scholarly journals Abdominal Pain-An Unusual Case of Anti-Phospholipid Syndrome

2019 ◽  
pp. 172-175
Author(s):  
Asim K ◽  
Vipparla NS ◽  
Farah W ◽  
El-Amir Z ◽  
Zatmar K
Keyword(s):  
Unusual Case ◽  
Systemic Disease ◽  
African American Female ◽  
Atypical Presentation ◽  
Connective Tissue Disorders ◽  
Catastrophic Event ◽  
Cardiolipin Antibodies ◽  
Underlying Pathophysiology ◽  
Prompt Diagnosis ◽  
Anti Phospholipid Syndrome

Antiphospholipid Syndrome (APS), an autoimmune disease associated with hypercoagulability, commonly presents as arterial and/or venous thrombosis, recurrent spontaneous abortions, and moderate thrombocytopenia. It can manifest as a standalone syndrome or a manifestation of a primary systemic disease. The incidence and prevalence of APS without an acquired cause is not well known, although some estimates show around 5 new cases per 100,000 persons per year. Antiphospholipid antibodies (APLA) include anti-cardiolipin, Lupus anticoagulant (LA), and antibeta-2 glycoproteins which are responsible for the underlying pathophysiology. APS is known to be associated with SLE, connective tissue disorders, various autoimmune diseases, malignancies, HIV, and drugs. Anti-cardiolipin antibody causing thrombosis represents a spectrum of APS which is usually associated with an acquired condition and rarely presents as a primary syndrome. We present the case of an African American female, aged 30, with an atypical presentation of a thrombotic episode and the presence of anti-cardiolipin antibodies without any associated secondary cause. Our case stands out because of the primary nature of APS and the atypical presentation with abdominal signs, both of which are rare and constitute only 1.5% of cases of APS. Sharp clinical suspicion with prompt diagnosis can potentially prevent progression to a catastrophic event.

scholarly journals Intrathyroidal Parathyroid Carcinoma: Report of an Unusual Case and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Lizette Vila Duckworth ◽  
William E. Winter ◽  
Mikhail Vaysberg ◽  
César A. Moran ◽  
Samer Z. Al-Quran
Keyword(s):  
Thyroid Gland ◽  
Parathyroid Carcinoma ◽  
Unusual Case ◽  
Thyroid Tissue ◽  
Parathyroid Tissue ◽  
African American Female ◽  
Thyroid Lobe ◽  
Local Infiltration ◽  
Sestamibi Scan ◽  
The Right

Intrathyroidal parathyroid carcinoma is an exceedingly rare cause of primary hyperparathyroidism. A 51-year-old African American female presented with goiter, hyperparathyroidism, and symptomatic hypercalcemia. Sestamibi scan revealed diffuse activity within an enlarged thyroid gland with uptake in the right thyroid lobe suggestive of hyperfunctioning parathyroid tissue. The patient underwent thyroidectomy and parathyroidectomy. At exploration, a 2.0 cm nodule in the usual location of the right inferior parathyroid was sent for intraoperative frozen consultation, which revealed only ectopic thyroid tissue. No parathyroid glands were identified grossly on the external aspect of the thyroid. Interestingly, postoperative parathyroid hormone levels normalized after removal of the thyroid gland. Examination of the thyroidectomy specimen revealed a 1.4 cm parathyroid nodule located within the parenchyma of the right superior thyroid, with capsular and vascular invasion and local infiltration into surrounding thyroid tissue. We present only the eighth reported case of intrathyroidal parathyroid carcinoma and review the literature.

scholarly journals An Unusual Case of Cerebellar Langerhans Cell Histiocytosis Relapse Post Bone Marrow Transplant for Systemic Disease

2020 ◽  
Author(s):  
Simon Nicol ◽  
Gemma Petts ◽  
Stavros Stivaros ◽  
Edmund Cheesman ◽  
Robert Wynn ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Langerhans Cell Histiocytosis ◽  
Unusual Case ◽  
Systemic Disease ◽  
Marrow Transplant ◽  
Langerhans Cell

Case Report: Penetrating Cardiac Injury Secondary to a Terrorism-Related Nail Bomb Explosion

2003 ◽  
Vol 18 (3) ◽  
pp. 249-252 ◽  
Author(s):  
Yasufumi Asai ◽  
Masashi Yoshida ◽  
Yoshihiko Kurimoto ◽  
Jeffrey L. Arnold
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Unusual Case ◽  
Surgical Intervention ◽  
Cardiac Injury ◽  
Pericardial Tamponade ◽  
Stab Wounds ◽  
Penetrating Cardiac Injury ◽  
Bomb Explosion ◽  
Prompt Diagnosis

