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Hypophosphatemic Osteomalacia Induced by Low-Dose Adefovir-Related Fanconi Syndrome.

Adefovir dipivoxil (ADV), an antiviral agent for chronic hepatitis B virus infection, has been associated with nephrotoxicity, particularly Fanconi syndrome, even at low doses (10 mg/day). Fanconi syndrome is a generalized proximal tubular dysfunction leading to phosphate wasting and hypophosphatemic osteomalacia. Here, the author reports a case of a 58-year-old man with a 2-year history of bone pain involving the left foot, upper back, and left scapula, later extending to the right foot and chest wall, without antecedent trauma. Magnetic resonance imaging revealed insufficiency fractures in b

Hemoglobin SS Nigerian Woman First Diagnosed at the Age of 52 years with Manifestation Mimicking Tuberculosis of the Spine.

Sickle cell anemia (SCA) is an inherited disorder of hemoglobin due to the presence of abnormal hemoglobin in a homozygous state. Manifestation is usually in infancy or early childhood due to gradual decrease in hemoglobin F level as age advances. Diagnosis in middle age is unusual. We present a woman who was diagnosed of SCA for the first time at middle age. The aim was to bring to the knowledge of physicians that patients with SCA can also present late so high index of suspicion is required to make diagnosis. A 52-year-old woman presented to orthopedic clinic with complaints of generalized b

Microangiopathy in multiple myeloma: a case of carfilzomib-induced secondary thrombotic microangiopathy successfully treated with plasma exchange and complement inhibition.

BACKGROUND: Thrombotic microangiopathy (TMA) is a potentially organ and life-threatening condition affecting patients with multiple myeloma (MM). Cases of proteasome inhibitor-induced TMA and specifically carfilzomib-induced TMA have been rarely reported and standards for diagnostic workup and treatment are not available. CASE PRESENTATION: We describe a case of a male MM patient under salvage therapy including proteasome inhibitor carfilzomib following chemotherapy and autologous stem cell transplantation. The patient then developed acute kidney injury with clinical and laboratory signs of T

Targeted drug approvals in 2023: breakthroughs by the FDA and NMPA.

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Long-term stabilization of metastatic melanoma with sodium dichloroacetate.

Sodium dichloroacetate (DCA) has been studied as a metabolic cancer therapy since 2007, based on a publication from Bonnet et al demonstrating that DCA can induce apoptosis (programmed cell death) in human breast, lung and brain cancer cells. Classically, the response of cancer to a medical therapy in human research is measured by Response Evaluation Criterial for Solid Tumours definitions, which define "response" by the degree of tumour reduction, or tumour disappearance on imaging, however disease stabilization is also a beneficial clinical outcome. It has been shown that DCA can function as

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

Interferon-Based Biopharmaceuticals: Overview on the Production, Purification, and Formulation.

The advent of biopharmaceuticals in modern medicine brought enormous benefits to the treatment of numerous human diseases and improved the well-being of many people worldwide. First introduced in the market in the early 1980s, the number of approved biopharmaceutical products has been steadily increasing, with therapeutic proteins, antibodies, and their derivatives accounting for most of the generated revenues. The success of pharmaceutical biotechnology is closely linked with remarkable developments in DNA recombinant technology, which has enabled the production of proteins with high specific

Emerging therapies for autosomal dominant polycystic kidney disease with a focus on cAMP signaling.

Autosomal dominant polycystic kidney disease (ADPKD), with an estimated genetic prevalence between 1:400 and 1:1,000 individuals, is the third most common cause of end stage kidney disease after diabetes mellitus and hypertension. Over the last 3 decades there has been great progress in understanding its pathogenesis. This allows the stratification of therapeutic targets into four levels, gene mutation and polycystin disruption, proximal mechanisms directly caused by disruption of polycystin function, downstream regulatory and signaling pathways, and non-specific pathophysiologic processes sha

Targeting fibrosis, mechanisms and cilinical trials.

Fibrosis is characterized by the excessive extracellular matrix deposition due to dysregulated wound and connective tissue repair response. Multiple organs can develop fibrosis, including the liver, kidney, heart, and lung. Fibrosis such as liver cirrhosis, idiopathic pulmonary fibrosis, and cystic fibrosis caused substantial disease burden. Persistent abnormal activation of myofibroblasts mediated by various signals, such as transforming growth factor, platelet-derived growth factor, and fibroblast growh factor, has been recongized as a major event in the occurrence and progression of fibrosi

Extrinsic airway compression: an unusual presentation of thoracic vertebral osteophytes from osteoarthritis.

Extrinsic airway compression secondary to vertebral osteophytes is a rare clinical entity. We report a case of an elderly patient presenting with pneumonia where a subsequent chest CT scan showed right main bronchus compression caused by lower thoracic vertebral osteoarthritis-related osteophytes. There were additional incidental findings of sclerotic skeletal lesions prompting a new diagnosis of metastatic prostate cancer. The pneumonia improved with antibiotic therapy. Interventional management of airway compression was not pursued in this patient given his poor functional state and advanced

Sternal Tumor Resection and Complex Chest Wall Reconstruction of a Solitary Plasmacytoma: A Report of a Rare Case.

Localized sternal plasmacytoma is a rare and aggressive oncologic condition. Surgical resection followed by radiotherapy offers the highest chance of cure. Radical resection of the chest wall is technically feasible and is associated with improved outcomes. Subsequent reconstruction using meshes, plates, and both autologous and allogenic tissues allows for the restoration of chest wall function and may prolong survival. Patients with solitary plasmacytoma require close follow-up to monitor for local recurrence or distant disease progression. We present a case of a 63-year-old man diagnosed wit

Relapsed Chronic Lymphocytic Leukemia Heralded by Parathyroid Hormone Related Peptide-Mediated Hypercalcemia.

