scholarly journals An Unusual Case of Subclinical Peripheral Neuropathy and Cervical Spondylosis in Atopic Myelitis

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Alev Leventoglu ◽  
Pelin Ozlu ◽  
Ferda Ince
Keyword(s):  
Unusual Case ◽  
Elevated Serum ◽  
Total Serum ◽  
Disc Disease ◽  
Degenerative Arthritis ◽  
Laboratory Findings ◽  
Serum Ige ◽  
Elevated Protein ◽  
History Of ◽  
Elevated Protein Level

Many cases of atopic myelitis have been reported in Japan; however very few were described in western countries. An 82-year-old woman with a past medical history of atopic dermatitis and asthma presented with progressive paresthesia (tingling) of both hands and tetraparesis. Before the onset of neurological symptoms, she complained of ichthyosis of both legs for 5 weeks. Magnetic resonance imaging demonstrated multisegmental degenerative arthritis, degenerative disc disease, and abnormal spinal cord signal intensity over several cervical segments, suggesting the diagnosis of myelitis. Total serum IgE level was elevated. Nerve conduction studies revealed asymmetric axonal sensorimotor neuropathy. The cerebrospinal fluid specimen showed lymphocytic pleocytosis and elevated protein level. Based on clinical, imaging, and laboratory findings, atopic myelitis was diagnosed. The diagnosis of atopic myelitis should be considered in myelopathy patients with history of atopy and elevated serum IgE levels.

scholarly journals Total serum IgE and parasite: specific IgG and IgA antibodies in human strongyloidiasis

1993 ◽  
Vol 35 (4) ◽  
pp. 361-365 ◽  
Author(s):  
Cláudio L. Rossi ◽  
Emilia E. H. Takahashi ◽  
Cláudia D. Partel ◽  
Lívia G.V.L. Teodoro ◽  
Luiz J. da Silva
Keyword(s):  
Elevated Serum ◽  
Clinical Manifestations ◽  
Case Series ◽  
Total Serum ◽  
Igg Antibodies ◽  
Serum Ige ◽  
Iga Antibodies ◽  
Specific Igg ◽  
Mean Concentration ◽  
Specific Igg Antibodies

Total serum IgE, and Strongyloides - specific IgG and IgA antibodies were studied in 27 patients with parasitologically proven strongyloidiasis. Clinical manifestations in this case series were investigated by a restrospective study of the patient's records. Total serum IgE levels were elevated (greater than 250 IU/ml) in 59% of the patients (mean concentration = 1364 IU/ml). Parasite - specific IgG and IgA antibodies were detected by ELISA in the serum of 23 (85.2%) and 21 (77.8%) patients, respectively. Elevated serum IgE and clinical manifestations were not useful indexes of the presence of strongyloidiasis. On the other hand, our results support the view that serologic tests, particularly ELISA for detecting Strongyloides - specific IgG antibodies, can be usefully exploited for diagnostic purposes in strongyloidiasis.

Pyoderma Vegetans

2001 ◽  
Vol 5 (3) ◽  
pp. 223-227 ◽  
Author(s):  
Anthony J. Papadopoulos ◽  
Robert A. Schwartz ◽  
Rajendra Kapila ◽  
Joseph A. Samady ◽  
Zbigniew Ruszczak ◽  
...  
Keyword(s):  
Pyoderma Gangrenosum ◽  
Hidradenitis Suppurativa ◽  
Fungal Infections ◽  
Elevated Serum ◽  
Rare Condition ◽  
Rare Disorder ◽  
Serum Ige ◽  
Histological Criteria ◽  
History Of ◽  
Criteria For Diagnosis

Background: Pyoderma vegetans is a rare condition that is clinically characterized by large verrucous plaques with elevated borders and multiple pustules. The etiology of this disorder remains unknown. Objectives: We describe a 24-year-old woman with rapidly evolving pyoderma vegetans. Our patient had the unique additional findings of a highly elevated serum IgE level and a history of hidradenitis suppurativa. Conclusions: Pyoderma vegetans is diagnosed on clinical and histological criteria. Differentiation must be made from disorders such as pyoderma gangrenosum, Sweet's syndrome, and deep fungal infections. We illustrate a case of pyoderma vegetans and review the literature on this rare disorder. Clinical and histological criteria for diagnosis are presented, as well as differentiation from some mimicking disorders.

scholarly journals Ehrlichia Meningoencephalitis: A Case Series

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Morena J ◽  
◽  
Antimisiaris M ◽  
Singh D ◽  
◽  
...  
Keyword(s):  
Elderly Patients ◽  
Direct Detection ◽  
Case Reports ◽  
Case Series ◽  
Suspected Case ◽  
Severe Thrombocytopenia ◽  
Laboratory Findings ◽  
Elevated Protein ◽  
History Of

