scholarly journals Rare Skeletal Complications in the Setting of Primary Hyperparathyroidism

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Nikos Sabanis ◽  
Eleni Gavriilaki ◽  
Eleni Paschou ◽  
Asterios Kalaitzoglou ◽  
Dimitrios Papanikolaou ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Holistic Approach ◽  
Unique Case ◽  
Skeletal Involvement ◽  
Asymptomatic Patients ◽  
Skeletal Complications ◽  
History Of ◽  
Recurrent Nephrolithiasis ◽  
Previous Medical History

Parathyroid carcinoma represents an extremely rare neoplasm with diverse clinical manifestations which vary from asymptomatic patients to severe complications of hypercalcemia or parathyrotoxicosis while skeletal involvement is rather common. Herein we aimed at presenting a unique case of a young patient with rare aggressive skeletal complications of parathyroid cancer that initially were misdiagnosed. Ossification of the cervical ligamentum flavum and skull tumor illustrates erosive bonny lesions of hyperparathyroidism that in association with previous medical history of recurrent nephrolithiasis and biochemical findings guide the diagnosis. We suggest that increased awareness and holistic approach are needed in order to recognize and further investigate signs and symptoms of hyperparathyroidism.

scholarly journals A unique case of congenital transmesocolic hernia with malrotation in a 25-year-old female: a case report

2019 ◽  
Vol 2019 (10) ◽  
Author(s):  
Aghyad Kudra Danial ◽  
Muhamad Zakaria Brimo Alsaman ◽  
Rama Zazo ◽  
Muhammad Mazketly ◽  
Mohammad Nour Kitaz ◽  
...  
Keyword(s):  
Transverse Colon ◽  
Medical Literature ◽  
Clinical Manifestations ◽  
Previous Surgery ◽  
Unique Case ◽  
Rare Type ◽  
Unusual Phenomenon ◽  
History Of ◽  
Hernia Orifice ◽  
Ladd’S Procedure

Abstract Congenital transmesocolic hernia of the transverse colon is a very rare type of internal hernia. In addition, intestinal malrotation is very rare in adults. Most of these patients do not have clear clinical manifestations. Incidence of congenital transmesocolic hernia of the transverse colon along with malrotation is an unusual phenomenon in medical literature and clinical practice. Here, we report a unique case of a 25-year-old woman diagnosed with transmesocolic hernia of the transverse colon and malrotation of the small intestine, without any history of trauma or previous surgery. The patient underwent surgery, where the hernia orifice was closed and Ladd’s procedure was performed.

scholarly journals Clinical characteristics of COVID-19 in children compared with adults in Shandong, China

2020 ◽  
Author(s):  
Wenjun Du ◽  
Jinhong Yu ◽  
Hui Wang ◽  
Xiaoguo Zhang ◽  
Shouwei Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Health Workers ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Case Series ◽  
Signs And Symptoms ◽  
Asymptomatic Patients ◽  
Positive Indicators ◽  
Clinical Signs And Symptoms

Abstract Aims & Background: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment.Methods: Retrospectively, two research centers’ case series of 67 consecutive hospitalized cases including 14 children cases with COVID-19 between 23 Jan 2020 to 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared.Results: Most cases in children were mild(21.4%) and conventional cases(78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough(21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults(p=0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils counts did in children compared with adults(p=0.00).There was an elevated level of LDH(p=0.01) and a lower level of CRP(p=0.00)and IL-6(p=0.01) in children compared with adults. There were 8 (57.1%)asymptomatic cases and 6 (42.9%)symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients(p=0.03). Even among asymptomatic patients, 5(62.5%)cases had pneumonia including 3 (60%) cases with bilateral pneumonia, which was not different compared with that of asymptomatic cases(p=0.58, p=0.74).Conclusions: The clinical symptoms of children are mild, and the positive indicators of laboratory tests are rare, which may easily cause clinical misdiagnoses.

scholarly journals Severe primary hypothyroidism in an apparently asymptomatic 19-year-old woman: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Rania Dannan ◽  
Sulaiman Hajji ◽  
Khaled Aljenaee
Keyword(s):  
Incidental Finding ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Primary Hypothyroidism ◽  
Conflicting Evidence ◽  
Thyroid Function Testing ◽  
History Of ◽  
Asymptomatic Individuals ◽  
High Index Of Suspicion

