scholarly journals Recurrent Multiple Symmetric Lipomatosis Affecting the Upper & Lower Limbs: A Case Report

2021 ◽  
Vol 8 (05) ◽  
pp. 5366-5369
Author(s):  
Inklebarger James ◽  
Zahid SK
Keyword(s):  
Case Report ◽  
Neurological Symptoms ◽  
Lower Limbs ◽  
Unknown Etiology ◽  
Surgical Interventions ◽  
Multiple Symmetric Lipomatosis ◽  
Fat Deposits ◽  
Madelung Disease

Madelung disease is a rare, metabolic, malignancy-associated and disfiguring condition of unknown etiology, characterized by potentially debilitating neurological, cardiopulmonary, gastric, musculoskeletal and psycho-social complications. Also known as multiple symmetric lipomatosis (MSL), Benign Lipomatosis (BSL), and Launois-Bensaude syndrome, MSL is characterized by the symmetrical growth of subcutaneous non-encapsulated fat deposits, usually around the neck, but in some cases also around shoulders, the upper trunk, chest and limbs, and hip girdle. These abnormal fat deposits may rapidly grow over a few months or slowly enlarge over several years. Expanding fatty deformations may be disabling, have disfiguring aesthetic consequences, and infiltrate or compress adjacent vital structures. This case illustrates that painful, massive growths may also occur around the knees, re-grow post excision, and present with compressive neurological symptoms necessitating further surgical interventions.

scholarly journals Atypical Manifestation of Polyneuropathy in Covid-19

2021 ◽  
Author(s):  
Nayara de Lima Froio ◽  
Ana Luisa Rosas Sarmento ◽  
Sonia Maria Cesar de Azevedo Silva ◽  
Lilia Azzi Collet da Rocha Camargo
Keyword(s):  
Case Report ◽  
Physical Therapy ◽  
Sore Throat ◽  
Neurological Symptoms ◽  
Lower Limbs ◽  
Neurological Manifestations ◽  
Sensory Motor ◽  
Hands And Feet ◽  
Atypical Manifestation

Context: Neurological manifestations of Sars-CoV-2 are progressively emerging. Cases of Guillain-Barré syndrome and its variants, with onset about 5-10 days after influenza symptoms, have been described. This paper reports a case of polyneuropathy with onset 90 days after a sore throat episode and persistence of IgM positivity in serology for Sars- Cov-2. We aim to raise awareness of this possibility. Case Report: A 56-year-old male, hypertensive, presented with sore throat on April 21, 2020. Serology for Covid-19 was performed with positive IgM. There was complete improvement of the symptom. At the end of July, he started a symmetrical paresthesia in the feet with ascension to the knees and, on August 20, paresthesia in the hands too. So, he went to IAMSPE (SP) and tactile and painful hypoesthesia in hands and feet, hypopalesthesia in lower limbs, a fall in the lower limbs upon Mingazzini’s maneuver, global hyporeflexia and talon gait were found. Just the following tests were changed: second Covid-19 serology IgM and IgG positives; ENMG: sensory motor polyneuropathy, primarily axonal, with signs of chronicity and without signs of acute denervation in the current. Started gabapentin and physical therapy. Patient still has paresthesia in hands and feet, but with partial improvement. Conclusion: This case alerts to neurological symptoms of Covid-19 in the medium and long term.

scholarly journals Unilateral Lichen Aureus in a Child - Case Report

2018 ◽  
Vol 74 (3) ◽  
pp. 277-279
Author(s):  
Heliana Freitas de Oliveira Góes ◽  
Marília Troyano de Castro Mendes ◽  
Aline Falci Loures ◽  
Ada Lobato Quattrino ◽  
Caren Dos Santos Lima ◽  
...  
Keyword(s):  
Young Adults ◽  
Case Report ◽  
Lower Limbs ◽  
Unknown Etiology

Lichen aureus is a subtype of a chronic benign pigmented purpuric dermatosis of unknown etiology. It shows predilection for lower limbs and generally affects young adults and, less often, children. We report a case of lichen aureus with a unilateral presentation in a child.

scholarly journals Yellow Nail Syndrome - a Case Report

2015 ◽  
Vol 7 (2) ◽  
pp. 61-68
Author(s):  
Mirjana Paravina ◽  
Ivana Binić ◽  
Danijela Popović ◽  
Dragana Ljubisavljević
Keyword(s):  
Case Report ◽  
Vitamin E ◽  
Female Patient ◽  
Respiratory Disease ◽  
Nail Plate ◽  
Chronic Respiratory Disease ◽  
Lower Limbs ◽  
Unknown Etiology ◽  
Yellow Nail Syndrome ◽  
Nail Bed

