Assuntos
Erros de Diagnóstico/prevenção & controle , Pancreatite/diagnóstico , Insuficiência Renal/diagnóstico , Cálculos Ureterais/complicações , Cateterismo Urinário/métodos , Doença Aguda , Diagnóstico Diferencial , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Múltiplas Afecções Crônicas , Insuficiência Renal/sangue , Insuficiência Renal/etiologia , Insuficiência Renal/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Cálculos Ureterais/diagnóstico , Cálculos Ureterais/fisiopatologiaRESUMO
Moyamoya disease (MMD) is a rare idiopathic cerebrovascular disease most common among the Asian population. Studies have shown that patients with MMD are at increased risk for developing psychiatric complications. We present a patient with hemorrhagic MMD (RNF213 gene mutation) who developed depression and catatonia over time following MMD-related strokes. While no guidelines exist for the management of such an uncommon scenario, it at least requires an interdepartmental approach. Our report highlights the medical complications of untreated MMD and its neuropsychiatric association with depression and catatonia.
RESUMO
Breast tumors have a predilection for metastasizing to the bone leading to cells being displaced by the cancer cells subsequently producing immature leukocytes and erythrocytes in the peripheral blood. We present a case of a 57-year-old female who was found to have myelophthisic anemia secondary to stage four lobular breast carcinoma metastasized to the bone marrow after being misdiagnosed as having thrombotic thrombocytopenia purpura. Diagnosis of myelophthisic anemia requires a thorough workup and treatment is based upon secondary management of the malignancy.
RESUMO
Necrotizing autoimmune myopathy (NAM), also known as necrotizing autoimmune myositis, is a heterogeneous group of diseases characterized by the presence of necrotic muscle fibers on biopsy, elevated creatine kinase (CK) levels, an abnormal electromyogram (EMG) result, and the associated antibodies. The anti-signal recognition particle (anti-SRP) and the anti-3-hydroxyl-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) antibodies are the two most prevalent antibodies identified with NAM. NAM is a rare disease that typically affects middle-aged Caucasian women. In this case report, we present the diagnosis of anti-SRP NAM in a middle-aged African American male. This case report displays the atypical presentation of NAM outside of the typical patient population as well as the need for additional research to determine the pathogenesis and the precise role of anti-SRP antibodies in NAM.
