2013-05-22T18:36:03Zhttp://www.ncbi.nlm.nih.gov/oai/oai.cgioai:pubmedcentral.nih.gov:27285042009-08-24casrepmedpmc-open
Aggressive Angiomyxoma of the Scrotum Mimicking Huge Hydrocele: Case Report and Literature Review
Morag, Roy
Fridman, Eduard
Mor, Yoram
Case Report
Aggressive Angiomyxoma (AAM) is a rare mesenchymal benign myxoid tumor of the pelvis and perineum which occurs almost exclusively in adult females. We are presenting a case of 64 year old male patient with a slowly growing scrotal swelling which has been regarded as hydrocele for 2 years. The patient was referred to scrotal exploration. At surgery a huge mass adjacent to the bulbar urethra was found, not involving the testicles. The morphological picture and the special stains were compatible with aggressive angiomyxoma of the scrotum and peritoneum.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728504/
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oai:pubmedcentral.nih.gov:27286052009-09-01casrepmedpmc-open
Solitary Fibrous Tumor Arising from the Sphenoid Sinus
Takasaki, Kenji
Watanabe, Takeshi
Hayashi, Tomayoshi
Kinoshita, Naoe
Kumagami, Hidetaka
Takahashi, Haruo
Case Report
Solitary fibrous tumor (SFT) is an uncommon neoplasm that usually arises from the pleura. To our knowledge, only 30 cases of SFTs in the nasal cavity and paranasal sinuses have been reported in the literature. We describe an SFT that arose from the right sphenoid sinus and extended to the nasal cavity and epipharynx. The tumor was completely removed by endoscopic sinus surgery without complication. The patient is taking an uneventful course without any evidence of recurrence of the disease 8 months after surgery now.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728605/
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oai:pubmedcentral.nih.gov:27286062009-08-31casrepmedpmc-open
Recurrent Bacteremia, a Complication of Cyanoacrylate Injection for Variceal Bleeding: Report of Two Cases and Review of the Literature
Galperine, T.
Flateau, C.
Venon, M. D.
Lescure, F. X.
Béraud, G.
Said Ibrahim, T.
Delisle, F.
Durand, F.
Faure, K.
Pialoux, G.
Guery, B.
Case Report
We report the first description of recurrent bacteremia in two patients after cyanoacrylate injection for gastric varices bleeding treated with antibiotics alone. Adapted and prolonged antibiotic treatment allowed a complete resolution of the infection with no relapse after more than 6 months. According to recent data, prophylactic antibiotics should be further investigated for patients with bleeding varices undergoing cyanoacrylate injection.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728606/
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oai:pubmedcentral.nih.gov:27286072009-08-31casrepmedpmc-open
Valproic Acid-Induced Myoclonus in a Demented Patient: A Case Report
Gardner, Tina M.
Aziz, Rehan
Muralee, Sunanda
Tampi, Rajesh R.
Case Report
Valproic acid and its derivatives are now commonly used to treat various psychiatric disorders in the elderly. Data indicates that the elderly patients are more susceptible to developing neuropsychiatric complications when treated with these medications. In this report, we describe the case of a 66-year-old woman with early-onset, Alzheimer's type dementia, who developed myoclonus when treated with a valproic acid preparation for behavioral disturbances associated with the dementia.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728607/
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oai:pubmedcentral.nih.gov:27286082009-09-01casrepmedpmc-open
A Case of Concurrent Riedel's, Hashimoto's and Acute Suppurative Thyroiditis
Pirola, I.
Morassi, M. L.
Braga, M.
De Martino, E.
Gandossi, E.
Cappelli, C.
Case Report
Riedel's thyroiditis (RT) is a rare form of infiltrative and inflammatory disease of the thyroid, first described by Bernard Riedel in 1896. The concurrent presence of RT and other thyroid diseases
has been reported, but, the association of RT with Hashimoto's thyroiditis and acute thyroiditis has
not yet been reported. We present a case of concurrent Riedel's, Hashimoto's and acute thyroiditis that occurred in a
45-year-old patient.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728608/
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oai:pubmedcentral.nih.gov:27286092009-08-31casrepmedpmc-open
Delayed Diagnoses: Nonspecific Findings and Diagnostic Challenges in Eating Disorders
Schwarz, Dan
Ponder, Kathryn L.
Feller, Edward R.
