Hallervorden-Spatz Syndrome: Case Report of a Typical Form

Hallervorden-Spatz syndrome is a rare neurodegenerative disease, related to mutations in a gene located on chromosome 20p13. Hallervorden-Spatz syndrome is characterized by iron accumulation in the basal ganglia, which leads to variable neurologic manifestations. It is reported the case of a 6 years old male patient, with history of neuro psycho motor development involution noticed since 1 year and 5 months of age and progressive development of dystonia, mostly on upper limbs and neck. Brain Magnetic Resonance Imaging (MRI) revealed bilaterally symmetric signal changes in globus pallidus and in the posterior limb of the internal capsule, findings that suggest neurodegenerative disease with iron accumulation or metabolic disease.

A Case Series of Spontaneous Secondary Pneumothorax in Post Covid Period: A Clinical Insight

Introduction: We are in the era of novel coronavirus pandemic. Each wave is teaching us something new about the disease pathology, long term prognosis. Nonetheless, COVID-19 is giving rise to new challenges to the clinicians every day with its new found complications, long haul Covid symptoms. Secondary spontaneous pneumothorax has been reported to be a rare complication, seen in 1%-2% of COVID-19 patients with a mean time occurrence of 24.3 days from the hospital admission during the early phase of intubation. Case discussion: We report a case series of four patients in post COVID period presented with sudden onset respiratory distress and hypoxia, diagnosed with spontaneous secondary pneumothorax. Out of three only one patient received NIV support during his past treatment for COVID-19 and others were treated with oxygen. Therefore, barotrauma secondary to positive pressure ventilation and rupture of cystic bulla cannot be a sole cause of this complication. Persistent chronic inflammatory process and ischemic damage of alveoli are other possible etiologies. Conclusion: We highlight in our case series the importance of clinical examination, especially chest auscultation, which most clinicians circumvent owing to the trepidation of contracting COVID-19. We also proposed large researches to identify causal association with pneumothorax and previous use of steroids to treat COVID-19, persistent inflammation, age, gender, comorbidity etc to prevent it, as it can be debilitating and fatal. A clinician should always keep pneumothorax as a differential in sudden deteriorating breathlessness and hypoxia in post COVID period as it may happen as late as >40 days from primary COVID diagnosis.