scholarly journals Conundrums of hypothyroidism

2018 ◽  
Vol 4 (3) ◽  
pp. 447
Author(s):  
Vidya D. Kharkar ◽  
Snahasish Naskar
Keyword(s):  
Atopic Dermatitis ◽  
Differential Diagnosis ◽  
Connective Tissue Disorder ◽  
Primary Hypothyroidism ◽  
Low Grade ◽  
Once Daily ◽  
Calcium Supplements ◽  
Low T3 ◽  
History Of ◽  
Laboratory Investigations

<p class="abstract">A 46 year old female came with complaints of dryness of skin and severe hair loss since 2-3 years. There was history of intermittent low grade fever, swelling all over body since 1 year; patient also complained of tingling numbness over bilateral legs and forearms along with difficulty in swallowing food. On further probing, history of difficulty in lifting arms above the head, constipation, generalised fatigue and drowsiness could be elicited. Patient also noticed raised skin coloured asymptomatic lesions over buttocks. On examination loss of eyebrows and alopecia in frontal and parietal scalp was seen. There was prominent follicular ostia and atrophy on scalp and body. Depressed keratotic papules with a generalized doughy feel of skin was appreciated all over body. A differential diagnosis of connective tissue disorder, widespread alopecia areata, folliculotropic mycosis fungoides, hypothyroidism and atopic dermatitis was made. Laboratory investigations revealed a low T3, T4 with a significantly raised TSH suggestive of a primary hypothyroidism. On histopathology mucin deposition in papillary and mid dermis was seen along with non-scarring pattern of alopecia. A diagnosis of hypothyroidism was made and patient was started on Tab. levothyroxin 75 micrograms once daily for 4 months along with hematinics, multivitamins and calcium supplements. Regular and frequent application of emollients was advised to the patient.</p>

scholarly journals Endometrial Stromal Sarcoma Arising in Colorectal Endometriosis: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Qiao Wang ◽  
Xia Zhao ◽  
Ping Han
Keyword(s):  
Differential Diagnosis ◽  
English Literature ◽  
Tumor Resection ◽  
Endometrial Stromal Sarcoma ◽  
Low Grade ◽  
Review Of The Literature ◽  
Primary Tumors ◽  
Colorectal Endometriosis ◽  
Stromal Sarcoma ◽  
History Of

Extrauterine endometrial stromal sarcoma (ESS) arising in endometriosis is extremely rare, particularly in the colorectum. It should always be included in the differential diagnosis of primary tumors originating from gastrointestinal tract in females, given that preoperative endoscopical biopsy may reveal no specific changes. We reported a case of ESS arising in colorectal endometriosis and reviewed the previous 7 cases reported in the English literature. Our patient, who was unavailable for tumor resection and refused further adjuvant therapy, played a role in representing the natural history of low-grade extragenital ESS. This case was the only death from ESS arising in colorectal endometriosis.

scholarly journals Atopic Dermatitis or Hyper IgE Syndrome?

2015 ◽  
Vol 35 (1) ◽  
pp. 59-61
Author(s):  
M Ahmed ◽  
A Kumar ◽  
D Raj
Keyword(s):  
Early Childhood ◽  
Atopic Dermatitis ◽  
Supportive Care ◽  
Female Child ◽  
Outpatient Department ◽  
Skin Infections ◽  
Hyper Ige Syndrome ◽  
History Of ◽  
Laboratory Investigations ◽  
Current Report

Eczema and skin infections are commonly encountered in children in the outpatient department. However, presence of both recurrent dermatitis and skin infections should alarm one to consider Hyper IgE syndrome (HIES) as a differential. Here we present a case of HIES in a two and a half year old female child with history of recurrent dermatitis and skin infections in the form of cold abscesses. Laboratory investigations showed markedly elevated IgE levels and high absolute eosinophils counts. Patient was treated with trimethoprim-sulfamethoxazole and supportive care. The current report highlights the fact that HIES can present in early childhood with just skin manifestations and without any significant pulmonary manifestations.J Nepal Paediatr Soc 2015;35(1):59-61

scholarly journals PRIMARY DIAPHYSEAL TUBERCULOUS OSTEOMYELITIS OF TIBIA

2014 ◽  
Vol 21 (06) ◽  
pp. 1282-1284
Author(s):  
Ghulam Mustafa Kaim Khan ◽  
Syed Mujahid Humail ◽  
Kamran Hafeez
Keyword(s):  
Weight Loss ◽  
Developing Countries ◽  
Differential Diagnosis ◽  
Osteolytic Lesion ◽  
Long Bone ◽  
Low Grade ◽  
X Rays ◽  
X Ray ◽  
Tuberculous Osteomyelitis ◽  
History Of

Diaphyseal tubercular osteomyelitis of long bone is extremely rare and few cases have been reported in literature. We are presenting a case of 17 years old girl presented with pain and swelling over lower half of leg for 7 months. There was often low grade fever but no history of weight loss or pulmonary symptoms. X-ray chest was normal. X-rays and MRI of involved leg were suggestive of osteomyelitis. Curettage and biopsy was done, report was suggestive of tuberculous osteomyelitis. As tuberculosis is still common in developing countries, for an osteolytic lesion in bone, tuberculous osteomyelitis should be considered in differential diagnosis.

