AN UNUSUAL CASE OF LYMPHOCYTIC HYPOPHYSITIS IN AYOUNG MAN PRESENTING WITH ELEVATED SERUM IGF-1

2009 ◽  
Vol 5 (3) ◽  
pp. 391-397 ◽  
Author(s):  
C Chadha
Keyword(s):  
Unusual Case ◽  
Elevated Serum ◽  
Lymphocytic Hypophysitis

Lymphocytic hypophysitis: Report of an unusual case of a rare disorder

2001 ◽  
Vol 24 (3) ◽  
pp. 190-193 ◽  
Author(s):  
M. Durán Martínez ◽  
C. Santonja ◽  
I. Pavón de Paz ◽  
S. Monereo Megías
Keyword(s):  
Unusual Case ◽  
Lymphocytic Hypophysitis ◽  
Rare Disorder

scholarly journals Isolated Langerhans cell histiocytosis in the hypothalamic-pituitary region: a case report

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weibin Zhou ◽  
Jia Rao ◽  
Chengjiang Li
Keyword(s):  
Langerhans Cell Histiocytosis ◽  
Clinical Symptoms ◽  
Elevated Serum ◽  
Urine Osmolality ◽  
Langerhans Cell ◽  
Lymphocytic Hypophysitis ◽  
Pituitary Stalk ◽  
High Signal ◽  
Cns Disorders ◽  
Hormonal Evaluation

Abstract Background Langerhans cell histiocytosis (LCH) is a rare disease that mainly affects children, but this disease is significantly rarer in patients who are older than 15 years. In this disease, any organ can be involved. The skeleton, skin and lung are commonly affected, and isolated hypothalamic-pituitary (HP) involvement is relatively rare. Here we report a 17-year-old adolescent with isolated HP-LCH of enlarged pituitary stalk presented with central diabetes insipidus (CDI). Case presentation A 17-year-old male adolescent with polydipsia and polyuria accompanied with elevated serum sodium level and low urine osmolality for 3 weeks was referred to our hospital. After admission, hormonal evaluation showed that his growth hormone (GH) was slightly elevated, and serum osmolality and glucose were normal. The fluid deprivation-vasopressin test demonstrated CDI. Imaging examination showed an obvious thickening of the pituitary stalk. Lymphocytic hypophysitis, sarcoidosis and granulation tissue lesions were suspected. After oral 1-deamino-8-Darginine vasopressin (DDAVP) and prednisone were administered for 2 months, symptoms were relieved, and he discontinued taking the drugs by himself. On reexamination, imaging revealed changes in the size and shape of the pituitary stalk, with thickened nodules. Then, a diagnostic biopsy of the pituitary stalk lesion was performed. Immunohistochemistry confirmed the definitive diagnosis of LCH. The clinical symptoms subsided with oral hormone replacements. Conclusion CDI is a rare symptom in children and adolescents. Most of the causes are idiopathic, while others are caused by central nervous system (CNS) disorders. Meanwhile, lymphocytic hypophysitis, germinoma, LCH and other CNS disorders can all present as thickening of the pituitary stalk, diffuse enlargement of the pituitary gland, and weakening of high signal intensity in the neurohypophysis on magnetic resonance imaging (MRI). The differential diagnosis among these diseases depends on immunohistochemistry evidence.

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 Importance of serum calcium in spontaneous neck haematoma

2020 ◽  
Vol 13 (9) ◽  
pp. e237267
Author(s):  
Matthew Zammit ◽  
Richard Siau ◽  
Alessandro Panarese
Keyword(s):  
Case Report ◽  
Parathyroid Hormone ◽  
Literature Review ◽  
Respiratory Distress ◽  
Serum Calcium ◽  
Unusual Case ◽  
Elevated Serum ◽  
Signs And Symptoms ◽  
Operative Management ◽  
Diagnostic Value

We present an unusual case of spontaneous cervical haemorrhage secondary to extra-capsular bleeding from a parathyroid adenoma. Signs and symptoms on presentation included sore throat, dysphagia and anterior chest ecchymosis. While CT confirmed active cervical haemorrhage, elevated serum calcium and parathyroid hormone raised suspicion of possible parathyroid pathology. This case report and literature review highlight the diagnostic value of serum calcium in presentations of acute spontaneous neck haematoma. This should be considered especially in the acute phase, where imaging may not identify the source of haemorrhage. Initial observation and deferred surgery is the treatment of choice, with emergency operative management reserved for respiratory distress and worsening compressive symptoms.

Elevated serum CA 19-9 with adnexal mass: is it always an ovarian malignancy?

