scholarly journals Possible Iodine-Induced Thyrotoxicosis in a Previously Healthy Adolescent following Administration of Iodinated Contrast Media

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Jennifer Apsan ◽  
Zoltan Antal
Keyword(s):  
Thyroid Disease ◽  
Pediatric Population ◽  
Disease Course ◽  
Case Presentation ◽  
Healthy Adolescent ◽  
Iodinated Contrast ◽  
Disease Case ◽  
History Of ◽  
Contrast Ct ◽  
Rule Out

Introduction. Jod-Basedow Syndrome refers to a paradoxical phenomenon in which large loads of iodine can cause hyperthyroidism. It is most commonly seen in populations already at risk for thyroid disease or those with underlying kidney disease. Case Presentation. We present a case of an acutely ill 17-year-old boy with symptomatic hyperthyroidism following an iodinated contrast CT scan to rule out appendicitis. Discussion/Conclusion. This case underscores the importance of recognizing this phenomenon even in the pediatric population and in those with no preexisting history of thyroid disease. Course complications including bronchospasm, hypertension, transaminitis, and bilateral palmar desquamating rash are rare and highlight the complexities involved in the disease state and in managing side effect profiles of treatment.

scholarly journals Denture Impaction Causing an Upper Esophageal Diverticulum

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Shireen Samargandy ◽  
Hani Marzouki ◽  
Talal Al-Khatib ◽  
Mazin Merdad
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
The Elderly ◽  
Barium Swallow ◽  
Diagnostic Challenge ◽  
Case Presentation ◽  
History Of ◽  
Endoscopic Diverticulotomy ◽  
Tomography Scan ◽  
Rule Out

Background. Dentures are a common cause of inadvertent foreign body ingestion particularly in the elderly. Due to their radiolucent nature, they often present a diagnostic challenge to care providing physicians. Case Presentation. A 66-year-old female presented to our otolaryngology clinic with a 2-year history of dysphagia. Her physical examination was unremarkable. Computed tomography scan of the neck and barium swallow suggested Zenker diverticulum. She was planned for endoscopic diverticulotomy; however, during surgery, a foreign body was incidentally found and retrieved, which was a partial lower denture. The diverticulum resolved thereafter, and the patient's symptoms abated. Conclusion. The authors recommend evaluating the esophagus endoscopically first in cases of upper esophageal diverticular formation, even when planning an open repair approach, to rule out any concealed foreign bodies.

scholarly journals Pediatric toxic polycystic thyroid

2017 ◽  
Vol 30 (7) ◽  
Author(s):  
Janeil M. Belle ◽  
Nektarios Vasilottos ◽  
Todd D. Nebesio ◽  
Benjamin C. James
Keyword(s):  
Thyroid Disease ◽  
Pediatric Population ◽  
Receptor Gene ◽  
Hormone Replacement ◽  
Gene Mutations ◽  
Rare Condition ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid ◽  
History Of

AbstractBackground:Polycystic thyroid disease (PCTD) is a rare condition and has been described in adults in the setting of subclinical and clinical hypothyroidism. We present the first known case of a pediatric patient with diffuse macrocystic degeneration of the thyroid.Clinical presentation:A 6-year-old previously healthy patient was evaluated after presenting with a 16-month history of an enlarging polycystic thyroid and hyperthyroidism. Markers of autoimmune thyroid disease including thyroid stimulating immunoglobulin (TSI), thyroid stimulating hormone (TSH) receptor antibody, thyroid peroxidase antibody and thyroglobulin antibody were negative. No family history of benign or malignant thyroid or cystic disease was present. The patient underwent a total thyroidectomy without perioperative complication. She remains euthyroid with thyroid hormone replacement therapy.Summary:To our knowledge, this is the first report of PCTD in the pediatric population associated with hyperthyroidism without evidence of autoimmune disease. Somatic activating thyrotropin-receptor gene mutations are known to cause non-autoimmune hyperthyroidism in children, however it is unknown if similar mechanisms are responsible for pediatric PCTD.Conclusions:Polycystic thyroid degeneration can occur in children and may result in a hyperthyroid state.

scholarly journals Herniation of ureter: a rare cause of hydroureteronephrosis

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Preeti Gupta ◽  
Pankaj Sharma ◽  
Vinay Maurya ◽  
Mukul Bhatia
Keyword(s):  
Inguinal Hernia ◽  
Previous History ◽  
Prior History ◽  
Ct Urography ◽  
Hernia Sac ◽  
Case Presentation ◽  
History Of ◽  
Contrast Ct ◽  
Inguinal Herniation

