Iatrogenic chronic adrenal insufficiency (clinical case)

2021 ◽  
Vol 19 (2) ◽  
pp. 77-79
Author(s):  
F. V. VALEEVA ◽  
◽  
T. S. YYLMAZ ◽  
T. A. KISELEVA ◽  
L. T. BAREEVA ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
General Condition ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Underlying Disease ◽  
Glucocorticoid Therapy ◽  
Dynamic Monitoring ◽  
Positive Trend ◽  
Laboratory Results ◽  
Systemic Glucocorticoids

The article presents a clinical case of a patient with chronic adrenal insufficiency, developed during many years of using glucocorticoid-containing ointments for the treatment of psoriasis. The anamnesis, laboratory results, diagnostic justification, treatment and dynamic monitoring are presented. It was noted that a change in treatment and prescription of systemic glucocorticoids led to a positive trend in clinical symptoms, confirmed by laboratory results and the general condition of the patient. The lack of alertness of patients and doctors when using local glucocorticoid therapy may be one of the causes of the development of chronic adrenal insufficiency. At the same time, correctly selected glucocorticosteroid therapy helps to stabilize the course of the underlying disease and reduce the risk of unwanted effects.

scholarly journals A case of late manifestation of primary adrenal insufficiency in the autoimmune polyglandular syndrome type 1

2019 ◽  
Vol 47 (2) ◽  
pp. 175-179
Author(s):  
V. V. Troshina ◽  
T. A. Grebennikova ◽  
Zh. E. Belaya
Keyword(s):  
Adrenal Insufficiency ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Syndrome Type ◽  
Primary Adrenal Insufficiency ◽  
Autoimmune Polyglandular Syndrome ◽  
Autoimmune Polyendocrine Syndrome ◽  
Autoimmune Polyglandular Syndrome Type ◽  
Timely Treatment

The article describes a clinical case of primary adrenal insufficiency which manifested at an atypically advanced age. Primary adrenal insufficiency combined with other clinical symptoms suggested the autoimmune polyendocrine syndrome type 1. Subsequently, the diagnosis was confirmed by the results of genetic testing. The particulars of the clinical case include the age of patient at manifestation of the disease (49  years). The lack of treatment resulted in dramatic clinical decompensation. This clinical case is intended to draw clinicians' attention to the necessity of detection of primary adrenal insufficiency and appropriate and timely treatment. Taking into account eventual diagnostic problems, it is necessary to raise awareness about this disease among practicing doctors of various specialties.

scholarly journals Clinical case: conservative treatment of sequestered disc herniation

2020 ◽  
pp. 67-71
Author(s):  
Inna Afanasyeva ◽  
Iryna Andrushchenko ◽  
Taras Bezghodov
Keyword(s):  
Conservative Treatment ◽  
Drug Treatment ◽  
Key Words ◽  
Disc Herniation ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Positive Trend ◽  
Spontaneous Disappearance ◽  
Hollow Capsule ◽  
Herniated Discs

The literature has a lot of descriptions of the spontaneous disappearance of herniated discs. This article presents a clinical case of conservative treatment of sequestered disc herniation applying a complex of drug treatment and kinesitherapy. After 5 months a positive trend was observed against the background of conservative treatment. A year later, there was a lack of clinical symptoms and, according to MRI, and positive dynamics in the form of a decrease in the caudal sequestration of L5-S1 to symmetrical circular protrusion (hollow capsule effect). Key Words: sequestered disc herniation, drug treatment, kinesitherapy, MRI.

scholarly journals Clinical case of lupus erythematosus panniculitis

2020 ◽  
Vol 23 (5) ◽  
pp. 334-340
Author(s):  
N. P. Teplyuk ◽  
O. V. Grabovskaya ◽  
Polina A. Razhev
Keyword(s):  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Observation ◽  
Combined Treatment ◽  
Dynamic Monitoring ◽  
Systemic Steroid ◽  
Lupus Panniculitis ◽  
Systemic Steroid Therapy ◽  
Systemic Glucocorticoids ◽  
Lupus Erythematosus Panniculitis

