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Uremic Paralytic Ileus in a 70 Years Old Female: A Diagnostic Dilemma.

Uremia has been associated with slowed intestinal motility, resulting in loss of peristalsis and the development of paralytic ileus. We present a case of uremia-induced paralytic ileus in a 70-year-old woman. The patient was admitted with a 7-day history of abdominal pain, vomiting, and constipation. Initial evaluation revealed a soft non-tender abdomen with decreased bowel sounds. Urgent ultrasonography showed dilated gut loops and sluggish gut motility, while atrophic kidneys with hydronephrosis were also appreciated. Routine biochemistry labs revealed elevated creatinine and potassium level

Amyloidosis for the Gastroenterologist: A Comprehensive Systematic Review of Diagnosis and Management of Gastrointestinal Manifestations.

BackgroundAmyloidosis is a rare, multisystem disorder characterized by extracellular deposition of misfolded protein fibrils. Gastrointestinal (GI) amyloidosis is uncommon but under-recognized due to nonspecific symptoms, but early diagnosis is critical to improve quality of life and prognosis. This comprehensive systematic review aimed to summarize current literature on GI and hepatic manifestations of amyloidosis, highlighting diagnostic and management strategies across the major subtypes of amyloidosis, in particular AL (immunoglobulin light chain), ATTR (transthyretin), and AA (serum amylo

Extraluminal amyloidoma of the pelvic cavity causing large bowel obstruction.

AMYLOIDOSIS IS A GROUP OF DIVERSE DISORDERS THAT FALL INTO SEVERAL MAJOR CATEGORIES: primary, secondary, dialysis-associated, and hereditary forms. Clinically, amyloidosis may be categorized as localized or systemic. The gastrointestinal tract is among the most common places for deposition of amyloid, but large, localized amyloid deposits are an uncommon occurrence and rarely cause extraluminal bowel compression resulting in obstruction as was seen in the case presented in this clinical scenario.

Клинические характеристики и результаты лечения у пациентов с множественным склерозом, anti-CD20s который переключился на фумараты: ретроспективный анализ базы данных США о претензиях на медицинское обслуживание.

Цель: Anti-CD20 Моноклональные антитела и фумараты являются широко распространенными множественными склерозами (MS), изменяющими болезни (DMT). Данные о переходе с anti-CD20s Другие ДМТ ограничены. Это ретроспективное, наблюдательное исследование базы данных по претензиям компании < < Комодо > > в области здравоохранения было направлено на оценку стратегии деэскалации в реальной когорте, сопоставление клинических характеристик, рецидивов, контактов в области здравоохранения (HCE) и расходов на медицинское обслуживание (HCC) между пациентами пожилого возраста. ≥18 годами с стабильны

Al amyloidosis.

UNLABELLED: DEFINITION OF THE DISEASE: AL amyloidosis results from extra-cellular deposition of fibril-forming monoclonal immunoglobulin (Ig) light chains (LC) (most commonly of lambda isotype) usually secreted by a small plasma cell clone. Most patients have evidence of isolated monoclonal gammopathy or smoldering myeloma, and the occurrence of AL amyloidosis in patients with symptomatic multiple myeloma or other B-cell lymphoproliferative disorders is unusual. The key event in the development of AL amyloidosis is the change in the secondary or tertiary structure of an abnormal monoclonal LC,

Endoscopic and Histological Diagnosis of Gastrointestinal Amyloidosis: A Narrative Review.

Amyloidosis encompasses a diverse group of systemic and localised disorders defined by the extracellular accumulation of misfolded proteins, leading to progressive tissue damage and multiorgan dysfunction. Gastrointestinal (GI) involvement is common, yet diagnosis is frequently delayed because symptoms are non-specific and endoscopic findings are equivocal. Recent advances in endoscopic technique, biopsy site selection and advancements in processing of pathological specimens have substantially improved the diagnosis of this condition. Targeted gastrointestinal biopsy, performed during endoscop

Совпадение в полном тексте источника
… Gastrointestinal symptoms, including chronic diarrhoea, abdominal pain, gastrointestinal bleeding, protein-losing enteropathy and intestinal pseudo-obstruction, are notoriously non-specific [ 9 , 10 ]. … Motility Disorders In a subset of patients, the endoscopic mucosal appearance is unremarkable despite clinically significant symptoms such as intractable constipation, intestinal pseudo-obstruction or gastroparesis. …

Construction and validation of a risk prediction model for perianal infection in HSCT patients: a retrospective cohort study.

