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1.
J Int Med Res ; 52(9): 3000605241272609, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39246065

RESUMO

The glomus tumor is a rare neoplasm that is typically found subungually in the extremities and functions as a specialized neurovascular organ. An extremely rare site for glomus tumors is the breast, with only a few reported cases. Breast glomus tumors present with three typical clinical signs: dull pain, focal tenderness, and cold sensitivity. Less than 10% of all glomus tumors are malignant. We herein present a case of a malignant glomus tumor originating in the breast. Distant metastasis was ruled out, and the tumor was completely resected. However, the patient unexpectedly developed rapid systemic metastasis, detected 5 weeks after tumor removal. Despite the administration of analgesics and targeted therapy, the patient died 1 month later. When treating patients with undiagnosed breast tumors, clinicians should pay attention to unexplained and repeatedly reported symptoms and consider the possibility of a rare disease. Our literature search revealed no cases of malignant glomus tumors originating in the breast, making this case the first of its kind.


Assuntos
Neoplasias da Mama , Tumor Glômico , Humanos , Tumor Glômico/patologia , Tumor Glômico/diagnóstico , Tumor Glômico/cirurgia , Feminino , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/diagnóstico , Pessoa de Meia-Idade , Evolução Fatal , Progressão da Doença
2.
Nihon Shokakibyo Gakkai Zasshi ; 121(9): 754-762, 2024.
Artigo em Japonês | MEDLINE | ID: mdl-39261056

RESUMO

An 84-year-old woman underwent laparoscopic partial hepatectomy for a single 3.0-cm-diameter nodule of hepatocellular carcinoma at segment 5. Although the postoperative condition was uneventful, multiple recurrences were observed six months after hepatic resection. Transcatheter arterial chemoembolization (TACE) was the second-line therapy. However, she was later diagnosed as TACE refractory due to residual tumor and presence of portal vein tumor thrombus. Third-line therapy was the combination of atezolizumab and bevacizumab, which was discontinued after 22 courses due to disease progression. Two months after the conclusion of chemotherapy, sudden onset of purpura was observed around her eyes and on her lower legs. Laboratory tests revealed severe thrombocytopenia, and she was diagnosed with secondary immune thrombocytopenic purpura. Steroids and immunoglobulin therapy were then administered. Although the immature platelet fraction increased after treatment, the platelet count did not. The patient died of intracranial hemorrhage 10 days after initiation of steroid and immunoglobulin therapy.


Assuntos
Anticorpos Monoclonais Humanizados , Bevacizumab , Carcinoma Hepatocelular , Neoplasias Hepáticas , Púrpura Trombocitopênica Idiopática , Humanos , Feminino , Neoplasias Hepáticas/tratamento farmacológico , Idoso de 80 Anos ou mais , Bevacizumab/administração & dosagem , Bevacizumab/efeitos adversos , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/administração & dosagem , Carcinoma Hepatocelular/tratamento farmacológico , Evolução Fatal , Hemorragias Intracranianas/induzido quimicamente , Hemorragias Intracranianas/etiologia , Hemorragias Intracranianas/diagnóstico por imagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
3.
Clin Lab ; 70(9)2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39257111

RESUMO

BACKGROUND: Group A Streptococcus causes a variety of human infections, including the life-threatening necrotizing fasciitis, which may be ignored by the patient. From hours to days, the infection may progress from an apparently benign skin lesion, usually mistaken for a spider or insect bite, to a highly lethal disease. We present a case of 57-year-old male with skin lesions on swelling left upper limb. METHODS AND RESULTS: The culture of secretion from epidermis and blood were positive for Group A Streptococcus (GAS), type ß hemolytic streptococcus. Intensive anti-infection therapy was applied. However, the necrosis of the limb deteriorated rapidly. He died from multiple organ failure, streptococcal toxic shock syndrome (STSS) and disseminated intravascular coagulation 13 days later. CONCLUSIONS: Necrotizing fasciitis is a rapidly progressive, destructive bacterial infection. Early recognition is the most important factor for survival.