Abstract Background Omentum and bowel loops are commonly seen in inguinal hernia. An unusual case of extraperitoneal herniation of ureter was detected in hernial sac with other contents, on computed tomography (CT) urography. Case presentation A 54-year-old male presented with inguinal hernia, with no previous history of surgery or trauma. Pre-operative screening showed a unilateral hydroureteronephrosis involving the pelvicalyceal system and entire ureter. No calculus was visualized in the ureter on ultrasound. On non-contrast CT (NCCT) followed by CT urography, the ureter was seen descending into the hernia sac causing hydroureteronephrosis. The patient subsequently underwent mesh repair surgery of the inguinal hernia with meticulous reduction of the herniated contents including the ureter, resulting in complete resolution of the hydroureteronephrosis. Conclusion An isolated extraperitoneal inguinal herniation of the ureter without concomitant urinary bladder involvement is extremely rare, especially with no prior history of trauma or surgery, as seen in our case. The case also exemplifies the role of pre-operative imaging as a protocol in cases of inguinal hernia to prevent per-operative complications.

scholarly journals A Series of Frustrations of Fever for Congenital Heart Disease: Case Report

2020 ◽  
Author(s):  
Cong Dai ◽  
Jian-Hua Yu ◽  
Yan-Hua Tang ◽  
Ren-Qiang Yang
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Social Life ◽  
Congenital Heart ◽  
Septal Defect ◽  
Case Presentation ◽  
Epidemic Area ◽  
Disease Case ◽  
History Of

Abstract Background: Fever, dry cough and fatigue are the most common symptoms of the coronavirus disease-2019 (COVID-19). During the COVID-19 pandemic in China, we treated a patient with fever and finally diagnosed congenital heart disease.Case presentation: An 18-year-old lady came to the fever clinic with a complaint about the symptoms of fever, dry cough and dyspnea for 15 days. She had a travel history of epidemic area two weeks ago. She had a low fever and dry cough accompanied with chest tightness and fatigue. Eventually she diagnosed ventricular septal defect complicated by infective endocarditis. Two months after surgery, the patient returned to normal social life and physical activity.Conclusion: Early surgical treatment is an effective strategy for ventricular septal defect patients complicated with IE, which can improve the early survival rate of patients.

scholarly journals (P2-59) Monocular Vision Loss Following Blunt Trauma

2011 ◽  
Vol 26 (S1) ◽  
pp. s155-s155
Author(s):  
P.M. Pustinger ◽  
D. Paratore
Keyword(s):  
Blunt Trauma ◽  
Vision Loss ◽  
Motor Vehicle ◽  
Pediatric Population ◽  
Rear Seat ◽  
Monocular Vision ◽  
Delayed Presentation ◽  
Case Presentation ◽  
Vehicle Collision ◽  
History Of

Blunt trauma is a leading cause of injury in the teenage population. The early detection of injury is the primary goal of emergency medicine in order to maintain an optimal functional capacity. This is of particular importance in the pediatric population. The following is a case presentation of monocular vision loss in a 14-year-old girl as a result of traumatic optic neuropathy. A motor vehicle collision was the cause of injury for this patient. She was an unrestrained rear seat passenger and struck her head on the driver's headrest during a frontal impact. A delayed presentation of over seven hours added to the complexity of this presentation. Further, a non-contrasted computed tomography (CT) scan of the head and orbits was unremarkable except for soft tissue swelling. The child was left with only light perception in the affected eye. This case presentation will illustrate the importance of immediate care, diagnostic studies, proper consultant input, follow-up care, and the natural history of the injury for this most unusual case.

scholarly journals Laparoscopic Repair of Internal Transmesocolic Hernia of Transverse Colon

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Tomokazu Kishiki ◽  
Toshiyuki Mori ◽  
Yoshikazu Hashimoto ◽  
Hiroyoshi Matsuoka ◽  
Nobutsugu Abe ◽  
...  
Keyword(s):  
Small Intestine ◽  
Internal Hernia ◽  
Transverse Colon ◽  
Surgical Procedure ◽  
History Of Surgery ◽  
Case Presentation ◽  
Internal Hernias ◽  
Old Japanese ◽  
History Of ◽  
Rule Out

Introduction. Internal hernias are often misdiagnosed because of their rarity, with subsequent significant morbidity.Case Presentation. A 61-year-old Japanese man with no history of surgery was referred for intermittent abdominal pain. CT suggested the presence of a transmesocolic internal hernia. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We found internal herniation of the small intestine loop through a defect in the transverse mesocolon, without any strangulation of the small intestine. We were able to complete the operation laparoscopically. The patient’s postoperative course was uneventful and the patient was discharged on postoperative day 6.Discussion. Transmesocolic hernia of the transverse colon is very rare. Transmesocolic hernia of the sigmoid colon accounts for 60% of all other mesocolic hernias. Paraduodenal hernias are difficult to distinguish from internal mesocolic transverse hernias. We can rule out paraduodenal hernias with CT.Conclusion. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We report a case of a transmesocolic hernia of the transverse colon with intestinal obstruction that was diagnosed preoperatively and for which laparoscopic surgery was performed.

