Morvan syndrome associated with LGI1 antibody: a case report

Abstract Background Morvan syndrome (MoS) is a rare autoimmune syndrome associated with antibodies against two kinds of potassium channel proteins, contactin associated protein-like 2 (CASPR2) and leucine-rich glioma inactivated protein 1 (LGI1). MoS patients with only LGI1-antibody seropositivity have rarely been reported. Here, we describe a 64-year-old male MoS patient with only LGI1-antibody seropositivity. Case presentation A 64-year-old male patient was referred to our hospital due to limb pain, widespread myokymia, insomnia, constipation, and hyperhidrosis for 1 month. The patient was diagnosed with MoS based on the clinical symptoms and positive LGI1-antibody in serum. He was treated with intravenous immunoglobulin (IVIG), intravenous methylprednisolone followed by oral prednisone, and other drugs for symptomatic relief. Several days later, myokymia and insomnia symptoms improved. After 60 days of follow-up, all the drugs had been stopped for 2 weeks, and the patient achieved complete remission without any medical side effects. Conclusion We report the clinical characteristics of a Chinese MoS patient with only LGI1-antibody seropositivity, and further support the view that non-neoplasm MoS patients respond well to immunotherapy.

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

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2021-0013 ◽

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.

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Chilaiditi Syndrome: A Case Report Highlighting the Intermittent Nature of the Disease

Case Reports in Medicine ◽

10.1155/2018/3515370 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Esha M. Kapania ◽

Christina Link ◽

Joshua M. Eberhardt

Keyword(s):

Case Report ◽

Complete Resolution ◽

Clinical Symptoms ◽

Case Reports ◽

Delayed Diagnosis ◽

Spontaneous Resolution ◽

Radiographic Evidence ◽

Case Presentation ◽

Chilaiditi Syndrome

Background. Chilaiditi syndrome is a phenomenon where there is an interposition of the colon between the liver and the abdominal wall leading to clinical symptoms. This is distinct from Chilaiditi sign for which there is radiographic evidence of the interposition, but is asymptomatic. Case Presentation. Here, we present the case of a patient who, despite having clinical symptoms for a decade, had a delayed diagnosis presumably due to the interposition being intermittent and episodic. Conclusions. This case highlights the fact that Chilaiditi syndrome may be intermittent and episodic in nature. This raises an interesting question of whether previous case reports, which describe complete resolution of the syndrome after nonsurgical intervention, are perhaps just capturing periods of resolution that may have occurred spontaneously. Because the syndrome may be intermittent with spontaneous resolution and then recurrence, patients should have episodic follow-up after nonsurgical intervention.

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Paediatric inflammatory multisystem syndrome temporally associated with COVID-19: a new virus and a new case presentation

BMJ Case Reports ◽

10.1136/bcr-2020-238531 ◽

2020 ◽

Vol 13 (12) ◽

pp. e238531

Author(s):

Phoebe Makiello ◽

Sima Svirpliene ◽

Lisa Finlay ◽

Jean McKnight

Keyword(s):

Clinical Symptoms ◽

Late Phase ◽

Upper Airway ◽

Intravenous Immunoglobulins ◽

Left Ventricular ◽

Haemodynamic Instability ◽

Case Presentation ◽

Full Resolution ◽

Inflammatory Syndrome

An 11-year-old boy presented with features resembling those described in health alerts on Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS), including persistent fever, haemodynamic instability and abdominal pain. Laboratory tests, including raised inflammatory markers, D-dimer, troponin and a coagulopathy, were consistent with PIMS-TS. Our patient required transfer to the paediatric intensive care unit; an echocardiography revealed left ventricular dysfunction. He was treated with intravenous immunoglobulins (Igs), corticosteroids and aspirin, with full resolution of clinical symptoms. A follow-up echocardiogram 1 month after discharge was unremarkable.Three SARS-CoV-2 PCRs on respiratory samples, taken over the initial 4-day period, were negative, as was a SARS-CoV-2 PCR on faeces 1 month after presentation; titres of IgG were clearly elevated. The negative PCRs in the presence of elevated titres of IgG suggest that the inflammatory syndrome might have developed in a late phase of COVID-19 infection when the virus was no longer detectable in the upper airway.

