scholarly journals Atypical parathyroid adenoma with clinically aggressive course of hyperparathyroidism: clinical case report

2018 ◽  
Vol 12 (1) ◽  
pp. 55-63 ◽  
Author(s):  
Natalia G. Mokrysheva ◽  
Anna K. Eremkina ◽  
Konstantin U. Slashchuk ◽  
Alexey I. Bespalov ◽  
Iya А. Voronkova ◽  
...  
Keyword(s):  
Clinical Case ◽  
Clinical Course ◽  
High Morbidity ◽  
Metabolic Disturbances ◽  
Atypical Adenoma ◽  
Preoperative Stage ◽  
Parathyroid Adenomas ◽  
Life Threatening ◽  
Atypical Parathyroid Adenoma ◽  
Aggressive Tumor

Primary hyperparathyroidism is common clinical endocrine disorder with a prevalence between 1–2%. Solitary parathyroid adenomas account from 80 to 85% of cases of PHPT, hyperplasia and multiple adenomas is up to 15%, parathyroid carcinoma is a very rare cause of PHPT, accounting for about a 1% of cases. Clinically aggressive and atypical adenomas should be separately noted because of severe clinical course and life-threatening hypercalcemia, high morbidity and mortality, unknown malignant potential. No definite criteria are considered to be present to distinguish preoperatively atypical adenoma from parathyroid typical adenoma or carcinoma. The clinical course of the disease remains the only tool that allows to suspect an aggressive tumor on the preoperative stage. We present the clinical case of a 61-year-old female patient with a clinically “aggressive” course of PHPT and severe metabolic disturbances of bone tissue due to the atypical adenoma of the parathyroid gland.

scholarly journals An Interesting Case of Life-Threatening Hypercalcemia Secondary to Atypical Parathyroid Adenoma versus Parathyroid Carcinoma

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Ankur Mishra ◽  
David Newman
Keyword(s):  
Parathyroid Adenoma ◽  
Serum Calcium ◽  
Parathyroid Carcinoma ◽  
Interesting Case ◽  
High Serum ◽  
En Bloc ◽  
Severe Hypercalcemia ◽  
Parathyroid Adenomas ◽  
Life Threatening ◽  
Atypical Parathyroid Adenoma

Context.Severe hypercalcemia is a life-threatening condition. Atypical parathyroid adenoma and parathyroid carcinomas are uncommon causes which can be difficult to differentiate.Objective.We report a case of a 36-year-old male with very high serum calcium due to a possible atypical parathyroid adenoma versus parathyroid carcinoma.Case Illustration.A serum calcium level of 23.2 mg/dl was noted on admission. He was initially treated with IV hydration, pamidronate, and salmon calcitonin to lower his calcium levels. He also underwent a surgical en bloc resection of parathyroid mass. Pathology showed a mixed picture consistent with possible atypical adenoma versus parathyroid carcinoma. However, due to the possible involvement of the recurrent laryngeal nerve, parathyroid carcinoma was more likely. Also after operation the patient developed hungry bones syndrome and his calcium was replaced vigorously. He continues to be on calcium, vitamin D, and calcitriol supplementation.Results.A review of the literature was conducted to identify previous studies pertaining to parathyroid adenomas and parathyroid cancer.Conclusion.We thereby conclude that hypercalcemia requires very careful monitoring especially after operation. Also it can be very difficult to distinguish between atypical parathyroid adenomas and parathyroid carcinomas as in our case and no clear cut guidelines yet exist to differentiate the two based on histology.

scholarly journals Benzocaine-Induced Methemoglobinemia. A Clinical Case

2018 ◽  
Vol 15 (5) ◽  
pp. 396-401
Author(s):  
Rustem F. Tepaev ◽  
Vladimir A. Vishnevskiy ◽  
Sergey A. Kuzin ◽  
Iuliia V. Sergey ◽  
Olga B. Gordeeva ◽  
...  
Keyword(s):  
Epidermolysis Bullosa ◽  
Clinical Picture ◽  
Clinical Case ◽  
Clinical Course ◽  
Current Data ◽  
Laboratory Confirmation ◽  
Life Threatening

