Severe lumbar spinal stenosis combined with Guillain-Barré syndrome: A case report

paythelady.612 shared this article with you from Inoreader Severe lumbar spinal stenosis combined with Guillain-Barré syndrome: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 16;9(5):1096-1102. doi: 10.12998/wjcc.v9.i5.1096. ABSTRACT BACKGROUND: Guillain-Barré syndrome (GBS) is a rare disorder that typically presents with ascending weakness, pain, paraesthesias, and numbness, which mimic the findings in lumbar spinal stenosis. Here, we report a case of severe lumbar spinal stenosis combined with GBS. CASE SUMMARY: A 70-year-old man with a history of lumbar spinal stenosis presented to our emergency department with severe lower back pain and lower extremity numbness. Magnetic resonance imaging confirmed the diagnosis of severe lumbar spinal stenosis. However, his symptoms did not improve postoperatively and he developed dysphagia and upper extremity numbness. An electromyogram was performed. Based on his symptoms, physical examination, and electromyogram, he was diagnosed with GBS. After 5 d of intravenous immunoglobulin (0.4 g/kg/d for 5 d) therapy, he gained 4/5 of stren gth in his upper and lower extremities and denied paraesthesias. He had regained 5/5 of strength in his extremities when he was discharged and had no symptoms during follow-up. CONCLUSION: GBS should be considered in the differential diagnosis of spinal disorder, even though magnetic resonance imaging shows severe lumbar spinal stenosis. This case highlights the importance of a careful diagnosis when a patient has a history of a disease and comes to the hospital with the same or similar symptoms. PMID:33644172 | PMC:PMC7896650 | DOI:10.12998/wjcc.v9.i5.1096 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Unilateral pulmonary hemorrhage caused by negative pressure pulmonary edema: A case report

paythelady.612 shared this article with you from Inoreader Unilateral pulmonary hemorrhage caused by negative pressure pulmonary edema: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1408-1415. doi: 10.12998/wjcc.v9.i6.1408. ABSTRACT BACKGROUND: Unilateral pulmonary hemorrhage is typically reported in young and healthy men with upper respiratory tract obstruction during anesthesia in special situations. Negative pressure in the lungs is created, resulting in negative pressure pulmonary edema (NPPE). CASE SUMMARY: A 78-year-old male patient diagnosed with spinal stenosis was admitted to receive a unilateral laminectomy with bilateral decompression. The patient had been diagnosed with hypertension four years earlier and asthma more than 70 years earlier. We experienced a unilateral alveolar hemorrhage associated with NPPE that occurred in a longstanding asthma patient who bit the intubated endotracheal tube for a short period during posture change at the end of surgery. Because diffuse alveolar hemorrhage accompanied by NPPE was caused in this case by airway obstruction in a n older patient with asthma without known risk factors, anesthesiologists should be careful not to induce airway irritation during anesthesia awakening in asthma patients. CONCLUSION: Because diffuse alveolar hemorrhage accompanied by NPPE can occur, anesthesiologists should take care not to induce airway irritation. PMID:33644209 | PMC:PMC7896690 | DOI:10.12998/wjcc.v9.i6.1408 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of corneal ulceration with a moisture chamber due to temporary lagophthalmos in a brain injury patient: A case report

paythelady.612 shared this article with you from Inoreader Management of corneal ulceration with a moisture chamber due to temporary lagophthalmos in a brain injury patient: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 16;9(5):1127-1131. doi: 10.12998/wjcc.v9.i5.1127. ABSTRACT BACKGROUND: This study describes the use of a moisture chamber to treat corneal ulceration due to temporary lagophthalmos in a critically ill patient. CASE SUMMARY: A 46-year-old woman was admitted to the intensive care unit after a car accident. She suffered multiple injuries that included brain injury and presented with moderately decreased consciousness and lagophthalmos in her right eye. Within 6 d, her consciousness improved considerably; at which time, exposure keratopathy occurred and worsened to corneal ulceration. Lubricating gel, antibiotic ointment, and bandage contact lens were all ineffective in preventing or treating the exposure keratopathy. Instead of tarsorrhaphy, a moisture chamber was applied which successfully controlled the corneal ulceration. The moisture chamber was discontinued when complete eyelid closure recovered a w eek later. CONCLUSION: A moisture chamber may be an effective, noninvasive alternative to tarsorrhaphy for treating severe exposure keratopathy due to temporary lagophthalmos. PMID:33644176 | PMC:PMC7896666 | DOI:10.12998/wjcc.v9.i5.1127 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Osseous Rosai-Dorfman disease of tibia in children: A case report