Assuntos
Fasciite Necrosante , Choque Séptico , Infecções Estreptocócicas , Streptococcus pyogenes , Fasciite Necrosante/diagnóstico , Fasciite Necrosante/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Streptococcus pyogenes/isolamento & purificação , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/tratamento farmacológico , Evolução Fatal , Choque Séptico/microbiologia , Choque Séptico/diagnóstico , Insuficiência de Múltiplos Órgãos/diagnóstico , Insuficiência de Múltiplos Órgãos/etiologia , Insuficiência de Múltiplos Órgãos/microbiologia , Antibacterianos/uso terapêutico , Coagulação Intravascular Disseminada/diagnóstico , Coagulação Intravascular Disseminada/microbiologia , Coagulação Intravascular Disseminada/etiologia
4.
BMJ Case Rep ; 17(9)2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39266023

RESUMO

Multidrug therapy has significantly reduced the global burden of Hansen's disease; however, complications from long-term treatment persist. A male resident of southern Kentucky, in his 30s and of Micronesian descent, presented with worsening abdominal pain associated with anorexia, fatigue, functional decline and occasional haemoptysis. He was compliant with multidrug therapy for leprosy. Laboratory investigations revealed pancytopenia. He was initially treated under a sepsis protocol and later switched to high-dose steroids due to a suspected immune reaction from missed corticosteroid doses. Despite aggressive treatment for refractory pancytopenia, the patient's condition deteriorated, and he passed away from cardiac arrest. Posthumous bone marrow biopsy revealed haemophagocytic lymphohistiocytosis secondary to disseminated histoplasmosis with bone marrow infiltration. This case highlights the importance of proactive fungal screening in immunocompromised leprosy patients, particularly in endemic regions, as early detection and timely intervention can prevent severe complications.


Assuntos
Histoplasmose , Linfo-Histiocitose Hemofagocítica , Humanos , Linfo-Histiocitose Hemofagocítica/diagnóstico , Linfo-Histiocitose Hemofagocítica/tratamento farmacológico , Linfo-Histiocitose Hemofagocítica/etiologia , Histoplasmose/diagnóstico , Histoplasmose/complicações , Histoplasmose/tratamento farmacológico , Masculino , Adulto , Evolução Fatal , Hanseníase/complicações , Hanseníase/diagnóstico , Hanseníase/tratamento farmacológico , Hospedeiro Imunocomprometido
5.
BMJ Case Rep ; 17(9)2024 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-39266034

RESUMO

Acute mesenteric ischaemia (AMI) is a life-threatening gastrointestinal complication uncommonly described in premature infants. The diagnosis of AMI is challenging and may be delayed due to the limitation of accurate diagnostic imaging and non-specific clinical signs. Furthermore, AMI can be misdiagnosed as necrotising enterocolitis (NEC) due to the overlapping clinical and radiological features. Though known to be associated with high mortality rates, early recognition and intervention can improve the survival rates in infants with AMI. We describe a case of a premature infant who presented with an acute abdomen and haemodynamic collapse, initially treated for NEC but later diagnosed with AMI intraoperatively. Due to the extensive bowel necrosis, surgical intervention was rendered futile and the infant finally succumbed to the disease.


Assuntos
Enterocolite Necrosante , Recém-Nascido Prematuro , Isquemia Mesentérica , Humanos , Enterocolite Necrosante/diagnóstico , Enterocolite Necrosante/cirurgia , Isquemia Mesentérica/diagnóstico , Isquemia Mesentérica/cirurgia , Isquemia Mesentérica/diagnóstico por imagem , Isquemia Mesentérica/etiologia , Diagnóstico Diferencial , Recém-Nascido , Evolução Fatal , Masculino , Doenças do Prematuro/diagnóstico , Abdome Agudo/etiologia , Doença Aguda
6.
BMJ Case Rep ; 17(9)2024 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-39266041

RESUMO

Alveolar capillary dysplasia with misalignment of pulmonary veins (ACDMPV) is an interstitial lung disease. In ACDMPV, respiratory impairment with severe pulmonary hypertension occurs from the early hours of life. Anomalies in the cardiovascular, gastrointestinal and genitourinary systems have been reported. However, little is known about upper airway abnormalities. We encountered a genetically diagnosed ACDMPV infant who presented with subglottic and bronchial stenosis. The prenatal diagnosis was hypoplastic left heart syndrome. Her respiratory condition worsened at 16 hours of life. We found subglottic stenosis when intubating. She died on day 7. Autopsy imaging with CT scan showed bilateral main bronchial stenosis. Chromosomal microarray revealed a 531 kb deletion in chromosome 16q24.1, including FOXF1.