BACKGROUND: This clinical case is interesting because of extreme rarity of lupus panniculitis in the population, as well as the possible risk of developing systemic lupus erythematosus. CASE REPORT: The article presents a clinical observation of a rare skin disorder lupus erythematosus panniculitis and the results of a successful combined treatment of the disease with systemic glucocorticoids (prednisolone), and an antimalarial agent (hydroxychloroquine). A review of the literature on the etiology, pathogenesis, and diagnosis of lupus panniculitis has been conducted. CONCLUSION. Early detection of lupus erythematosus panniculitis (LEP) makes systemic steroid therapy and quinoline drugs more effective in achieving remission. That is why dynamic monitoring of patients with LEP is important to identify new or progressive symptoms.

scholarly journals Analysis of the Clinical Case of Long-term Monitoring of a Patient with Comorbid Depression: Special Considerations of Psychopharmacotherapy

2020 ◽  
Vol 8 (2) ◽  
pp. 90-103
Author(s):  
V. V. Arkhipov ◽  
E. K. Abakumova ◽  
Ya. S. Dmitrieva ◽  
N. I. Zykova ◽  
Yu. R. Bolsunovskaya
Keyword(s):  
Personality Disorders ◽  
Clinical Case ◽  
Depressive Disorders ◽  
Clinical Symptoms ◽  
Personalised Medicine ◽  
Dynamic Monitoring ◽  
Comorbid Depression ◽  
Vascular Depression ◽  
Psychotropic Medicines

Depression associated with somatic diseases ranks high among other depressive disorders and has a number of specifi c clinical features as compared to classic depression.The aim of the study was to analyse specifi c features of comorbid depression clinical course, its diagnosis, and methodology for the selection of psychopharmacotherapy—using a clinical case as an example.Results: the authors carried out a detailed retrospective clinical analysis of medical records of long-term (over three years) dynamic monitoring of a patient with comorbid vascular depression. They explored the tactics of selecting pharmacotherapy for anxiety-depressive disorder given the underlying chronic cerebral ischemia, atherosclerosis of brachiocephalic arteries, аrterial hypertension, and atherosclerotic cardiosclerosis. The primary focus was on specifi c aspects of vascular depression pharmacotherapy that were governed by a diverse clinical picture of comorbid personality disorders, dynamic transformation of somatic, neurological, and psychic symptoms and syndromes in a patient. The paper highlights the need for alignment of scientifi c and methodological approaches to assessment of potential risks associated with the use of psychotropic medicines.Conclusions: the choice of rational psychopharmacotherapy for vascular depression should be governed by the data on the drug effi cacy for the prevailing clinical symptoms, by the age and gender characteristics of the patient, by compensation status of organs and systems, as well as by genetic, personal, and social characteristics that aff ect the disease progression. The use of a comprehensive multidisciplinary approach to the diagnosis and treatment of comorbid personality disorders, as well as implementation of personalised medicine methodology in clinical practice in order to assess the patient’s condition as infl uenced by changes in his/her somatic, neurological, psychic status and the results of psychological testing, will increase the effi cacy and safety of treatment. 

Possibilities of correction of menopausal disorders in women with the use of medicine Menopace

2016 ◽  
pp. 95-100
Author(s):  
G.I. Reznichenko ◽  
◽  
N.Yu. Reznichenko ◽  
V.Yu. Potebnya ◽  
K.I. Kovalenko ◽  
...  
Keyword(s):  
General Condition ◽  
Clinical Symptoms ◽  
Average Score ◽  
Control Group ◽  
Climacteric Syndrome ◽  
Basic Subgroup ◽  
Menopausal Syndrome ◽  
Natural Menopause ◽  
Surgical Menopause ◽  
Observation Period