paythelady.612 shared this article with you from Inoreader Osseous Rosai-Dorfman disease of tibia in children: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1416-1423. doi: 10.12998/wjcc.v9.i6.1416. ABSTRACT BACKGROUND: Rosai-Dorfman disease (RDD), or sinus histiocytosis with massive lymphadenopathy, is a benign histiocytic disorder. Extranodal involvement is common, occurring in > 40% of patients, but bone involvement occurs in < 10% of cases. In addition, primary bone RDD is extremely rare. The majority of patients are adolescents and young adults, and the mean age at onset is 20-years-old. CASE SUMMARY: We report an 8-year-old Chinese girl who presented to our hospital with an insidious onset of swelling and pain in the middle shaft of her right tibia for 4 mo. We performed total surgical resection of the right tibia lesion and allograft transplantation. A good prognosis was confirmed at the 6 mo follow-up. Pain and swelling symptoms were totally relieved, range of motion of her right knee and ankle returned to normal, and there was no cl inical evidence of lesion recurrence at last follow up. Our case is the second reported case of osseous RDD without lymphadenopathy in the shaft of the tibia of a child. CONCLUSION: Extranodal RDD is a rare disease and can be misdiagnosed easily. Lesion resection and allograft transplantation are an option to treat extranodal RDD in children with good short term result. Pediatric orthopedist should be aware of this rare disease, especially extranodal involvement. PMID:33644210 | PMC:PMC7896673 | DOI:10.12998/wjcc.v9.i6.1416 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronic myelomonocytic leukemia-associated pulmonary alveolar proteinosis: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Chronic myelomonocytic leukemia-associated pulmonary alveolar proteinosis: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 16;9(5):1156-1167. doi: 10.12998/wjcc.v9.i5.1156. ABSTRACT BACKGROUND: Pulmonary alveolar proteinosis (PAP) is a rare condition that can cause progressive symptoms including dyspnea, cough and respiratory insufficiency. Secondary PAP is generally associated with hematological malignancies including chronic myelomonocytic leukemia (CMML). To the best of our knowledge, this is the first reported case of PAP occurring secondary to CMML. CASE SUMMARY: We report the case of a 63-year-old male who presented with a recurrent cough and gradually progressive dyspnea in the absence of fever. Based upon clinical symptoms, computed tomography findings, bone marrow aspiration, flow cytometry studies and cytogenetic analyses, the patient was diagnosed with PAP secondary to CMML. He underwent whole lung lavage in March 2016 to alleviate his dyspnea, after which he began combined chemotherapeutic treatment with decit abine and cytarabine. The patient died in January 2020 as a consequence of severe pulmonary infection. CONCLUSION: This case offers insight regarding the mechanistic basis for PAP secondary to CMML and highlights potential risk factors. PMID:33644180 | PMC:PMC7896663 | DOI:10.12998/wjcc.v9.i5.1156 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Abdominopelvic leiomyoma with large ascites: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Abdominopelvic leiomyoma with large ascites: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1424-1432. doi: 10.12998/wjcc.v9.i6.1424. ABSTRACT BACKGROUND: Leiomyoma of the uterus is relatively common, but uterine leiomyoma of the greater omentum is rare. CASE SUMMARY: Here, we report the case of a 22-year-old woman who presented with a 3 mo history of progressive abdominal distension and a hypervascular abdominopelvic mass. Due to a high serum concentration of CA125, the preoperative diagnosis was unclear. During surgery, 5 L of ascites was removed. An 18.8 cm solid mass, which was pedunculated from the uterine fundus and exhibited complex adhesion to the greater omentum, was removed. The CA125 level was reduced postoperatively, and a pathologic study confirmed that the mass was a leiomyoma that originated in the uterus. CONCLUSION: Uterine leiomyoma can share vessels with the greater omentum. This case highlights the difficulty of diagnosing pseudo-Meigs syndrome and the impor tance of imaging and laboratory examinations. PMID:33644211 | PMC:PMC7896699 | DOI:10.12998/wjcc.v9.i6.1424 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Negative conversion of autoantibody profile in chronic hepatitis B: A case report

