Sarcoidosis in a young adult: A rare sequelae of COVID-19 infection.

Key Clinical Message: This case illustrates sarcoidosis as a potential complication of COVID-19, highlighting the need for a comprehensive diagnostic approach, including histopathology and prolonged monitoring, to distinguish it from post-COVID fibrosis. Further research is crucial to elucidate these associations and understand their underlying mechanisms. Abstract: Severe Acute Respiratory Syndrome Coronavirus- 2 (SARS-CoV-2), a positive-sense single-stranded RNA virus, causes COVID-19 and has been linked to autoimmune disorders. Sarcoidosis is a multi-system disease that is frequently triggered by infections. It is characterized by non-necrotizing granulomas in multiple organs. We present a case of sarcoidosis as rare sequelae of COVID-19. A 26-year-old man presented with mild COVID-19 symptoms, followed by prolonged fever and cough despite initial therapy, prompting a provisional diagnosis of post-COVID fibrosis. A subsequent assessment at a tertiary hospital revealed dyspnea, weight loss, and abnormal chest imaging, all of which were consistent with pulmonary sarcoidosis with pulmonary tuberculosis as a differential diagnosis. A biopsy taken during bronchoscopy confirmed pulmonary sarcoidosis and treatment with inhalation steroids resulted in symptom relief, which was followed by remission with oral steroid therapy. Sarcoidosis is a systemic disease of unknown etiology, characterized by non-necrotizing granulomas in multiple organs. It may be triggered by infections and involves an abnormal immune response. COVID-19 can potentially initiate sarcoidosis, with both sharing common immune mechanisms. Diagnosis involves imaging and biopsy, and treatment typically includes glucocorticoids and regular monitoring. This case report emphasizes the potential link between COVID-19 and autoimmune conditions like sarcoidosis, highlighting the need for a comprehensive diagnostic approach and long-term observation to distinguish between sarcoidosis and post-COVID fibrosis.

Achalasia cardia: A case report in young female.

Key Clinical Message: This case emphasizes the need for early recognition and accurate diagnosis of achalasia in young adults to avoid exacerbation of the condition and misdiagnosis as GERD. Patient outcomes and quality of life are greatly enhanced by suitable diagnostic techniques, appropriate therapy, interdisciplinary care, and comprehensive patient education along with frequent follow-ups. Abstract: Achalasia results from the degeneration of inhibitory ganglion cells within the esophageal myenteric plexus and the lower esophageal sphincter (LES), leading to a loss of inhibitory neurons and resulting in the absence of peristalsis with failure of LES relaxation. Its origins are multifactorial, potentially involving infections, autoimmune responses, and genetics, with equal incidence in males and females. The hallmark symptoms include progressive dysphagia for solids and liquids, along with regurgitation, heartburn, and non-cardiac chest pain. A 22-year-old female patient initially diagnosed with gastroesophageal reflux disease (GERD) received proton pump inhibitors and antacid gel for persistent dysphagia and regurgitation. Subsequent tests including barium esophagogram and manometry indicated Type II Achalasia Cardia. The patient showed clinical improvement with relief of dysphagia, regurgitation, and heartburn symptoms after pneumatic balloon dilatation (PBD). She was advised to follow up after 6 months with upper gastrointestinal (UGI) endoscopy and manometry in the outpatient clinic for regular endoscopic surveillance as there is a risk of transformation to esophageal carcinoma. Diagnosing achalasia in young adults poses challenges due to its diverse presentation and resemblance to other esophageal disorders like GERD. Diagnosis relies on clinical symptoms and imaging studies such as barium esophagogram revealing a bird's beak appearance and esophageal manometry showing absent peristalsis. UGI endoscopy is needed to rule out malignancy. Treatment options include non-surgical approaches like medication and Botox injections, as well as surgical methods such as pneumatic balloon dilation, laparoscopic Heller myotomy, and per-oral endoscopic myotomy (POEM). The treatment options depend upon the patient's condition at presentation and their individual choices. This case report emphasizes that it is crucial to consider achalasia as a potential differential diagnosis in young adults with dysphagia, especially if conventional treatments for acid peptic disorder do not alleviate symptoms. Prompt diagnosis and appropriate management can lead to significant clinical improvement and better patient outcomes.

Erasmus syndrome: A rare case report of silicosis and systemic sclerosis.

People with silicosis may develop Erasmus syndrome, a condition characterized by the emergence of systemic sclerosis (SSc) after silica exposure. This case study emphasizes the significance of understanding the connection between occupational silica exposure, silicosis, and SSc. A 24-year-old male stonecutter got silicosis and a form of SSc following 8 years on his job as a stonecutter. The signs and symptoms the patient experienced were Raynaud's phenomenon, cutaneous fibrosis, arthralgia, digital pitting, and respiratory distress. High-resolution computed tomography (HRCT) revealed interstitial lung disease and calcified mediastinal lymph nodes. This case study demonstrates the clinical importance of the relationship between occupational silica exposure, silicosis, SSc, and Erasmus syndrome. Healthcare providers need to be aware of the possible difficulties and issues that may result from silica exposure. They should prioritize quick detection and efficient treatment plans for those who have been exposed to silica while on the job.