RESUMO
Celiac disease is an immune-mediated disorder triggered by dietary gluten. It classically presents with gastrointestinal symptoms. It may also present with atypical manifestations like anemia, arthritis, infertility, or other neurological symptoms. However, arthralgia as a sole manifestation of celiac disease is a rare clinical scenario. Even though the clinical spectrum of celiac disease is broad, prompt diagnosis and management exert a protective effect against complications of celiac disease. We want to highlight and expand on the existing knowledge on atypical presentations about celiac disease.
RESUMO
Somatostatin receptors (SSTR) are expressed in various neoplasms and can be targeted for both diagnostics as well as therapeutics. This systematic review aims to compile and discuss the prevalence of somatostatin receptor expression in various neoplasms. We performed a literature search from Google Scholar and PubMed using relevant keywords to look for all publicly available data regarding SSTR expression in various cancers. Both histopathological and radiographical studies were included for SSTR assessment. We found that many cancers express SSTR with varying prevalence. SSTR is now a well-established theranostics biomarker. We now have highly sensitive and specific diagnostic modalities like gallium 68 DOTATATE and copper 64 DOTATATE scans to screen for SSTR-2 and then target it therapeutically with lutetium 177 DOTATATE. A thorough understanding of SSTR expression in other tumors will open the channels for exploring potential SSTR targeting.
RESUMO
Sarcoidosis is a chronic granulomatous disorder mostly known to affect the respiratory system. However, about 5-10% of cases develop neurological complications, either de novo or in patients with known sarcoidosis. The most common complications as cited by current literature include cranial nerve palsies, meningitis, and myelopathy. A unilateral thalamic lesion is an extremely rare presentation of disease. As the neurological manifestations of sarcoidosis are uncommon and variable, it poses a diagnostic challenge. We present a challenging case with worsening paraparesis and a step-by-step approach to how it was diagnosed as neurosarcoidosis. We aimed to create awareness about this uncommon manifestation to avoid misdiagnosis and promote early recognition of neurosarcoidosis.
RESUMO
Low-grade adenosquamous breast carcinoma (LGASC) is an atypical variant of metaplastic breast cancer. It differs from metaplastic carcinoma and has an indolent behavior. It usually presents as a palpable lump, unlike in our case, which had an incidental presentation. Because of its rarity, it often creates a clinical and diagnostic challenge. With the risk of local recurrence, the current management is aggressive with excision. Chemoradiation has been used in a few cases, but optimal management is unclear. Our manuscript aims to add to the existing knowledge on LGASC.
RESUMO
The urine pregnancy kit tests are commonly used in women of childbearing age to detect pregnancy. However, these tests may fail to detect pregnancy, rarely leading to inadvertent lab and radiation exposure. The hook-effect is a rare but important phenomenon, rendering the kit tests false negative due to an improper antigen-antibody ratio.
RESUMO
Isolated aortitis is a rare entity and was recently included in the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides under the single organ vasculitis group. Isolated aortitis represents a challenging situation due to the lack of reliable diagnostic methodology. Here, we describe the case of a 46-year-old woman who presented with severe upper back pain. She tested negative for pulmonary embolism, myocardial infarction, and other usual causes of back pain. The case highlights the clinical presentation of a rare disease with a usual symptom.