Hypercalcemia is a common, serious complication in patients with malignancy and is associated with significant morbidity. Compared to patients with solid tumor malignancies, the reported incidence of hypercalcemia in patients with indolent lymphoid malignancies is lower and rare in those with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). In this report, we describe the case of a patient with a history of CLL/SLL previously treated with multiple lines of therapy and thought to be in remission who presented with symptomatic, severe hypercalcemia. Her calcium initially improv

Risk factors of partial IgA deficiency among low serum IgA patients: a retrospective observational study.

IntroductionPartial IgA deficiency (pIgAD), including selective IgA deficiency, is one of the most common types of immunodeficiency. Early detection is crucial to prevent complications, such as recurrent infections and anaphylactic reactions to blood derivatives.Material and methodsUseful screening methods have not yet been established. We conducted a single-center retrospective observational study, with low serum IgA patients to clarify the risk factors of pIgAD among patients with low serum levels of IgA. All patients with low serum IgA levels treated in our outpatient clinic from April 2010

Chemotherapy-induced peripheral neuropathy.

Neuropathy is associated with side effects of frontline chemotherapeutics, which is a prominent therapy utilized in prevalent cancers. Peripheral neuropathy negatively impacts quality of life in cancer patients and survivors. It also affects the dose plan of the treatment, thereby limiting the efficacy of the treatment. We searched the electronic database PubMed for pre-clinically and clinically controlled trials reporting neuropathy of adverse effects, a result of chemotherapy in cancer patients. It was observed clearly that many reports provide clinical evidence to rapidly growing neuropathy

Оптимальный выбор способа управления лекарствами в отношении внутримышечной и подкожной инъекции.

Внутримышечное (IV), внутримышечное (IM) и подкожное (SC) three - наиболее часто используемые пути инъекции для лечения лекарств. Время от времени проводились сравнительные исследования СК по отношению к IV, IM по отношению к IV, или IM по сравнению с СК, и некоторые новые выводы совершенно отличаются от рекомендаций в отношении дозировки, описанных в предписаниях в отношении информации. Однако врачи, возможно, до сих пор не знают о таких новых фактах при выборе методов лечения. Поиск литературы MetodsA был проведен с использованием PubMed, MedLINE и Web of Sciences TM Core Collection для анал

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… Potassium chloride injection must be diluted and infused over a certain period of time. IV push/bolus, SC, and IM are contraindicated routes that would result in the patient receiving too much potassium too quickly. …

Lithium: A Promising Anticancer Agent.

Lithium is a therapeutic cation used to treat bipolar disorders but also has some important features as an anti-cancer agent. In this review, we provide a general overview of lithium, from its transport into cells, to its innovative administration forms, and based on genomic, transcriptomic, and proteomic data. Lithium formulations such as lithium acetoacetate (LiAcAc), lithium chloride (LiCl), lithium citrate (Li3C6H5O7), and lithium carbonate (Li2CO3) induce apoptosis, autophagy, and inhibition of tumor growth and also participate in the regulation of tumor proliferation, tumor invasion, and

Osseous Sarcoidosis Mimicking Metastatic Disease in a Patient With Longstanding Pulmonary Sarcoidosis: A Case Report.

Sarcoidosis is a multisystem granulomatous disease in which osseous involvement is uncommon and most often affects the small bones of the hands and feet, whereas axial skeletal disease remains underrecognized and may mimic metastatic malignancy. A 72-year-old man with longstanding pulmonary sarcoidosis and moderate persistent asthma was incidentally found to have multifocal sacral and iliac bone lesions on lumbar spine magnetic resonance imaging (MRI) obtained for evaluation of back pain and radiculopathy. These lesions were radiologically suspicious for osseous metastases, prompting systemic

Hypercalcemia-Associated Hodgkin's Lymphoma Presenting as Normal Pressure Hydrocephalus: A Case Report.

Hodgkin's lymphoma is a malignancy of the lymphatic system that can rarely present with advanced-stage features such as spinal cord involvement and hypercalcemia. We present the case of a 63-year-old Caucasian male with advanced Hodgkin's lymphoma, presenting with hypercalcemia and symptoms resembling normal pressure hydrocephalus. The patient exhibited gait impairment, altered mental status, and urinary incontinence, forming the classic triad seen in normal pressure hydrocephalus. Laboratory findings revealed leukocytosis, anemia, hypercalcemia, and acute kidney injury. Imaging showed extensi

Orbital Onslaught: An Atypical Presentation of Mucormycosis in a Diabetic and Hypertensive Patient.

Mucormycosis, primarily known to affect the sinuses and brain, severely threatens immunocompromised individuals. Its occurrence in the orbital region is rare and potentially devastating. We report a unique case of a 50-year-old male with longstanding diabetes and hypertension who exhibited isolated orbital mucormycosis confined to the right eye. The patient presented with fever and acute vision loss without classic sinusitis symptoms; earlier mismanagement led to an aggressive relapse. An orbital computed tomography (CT) scan revealed inflammatory changes indicative of an early-stage invasive

Secondary Hyperparathyroidism Presenting as a Brown Tumor: A Case Report and Review of the Literature.

Severe secondary hyperparathyroidism in advanced stages of chronic kidney disease (CKD) is associated with CKD-related mineral and bone disease (CKD-MBD). A 70-year-old woman was admitted at the Hospital for generalized bone pain and peripheral edema. Initial laboratory tests revealed normocytic anemia and severe renal dysfunction, and further tests evidenced severe secondary hyperparathyroidism. Full-body computerized tomography showed an osteolytic lesion in the right iliac wing. The iliac bone lesion was biopsied and histological examination was consistent with the diagnosis of a brown tumo