Case Report
Objective. Eating disorders commonly present with nonspecific findings, masquerading as other, more common etiologies of malnutrition and wasting. In low-prevalence populations, these ambiguities can complicate clinicians' diagnostic reasoning, resulting in delayed or missed diagnoses. Method. We report the atypical case of a 51-year-old male with a five-year history of unexplained weight loss despite extensive past medical evaluation. Previous documentation of profound lymphopenia and bone marrow atrophy had not been linked to a known association with eating disorders. Results. Evaluation for medical etiologies of wasting was negative. Following psychiatric evaluation, the patient was diagnosed with an eating disorder, not otherwise specified, and admitted to a specialized nutritional rehabilitation program. Conclusion. The nonspecific clinical history, physical exam, and laboratory abnormalities of eating disorders can make these diagnoses challenging and delay appropriate treatment. Clinicians should consider eating disorders in patients with malnutrition, severe lymphopenias, and gelatinous marrow transformation early in their workup, so as to avoid potentially negative outcomes.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728609/
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oai:pubmedcentral.nih.gov:27286102009-09-01casrepmedpmc-open
Two Adults with Adrenal Myelolipoma and 21-Hydroxylase Deficiency
Nermoen, Ingrid
Følling, Ivar
Vegge, Kjetil
Larmo, Arne
Nedrebø, Bjørn Gunnar
Husebye, Eystein Sverre
Løvås, Kristian
Case Report
We present incidentally discovered adrenal myelolipomas in two adult males with untreated congenital adrenal hyperplasia (CAH). The patients had simple virilizing form of CAH due to mutations in the CYP21 gene coding for 21-hydroxylase; one was heterozygous for the I172N mutation and the other compound heterozygous for the I172N and I2splice mutations. The masses were not removed since myelolipomas are considered benign tumors, and the tumor size did not increase during four- and nine-year observation periods. An adrenal myelolipoma is an important exception to the rule that large tumours should be removed. Untreated CAH with prolonged excessive ACTH stimulation might contribute to the growth of adrenal masses. CAH should be considered as a differential diagnosis of patients with adrenal masses or adrenal myelolipomas.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728610/
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oai:pubmedcentral.nih.gov:27286122009-08-31casrepmedpmc-open
A Case Report of Coronary-Subclavian Steal Syndrome Treated with Carotid to Axillary Artery Bypass
Al-Jundi, Wissam
Saleh, Aiman
Lawrence, Kathryn
Choksy, Sohail
Case Report
Coronary-subclavian steal syndrome results from atherosclerotic disease of the proximal subclavian artery causing reversal of flow in an internal mammary artery used as conduit for coronary artery bypass. This rare complication of cardiac revascularisation leads to recurrence of myocardial ischaemia. When feasible, subclavian angioplasty and/or stent placement can provide acceptable result for these patients. Vascular reconstruction through carotid to subclavian artery bypass has been the standard procedure of choice. Other interventions in literature include axilloaxillary bypass and subclavian carotid transposition. This case report describes the use of carotid axillary artery bypass for the treatment of coronary-subclavian steal syndrome.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728612/
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oai:pubmedcentral.nih.gov:27286132009-08-31casrepmedpmc-open
Tonic Pupil Following Pars Plana Vitrectomy and Endolaser
Ebrahim, Benyamin
Frohman, Larry
Zarbin, Marco
Bhagat, Neelakshi
Case Report
Tonic pupil was observed in a 67 year-old patient following a retinal detachment repair with pars plana vitrectomy, endolaser and silicone oil tamponade performed under retrobulbar anesthesia. The probable location of disturbance is the postganglionic parasympathetic fibers in the short ciliary nerves along their course to the pupil in the suprachoroidal space. A likely explanation for this phenomenon is injury to short ciliary nerves by endolaser treatment.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728613/
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oai:pubmedcentral.nih.gov:27286142009-08-31casrepmedpmc-open
Myopathy with Concurrent Tadalafil and Simvastatin
Gargante, Maria Pia
Vacante, Marco
Russo, Cristina
Malaguarnera, Mariano
Case Report
A 48-year-old man, using statin, was admitted to hospital with progressive myalgia after consumption of tadalafil and simvastatin. Muscle pain and penile erection disappeared seven days after interruption of therapy. This case demonstrates the interaction of tadalafil with simvastatin resulting in myopathy. Muscle damage could be attributed to the common metabolic way of these two drugs which is cytochrome P450 isoenzyme system.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728614/
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oai:pubmedcentral.nih.gov:27292372009-08-28casrepmedpmc-open
Traumatic Lumbosacral Dislocation Treated with Posterior Lumbar Interbody Fusion Using Intersomatic Cages
Tofuku, Katsuhiro
Koga, Hiroaki
Yone, Kazunori
Komiya, Setsuro
Case Report
A 35-year-old man was struck by a car on his right side and presented with paraparesis of both lower extremities. Radiographic examination revealed multiple transverse process fractures and anterior displacement of L5 on S1. Computed tomography revealed a bilateral anterior facet dislocation of the fifth lumbar vertebra on the sacrum. MRI showed rupture of the posterior ligamentous complex. A posterior lumbar interbody fusion using two intersomatic cages and pedicle screw instrumentation and posterior fusion were performed. Although no major disc lesion was found at the level of L5-S1 on preoperative MRI, a severely collapsed L5-S1 disc was found intraoperatively. Two years after surgery, the patient was asymptomatic with normal neurological findings, and has resumed normal activity. We believe that lumbosacral dislocation can be considered a three-column injury with an L5-S1 disc lesion, and, therefore, requires a solid circumferential segmental arthrodesis to improve fusion rate.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729237/
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oai:pubmedcentral.nih.gov:27292382009-09-01casrepmedpmc-open
Pleural FDG Uptake More Than a Decade after Talc Pleurodesis
Peek, Hilke
van der Bruggen, Wouter
Limonard, Gijs
Case Report
Talc pleurodesis induces a strong local inflammatory reaction which can be detected by PET scan for years after the procedure. When patients undergo PET scanning in the workup of a suspected malignancy later in life, pleural FDG uptake may unnecessarily lead to an additional invasive diagnostic workup. We present two cases of positive pleural PET findings more than 10 years after talc pleurodesis, where we adopted a watchful waiting approach. Positive pleural PET findings as a result of prior talc pleurodesis should always be included in the differential diagnosis of pleural abnormalities.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729238/
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oai:pubmedcentral.nih.gov:27292392009-08-31casrepmedpmc-open
Cronkhite-Canada Syndrome: Gastric Involvement Diagnosed by MDCT
Samet, Jonathan D.
Horton, Karen M.
Fishman, Elliot K.
Iacobuzio-Donahue, Christine A.
