Differentiating autoimmune hepatitis from liver dysfunction due to adult-onset Still's disease is important in deciding whether to terminate or continue corticosteroid therapy, and also in terms of management of cirrhosis and surveillance of hepatocellular carcinoma. Liver biopsy is thought to be the most important determinant for differential diagnosis.
We describe a case of a 2-month-old female displaying clinical phenotype of HIES related disease with severe eczematous dermatitis recalcitrant to corticosteroids. Genetic panel showed a variant of unknown significance in key immune regulator of PGM3. Patient achieved nearly complete response from off-label use of dupilumab.
Background: Repositioning a traumatized tooth involves, first, replacing and second stabilizing it. Stabilization, on the other hand, usually requires flexible splints. Occasionally the immediate replacement may be impossible being necessary to use other procedure. Methods: When complete replacement is not possible,
A 49-year-old male presented with a gradually progressive loss of vision in both eyes. Funduscopic examination revealed bilateral optic disc swelling and two yellowish elevated choroidal lesions in the LE. Ophthalmic imaging raised suspicion of choroidal metastasis. Adenocarcinoma of the lung was detected in further systemic evaluation.
Granular parakeratosis is an acquired keratinization disease. We describe the unusual presentation of granular parakeratosis. A 27-year-old healthy female presented with multiple erythematous and brown discoloration plaques on the dorsal aspect of her hands for eight months. Repeated washing, using detergents, and maceration of the skin could develop her lesion.
Hepatitis E virus (HEV) is transmitted via the fecal-oral route and can cause chronic infection in immunocompromised individuals. A 23-year-old man with no medical history visited our hospital after testing HEV positive during blood donation. Although he did not develop acute hepatitis, HEV IgA remained positive for over eight months.
Gastric metastases originating from breast carcinomas and type 4 advanced gastric cancers are often difficult to distinguish because of their similar endoscopic and pathologic characteristics. This often delays early intervention and accordingly affects prognosis. Immunohistochemical analyses are important for both diagnosis and treatment of breast carcinomas.
Primary scrotal lipoma is a rare urological diagnosis. It is usually diagnosed incidentally as most of time initial diagnosis may be confused with other common etiology of scrotal masses. Here, we present a case a rare case of scrotal lipoma with initial misdiagnosis of hydrocele at primary health facility.
Deposition of hydroxyapatite crystals in the para-articular soft tissues is a well-known condition. However, this condition has been rarely described in acromioclavicular joint . We report a case of 55 year gentleman, presented with acute onset of shoulder pain , who was diagnosed with calcific periarthritis of acromioclavicular joint.
A 2-year-old boy was diagnosed with ileocecal intussusception and underwent surgical treatment and appendectomy. Appendix histopathology revealed lymphoid cells with hyperchromatic nuclei, high mitotic activity, and starry sky appearance. The patient was diagnosed with Burkitt's lymphoma, which involves many organs, such as the appendix, liver, kidney, and bone marrow.
In this study, total knee arthroplasty was performed in a patient with pigmented villonodular synovitis. During surgery, severe black discoloration of the articular cartilage and menisci was observed in the patient. According to literatures, this is the first case report of severe articular cartilage pigmentation in a patient with PVNS.
The patient is a 33-year-old Iranian woman without a significant past medical history with the full range of narcolepsy symptoms that started within two weeks after her recovery from COVID-19. Sleep studies revealed increased sleep latency and three sleep-onset rapid eye movement events, compatible with a narcolepsy-cataplexy diagnosis.
A 64-year-old man presented with asymmetric paresthesia and subsequent weakness of his feet and a 10-kg weight loss over 40 days. Electrodiagnostic studies revealed distal axonal sensory-motor polyneuropathy with ongoing axonal loss. A peroneal nerve biopsy showed intravascular proliferation of CD-20 positive lymphocytes, which suggested intravascular large B-cell lymphoma.
A 30-year-old man presented with sudden chest pain and evidence of multiple cystic lesions in both long and left-sided pneumothorax in HRCT. H&E stained section and IHC for CD1a and S100 were positive in lung samples. The patient was treated with the diagnosis of Isolated pulmonary langerhans cell histiocytosis.