Abstract Yellow nail syndrome is a rare disease of unknown etiology. It is clinically characterized by a triad of yellow nails, lymphedema at one or more sites, and chronic respiratory disease (bronchitis, bronchiectasis and rhinosinusitis). All nails may be affected, but some may be spared. The nail plates are yellowish green, thickened, occasionally with transverse ridging and onycholysis, with increased longitudinal and transversal over-curvature, with partial or complete separation of the nail plate from the nail bed, without lunula and cuticle and slow nail growth rate. The lymphedema is usually peripheral, affecting the lower limbs, or in the form of pleural effusion. This is a case report of a 47-year-old female patient who presented with nail changes at the age of 40; two years later the patient developed lymphedema of the lower limbs, and a year later a chronic respiratory disease. The affected nails were yellow to yellow-gray, with thickened nail plates separated from the nail bed, ingrown in the perionychium, without lunula. At the same time, additional examinations revealed the following associated conditions: edema of talocrural joints in both legs, chronic obstructive bronchitis, bronchial asthma, chronic rhinitis with bilateral nasal polyposis, labile arterial hypertension. Apart from the management of chronic respiratory disease, oral vitamin E capsules (200 mg 3 times a day) and topical vitamin E solution were administered over 15 months. The nails began to grow, and the newly grown nails were of normal pigmentation. In conclusion, we present a case of an adult female patient with yellow nail syndrome, and a recognized association of peripheral edema and chronic pulmonary disease. The patient had a typical clinical picture, all the nails were affected, but showed a favorable response to systemic and topical vitamin E therapy.

scholarly journals EP30 Sensory ganglionopathy as a possible presenting feature of Sjögren’s syndrome

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Preeya Ummur ◽  
Kirsty Levasseur ◽  
Yee Suh Tee ◽  
Benjamin Fisher
Keyword(s):  
Case Report ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Neurological Symptoms ◽  
Lower Limbs ◽  
Sensory Axons ◽  
Sensory Ganglionopathy ◽  
Sjögren‘S Syndrome

Abstract Case report - Introduction Primary Sjögren’s syndrome is a systemic autoimmune disease affecting the exocrine glands, commonly resulting in dryness of mouth and eyes. It can also rarely present with neurological symptoms most commonly peripheral neuropathies. The case highlights a rare case of sensory and motor neuropathy with some features suggestive of Sjögren’s syndrome as an underlying diagnosis. Case report - Case description A 54-year-old Caucasian lady was transferred from a local hospital for specialist neurology care. She described widespread paraesthesia over two months progressing to lower limb weakness worsening over a two-day period. Her symptoms further progressed to involve her arms and new blurred vision. On further questioning she reported previous severe mouth ulcers, possible genital ulcers and painful jaw swelling with long standing history of dry mouth. On thorough neurological examination, the positive findings were mild ptosis of the right eye, paraesthesia on palpation of face, upper limbs had a flaccid tone with reduced power and pseudoathetosis of outstretched arms, reduced proprioception, and absent reflexes. Lower limbs were more affected with worse power and absent proprioception. Schirmer’s test showed normal tear production but saliva production was reduced. MRI brain and spine were reported as pathological enhancement in both optic nerves, no obvious brain parenchymal abnormality, no obvious spinal cord abnormality. Lumbar puncture CSF pro 0.38, white cells 12 (poly 50%, mono 50%), red cells 3700, no organisms on gram stain, opening pressure 21.5 cmH2O. Sural nerve biopsy demonstrated profound loss of sensory axons, severe loss of large myelinated fibres in all fascicles with motor nerve involvement. Muscle biopsy demonstrated chronic neurogenic atrophy. Rheumatology screen showed positive anti Ro 52 antibodies (on an extended myositis screen). EMG demonstrated neurophysiological evidence of widespread marked loss of sensory axons in the upper and lower limbs and partial loss of motor axons in several lower limb territories. USS parotid glands showed some possibly mildly abnormal areas, minor salivary gland biopsy was normal. She received methylprednisolone, IV immunoglobulin and two courses of plasma exchange. Given some improvement following this treatment, further immunosuppression was felt to be appropriate. Initially Mycofenolate mofetil was started and Rituximab is now being considered. Case report - Discussion This case demonstrates a mixed neuropathy picture. Following thorough investigations, many differential diagnoses of mixed neuropathy were considered and excluded (e.g. Guillain Barre, Syphilis, MS, HIV, Hepatitis). Neurological symptoms can develop before the onset of sicca symptoms in Sjögren’s syndrome. With a positive Anti Ro52, xerostomia and clinical improvement with methylprednisolone and plasmaphereses it seems likely there is an underlying autoimmune diagnosis in this case and despite a normal biopsy she would meet the 2016 ACR/EULAR classification criteria for Sjögren’s syndrome. Case report - Key learning points Sjögren’s syndrome should be considered as a potential underlying cause in patients with a sensory ganglionopathy. Neurological symptoms can develop before the onset of sicca symptoms in Sjögren’s syndrome.

