PubMed Central (PMC3 - NLM DTD)
Archive of life sciences journal literature at the U.S. National Institutes of Health (NIH), developed and managed by NIH's National Center for Biotechnology Information (NCBI) in the National Library of Medicine (NLM).
Superficial siderosis associated with abundant τ and α-synuclein accumulation - Takao, Masaki; Murayama, Shigeo; Yoshida, Youji; Mihara, Ban
A Japanese male developed deafness, pyramidal signs and ataxia at age 50. A cerebrospinal fluid examination showed elevated levels of iron, transferrin and ferritin. Brain MRI showed atrophy of the cerebellum and pons as well as potential iron deposits on the surface of the brain. At autopsy, the brain weighed 1090 g and showed severe atrophy and necrosis of the cerebellum. No vascular malformation was observed. Extensive deposits of hemosiderin that were well stained with Berlin blue and ferritin immunohistochemistry were present at the surface and in the superficial layers of the cerebrum, brainstem, cerebellum and spinal cord. In these...
Kikuchi-Fujimoto’s disease involving mesenteric nodes: a report and review of literature - Vijayaraghavan, R; Chandrashekar, R; A, Saraswathi; Belagavi, CS
An adolescent boy underwent laparoscopic evaluation with persisting fever associated with colicky abdominal pain of about 3 weeks duration after a CT study of his abdomen revealed mesenteric adenopathy. Histopathological evaluation of the excised mesenteric nodes showed features of histiocytic necrotising lymphadenopathy suggestive of Kikuchi-Fujimoto lymphadenopathy which was confirmed on immunehistochemistry staining. Kikuchi-Fujimoto’s disease involving the mesenteric nodes is extremely unusual and can be confounding with a mistaken diagnosis of and prolonged treatment for tuberculosis. The authors present a case of Kikuchi-Fujimoto’s disease involving the mesenteric lymph nodes and discuss the various aspects of diagnosis and management of the case...
Complete AV-block secondary to lithium-clozapine therapy and relapsing multiple sclerosis in a bipolar patient - Gabeler, Edward EE; van Miltenburg, Addy JM
A complete atrioventricular block (CAVB) can be a lethal complication when it is not treated directly with isoprenaline and pacemaker therapy. The overall incidence of CAVB varies between 4 to 8 per cent with a mortality OR of 3.2 within 30 days if untreated. Main causes of CAVB are inferior myocardial infarction, congenital AV node malformation, mitral valve insufficiency and valve surgery, metabolic disorders and intoxications. The authors describe a case with a CAVB due to lithium-clozapine therapy and relapsing multiple sclerosis.
Undue delay in the diagnosis of lung cancer due to the clinician’s preoccupation with pre-existing tuberculosis - Revannasiddaiah, Swaroop; Madabhavi, Irappa; Thakur, Priyanka; Seam, Rajeev Kumar
The authors report the case of a seminomadic older patient who had already received a course of antitubercular treatment and within a few weeks of completion suffered resurgence of symptoms. His treating physician assumed it to be relapse of tuberculosis and hence re-started the patient on antitubercular treatment. Though the mass lesion on CT scan procured by the primary care physician suggested the possibility of a neoplasm, areas of necrosis within the mass led to a ‘cavitary appearance’, which unfortunately happens to be a feature of tuberculosis. Once the patient presented to the authors, they performed cytological investigations which established...
Sciatica as a presenting feature of thyroid follicular adenocarcinoma in a 79-year-old woman - Ogbodo, Elisha; Kaliaperumal, Chandrasekaran; Keohane, Catherine; Bermingham, Niamh; Kaar, George
The authors describe an unusual case of metastatic thyroid follicular adenocarcinoma presenting with sciatica in a 79-year-old woman. The primary thyroid tumour was undiagnosed until this clinical presentation. The patient gave a short history of back pain and right-sided sciatica, which was progressive and nocturnal in nature. Neuroimaging revealed an enhancing intradural mass lesion, which was completely excised through a right L1-L3 hemilaminectomy. Histopathological examination of the excised tissue revealed a follicular thyroid carcinoma. Subsequent metastatic investigation revealed a heterogeneously attenuating mixed solid cystic mass in a retrosternal thyroid gland, with multiple solid pulmonary nodules suggestive of metastatic disease. She...
