A case of congenital diffuse lipomatosis in ophthalmic practice

A clinical case of a childhood form of diffuse lipomatosis is considered. The clinical picture and diagnostic methods necessary for the establishment of a clinical diagnosis are reflected. When observing patients with diffuse lipomatosis, it is required to involve specialists of various specialties and conduct thorough diagnostic measures to verify the clinical diagnosis and select the appropriate treatment methods. Key words: congenital malformations of the organ of vision, germ layers, mesenchyme, connective tissue, lipomatosis.

Clinical Case of Organic Pseudopsychopathic Disorder in a Teenager in Terms of Differential Diagnostics with Childhood Schizophrenia

Background: Organic personality disorder is one of the most pressing problems of modern practical psychiatry, due to the multifactorial etiology of this pathology, the variety of clinical symptoms, and the complexity of differential diagnosis. Results: The clinical analysis of a difficult to diagnose case, of a 13-year-old girl who committed an act of criminal aggression is presented. Based on anamnesis data, examination data, analysis of the features of psychopathological symptoms and dynamic clinical observation, the final diagnosis of "Organic pseudopsychopathic personality disorder due to mixed causes (perinatal factors and traumatic brain injury), with significant behavioral disorders requiring treatment, with schizophrenic symptoms" was made. Initially mistaken for the childhood form of schizophrenia based on the clinical pattern and complaints. Methods: The results of the patient's clinical examination using a complex of psychodiagnostic techniques, instrumental research methods, observation data in the department, and an analysis of the patient’s anamnesis are presented. Conclusion: The main stages of diagnosis, the course of the study, the difficulties in the differential diagnosis, and the key insights that played a role in substantiating the diagnosis are highlighted.

During’s herpetiform dermatitis in pediatric dermatology: issues of diagnostics and treatment

This article presents a case of clinical observation of a 5-year-old child with herpetiformis dermatitis (Duhrings). This rare dermatosis is characterized by a chronic relapsing course, the presence of itching polymorphic rashes, typical histological and immunomorphological signs. The diagnosis was made on the basis of the clinical picture, histological and immunohistochemical studies of skin biopsy, as well as the results of HLA typing by PCR. Clinical observation of this case is of interest to practicing physicians-dermatologists due to the rare occurrence of Duhrings herpetiformis in children, the complexity of differential diagnostic search, which requires further generalization of experience using histological, immunohistochemical and molecular genetic research methods. The disease is clearly differentiated from other rashes with the formation of subepidermal blisters according to histological, immunological and gastrointestinal criteria. The prevalence of dermatosis in various populations of the Europian race ranges from 10 to 39 cases per 100,000 population. Duhrings dermatitis herpetiformis can develop at any age (cases of the childhood form of Dhrings dermatitis herpetiformis have been reported), but most often the disease occurs at the age of 4050 years. Dermatitis herpetiformis persists indefinitely with variable severity. In patients with Duhrings dermatitis, associated gluten-sensitive enteropathy is often noted, which in most cases is asymptomatic.

A Misdiagnosed Case of Hypertrophic Gastropathy

Hypertrophic gastropathy is a rare idiopathic hyperproliferative disorder which may present as Menetrier’s disease (MD) characterized by foveolar hyperplasia in the gastric fundus and body. It is often accompanied by a severe loss of plasma proteins (including albumin) from the altered gastric mucosa. The disease occurs in two forms, a childhood form due to cytomegalovirus infection and an adult form attributed to overexpression of transforming growth factor-alpha (TGF-α). The most common symptoms include epigastric pain with fullness and vomiting and generalized peripheral edema with hypoalbuminemia. We present a case of 75-year-old female presenting with epigastric pain and vomiting. Upper gastrointestinal endoscopy and computed tomography scan revealed an irregular mucosal fold at the body and antrum and thickening of the stomach wall, respectively. Though the endoscopic gastric mucosal biopsy was nonspecific, the patient underwent partial gastrectomy due to clinicoradiological suspicion of carcinoma. On histopathology, the case was reported as hypertrophic gastropathy, consistent with MD. Though there is a strong clinical and radiological suspicion of malignancy in the hypertrophied gastric mucosa, MD should be one of the important differential diagnoses.

Cannabinoids and Epilepsy

Cannabis has historically been drug of choice in treating epilepsy, particularly in the 1800’s. However, there have been no modern controlled clinical trials on the effectiveness of cannabis or THC in treating seizures in humans. Preclinical research suggests that CB1 agonists reduce seizures in animal models, however, there is also some evidence that THC may be proconvulsant. It is now known epilepsy can substantially modify the endocannabinoid signalling system, by modifying the relative activation of excitatory glutamate and inhibitory GABA transmission. Considerable recent media interest has focussed on the potential of CBD to reduce seizures in a childhood form of epilepsy called Dravet’s syndrome. The evidence for the anti-convulsant potential of CBD and other cannabinoids is reviewed in this chapter.