Diabetes insipidus with impaired vision caused by germinoma and perioptic meningeal seeding: A case report

paythelady.612 shared this article with you from Inoreader Diabetes insipidus with impaired vision caused by germinoma and perioptic meningeal seeding: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1976-1982. doi: 10.12998/wjcc.v9.i8.1976. ABSTRACT BACKGROUND: Germinoma is a type of germ cell tumor that most frequently arises in the midline axis of the brain. Impaired vision is a clinical manifestation of germinnoma. Although rare, intracranial germinoma seeding to the perioptic arachnoid space is one cause of visual acuity decrease. CASE SUMMARY: An 11yearold girl who presented with polyuria and polydipsia and subsequently developed diminution of vision. Imaging showed bilateral heterogeneous enhancement of the optic nerve sheaths and atrophy of the optic nerve, and transsphenoidal biopsy revealed a germinoma. The patient experienced poor visual recovery following chemotherapy and radiotherapy. Germinomas are rare and they are mostly identified in children and adolescents. The manifestations include diabetes insipidus, pituitary dysfunction, visual complaints, etc. The mechanisms that lead to visual loss include intracranial hypertension, compression of optic chiasma, and tumor invasion. A literature review was performed to summarize the cases with a tumor infiltrating the optic nerve. Most of the reported patients were adolescents and presented with anterior pituitary hormone deficiency. Enhancement of optic nerve sheaths and optic disc pallor could be identified in most of the cases. The purpose of this report is to provide awareness that in cases where a germinoma is associated with visual loss, though rare, perioptic meningeal seeding should be taken into consideration. CONCLUSION: The case report suggests that children with diabetes insipidus need a complete differential diagnosis. PMID:33748249 | PMC:PMC7953398 | DOI:10.12998/wjcc.v9.i8.1976 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A three-year clinical investigation of a Chinese child with craniometaphyseal dysplasia caused by a mutated ANKH gene

paythelady.612 shared this article with you from Inoreader A three-year clinical investigation of a Chinese child with craniometaphyseal dysplasia caused by a mutated <em>ANKH</em> gene Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1853-1862. doi: 10.12998/wjcc.v9.i8.1853. ABSTRACT BACKGROUND: Craniometaphyseal dysplasia (CMD) is a rare genetic disorder. Autosomal dominant CMD (AD-CMD) is caused by mutations in the ANKH gene. Affected individuals typically have distinctive facial features including progressive thickening of the craniofacial bones. Treatment for AD-CMD primarily consists of surgical intervention to release compression of the cranial nerves and the brain stem/spinal cord. To alleviate progression of the clinical course and improve the quality of life in children waiting to undergo the necessary surgery, we investigated clinical changes in a diagnosed patient with AD-CMD over three years. CASE SUMMARY: A 17-mo-old boy presented with progressive nasal obstruction, snoring and hearing loss symptoms. Physical examination showed enlargement of the head circumference and clinical features such as wide nas al bridge, paranasal bossing, widely spaced eyes with an increased bizygomatic width, and a prominent mandible. The patient underwent otolaryngological examination, endoscopy, hearing test, laboratory examination of phosphorus and bone metabolism, cranial and femoral computed tomography, X-ray and next-generation sequencing. The patient was diagnosed with AD-CMD due to p.Phe377 deletion (c.1129_1131del) on exon 9 of the ANKH gene. After adherence to a prescribed low-calcium diet, the boy's alkaline phosphatase (ALP) levels continuously decreased to within the normal range. However, after 14 mo of dietary intervention, his parents altered his diet to an intermittent low-calcium diet to include milk and eggs. The patient's ALP was slightly higher than normal after the dietary change but remained close to the normal range. His serum osteocalcin changed to within normal levels after dietary regulation for 33 mo. His serum combined beta C-terminal telopeptide of type I collagen al so continuously decreased after the nutritional intervention, although still slightly higher than normal levels. Despite fluctuating blood test results, the boy's nasal symptoms were markedly relieved and steadily improved after dietary intervention. No significant changes were found in the craniofacial bones by cranial radiography. Close monitoring of clinical features is still ongoing. Calcitriol treatment is currently under consideration and a surgical procedure is planned as necessary in the future. CONCLUSION: We herein report the first Chinese case of AD-CMD with heterozygous mutation of p.Phe377 deletion (c.1129_1131del) on the ANKH gene. Biochemical alterations were significantly improved after dietary intervention indicating that a low-calcium diet may be applied in pediatric AD-CMD patients with ANKH mutations to help alleviate phenotypic manifestations and improve the quality of life before surgical intervention. Further large scale studies are needed to replicate these findings and to establish the appropriate timing for nutritional and surgical interventions. PMID:33748234 | PMC:PMC7953411 | DOI:10.12998/wjcc.v9.i8.1853 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Madelung disease: A case report