Assuntos
Laringoestenose , Síndrome da Persistência do Padrão de Circulação Fetal , Alvéolos Pulmonares , Humanos , Feminino , Recém-Nascido , Síndrome da Persistência do Padrão de Circulação Fetal/complicações , Síndrome da Persistência do Padrão de Circulação Fetal/genética , Laringoestenose/etiologia , Evolução Fatal , Alvéolos Pulmonares/anormalidades , Alvéolos Pulmonares/patologia , Constrição Patológica , Veias Pulmonares/anormalidades , Veias Pulmonares/diagnóstico por imagem , Fatores de Transcrição Forkhead
7.
BMC Vet Res ; 20(1): 423, 2024 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-39304874

RESUMO

BACKGROUND: Dictyocaulosis is a parasitic disease caused by pulmonary nematodes from genus Dictyocaulus affecting various ungulate hosts. It can cause verminous bronchopneumonia and for heavily infected individuals, fatal outcomes can occur. CASE PRESENTATION: The study describes the case of a male European bison which died three months after relocation from Slovakia to one of the reintroduction areas in Nucșoara village, Fagaraș Mountains, Romania. Necropsy revealed the presence of pulmonary nematodes in the respiratory tract. Morphology and molecular diagnosis was performed and Dictyocaulus viviparus was identified. CONCLUSION: Rigorous health monitoring is essential to assure the success of reintroduction programs, understanding and preventing infectious diseases and limiting their impact on population health.


Assuntos
Bison , Infecções por Dictyocaulus , Dictyocaulus , Animais , Masculino , Dictyocaulus/isolamento & purificação , Evolução Fatal , Pneumonia/veterinária , Eslováquia , Romênia , Espécies Introduzidas
8.
Wiad Lek ; 77(8): 1627-1632, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39231336

RESUMO

Coronavirus disease (COVID-19), which broke out in China and caused a devastating pandemic worldwide, is associated with a significantly increased risk of thrombotic complications, especially pulmonary embolism. During the COVID-19 pandemic, investigations have reported a high incidence of venous thromboembolic (VTE) events in hospitalized patients with COVID-19, often despite thromboprophylaxis. Current recommendations for thromboprophylaxis are based on randomized clinical trials, which usually exclude patients at а potentially high risk of hemorrhagic complications. This category includes patients with liver cirrhosis complicated by variceal bleeding, thrombocytopenia, and coagulopathy. We present three patients who suffered severe covid pneumonia and were hospitalized with acute variceal bleeding, who developed fatal thromboembolic complications in the postoperative period.


Assuntos
COVID-19 , Hemorragia Gastrointestinal , Cirrose Hepática , Complicações Pós-Operatórias , Humanos , COVID-19/complicações , Varizes Esofágicas e Gástricas/etiologia , Evolução Fatal , Hemorragia Gastrointestinal/etiologia , Cirrose Hepática/complicações , Cirrose Hepática/cirurgia , Complicações Pós-Operatórias/etiologia , SARS-CoV-2 , Tromboembolia Venosa/etiologia
9.
Rinsho Ketsueki ; 65(8): 737-741, 2024.
Artigo em Japonês | MEDLINE | ID: mdl-39231701