BackgroundPerianal infection is a frequent and detrimental complication in patients undergoing hematopoietic stem cell transplantation (HSCT), leading to significant morbidity and extended hospital stays. Despite its clinical significance, a substantial gap remains in our ability to proactively identify high-risk individuals. However a validated predictive model is actually lacking and it is still unclear how to identify these patients before the onset of infection.ObjectiveThis study aimed to develop and to validate a risk prediction model for the accurate assessment of perianal infection ris

Совпадение в полном тексте источника
… Vincristine and intestinal pseudo-obstruction in children: report of 5 cases, literature review, and suggested management. J Pediatr Hematol Oncol. (2010) 32:e126–30. doi: 10.1097/MPH.0b013e3181d7742f, PMID: 22. Yu Z, Qin C, Cao M, He X, Ren H, Liu H. …

Endoscopic and pathological characteristics of gastrointestinal amyloidosis: a retrospective analysis.

BackgroundGastrointestinal amyloidosis (GIA) is a rare manifestation of amyloidosis, characterized by amyloid fibril deposition in the gastrointestinal tract, leading to a range of clinical symptoms. Early diagnosis is challenging due to the nonspecific nature of endoscopic and clinical findings.ObjectiveTo analyze the clinical, endoscopic, and pathological characteristics of GIA and identify potential diagnostic markers for earlier detection.MethodsA retrospective study was conducted on 36 patients diagnosed with GIA based on histopathological findings, including Congo Red staining. Clinical,

Совпадение в полном тексте источника
… Pamarthy R Berumen A Breen-Lyles M Comparing clinical, imaging, and physiological correlates of intestinal pseudo-obstruction: systemic sclerosis vs amyloidosis and paraneoplastic syndrome Clin Transl Gastroenterol 2020 11 e00206 10.14309/ctg.0000000000000206 32931184 PMC7410023 Pamarthy R, Berumen A … Comparing clinical, imaging, and physiological correlates of intestinal pseudo-obstruction: systemic sclerosis vs amyloidosis and paraneoplastic syndrome. Clin Transl Gastroenterol. 2020;11:e00206. 32931184 10.14309/ctg.0000000000000206 PMC7410023 8. …

Rare Diseases of the Nose, the Paranasal Sinuses, and the Anterior Skull Base.

Due to their low incidence and thus resulting limited diagnostic criteria as well as therapeutic options, rare diseases of the nose, the paranasal sinuses, and the anterior skull base are a significant challenge. The value as of which a disease has to be considered as rare amounts to a maximum of 5 patients per 10 000 people. Within these diseases, however, there are extreme differences. Some rare or orphan diseases like for example the inverted papilloma belong to regularly diagnosed and treated diseases of larger departments of oto-rhino-laryngology whereas other rare diseases and malformati

Infectious Diseases

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Peritoneal Amyloid as a Presenting Manifestation of AL Amyloid.

Amyloid is a systemic disease characterized by extracellular deposition of misfolded protein. Gastrointestinal and peritoneal deposition of light chain (AL) amyloid is an under-recognized manifestation of this systemic disease, usually as a late sequela. Here we present a case of recently diagnosed AL peritoneal amyloid that presented in the context of recurrent, acute onset abdominal discomfort and was found to have bowel obstruction complicated by perforation in the setting of AL-mediated gastrointestinal tract infiltration and dysmotility.

Совпадение в полном тексте источника
… Primary gastrointestinal amyloid: an unusual cause of acute intestinal pseudo-obstruction. Case Rep Gastroenterol. 2019;13(3):462–467. doi: 10.1159/000503897. 48. Cowan AJ, Skinner M, Seldin DC, et al. Amyloid of the gastrointestinal tract: a 13-year, single-center, referral experience. …

Heyde Syndrome Unveiled: A Case Report with Current Literature Review and Molecular Insights.

