical resection, microscopic examination showed predominantly plasmacytes, and histochemical studies confirmed a polyclonal origin consistent with nonneoplastic plasma cell granuloma. We believe this is the first case report of plasma cell granuloma affecting the middle ear and mastoid.

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