ABSTRACT
Key Clinical Message: We present a case of Bing-Neel syndrome a rare central nervous system lymphoplasmocytic lymphoma associated with Waldenstrom macroglobulinemia. Diagnosis should be considered in the context of unexplained neurological symptoms in the presence of macroglobulinemia. Abstract: Waldenstroms macroglobulinaemia (WM) is a rare B-cell lymphoma representing ~2% of all hematological malignancies. While most neurological complications of WM are secondary to the overproduction of immunoglobulin M (IgM), Bing-Neel syndrome (BNS) is an extremely rare direct central nervous system (CNS) infiltration by malignant lymphoplasmocytic lymphoma (LPL) cells. Limited information on BNS exists in the literature with sparse case reports and case series. Here, we present a diagnostically challenging BNS case successfully treated with systemic chemoimmunotherapy and ibrutinib, with remarkable clinical response.
ABSTRACT
SUMMARY: Carbimazole is a commonly used antithyroid drug (ATD), which is associated with several well-established side effects. However, Carbimazole-induced rhabdomyolysis is rarely reported in the literature. We report a 27-year-old male who presented with upper limb myalgia and significantly raised creatine kinase elevation, 1-month post commencement of Carbimazole for Graves' disease. Carbimazole was ceased with subsequent clinical and biochemical improvement. Though the pathophysiology remains unclear, we hope to raise awareness regarding this rare adverse effect with a view to promote early recognition and prompt discontinuation of the offending medication caused by a commonly used medication in endocrinology. LEARNING POINTS: Musculoskeletal complaints can relate to unidentified and untreated hyperthyroidism. However one must be mindful that the treatment for these disorders can too induce myopathies. ATD-induced myopathy should be considered when there is a temporal relationship between introduction of ATDs and the onset of symptoms. If ATD-induced myopathy is being considered, other causes of myopathy should still be outruled. Prompt discontinuation of potentially offending medications may provide resolution of symptoms and avoid significant consequences.
ABSTRACT
Animal personality, defined as consistent differences among individuals in their behaviour, is being increasingly studied as it might lead to a new understanding of the evolution of behaviours. Despite a clear interest in studying personality in a wide range of taxa for comparative analyses, studies on invertebrates are still scarce. Here, we investigated the personality of a ground beetle, Nebria brevicollis, which is widespread in Europe and invasive in North America. We measured seven behavioural traits from an array of three different tests: (i) activity and exploration related traits; (ii) reaction to a threat, and (iii) phototaxis. The repeatability was tested by measuring all behaviours twice, on different days. All behavioural traits were consistent through time, highlighting the presence of personality in the beetle. In addition, we analysed the relationship between the different traits and highlighted two clusters of behaviours (behavioural syndrome), one grouping activity, exploration and boldness traits, and a second one consisting of responses to a threat. This study is the first to our knowledge to provide evidence for personality dimensions within the vast group of the Carabidae. It also constitutes a preliminary step in the experimental investigation of the importance of animal personality in invasive species.