Congenital Syphilis Simulating Bone Neoplasm in 2-Month Old Infant – Case Report

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Case Report ◽  
Congenital Syphilis ◽  
Eosinophilic Granuloma ◽  
Osteolytic Lesion ◽  
Lower Limbs ◽  
Upper Body ◽  
Elective Cesarean Section ◽  
Distal Fibula ◽  
X Ray

Introduction: Congenital Syphilis (CS) occurs through the transplacental transmission of Treponema pallidum in inadequately treated or non-treated pregnant women, and is capable of severe consequences such as miscarriage, preterm birth, congenital disease and/or neonatal death. CS has been showing an increasing incidence worldwide, with an increase of 208% from 2009 to 2015 in Brazil. Case report: 2-month old infant receives care in emergency service due to edema of right lower limb with pain in mobilization. X-ray with osteolytic lesion in distal fibula. Infant was sent to the Pediatrics Oncology clinic. Perinatal data: 7 prenatal appointments, negative serology at 10 and 30 weeks of gestation. End of pregnancy tests were not examined and tests for mother’s hospital admission were not requested. Mother undergone elective cesarean section at 38 weeks without complications. During the pediatric oncologist appointment, patient showed erythematous-squamous lesions in neck and other scar-like lesions in upper body. A new X-ray of lower limbs showed lesions in right fibula with periosteal reaction associated with aggressive osteolytic lesion compromising distal diaphysis, with cortical bone rupture and signs of pathological fracture, suggestive of eosinophilic granuloma. She was hospitalized for a lesion biopsy. Laboratory tests: hematocrit: 23.1 / hemoglobin 7.7 / leukocytes 10,130 (without left deviation) / platelets 638,000 / Negative Cytomegalovirus IgG and IgM and Toxoplasmosis IgG and IgM / VDRL 1:128. Congenital syphilis diagnosis with skin lesions, bone alterations and anemia. Lumbar puncture: glucose 55 / total proteins 26 / VDRL non reagent / 13 leukocytes (8% neutrophils; 84% monomorphonuclear; 8% macrophages) and 160 erythrocytes / negative VDRL and culture. X-ray of other long bones, ophthalmological evaluation and abdominal ultrasound without alterations. Patient was hospitalized for 14 days for treatment with Ceftriaxone 100mg/kg/day, due to the lack of Crystalline Penicillin in the hospital. She is now under outpatient follow-up. Discussion: CS is responsible for high rates of morbidity and mortality. The ongoing increase of cases of this pathology reflects a severe health issue and indicates failures in policies for the prevention of sexually transmitted diseases, with inadequate follow-up of prenatal and maternity protocols.

scholarly journals Erythromelanosis Follicularis Faciei et Colli: A Case Report in a Caucasian Male and Brief Review of the Literature

2020 ◽  
Vol 12 (3) ◽  
pp. 231-235
Author(s):  
Carl Maximilian Thielmann ◽  
Wiebke Sondermann
Keyword(s):  
Case Report ◽  
Family History ◽  
Clinical Presentation ◽  
Rare Condition ◽  
Unknown Etiology ◽  
Review Of The Literature ◽  
Caucasian Male

Erythromelanosis follicularis faciei et colli, a rare condition of unknown etiology, was first described by Kitamura et al. from Japan in 1960. It is characterized by a triad consisting of well-demarcated erythema, hyperpigmentation, and follicular papules. We report the case of a 50-year-old Caucasian male, who had asymptomatic symmetrical facial lesions since the age of 42. His family history was unremarkable. Published erythromelanosis follicularis faciei et colli cases of the last 10 years are summarized in this report to demonstrate the variability and differences in the clinical presentation of this uncommon diagnosis.

