A fatal outcome in a patient with coeliac disease who suspended a strict gluten-free diet: a case report

Coeliac disease (CD) is an autoimmune small bowel disease that occurs in susceptible individuals that develop an immunological reaction to gluten. A strict gluten-free diet (GFD) is the primary treatment for CD. This case report describes a patient with CD recurrence due to a discontinuation of a strict GFD by the patient. After recurrence, the patient developed fever and pancytopaenia, and quickly died of haemophagocytic lymphohistiocytosis (HLH). To the best of our knowledge, this is the first description of a case of CD associated with HLH due to discontinued GFD, which may contribute to improving the awareness of the importance of maintaining a strict GFD and having regular follow-up examinations.

A CASE REPORT ON MULTISYSTEMIC INFLAMMATORY SYNDROME- CHILDREN HOW THE DIAGNOSIS AND TREATMENT COULD BE CHALLENGING

Although COVID 19 infections in children are generally mild and non-fatal, there is increasing recognition of a multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, leading to severe illness and long-term sequelae. Even though there is some evidence that the MIS-C is a post-viral immunological reaction to COVID-19, understanding of the immune response induced by SARS-CoV-2 remains unclear.Various local and international guidelines are being widely practiced in the diagnosis and management of patients with MIS-C. A case report of a young child who was diagnosed and managed as MIS-C is discussed here. The diagnostic challenges with the available case definitions and currently accepted treatment options are elaborated herein.

A neurologist’s rhombencephalitis after comirnaty vaccination. A change of perspective

Rhombencephalitis is an orphan disease of multiple causes that may manifest with facial palsy, limb ataxia and reduced consciousness. Up to now it is described after COVID-19 infection and in this (personal) case was found up to 8 weeks after Comirnaty vaccination. So far, we do not fully understand the pathophysiological characteristics of encephalitis associated with SARS-CoV-2. In rare cases, vaccination may cause an immunological reaction and delayed inflammation, the consequences of which we have not yet deciphered. Rhombencephalitis should be considered as a rare potential mRNA-associated vaccination side effect.

Neurological manifestation of cancer – paraneoplastic syndromes

Neurological paraneoplastic syndromes (NPS) belong to a heterogeneous group of disorders affecting the nervous system. NPS occur as a result of immunological reaction to the tumor. As a result, the isolated syndrome is formed and manifests itself in many different ways, for example: limbic encephalitis, ataxia, dominant cerebellar degeneration, psychiatric disturbances, myasthenia gravis or diffuse encephalomyelitis. Detection of NPS is solely based on the presence of specific anti-neural antibodies. Although NPS had been previously considered unresponsive to therapy, some research has shown that there are effective therapies, including cancer- and immunotherapy targeted therapies.

Hemisferic encephalic involviment associated with sars- cov-2

Context: The novel severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) emerged in Wuhan, China and rapidly spread worldwide. Although the predominant clinical presentation is with respiratory disease, neurological manifestations are being recognised increasingly. Case report: In this report, we demonstrate a case of hemispheric brain in volvement as a neurological manifestation of Sars-cov-2 in a 74-year-old patient admitted to Hospital Santa Izabel (HSI) between May and July 2020. Conclusion: In COVID-19, although the predominant clinical presentation is with respiratory disease, neurological complications have been reported. Severe neurological complications are either because of direct viral invasion, immunological reaction, or hypoxic metabolic changes. The patients with encephalitis are usually severely or critically ill.

Serum markers for immunological response to metal alloys of endoprostheses

A study of solid-phase structures of blood serum using wedge-shaped and marginal dehydration methods (Litos system technology) was conducted in order to find out the causes of an inflammatory reaction followed by fibrosis in the second operated joint in a patient with bilateral knee arthritis. The study was aimed at identifying specific morphological markers that characterize the bodys response to the endoprosthesis material. Its solid-phase structures indicated the activation of a hyperergic reaction with daily incubation of blood serum with an alloy of titanium, aluminum, and vanadium. On the contrary, the immunological activity of blood serum can be suppressed and the structures present in it can be transformed into amorphous detritus with the incubation of an alloy of cobalt, chromium, and molybdenum. It was observed from the study that the nature of the immunological reaction of a sensitized organism depends on the type of metals that are part of the endoprosthesis. The immune response causes inflammation of the periarticular tissue, followed by its fibrosation and the formation of a scar demarcation shell that separates the periarticular tissue from the endoprosthesis and performs the function of an immunological barrier on the alloy of titanium, aluminum, and vanadium. On the other hand, an immunological reaction causes the destruction of inflamed periarticular tissue, followed by gradual destruction of the articular bag on the alloy of cobalt, chromium, and molybdenum.