Case Report
Chronkhite-Canada is a rare nonfamilial polyposis syndrome that usually presents as chronic malabsorption in adults. We present a case of a-73-year old woman with chronic gastrointestinal bleeding and malnutrition. On CT imaging she was found to have massive gastric polyps, which on biopsy was most consistent with Cronkhite-Canada syndrome.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729239/
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oai:pubmedcentral.nih.gov:27292482009-08-31casrepmedpmc-open
Subarachnoid Hemorrhage Associated with Ventricular Fibrillation and Out-of-Hospital Cardiac Arrest
Fukushima, Hidetada
Nishio, Kenji
Okuchi, Kazuo
Case Report
Aneurysmal subarachonoid hemorrhage (SAH) is a common cause of out-of-hospital cardiac arrest (OHCA). Even after successful resuscitation, most of these SAH patients suffer brain death or enter a vegetative state. To our knowledge, survival without neurological damage from SAH following OHCA is quite a rare event. We treated a case of SAH who presented with OHCA and survived without neurological sequelae. A 50-year-old woman presented with ventricular fibrillation (VF), and was successfully resuscitated before hospital arrival. Since there was no evidence of acute coronary syndrome, a head CT scan was performed and established the diagnosis of SAH. On arrival, she was comatose, however, 3 hours after admission, her neurological status recovered. She underwent treatment for the ruptured aneurysms and was discharged from hospital without any neurological deficits.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729248/
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oai:pubmedcentral.nih.gov:27292492009-08-24casrepmedpmc-open
Central Retinal Vein Occlusion with Therapeutic Level of Anticoagulation
Salim, Sarwat
Lam, Wai-Ching
Hanna, Wahid
Case Report
Purpose. To describe a patient with two episodes of deep venous thrombosis and factor V Leiden mutation who presented with central retinal vein occlusion (CRVO) despite prophylactic use of
warfarin sodium (Coumadin). Methods. A case report of a 44-year-old woman with a history of recurrent deep venous thrombosis and Factor V Leiden mutation was placed on lifelong prophylactic therapy with warfarin. The patient presented
with CRVO in the left eye despite therapeutic levels of warfarin. Results. Extensive systemic
evaluation disclosed high titers for antinuclear antibody (ANA). Conclusion. Systemic anticoagulation with warfarin may not preclude further thrombotic episodes. In younger patients presenting with retinal vein occlusion and pre-existing multiple thrombophilic risk factors, a multidisciplinary approach is recommended to explore other therapeutic options to avoid further thromboembolic complications.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729249/
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oai:pubmedcentral.nih.gov:27292502009-08-28casrepmedpmc-open
Corrected Scoliosis, Cholinesterase Deficiency, and Cesarean Section: A Case Report
Somers, Roy
Jacquemyn, Yves
Sermeus, Luc
Vercauteren, Marcel
Case Report
We describe a patient with severe scoliosis for which corrective surgery was performed at the age of 12. During a previous caesarean section under general anaesthesia pseudocholinesterase deficiency was discovered. Ultrasound guided spinal anaesthesia was performed enabling a second caesarean section under loco-regional anaesthesia.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729250/
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oai:pubmedcentral.nih.gov:27292512009-08-28casrepmedpmc-open
Ease of Using a Dedicated Percutaneous Closure Device after Inadvertent Cannulation of the Subclavian Artery: Case Report
Devriendt, Arnaud
Tran-Ngoc, Emmanuel
Gottignies, Philippe
Castro-Rodriguez, José
Lomas, Oliver
Jamart, Sophie
Knecht, Sébastien
Case Report
Inadvertent puncture of the subclavian artery is a relatively frequent and potentially disastrous complication of attempted central venous access. Due to its noncompressible location, accidental subclavian arterial cannulation may result in hemorrhage as the sheath is removed. We report a new case of successful percutaneous closure of the subclavian artery which had been inadvertently cannulated, using a closure device based on a collagen plug (Angio-Seal, St. Jude Medical). This was performed in a patient who had received maximal antiplatelet and anticoagulation therapies because of prior coronary stenting in the context of cardiogenic shock. There was no prior angiographic assessment, as arterial puncture was presumed to have been distal to the right common artery and vertebral arteries. No complications were observed in this high-risk patient, suggesting that this technique could be used once the procedure has been evaluated prospectively.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729251/
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oai:pubmedcentral.nih.gov:27292522009-08-28casrepmedpmc-open
Prehospital Use of the Intubating Laryngeal Mask Airway in Patients with Severe Polytrauma: A Case Series
Mason, Andrew M.
Case Report
A case series of five patients is described demonstrating the utility of the intubating laryngeal mask airway in the prehospital setting, both as a primary airway rescue device and as a bridge to tracheal intubation. All patients were hypoxaemic, had sustained severe polytrauma and were trapped in their vehicles following road traffic collisions. A probability of survival study showed better-than-predicted outcomes for the group as a whole.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729252/
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oai:pubmedcentral.nih.gov:27292542009-08-28casrepmedpmc-open
Mood Disorder Due to a General Medical Condition with Manic Features
Oliveira, J. P.
Morais, S. L.
Araújo, D.
Carlotti, C. G.
Colli, B. O.
Crippa, J. A. S.
Cecílio Hallak, J. E.
Case Report
This case report describes a patient with manic and psychotic symptoms who had a history of neurocysticercosis and presented with an episode of hypertensive hydrocephalus in 2003. Despite her history, she was initially treated for primary psychiatric disease.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729254/
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oai:pubmedcentral.nih.gov:27292552009-08-31casrepmedpmc-open
Dislocation after Hemiarthroplasty due to Insufficiency Fracture of the Superior Acetabulum: A Case Report
Nozawa, Masahiko
Nishiura, Takashi
Maezawa, Katsuhiko
Matsuda, Keiji
Morio, Hidenori
Case Report
Insufficiency fracture of the superior part of the acetabulum after hemiarthroplasty has not been reported before. Here we report a case of dislocation after hemiarthroplaty due to insufficiency fracture of the acetabulum. In our patient, insufficiency fracture of the ilium immediately above the acetabulum produced obvious evidence of compression and collapse that led to dislocation of the outer head of the femoral component. This patient had subsequently been treated with a cementless socket inserted into the fractured acetabulum. We should remember the possibility of insufficiency fracture of the superior acetabulum after hemiarthroplasty, particularly in elderly patients suffering from chronic postoperative pain and disability.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729255/
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oai:pubmedcentral.nih.gov:27292642009-08-28casrepmedpmc-open
Myositis, Vasculitis, Hepatic Dysfunction in Adult-Onset Still's Disease
Yanai, Hidekatsu
Furutani, Nobuyuki
Yoshida, Hiroshi
Tada, Norio
Case Report
Although hepatic dysfunction is common in adult-onset Still's disease (AOSD), sometimes it is difficult to differentiate hepatic dysfunction due to AOSD itself from drug-induced hepatic dysfunction. Further, myalgia often occurs in patients with AOSD; however, AOSD patients complicated with myositis are rare. We report a 43-year-old Japanese man with AOSD who developed myositis and hepatic dysfunction which were deteriorated by multiple nonsteroidal antiinflammatory drugs (NSAIDs) and were dramatically ameliorated by a low-dose steroid therapy. A skin biopsy of salmon pink rash which is characteristic for AOSD showed leukocytoclastic vasculitis, and the markers for vasculitis, plasma von Willebrand factor, and vascular endothelial growth factor levels were elevated in this patient, suggesting an association between AOSD and systemic vasculitis.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729264/
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oai:pubmedcentral.nih.gov:27292732009-08-28casrepmedpmc-open
Breast Angiosarcoma Metastatic to the Ovary
Souza, Frederico F.
