scholarly journals The "disease of the crazy hatman" and the effects of human exposure to mercury: A case report / A "doença do homem do chapéu maluco" e os efeitos da exposição humana ao mercúrio: Um relato de caso

2021 ◽  
Vol 7 (12) ◽  
pp. 120602-120610
Author(s):  
Túlio Mohammad da Costa Sahori ◽  
Ana Luísa Sena Morais Gratão ◽  
Bárbara Queiroz De Figueiredo ◽  
Diogo Gonçalves Souto ◽  
Gardênia Silva Amorim ◽  
...  
Keyword(s):  
Case Report ◽  
Small Amplitude ◽  
Human Exposure ◽  
Clinical Case ◽  
Motor Coordination ◽  
Inorganic Mercury ◽  
Mercury Vapor ◽  
Lower Limbs ◽  
Motor Speed ◽  
Behavioral Impairment

INTRODUCTION: Mercury, in addition to being a heavy metal, is considered a neurotoxin, that is, a substance capable of negatively affecting the neurological functions of the human body. Nowadays, ““Mad Hatter's Disease”” is the name used to characterize these neurological disorders caused by mercury. PURPOSE: to report a clinical case of the manifestation of “Mad Hatter's Disease”, as well as to discuss about the effects of human exposure to mercury. METHODOLOGY: this is a clinical case report, in which the patient is essential. CASE REPORT: A 45-year-old male patient, gold miner, from a riverside community in the Amazon, was referred to the hospital with complaints of headache, extremities tremor, diarrhea, tiredness, discouragement, irritability, depression, unusual shyness and hallucinations. On physical examination, the patient was anxious, irritable, symmetrical small-amplitude tremors in the extremities, hyperreflexia ++/4+ in the upper limbs, +/4+ in the lower limbs, normal muscle strength, mild ataxia of the right hand, stained skin and mucous membranes, and acyanotic, with erythematous-scaly lesions, confluent on the trunk, palms and soles of the feet. Screening for mercury poisoning was performed, where it was found, both in blood and urine, the presence of mercury 20 times above the biological tolerance limit. A battery of specific neuropsychological tests was carried out in neurotoxicological assessments and these demonstrated impairment of the cognitive domains (deficit of memory, attention, concentration, reasoning and abstraction) and alterations in motor functions, showing reduced coordination and motor speed. The diagnosis of hydrargyrism or occupational chronic metallic mercuralism (MMCO) was given. DISCUSSION: Chronic occupational exposure to inorganic mercury can cause subclinical abnormalities, as well as long-term psychomotor and neuromuscular behavioral impairment. Neuropsychiatric abnormalities (inattention, memory, interpretation, and motor performance) appear to be dose-related. FINAL CONSIDERATIONS: chronic exposure to metallic mercury vapor characteristically compromises the nervous system, initially with nonspecific symptoms and, later, with characteristic motor disorders - small amplitude tremor, paresis, dysreflexia and difficulty in motor coordination, which gives rise to the "Disease of the Mad Hatter”, and inhaling large amounts of mercury vapor can be lethal.

scholarly journals Spondylodiscitis and early diagnosis: a case report

2021 ◽  
Author(s):  
Mariana Moreira Soares de Sa ◽  
Emanuelle Ferreira Barreto ◽  
Marina Soares Vilela ◽  
Roberta Kelly Netto Vinte Guimarães ◽  
Vanessa Alves Lobato ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Early Diagnosis ◽  
Lower Limb ◽  
Clinical Case ◽  
Lower Limbs ◽  
Lumbosacral Spine ◽  
Low Back ◽  
Left Lower Limb

Context: Spondylodiscitis is a term that includes vertebral osteomyelitis, spondylitis and discitis. Among the vertebrae, the most affected are the lumbar (45%), followed by the thoracic (35%). Adults present themselves progressively, with a predominant complaint of low back pain and pain on palpation of the affected site, with significant limitation of movement due to muscle spasms. Report a clinical case with an emphasis on the possibility of early diagnosis and correct treatment aimed at the recovery of patients with neurological sequelae. Analysis of medical records in a patient admitted to the neurology ward of Santa Casa de Belo Horizonte. Clinical Case report: A.I.S. patient, 45 years old, with chronic low back pain due to asymmetry of the left lower limb. History of wear of the femoral head diagnosed in adolescence. Evolving for 2 months with progressive weakness in the lower limbs, associated with paresis and paresis in the left lower limb. He performed abdominal USG which showed hepatosplenomegaly with collateral circulation, increased caliber of the portal, splenic and superior mesenteric veins. Tomography of the lumbosacral spine with osteolytic lesions in the joints of L2-L3, L3-L4 and L4-L5., With almost total osteolysis of the L4 vertebral body, retropulsion of much later at this level, suggesting spondylodiscitis. The resonance of the lumbar spine performed with acute spondylodiscitis L2-L3 and L3-L4, compressing the roots of the equine tail with a comprehensive potential, remains as the emerging emerging roots. Liquid filling of the L3- L4 intervebral disc compatible with acute spondylodiscitis. Staphylococcus aureus and enterobacteria are responsible for more than half of the cases of non-tuberculosis. Conclusion: The diagnosis of discitis can be quite difficult, due to the rarity of the disease, the insidious symptoms and the high prevalence of low back pain in the general population. It is considered an important morbidity factor, as it causes an important neurological sequel. In addition, it points to the importance of differential diagnosis of low back pain in the population.

