Pulmonary Enteric Adenocarcinoma: A Very Rare Case Report from Qatar.

A 78-year-old male patient presented with dyspnea, loss of appetite, and weight loss. Workup and imaging showed suspected malignant lung lesion. Biopsy was done and showed features of pulmonary enteric adenocarcinoma (PEAC). This is a very rare disease and its diagnosis is challenging.

Endomyocardial Fibrosis With Bilateral Ventricular Thrombus: A Case Report and Literature Review.

Endomyocardial fibrosis (EMF) is a rare restrictive cardiomyopathy in non-tropical areas. It is seen in most of the patients living in or coming from tropical areas, and is rarely seen in patients who have never visited these areas. It is characterized by fibrotic thickening of the endocardium, predominantly affecting the ventricular apices and inflow tracts. Although thrombus formation is a known complication in various cardiac conditions such as atrial fibrillation, atrial flutter, ventricular heart disease, and patent foramen ovale, the occurrence of bilateral thrombus in EMF is exceptionally rare. We present a case report describing a unique finding of bilateral ventricular thrombus in a patient diagnosed with EMF, highlighting the clinical presentation, diagnostic approach, and management challenges associated with this rare phenomenon.

A Subacute Presentation of Isolated Tuberculous Septic Hip Arthritis.

Tuberculous septic arthritis is a rare type of septic arthritis that is caused by Mycobacterium tuberculosis. However, it can lead to devastating complications if not diagnosed and treated correctly. We hereby report a 41-year-old female with no medical history who presented with a three-week history of right hip pain and inability to bear weight, found to have moderate to severe tenderness at the right anterior hip and gluteal area and limitation of joint movement. Magnetic resonance imaging (MRI) of the hip showed features of right hip septic arthritis with synovitis and anteromedial and posteromedial small collections. She was diagnosed with tuberculosis (TB) after joint fluid aspiration, and she was started on anti-TB treatment including isoniazid, rifampicin, ethambutol, and pyrazinamide directly after. Considering the case and the subacute presentation that can mimic bacterial septic arthritis, clinicians should always consider TB infection in their differential diagnosis upon assessing a suspected patient with septic arthritis even with a subacute presentation to achieve the correct diagnosis and start appropriate treatment to avoid its harmful complications.

Thrombocytopenia secondary to iron deficiency anemia responding to iron therapy.

A broad spectrum of diseases can cause anemia and thrombocytopenia. Some of these diseases are a hematological emergency; others are benign diseases, so early and accurate diagnosis is crucial in managing such patients. Usually, IDA is associated with thrombocytosis or normal platelets; however, in rare cases, IDA can be associated with thrombocytopenia; even though, thrombocytopenia that occurs with IDA responds to iron therapy. Iron therapy rarely causes transient thrombocytopenia per se. We are reporting an African female patient who is found to have thrombocytopenia secondary to iron deficiency anemia (IDA), and she responded to iron replacement therapy initially with a transient drop in platelets, followed by a rapid rise in platelets till platelets reached the normal level.

Severe Hypokalemia as a Rare Presentation of Disseminated Tuberculosis.

Disseminated tuberculosis (TB) is a mycobacterial infection in which the mycobacteria have spread from the lungs to other parts of the body through the blood or lymph system. We report a 38-year-old patient who presented with fever and severe weakness for five days. His initial workup in the emergency room showed severe hypokalemia resistant to multiple doses of potassium replacement. The patient later showed features of meningitis. His cerebrospinal fluid analysis confirmed tuberculous meningitis. After starting on anti-tuberculous medications, his hypokalemia improved significantly. Sputum culture was positive for TB, and the patient labeled as disseminated TB. Despite severe hypokalemia being a rare association with TB, disseminated TB can be considered the possible cause in patients presenting with severe hypokalemia and fever. Renal tubular defect could be the proposed mechanism causing potassium losing nephropathy.

Discrepancy between Serum Ferritin and Liver Iron Concentration in a Patient with Hereditary Hemochromatosis - The Value of T2* MRI.

Primary hemochromatosis is an inherited disorder, and the homeostatic iron regulator (HFE) gene C282Y mutation is a common cause of hemochromatosis in Europe. We are reporting a case of a 56-year-old female known to have hemochromatosis with the HFE gene C282Y mutation with a serum ferritin level of 482 µg/L who underwent heart and liver T2* MRI which showed no evidence of iron overload - neither in the heart nor in the liver. This indicates that there is a discrepancy between serum ferritin and liver iron concentration by MRI and the superiority of T2* MRI in diagnosis and follow-up of iron overload in patients with hereditary hemochromatosis.