Katkar, Amol
den Abbeele, Annick D. Van
Dipiro, Pamela J.
Case Report
Ovarian masses are common findings in general gynecological practice. Approximately 5%–10% of ovarian malignancies are diagnosed as metastatic tumors. Primary angiosarcoma can arise anywhere in the body and when it arises in the breast, it usually affects women in their 3rd and 4th decades and accounts for one in 1700–2300 cases of primary breast cancer. Although unusual, breast angiosarcomas tend to metastasize hematogenously rather than lymphogenously, have high rates of local recurrence, that often develop metastases soon after treatment, and have a dismal prognosis. We present a case of a solitary ovarian metastasis from angiosarcoma of the breast.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729273/
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oai:pubmedcentral.nih.gov:27292742009-08-28casrepmedpmc-open
Severe Facet Joint Arthrosis Caused C7/T1 Myelopathy: A Case Report
Aizawa, Toshimi
Ozawa, Hiroshi
Hoshikawa, Takeshi
Kusakabe, Takashi
Itoi, Eiji
Case Report
Cervical myelopathy is caused by degenerative processes of the spine including intervertebral disc herniation and posterior spur usually developing at C3/4 to C5/6. C7/T1 single level myelopathy is very rare because of the anatomical characteristics. Facet joint arthrosis can be a cause of cervical myelopathy but only a few cases have been reported. The authors report an extremely rare case of C7/T1 myelopathy caused by facet joint arthrosis. A 58-year-old male presented with hand and gait clumsiness. The radiological examinations revealed severe C7/T1 facet joint arthrosis with bony spur extending into the spinal canal, which compressed the spinal cord laterally. The T1 spinous process indicated nonunion of a “clay-shoveler's” fracture, which suggested that his cervico-thoracic spine had been frequently moved, and thus severe arthrosis had occurred in the facet joints. A right hemilaminectomy of C7 and C7/T1 facetectomy with single level spinal fusion led to complete neurological improvement.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729274/
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oai:pubmedcentral.nih.gov:27292752009-08-28casrepmedpmc-open
Effective Monotherapy with Amrubicin for a Refractory Extrapulmonary Small-Cell Carcinoma of the Liver
Isobe, Taichi
Yanai, Shunichi
Kusaba, Hitoshi
Yada, Shinichiro
Kuroda, Yosuke
Tamiya, Sadafumi
Matsumoto, Takayuki
Baba, Eishi
Harada, Mine
Case Report
Small-cell carcinoma of the liver is a rare neoplasm, and no standard treatment for it has yet been established. A 72-year-old man with an extensive disease stage of small-cell carcinoma of the liver was treated with systemic chemotherapy consisting of cisplatin and etoposide (PE) followed by irinotecan. Although the masses were markedly decreased once after the sixth course of PE, amrubicin monotherapy as third-line chemotherapy was started because the hepatic masses had increased again. The administration of amrubicin was repeated in 8 courses with regression of the disease, resulting in a 26-month survival since the first-line chemotherapy was started. This is the first case report of a refractory EPSCC successfully treated with amrubicin.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729275/
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oai:pubmedcentral.nih.gov:27292762009-08-31casrepmedpmc-open
Benzylthiouracil-Induced Glomerulonephritis
Trimeche Ajmi, Sihem
Braham, Rim
Toumi, Sarra
Chadli Chaieb, Molka
Maaroufi, Amel
Ach, Koussay
Chaieb, Larbi
Case Report
Vasculitis is a rare complication of antithyroid drugs (ATDs). It was first described with Propylthiouracil (PTU). We report a new case of antineutrophil cytoplasmic antibody (ANCA) vasculitis with glomerulonephritis induced by Benzylthiouracile (BTU). A 50-year-old man with Graves disease treated with BTU developed general malaise and haematuria without skin rash or respiratory involvement. Laboratory data revealed acute renal failure with proteinuria and haematuria. An indirect immunofluorescence test for ANCA was positive, showing a perinuclear pattern with specificity antimyeloperoxidase (MPO). A renal biopsy was performed and revealed pauci-immune extracapillary glomerular nephropathy and necrotic vasculitis lesions. Based on these findings we concluded to the diagnosis of rapidly progressive glomerulonephritis associated with ANCA induced by BTU therapy. The drug was therefore discontinued and the patient was treated with steroids and immunosuppressive treatment during 3 months. Renal failure, proteinuria and haematuria significantly improved within 2 months. However, P-ANCA remained positive until 10 months after drug withdrawal. Thyroid function was kept within normal range using iodine solution. We demonstrated clearly that BTU may induce severe forms of vasculitis with glomerulonephritis. Thus, the ANCA must be measured when confronted to systemic manifestation during treatment.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729276/
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oai:pubmedcentral.nih.gov:27292882009-08-28casrepmedpmc-open
Survival Following Rectal Impalement through the Pelvic, Abdominal, and Thoracic Cavities: A Case Report
Moncure, Michael
Konie, Jared A.