scholarly journals Negative-pressure-related diffuse alveolar hemorrhage after monitored anesthesia care for vertebroplasty: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yumin Jo ◽  
Jagyung Hwang ◽  
Jieun Lee ◽  
Hansol Kang ◽  
Boohwi Hong
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Negative Pressure ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Unknown Etiology ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
X Ray ◽  
Chest X Ray

Abstract Background Diffuse alveolar hemorrhage (DAH) is a rare, life-threatening condition that can present as a spectrum of nonspecific symptoms, ranging from cough, dyspnea, and hemoptysis to severe hypoxemic respiratory failure. Perioperative DAH is frequently caused by negative pressure pulmonary edema resulting from acute airway obstruction, such as laryngospasm, although hemorrhage itself is rare. Case presentation This case report describes an unexpected hemoptysis following monitored anesthesia care for vertebroplasty. A 68-year-old Asian woman, with a compression fracture of the third lumbar vertebra was admitted for vertebroplasty. There were no noticeable events during the procedure. After the procedure, the patient was transferred to the postanesthesia care unit (PACU), at which sudden hemoptysis occurred. The suspected airway obstruction may have developed during transfer or immediate arrive in PACU. In postoperative chest x-ray, newly formed perihilar consolidation observed in both lung fields. The patients was transferred to a tertiary medical institution for further evaluation. She diagnosed with DAH for hemoptysis, new pulmonary infiltrates on chest x-ray and anemia. The patient received supportive care and discharged without further events. Conclusions Short duration of airway obstruction may cause DAH, it should be considered in the differential diagnosis of postoperative hemoptysis of unknown etiology.

Refractory eosinophilic fasciitis successfully treated with infliximab: A case report

2021 ◽  
pp. 239719832110043
Author(s):  
Paulina Śmigielska ◽  
Justyna Czarny ◽  
Jacek Kowalski ◽  
Aleksandra Wilkowska ◽  
Roman J. Nowicki
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Treatment Failure ◽  
Immunosuppressive Drugs ◽  
Unknown Etiology ◽  
High Dose ◽  
Eosinophilic Fasciitis ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

Eosinophilic fasciitis is a rare connective tissue disease of unknown etiology. Therapeutic options include high-dose corticosteroids and other immunosuppressive drugs. We present a typical eosinophilic fasciitis case, which did not respond to first-line treatment, but improved remarkably after infliximab administration. This report demonstrates that in case of initial treatment failure, infliximab might be a relatively safe and effective way of eosinophilic fasciitis management.

scholarly journals New Species of Soldier Fly—Sargus bipunctatus (Scopoli, 1763) (Diptera: Stratiomyidae), Recorded from a Human Corpse in Europe—A Case Report

Insects ◽  
2021 ◽  
Vol 12 (4) ◽  
pp. 302
Author(s):  
Marek Michalski ◽  
Piotr Gadawski ◽  
Joanna Klemm ◽  
Krzysztof Szpila
Keyword(s):  
Case Report ◽  
New Species ◽  
Dna Barcoding ◽  
Forensic Entomology ◽  
Morphological Characters ◽  
Lower Limbs ◽  
Black Soldier Fly ◽  
Hermetia Illucens ◽  
Practical Applications ◽  
Human Corpse

The only European Stratiomyidae species known for feeding on human corpses was the black soldier fly Hermetia illucens (Linnaeus, 1758). Analysis of fauna found on a human corpse, discovered in central Poland, revealed the presence of feeding larvae of another species from this family: the twin-spot centurion fly Sargus bipunctatus (Scopoli, 1763). The investigated corpse was in a stage of advanced decomposition. The larvae were mainly observed in the adipocere formed on the back and lower limbs of the corpse, and in the mixture of litter and lumps of adipocere located under the corpse. Adult specimens and larvae were identified based on morphological characters, and final identification was confirmed using DNA barcoding. Implementing a combination of morphological and molecular methods provided a reliable way for distinguishing the larvae of S. bipunctatus and H. illucens. The potential of S. bipunctatus for practical applications in forensic entomology is currently difficult to assess. Wide and reliable use of S. bipunctatus in the practice of forensic entomology requires further studies of the bionomy of this fly.

Sign in / Sign up

Export Citation Format

Share Document