scholarly journals Pediatric P-ANCA Vasculitis following COVID-19

2021 ◽  
Author(s):  
Yaron Fireizen ◽  
Cyrus Shahriary ◽  
Maria Imperial ◽  
Inderpal Randhawa ◽  
Nastasia Nianiaris ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Kidney Injury ◽  
The Body ◽  
Pediatric Case ◽  
Case Presentation ◽  
Necrotizing Glomerulonephritis ◽  
History Of ◽  
Complex Deposition ◽  
Inflammatory Syndrome ◽  
Pulse Steroids

Background: Perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA), a subset of ANCA, are associated with a multisystem vasculitis affecting small blood vessels in the body. A handful of adult patients who developed vasculitis post-COVID-19 infection have been reported. Although COVID-19 infection has been shown to drive an exaggerated immune response in the pediatric population, such as MIS-C (multisystem inflammatory syndrome in children), only one case of vasculitis following COVID-19 infection has been reported previously in children. Case presentation: Seventeen-year-old male with a past medical history of COVID-19 pneumonia two months prior presented with acute kidney injury/failure and diffuse alveolar hemorrhage (DAH). Rheumatologic workup revealed P-ANCA and Myeloperoxidase (MPO) positivity. Kidney biopsy showed necrotizing glomerulonephritis with limited immune complex deposition. Subsequently, he was treated with pulse steroids, plasmapheresis, and ultimately started on cyclophosphamide. Conclusions: To our knowledge, this report presents the second reported pediatric case of P-ANCA / MPO vasculitis following COVID-19 infection.

scholarly journals A patient with dextrocardia and chagas disease: case report and literature review

Case reports ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. 50-61
Author(s):  
Julián Felipe Porras-Villamil ◽  
Mario Javier Olivera
Keyword(s):  
Literature Review ◽  
Chagas Disease ◽  
Lower Limb ◽  
Case Reports ◽  
Serological Tests ◽  
Case Presentation ◽  
Disease Case ◽  
Limb Edema ◽  
History Of ◽  
Cruzi Infection

Introduction: About half a million patients in Colombia are currently infected with Trypanosoma cruzi. However, little is known about patients with Chagas disease and anatomical defects such as dextrocardia. Case presentation: A 52-year-old male patient with a 4-year history of dyspnea, chest pain, lower limb edema and syncope (requiring hospitalization), arrhythmias and dextrocardia, underwent serological tests for T. cruzi that were positive. A literature review was conducted to find case reports of patients with dextrocardia or situs inversus and Chagas disease in order to determine the proper treatment. Conclusion: Cases of patients with dextrocardia and Chagas disease are rare. Besides the reported case, only three other cases were found in the literature, which were relatively similar, although they could be considered more severe. According to the findings, the use of etiological treatment is acceptable in patients with coronary anatomic abnormalities and T. cruzi infection. The present case draws attention to the importance of adequately approaching and monitoring this type of patient.

Case Exercise: Toxic Exposure-Related Illness: Causation, Diagnosis, and Permanent Impairment

2007 ◽  
Vol 12 (2) ◽  
pp. 4-8
Author(s):  
Frederick Fung
Keyword(s):  
Concentration Level ◽  
Treatment Plan ◽  
Toxic Exposure ◽  
Dose Response Relationship ◽  
Specialty Board ◽  
History Of ◽  
Subjective Complaints ◽  
Based Medicine ◽  
Illness Causation ◽  
Rule Out

Abstract A diagnosis of toxic-related injury/illness requires a consideration of the illness related to the toxic exposure, including diagnosis, causation, and permanent impairment; these are best performed by a physician who is certified by a specialty board certified by the American Board of Preventive Medicine. The patient must have a history of symptoms consistent with the exposure and disease at issue. In order to diagnose the presence of a specific disease, the examiner must find subjective complaints that are consistent with the objective findings, and both the subjective complaints and objective findings must be consistent with the disease that is postulated. Exposure to a specific potentially causative agent at a defined concentration level must be documented and must be sufficient to induce a particular pathology in order to establish a diagnosis. Differential diagnoses must be entertained in order to rule out other potential causes, including psychological etiology. Furthermore, the identified exposure at the defined concentration level must be capable of causing the diagnosis being postulated before the examiner can conclude that there has been a cause-and-effect relationship between the exposure and the disease (dose-response relationship). The evaluator's opinion should make biological and epidemiological sense. The treatment plan and prognosis should be consistent with evidence-based medicine, and the rating of impairment must be based on objective findings in involved systems.

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 155-160
Author(s):  
Mohsen Aghapoor ◽  
◽  
Babak Alijani Alijani ◽  
Mahsa Pakseresht-Mogharab ◽  
◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
The Body ◽  
Lower Limbs ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Death Case ◽  
Therapeutic Results ◽  
History Of ◽  
Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

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