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EN100705
|
Exam: HCV
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: protein
|
45.5.
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: albumin
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: infection
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: actin
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: SMA
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: desmin
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: cytokeratin
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: CD34
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: catenin
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: Ki67
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: polypneic
|
24 cycles/min.
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: saturation
|
97%.
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: glucose
|
2.24 g/L.
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: HMB
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Exam: Melan-A
|
not available
| 0 |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN106489
|
Exam: temperature
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: pressure
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: HB
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: WBC
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: lymphocytes
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: Monocytes
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: Eosinophils
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: Platelets
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: HBsAg
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: HBeAg
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: VDRL
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: AFP
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: HIV
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: HCV
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: albumin
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: infection
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: actin
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: SMA
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: desmin
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: cytokeratin
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: CD34
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: catenin
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: Ki67
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: polypneic
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: saturation
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: glucose
|
not available
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: protein
|
positive.
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: HMB
|
positive.
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN106489
|
Exam: Melan-A
|
positive.
| 0 |
An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett's esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia.
|
EN107424
|
Exam: temperature
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: pressure
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: HB
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: WBC
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: lymphocytes
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: Monocytes
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: Eosinophils
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: Platelets
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: HBsAg
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: HBeAg
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: VDRL
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: AFP
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: HIV
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: HCV
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: protein
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: albumin
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: infection
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: actin
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: SMA
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: desmin
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: cytokeratin
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: CD34
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: catenin
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: Ki67
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: polypneic
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: saturation
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: glucose
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: HMB
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN107424
|
Exam: Melan-A
|
not available
| 0 |
Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases. The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations. The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization. CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas. The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.
|
EN100605
|
Exam: temperature
|
38.2°C.
| 1 |
A 22-year-old woman, without any formerly diagnosed diseases, presented to the emergency department with a 3 day history of dyspnea, fatigue and central chest pain.
She reported increasing dyspnea that developed in the previous month. She also had intermittent pain in the small joints for several months.
There was no family history of SLE.
On examination, she had a temperature of 38.2°C, a heart rate of 115 beats/minute, blood pressure of 90/60mmHg, respiratory rate of 25 breaths/minute, muffled heart sounds and jugular distention.
The electrocardiogram showed sinus tachycardia and low voltage.
The chest radiograph showed an enlargement of the cardiac silhouette with a right-sided pulmonary effusion.
The echocardiography revealed a large circumferential pericardial effusion, with diastolic collapse of the right atrium, dilated inferior vena cava and 30% respiratory variation of the Doppler mitral valve, confirming the diagnosis of cardiac tamponade.
Initial workup showed normochromic normocytic anemia with hemoglobin at 8.5g/dl, CRP: 75mg/L, renal and liver function tests were normal. Emergency pericardiocentesis was indicated but could not be performed because of the incapability to place the guidewire into the pericardial cavity. So, urgent surgical pericardiectomy with window procedure was realized, 1200 of clear fluid was evacuated.
The pericardial fluid contained 2900 white blood cells/mm³, 100 red blood cells/mm³, bacteriological culture and cytologic examinations yielded negative results.
The pericardial biopsy showed features of nonspecific inflammation, malignancy and tuberculosis were ruled out.
Further investigations were accomplished to determine the etiology. Immunological workup revealed antinuclear antibodies titer of 1:1280, positive anti-SSA and anti-SM antibodies and hypocomplementemia. The coombs test was positive.
The diagnosis of systemic lupus erythematosus was established based on hemolytic anemia, serositis, arthralgia, positive anti nuclear and anti SM antibodies and low complement.
The patient was started on intravenous therapy with methylprednisolone followed by prednisone 60mg by mouth daily with hydroxychloroquine.
She had a good clinical response and control echocardiography showed complete resolution of the pericardial effusion without recurrence.
|
EN100605
|
Exam: pressure
|
90/60mmHg.
| 1 |
A 22-year-old woman, without any formerly diagnosed diseases, presented to the emergency department with a 3 day history of dyspnea, fatigue and central chest pain.
She reported increasing dyspnea that developed in the previous month. She also had intermittent pain in the small joints for several months.
There was no family history of SLE.
On examination, she had a temperature of 38.2°C, a heart rate of 115 beats/minute, blood pressure of 90/60mmHg, respiratory rate of 25 breaths/minute, muffled heart sounds and jugular distention.
The electrocardiogram showed sinus tachycardia and low voltage.
The chest radiograph showed an enlargement of the cardiac silhouette with a right-sided pulmonary effusion.