RESUMO

Histiocytic sarcoma (HS) is a rare aggressive hematological malignancy reported to occur secondary to B cell lymphoma. We report a case of HS secondary to splenic marginal zone lymphoma (SMZL) complicated by autoimmune hemolytic anemia (AIHA) in a 64-year-old man. He was referred to our department with anemia and was diagnosed as having AIHA. After starting treatment with prednisolone, atypical lymphocytes appeared in his blood tests, and a bone marrow biopsy revealed invasion by B cell lymphoma. A CT scan showed splenomegaly and a pancreatic mass, which confirmed the diagnosis of SMZL. The patient received bendamustine and rituximab as chemotherapy, which rapidly improved the anemia and splenomegaly and reduced atypical lymphocytes. However, left lumbar back pain appeared along with an increase in the pancreatic mass, and he died suddenly of acute renal failure. An autopsy revealed that the tumor had invaded several organs including the pancreas, and immunohistochemistry was positive for CD163, leading to the diagnosis of HS. Furthermore, the specimens of SMZL and HS were positive for IgH gene reconstitution, and exome analysis showed genetic abnormalities in 226 genes including CARD11, suggesting that the SMZL and HS had the same origin.


Assuntos
Sarcoma Histiocítico , Linfoma de Zona Marginal Tipo Células B , Neoplasias Esplênicas , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Esplênicas/genética , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/diagnóstico , Linfoma de Zona Marginal Tipo Células B/genética , Linfoma de Zona Marginal Tipo Células B/patologia , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/tratamento farmacológico , Sarcoma Histiocítico/patologia , Sarcoma Histiocítico/genética , Sarcoma Histiocítico/diagnóstico , Sequenciamento do Exoma , Evolução Fatal
10.
Rinsho Ketsueki ; 65(8): 742-746, 2024.
Artigo em Japonês | MEDLINE | ID: mdl-39231702

RESUMO

Lomentospora prolificans is a rare filamentous fungus that causes invasive fungal disease (IFD) in immunocompromised patients with hematological malignancies, as well as hematopoietic cell or solid organ transplant recipients. A 75-year-old woman was diagnosed with acute myeloid leukemia, and started induction therapy with azacitidine and adjusted-dose venetoclax along with antifungal prophylaxis with fluconazole. On day 7, she became febrile and chest CT imaging showed multiple nodules in both lung fields, and the serum galactomannan antigen index became positive, indicating probable IFD. Anti-fungal therapy with liposomal amphotericin B was immediately initiated; however, the patient's condition rapidly deteriorated, and she died on day 15. L. prolificans was later identified in blood culture tests that had been repeatedly performed while she had been febrile. L. prolificans is generally resistant to most antifungal agents, which can make it fatal. As early definitive diagnosis is difficult, it may be appropriate to consider combination therapy when conventional anti-IFD therapy seems inadequate.


Assuntos
Azacitidina , Compostos Bicíclicos Heterocíclicos com Pontes , Leucemia Mieloide Aguda , Sulfonamidas , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Idoso , Feminino , Azacitidina/administração & dosagem , Azacitidina/uso terapêutico , Sulfonamidas/administração & dosagem , Compostos Bicíclicos Heterocíclicos com Pontes/administração & dosagem , Compostos Bicíclicos Heterocíclicos com Pontes/uso terapêutico , Evolução Fatal , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Quimioterapia de Indução , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Infecções Fúngicas Invasivas/tratamento farmacológico , Infecções Fúngicas Invasivas/diagnóstico , Micoses/tratamento farmacológico , Micoses/diagnóstico
11.
BMJ Case Rep ; 17(9)2024 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-39306339

RESUMO

Intravascular large B-cell lymphoma (IVLBCL) is a rare type of non-Hodgkin's lymphoma. Common neurological symptoms are cognitive impairment and dementia. Only a few cases have been published reporting intracranial haemorrhage due to IVLBCL. We present a case of a female patient in her late 60s who presented with an atypical intracerebral haemorrhage as the first major complication of an IVLBCL. The patient's condition declined rapidly. She died several weeks later due to haemorrhagic shock. The definitive diagnosis was achieved postmortem. Due to aggressive disease progression, the diagnosis of IVLBCL is still challenging and can therefore lead to incorrect or delayed treatment, especially in cases of unusual manifestations like lobar intracranial haemorrhage.


