scholarly journals Chronic Paronychia and Onychomadesis in Pemphigus Vegetans: An Unusual Presentation in a Rare Autoimmune Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Thanisorn Sukakul ◽  
Supenya Varothai
Keyword(s):  
Autoimmune Disease ◽  
Rare Variant ◽  
Clinical Presentation ◽  
Final Diagnosis ◽  
Direct Immunofluorescence ◽  
Unusual Manifestation ◽  
Blood Tests ◽  
Immunofluorescence Studies ◽  
Elisa Technique ◽  
Pemphigus Vegetans

Pemphigus vegetans is a rare variant of deep acantholytic pemphigus which usually presents with vesiculobullous rash and vegetative plaques on the folds. We report a case of pemphigus vegetans patient who presented with rashes on tips of fingers and toes resembling paronychia and onychomadesis that misled the diagnosis for months. The final diagnosis of Hallopeau-type pemphigus vegetans was made based on histopathology and direct immunofluorescence studies. Interestingly, not only the clinical presentation was atypical, but blood tests for anti-desmoglein 1 and 3 antibodies by ELISA technique were also negative. Thus, the rare unusual manifestation of pemphigus vegetans in this patient may associate with different autoantibodies to desmosomal proteins compared with those of classic pemphigus patients.

scholarly journals Clinical Presentation and Treatment Outcome of Abdominal Tuberculosis

2014 ◽  
Vol 15 (2) ◽  
pp. 131-134
Author(s):  
Oliur Rahman ◽  
Anwarul Kabir ◽  
Prodip Kumar Biswas ◽  
AMM Shoriful Islam ◽  
AB Siddik ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Clinical Presentation ◽  
Abdominal Distension ◽  
Abdominal Tuberculosis ◽  
Final Diagnosis ◽  
Drop Out ◽  
Low Grade ◽  
College Hospital ◽  
Abdominal Lymph Node ◽  
Female Ratio

Background: Tuberculosis is common in our country. It commonly affects the lungs but in up to one third of the cases involve other organs. Abdominal tuberculosis is one of the important extrapulmonary tuberculosis.It has varied presentation, frequently mimicking other common and rare diseases. Materials and Methods:It is a prospective observational study done to see the clinical presentation and treatment outcome of abdominal tuberculosis in medicine, surgery and gastroenterology department Sylhet M A G Osmani Medical College Hospital during Jan 2008-Dec2008. Sample was collected purposively. All patients were undergone detailed history, clinical examination, relevant investigation and follow up till the end of six months anti tubercular chemotherapy.Data recorded in predesigned record form. Statistical analysis was done with SPSS software. All data presented as percentage or mean. Result: From the 50 cases of abdominal TB, 26 (52%) were male and 24 (48%) were female. Male and female ratio was 1.04:1. Here most of the patients were in the age of 21-30 years and mean age was 29.3 years,majority of them were from poor socioeconomic status(18%) had associated pulmonary tuberculosis.The common presentation exhibited by the patients were weight loss (100%), low grade fever (88%), abdominal pain (86%), bowel disturbance (84%), anorexia (80%), nausea and vomiting (70%), abdominal distension (46%), , ascites (42%).Most of the patients were anaemic with raised ESR.Ultrasonography revealed ascites,abdominal lymphadenopathy and thick walled bowel. Colonoscopy found nodularity and ulceration with narrowing. Ascitic fluid was exudative with predominant lymphocyte count. Laparoscopy and laparotomy revealed tubercle on the intestine and the mesentery with thickening and bowel stricture. All the biopsy reports were consistent with tuberculosis. Site of involvement in decreasing frequency were ileocaecal (44%), peritoneal (16%), abdominal lymph node (8%), ascending colon (8%), small bowel (6%),transverse colon (4%), sigmoid colon (2%), rectum (2%), gastric (2%) and duodenal (2%) but multiple site in 6%.The treatment was given as per the WHO guidelines with category I drugs and found- 86% cured with anti TB alone, 4% needed surgery for intestinal obstruction along with anti TB, and 10% drop out from follow up.Conclusion:The clinical presentations of abdominal TB appear not specific for the condition. Thus, careful approach and supportive results are required in order to issue the final diagnosis. If diagnosed early, it can be treated successfully with the conventional anti-TB drugs. DOI: http://dx.doi.org/10.3329/jom.v15i2.20686 J MEDICINE 2014; 15 : 131-134