paythelady.612 shared this article with you from Inoreader Madelung disease: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1983-1988. doi: 10.12998/wjcc.v9.i8.1983. ABSTRACT BACKGROUND: Madelung disease (MD) is a rare disorder of fat metabolism, resulting in diffuse, symmetrical and painless deposition of adipose tissue in subcutaneous superficial fascial space and/or deep fascia space of the head, neck and shoulders, etc. CASE SUMMARY: We report a case of MD accompanied by type 2 diabetes in a 61-year-old Chinese male. The patient presented with progressive fat deposition over the mandible, neck, abdomen and elbows. He had a history of smoking and alcohol abuse. Excessive fat deposition was seen in the mandible, elbows and the abdominal area of the patient by ultrasonic examination. Computed tomography showed diffuse and marked soft masses (fat density) in the subcutaneous superficial fascia space of the neck. The patient was diagnosed with MD. He was advised to abstain from alcohol and was followed up reg ularly. CONCLUSION: This report discusses the pathogenesis, diagnosis and treatment of MD, and raises the clinician's awareness of this disease. PMID:33748250 | PMC:PMC7953395 | DOI:10.12998/wjcc.v9.i8.1983 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Subcutaneous panniculitis-like T-cell lymphoma invading central nervous system in long-term clinical remission with lenalidomide: A case report

paythelady.612 shared this article with you from Inoreader Subcutaneous panniculitis-like T-cell lymphoma invading central nervous system in long-term clinical remission with lenalidomide: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1885-1892. doi: 10.12998/wjcc.v9.i8.1885. ABSTRACT BACKGROUND: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) involvement in the central nervous system (CNS) is particularly rare. SPTCL with CNS involvement has an exceedingly poor prognosis, and no optimum therapeutic method has been discovered. To the best of our knowledge, this is the first reported case of SPTCL invading the CNS achieving long-term remission with lenalidomide maintenance therapy. CASE SUMMARY: A 63-year-old man diagnosed with SPTCL was admitted to the hospital with severe headache for 15 d after four cycles of chemotherapy. Subsequent to the treatment, the patient developed CNS involvement. Craniotomy biopsy was pathologically diagnosed as CNS T-cell lymphoma, and two courses of chemotherapy were performed postoperatively. Due to the intolerance of the side effects of chemotherapeutic drugs, the patient received len alidomide instead. The magnetic resonance imaging of the head at the 8 mo follow-up indicated no signs of recurrence, and the vital signs were stable. CONCLUSION: Lenalidomide deserves further investigation as a targeted drug for SPTCL cases involving the CNS. PMID:33748238 | PMC:PMC7953407 | DOI:10.12998/wjcc.v9.i8.1 885 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngopharyngeal reflux disease management for recurrent laryngeal contact granuloma: A case report

paythelady.612 shared this article with you from Inoreader Laryngopharyngeal reflux disease management for recurrent laryngeal contact granuloma: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1989-1995. doi: 10.12998/wjcc.v9.i8.1989. ABSTRACT BACKGROUND: Laryngeal contact granuloma (LCG) is difficult to treat and frequently associated with high persistence and recurrence, despite the availability of both surgical and pharmacological treatment options. An appropriate strategy is therefore needed to help patients with multiple recurrences of LCG to potentially avoid unnecess-ary surgery. CASE SUMMARY: We describe the case of a 34-year-old male patient with recurrent LCG in which a good response was achieved through successful management of laryngophar-yngeal reflux disease using a combination pharmacotherapeutic regimen consisting of anti-reflux therapy, pepsin secretion inhibition, bile acid neutralization, and lifestyle modifications. This patient underwent surgery to excise the granuloma, then relapsed, underwent a second surgery, which was followed by a second recurrence. The gra nuloma then disappeared after 9 mo of combined treatment with ilaprazole enteric-coated capsules (10 mg qd), mosapride tablets (5 mg tid) and compound digestive enzyme capsules (2 tablets). The drug regimen was discontinued after one year, and no recurrence of the lesion has been reported during the one-year follow-up period. CONCLUSION: We report a combination of pharmacotherapeutics and lifestyle modifications for the management of laryngopharyngeal reflux disease to address recurring LCG. PMID:33748251 | PMC:PMC7953387 | DOI:10.12998/wjcc.v9.i8.1989 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk factors for post-hepatectomy liver failure in 80 patients