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Long-term application of hydroxychloroquine could not prevent the infection of COVID-19

The Journal of Infection in Developing Countries ◽

10.3855/jidc.13527 ◽

2020 ◽

Vol 14 (12) ◽

pp. 1368-1373

Author(s):

Yin Zhu ◽

Yongping Chen ◽

Yuewen Gong ◽

Aijun Pan ◽

Huijie Ding ◽

...

Keyword(s):

Clinical Symptoms ◽

Oxygen Intake ◽

Case Presentation ◽

Reactive Protein ◽

Ceftriaxone Sodium ◽

Hospital Stays ◽

Hs Crp ◽

Current Report

Introduction: Current pandemic of the coronavirus induced disease 2019 (COVID-19) presents an urgent issue to the world due to lack of vaccine and medication. Hydroxychloroquine (HCQ) has generated a lot of controversies whether it is effective in prevention and treatment of COVID-19. Current report presents a 63-year-old woman who has taken HCQ for many years but still infected by COVID-19. Case presentation: A patient with rheumatoid arthritis came to the clinic with fever and sore throat. The patient has been treated with 200 mg HCQ per day since 2016. Laboratory tests showed that the patient had lymphopenia, increased levels of high-sensitive C-reactive protein (hs-CRP) and serum Interleukin-6 (IL-6). Chest radiography showed that the patient had pneumonia. Throat swab test confirmed COVID-19 positive. On admission, she was treated with nebulized interferon alfa-2b, oral Lopinavir/Ritonavir, and ceftriaxone sodium for the COVID-19 in addition to HCQ. The patient stayed in hospital for 18 days, recovered from oxygen intake, and eventually discharged from hospital. Follow up investigation showed the patient developed antibody against COVID-19. Conclusions: Long-term application of HCQ could not prevent COVID-19 infection, but whether HCQ exerts benefit to alleviation of clinical symptoms and duration of hospital stays remains to be further investigated.

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Medical treatment for an isolated renal multilocular hydatid cyst in an elderly: a case report

BMC Nephrology ◽

10.1186/s12882-020-02064-5 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Atie Moghtadaie ◽

Seyed Amir Miratashi Yazdi ◽

Minoo Mohraz ◽

Hoda Asefi ◽

Effat Razeghi

Keyword(s):

Medical Treatment ◽

Hydatid Cyst ◽

Medical Therapy ◽

Clinical Symptoms ◽

Renal Involvement ◽

Hydatid Cysts ◽

Medical Treatments ◽

Case Presentation ◽

Almost All

Abstract Background Almost all cases of renal hydatid cysts need surgical intervention for treatment. We report a case of isolated renal hydatid cyst treated successfully only with medical therapy. Case presentation This case is a 79-year-old veterinarian presented with right flank pain, hydatiduria and positive echinococcus granulosus serology. A 70*50 mm cyst with daughter cysts in mid-portion of right kidney on presentation was changed into a 60*40 mm cyst without daughter cysts at last follow-up. Due to patient’s refusal of surgery, our patient received medical treatment including praziquantel and albendazole. After completion of first round of treatment, recurrence occurred and the same treatment was repeated. At last, the cyst became inactive and calcified with negative serology and no clinical symptoms under medical treatment. Conclusion The treatment of choice in renal hydatid cyst is surgery; although there are some reports about the efficacy of medical treatments for hydatid cysts but lower rates of recurrence and higher efficacy put surgery in a superior position compared to medical approaches. Our case showed relative success of medical treatment, despite the presence of a large multilocular renal involvement. Thus, medical therapy without surgery can be considered in very particular cases with isolated renal hydatid cysts.