scholarly journals Pure neural leprosy or amyloid neuropathy? systematic review and clinical case report

2021 ◽  
Author(s):  
Carlos Dornels Freire de Souza ◽  
Lucas Gomes Santos ◽  
João Paulo Silva de Paiva ◽  
Thiago Cavalcanti Leal ◽  
Gibson Barros de Almeida Santana ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Sural Nerve ◽  
Clinical Case ◽  
Polarized Light ◽  
Final Diagnosis ◽  
Lower Limbs ◽  
Moderate Intensity ◽  
Cross Sectional ◽  
Amyloid Polyneuropathy

Objective: To review the literature, including a clinical case discussion with suspicion of pure neural leprosy and final diagnosis of amyloid neuropathy. Methods: The study was conducted on May 28, 2020. A systematic review of the literature was conducted, with searches in PubMed, Medline, Lilacs and BVS MS using the descriptors: neuritic leprosy, pure neural leprosy, primary neural leprosy, pure neuritic leprosy, amyloid polyneuropathy, amyloid neuropathies, amyloid polyneuropathy. Clinical trials, cohorts, cross-sectional, clinical cases and case studies, published in Portuguese, English or Spanish between 2010 and 2020 were included. Then, a case report with an initial suspicion of pure neural leprosy was presented. Laboratory tests, electroneuromyography, ultrasound and biopsy of the sural nerve were requested. Results: 23 scientific texts were included. No publications with the two themes together were found. Diagnosis of pure neural leprosy and the possibility of using auxiliary resources were the most prominent themes in the studies. In the clinical case, the patient’s electroneuromyography showed sensitive and motor polyneuropathy of lower limbs, symmetrical, of moderate intensity, of the mixed type (axono- demyelinating), sensitive and axonal. Ultrasonography of the sural nerve revealed changes in the contour of the deep fibular nerves and biopsy of the sural nerve demonstrated the accumulation of amorphous eosinophilic material in the nerve path and Congo red staining showed birefringence of the deposit in applegreen under polarized light. The final diagnosis was amyloidotic neuropathy. Conclusion: Clinical diagnosis was amyloidotic neuropathy. Diagnosis of pure neural leprosy in endemic areas of Brazil is a challenge for the health system.

Clinical Case Report: Manifestation of Hereditary Neuralgic Amyotrophy in Childhood

2014 ◽  
Vol 45 (S 01) ◽  
Author(s):  
L. Voges ◽  
G. Stettner ◽  
D. Weise ◽  
K. Brockmann ◽  
J. Gärtner ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Case ◽  
Neuralgic Amyotrophy

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.

GH/TSH secreting adenoma: a clinical case report: GH/TSH secreting adenoma: a clinical case report

2018 ◽  
Author(s):  
Tatiana Tarasova ◽  
Alexander Lutsenko ◽  
Elena Przhiyalkovskaya ◽  
Ekaterina Pigarova ◽  
Larisa Dzeranova ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Case

Designing Smile of a Worn Out Dentition - a Clinical Case Report

2012 ◽  
Vol 2 (5) ◽  
pp. 415-417
Author(s):  
Dr. Bansi M Bhusari ◽  
◽  
Dr. Shruti Sura ◽  
Dr. Kalpan Desai ◽  
Dr. Ridhima Mahajan
Keyword(s):  
Case Report ◽  
Clinical Case

Myotonic dystrophy Rossolimo-Churchman-Steinert-Batten (clinical case)

2020 ◽  
pp. 71-72
Author(s):  
И.А. Синельникова ◽  
И.В. Сопрунова ◽  
О.П. Николаева
Keyword(s):  
Case Report ◽  
Myotonic Dystrophy ◽  
Clinical Case ◽  
Molecular Genetic ◽  
Ctg Repeats ◽  
Molecular Genetic Method ◽  
Genetic Method ◽  
Family Case ◽  
Dmpk Gene

В статье представлено описание семейного случая миотонической дистрофии Россолимо-Штейнерта-Куршмана-Баттена. Диагноз подтвержден в результате ДНК-диагностики: выявлено увеличенное число копий CTG-повтора гена DMPK, ответственного за развитие миотонической дистрофии. A family case report of Rossolimo-Steinert-Curschmann myotonic dystrophy is presented. An increased number of copies of CTG-repeats of the DMPK gene responsible for the development of MD, i.e., the diagnosis was confirmed by molecular genetic method.

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