Assuntos
Hemorragia Cerebral , Linfoma Difuso de Grandes Células B , Humanos , Feminino , Hemorragia Cerebral/etiologia , Hemorragia Cerebral/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/complicações , Evolução Fatal , Pessoa de Meia-Idade , Neoplasias Vasculares/diagnóstico , Neoplasias Vasculares/complicações , Diagnóstico Diferencial , Idoso
12.
BMJ Case Rep ; 17(9)2024 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-39306333

RESUMO

Gastric cancer primarily metastasizes to the peritoneum, liver and lungs, with bone marrow involvement being a rare occurrence, found in less than 1% of cases. Disseminated carcinomatosis of the bone marrow (DCBM) is characterised by widespread infiltration of cancer cells into the bone marrow, leading to haematological disorders such as disseminated intravascular coagulation and thrombocytopenia. We present a unique case of a man in his late 50s with acute thrombocytopenia as the initial symptom, subsequently diagnosed with gastric cancer on bone marrow examination. Despite receiving chemotherapy, the patient's condition deteriorated rapidly, emphasising the challenging management and poor prognosis associated with DCBM. This case underscores the need for improved diagnostic strategies and therapeutic approaches to enhance patient outcomes in DCBM associated with gastric cancer.


Assuntos
Adenocarcinoma , Neoplasias da Medula Óssea , Neoplasias Gástricas , Humanos , Masculino , Neoplasias Gástricas/patologia , Neoplasias Gástricas/secundário , Neoplasias da Medula Óssea/secundário , Adenocarcinoma/secundário , Adenocarcinoma/patologia , Pessoa de Meia-Idade , Evolução Fatal , Medula Óssea/patologia , Trombocitopenia
13.
BMJ Case Rep ; 17(9)2024 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-39304216

RESUMO

This case report discusses a patient with systemic lupus erythematosus (SLE) treated with low-dose azathioprine who developed progressive multifocal leukoencephalopathy (PML). PML is a rare, severe, demyelinating disease linked to John Cunningham polyomavirus (JCV) reactivation.Treated with pembrolizumab, an immune checkpoint inhibitor, the patient initially improved. However, after the fourth dose, her condition rapidly worsened resulting in treatment discontinuation and death. Similar cases highlight the complex interplay of factors in PML development in SLE patients, including immunosuppression and genetic factors. The use of pembrolizumab in PML and SLE necessitates careful consideration of potential complications.


Assuntos
Anticorpos Monoclonais Humanizados , Leucoencefalopatia Multifocal Progressiva , Lúpus Eritematoso Sistêmico , Humanos , Leucoencefalopatia Multifocal Progressiva/induzido quimicamente , Leucoencefalopatia Multifocal Progressiva/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/complicações , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Feminino , Evolução Fatal , Vírus JC/isolamento & purificação , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Azatioprina/efeitos adversos , Azatioprina/uso terapêutico , Inibidores de Checkpoint Imunológico/efeitos adversos , Imageamento por Ressonância Magnética
14.
Folia Med Cracov ; 64(1): 53-56, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-39254581

RESUMO

Herein we present the fatal case of premature baby with coincidence of extreme form of ectopia cordis and hypoplastic left heart structures.


Assuntos
Ectopia Cordis , Humanos , Ectopia Cordis/patologia , Ectopia Cordis/complicações , Recém-Nascido , Evolução Fatal , Síndrome do Coração Esquerdo Hipoplásico/complicações , Feminino , Masculino , Recém-Nascido Prematuro
15.
BMC Pediatr ; 24(1): 564, 2024 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-39237896

RESUMO

Two cases of neonatal splenic hemorrhage with acute cardiorespiratory failure are described in this report. The first case involves a full-term neonate who was found unresponsive without any witnesses and could not be successfully resuscitated. A postmortem diagnosis revealed a splenic hemorrhage. Second case is an extremely premature neonate who experienced a witnessed cardiovascular collapse on the 14th day of life. Rapid cardiovascular support was administered, resulting in a positive outcome. While splenic hemorrhage is commonly associated with traumatic events, these cases highlight the need of considering spontaneous splenic hemorrhages as a potential cause of acute neonatal compromise, even in the absence of birth-related trauma (e.g., asphyxia, prolonged labor, clavicle fractures, brachial plexus injuries). This report emphasizes the importance of including splenic hemorrhage timely in the differential diagnosis of neonatal cardiorespiratory instability, especially in the absence of more common diagnoses, and discusses the challenges associated with its recognition and treatment.


