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Pruritus in Systemic Diseases: A Review of Etiological Factors and New Treatment Modalities.

Pruritus is the most frequently described symptom in dermatology and can significantly impair the patient's quality of life. In 10-50% of adults with persistent pruritus, it can be an important dermatologic clue for the presence of a significant underlying systemic disease such as renal insufficiency, cholestasis, hematologic disorder, or malignancy (Etter and Myers, 2002; Zirwas and Seraly, 2001). This review describes the presence of pruritus in different systemic diseases. It is quite important to discover the cause of pruritus for providing relief for the patients experiencing substantial

Pharyngeal-Esophageal Malignancies with Dermatologic Paraneoplastic Syndrome.

Systemic changes often send signals to the skin, and certain neoplastic diseases of the internal organs can also trigger skin manifestations. In this article, the authors make clinical photography presentations of the patients seen at our clinic with dermatologic paraneoplastic syndromes within pharyngeal-esophageal malignancies, describe several paraneoplastic dermatoses, and also review high-quality scientific literature in order to be able to highlight the dermatological signs of pharyngoesophageal malignant tumors. The majority of our patients with paraneoplastic dermatoses, filtering for

Chronic pruritus: a narrative review.

Chronic pruritus encompasses a manifestation of several cutaneous, allergic, infectious, neurological, psychological, and systemic conditions, whose etiological investigation and therapeutic strategy can be challenging. This comprehensive review aims to enhance the understanding of pruritus by highlighting important elements in its pathogenesis, including keratinocytes, Merkel cells and mast cells, nerve fibers, histaminergic and nonhistaminergic pathways, and the interaction of itch signals with the central nervous system. Diagnostic evaluation of chronic pruritus may require a meticulous app

Skin manifestations associated with systemic diseases - Part II.

The skin, by reflecting internal processes, externalizes what happens inside the body in many diseases. Thus, the skin, as an organ, extrapolates its functions of protection, barrier and signals the existence of systemic diseases, expanding the importance of the dermatologist beyond the skin surface. Thus, the dermatologist investigates diagnostic hypotheses for conditions related to all systems and refers patients to the appropriate specialty. Combined with examination by a trained eye, the skin, due to its easy access, is still the ideal place for performing biopsies, which often clarify the

Humoral Hypercalcaemia in Metastatic Gallbladder Cancer Presenting as Delirium: A Case Report.

Hypercalcaemia of malignancy (HCM) is a recognised paraneoplastic complication of advanced cancer, with HHM being mediated predominantly by parathyroid hormone-related protein (PTHrP) secretion. While commonly observed in squamous cell carcinomas, it is exceedingly rare in gallbladder adenocarcinoma, with only isolated case reports described in the literature. We report a man in his 50s with metastatic gallbladder cancer who presented with colicky abdominal pain, constipation, fatigue, low mood, delayed responses and insomnia. Delirium was diagnosed based on the Diagnostic and Statistical Manu

The Rise of Oncoendocrinology: How Modern Cancer Therapies Are Reshaping Endocrine Practice.

The emergence of immune checkpoint inhibitors, targeted therapies, CAR T-cell therapy, and antibody-drug conjugates has transformed modern oncology, significantly improving survival across a wide range of malignancies. However, these advances have also introduced a growing spectrum of endocrine and metabolic complications, redefining the scope of endocrine practice. Therapy-induced endocrinopathies, including thyroid dysfunction, hypophysitis, adrenal insufficiency, diabetes, pancreatitis, dyslipidemia, gonadal dysfunction, and metabolic syndrome, are recognized as clinically significant and o

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… endocrine syndromes, in which ectopic hormone production by tumors can mimic metastatic disease and complicate diagnosis and prognosis [ 14 , 15 , 16 ]. … Paraneoplastic endocrine syndromes. Endocr. Relat. Cancer. 2017;24:R173–R190. doi: 10.1530/ERC-17-0036. 17. Jensen M.V., Rugbjerg K., de Fine Licht S., Johansen C., Schmiegelow K., Andersen K.K., Winther J.F. …

Acute pancreatitis with hypercalcemia caused by primary hyperparathyroidism associated with paraneoplastic syndrome: A case report and review of literature.