The echocardiography revealed a large circumferential pericardial effusion, with diastolic collapse of the right atrium, dilated inferior vena cava and 30% respiratory variation of the Doppler mitral valve, confirming the diagnosis of cardiac tamponade.
Initial workup showed normochromic normocytic anemia with hemoglobin at 8.5g/dl, CRP: 75mg/L, renal and liver function tests were normal. Emergency pericardiocentesis was indicated but could not be performed because of the incapability to place the guidewire into the pericardial cavity. So, urgent surgical pericardiectomy with window procedure was realized, 1200 of clear fluid was evacuated.
The pericardial fluid contained 2900 white blood cells/mm³, 100 red blood cells/mm³, bacteriological culture and cytologic examinations yielded negative results.
The pericardial biopsy showed features of nonspecific inflammation, malignancy and tuberculosis were ruled out.
Further investigations were accomplished to determine the etiology. Immunological workup revealed antinuclear antibodies titer of 1:1280, positive anti-SSA and anti-SM antibodies and hypocomplementemia. The coombs test was positive.
The diagnosis of systemic lupus erythematosus was established based on hemolytic anemia, serositis, arthralgia, positive anti nuclear and anti SM antibodies and low complement.
The patient was started on intravenous therapy with methylprednisolone followed by prednisone 60mg by mouth daily with hydroxychloroquine.
She had a good clinical response and control echocardiography showed complete resolution of the pericardial effusion without recurrence.
|
EN100605
|
Exam: hemoglobin
|
8.5g/dl.
| 1 |
A 22-year-old woman, without any formerly diagnosed diseases, presented to the emergency department with a 3 day history of dyspnea, fatigue and central chest pain.
She reported increasing dyspnea that developed in the previous month. She also had intermittent pain in the small joints for several months.
There was no family history of SLE.
On examination, she had a temperature of 38.2°C, a heart rate of 115 beats/minute, blood pressure of 90/60mmHg, respiratory rate of 25 breaths/minute, muffled heart sounds and jugular distention.
The electrocardiogram showed sinus tachycardia and low voltage.
The chest radiograph showed an enlargement of the cardiac silhouette with a right-sided pulmonary effusion.
The echocardiography revealed a large circumferential pericardial effusion, with diastolic collapse of the right atrium, dilated inferior vena cava and 30% respiratory variation of the Doppler mitral valve, confirming the diagnosis of cardiac tamponade.
Initial workup showed normochromic normocytic anemia with hemoglobin at 8.5g/dl, CRP: 75mg/L, renal and liver function tests were normal. Emergency pericardiocentesis was indicated but could not be performed because of the incapability to place the guidewire into the pericardial cavity. So, urgent surgical pericardiectomy with window procedure was realized, 1200 of clear fluid was evacuated.
The pericardial fluid contained 2900 white blood cells/mm³, 100 red blood cells/mm³, bacteriological culture and cytologic examinations yielded negative results.
The pericardial biopsy showed features of nonspecific inflammation, malignancy and tuberculosis were ruled out.
Further investigations were accomplished to determine the etiology. Immunological workup revealed antinuclear antibodies titer of 1:1280, positive anti-SSA and anti-SM antibodies and hypocomplementemia. The coombs test was positive.
The diagnosis of systemic lupus erythematosus was established based on hemolytic anemia, serositis, arthralgia, positive anti nuclear and anti SM antibodies and low complement.
The patient was started on intravenous therapy with methylprednisolone followed by prednisone 60mg by mouth daily with hydroxychloroquine.
She had a good clinical response and control echocardiography showed complete resolution of the pericardial effusion without recurrence.
|
EN100605
|
Exam: CRP
|
75mg/L.
| 1 |
A 22-year-old woman, without any formerly diagnosed diseases, presented to the emergency department with a 3 day history of dyspnea, fatigue and central chest pain.
She reported increasing dyspnea that developed in the previous month. She also had intermittent pain in the small joints for several months.
There was no family history of SLE.
On examination, she had a temperature of 38.2°C, a heart rate of 115 beats/minute, blood pressure of 90/60mmHg, respiratory rate of 25 breaths/minute, muffled heart sounds and jugular distention.
The electrocardiogram showed sinus tachycardia and low voltage.
The chest radiograph showed an enlargement of the cardiac silhouette with a right-sided pulmonary effusion.
The echocardiography revealed a large circumferential pericardial effusion, with diastolic collapse of the right atrium, dilated inferior vena cava and 30% respiratory variation of the Doppler mitral valve, confirming the diagnosis of cardiac tamponade.