The article describes a clinical case of the development of a severe, life-threatening methemoglobinemia in a patient with a dystrophic form of congenital epidermolysis bullosa while receiving a drug containing benzocaine. The current data on classification, pathogenesis, clinical course and methods for treating this state has been presented. Many substances and drugs that are methemoglobin formers are widespread and can cause chronic methemoglobinemia. Acute severe methemoglobinemia is accompanied by life-threatening organ disorders. In some cases, it may be difficult to diagnose methemoglobinemia due to the polymorphism of the clinical picture, the need for laboratory confirmation of the diagnosis, which may be underperformed in the absence of adequate alertness. The presented clinical case will be useful for doctors of various specialties.

Clinical Case: Complications after Endovascular Treatment of Intracranial Aneurysm in a Patient after Subarachnoid Hemorrhage

2020 ◽  
Vol 8 (1) ◽  
pp. 9-15
Author(s):  
Petrov Nikolay ◽  
◽  
Marinova R. ◽  
Odiseeva Ev.
Keyword(s):  
Intracranial Aneurysm ◽  
Endovascular Treatment ◽  
Clinical Case ◽  
Endovascular Coiling ◽  
Published Data ◽  
Military Medical Academy ◽  
Life Threatening ◽  
Arachnoid Hemorrhage ◽  
The Right ◽  
Brain Artery

Abstract: Intracranial aneurysm is one of the most common neurovascular complications. During the recent years the accepted treatment of enraptured cranial aneurysm is noninvasive endovascular coiling. This technique is modern but it is not without complications which can be serious and life-threatening. A clinical case of a patient admitted to the ICU of Military Medical Academy - Sofia with sub arachnoid hemorrhage is described. After a positive clinical course, the check-up magnetic resonance showed intracranial aneurism of the right carotid artery. The patient underwent angiographic endovascular treatment. Vasospasm of the middle and right brain artery and thrombosis were detected during the procedure. Attempt of thromboaspiration was made without success. This article reviews published data on broad-spectrum researches concerning complications of endovascular coiling of intracranial aneurysms and the ways to prevent and reduce them.

Cervicofacial Emphysema Secondary to Facebow Injury: A Case Report

2009 ◽  
Vol 33 (4) ◽  
pp. 333-336
Author(s):  
Marco Cicciù ◽  
Giovanni Battista Grossi ◽  
Mario Beretta ◽  
Davide Farronato ◽  
Concetta Scalfaro ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Subcutaneous Emphysema ◽  
Clinical Case ◽  
Dental Procedure ◽  
Life Threatening ◽  
Facial Area ◽  
Orthodontic Device ◽  
Physical Findings

Aim: To report the clinical case of a child with facial and periorbital emphysema caused by an orthodontic device. Case report: An 11-year-old child presented to our clinic showing moderate swelling of the left facial area. Based on his dental history, physical findings, and instrument examinations, the diagnosis of cervicofacial emphysema was established, caused by disengagement of the facebow. One week later, all swelling and crepitus had disappeared without complications. Most patients who develop subcutaneous emphysema after a dental procedure have only moderate local swelling, which normally resolves spontaneously and without complications within a week. However, the spread of large amounts of air into the deeper spaces may cause life-threatening sequelae. Conclusions: Orthodontists should be aware that the use of extraoral traction applied via a facebow can cause soft tissue injures and emphysema of the cervicofacial region. It is important to avoid misdiagnosis and to appropriately inform patient and parents about this condition.

scholarly journals Metabolic disturbances of the vitamin A pathway in human diaphragmatic hernia