BACKGROUND: Although acute pancreatitis associated with hyperparathyroidism has occasionally been reported, acute pancreatitis with metabolic encephalopathy caused by hyperparathyroidism combined with paraneoplastic syndrome is an extremely rare entity and poorly described in the literature. CASE SUMMARY: We present a case of a 56-year-old female with upper abdominal discomfort and intermittent nausea and vomiting for 1 wk, without apparent abdominal pain or bloating, no jaundice and decreased blood pressure at the outset. The patient was ultimately diagnosed with moderately severe acute panc

Hypercalcemia-Leukocytosis syndrome and adenosquamous lung carcinoma: An overlooked conjugation.

Hypercalcaemia and leukocytosis are two paraneoplastic conditions associated with poor prognosis. Adenosquamous carcinoma is a rare and aggressive histological subtype of lung cancer consisting of adenocarcinoma and squamous cell components. We report the case of a 57-year-old male smoker who was admitted to the Emergency Room with skull and neck tumefactions, confusion and deteriorated general condition. The complementary study in the ER revealed severe hypercalcaemia (19.8 mg/dL), leukocytosis (18.7 × 109/L) and extensive osteolytic lesions of the skull on cranioencephalic computer tomograph

Guillain-Barré syndrome in a patient with multiple myeloma after bortezomib therapy: A case report.

BackgroundBortezomib is a first-line drug approved for patients with multiple myeloma (MM) and has significantly increased their overall survival. However, bortezomib-induced peripheral neuropathy (PN) remains a significant side effect that has led to its discontinuation in some patients. Guillain-Barré syndrome (GBS) is recognized as an immune-mediated PN characterized by the involvement of multiple nerve roots and peripheral nerves and albuminocytologic dissociation in cerebrospinal fluid (CSF) tests. Intravenous immunoglobulin (IVIG) and plasmapheresis are effective.Case summaryA 45-year-ol

Beyond the Obstruction: Recognising Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal Plasma Cell Disorder, and Skin Changes (POEMS) Syndrome in a Patient With Budd-Chiari Syndrome.

Polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes (POEMS) syndrome is a rare paraneoplastic disorder caused by an underlying monoclonal plasma cell neoplasm. We report a rare case of a 52-year-old man who presented with subacute sensorimotor neuropathy, hepatosplenomegaly, ascites, pleural effusion, thrombocytosis, gynecomastia, and osteosclerotic bone lesions. Investigations revealed elevated vascular endothelial growth factor (VEGF) levels and clonal plasma cells, consistent with POEMS syndrome. He was also found to have hepatic vein thrombosis,

Association of stiff-person syndrome with autoimmune endocrine diseases.

BackgroundStiff-person syndrome (SPS) and its subtype, stiff limb syndrome (SLS), are rare neurological disorders characterized by progressive muscular rigidity and spasms. Glutamic acid decarboxylase (GAD) is the enzyme that catalyzes the production of γ-aminobutyric acid (GABA), a major inhibitory neurotransmitter of the central nervous system. SPS is an autoimmune disease triggered by anti-glutamic acid decarboxylase antibody (anti-GAD Ab). Clinically, anti-GAD Ab is associated with SPS, type 1 diabetes mellitus (T1DM), and other autoimmune diseases.AimTo investigate the link of autoimmune

Small Cell Carcinoma of the Gallbladder: Case Report and Comprehensive Analysis of Published Cases.

Background. Gallbladder small cell carcinoma is a rare and highly aggressive malignancy with no established standard of care treatment. We described here a case report of small cell gallbladder cancer and we then performed a comprehensive review of 72 case reports of this disease. Methods. Published case reports of small cell carcinoma of the gallbladder between 1983 and 2014 were reviewed. Treatment modalities and survival were analyzed for metastatic and localized disease. Results. Median overall survival for all patients was 13 months. Metastatic disease was identified in 72% of cases. Trea

Hyponatremia and hypercalcemia: a study of a large cohort of patients with lung cancer.

BackgroundHyponatremia and hypercalcemia are reported to be associated with poorer prognosis in lung cancer. Our study assessed the incidence of hyponatremia and hypercalcemia in a recent large cohort of patients diagnosed with lung cancer in an academic institution and correlated incidence with patient and tumour parameters.MethodsAll patients presented at our regional lung cancer multidisciplinary team meeting between January 2011 and December 2016 were included. The incidence of hyponatremia (serum sodium ≤135 mEq/L) and hypercalcemia (serum calcium >2.62 mmol/L), including severity (mild,

MR imaging findings in some rare neurological complications of paediatric cancer.