Initial workup showed normochromic normocytic anemia with hemoglobin at 8.5g/dl, CRP: 75mg/L, renal and liver function tests were normal. Emergency pericardiocentesis was indicated but could not be performed because of the incapability to place the guidewire into the pericardial cavity. So, urgent surgical pericardiectomy with window procedure was realized, 1200 of clear fluid was evacuated.
The pericardial fluid contained 2900 white blood cells/mm³, 100 red blood cells/mm³, bacteriological culture and cytologic examinations yielded negative results.
The pericardial biopsy showed features of nonspecific inflammation, malignancy and tuberculosis were ruled out.
Further investigations were accomplished to determine the etiology. Immunological workup revealed antinuclear antibodies titer of 1:1280, positive anti-SSA and anti-SM antibodies and hypocomplementemia. The coombs test was positive.
The diagnosis of systemic lupus erythematosus was established based on hemolytic anemia, serositis, arthralgia, positive anti nuclear and anti SM antibodies and low complement.
The patient was started on intravenous therapy with methylprednisolone followed by prednisone 60mg by mouth daily with hydroxychloroquine.
She had a good clinical response and control echocardiography showed complete resolution of the pericardial effusion without recurrence.
|
EN100605
|
Exam: Ca-125
|
not available
| 1 |
A 22-year-old woman, without any formerly diagnosed diseases, presented to the emergency department with a 3 day history of dyspnea, fatigue and central chest pain.
She reported increasing dyspnea that developed in the previous month. She also had intermittent pain in the small joints for several months.
There was no family history of SLE.
On examination, she had a temperature of 38.2°C, a heart rate of 115 beats/minute, blood pressure of 90/60mmHg, respiratory rate of 25 breaths/minute, muffled heart sounds and jugular distention.
The electrocardiogram showed sinus tachycardia and low voltage.
The chest radiograph showed an enlargement of the cardiac silhouette with a right-sided pulmonary effusion.
The echocardiography revealed a large circumferential pericardial effusion, with diastolic collapse of the right atrium, dilated inferior vena cava and 30% respiratory variation of the Doppler mitral valve, confirming the diagnosis of cardiac tamponade.
Initial workup showed normochromic normocytic anemia with hemoglobin at 8.5g/dl, CRP: 75mg/L, renal and liver function tests were normal. Emergency pericardiocentesis was indicated but could not be performed because of the incapability to place the guidewire into the pericardial cavity. So, urgent surgical pericardiectomy with window procedure was realized, 1200 of clear fluid was evacuated.
The pericardial fluid contained 2900 white blood cells/mm³, 100 red blood cells/mm³, bacteriological culture and cytologic examinations yielded negative results.
The pericardial biopsy showed features of nonspecific inflammation, malignancy and tuberculosis were ruled out.
Further investigations were accomplished to determine the etiology. Immunological workup revealed antinuclear antibodies titer of 1:1280, positive anti-SSA and anti-SM antibodies and hypocomplementemia. The coombs test was positive.
The diagnosis of systemic lupus erythematosus was established based on hemolytic anemia, serositis, arthralgia, positive anti nuclear and anti SM antibodies and low complement.
The patient was started on intravenous therapy with methylprednisolone followed by prednisone 60mg by mouth daily with hydroxychloroquine.
She had a good clinical response and control echocardiography showed complete resolution of the pericardial effusion without recurrence.
|
EN100605
|
Exam: free-T4
|
not available
| 1 |
A 22-year-old woman, without any formerly diagnosed diseases, presented to the emergency department with a 3 day history of dyspnea, fatigue and central chest pain.
She reported increasing dyspnea that developed in the previous month. She also had intermittent pain in the small joints for several months.
There was no family history of SLE.
On examination, she had a temperature of 38.2°C, a heart rate of 115 beats/minute, blood pressure of 90/60mmHg, respiratory rate of 25 breaths/minute, muffled heart sounds and jugular distention.
The electrocardiogram showed sinus tachycardia and low voltage.
The chest radiograph showed an enlargement of the cardiac silhouette with a right-sided pulmonary effusion.
The echocardiography revealed a large circumferential pericardial effusion, with diastolic collapse of the right atrium, dilated inferior vena cava and 30% respiratory variation of the Doppler mitral valve, confirming the diagnosis of cardiac tamponade.
Initial workup showed normochromic normocytic anemia with hemoglobin at 8.5g/dl, CRP: 75mg/L, renal and liver function tests were normal. Emergency pericardiocentesis was indicated but could not be performed because of the incapability to place the guidewire into the pericardial cavity. So, urgent surgical pericardiectomy with window procedure was realized, 1200 of clear fluid was evacuated.