Abstract Background Hypothyroidism is diagnosed on the basis of laboratory tests because of the lack of specificity of the typical clinical manifestations. There is conflicting evidence on screening for hypothyroidism. Case presentation We report a case of an apparently healthy 19-year-old Kuwaiti woman referred to our clinic with an incidental finding of extremely high thyroid-stimulating hormone (TSH), tested at the patient’s insistence as she had a strong family history of hypothyroidism. Despite no stated complaints, the patient presented typical symptoms and signs of hypothyroidism on evaluation. Thyroid function testing was repeated by using different assays, with similar results; ultrasound imaging of the thyroid showed a typical picture of thyroiditis. Treatment with levothyroxine alleviated symptoms and the patient later became biochemically euthyroid on treatment. Conclusion There is controversy regarding screening asymptomatic individuals for hypothyroidism; therefore, it is important to maintain a high index of suspicion when presented with mild signs and symptoms of hypothyroidism especially with certain ethnic groups, as they may be free of the classical symptoms of disease.

scholarly journals Right Cerebellar Tuberculosis with Cranial Nerve Palsy in Pulmonary Tuberculosis Patient

2021 ◽  
Vol 7 (2) ◽  
pp. 65
Author(s):  
I Komang Rusgi Yandi ◽  
Isnin Anang Marhana
Keyword(s):  
Young Adult ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Tuberculosis Patient ◽  
Public Health Issue ◽  
High Morbidity ◽  
Radiological Findings ◽  
Blurred Vision ◽  
History Of

Introduction: Tuberculosis (TB) is a major public health issue. The most devastating clinical manifestations of TB is Central nervous system (CNS) TB. CNS TB is found approximately in 1% of all patients with active TB, and cerebellar TB is rarely reported. CNS TB can present as meningitis, arachnoiditis, tuberculomas, or the uncommon forms of tuberculous subdural empyema and brain abscess.Case: A 23-year-old patient was reported in October 2018 with signs and symptoms of 2-month history of vertigo, headache, vomiting, weakness, fever, blurred vision, lingual palsy, dysmetria, and decrease of consciousness. The patient had a few months of history of cough, contact with a TB patient, his father, and loss of body weight. On admission, the patient had fever (38.50 C) and Glasgow coma score of 13.Discussion:  CNS TB can occur in an immunocompromised patient with malnutrition, whether a child or young adult. The patient in this case had risk factors because he is a young adult and had contact with a patient of TB, his father. Based on epidemiology, clinical signs and symptoms, radiological findings, and the result of AFB-stained sputum, the patient was diagnosed with right cerebellar TB and PTB.Conclusion: The high morbidity and mortality characteristics of CNS TB are very important to note, thus the prompt diagnosis and therapy should be done. The specific therapy of ATD combined with surgery seems to provide a good result. The clinical and radiological findings were used as the evaluation of the medication.

scholarly journals MUCOPOLYSACARIDOSIS TYPE IIIB MISDIAGNOSED AS AN AUTISTIC SPECTRUM DISORDER: A CASE REPORT AND LITERATURE REVIEW

2021 ◽  
Vol 39 ◽  
Author(s):  
Alan Tibério Dalpiaz Irigonhê ◽  
Angélica Malman Thomazine Moreira ◽  
Daniel Almeida do Valle ◽  
Mara Lúcia Schmitz Ferreira Santos
Keyword(s):  
Rare Case ◽  
Autistic Spectrum Disorder ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Behavioral Changes ◽  
Case Description ◽  
Diagnostic Challenge ◽  
Metabolic Investigation ◽  
History Of ◽  
Established Treatment

ABSTRACT Objective: To report a rare case of mucopolysaccharidosis IIIB in a pediatric patient, with emphasis on the description of the clinical manifestations and the early diagnosis. Case description: A 14-year-old male patient, who presented regression of neuropsychomotor development since his three years and six months old, with speech loss and frequent falls, evolving with behavioral changes, with agitation and aggressiveness. Although being diagnosed with autism, there was no response to the established treatment; he was subsequently submitted to metabolic investigation, which lead to the diagnosis of Mucopolysaccharidosis IIIB. Comments: Identifying a metabolic disorder requires connecting multiple signs and symptoms, as well as eliminating other apparent causes. MPS IIIB is a diagnostic challenge, particularly in the early stages and in the absence of a family history of the disease.

