Medicine
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Sodium valproate is a widely used antiepileptic drug and also used to prevent postoperative seizures in neurosurgery. Anemia caused by sodium valproate is occasionally reported and most are from pediatric patients. ⋯ Hematologic toxicity of sodium valproate can occur quickly. Regular complete blood count test helps to make prompt diagnosis and drug discontinuation leads to the recovery.
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Acute kidney injury is common and correctable in patients with a hyperosmolar hyperglycemic state (HHS). Nevertheless, hyperglycemic crisis may also contribute to the development of rhabdomyolysis, which can worsen renal function and lead to high mortality in such patients. ⋯ Rhabdomyolysis is a complication of HHS. Delayed detection can be fatal, and timely renal replacement therapy can result in an excellent prognosis. Therefore, it is crucial for clinicians to detect and treat such patients as early as possible to avoid impairing their renal function.
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Adenocarcinoma and neuroendocrine tumors are a very rare combination of double primary pancreas tumor. ⋯ The possibility of multiple primary tumors of different histological origin should be considered when multiple different pancreatic lesions are detected on images. Computed tomography (CT) and magnetic resonance imaging (MRI) play key roles in the management of multiple tumors in the pancreas.
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Case Reports
A rare case report of hypertrophic cardiomyopathy induced by catecholamine-producing tumor.
Catecholamine-producing tumors are rare, occurring in less than 0.2% of patients with hypertension, but can have relevant cardiovascular morbidity and mortality. ⋯ We report a rare case of catecholamine-induced cardiomyopathy due to an adrenal adenoma mixed with nodules enriched in epinephrine-types secreting granules.
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This study aimed to compare the sensitivity and accuracy for the detection of small lesions in patients with hepatocellular carcinoma (HCC) using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and 64-slice computed tomography (CT) enhanced scanning, and to evaluate the necessity to perform MRI in patients diagnosed with HCC by CT. The clinical data from 209 patients with HCC diagnosed prior to surgery in the Affiliated Hospital of Guilin Medical University, China were retrospectively analyzed. The 64-slice dynamic contrast-enhanced multi-detector CT (MDCT) and 3.0 T Gd-EOB-DTPA DCE MRI procedures were successively carried out on all patients who were enrolled in a self-controlled study including detection and diagnosis of HCC lesions by MRI and CT, respectively. ⋯ In addition, MRI detected lesions in 15 cases (7.81% in the total of 209 cases) that were not diagnosed by CT. Among these cases, 2 patients were diagnosed to have no lesion by CT. Gd-EOB-DTPA DCE-MRI performed as a routine check prior to surgery in HCC patients can improve the detection of small HCC lesions.