Assuntos
Hemorragia , Humanos , Recém-Nascido , Evolução Fatal , Hemorragia/etiologia , Hemorragia/diagnóstico , Masculino , Esplenopatias/complicações , Esplenopatias/etiologia , Feminino , Lactente Extremamente Prematuro , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/complicações , Insuficiência Respiratória/etiologia
16.
Medicine (Baltimore) ; 103(22): e38383, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-39259089

RESUMO

BACKGROUND: Nonalcoholic steatohepatitis (NASH) is an important etiology of hepatocellular carcinoma (HCC), and there is no established therapy for this syndrome. Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, autonomic dysregulation, and neural crest tumor (ROHHAD(NET)) is an extremely rare syndrome considered to be life-threatening, with death occurring around 10 years of age. We present the oldest known autopsy case of this syndrome that developed HCC. This case provided important information on not only improving the course of this syndrome, but also understanding the natural history and therapeutic modalities of NASH and HCC. METHODS: The patient was diagnosed with ROHHAD(NET) syndrome in childhood, and liver cirrhosis due to NASH was diagnosed at age 17. HCC was detected at age 20, and embolization and irradiation were performed. At age 21, she died from accidental acute pancreatitis and subsequent liver failure and pulmonary hemorrhage. RESULTS: Rapid onset of obesity, hypoventilation, and hypothalamic disturbance appeared in childhood and was diagnosed as this syndrome. At age 17, liver cirrhosis due to NASH was diagnosed by liver biopsy, and at age 20, HCC was diagnosed by imaging. Transarterial chemoembolization and irradiation were performed, and the HCC was well controlled for a year. CONCLUSION: At age 21, she died from accidental acute pancreatitis, subsequent liver failure and pulmonary hemorrhage. Autopsy revealed that the HCC was mostly necrotized. This case was valuable not only for other ROHHAD(NET) syndrome cases, but also in improving our understanding of the natural history of NASH and HCC.


Assuntos
Autopsia , Carcinoma Hepatocelular , Doenças Hipotalâmicas , Hipoventilação , Neoplasias Hepáticas , Hepatopatia Gordurosa não Alcoólica , Humanos , Feminino , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/terapia , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/terapia , Hipoventilação/etiologia , Hipoventilação/complicações , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/patologia , Doenças Hipotalâmicas/complicações , Doenças Hipotalâmicas/diagnóstico , Obesidade/complicações , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/terapia , Evolução Fatal , Adulto Jovem , Doenças do Sistema Nervoso Autônomo/etiologia , Síndrome
17.
Ned Tijdschr Geneeskd ; 1682024 08 13.
Artigo em Holandês | MEDLINE | ID: mdl-39228350

RESUMO

Group A-streptococcal (GAS) infection can lead to various clinical presentations and is fulminant when it reaches the deep tissues, leading to a high morbidity and mortality. The severity of postpartum GAS infections is widely known. In this case report we describe the course of disease in a pregnant patient with GAS toxic shock syndrome with initial complaints of abdominal pain, diarrhea and fetal demise at first presentation. Within 10 hours this patient died. It is important to stay vigilant for a fulminant GAS infection in pregnant patients, to recognize it quickly and treat it adequately.