Arthroscopy-Assisted Retrograde Drilling of Osteochondral Lesions of the Talar Dome

2005 ◽  
Vol 95 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Scott C. Nelson ◽  
Darryl M. Haycock
Keyword(s):  
Clinical Presentation ◽  
Osteochondral Lesion ◽  
Final Diagnosis ◽  
Osteochondral Lesions ◽  
Resonance Imaging ◽  
Talar Dome ◽  
Advanced Imaging ◽  
Retrograde Drilling ◽  
High Index Of Suspicion

Traumatic ankle conditions can lead to long-term sequelae if a pathologic process is misdiagnosed. The clinical presentation of an osteochondral lesion of the talar dome requires the clinician to have a high index of suspicion, and advanced imaging is often necessary to make the final diagnosis. Treatment should be initiated once the lesion is appropriately staged by radiologic or magnetic resonance imaging. We discuss the use of arthroscopy-assisted retrograde drilling of the medial talar dome that spares the articular cartilage within the talotibial articulation. (J Am Podiatr Med Assoc 95(1): 91–96, 2005)

scholarly journals Perforated Meckel’s Diverticulitis in a Patient with Unknown Intestinal Malrotation: Clinical Pitfall

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Marie Burgard ◽  
Floryn Cherbanyk ◽  
François Pugin ◽  
Bernhard Egger
Keyword(s):  
Acute Appendicitis ◽  
Clinical Presentation ◽  
Final Diagnosis ◽  
Intestinal Malrotation ◽  
Radiological Imaging ◽  
Atypical Clinical Presentation ◽  
Lower Abdominal Quadrant ◽  
Meckel’S Diverticulitis ◽  
The Right ◽  
Abdominal Quadrant

Symptomatic Meckel’s diverticulum is rare in adults. The most frequent complications are intestinal obstruction and diverticulitis. Diagnosis of Meckel’s diverticulitis can be challenging due to nonspecific clinical manifestation of pain in the right lower abdominal quadrant, mimicking acute appendicitis. If associated with congenital malformation, such as intestinal malrotation, the anomalous anatomy makes the diagnosis even more challenging. In such cases, radiological imaging is essential to guide further management. We present a case of Meckel’s diverticulitis in which physicians were initially misguided because of the atypical clinical presentation. Yet, anamnestic details directed to a potential underlying malformation, leading to supplementary radiological examination and the final diagnosis.

scholarly journals Clinical Presentation of Epileptic Seizures in a Child with a Final Diagnosis of Atrial Fibrillation: A Pediatric Case Report

2016 ◽  
Vol 38 (3) ◽  
pp. 125-126
Author(s):  
Ayse Kacar Bayram ◽  
Ozge Pamukcu ◽  
Sefer Kumandas ◽  
Zubeyde Gunduz ◽  
Mehmet Canpolat ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Case Report ◽  
Clinical Presentation ◽  
Epileptic Seizures ◽  
Final Diagnosis ◽  
Pediatric Case

scholarly journals Clinical diagnostic application of metagenomic next-generation sequencing in children with severe pneumonia

2019 ◽  
Author(s):  
Heping Wang ◽  
Zhiwei Lu ◽  
Yaomin Bao ◽  
Yonghong Yang ◽  
Ronald de Groot ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Mycoplasma Pneumoniae ◽  
Severe Pneumonia ◽  
Clinical Diagnostics ◽  
Nucleic Acid Amplification ◽  
Direct Immunofluorescence ◽  
Specific Information ◽  
Next Generation ◽  
Blood Tests ◽  
Generation Sequencing