AbstractPenetrating cardiac injuries commonly occur secondary to gunshot or stab wounds. This is a report an unusual case of a patient who sustained a penetrating cardiac injury due to a nail from a terrorism-related, nail-bomb explosion. Associated problems included pericardial tamponade, penetrating cardiac injuries, acute, traumatic, myocardial infarction, and a penetrating lung injury. Prompt diagnosis and aggressive surgical intervention resulted in full recovery of the patient.

scholarly journals PNR-41AN UNUSUAL CASE OF CEREBELLAR LANGERHANS CELL HISTIOCYTOSIS RELAPSE POST BONE MARROW TRANSPLANT FOR SYSTEMIC DISEASE

2016 ◽  
Vol 18 (suppl 3) ◽  
pp. iii15.3-iii15
Author(s):  
S. Nicol ◽  
S. Stivaros ◽  
E. Cheesman ◽  
V. Josan ◽  
A. Penn
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Langerhans Cell Histiocytosis ◽  
Unusual Case ◽  
Systemic Disease ◽  
Marrow Transplant ◽  
Langerhans Cell

Catastrophic Anti-phospholipid Syndrome in the Absence of IgG Anti-cardiolipin Antibodies

1995 ◽  
Vol 24 (6) ◽  
pp. 389-391 ◽  
Author(s):  
M. Kennedy ◽  
J. Jackson ◽  
I. Khan ◽  
P. W. N. Keeling ◽  
E. Gaffney
Keyword(s):  
Cardiolipin Antibodies ◽  
Anti Phospholipid Syndrome

Polymyositis and dermatomyositis

2013 ◽  
Author(s):  
Hector Chinoy ◽  
Robert G. Cooper
Keyword(s):  
Muscle Weakness ◽  
Inflammatory Cell ◽  
Evidence Base ◽  
Inflammatory Myopathies ◽  
Connective Tissue Disorders ◽  
Antibody Testing ◽  
Muscle Enzymes ◽  
Skeletal Muscle Weakness ◽  
Form Part ◽  
Prompt Diagnosis

Polymyositis (PM), dermatomyositis (DM), and inclusion body myositis (IBM) form part of the idiopathic inflammatory myopathies (IIM), a heterogeneous group of rare autoimmune diseases characterized by an acquired proximal muscle weakness, raised muscle enzymes (including creatine kinase), inflammatory cell infiltrates in muscle biopsy tissue, electrophysiological abnormalities, and presence of circulating myositis-specific/myositis-associated autoantibodies. The underlying aetiology of IIM is poorly understood, but likely involves interactions between environmental and genetic risk factors. Myositis may also manifest in association with other connective tissue disorders. The predominant clinical presentation of IIM is skeletal muscle weakness, but many extramuscular features can also occur. Access to good neuropathological support is essential in securing an accurate IIM diagnosis and excluding non-inflammatory myopathies, although IBM is often difficult to distinguish from PM. Antibody testing can help define IIM clinical subtypes, including cancer-associated myositis, predict prognosis, and help in optimizing treatment decisions. MRI can be invaluable for differentiating disease activity from damage, and detecting treatment-induced interval changes. Therapeutic effectiveness of new and existing treatments (where the evidence base remains poor) depends on making a prompt diagnosis and initiating early and appropriately aggressive treatment to prevent establishment of muscle damage. This chapter attempts to summarize the salient features of IIM and update the reader about currently used diagnostics and treatment paradigms in this rare and understudied disease.

scholarly journals The Cat with Neurological Manifestations of Systemic Disease

2009 ◽  
Vol 11 (5) ◽  
pp. 395-407 ◽  
Author(s):  
Marc Kent
Keyword(s):  
Nervous System ◽  
Early Recognition ◽  
Systemic Disease ◽  
Clinical Signs ◽  
Evidence Base ◽  
Neurological Deficits ◽  
Systemic Diseases ◽  
Special Issue ◽  
The Impact ◽  
Prompt Diagnosis

Practical relevance A number of systemic diseases are associated with neurological deficits. Most systemic diseases that impact on the nervous system result in multifocal neurological signs; however, isolated deficits can also be observed. This article reviews the clinical signs, pathophysiology, diagnosis, treatment and prognosis of four important systemic diseases with neurological consequences: feline infectious peritonitis, toxoplasmosis, hypertension and hepatic encephalopathy. Clinical challenges Early recognition of systemic signs of illness in conjunction with neurological deficits will allow for prompt diagnosis and treatment. While neurological examination of the feline patient can undoubtedly be challenging, hopefully the accompanying articles in this special issue will enable the clinician to approach these cases with more confidence. Evidence base The veterinary literature contains numerous reports detailing the impact of systemic disease on the nervous system. Unfortunately, very few references provide detailed descriptions of large cohorts of affected cats. This review summarises the literature underpinning the four key diseases under discussion.