Objective: We present the distinct clinical and laboratory findings in two cases of Ehrlichia meningoencephalitis, along with one suspected case. Background: The number of cases of Ehrlichia chaffeensis reported to the CDC has more than doubled from 2007-2017. A PubMed literature search using the words “Ehrlichiosis and meningoencephalitis” revealed five case reports with neurologic manifestations. Design/Methods: This is a retrospective observational study. Two elderly patients presented with encephalopathy, fever, transaminitis, thrombocytopenia, a positive E. chaffeensis Polymerase Chain Reaction (PCR) in Serum, and Cerebrospinal Fluid (CSF) with a lymphocytic or neutrophilic pleocytosis and elevated protein. One patient had similar symptoms and a positive E. chaffeensis PCR, but lumbar puncture was unable to be performed due to severe thrombocytopenia. They presented in May or June. Doxycycline was started within 2-3 days after presentation to the hospital. Follow up five months later revealed all patients were close, or back to baseline. Results and Conclusions: Suspicion of Ehrlichia meningoencephalitis should be raised in elderly patients presenting with fever and encephalopathy in the summer season with history of tick bite or residence in wooded areas. Thrombocytopenia and transaminitis should raise further suspicion. CSF studies typically show a lymphocytic pleocytosis and elevated protein. PCR technique allows for direct detection of pathogen-specific DNA and is the preferred method of detection during the acute phase of illness. Prompt treatment with doxycycline results in good outcomes. Doxycycline is not included in the typical meningitis regimen, therefore, this disease is important to quickly identify as delay in Doxycycline can result in worse outcomes.

scholarly journals 474 Relationship Between Total Serum IgE, Atopy, and Obesity in Children With or Without Family History of Atopic Disease

2012 ◽  
Vol 5 ◽  
pp. S150-S151
Author(s):  
Budi Setiabudiawan ◽  
Reni Ghrahani ◽  
Gartika Sapartini ◽  
Putria Rayani ◽  
Citra Amelinda ◽  
...  
Keyword(s):  
Family History ◽  
Atopic Disease ◽  
Total Serum ◽  
Serum Ige ◽  
History Of ◽  
Obesity In Children

scholarly journals Recurrent Graves’ hyperthyroidism after prolonged radioiodine-induced hypothyroidism

2017 ◽  
Vol 8 (7) ◽  
pp. 111-115 ◽  
Author(s):  
Fariha Salman ◽  
Hooman Oktaei ◽  
Solomon Solomon ◽  
Ebenezer Nyenwe
Keyword(s):  
Unusual Case ◽  
Cost Effective ◽  
Thyroid Stimulating Hormone ◽  
Free Triiodothyronine ◽  
Laboratory Findings ◽  
Total Thyroxine ◽  
Ventricular Response ◽  
History Of ◽  
Irregular Pulse ◽  
Recurrent Hyperthyroidism

Background: Radioactive iodine (RAI) is the most cost effective therapy for Graves’ disease (GD). Patients with GD who have become hypothyroid after therapeutic RAI, rarely develop recurrence of disease. Herein we describe a case of recurrence of thyrotoxicosis after 2 years of hypothyroidism. Methods: We present the clinical features, laboratory findings, imaging and management of an unusual case of recurrent hyperthyroidism. Results: A 48-year-old male presented to the emergency room with a 2-day history of palpitation, chest discomfort and 30 pounds of weight loss. Examination was remarkable for rapid and irregular pulse, diffuse thyromegaly and brisk deep tendon reflexes but no eye changes or tremors. Laboratory tests showed thyroid-stimulating hormone (TSH) of <0.004 (0.3–5.6 mIU/ml), free thyroxine (FT4) 4.96 (0.9–1.8 ng/dl), free triiodothyronine (FT3) >20 (1.8–4.7 pg/ml), total thyroxine >800 (80–200 ng/dl). Electrocardiogram showed atrial fibrillation with rapid ventricular response. RAI uptake and scan showed a homogenous gland with 54% uptake in 6 h and 45% in 24 h. He was treated with propranolol and propylthiouracil with some clinical improvement. He subsequently underwent RAI therapy and developed hypothyroidism after 8 weeks. Hypothyroidism was treated with levothyroxine. At 2 years after RAI ablation, he again developed symptoms of hyperthyroidism and had suppressed TSH. The levothyroxine dose was stopped, 3 weeks after discontinuing levothyroxine, he remained hyperthyroid with TSH of 0.008 and FT4 of 1.62 and FT3 of 4.8. RAI uptake demonstrated 17% uptake at 24 h. Conclusion: Recurrent hyperthyroidism in GD is uncommon after development of post-ablative hypothyroidism. Our case illustrates the need for continued surveillance.