paythelady.612 shared this article with you from Inoreader Negative conversion of autoantibody profile in chronic hepatitis B: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 16;9(5):1196-1203. doi: 10.12998/wjcc.v9.i5.1196. ABSTRACT BACKGROUND: Autoimmune antibodies are detected in many diseases. Viral infections are accompanied by several immunopathological manifestations. Some autoimmune antibodies have been associated with the immune response induced by virus or drugs. Thus, a comprehensive diagnosis of chronic hepatitis B combined with autoimmune hepatitis is required, and immunosuppressant or antiviral therapy should be carefully considered. CASE SUMMARY: We present a case of a patient who had negative transformation of autoimmune antibodies during chronic active hepatitis B. A 50-year-old female who had a history of asymptomatic hepatitis B virus carriers for more than 10 years presented to the hospital with the complaint of weakness for 1 wk. Blood tests revealed elevated liver enzymes; the detection of autoantibodies was positive. Hepatitis B viral load was 721000 00 IU/mL. The patient started tenofovir alafenamide fumigate 25 mg daily. Liver biopsy was performed, which was consistent with chronic active hepatitis B. The final diagnosis of the case was chronic active hepatitis B. The autoimmune antibodies turned negative after 4 wk of antiviral therapy. The patient recovered and was discharged with normal liver function. There was no appearance of autoantibodies, and liver function was normal at regular follow-ups. CONCLUSION: Autoimmune antibodies may appear in patients with chronic active hepatitis. It is necessary to differentiate the diagnosis with autoimmune hepatitis. PMID:33644184 | PMC:PMC7896659 | DOI:10.12998/wjcc.v9.i5.1196 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Unusual presentation of granulomatosis with polyangiitis causing periaortitis and consequent subclavian steal syndrome: A case report

paythelady.612 shared this article with you from Inoreader Unusual presentation of granulomatosis with polyangiitis causing periaortitis and consequent subclavian steal syndrome: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1433-1438. doi: 10.12998/wjcc.v9.i6.1433. ABSTRACT BACKGROUND: Granulomatosis with polyangiitis (GPA) is a rare autoimmune disease that involves small-to-medium-sized vessels and forms necrotizing vasculitis with granulomatous inflammation. The formation of a large vessel lesion in GPA patients has been scarcely reported, and it can cause confusion in the diagnosis. CASE SUMMARY: A 27-year-old man presented with mild left-sided pleuritic chest pain that started one year prior. An imaging study revealed up to 2.5 cm-sized two irregular nodular consolidation nodule in the left lower lobe. Both nodules showed central necrosis. Also, there was a periaortic mass occluding the branching porting of the subclavian artery. He had positive anti-neutrophil cytoplasmic antibodies (ANCAs), but myeloperoxidase-ANCAs and proteinase 3-ANCAs were negative. The patient also developed symptoms of subclavian vein syndrome during the follow-up. Wedge resection of the lung revealed necrotizing vasculitis, destructive parenchymal abscess and surrounding granuloma, and therefore diagnosed of GPA. The patient started on methotrexate and steroid therapy with a relief of symptomatic. CONCLUSION: Here, we present an unusual manifestation of GPA with periaortitis and consequent subclavian steal syndrome, which has never been previously described. This case alerts us that we should include GPA in the differential diagnosis of large vessel vasculitis as well as subclavian steal syndrome. PMID:33644212 | PMC:PMC7896677 | DOI:10.12998/wjcc.v9.i6.1433 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Infective bicuspid aortic valve endocarditis causing acute severe regurgitation and heart failure: A case report