The objective: to determine the efficacy of medicine «Menopace» in treatment of women with natural and surgical menopause. Patients and methods. 20 women (I group) with a natural menopause were examined (basic subgroup consisted of 10 patients who used Menopace for 3 months; control subgroup consisted of 10 patients). 20 women (II group) with surgical menopause were examined (basic subgroup consisted of 10 patients who received Menopace for 3 months; control subgroup consisted of 10 patients). Results. The average score of neurovegetative and emotional manifestations of climacteric syndrome during the observation period decreased in women with natural and surgical menopause who used Menopace, compared with subgroups of patients who had not used the medicine. Conclusions. 1. The use of the medicine Menopace in women with natural menopause after 3 months showed the disappearance of clinical symptoms of climacteric syndrome in 70% of the cases, and significant improvement in general condition in 30% of cases. 2. During surgical menopause after 1 month of treatment with Menopace manifestations of sweating were observed 4.5 times less often than in control group, tides were observed 7 times less often than in control group. Neurovegetative and psychoemotional symptoms of menopause were absent in 80% of women after 3 months of treatment and in 20% of cases significant improvement was shown. 3. The obtained results give grounds to recommend wide use of Menopace in practical work for the treatment of menopausal syndrome during natural and surgical menopause. Key words: menopause, therapy, Menopace.

scholarly journals Variable clinical characteristics and laboratory results in five patients with Chinese Good's syndrome (thymoma and hypogammaglobulinemia): an 8-year retrospective analysis in a university hospital in China

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jinyao Ni ◽  
Junwu Zhang ◽  
Yanxia Chen ◽  
Weizhong Wang ◽  
Jinlin Liu
Keyword(s):  
Information System ◽  
Lichen Planus ◽  
Hospital Information System ◽  
Clinical Characteristics ◽  
Opportunistic Infections ◽  
Clinical Symptoms ◽  
University Hospital ◽  
Ivig Treatment ◽  
Good’S Syndrome ◽  
Laboratory Results

Abstract Background Good's syndrome (GS) is a rare secondary immunodeficiency disease presenting as thymoma and hypogammaglobulinemia. Due to its rarity, the diagnosis of GS is often missed. Methods We used the hospital information system to retrospectively screen thymoma and hypogammaglobulinemia patients at the First Affiliated Hospital of Wenzhou Medical University from Apr 2012 to Apr 2020. The clinical, laboratory, treatment, and outcome data for these patients were collected and analyzed. Results Among the 181 screened thymoma patients, 5 thymoma patients with hypogammaglobulinemia were identified; 3 patients had confirmed diagnoses of GS, and the other 2 did not have a diagnosis of GS recorded in the hospital information system. A retrospective review of the clinical characteristics, laboratory results, and follow-up data for these 2 undiagnosed patients confirmed the diagnosis of GS. All 5 GS patients presented with pneumonia, 2 patients presented with recurrent skin abscesses, 2 patients presented with recurrent cough and expectoration, 1 patient presented with recurrent oral lichen planus and diarrhea, and 1 patient presented with tuberculosis and granulomatous epididymitis. In the years after the diagnosis of hypogammaglobulinemia with mild symptoms, all 5 patients had received irregular intravenous immunoglobulin (IVIG) treatment. As the course of the disease progressed, the clinical symptoms of all patients worsened, but the symptoms were partly resolved with IVIG in these patients. However, 4 patients died due to comorbidities. Conclusion GS should be investigated as a possible diagnosis in thymoma patients who present with hypogammaglobulinemia, especially those with recurrent opportunistic infections, recurrent skin abscesses, chronic diarrhea, or recurrent lichen planus.