scholarly journals Gluten Sensitivity Presenting as a Neuropsychiatric Disorder

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Stephen J. Genuis ◽  
Rebecca A. Lobo
Keyword(s):  
Scientific Literature ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Sole Source ◽  
Medical Community ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Neuropsychiatric Manifestations ◽  
History Of ◽  
Pathophysiologic Mechanisms

There has been increasing recognition in the medical community and the general public of the widespread prevalence of gluten sensitivity. Celiac disease (CD) was initially believed to be the sole source of this phenomenon. Signs and symptoms indicative of nonceliac gluten sensitivity (NCGS), in which classical serum and intestinal findings of CD may be absent, have been frequently reported of late. Clinical manifestations in patients with NCGS are characteristically triggered by gluten and are ameliorated or resolved within days to weeks of commencing a gluten-free diet. Emerging scientific literature contains several reports linking gluten sensitivity states with neuropsychiatric manifestations including autism, schizophrenia, and ataxia. A clinical review of gluten sensitivity is presented alongside a case illustrating the life-changing difference achieved by gluten elimination in a patient with a longstanding history of auditory and visual hallucinations. Physicians in clinical practice should routinely consider sensitivity issues as an etiological determinant of otherwise inexplicable symptoms. Pathophysiologic mechanisms to explain the multisystem symptomatology with gluten sensitivity are considered.

scholarly journals SARCOIDOSIS IN MILITARY PERSONNEL: BASES OF DIAGNOSTICS, TREATMENT AND FOLLOW-UP

2019 ◽  
Vol 5 (4) ◽  
pp. 7-14
Author(s):  
A. A. Zaitsev ◽  
A. A. Wiesel ◽  
D. N. Antipushina
Keyword(s):  
Military Personnel ◽  
Military Service ◽  
Clinical Manifestations ◽  
Law Enforcement Agencies ◽  
Factors Associated ◽  
Asymptomatic Patients ◽  
Unified Algorithm ◽  
History Of ◽  
Diffusion Function ◽  
The Military

Sarcoidosis is an urgent problem for the military medical service of various law enforcement agencies. In recent years, there has been an increase in the incidence of sarcoidosis among young people undergoing military service and the creation of a unified algorithm of medical care for this contingent is important. The publication presents the epidemiology of the disease, known risk factors, and triggers for the development of sarcoidosis in military sailors. The most important factors associated with a high risk of sarcoidosis are: high dustiness of the air, diesel and rocket fuel vapors, and various types of radiation. In military personnel, the second stage of sarcoidosis is most common. The recurrence rate of the disease is 20%, and the factors associated with the recurrent course of sarcoidosis in military personnel are — the age of more than 35 years; the presence of clinical manifestations of sarcoidosis (cough, weakness, shortness of breath); forced lung capacity <85%; a history of systemic glucocorticosteroids. The article presents the recommended algorithm and methods for examining patients with sarcoidosis. It is noted that the main point is the mandatory morphological verification of the process in the military. Special attention is paid to the treatment of sarcoidosis in the publication. It is noted that, given the high frequency of remissions, treatment is not indicated for stage I, as well as for asymptomatic patients with stages II and III of sarcoidosis, provided that only mild disorders of the ventilation and diffusion function of the lungs are present. All patients with sarcoidosis are subject to active medical supervision.

Primer on Multiple Sclerosis

2016 ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Professionals ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Diagnostic Strategies ◽  
History Of ◽  
Clinical Signs And Symptoms ◽  
Nursing Health

Primer on Multiple Sclerosis, second edition is designed to be a practical guide to the basic science and clinical manifestations of multiple sclerosis. It is intended primarily for neurologists and other health care professionals who treat persons with this disease. The book starts with a review of the history of multiple sclerosis and the basic genetics, immunology, electrophysiology, and pathophysiology that are central to the disease. It then reviews the common and uncommon clinical signs and symptoms of multiple sclerosis and the management of these conditions. The latest diagnostic strategies are presented. There is extensive coverage of approved and experimental disease-modifying therapies, including algorithms to assist clincians in choosing these therapies. Complementary and alternative therapies that are popular among persons with multiple sclerosis are examined. New additions to this edition include a chapter for nursing health care professionals, and updates on therapeutics. Unique to this book are the chapters on the legal, psychosocial, and vocational issues that often present challenges for person with multiple sclerosis, topics that typically are not covered in standard texts.