paythelady.612 shared this article with you from Inoreader Infective bicuspid aortic valve endocarditis causing acute severe regurgitation and heart failure: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 16;9(5):1221-1227. doi: 10.12998/wjcc.v9.i5.1221. ABSTRACT BACKGROUND: Infective endocarditis (IE) is an uncommon but potentially life-threatening infection, which occasionally develops into acute severe valve insufficiency leading to the onset of heart failure, and necessitates timely intervention. However, the variable and atypical clinical manifestations always make the early detection of IE difficult and challenging. CASE SUMMARY: A 45-year-old female who was previously healthy presented with exertional shortness of breath and paroxysmal nocturnal dyspnea. She also suffered from a significant decrease in exercise capacity, whereas her body temperature was normal. She had severe hypoxemia and hypotension along with a marked aortic valve murmur. Diffuse pulmonary edema and bilateral pleural effusion were observed on both chest X-ray and computed tomography scan. Transthoracic echocardiography was pe rformed immediately and revealed severe regurgitation of the bicuspid aortic valve. Transesophageal echocardiography was further performed and vegetations were detected. In addition to adequate medical therapy and ventilation support, the patient underwent urgent and successful aortic valve replacement. Her symptoms were significantly relieved and the postoperative chest X-ray showed that pulmonary edema was significantly reduced. Histopathology of the resected valve and positive microorganism culture of the surgical specimen provided evidence of definite IE. CONCLUSION: IE should be considered in critical patients with refractory heart failure caused by severe bicuspid aortic valve regurgitation. PMID:3364418 8 | PMC:PMC7896646 | DOI:10.12998/wjcc.v9.i5.1221 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative discal pseudocyst and its similarities to discal cyst: A case report

paythelady.612 shared this article with you from Inoreader Postoperative discal pseudocyst and its similarities to discal cyst: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1439-1445. doi: 10.12998/wjcc.v9.i6.1439. ABSTRACT BACKGROUND: Postoperative discal pseudocyst (PDP) is a rare condition that presents after surgery for lumbar disc herniation. Due to the lack of information, the diagnosis and treatment of PDP remain controversial. Herein, we report a PDP case that occurred following percutaneous endoscopic lumbar discectomy and received conservative treatment. Additionally, we review all the published literature regarding PDP and propose our hypothesis regarding PDP pathology. CASE SUMMARY: A 23-year-old man presented with a relapse of low back pain and numbness in his left lower extremity after undergoing percutaneous endoscopic lumbar discectomy for lumbar disc herniation. Repeat magnetic resonance imaging demonstrated a cystic lesion at the surgical site with communication with the inner disc. The patient was diagnosed as having PDP. The patient received c onservative treatment, which resulted in rapid improvement and spontaneous regression of the lesion, and had a favorable outcome in follow-up. CONCLUSION: PDP and discal cyst (DC) exhibit similarities in both histological and epidemiological characteristics, which indicates the same pathological origin of PDP and DC. The iatrogenic annular injury during discectomy might accelerate the pathological progression of DC. For patients with mild to moderate symptoms, conservative treatment can lead to great improvement, even inducing spontaneous regression. However, surgical cystectomy is necessary in patients with neurological deficits and where conservative treatment is ineffective. PMID:33644213 | PMC:PMC7896671 | DOI:10.12998/wjcc.v9.i6.1439 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Animal models of cathartic colon

paythelady.612 shared this article with you from Inoreader Animal models of cathartic colon Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 26;9(6):1251-1258. doi: 10.12998/wjcc.v9.i6.1251. ABSTRACT The incidence of cathartic colon has been increasing, but satisfactory treatments are still lacking. In order to study the pathological mechanisms of the disorder and identify effective treatment methods, researchers have established different animal models of cathartic colon. This minireview briefly summarizes several common cathartic colon animal models, induced with anthraquinone laxatives such as rhubarb, total anthraquinone, rhein, and emodin, or induced with diphenylmethane laxatives such as phenolphthalein. The advantages and limitations of these models are evaluated and analyzed. We hope that this review will facilitate the selection of suitable models and improve relevant modeling methods. We anticipate the development of more convenient and stable models that can reflect the characteristics of cathartic colon in humans, and serve as useful tools for further studies. PMID:33644192 | PMC:PMC7896687 | DOI:10.12998/wjcc.v9.i6.1251 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.