paythelady.612 shared this article with you from Inoreader Risk factors for post-hepatectomy liver failure in 80 patients Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1793-1802. doi: 10.12998/wjcc.v9.i8.1793. ABSTRACT BACKGROUND: Post-hepatectomy liver failure (PHLF) is a serious complication and a leading cause of death after hepatectomy, an accurate prediction of PHLF is important for improvement of prognosis after hepatectomy. AIM: To retrospectively analyze the risk factors for postoperative liver failure in patients undergoing hepatectomy for liver tumors. METHODS: The clinical data of 80 patients undergoing hepatectomy in our hospital from June 2018 to January 2020 were collected. With laboratory examination as well as pre- and post-operative abdominal three-dimensional reconstructive computed tomography, the demographic data, surgical data, biochemical indicators, coagulation index, routine blood tests, spleen and liver volumes, relative remnant liver volume, and other related indicators were obtained and compared between patients with PHLF and those without PHLF. RESULTS: PHLF occurred in 19 (23.75%) patients. Univariate logistic regression analysis showed that gender, history of hepatitis/cirrhosis, and preoperative bilirubin, albumin, coagulation function, albumin-bilirubin ratio, aspartate amino-transferase-to-platelet ratio index (APRI), Model for End-Stage Liver Disease score, spleen volume (SV), spleen volume/liver volume ratio (SV/LV), and relative remnant liver volume were statistically associated with the occurrence of PHLF (all P < 0.05). Multivariate regression analysis showed that preoperative total bilirubin, platelets (PLT), APRI, and SV/LV were independent risk factors for PHLF (all P < 0.05). The area under the curve and cut-off values were 0.787 and 18.6 mmol/L for total bilirubin, 0.893 and 146 × 1012/L for PLT, 0.907 and 0.416 for APRI, and 0.752 and 20.84% for SV/LV, respectively. CONCLUSION: For patients undergoing liver resection, preoperative total biliru bin, PLT, APRI, and SV/LV are independent risk factors for PHLF. These findings may provide guidance to safely perform liver surgery in such patients. PMID:33748228 | PMC:PMC7953404 | DOI:10.12998/wjcc.v9.i8.1793 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mycobacterium abscessus infection after facial injection of argireline: A case report

paythelady.612 shared this article with you from Inoreader <em>Mycobacterium abscessus</em> infection after facial injection of argireline: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1996-2000. doi: 10.12998/wjcc.v9.i8.1996. ABSTRACT BACKGROUND: The incidence of infection with Mycobacterium abscessus (M. abscessus) has increased in recent years. This increase is partly associated with invasive cosmetic procedures. CASE SUMMARY: The purpose of this case summary is to increase clinicians' awareness of M. abscessus infection and reduce mycobacterial infection caused by cosmetic procedures. We report the case of a 45-year-old woman who received acetyl hexapeptide-8 (argireline) injections in the forehead and temples, and erythema, nodules, and abscesses appeared at the injection sites after one week. The pus specimens were examined by microbiological culture and confirmed to be positive for M. abscessus. Clarithromycin 500 mg twice daily and moxifloxacin 400 mg once daily were administered for 5 mo and the lesions gradually subsided. CONCLUSIO N: We report here for the first time a case of infection with M. abscessus after argireline injection. This condition is easily misdiagnosed as a common bacterial infection. Microbiological examinations are helpful for diagnosis and standardized cosmetic procedures can prevent infection with M. abscessus. PMID:33748252 | PMC:PMC7953399 | DOI:10.12998/wjcc.v9.i8.1996 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gastroesophageal varices in a patient presenting with essential thrombocythemia: A case report