Kretzer, Adam B.
DiPasco, Peter J.
Braxton, Carla C.
Case Report
Impalement injuries are a unique form of penetrating trauma and are typically associated with a fall onto the object (Steele, 2006). We present the case of a 45-year-old man who reportedly slipped in his bathtub and fell onto a broomstick. Radiographic examination revealed a slender mass extending from his rectum to the right side of his neck. A review of English literature suggests that this is the second reported case in the last 100 years describing the successful management of an impalement injury traversing the pelvic, abdominal, and thoracic cavities. The management of this case is described.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729288/
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oai:pubmedcentral.nih.gov:27292892009-08-26casrepmedpmc-open
Side-Alternating Vibration Training Improves Muscle Performance in a Patient with Late-Onset Pompe Disease
Khan, Aneal
Ramage, Barbara
Robu, Ion
Benard, Laura
Case Report
Side-alternating vibration training (SAVT) was used for 15 weeks in a patient with Late-onset Pompe disease who had never used enzyme replacement or chaperone therapy. Prior to the use of SAVT, the patient had experienced declining muscle performance and her 6-minute walk distance decreased from 210 to 155 metres in 6 months. After SAVT, her 6-minute walk distance increased 70% from 166 to 282 metres, muscle jumping power increased by 64% from 83 to 166 watts, isometric knee extensor strength increased 17% from 38 to 44 Nm, and she achieved a more normal pattern of ankle, knee, and joint kinematics and kinetics. Her functional ability measured through the Rotterdam 9-item score was unchanged at 19/36. There were no elevations in serum creatine kinase or lactate. This is the first report, to our knowledge, of a performance improvement in a patient with Pompe disease using SAVT.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729289/
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oai:pubmedcentral.nih.gov:27292902009-08-28casrepmedpmc-open
Recurrent Fistula between Ileal Pouch and Vagina—Successful Treatment with a Gracilis Muscle Flap
Aydin, Feride
Eisenberger, Claus Ferdinand
Raffel, Andreas
Rehders, Alexander
Hosch, Stefan Benedikt
Knoefel, Wolfram Trudo
Case Report
Fistulae between an ileal pouch and the vagina are an uncommon complication of ileal pouch-anal anastomosis following proctocolectomy and mucosectomy in patients with familial adenomatous polyposis coli. Several reports describe the successful use of muscle flaps to close recurrent pouch-vaginal-fistulae (PVF). However, series only contain small numbers and an optimal management has not yet been determined. We report the case of a 26-year old woman with a third recurrence of a PVF after proctocolectomy for treatment of familial adenomatous polyposis in October 2005. Because local approaches failed, definitive closure of the fistula was achieved by interposition of a gracilis muscle flap between the pouch-anal anastomosis and the vagina. The postoperative course was uneventful; the patient was discharged 7 days after surgery and remained free of recurrence and symptomatic complaints for 22 months now. The gracilis muscle flap proved to be an effective method in the treatment of recurrent PVF.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729290/
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oai:pubmedcentral.nih.gov:27292942009-08-28casrepmedpmc-open
Recurrent Villous Adenoma with High-Grade Dysplasia Arising in a Urethral Diverticulum
Zarineh, Alireza
Bulakhtina, Elena
Olson, Peter R.
Silverman, Jan F.
Case Report
Villous adenomas of the urinary tract are an uncommon, well-recognized entity, described in different locations. However, the occurrence of this lesion in the female urethral diverticulum is very unusual. We present the first case of a recurrent villous adenoma with high-grade dysplasia unassociated with adenocarcinoma, arising from a urethral diverticulum. A 75-year-old African-American female presented with urethral prolapse complaining of mild voiding difficulty, stress incontinence, and mild spotting of blood. Histological examination revealed a papillary lesion with finger-like processes lined by pseudostratified columnar epithelium with abundant goblet cells. There were focal areas with stratification to the luminal surface and loss of nuclear polarity and atypical mitoses, interpreted as villous adenoma with high-grade dysplasia. The lesion
recurred at one year without evidence of malignant transformation. We also present a brief literature review of urothelial villous adenomas.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729294/
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oai:pubmedcentral.nih.gov:27292952009-08-24casrepmedpmc-open
Suicidal Ideation Induced by Episodic Cannabis Use
Raja, Michele
Azzoni, Antonella
Case Report
The report describes a patient who presented suicidal ideation only in two different occasions, immediately after acute cannabis intoxication. He used cannabis only in these two circumstances. Although a definite association between cannabis use and suicidal ideation or behavior has been already reported in the literature, the described case presents two original clinical aspects that deserve consideration. First, episodic assumption of cannabis induced suicidal ideation abruptly. Second, suicidal ideation appeared independent of mood depression, stressors, or life events, suggesting that suicidality may be not a direct consequence of depression and appears to be a relatively independent psychopathological dimension.
There seems to be no linear relation between the severity of depression and the risk of suicide.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729295/
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oai:pubmedcentral.nih.gov:27293132009-08-28casrepmedpmc-open
Solitary Tibial Osteolytic Lesion
Pakos, Emilios E.
Gartzonikas, Dimitrios N.
Tsekeris, Pericles G.
Xenakis, Theodore A.
Case Report
We report an unusual case of solitary osteolytic tibial metastasis from a primary endometrial cancer in a 62-year-old woman. The primary cancer was treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy combined with postoperative external beam radiotherapy, while the tibial metastasis was treated with an above knee amputation. The rarity of the case lies on the fact that metastases distally to the elbow and knee are uncommon and endometrial cancer rarely gives distal bone metastases and particularly solitary to the extremities.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729313/
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oai:pubmedcentral.nih.gov:27293192009-08-28casrepmedpmc-open
Ovarian Teratoma Masquerading as a CSF Pseudocyst in a Female with a Ventriculoperitoneal Shunt
Mislow, John M. K.