Abstract Background: Pneumonia is one of the most important causes of morbidity and mortality in children. Identification and characterization of pathogens that cause infections are crucial for accurate treatment and accelerated recovery of the patients. However, in most cases the causative agent cannot be identified partly due to the limited spectrum covered by current diagnostics based on nucleic acid amplification. Therefore, in this study we explored the application of metagenomic next-generation sequencing (mNGS) for the diagnosis of children with severe pneumonia. Methods: From April to July 2017, 32 children were hospitalized with severe pneumonia in Shenzhen Children’s Hospital. Blood tests were conducted immediately after hospitalization to assess infection, oropharygeal swabs were collected to identify common pathogens. After bronchoscopy, bronchoalveolar lavage fluids (BALFs) were collected for further pathogen identification using standardized laboratory and mNGS. Results: Blood tests were normal in 3 of the 32 children. In oropharygeal swabs from 5 patients Mycoplasma pneumoniae by qPCR, 27 cases showed negative results for common pathogens. In BALFs we detected 6 cases with Mycoplasma pneumoniae with qPCR, 9 patients with adenovirus by using a Direct Immunofluorescence Assay (DFA) and 4 patients with bacterial infections, as determined by culture, In 3 of the cases a co-infection was detected. In 15 cases no common pathogens were found in BALF samples, using the current diagnostics, while in all the 32 BALFS pathogens were identified using mNGS, including adenovirus, Mycoplasma pneumoniae, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, cytomegalovirus andbocavirus. Conclusions: mNGS can increase the sensitivity of detection of the causative pathogens in children with severe pneumonia. In addition, mNGS will give more strain specific information, will help to identify new pathogens and could potentially help to trace and control outbreaks. In this study we have shown that it is feasible to have the results within 24 hours, making the application of mNGS feasible for clinical diagnostics.

scholarly journals Paramyxoviruses and Multiple Sclerosis

2012 ◽  
Vol 9 (3) ◽  
pp. 500-503
Author(s):  
Baghdad Science Journal
Keyword(s):  
Multiple Sclerosis ◽  
Autoimmune Disease ◽  
Environmental Factors ◽  
Neurological Disease ◽  
Epidemiological Data ◽  
Igg Antibodies ◽  
Significant Difference ◽  
Elisa Technique

Multiple Sclerosis (MS) is a progressive neurological disease characterized by periods of quiescence and exacerbation, epidemiological data suggest the notion that MS is an acquired autoimmune disease caused by environmental factors, probably infectious, in genetically susceptible individuals.The submitted research was attempted to study the possible viral (Paramyxoviruses) role in MS, the sera of 57 MS patients were assayed for anti-measles and anti-mumps IgG antibodies using ELISA technique, the results were compared in order to establish the presence or absence of a significant difference regarding both number of positive cases and antibodies titer between the two groups, the results revealed that there is no in number of measles positive cases in both MS patients and controls while a significant difference in number of positive cases of mumps and measles anti-measles IgG titer and a highly significant difference regarding mumps IgG Abs titer between the two studied groups, this may be considered as a preliminary indicator to the role of those two paramyxoviruses in MS.

scholarly journals The Frequency and Causes of Subepidermal Gaps or Blisters and the Compliance Rate Between Clinical Diagnosis and Pathology Reports from 2015 to 2019

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Abbas Darjani ◽  
Hojat Eftekhari ◽  
Seyedeh Rojin Amini Rad ◽  
Narges Alizadeh ◽  
Rana Rafiee ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Skin Diseases ◽  
Histopathological Examination ◽  
Compliance Rate ◽  
Clinical Manifestations ◽  
Final Diagnosis ◽  
Direct Immunofluorescence ◽  
Diagnostic Challenge ◽  
Cross Sectional ◽  
Pathology Reports

Background: Skin diseases are the fourth most common cause of human illness, and blisters with different clinical manifestations make a diagnostic challenge. Objectives: This study aimed to evaluate the frequency and causes of subepidermal gaps or blisters, as well as the compliance rate between the initial and final clinical diagnoses based on pathology reports. Methods: In this cross-sectional study, pathology reports of subepidermal blisters or gaps were evaluated in the patients referred to the Razi Laboratory of Rasht from 2015 to 2019. The samples were examined by a pathologist after hematoxylin and eosin staining. The reports included demographic information, clinical differential diagnoses, final diagnosis, direct immunofluorescence findings, and salt split results. Finally, the compliance rate of clinical diagnosis with pathology reports was determined. Results: A total of 183 pathology reports were evaluated, 170 of which contained the final diagnosis. Females were more frequently affected by the disease, and pemphigoid bolus and lichen planus were the most prevalent final diagnoses. The compliance rate between the initial and final diagnoses was 94%. About 37.2% of the reports lacked direct immunofluorescence (DIF) and salt split, and only 42.6% of the samples had undergone DIF examination, while 20.2% had both DIF and salt split. There was no significant association between the compliance rate of the final diagnosis with age, sex, and undergoing diagnostic tests. Conclusions: A high incidence of subepidermal gaps or blisters was seen in middle-aged individuals and females. The compliance rate of the initial clinical diagnosis with the final diagnosis based on pathological reports was high. Our findings emphasize the importance of histopathological examination and the complementary role of direct immunofluorescence and salt split in diagnosis.