scholarly journals Primary Staphylococcus aureus Pericarditis

2020 ◽  
Vol 15 (2) ◽  
pp. 39-41
Author(s):  
Haya Aziz ◽  
Marc Bienz ◽  
Abdullah Esmaiel ◽  
George Thanassoulis
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Unusual Case ◽  
Facteurs De Risque ◽  
Prise En Charge ◽  
Hematogenous Spread ◽  
Pericardial Disease ◽  
Bacterial Pericarditis ◽  
Focus Of Infection ◽  
Prompt Diagnosis

Bacterial pericarditis is a rare but fulminant disease that requires prompt diagnosis and management.  It most commonly occurs from direct extension of an adjacent focus of infection or by hematogenous spread to the pericardium from more distant septic foci.  Predisposing risk factors include immunosuppression, uremia, collagen vascular disease and thoracic surgery. We present the case of a 77-year-old gentleman with no previous pericardial disease who was diagnosed with primary Staphylococcus aureus pericarditis. The patient was treated with percutaneous pericardial effusion drainage and appropriate antibiotics resulting in complete resolution of his symptoms. This unusual case emphasizes that although it is frequently associated with significant morbidity and mortality, purulent pericarditis can present in a more indolent manner and in the absence of typical predisposing risk factors. ResumeLa péricardite bactérienne est une maladie rare mais fulgurante qui nécessite un diagnostic et une prise en charge rapides. Elle survient le plus souvent dans le prolongement direct d’un foyer infectieux adjacent ou par propagation hématogène au péricarde à partir de foyers septiques plus éloignés. Les facteurs de risque prédisposants sont l’immunosuppression, l’urémie, les maladies vasculaires du collagène et la chirurgie thoracique. Nous présentons le cas d’un homme de 77 ans, sans antécédents de maladie péricardique, chez qui on a diagnostiqué une péricardite primaire à Staphylococcus aureus. Le patient a été traité par un drainage percutané d’effusion péricardique et des antibiotiques appropriés, ce qui a permis de résoudre complètement ses symptômes. Ce cas inhabituel souligne que, bien qu’elle soit fréquemment associée à une morbidité et une mortalité importantes, la péricardite purulente peut se présenter de manière plus indolente et en l’absence de facteurs de risque prédisposants typiques.

scholarly journals Atypical presentation of adenosquamous carcinoma: A case report

2018 ◽  
Vol 6 ◽  
pp. 2050313X1880121
Author(s):  
Annie Genois ◽  
Catherine Maari ◽  
Danielle Bouffard
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Clinical Presentation ◽  
Adenosquamous Carcinoma ◽  
Malignant Neoplasm ◽  
Atypical Presentation ◽  
Rare Tumour ◽  
The Past ◽  
Prompt Diagnosis

Cutaneous adenosquamous carcinoma is a rare malignant neoplasm that is more aggressive than conventional squamous cell carcinoma. The typical clinical presentation is an indurated papule or plaque on the head and neck of elderly patients. The authors report the case of a 52-year-old man with a right scrotal and inguinal tumour measuring 10 cm × 15 cm that had progressed over the past 2 years. The histological examination was compatible with adenosquamous carcinoma. Metastatic inguinal and pelvic lymph nodes were identified. This case demonstrates an atypical presentation of a rare tumour. Adenosquamous carcinoma is more aggressive than conventional squamous cell carcinoma, and prompt diagnosis is important.

scholarly journals The unusual presentation of a vascular injury after lumbar microdiscectomy: case report

2016 ◽  
Vol 24 (3) ◽  
pp. 381-384 ◽  
Author(s):  
Daniel Huttman ◽  
Mathew Cyriac ◽  
Warren Yu ◽  
Joseph R. O'Brien
Keyword(s):  
Vascular Injury ◽  
Pulmonary Embolus ◽  
Unusual Case ◽  
Rare Complication ◽  
Iliac Vein ◽  
Lumbar Spine Surgery ◽  
Common Iliac Vein ◽  
Atypical Presentation ◽  
Lumbar Microdiscectomy ◽  
The Right

Vascular injury during lumbar spine surgery is a relatively rare complication but can have devastating outcomes. The injury may not be apparent during surgery and can present acutely or late in various manners, and some injuries can be asymptomatic. This report discusses the unusual case of a 35-year-old woman who underwent a right L4–5 microdiscectomy for disc herniation and 4 days postoperatively presented with a pulmonary embolus. A subsequent CT scan revealed a pseudoaneurysm and arteriovenous fistula of the right common iliac vein and artery, which gave rise to the embolus. The patient received a right iliac artery stent, and at 4 months after surgery she continues to be symptom free. This report describes the atypical presentation of vascular injury after lumbar microdiscectomy and stresses the importance of cautiously using the pituitary rongeur when removing deeper disc fragments.

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