Slotkin, Jonathan R.
Proctor, Mark R.
Case Report
Background. In today's fast-paced and high-acuity emergency departments, clinicians are often compelled to triage cases so rapidly that a differential diagnosis consistent with the history and physical examination is not comprehensive. Case Report. This case report describes the unexpected finding of a cystic ovarian neoplasm in a young female with an abdominal mass and a ventriculoperitoneal shunt, initially diagnosed as a cerebrospinal fluid pseudocyst. We use this case to illustrate that the astute clinician must always synthesize a diagnosis from all data sources and not to rely on initial radiographic evaluations. Conclusions. This remarkable case demonstrates that all differential diagnoses must be entertained in order to rapidly and accurately diagnose a patient with a cystic abdominal mass.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729319/
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oai:pubmedcentral.nih.gov:27293202009-08-28casrepmedpmc-open
Moyamoya Disease with Peripheral Pulmonary Artery Stenoses and Coronary Artery Fistulae
Reardon, Lindsay
Maree, Andrew O.
de Moor, Michael
Case Report
Moyamoya is a progressive disorder of the cerebral vasculature. Our report describes a rare case of Moyamoya disease with distal peripheral pulmonary artery stenoses and coronary fistulae in a 12-year-old Caucasian female patient.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729320/
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oai:pubmedcentral.nih.gov:27294232009-08-26casrepmedpmc-open
Cephalic Tetanus from Penetrating Orbital Wound
Guyennet, Eloïse
Guyomard, Jean-Laurent
Barnay, Emilie
Jegoux, Franck
Charlin, Jean-François
Case Report
Tetanus is a neurologic disorder caused by tetanospasmin, a protein toxin elaborated by Clostridium tetani. Cephalic tetanus is a localized form of the disease causing trismus and dysfunction of cranial nerves. We report the case of a man who presented with facial trauma, complete ophthalmoplegia, exophthalmos, areactive mydriasis, and periorbital hematoma. An orbital CT revealed air bubbles in the right orbital apex. The patient was given a tetanus toxoid booster and antibiotherapy. After extraction of a wooden foreign body, the patient developed right facial nerve palsy, disorders of swallowing, contralateral III cranial nerve palsy, and trismus. Only one case of cephalic tetanus from penetrating orbital wound has been reported in literature 20 years ago. When a patient presents with an orbital wound with ophthalmoplegia and signs of anaerobic infection, cephalic tetanus should be ruled out.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729423/
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oai:pubmedcentral.nih.gov:27294242009-08-28casrepmedpmc-open
Percutaneous Curettage and Continuous Irrigation for MRSA Lumbar Spondylodiscitis: A Report of Three Cases
Yamagami, Yoshiki
Shibuya, Sei
Komatsubara, Satoshi
Yamamoto, Tetsuji
Arima, Nobuo
Case Report
There has been a recent increase in pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus (MRSA) associated with an increasing number of compromised patients. As long as serious paralysis is absent, we recommend percutaneous curettage and continuous irrigation as an effective treatment for MRSA lumbar spondylodiscitis. Under local anesthesia, the affected lumbar discs were curetted using percutaneous nucleotomy, and tubes were placed for continuous irrigation. The period of continuous irrigation was generally 2 weeks. Infection was controlled after one procedure in two cases and after two procedures in one case. Postoperative radiography and magnetic resonance imaging (MRI) showed callus formation, normalized signal intensity in vertebral bodies, and regression of abscesses. Open surgery under general anesthesia has been considered risky in patients with poor performance status or old age. The present method, which is an application of needle biopsy, can be performed under local anesthesia and is minimally invasive.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729424/
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oai:pubmedcentral.nih.gov:27294252009-08-28casrepmedpmc-open
Salvage of Upper Limb following a Severe Crushing Trauma: Immediate Reconstruction with a Free Flap and Subsequent Hyperbaric Oxygen Therapy
Serra, M. P.
Longhi, P.