2015 ◽  
Vol 308 (2) ◽  
pp. L147-L157 ◽  
Author(s):  
Karen Coste ◽  
Leonardus W. J. E. Beurskens ◽  
Pierre Blanc ◽  
Denis Gallot ◽  
Amélie Delabaere ◽  
...  
Keyword(s):  
Diaphragmatic Hernia ◽  
Perinatal Death ◽  
Single Gene ◽  
Gene Mutations ◽  
Transcriptional Analysis ◽  
Metabolic Disturbances ◽  
Common Life ◽  
Retinoid Signaling ◽  
Life Threatening ◽  
Surgically Induced

Congenital diaphragmatic hernia (CDH) is a common life-threatening congenital anomaly resulting in high rates of perinatal death and neonatal respiratory distress. Some of the nonisolated forms are related to single-gene mutations or genomic rearrangements, but the genetics of the isolated forms (60% of cases) still remains a challenging issue. Retinoid signaling (RA) is critical for both diaphragm and lung development, and it has been hypothesized that subtle disruptions of this pathway could contribute to isolated CDH etiology. Here we used time series of normal and CDH lungs in humans, in nitrofen-exposed rats, and in surgically induced hernia in rabbits to perform a systematic transcriptional analysis of the RA pathway key components. The results point to CRPBP2, CY26B1, and ALDH1A2 as deregulated RA signaling genes in human CDH. Furthermore, the expression profile comparisons suggest that ALDH1A2 overexpression is not a primary event, but rather a consequence of the CDH-induced lung injury. Taken together, these data show that RA signaling disruption is part of CDH pathogenesis, and also that dysregulation of this pathway should be considered organ specifically.

Do patients with atypical parathyroid adenoma need a close follow-up?

2021 ◽  
Author(s):  
Federica Saponaro ◽  
Elena Pardi ◽  
Laura Mazoni ◽  
Simona Borsari ◽  
Liborio Torregrossa ◽  
...  
Keyword(s):  
Parathyroid Adenoma ◽  
Serum Calcium ◽  
Good Prognosis ◽  
Histopathological Diagnosis ◽  
Symptomatic Disease ◽  
Asymptomatic Patients ◽  
Parathyroid Adenomas ◽  
Relevant Role ◽  
Atypical Parathyroid Adenoma

Abstract Context Atypical parathyroid adenomas (APAs) are neoplasms with uncertain malignant potential but lack unequivocal histological signs of malignancy. Objective To retrospectively evaluate the clinical and biochemical profiles of patients with APA, the outcome after parathyroidectomy (PTX), and the presence of CDC73 germline and somatic mutations. Design Monocentric study on consecutive patients undergoing PTX for primary hyperparathyroidism (PHPT) between June 2000 and December 2020. Patients Fifty-eight patients with a confirmed histopathological diagnosis of APA. Age and sex-matched controls with parathyroid adenoma (PA) were also included. Results Fifty-four patients had sporadic PHPT and four familial isolated hyperparathyroidism (FIHP). Thirty-four patients (59%) had a symptomatic disease. Serum calcium and PTH levels were significantly higher in symptomatic compared to asymptomatic patients (P=0.048 and 0.008, respectively). FIHP patients were younger than the sporadic counterpart (30±17yr vs. 55±13 yrs). APA patients had significantly higher serum calcium and PTH levels and lower 25(OH)D concentration, BMD and T-score at 1/3 distal radius compared to those with PA. Four of 56 APA patients displayed a CDC73 germline mutation. No somatic CDC73 mutation was identified in 24 tumor specimens. The mean follow-up after surgery was of 60±56.4 months. All but six patients (90%), five with apparently sporadic PHPT and one with FIHP, were cured after surgery. Conclusions The large majority of patients with APA, despite a moderate/severe phenotype, have a good prognosis. Germline CDC73 mutation-positive patients had a higher rate of persistent/recurrent disease. CDC73 gene alterations do not seem to have a relevant role in the tumorigenesis of sporadic APA.