Neurological complications of paediatric cancers are a substantial problem. Complications can be primary from central nervous system (CNS) spread or secondary from indirect or remote effects of cancer, as well as cancer treatments such as chemotherapy and radiation therapy. In this review, we present the clinical and imaging findings of rare but important neurological complications in paediatric patients with cancer. Neurological complications are classified into three phases: pre-treatment, treatment and post-remission. Paraneoplastic neurological syndromes, hyperviscosity syndrome, haemophag

POEMS syndrome misdiagnosed as liver cirrhosis: a case report.

POEMS syndrome is a rare multisystem paraneoplastic disorder characterized by polyneuropathy and monoclonal plasma cell proliferation, often leading to delayed diagnoses due to variable clinical manifestations. A 62-year-old woman presented with persistent bilateral eyelid edema as the initial symptom and abdominal distension as the predominant complaint. She was misdiagnosed with liver cirrhosis and remained undiagnosed for 6 years. Multidisciplinary evaluation revealed monoclonal IgA λ protein, markedly elevated vascular endothelial growth factor, and neurophysiological evidence of periphera

Neoplasm related mortality risk in Systemic Sclerosis: a nationwide study.

BackgroundThe higher mortality rates in patients with Systemic sclerosis (SSc) are related to SSc activity, cardiovascular disease, and neoplasms, among other factors. Our objective was to assess the impact of solid organ neoplasms (SON) and hematological neoplasms (HN) on mortality among SSc patients.MethodsA retrospective, observational comparison of SON and HN-related deaths in SSc patients with those in the general Spanish population was conducted using data from the Spanish Hospital Discharge Database. Binary logistic regression was used to analyze the impact of SSc on mortality risk from

Case Report: Acute Kidney Injury Due to Chronic Milk-Alkali Syndrome in a Patient With Colon Cancer.

BACKGROUND: Common causes of hypercalcemia include primary hyperparathyroidism and paraneoplastic syndrome of malignancy. Because of this, physicians can easily miss extrinsic causes of hypercalcemia such as milk-alkali syndrome in patients with cancer. We successfully treated a case of acute kidney injury due to severe hypercalcemia caused by milk-alkali syndrome due to long-term milk drinking in a patient with colon cancer. CASE DESCRIPTION: A 62-year-old man was referred to nephrology for hypercalcemia and azotemia that was found during preoperative evaluation for colon cancer surgery. The

Neurologic adverse events of cancer immunotherapy.

Cancer immunotherapy encompasses a wide range of treatment modalities that harness the anti-tumor effects of the immune system and have revolutionized oncological treatment in recent years, with approval for its use in more and more cancers. However, it is not without side effects. Several neurological adverse events have been recognized associated with immune checkpoint inhibitors (ICI) and chimeric antigen receptor (CAR) T-cell therapy, the two main classes of cancer immunotherapy. With the increase in the prevalence of oncological diseases and this type of therapy, it is improbable that neu

Hypercalcemia in poorly differentiated endometrial cancer: a report of two cases.

BACKGROUND: Hypercalcemia as a paraneoplastic syndrome is associated with poor prognosis. It is most commonly caused by parathyroid hormone-related protein (PTHrP) production, less commonly by bony metastases, and very rarely by ectopic parathyroid hormone (PTH) secretion. Hypercalcemia in endometrial cancer is relatively rare. CASE PRESENTATION: We present two cases of hypercalcemia in patients with poorly differentiated endometrial cancer, both of whom had elevated PTH levels and no evidence of parathyroid disease or bone metastases at baseline. In the first case, hypercalcemia rapidly prog

An update on malignant tumor-related stiff person syndrome spectrum disorders: clinical mechanism, treatment, and outcomes.

Stiff person syndrome (SPS) is a rare central nervous system disorder associated with malignancies. In this review, we retrieved information from PubMed, up until August 2023, using various search terms and their combinations, including SPS, stiff person syndrome spectrum disorders (SPSSDs), paraneoplastic, cancer, and malignant tumor. Data from peer-reviewed journals printed in English were organized to explain the possible relationships between different carcinomas and SPSSD subtypes, as well as related autoantigens. From literature searching, it was revealed that breast cancer was the most