Case Report
A microsurgical latissimus dorsi flap was performed for resurfacing a large soft tissue defect of the forearm with exposure of the vital structures and contaminated wound. Early coverage of a defect is a generally accepted concept to achieve a better functional result. The authors present a case report where a free latissimus dorsi flap with subsequent hyperbaric oxygen therapy allowed a successful single stage reconstruction of this complex severely contaminated defect.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729425/
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oai:pubmedcentral.nih.gov:27294462009-08-28casrepmedpmc-open
Kimura's Disease
Guimaraes, Cláudia Savassi
Moulton-Levy, Natalie
Sapadin, Allen
Vidal, Claudia
Case Report
Kimuras disease is a chronic inflammatory disorder of unknown etiology. It is rare in the West, but endemic in Asia. It typically presents as solitary or multiple subcutaneous nodules, that slowly increase in size. The lesions are variably painful and pruritic. It often accompanied by regional lymphadenopathy, raised serum eosinophil counts, and markedly elevated serum immunoglobulin E levels. Histologically, the lesions are characterized by reactive lymphoid follicles with eosinophilic infiltration and an increased amount of postcapillary venules. The optimal treatment for KD remains controversial. Although the condition seldom resolves spontaneously, malignant transformation has not been reported to date, and the prognosis is good. We describe a male patient with a 4-year pruritic progressive “bump” in front of his left ear. On physical examination, the patient had 2 discrete lesions on the left side of his face near his ear. Postauricularly, there was a 3 × 5
cm erythematous to violaceous, indurated nodule. Preauricularly, there was a similar, but smaller cyst-like nodule. Punch biopsy showed a superficial and deep nodular and interstitial infiltrate, reactive lymphoid follicles with a dense infiltration of eosinophils and areas of eosinophilic follicle lysis. The patient received intralesional triamcinolone acetonide injections 10 mg/cc behind left ear with a good improvement.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729446/
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oai:pubmedcentral.nih.gov:27294472009-08-28casrepmedpmc-open
Nephrolithiasis Caused by Ceftriaxone in a 3-Year-Old Child with Ureteropelvic Junction Obstruction
Stojanovic, Vesna
Djuric Vijatov, Gordana
Case Report
We report the case of a 3-year-old boy with urinary tract malformation (left sided stenosis of the ureteropelvic junction) which was precipitating factor for ensuing nephrolithiasis of the left kidney during the therapy with ceftriaxone. The treatment with spasmolytics was initiated, together with the forced parentheral hydration. After 3 weeks, there was no evidence of calculi in the urinary tract.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729447/
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oai:pubmedcentral.nih.gov:27294482009-08-26casrepmedpmc-open
Eosinophilic Enteritis with Ascites in a Patient with Overlap Syndrome
Aslanidis, Spyros
Pyrpasopoulou, Athina
Soufleris, Kostas
Kazantzidou, Eirini
Douma, Stella
Case Report
Gastrointestinal involvement is frequent in patients with systemic lupus erythematosus (SLE). Eosinophilic gastroenteritis, however, has only rarely been described in rheumatological conditions, despite its reported connection to autoimmune diseases, such as hypereosinophilic syndrome, vasculitides, and systemic mastoidosis. It presents typically with abdominal pain and diarrhea and is only exceptionally associated with ascites. Diagnosis can be problematic, as several other clinical conditions (malignancies, infection/tuberculosis, and inflammatory bowel diseases) have to be ruled out. It is basically a nonsurgical disease, with excellent recovery on conservative treatment. We report the rare case of a young woman with overlap syndrome who presented with abdominal pain and ascites. The diagnosis of eosinophilic enteritis was made based on clinical, radiological, and laboratory criteria. The patient was treated with corticosteroids with excellent response.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729448/
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oai:pubmedcentral.nih.gov:27294502009-08-24casrepmedpmc-open
Echocardiographic Assessment of Ebstein's Anomaly in a 60-Year-Old Man
Palmerini, Elisabetta
Federici, Duccio
Del Pasqua, Alessia
Bernazzali, Sonia
Lisi, Matteo
Chiavarelli, Mario
Mondillo, Sergio
Case Report
We present an echocardiographic evaluation of an elderly man affected with Ebstein's anomaly. In the natural history of this congenital disease only 5% of patients survive beyond the fifth decade. The patient presented severe right heart failure and he was refered to our institution for heart transplantation.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729450/
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oai:pubmedcentral.nih.gov:27294682009-08-25casrepmedpmc-open
Successful Primary Treatment of a Hydatidiform Mole with Methotrexate and EMA/CO
De Vos, M.
Leunen, M.
Fontaine, C.
De Sutter, Ph.
Case Report
Background. The preferred treatment method of most hydatidiform moles is suction aspiration. In rare circumstances uterine abnormalities may preclude surgical treatment. Case. We report a case of complete molar pregnancy successfully treated with methotrexate followed by EMA/CO. A 38-year-old woman with a complete hydatidiform mole and multiple uterine fibroids underwent a failed attempt at suction aspiration. Following treatment with methotrexate, a nonmetastatic persistent trophoblastic tumour developed. Six cycles of EMA/CO led to complete remission. Conclusion. We propose that primary treatment of molar pregnancies with chemotherapy is a useful treatment option in cases where uterine abnormalities interfere with suction aspiration.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729468/
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oai:pubmedcentral.nih.gov:27294692009-08-26casrepmedpmc-open
Ectodermal Dysplasia with Amastia: A Case of One-Step Reconstruction
Klinger, M.
Caviggioli, F.
Banzatti, B.
Fossati, C.
Villani, F.
Case Report
Background. Female patients presenting amastia associated with ectodermal dysplasia are not frequently encountered, but they are of great clinical interest and surgically demanding. Traditionally, skin alterations related to Ectodermal Dysplasia have addressed plastic surgeons to perform a two-stage approach in amastia associated with this congenital pathologic condition. This article describes an alternative method for correcting this deformity trough a mammary reconstruction in one surgical stage. Materials and Methods. We report a case of 26-year-old female patient with bilateral amastia associated with ectodermal dysplasia. Amastia in this patient was treated with implantation of subpectoral silicone gel prostheses, without previously breast tissue expansion. Results. At 18 months of follow-up after surgey, there were no complications and excellent cosmetic results were achieved. Patient and surgeon satisfaction was high and the patient underwent a bilateral areola-tattoo. Conclusions. One-stage mammary reconstruction have showed to be a reliable and effective technique also when amastia is associated with Ectodermal Dysplasia, suggesting a still satisfying biomechanical performance of the skin in this pathology.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729469/
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oai:pubmedcentral.nih.gov:27294702009-08-28casrepmedpmc-open
Lipoma of the Uterine Corpus: Exceptional Eventuality Combined with an Ovarian Thecoma
Vilallonga, R.
García, A.
Castellví, J.
Fort, J. M.
Armengol, M.
Ramón y Cajal, S.
Case Report
Uterine lipomas are very uncommon with symptoms that are similar to leiomyomas. Their diagnosis is always histological although some radiological methods may suggest their existence prior to surgery. They are sometimes associated with endometrial pathology, but there are no previous reported cases related to ovarian thecoma. Their prognosis is excellent. Clinical, radiological, morphologic, and immunohistochemical findings are shown which correspond to uterine lipoma associated with endometrial polyps and ovarian thecoma.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729470/
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oai:pubmedcentral.nih.gov:27294712009-08-24casrepmedpmc-open
Successful Tricuspid Valve Replacement in a Patient with Severe Pulmonary Arterial Hypertension and Preserved Right Ventricular Systolic Function
Aboulhosn, Jamil A.