paythelady.612 shared this article with you from Inoreader Gastroesophageal varices in a patient presenting with essential thrombocythemia: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1871-1876. doi: 10.12998/wjcc.v9.i8.1871. ABSTRACT BACKGROUND: Gastroesophageal varices are a rare complication of essential thrombocythemia (ET). ET is a chronic myeloproliferative neoplasm (MPN) characterized by an increased number of blood platelets. CASE SUMMARY: A 46-year-old woman, who denied a history of liver disease, was admitted to our hospital on presentation of hematemesis. Laboratory examination revealed a hemoglobin level of 83 g/L, and a platelet count of 397 × 109/L. The appearance of gastric and esophageal varices with red colored signs as displayed by an urgent endoscopy was followed by endoscopic variceal ligation and endoscopic tissue adhesive. Abdominal computed tomography revealed cirrhosis, marked splenomegaly, portal vein thrombosis and portal hypertension. In addition, bone marrow biopsy and evidence of mutated Janus kinase 2, substantiated the onset of ET. The patient was asymptomatic with regular routine blood testing during the 6-mo follow-up period. Therefore, in this case, gastroesophageal varices were induced by ET. CONCLUSION: MPN should be given considerable attention when performing differential diagnoses in patients with gastroesophageal varices. An integrated approach such as laboratory tests, radiological examination, and pathological biopsy, should be included to allow optimal decisions and management. PMID:33748236 | PMC:PMC7953392 | DOI:10.12998/wjcc.v9.i8.1871 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Inadvertent globe penetration during retrobulbar anesthesia: A case report

paythelady.612 shared this article with you from Inoreader Inadvertent globe penetration during retrobulbar anesthesia: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):2001-2007. doi: 10.12998/wjcc.v9.i8.2001. ABSTRACT BACKGROUND: To report the possible reasons for needle perforation and complications related to perforation, as well as the clinical management of subretinal hemorrhage (SRH) during retrobulbar injection. CASE SUMMARY: A 65-year-old female was scheduled to undergo pars plana vitrectomy (PPV) in her left eye for rhegmatogenous retinal detachment (RRD). During retrobulbar anesthesia, needle perforation of the globe occurred. Massive SRH in the inferotemporal quadrant together with vitreous hemorrhage were observed. The patient underwent PPV combined with retinotomy for removal of the massive SRH. After earlier surgical intervention, successful reattachment of the retina was achieved. CONCLUSION: Inadvertent globe penetration during retrobulbar anesthesia is associated with a poor prognosis and may result in blindness. Timely detection and e arlier intervention may be beneficial. PMID:33748253 | PMC:PMC7953384 | DOI:10.12998/wjcc.v9.i8.2001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Conservative endodontic management using a calcium silicate bioceramic sealer for delayed root fracture: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Conservative endodontic management using a calcium silicate bioceramic sealer for delayed root fracture: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1835-1843. doi: 10.12998/wjcc.v9.i8.1835. ABSTRACT BACKGROUND: The success rate of conservative endodontic management for root fracture varies greatly based on different methods used. It has been rarely reported that calcium silicate-based materials are applied in root fracture treatment. CASE SUMMARY: A 38-year-old male patient presented with spontaneous pain from the upper left anterior teeth for 1 wk. The spontaneous pain was subsequently relieved, but pain on mastication persisted for 3 d. The patient had a dental trauma from a boxing match 15 years ago. Cone beam computed tomography showed that the maxillary left central incisor had oblique fracture lines and a radiolucent lesion around the fracture line. The tooth was diagnosed with an oblique root fracture with no healing and symptomatic apical periodontitis. In the following conservative endodontic management, the coronal and apical fr agments of the canal both were chemo-mechanically prepared and obturated using a single cone gutta-percha with iRoot SP (Innovative BioCreamix Inc, Vancouver, Canada), a new calcium silicate-based bioceramic root canal sealer. At follow-ups at 1, 6, 12, and 24 mo, the patient was asymptomatic and the radiolucency around the fracture line was healing radiographically. CONCLUSION: Conservative root canal treatment is an alternative treatment in some cases of oblique root fracture with no healing. The application of bioceramic sealers and single core obturation techniques may also be essential to obtain an excellent outcome. PMID:33748232 | PMC:PMC7953412 | DOI:10.12998/wjcc.v9.i8.1835 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.