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Laparoscopic therapy of the coeliac artery compression syndrome: a critical analysis of the current standard procedure

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0121 ◽

2020 ◽

Vol 102 (2) ◽

pp. 104-109 ◽

Cited By ~ 1

Author(s):

M Sahm ◽

R Otto ◽

M Pross ◽

T Scholbach ◽

R Mantke

Keyword(s):

Flow Velocity ◽

Doppler Ultrasonography ◽

Clinical Symptoms ◽

Standard Procedure ◽

Symptomatic Relief ◽

Current Standard ◽

Median Arcuate Ligament ◽

Coeliac Artery ◽

Arcuate Ligament

Introduction Median arcuate ligament syndrome has been known anatomically for approximately 100 years and results from a compression of the coeliac axis by fibrous attachment of the diaphragmatic crura. Owing to the rarity of the disease and limited available data, many aspects of treatment are controversial. Currently, laparoscopic decompression is considered by several authors as standard surgical procedure. We present an analysis of the clinical routine of MALS therapy. Methods We conducted a prospective observational trial in patients with MALS between March 2016 and August 2018, in which clinical symptoms, diagnostic evaluation, procedures with complication analysis and follow-up data were recorded. Results A total of 18 patients (12 female, 6 male) with MALS, aged between 15 and 65 years, were included in this study. All patients presented with long-standing abdominal pain. Preoperative Doppler ultrasonography showed a flow velocity of the coeliac artery averaging 289.9cm/second in mid-position of the diaphragm, 285.9cm/second in expiration and 199.0cm/second in inspiration. All operated patients underwent laparoscopic decompression; two patients received an angiographic intervention. Postoperatively, a significant decrease of the flow velocity in mid-position of the diaphragm was detected (P = 0.018). At follow-up after 5.2 months, 50.0% of the patients were pain-free, 37.5% reported symptomatic relief and 12.5% showed evidence for a recurrence. Conclusion MALS is challenging both diagnostically and therapeutically. Laparoscopy with release of the median arcuate ligament is an essential part of the therapy and can be confirmed by Doppler ultrasonography. Disease outcome is also influenced by several predictive factors.

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Renal Endometriosis Mimicking Cystic Renal Tumor: Case Report and Literature Review

Frontiers in Medicine ◽

10.3389/fmed.2021.684474 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ye Yang ◽

Xinxin Zhao ◽

Ying Huang

Keyword(s):

Renal Mass ◽

Clinical Symptoms ◽

Renal Tumor ◽

Cystic Mass ◽

Case Presentation ◽

Contrast Enhanced ◽

The Right ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography

Background: Endometriosis mainly affects female pelvic tissues and organs, and the presence of endometriosis in the kidney is extremely rare.Case Presentation: We report a case of a 48-year-old woman who presented with intermittent hematuria. She was found to have a cystic mass on renal ultrasonography, and contrast-enhanced computed tomography (CT) showed slight enhancement of the cystic wall and septa. These findings were indicative of cystic renal tumor. The patient subsequently underwent partial right nephrectomy. Histopathology revealed endometriosis of the right renal parenchyma. The patient recovered well and had no evidence of a recurrent renal mass at the 3 months' follow up.Conclusion: The possibility of renal endometriosis should be considered in a female patient with a cystic renal mass and clinical symptoms related to the menstrual cycle.

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Case report: a case of primary pulmonary glomus tumor

10.21203/rs.2.22606/v1 ◽

2020 ◽

Author(s):

shuangshuang Deng ◽

Jianhao Huang ◽

Qi Yin ◽

Jinli Gao ◽

Feilong Wang ◽

...