Effusive-constrictive pericarditis in the absence of overt pericardial disease on multiple imaging modalities - Jones, Julia Dawn; Ashrafi, Reza; McDougall, Steffan P; Khand, Aleem U
Effusive-constrictive pericarditis (ECP) is a rare condition that may prove fatal without appropriate treatment. In ECP, there is concomitant existence of a pericardial effusion and CP, that together lead to impaired cardiac filling. Therapeutic pericardiocentesis only addresses part of the problem; surgical pericardiectomy may be required to relieve the constrictive element. Imaging in ECP characteristically demonstrates calcification or thickening of the pericardium. The authors describe a case of ECP were a number of imaging modalities (including echocardiography, cardiac magnetic resonance and CT) did not identify overt pericardial disease. The patient underwent surgical pericardiectomy that led to a rapid resolution of...
Congenital infantile myofibroma causing intrauterine death in a twin - Aye, Christina Yi Ling; Gould, Steve; Akinsola, S Adeyemi
While infantile myofibromatosis is the most common mesenchymal tumour of infancy, only around 300 cases have been reported. The authors report a 33-year-old para 1 with an uncomplicated, dichorionic diamniotic twin pregnancy who was diagnosed with an intrauterine death of one twin at 36+5 weeks gestation. At caesarean section, a macerated male stillborn weighing 2.72 kg was delivered. Postmortem examination revealed a pedunculated lesion attached to the left shoulder and underlying muscle consistent with a congenital myofibroma. The cause of death was postulated to be haemorrhage from the tumour surface causing fetal anaemia.
Juvenile idiopathic arthritis coexisting with sickle cell disease: two case reports - Adelowo, Olufemi; Edunjobi, Adebayo Samuel
Two cases of coexisting juvenile idiopathic arthritis (JIA) and sickle cell disease (ages 7 and 17) are presented. The diagnoses of JIA were delayed for years because of the similarity of presentations in the two conditions. Both cases had been treated with non-steroidal anti-inflammatory drugs for years. Both had positive rheumatoid factor, and elevated erythrocyte sedimentation rate (ESR) while one of the patients had elevated serum ferritin and anticyclic citrullinated protein. Radiology showed marked arthritic changes with presence of avascular necrosis in a patient’s head of femur. Both cases were treated with etanercept for 6 months each, as well as...
An unusual cause of school refusal - Meenai, Zafar; Sarkar, Nupur; Biswas, Rakesh
A 6-year-old school boy was brought to the child developmental specialist with complaints of school absenteeism and school refusal behaviour of 7 months duration. Before the onset of school refusal, he had two episodes of unresponsiveness with abnormal posturing preceded by vertigo, which were diagnosed and managed as epileptic seizures. Following these episodes, he started avoiding school due of episodic palpitations, ‘nervousness’ and sweating. However, the episodes of unresponsiveness did not recur. His symptoms were attributed to stress/anxiety by both the examining physicians as well as the parents because repeated clinical evaluation including 12-lead ECG done three times and echocardiography...
Memory deficits due to brain injury: unique PET findings and dream alterations - Nishida, Masaki; Nariai, Tadashi; Hiura, Mikio; Ishii, Kenji; Nishikawa, Toru
The authors herein report the case of a young male with memory deficits due to a traumatic head injury, who presented with sleep-related symptoms such as hypersomnia and dream alterations. Although MRI and polysomnography showed no abnormalities, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and 11C flumazenil (FMZ)-PET revealed findings consistent with cerebral damage to the affected temporal region. The memory deficit of the patient gradually improved in parallel with the relief of the sleep-related symptoms. FDG-PET showed considerable improvement in glucose metabolism when he had recovered, however, evidence of neural loss remained in the FMZ-PET findings.