Assuntos
Complicações Infecciosas na Gravidez , Choque Séptico , Infecções Estreptocócicas , Streptococcus pyogenes , Humanos , Gravidez , Feminino , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/microbiologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/complicações , Streptococcus pyogenes/isolamento & purificação , Evolução Fatal , Adulto , Choque Séptico/microbiologia , Morte Fetal
18.
J Med Case Rep ; 18(1): 424, 2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39256774

RESUMO

BACKGROUND: Glioblastoma is a highly malignant disease with limited treatment options. Ibrutinib, a covalent Bruton tyrosine kinase inhibitor, is an oral agent with manageable side effects used for hematological diseases including Waldenström macroglobulinemia. We present the case of a 69-year-old Caucasian male patient treated with ibrutinib for suspected Bing-Neel syndrome (BNS), which following a biopsy, was reclassified as glioblastoma. CASE PRESENTATION: In December 2018, a 69-year-old Caucasian male patient was diagnosed with Waldenström macroglobulinemia. As the patient was asymptomatic, without bone marrow failure or high M-component count, watchful waiting was initiated. Due to increasing neurological symptoms, the patient, based on magnetic resonance imaging, was diagnosed with Bing-Neel syndrome in May 2019. The patient received different treatments before starting ibrutinib monotherapy in August 2019 due to disease progression, both on magnetic resonance imaging and clinically. The patient remained clinically stable for 7 months. In March 2020, the patient developed headaches, and both magnetic resonance imaging and a biopsy revealed glioblastoma IDH-wildtype. Treatment was changed in line with the new diagnosis, but the patient died at the end of 2020. CONCLUSION: We present a case in which a patient with glioblastoma IDH-wildtype remained clinically stable for 7 months when treated with ibrutinib monotherapy, which is similar to what would be expected for the standard treatment for glioblastoma. To our knowledge, this is the first patient receiving ibrutinib for a glioblastoma IDH-wildtype with a meaningful clinical outcome. Our case may therefore support previous nonclinical findings, indicating a therapeutic value of ibrutinib in patients with glioblastoma and support for further investigation of ibrutinib as a possible treatment for glioblastoma.


Assuntos
Adenina , Glioblastoma , Imageamento por Ressonância Magnética , Piperidinas , Macroglobulinemia de Waldenstrom , Humanos , Adenina/análogos & derivados , Adenina/uso terapêutico , Masculino , Glioblastoma/tratamento farmacológico , Glioblastoma/patologia , Idoso , Piperidinas/uso terapêutico , Macroglobulinemia de Waldenstrom/tratamento farmacológico , Evolução Fatal , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/secundário , Inibidores de Proteínas Quinases/uso terapêutico
19.
Virol J ; 21(1): 221, 2024 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-39285293

RESUMO

BACKGROUND: Elephant endotheliotropic herpesvirus (EEHV) infection is the most common cause for lethal hemorrhagic disease in captive juvenile Asian elephants (Elephas maximus). Although EEHV1 is known as the most likely cause of fatal haemorrhagic disease in Asian elephants, EEHV5 was lately involved in lethal cases of haemorrhagic disease in captive elephants. CASE PRESENTATION: Here we report the first death of a four-year old Asian elephant diagnosed with EEHV5 in Germany. Molecular diagnosis yielded detection of EEHV5 DNA in all tested tissues. Histopathological examination revealed typical features of hemorrhagic disease in all examined organs. EEHV5 was sequenced from total DNA isolated from heart tissue by Illumina and Nanopore sequencing. Sequencing data showed 3,881 variants, distributed across the entire genome, compared to the published EEHV5 sequence. CONCLUSIONS: We have detected EEHV5 in a fatal disease case of a male Asian elephant. Whole genome sequencing revealed substantial differences of our DNA isolate compared to available EEHV5 sequences. This report of fatal haemorrhagic disease associated with EEHV5 infection should raise awareness for EEHV5 as an important elephant pathogen. Genome sequencing and downstream SNPs analysis will further encourage future research to understand genetic diversity, pathogenesis and virulence of EEHVs with respect to developing new diagnostic methods, prophylactic strategies, and implementation of surveillance and control measures.


Assuntos
Elefantes , Infecções por Herpesviridae , Herpesviridae , Animais , Elefantes/virologia , Infecções por Herpesviridae/veterinária , Infecções por Herpesviridae/virologia , Alemanha , Masculino , Evolução Fatal , Herpesviridae/genética , Herpesviridae/isolamento & purificação , Herpesviridae/classificação , DNA Viral/genética , Genoma Viral/genética , Filogenia , Análise de Sequência de DNA , Variação Genética , Sequenciamento Completo do Genoma
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