Asian Journal of Case Reports in Medicine and Health
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Coinfection Tuberculosis and Borreliosis: A Granulomatosis Etiology
No full textUveitis is an intraocular inflammation that specifically affects the uvea. The granulomatous nature is defined by large inflammatory cell precipitates on the corneal endothelial tissue, inflammatory nodules located at the edge of the pupil, or within the iris stroma. The etiologies are as variable as they are diverse, making diagnosis difficult; they can be idiopathic or secondary to autoimmune conditions such as Vogt-Koyanagi-Harada disease or multiple sclerosis secondary to an inflammatory disease such as sarcoidosis, or to an infectious disease such as tuberculosis or Lyme disease, and sometimes secondary to the overlap of two conditions, one potentially masking the other. This article reports the case of a patient who presented with bilateral granulomatous panuveitis and for whom the etiological workup revealed two associated granulomatous conditions: tuberculosis and borreliosis
Giant Cell Arteritis or Formerly Known as Horton's Disease When the Puzzle is Complete: A Case Report
No full textGiant cell arteritis, formerly known as Horton's disease, is a vasculitis affecting the large vessels, specifically the aorta, with a preference for the supra-aortic trunks. Its etiology remains unknown, but two risk factors have been identified: a genetic predisposition and the hypothesis of a likely viral infectious agent. The pathophysiology is increasingly understood due to advances in immunological and genetic knowledge. It generally affects patients over 50 years old and clinically manifests as headaches, scalp paresthesias, and jaw claudication, evolving in a context of low-grade fever and general deterioration. It is often associated with polymyalgia rheumatica, and the most feared complication is blindness. Clinical examination reveals a decrease or abolition of temporal pulses. Diagnosis is histological, via temporal artery biopsy or, failing that, through a PET-CT scan. The condition is highly sensitive to corticosteroids, with a favorable prognosis under treatment. However, relapses can occur during corticosteroid tapering, potentially necessitating a minimally effective maintenance dose of at least 1 mg/day of corticosteroids such as prednisone. Our work consists of an observation of a patient reporting a florid and complete picture of Horton's disease both clinically and biologically with significant radiological manifestations
Saroglitazar Reduced Liver Fat and Fibrosis in Metabolic Dysfunction Associated Steatotic Liver Disease: A Case Report
No full textMetabolic Dysfunction Associated Steatotic Liver Disease (MASLD) is revised nomenclature of Non-alcoholic fatty liver disease (NAFLD) which is very commonly prevalent condition in India. Currently only one drug Saroglitazar is approved for treatment of NAFLD in India. It is a dual peroxisome proliferator-activated receptor (PPAR α/γ) agonist which improves insulin sensitivity and reduce triglyceride along with liver fat and fibrosis in NAFLD cases. In this case study, MASLD patient was prescribed Saroglitazar 4 mg once daily along with existing anti-diabetic and lipid lowering therapy and at 24 weeks; Saroglitazar had shown significant improvement in glycemic, lipid and transient elastography parameters
A Case Report on Multiple Myeloma: Masquerading Neoplasm in a 36-Year-Old Female
No full textAim: We aim to highlight this rare presentation to alert clinicians to atypical multiple myeloma (MM) cases, enabling earlier diagnosis and better patient outcomes. This report may contribute to the medical literature by illustrating how MM can masquerade as other conditions in absence of characteristic clinical features, leading to potential diagnostic dilemmas and pitfalls, hence, encouraging clinicians to maintain high index of suspicion, particularly in unusual demographics. This helps identify patterns or variations and stimulates further investigations into MM's different presentation and progression.
Presentation of Case: This article features a 36-year-old female with an initial presentation of fever, multiple symmetrical joint pains, oral ulcer, and alopecia with no hypercalcemia or lytic bone lesions, and provisional diagnoses of connective tissue disorders, lymphoma, leukemia, and infectious etiologies but confirmatory tests conclusive of MM.
Discussion: MM, a clonal plasma cell proliferative disorder, usually presents with osteolytic bone lesions accompanied by hypercalcemia, anemia, and/or renal dysfunction. It predominantly affects elderly males, with a median diagnosis age of 70. MM is rare under 40, creating less suspicion and delayed diagnosis. However, age is a pivotal prognostic feature because of its associated comorbidities and performance index; thus, young patients have a better prognosis, making early diagnosis even more important.