The pericardial fluid contained 2900 white blood cells/mm³, 100 red blood cells/mm³, bacteriological culture and cytologic examinations yielded negative results.
The pericardial biopsy showed features of nonspecific inflammation, malignancy and tuberculosis were ruled out.
Further investigations were accomplished to determine the etiology. Immunological workup revealed antinuclear antibodies titer of 1:1280, positive anti-SSA and anti-SM antibodies and hypocomplementemia. The coombs test was positive.
The diagnosis of systemic lupus erythematosus was established based on hemolytic anemia, serositis, arthralgia, positive anti nuclear and anti SM antibodies and low complement.
The patient was started on intravenous therapy with methylprednisolone followed by prednisone 60mg by mouth daily with hydroxychloroquine.
She had a good clinical response and control echocardiography showed complete resolution of the pericardial effusion without recurrence.
|
EN100605
|
Exam: TSH
|
not available
| 1 |
A 22-year-old woman, without any formerly diagnosed diseases, presented to the emergency department with a 3 day history of dyspnea, fatigue and central chest pain.
She reported increasing dyspnea that developed in the previous month. She also had intermittent pain in the small joints for several months.
There was no family history of SLE.
On examination, she had a temperature of 38.2°C, a heart rate of 115 beats/minute, blood pressure of 90/60mmHg, respiratory rate of 25 breaths/minute, muffled heart sounds and jugular distention.
The electrocardiogram showed sinus tachycardia and low voltage.
The chest radiograph showed an enlargement of the cardiac silhouette with a right-sided pulmonary effusion.
The echocardiography revealed a large circumferential pericardial effusion, with diastolic collapse of the right atrium, dilated inferior vena cava and 30% respiratory variation of the Doppler mitral valve, confirming the diagnosis of cardiac tamponade.
Initial workup showed normochromic normocytic anemia with hemoglobin at 8.5g/dl, CRP: 75mg/L, renal and liver function tests were normal. Emergency pericardiocentesis was indicated but could not be performed because of the incapability to place the guidewire into the pericardial cavity. So, urgent surgical pericardiectomy with window procedure was realized, 1200 of clear fluid was evacuated.
The pericardial fluid contained 2900 white blood cells/mm³, 100 red blood cells/mm³, bacteriological culture and cytologic examinations yielded negative results.
The pericardial biopsy showed features of nonspecific inflammation, malignancy and tuberculosis were ruled out.
Further investigations were accomplished to determine the etiology. Immunological workup revealed antinuclear antibodies titer of 1:1280, positive anti-SSA and anti-SM antibodies and hypocomplementemia. The coombs test was positive.
The diagnosis of systemic lupus erythematosus was established based on hemolytic anemia, serositis, arthralgia, positive anti nuclear and anti SM antibodies and low complement.
The patient was started on intravenous therapy with methylprednisolone followed by prednisone 60mg by mouth daily with hydroxychloroquine.
She had a good clinical response and control echocardiography showed complete resolution of the pericardial effusion without recurrence.
|
EN100090
|
Exam: height
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: fever
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: FGSI
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: UFGSI
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: LRINEC
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: SOFA
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: APACHE
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: pancytopenia
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: hemoglobin
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: albumin
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: fibrinogen
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: triglycerides
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: ferrintin
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: dehydrogenase
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: neutrophils
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: WBC
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: BCR-ABL
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: pressure
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
EN100090
|
Exam: lymphoblasts
|
not available
| 4 |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth. The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route. There was no use of instrumentation and she cried spontaneously at birth. Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral. Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids. There were marked chemosis bilaterally worst in the right. Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal. Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis. The child was admitted into Special baby care unit (SBCU) of our hospital to facilitate close monitoring. She was also reviewed by the pediatrician and no other abnormality was found. Perforated transparent catellar shield was applied over the eyes bilaterally to prevent trauma to the conjunctivae. She was commenced on hypertonic saline 4 hourly and piece of gauze soaked with hypertonic saline was placed over the prolapsed chemosed palpebral conjunctivae for 3hours once in a day. She was also commenced on 2 hourly ciprofloxacin hydrochloride USP equivalent to ciprofloxacin 0.3% w/v) and maxitol ointment at night. On the 3rd day of admission, the chemosis on the right had resolved significantly but there was still poor right lid opening. However, on the 5th day of admission, both chemosis had resolved totally with spontaneous eye lid opening. Both eyeballs were normal.
|
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