scholarly journals NON-SPECIFIC ULCERATIVE COLITIS AND COVID-19, A CASE STUDY

2021 ◽  
Vol 5 (1) ◽  
pp. 89-92
Author(s):  
Z. P. Lemeshevskaya ◽  
◽  
M. V. Pavlukevich ◽  
N. I. Procopchik ◽  
◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Case ◽  
Clinical Laboratory ◽  
Clinical Course ◽  
Medical Documentation ◽  
Atypical Form ◽  
History Of ◽  
Hematoxylin And Eosin ◽  
Somatic Diseases

Background. COVID-19 infection keeps changing our understanding of its clinical course when associated with various somatic diseases. Objective. To present a clinical case of a patient with non-specific ulcerative colitis (NUC) and COVID-19 infection. Material and methods: medical documentation, general clinical, laboratory and instrumental data as well as histological examination of bioptates stained with hematoxylin and eosin that were obtained during colonoscopy. Results. The article presents a case history of a patient with manifestations of severe total NUC developed in association with the subclinical form of COVID-19 infection, the former being the cause of death in concomitant pathology. Conclusions. This clinical case describes a variant of an unfavorable outcome of NUC, one of the reasons for the manifestation of which was the atypical form of COVID-19 infection, which became a trigger for an autoimmune inflammatory process in the intestine. The accumulation of new knowledge about the features of the pathogenesis and manifestations of both pathologies will make it possible to improve the effectiveness of treatment and predict the course and outcomes of combined pathology.

scholarly journals Acute Peritonitis: A Rare Complication Revealing Intestinal Tuberculosis

2019 ◽  
Vol 1 (3) ◽  
pp. 15-17
Author(s):  
Sabbah M ◽  
Trad D ◽  
Jemmali C ◽  
Jouini R ◽  
Elloumi H ◽  
...  
Keyword(s):  
Rare Complication ◽  
Intestinal Tuberculosis ◽  
High Morbidity ◽  
Acute Peritonitis ◽  
Life Threatening ◽  
Tuberculosis Diagnosis ◽  
Inflammatory Bowel ◽  
Life Threatening Complication ◽  
Specific Symptoms ◽  
Disease Free

Intestinal tuberculosis diagnosis is often difficult because of non-specific symptoms, miming many other conditions such as malignancy, infectious disease, and inflammatory bowel disease. Free intestinal perforation is an uncommon but life-threatening complication of intestinal tuberculosis, associated with high morbidity and mortality.

Anorexia nervosa and the gastrointestinal tract

2021 ◽  
pp. flgastro-2021-101857
Author(s):  
Wisam Jafar ◽  
James Morgan
Keyword(s):  
Anorexia Nervosa ◽  
Healthcare Professionals ◽  
Signs And Symptoms ◽  
Nutritional Therapy ◽  
Nutrition Support ◽  
Multidisciplinary Teams ◽  
High Morbidity ◽  
Support Teams ◽  
Life Threatening ◽  
Acute Admissions

Anorexia nervosa (AN) is a complex eating disorder associated with a high morbidity and mortality, however, there is a lack of dedicated training for healthcare professionals outside of mental health specialities. There has been a reported increase in acute admissions of patients with AN, which may have been precipitated by the isolation and loss of support networks created by the COVID-19 pandemic. The purpose of this review is to highlight that AN can present with a wide variety of signs and symptoms relating to both the hollow and solid organs of the gastrointestinal (GI) tract some of which may even be life threatening. The overlap of symptoms with several other functional and organic GI diseases makes diagnosis challenging. Gastroenterologists and allied healthcare professionals need to be aware of the wide array of possible GI manifestations not only to help rationalise investigations but to also facilitate early involvement of the relevant multidisciplinary teams. Many of the GI manifestations of AN can be reversed with careful nutritional therapy under the guidance of nutrition support teams.

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