Conclusion: The consequences of undiagnosed MM are severe and show an increased risk of death underlining the cruciality of quick diagnosis with a Sherlockian mindset and interdisciplinary approach for lowering morbidity. This case underscores the importance of considering MM in differential diagnoses, even when it seems unlikely
A Comprehensive Review of COVID-19 Vaccines, Adverse Reactions, and the Imperative of Early Diagnosis
No full textBullous pemphigoid (BP) is a rare autoimmune subepidermal blistering disorder and is defined by the existence of circulating G immunoglobulins (IgG) against basement membrane antigens BP180 and BP230, the immunobullous skin disorder characteristically presents with intense bullae and intense generalized pruritis, where the immune system attacks a thin layer of tissue below the outer layer of skin. Most of the BP cases are due to autoantibodies against proteins arranged at the dermal-epidermal junction, BP is also caused by systemic medications. Either the presence of certain triggering factors in the covid vaccine or the dissimilarity between the vaccine structure and the basement membrane antigens, had activated the B-cell immunity and therefore the production of antibodies, which is the main cause behind the activation of BP. A classic case of this condition is presented here to highlight and to create awareness about the symptoms occurred after COVID-19 vaccination. A 41-year-old female patient presented with BP caused after the administration of 1st dose of covid vaccine
Imaging Findings in Complicated Hepato-biliary Ascariasis: A Case Report
No full textAim: To review the clinical presentation and demonstrate imaging findings in complicated Hepatobiliary Ascariasis (HBA) and its management.
Presentation: A 45 years old male diabetic patient presented with the symptoms of fever, hiccoughs, abdominal bloating, nausea, and bilious vomiting lasting for 10 days with elevated bilirubin and Alkaline phosphatase levels.
Discussion: HBA arises from the migration of the intestinal parasite Ascaris lumbricoides from the duodenum into the biliary tree causing obstruction. HBA may present as, acute cholecystitis, biliary colic, pyogenic cholangitis, pancreatitis, obstructive jaundice, hepato-lithiasis and hepatic abscess. Significant morbidity and mortality are associated with HBA complications and hence early diagnosis and management is of utmost significance. Majority of cases are treated conservatively. Endoscopic withdrawal of Ascaris lumbricoides is feasible only upon the availability of expert endoscopy services and surgical removal if unavailable.
Conclusion: HBA though uncommon, it can direct to serious morbidity and mortality which necessitate early diagnosis of the disease. Clinical features of Ascariasis and laboratory tests are commonly non-specific. Multiple Imaging methods aids in morphological recognition of the roundworm, potential complications of HBA and treatment follow up
A Rare Case Report on Clinical Insights of Chronic Inflammatory Demyelinating Polyradiculoneuropathy
No full textChronic inflammatory demyelinating polyradiculoneuropathy (CIDP) CIDP is a rare and heterogenous autoimmune disorder of the peripheral nervous system that attacks myelin sheath around the peripheral nerves. It is characterized by muscle weakness and sensory deficits, numbness that can lead to significant neurological disability evolving over more than 8 weeks. Raised protein concentrations in CSF and heterogeneous slowing of nerve conduction are typical of the condition. Understanding of its pathophysiology has recently improved, although its causes remain unclear. Diagnosis is sometimes challenging and can require use of neuro imaging and nerve biopsy. The diagnosis is also based on a combination of clinical examination findings, electrodiagnostic studies, and other supportive evidence. Recognizing CIDP and distinguishing it from other chronic polyneuropathies is important because many patients with CIDP are highly responsive to treatment with corticosteriods, immunosuppressive or immunomodulatory therapies. This case report summarizes the variants of CIDP, diagnosis and current treatment strategies
Diabetic Ketoacidosis Revealing Adult Cystic Fibrosis Associated with Graves' Disease: About One Case
No full textCystic fibrosis is most often diagnosed in the first years of life due to pancreatic insufficiency and respiratory damage with chronic bronchial suppuration. However, moderate or monosymptomatic forms may only appear in adulthood. As for Graves' disease, it is an autoimmune pathology causing hyperthyroidism, its most characterising manifestation being a homogeneous goiter. It preferentially affects relatively young women, but can occur at any age. The association of cystic fibrosis and Graves' disease is a possibility described in the medical literature and that our case illustrates, this association can be fatal when cystic fibrosis is responsible for diabetes at the insulin deficiency stage and the latter is associated to hyperthyroidism canceling out any effect of insulin treatment, thus endangering its vital prognosis
Pleural Effusion as a Rare Manifestation of CML: Report of a Case
No full textChronic myeloid leukemia has the highest prevalence rate among all the oncological cases around the globe. It possesses a very significant risk to the public in various forms. About 1 person in 526 will get CML in their lifetime. Nowadays, it's very challenging to understand the proper symptoms of these diseases. However, chronic myeloid leukemia with pleural effusion is extremely uncommon and poorly understood. We report a case of a 45-year-old female patient diagnosed with bilateral pleural effusion and chronic myeloid leukemia
Radiological Diagnosis of Thrombophlebitis of the Right Ovarian Vein: A Case Report
No full textOvarian vein thrombosis (OVT) is a rare condition usually occurring in the postpartum period. Its incidence outside the postpartum period is not known. We reported a case of a 23-year-old patient at Amath DANSOKHO National Hospital Center in Kédougou, Senegal, she had no particular gestational history, she was non-febrile with overall negative laboratory tests apart a C-reactive protein (CRP) that was twice as high as normal. The abdominal CT scan made led to the diagnosis of thrombophlebitis of the right ovarian vein on probable pelvic inflammatory disease. Treatment combining anticoagulant, antibiotic and anti-inflammatory improved the clinical sign.