Heyde syndrome, marked by aortic stenosis, gastrointestinal bleeding from angiodysplasia, and acquired von Willebrand syndrome, is often underreported. Shear stress from a narrowed aortic valve degrades von Willebrand factor multimers, leading to angiodysplasia formation and von Willebrand factor deficiency. This case report aims to raise clinician awareness of Heyde syndrome, its complexity, and the need for a multidisciplinary approach. We present a 75-year-old man with aortic stenosis, gastrointestinal bleeding from angiodysplasia, and acquired von Willebrand syndrome type 2A. The patient w

Infectious Diseases

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Joint manifestations revealing inborn metabolic diseases in adults: a narrative review.

Inborn metabolic diseases (IMD) are rare conditions that can be diagnosed during adulthood. Patients with IMD may have joint symptoms and the challenge is to establish an early diagnosis in order to institute appropriate treatment and prevent irreversible damage. This review describes the joint manifestations of IMD that may be encountered in adults. The clinical settings considered were arthralgia and joint stiffness as well as arthritis. Unspecific arthralgias are often the first symptoms of hereditary hemochromatosis, chronic low back pain may reveal an intervertebral disc calcification in

Acute kidney injury: pathogenesis and therapeutic interventions.

Acute kidney injury (AKI) is a prevalent clinical condition that is associated with unacceptably high morbidity and mortality, as well as the development of chronic kidney disease (CKD). The pathogenesis of AKI is highly complex and heterogeneous, primarily attributed to metabolic disturbances arising from the disease itself and the administration of medications related to treatment. In recent years, AKI in cancer patients is highly concerned. The emergence of AKI caused injuries and dysfunction of remote organs but also enhanced the health-care costs. It's essential for early recognition of A

Multidisciplinary supportive care in systemic light chain amyloidosis.

The immunoglobulin light-chain amyloidosis is a multisystemic disease which manifests by damage to the vital organs by light chain-derived amyloid fibril. Traditionally, the treatment has been directed to the underlying plasma cell clone with or without high dose chemotherapy followed by autologous stem cell transplantation using melphalan based conditioning. Now with the approval of highly tolerable anti-CD38 monoclonal antibody daratumumab based anti-plasma cell therapy in 2021, high rates of hematologic complete responses are possible even in patients who are otherwise deemed not a candidat

Infarcts and ischemia in the abdomen: an imaging perspective with an emphasis on cross-sectional imaging findings.

Infarcts and ischemia of abdominal organs may present with acute abdominal pain, and early diagnosis is crucial to prevent morbidity and mortality. Unfortunately, some of these patients present in poor clinical conditions to the emergency department, and imaging specialists are crucial for optimal outcomes. Although the radiological diagnosis of abdominal infarcts is often straightforward, it is vital to use the appropriate imaging modalities and correct imaging techniques for their detection. Additionally, some non-infarct-related abdominal pathologies may mimic infarcts, cause diagnostic con

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Hypertrophic Cardiomyopathy Phenocopies: Classification, Key Features, and Differential Diagnosis.

Among cardiomyopathies, the hypertrophic phenotype is the most common, and hypertrophic cardiomyopathy (HCM) phenocopies represent a heterogeneous group of conditions. They are defined by a left ventricular wall thickness ≥15 mm in the absence of other causes such as loading conditions, ischemia, or valvular disease. Although they mimic similar clinical and morphological features, their etiologies are distinct and include genetic, metabolic, and infiltrative mechanisms. Therefore, accurate classification and differential diagnosis are crucial for effective management and treatment. Sarcomeric

Fatal Type B Lactic Acidosis Associated With Metastatic Colorectal Cancer: A Case Report With Review of Literature, Pathogenesis, and Treatment.

Type B lactic acidosis associated with malignancy is a life-threatening complication and mostly seen in hematological malignancies but can also be seen in solid tumors. We report a rare case of a 64-year-old female diagnosed with metastatic adenocarcinoma of the colon with liver metastasis associated with severe type B lactic acidosis. We discuss pathophysiology, previously reported cases, and their outcomes. The most widely used therapies are bicarbonate infusion, thiamine supplementation, chemotherapy, and supportive care but is associated with poor outcomes, and no standard treatment recomm