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Kah Teik Chew ◽  
Izyan Atiqah Zakaria ◽  
Muhammad Azrai Abu ◽  
Mohd Faizal Ahmad ◽  
Erica Yee Hing ◽  
...  
Keyword(s):  
Unusual Case ◽  
Adnexal Mass ◽  
Elevated Serum ◽  
Initial Diagnosis ◽  
Reproductive Age ◽  
Ovarian Malignancy ◽  
Women Of Reproductive Age ◽  
Gynaecological Disease ◽  
Histopathological Report

Abstract Endometriotic cysts a common benign gynaecological disease in women of reproductive age. We report an unusual case of ruptured endometrioma associated with increased CA 19-9. A 27-year-old woman presented with an acute abdomenal adnexal mass and elevated CA 19-9. The initial diagnosis of ovarian malignancy turned out to be a ruptured endometrioma, confirmed during surgery and in the histopathological report.

scholarly journals Delayed Manifestation of Shunt Nephritis: A Case Report and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-9
Author(s):  
Michael Babigumira ◽  
Benjamin Huang ◽  
Sherry Werner ◽  
Wajeh Qunibi
Keyword(s):  
Unusual Case ◽  
Propionibacterium Acnes ◽  
Elevated Serum ◽  
Skin Lesions ◽  
Review Of The Literature ◽  
Intravenous Antibiotic ◽  
Dense Deposits ◽  
Shunt Nephritis ◽  
New Onset

We present an unusual case of shunt nephritis in a 39-year-old male who presented 21 years after placement of a ventriculoperitoneal (VP) shunt. He complained of fevers, headaches, dizziness, and urticarial plaques on arms, trunks, and legs and was found to have anemia, low complement levels, elevated serum creatinine, proteinuria, and new onset microhematuria. Blood and urine cultures were negative. Renal biopsy showed features of acute tubulointerstitial nephritis attributed to vancomycin use. Glomeruli showed increased mesangial hypercellularity and segmental endocapillary proliferation. Immunofluorescence showed focal IgM and C3 staining. Electron microscopy revealed small subendothelial electron-dense deposits. Symptoms and renal insufficiency appeared to improve with antibiotic therapy. He was discharged and readmitted 2 months later with similar presentation. CSF grewPropionibacterium acnesand shunt hardware grew coagulase-negativeStaphylococcus. He completed an intravenous antibiotic course and was discharged. On 1-month follow-up, skin lesions persisted but he was otherwise asymptomatic. Follow-up labs showed significant improvement. We did a brief systematic review of the literature on shunt nephritis and report our findings on 79 individual cases. In this review, we comment on the presentation, lab findings, pathological features, and management of this rare, potentially fatal, but curable disease entity.

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.

scholarly journals IgG4 Inflammatory Pseudotumor of the Kidney

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Ahmed N. Alkhasawneh ◽  
Robert W. Allan
Keyword(s):  
Inflammatory Pseudotumor ◽  
Unusual Case ◽  
Plasma Cells ◽  
Middle Age ◽  
Elevated Serum ◽  
Serum Igg4 ◽  
Systemic Disorder

Hyper-IgG4 disease is a rare systemic disorder that usually affects middle age males. It is characterized by elevated serum IgG4 levels and infiltration of organs by IgG4 positive plasma cells associated with fibrosis. Patients usually present with mass or masses in the involved organ that mimic neoplasia. While initially described in the pancreas, IgG4-related inflammatory tumors have been now described in many organs. We describe an unusual case of an IgG4-related pseudotumor of the kidney.

The Ultrastructure of Lymphocytic Hypophysitis

1981 ◽  
Vol 39 ◽  
pp. 466-467
Author(s):  
S.L. Asa ◽  
K. Kovacs ◽  
J. M. Bilbao ◽  
R. G. Josse ◽  
K. Kreines
Keyword(s):  
Electron Microscopy ◽  
Plasma Cells ◽  
Secretory Granules ◽  
Sella Turcica ◽  
Uranyl Acetate ◽  
Lymphocytic Hypophysitis ◽  
Pituitary Cells ◽  
Transmission Electron ◽  
Ultrathin Sections ◽  
Mass Lesions

Seven cases of lymphocytic hypophysitis in women have been reported previously in association with various degrees of hypopituitarism. We report two pregnant patients who presented with mass lesions of the sella turcica, clinically mimicking pituitary adenoma. However, pathologic examination revealed extensive infiltration of the anterior pituitary by lymphocytes and plasma cells with destruction of the gland. To our knowledge, the ultrastructural features of lymphocytic hypophysitis have not been studied so far.For transmission electron microscopy, tissue from surgical specimens was fixed in glutaraldehyde, postfixed in OsO4, dehydrated and embedded in epoxy-resin. Ultrathin sections were stained with uranyl acetate and lead citrate and examined with a Philips 300 electron microscope.Electron microscopy revealed adenohypophysial cells of all types exhibiting varying degrees of injury. In the areas of most dense inflammatory cell infiltration pituitary cells contained large lysosomal bodies fusing with secretory granules (Fig. 1), as well as increased numbers of swollen mitochondria, indicating oncocytic transformation (Fig. 2).

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