Oudiz, Ronald J.
Dave, Amish S.
Ardehali, Abbas
Ross, David J.
Case Report
A 56-year-old patient with severe pulmonary hypertension developed severe tricuspid regurgitation, right-sided heart failure, and congestive hepatopathy. She was transferred for possible lung transplant and/or tricuspid valve surgery. Clinical and echocardiographic assessment provided confidence that acute tricuspid valve failure was responsible for the decompensation and that tricuspid valve replacement despite pulmonary hypertension could be performed.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729471/
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oai:pubmedcentral.nih.gov:27294722009-08-24casrepmedpmc-open
Acute Cholecystitis Caused by Ceftriaxone Stones in an Adult
Becker, Christian D.
Fischer, Robert A.
Case Report
Acute cholecystitis is a major health problem. There are multiple etiologies to be considered and early recognition of the condition is important to optimize management and outcome. We report the first case in the medical literature of symptomatic acute cholecystitis triggered by ceftriaxone-associated gallbladder sludge formation and, importantly, solid ceftriaxone gallstone formation in an adult patient with underlying mineral and pigment cholecystolithiasis, necessitating cholecystectomy. This case serves as a reminder for physicians to keep this uncommon cause of cholecystolithiasis and cholecystitis in mind in patients who receive prolonged ceftriaxone therapy. These patients should be cautioned to promptly report to their physicians any signs or symptoms of cholecystitis in order to ensure timely and appropriate evaluation.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729472/
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oai:pubmedcentral.nih.gov:27294732009-08-25casrepmedpmc-open
Truths and Lies from the Polysomnography ECG Recording: An Electrophysiologist Perspective
Baranchuk, Adrian
Quinlan, Christina
Michael, Kevin
Simpson, Christopher S.
Redfearn, Damian P.
Fitzpatrick, Michael
Case Report
Polysomnography remains the gold standard for diagnosis of Sleep Apnea (SA) and evaluation of the apnea/hypopnea index (AHI) which is used as the primary index of SA severity. The electrocardiogram (typically a single lead) obtained during the polysomnographic study is usually used to report the association between SA and cardiac rhythm disturbances. These findings help in guiding medical decisions but they could also represent a source for confusion. Electrophysiologists are frequently consulted to determine whether interventions need to be taken. We present 2 cases where the ECG during a polysomnography study required the intervention of an electrophysiologist to help with management.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729473/
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oai:pubmedcentral.nih.gov:27294742009-08-25casrepmedpmc-open
Reimplantation of an Anomalous Coronary Artery Arising from the Pulmonary Artery
Quarti, Andrea
D'Alfonso, Alessandro
Colaneri, Massimo
Baldinelli, Alessandra
Bettuzzi, Maria Grazia
Pozzi, Marco
Case Report
A case of anomalous origin of the left coronary artery from the pulmonary artery in a patient with the origin of the coronary opposite to the aorta is reported. Between many surgical options we conclude to reestablish a double coronary system reconnecting the coronary through a conduit created with a pulmonary wall baffle and an autologous pericardial patch.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729474/
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oai:pubmedcentral.nih.gov:27294752009-08-26casrepmedpmc-open
Mitoxantrone Therapy for Acute Posterior Multifocal Placoid Pigment Epitheliopathy with Cerebral Vasculitis
Massé, Hélène
Guyomard, Jean-Laurent
Baudet, Dominique
Pinel, Jean-François
Edan, Gilles
Charlin, Jean-François
Case Report
Purpose. To report favorable outcome of a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) associated with cerebral vasculitis after treatment with immunosuppressive therapy by mitoxantrone. Design. Single case report. Method. A 22-year-old man presented with acute isolated bilateral loss of vision revealing APMPPE. Corticosteroid therapy was initiated and visual acuity gradually improved. Seventeen days later, visual function deteriorated again, associated with flu-like syndrome and severe headaches. A relapse of APMPPE was diagnosed, complicated with lymphocytic meningitis and cerebral ischemia. Intravenous therapy with mitoxantrone was performed in combination with methylprednisolone. Results. Headaches disappeared in a few days whereas visual acuity gradually improved and stabilized at 20/40 in the right eye and 20/32 in the left eye. No adverse event was observed. Clinical improvement was confirmed by magnetic resonance imaging. Conclusion. Cerebral vasculitis is the most severe complication of the extraocular manifestations of APMPEE. This diagnosis should be evoked when severe headaches or behavior disorder are associated with APMPEE.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729475/
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oai:pubmedcentral.nih.gov:27294852009-08-24casrepmedpmc-open
Elevated Aminotransaminases As the First Manifestation of Sarcoidosis
Nawfal, Georges
Budin, Christelle
Bouvier, Raymonde
Lachaux, Alain
Case Report
Sarcoidose is a rare disease in children. The aminotransaminase level is often normal to moderately elevated (2 to 3 folds of the normal level). We report the case of a child who presented an aminotransaminase level that was 10 times the normal level, as the first manifestation of sarcoidosis.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729485/
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oai:pubmedcentral.nih.gov:27294872009-08-24casrepmedpmc-open
Idiopathic Acquired Leukonychia in a 34-Year-Old Patient
Bongiorno, Maria Rita
Aricò, Mario
Case Report
We present a rare case of a 34-year-old patient with persistent, progressive, acquired leukonychia
totalis and partialis. Idiopathic acquired leukonychia is a rare chromatic disorder of the nail not associated with other abnormalities and discernible etiology. Our case report did not link the inheritance of leukonychia with diverse clinical syndromes. To our knowledge, only five cases of idiopathic, acquired, true total leukonychia were found in literature. This case was the sixth patient with asymptomatic idiopathic, white fingernails, and toenails without a hereditary cause.
Hindawi Publishing Corporation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729487/
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