Keyword(s):

Tumor Recurrence ◽

Glomus Tumor ◽

Clinical Symptoms ◽

Clinical Manifestations ◽

Final Diagnosis ◽

Case Presentation ◽

Glomus Tumors ◽

Disease Case ◽

The Right

Abstract Background Glomus tumors, as extremely rare tumors of the lung, since their rarity and the variety of the clinical symptoms, tend to be misdiagnosed. The location of these tumors as well as their early diagnosis is a pivot for the prognosis of the disease. Case presentation We report a case of old patient whose final diagnosis was primary pulmonary glomus tumor. She initially was found a nodule in the right lung, which was enlarged during follow-up and finally confirmed after surgery. Postoperative pathology was considered as a primary pulmonary glomus tumor. There has been no evidence of tumor recurrence or metastasis so far. Conclusion Primary pulmonary glomus tumor is rare. The clinical manifestations are related symptoms occupying lesions in the lung. The diagnosis of the tumor depends on histopathology and immunohistochemistry. Surgical resection is considered as the most eﬀective treatment for this condition.

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Metameric spinal AVM: Long-term symptomatic relief achieved by embolization of the extradural component

Interventional Neuroradiology ◽

10.1177/1591019919828135 ◽

2019 ◽

Vol 25 (4) ◽

pp. 469-473

Author(s):

B Drake ◽

S Patro ◽

A Quateen ◽

EA Cora ◽

S Finitsis ◽

...

Keyword(s):

Spinal Cord ◽

Arteriovenous Malformations ◽

Symptomatic Relief ◽

Venous Drainage ◽

Dramatic Improvement ◽

Spinal Angiography ◽

Case Presentation ◽

Spinal Avm

Background Metameric spinal cord arteriovenous malformations (AVMs) are rare lesions characterized by an intradural and extradural component. They are difficult to treat surgically by the endovascular route. We report a case in which symptomatic relief was achieved by embolization of the extradural component only. Case presentation A 35-year-old woman presented with acute worsening of back pain, weakness in the left leg and urinary retention. Spinal angiography showed a metameric spinal cord AVM with partial common venous drainage of the extradural and intradural components. Conclusions Targeted embolization of the extradural component led to dramatic improvement of the patient’s symptoms, probably by achieving venous decongestion. She remains neurologically stable at two years’ follow-up.

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A CLINICAL EFFECT OF AABHADI CHOORNA ON KATISHOOLA W.S.R. TO ASTHIMAJJAGAT VATA - A CASE STUDY

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v6.i3.2018.1511 ◽

2018 ◽

Vol 6 (3) ◽

pp. 172-175

Author(s):

Pooja Santosh Gugale ◽

Mukund .M. More

Keyword(s):

Clinical Symptoms ◽

Symptomatic Relief ◽

Therapeutic Effects ◽

Intervertebral Disc Space ◽

Disc Space ◽

Tingling Sensation ◽

Inflammatory Drugs ◽

Ayurvedic Treatment

Katishoola is one of the vatavyadhi and it is the commonest disorder found in clinical practice. According to Ayurveda, Katishoola is the diseases with pain in lumber region. Katishoola can be equated with low back pain .The allopathic system of medicine use non-steroidal anti-inflammatory drugs, analgesics, which is not safe and effective for katishoola. A 60 year old male patient had suffering from progressive pain in lower back and difficulty in bending forward over 25 ˚ and tingling sensation in both leg since last 12 months. X-ray of lumbo-sacral region indicated that patient was suffering from reduced L4-L5 intervertebral disc space and bony ankylosis of L4-L5 and degenerative changes in spine. He was taken modern treatment but doesn’t get satisfactory relief even. For Ayurvedic treatment he came at opd of kaychikitsa department of Seth Sakharam Nemchand Jain Ayurvedic Hospital, Solapur. He was treated for 21 days with 3 times treatment follow up. The response of the treatment was recorded and therapeutic effects were evaluated through symptomatic relief. Clinical symptoms were significantly reduced and degree of anterior flexion increased from 25˚ to 90 ˚. This regimen is effective in successfully treating katishoola by helping to reduce the symptoms and improving the degree of anterior flexion.

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