scholarly journals Tubercular Osteomyelitis of Tibia: A Case Report

2019 ◽  
Vol 2 (1) ◽  
pp. 92-94
Author(s):  
Amin Kumar Shrestha ◽  
Suman Raja Shrestha ◽  
Gopesh Kumar Thakur ◽  
Arjun Prasad Dumre
Keyword(s):  
Weight Loss ◽  
Differential Diagnosis ◽  
Osteolytic Lesion ◽  
Extrapulmonary Tuberculosis ◽  
Long Bone ◽  
Low Grade ◽  
X Rays ◽  
X Ray ◽  
Tuberculous Osteomyelitis ◽  
History Of

Tubercular osteomyelitis of long bone is extremely rare and very few cases have been reported in literature. We are presenting a case of 43 years gentlemen presented with pain and swelling over lower half of leg for 5 months. There was associated pus discharging sinus and often low-grade fever but no history of weight loss or pulmonary symptoms. X-ray chest was normal. X-rays of involved leg was suggestive of osteomyelitis. Curettage and Biopsy was done, report was suggestive of tuberculous osteomyelitis. As tuberculosis is still common in developing countries like Nepal, for any osteolytic lesion in bone, tubercular osteomyelitis should always be considered in differential diagnosis. Keywords: extrapulmonary tuberculosis; osteolytic lesion in bone; tubercular osteomyelitis.

scholarly journals Cat scratch disease- a case report

2015 ◽  
Vol 5 (1) ◽  
pp. 316-317 ◽  
Author(s):  
BH Nazma Yasmeen ◽  
Rowshan Akhter Jahan ◽  
Shafi Ahmed ◽  
Mahfuza Hussain ◽  
Abbas Uddin Khan ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Lymph Node ◽  
Physical Examination ◽  
Lymph Node Biopsy ◽  
Low Grade ◽  
Cat Scratch Disease ◽  
Medical College ◽  
Node Biopsy ◽  
History Of

We are reporting a case of a 10 year old boy admitted in Dhaka Shishu (Children) hospital with the complaints of –swelling of both side of inguinal region for 2 months, tenderness of the same area for 1 month and low grade fever for 2 months. With the history and physical examination of the patients our differential diagnosis was Tuberculosis/Lymphoma/Cat scratch disease (CSD). He had only a history of contact with a kitten for 1 week 3 months back but no history of cat scratch or bite. Lymph node biopsy revealed that it was a case of Cat scratch disease.Northern International Medical College Journal Vol.5(1) 2013: 316-317

Newly diagnosed type 1 diabetes in a 93 year old

2022 ◽  
Vol 15 (1) ◽  
pp. e246799
Author(s):  
Waqar Ahmad ◽  
Catherine Bates ◽  
Laura Dale ◽  
Naveen Siddaramaiah
Keyword(s):  
Type 1 Diabetes ◽  
Venous Blood ◽  
Primary Hypothyroidism ◽  
Intravenous Insulin ◽  
Parietal Cell Antibodies ◽  
High Clinical Suspicion ◽  
History Of ◽  
Laboratory Investigations ◽  
Venous Blood Gas

Type 1 diabetes is typically a disease of young but can present at any age. We present a case of a 93-year-old woman who presented with 10 days history of feeling lethargic, polydipsia and decreased appetite. Her capillary blood glucose was raised at 25 mmol/L with significant ketonaemia and venous blood gas showing metabolic acidosis. She had a background of primary hypothyroidism and vitamin B12 deficiency with weakly positive parietal cell antibodies. Laboratory investigations confirmed diabetes with HbA1c of 117 mmol/mol (12.9%). In view of high clinical suspicion of type 1 diabetes, her diabetes autoantibodies were checked which showed strongly positive anti-GAD antibody with titre of >2000 IU/mL (range<10) confirming our diagnosis. She was treated with diabetic ketoacidosis protocol with intravenous fluids and intravenous insulin. On recovery, she was discharged home on once daily insulin with aim to self-manage diabetes with support from district nurses and to avoid hypoglycaemia.

Primary acquired melanosis (PAM) without atypia/WHO low-grade conjunctival melanocytic intraepithelial lesion over areas of oculodermal melanocytosis

2020 ◽  
Vol 13 (10) ◽  
pp. e236741
Author(s):  
Bashar M Bata ◽  
Sachin M Salvi ◽  
Hardeep Singh Mudhar
Keyword(s):  
Bulbar Conjunctiva ◽  
Low Grade ◽  
Primary Acquired Melanosis ◽  
Conjunctival Biopsy ◽  
History Of ◽  
Intraepithelial Lesion ◽  
The Relationship ◽  
Oculodermal Melanocytosis ◽  
Substantia Propria ◽  
New Onset

An elderly white man with a history of left oculodermal melanocytosis presented with new onset brown pigmentation of the left bulbar and inferior tarsal conjunctiva. The bulbar conjunctival pigmentation was at the level of the conjunctival epithelium and was overlying areas of typical slate-grey scleral pigmentation characteristic of oculodermal melanocytosis. Both areas of new pigmentation were biopsied. The bulbar conjunctiva revealed primary acquired melanosis (PAM) without atypia with increased melanin production and the tarsal conjunctival biopsy showed PAM without atypia sine pigmentio overlying areas of substantia propria spindle-shaped heavily pigmented melanocytes of oculodermal melanocytosis. The case report examines the relationship between the epithelial and substantia propria melanocytes and correlates the findings with what is known about this association from the dermatopathology literature.

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