scholarly journals Pemphigus Vegetans of Neumann Type on Lip: A Case Report

2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Anil P Gosavi ◽  
Ravindranath Brahmadeo Chavan ◽  
Jheel Shriniwas Ambike ◽  
Nitika S Deshmukh
Keyword(s):  
Case Report ◽  
Rare Variant ◽  
Pemphigus Vulgaris ◽  
Common Disease ◽  
Middle Aged ◽  
Rare Presentation ◽  
Neumann Type ◽  
Pemphigus Vegetans ◽  
Intralesional Steroids

: Pemphigus is a chronic autoimmune vesiculobullous disease caused by autoantibodies directed against desmogleins (Dsgs). Pemphigus vegetans is a rare variant of pemphigus vulgaris, characterized by vegetative plaques, primarily occurring in flexures. It is a less common disease and involves the skin and mucosa due to disintegration of cellular adherence (acantholysis), resulting in intradermal split. We report this case of pemphigus vegetans of Neumann type for its rare presentation. We report a case of pemphigus vegetans, involving lips in a middle-aged female and sparing flexural areas. This patient was diagnosed on the basis of histopathology and treated successfully with intralesional steroids, resulting in the resolution of her plaques.

scholarly journals Giant Ileocecal Inflammatory Fibroid Polyp: Unique Clinical Presentation

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Hatim Almaghrabi ◽  
Murouj Almaghrabi ◽  
Haneen Al-Maghrabi
Keyword(s):  
Clinical Presentation ◽  
Histopathological Examination ◽  
Ileocecal Valve ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Treatment Method ◽  
Lesion Size ◽  
Resected Tissue ◽  
Fibroid Polyp ◽  
Immunohistochemical Studies

Inflammatory fibroid polyps (IFPs) are infrequent gastrointestinal tract benign neoplasms. They mostly occur in the stomach especially the antrum. Signs and symptoms depend on their anatomic location and lesion size. Lesion biopsies are very challenging for accurate diagnosis in these lesions. Histopathological examination of resected tissue along with immunohistochemical studies is the perfect way to confirm the final diagnosis. In this paper, the authors present an unusual case of IFP in a 23-year-old female patient presented to the emergency room (ER) with a picture of intestinal obstruction and severe abdominal pain. Her investigations revealed a huge mass located at the ileocecal valve, with overall features mimic gastrointestinal stromal tumor (GIST) clinical presentation. Surgical resection is considered the most commonly used treatment method. The overall prognosis is good with a low risk of recurrence.

Cancer of the Pancreas: Clinical Outcome in 76 Cases

1986 ◽  
Vol 72 (6) ◽  
pp. 601-607 ◽  
Author(s):  
Vittorio Pugliese ◽  
Sebastiano Saccomanno ◽  
Luigina Bonelli ◽  
Daniela Barone ◽  
Massimo Conio ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Clinical Outcome ◽  
Clinical Presentation ◽  
High Sensitivity ◽  
Radical Resection ◽  
Final Diagnosis ◽  
Diagnostic Techniques ◽  
Tissue Diagnosis ◽  
Cancer Of The Pancreas

A final diagnosis of pancreatic cancer was established in 76 consecutive patients during 4 years. The clinical outcome was evaluated retrospectively, as well as clinical presentation and its impact on the rate of resectability. Even though the diagnostic techniques showed a high sensitivity, only 18.4% of patients had a radical resection performed. In 77.6% of the cases a tissue diagnosis had been obtained. However, in only 1/5 of them was the tissue proof obtained preoperatively. This review confirms that the survival of patients with pancreatic cancer is poor, with slight advantages in the few resectable cases. Therefore, an earlier diagnosis should be attempted in high-risk symptomatic patients, selected by means of nonaggressive tests and evaluated by means of more accurate diagnostic techniques, when suitable.

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