scholarly journals IgA nephropathy with diffuse alveolar haemorrhage

2018 ◽  
Vol 11 (1) ◽  
pp. e227382 ◽  
Author(s):  
Shinichi Miyazaki ◽  
Akiko Hattori ◽  
Yasumasa Kuno ◽  
Takuya Ikeda
Keyword(s):  
Iga Nephropathy ◽  
Elevated Serum ◽  
Pulmonary Complications ◽  
Alveolar Haemorrhage ◽  
Good Effect ◽  
Diffuse Alveolar Haemorrhage ◽  
Laboratory Findings ◽  
Primary Glomerulonephritis ◽  
History Of ◽  
Pulmonary Renal Syndrome

Immunoglobulin (Ig)A nephropathy is the most common cause of primary glomerulonephritis worldwide. While IgA nephropathy has been associated with a variety of other diseases, pulmonary complications are extremely rare. A 58-year-old man presented with a 2-week history of fever and exertional dyspnoea. A chest imaging revealed bilateral consolidation predominantly in upper lungs. Laboratory findings showed elevated serum creatinine with proteinuria and haematuria. Flexible bronchoscopy revealed diffuse alveolar haemorrhage, and IgA nephropathy was confirmed on a renal biopsy. He received prednisone with good effect. This case highlights the need to consider IgA nephropathy in the differential diagnosis of pulmonary renal syndrome.

scholarly journals Epithelioid haemangioendothelioma – A rare cause of pleural effusion

Pneumologia ◽  
2021 ◽  
Vol 69 (4) ◽  
pp. 248-255
Author(s):  
Ana Constantin ◽  
Anca Macri ◽  
Florin Dumitru Mihălțan
Keyword(s):  
Pleural Effusion ◽  
Signs And Symptoms ◽  
Rare Tumour ◽  
Antituberculous Treatment ◽  
Elevated Protein ◽  
Initial Symptoms ◽  
Vascular Origin ◽  
History Of ◽  
Elevated Protein Level ◽  
Epithelioid Haemangioendothelioma

Abstract We present the case of a 44-year-old patient, with a history of lymphatic tuberculosis, diagnosed with a pleural effusion associated with pulmonary consolidations. Pleural effusions are frequent in the general population, presenting an incidence of 3–4 cases/1000 people. The etiological diagnosis can be difficult, as they can be secondary to a variety of diseases. Numerous extrapulmonary disorders can explain fluid accumulations in the pleural space with elevated protein level (exudates). However, more frequently they are the result of pulmonary diseases – inflammatory, infectious or neoplastic. The case entailed a differential diagnosis between pulmonary and pleural tuberculosis and neoplastic diseases. Despite receiving antituberculous treatment, the patient’s initial symptoms worsen, the patient starts presenting new signs and symptoms, and the fluid’s characteristics change – expression of an unfavourable evolution. Establishing the diagnosis proved to be difficult as invasive procedures were necessary. We diagnosed an extremely rare tumour, of vascular origin as the cause of the pleural effusion. Epithelioid haemangioendothelioma (EHE) presents an incidence of 1 in 1 million people. In conclusion, when treating a patient for pleural effusion, the lack of improvement entails reconsidering the initial diagnosis and performing more extensive tests.

scholarly journals An Unusual Case of Anti-GBM Antibody Elevation in HIV-Associated Nephropathy

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Vinay Minocha ◽  
Raafat Makary ◽  
Andreea Poenariu
Keyword(s):  
Hiv Infection ◽  
Unusual Case ◽  
Elevated Serum ◽  
Kidney Injury ◽  
African American Female ◽  
Case Presentation ◽  
A Value ◽  
Biopsy Confirmation ◽  
History Of ◽  
Nephrotic Range Proteinuria

Introduction.The most commonly seen glomerular disease in HIV infected patients is HIV-associated nephropathy (HIVAN); however, a multitude of other nephropathies can occur in HIV infection with an almost equal cumulative frequency. We report an unusual case of a patient with clinical and histological evidence of HIVAN in which the diagnosis was initially confounded by the finding of an elevated serum anti-glomerular basement membrane (anti-GBM) antibody.Case Presentation.We present a case of a 27-year-old African American female with a history of schizophrenia, cocaine abuse, and HIV infection who upon admission to our hospital was found to have severe acute kidney injury requiring hemodialysis. Urine studies revealed nephrotic range proteinuria and a serological workup was positive for anti-GBM antibody elevation with a value of 91 units (normal: 0–20 units). A renal biopsy revealed HIVAN with no evidence of crescentic glomerulonephritis or anti-GBM disease.Conclusion.This case highlights the need for careful interpretation of anti-GBM antibody tests in HIV infected patients with kidney disease and, in particular, the need for biopsy confirmation of the diagnosis prior to starting therapy. More research is needed to study the prognostic correlation between the degree of anti-GBM antibody elevation in HIVAN and disease severity.

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