scholarly journals Clinical manifestations of allergic rhinitis in children at Denpasar Hospital

2001 ◽  
Vol 41 (3) ◽  
pp. 160
Author(s):  
Gary Adhianto ◽  
Hendra S
Keyword(s):  
Allergic Rhinitis ◽  
Atopic Dermatitis ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Allergic Diseases ◽  
Prick Test ◽  
Pediatric Allergy ◽  
The Family ◽  
History Of ◽  
Reported Data

This is a retrospective study by collecting data from the medical record of children diagnosed as allergic rhinitis at the Pediatric Allergy & Immunology out patient clinic at Denpasar Hospital between January 1996 and December 2000. Reported data including identifying patient, signs and symptoms, atopic history of the family, skin prick test (SPT) result and the environmental factors. Fifty-five from 297 children (18.5%) attending the Pediatric Allergy & Immunology out patient clinic were diagnosed as allergic rhinitis. Thirty nine were male and 16 female. The age ranged from 6 months to 15 years old. The majority of signs and symptom were sneezing and rhinorrhea (26%), itchy nose (23%), blocked nose (14%) and itchy eyes(12%).. Four children had history of atopic dermatitis, 1 food allergy, 10 asthma, 3 urticaria, 2 drug allaaaergy, 4 h-ad history of both atopic dermatitis and urticaria, 13 both asthma and urticaria, 2 both asthma and drug allergy and 6 children had no history of allergic diseases. Thirty three (60%) one of the parents and 12 (21.8%) both parents ever had allergic diseases. According to SPT, 27 (55.1%) of this children had positive reaction to inhalant allergen, 13 (26.5%) to food allergen and 13 (26.5%) had negative reaction.

scholarly journals Clinical phenotypes of primary hyperparathyroidism in hospitalized patients who underwent parathyroidectomy

2021 ◽  
Author(s):  
Liubov G. Yanevskaya ◽  
Tatiana Karonova ◽  
Ilya V Sleptsov ◽  
Marina Evgenevna Boriskova ◽  
Aluza Ramilevna Bakhtiyarova ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Final Analysis ◽  
Urinary Calcium ◽  
Imaging Data ◽  
Ipth Level ◽  
Skeletal Involvement ◽  
Symptomatic Disease ◽  
Saint Petersburg ◽  
Medical Centers ◽  
Asymptomatic Patients

Objective. The aim of our study was to investigate the distribution of the PHPT clinical manifestations and biochemical features in patients who underwent parathyroidectomy. Materials and methods. Medical records of 449 patients from three Medical Centers (Saint-Petersburg, Russia), hospitalized during a period from 2011 to 2018, were reviewed. History and anthropometric data, laboratory results (iPTH, total and  iCa, phosphorus, ALP, 24-h urinary calcium, 25(OH)D) and imaging data (ultrasonography, scintigraphy, CT/MRI scan, DXA) were analyzed. Results. Three hundred ninety-four patients were included in the final analysis. Median age was 60 years with 94.2 % being women. Symptomatic disease was evident in 222 (56.4%) patients, asymptomatic in 172 (43.6%). Skeletal involvement was more common for women, while frequency of other manifestations did not differ in both genders. There was no difference between symptomatic and asymptomatic patients in age. Serum iPTH level was higher in symptomatic patients (202.9 and 181.0 pg/ml, p=0.022). Serum 25(OH)D level was estimated in few patients and negatively correlated with PTH (r= -0.294, p=0.005), iCa (r= -0.268, p=0.010) and total Ca (r= -0.284, p=0.014) levels. Manifestations of CVD were observed in 67.7% of cases and affected equally both symptomatic and asymptomatic patients (70.7% and 63.4%, p=0.076). Both age and BMI were higher in patients with CVD, whether or not they were symptomatic (62 and 53 years, p<0.0001; 30.4 vs 26.0 kg/m2, p<0.0001, respectively). Conclusions. This experience illustrates that symptomatic phenotype is still the most common form of PHPT.

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