ULTRASONIC STUDY IN DIAGNOSTICS OF PERIPHERAL NEUROPATHIES (CASE FROM PRACTICE)

2021 ◽  
pp. 144-146
Author(s):  
Hamanovich A.I. ◽  
◽  
Baida A.G. ◽  
Koyalo L.G. ◽  
Levantsevich V.V. ◽  
...  
Keyword(s):  
Nervous System ◽  
Gold Standard ◽  
Peripheral Nerves ◽  
Peroneal Nerve ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Nerve Trunk ◽  
Peripheral Neuropathies ◽  
Ultrasound Scanning ◽  
Electrophysiological Methods

Electrophysiological methods, such as electromyography and neuromyography, are traditionally recognized as the "gold standard" for detecting pathology of the peripheral nervous system. It should be noted, however, that the information obtained during the above examinations does not give an idea of the state of the surrounding tissues, does not indicate the nature and cause of damage to the nerve trunk, and does not always accurately reflect the localization of changes. At the same time, it is this information that helps to determine the tactics of conservative or surgical treatment of the patient. Ultrasound scanning is quite successfully used in the diagnosis of damage and diseases of the peripheral nerves. The article presents a clinical case of a diagnostic search for a causative disease in a patient with clinical symptoms of neuropathy of the peroneal nerve.

scholarly journals Clinical case of myocardial infarction with unspecified familial hypercholesterolemia

2022 ◽  
Vol 17 (4) ◽  
pp. 74-78
Author(s):  
N. G. Lozhkina ◽  
A. N. Spiridonov
Keyword(s):  
Myocardial Infarction ◽  
Familial Hypercholesterolemia ◽  
Clinical Case ◽  
Autosomal Dominant ◽  
Clinical Symptoms ◽  
Cholesterol Metabolism ◽  
Single Gene ◽  
Low Density Lipoproteins ◽  
Dominant Disease ◽  
Appropriate Therapy

Familial hypercholesterolemia is a hereditary autosomal dominant disease characterized by a violation of cholesterol metabolism. This nosology was first described in the late 1930s by the Norwegian clinician Karl Moeller, he proposed the idea that hypercholesterolemia and tendon xanthomas are associated with cardiovascular diseases through the inheritance of a single gene. In 1964, two clinical phenotypes of familial hypercholesterolemia were discovered: heterozygous and homozygous, associated with an unfavorable prognosis. To date, it is known that the long-running process of accumulation of low-density lipoproteins in the intima of blood vessels may not have clinical symptoms for many years due to the developed system of collaterals and the absence of hemodynamically significant stenosis. However, without timely diagnosis and appropriate therapy, this condition inevitably leads to the development of a cardiovascular event. The article presents a clinical case demonstrating the development of myocardial infarction in a patient with a late diagnosis of this disease.

scholarly journals Riedel's thyroiditis: diagnostic difficulties (clinical case and brief review)

2021 ◽  
pp. 166-171
Author(s):  
A. A. Rybakova ◽  
N. M. Platonova ◽  
T. V. Soldatova ◽  
N. V. Tarbaeva ◽  
T. S. Panevin ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Clinical Case ◽  
Clinical Performance ◽  
Fine Needle Biopsy ◽  
Morphological Description ◽  
Positive Trend ◽  
Riedel’S Thyroiditis ◽  
Compression Syndrome ◽  
Diagnostic Difficulties ◽  
Riedel's Thyroiditis

Riedel's thyroiditis is a rare disease characterized by chronic fibrosis. Clinical performance of this disease is dense stony goiter, which can poorly be displaced during palpation. The overgrowth of the goiter can lead to the development of compression syndrome. To diagnose we need to made fine needle biopsy and made the final diagnose according to its results or according to the morphological description of the postoperative material. An important step in the diagnosis of Riedel's thyroiditis is the determination of serum IgG and IgG4 to exclude an IgG4-associated disease. Treatment of this disease includes drug therapy, which is based on glucocorticosteroids administration or surgical treatment when develops compression syndrome. This article presents a clinical case of a patient with Riedel's thyroiditis; the main complaints were associated with the growth of goiter and the development of compression syndrome. In this regard, patient underwent surgery on the thyroid gland, and after this we get final diagnose. Due to feeling unwell, drug therapy with glucocorticosteroids was prescribed, against the background of which we noted a positive trend.

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