Medicine
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Review Case Reports
Adult-onset neuronal ceroid lipofuscinosis misdiagnosed as autoimmune encephalitis and normal-pressure hydrocephalus: A 10-year case report and case-based review.
Neuronal ceroid lipofuscinoses (NCLs) are rare, fatal, inherited neurodegenerative disorders characterized by myoclonic epilepsy, cognitive decline, brain atrophy, and retinopathy. The pathogenesis and clinical manifestations of NCL are not well understood and frequently result in misdiagnosis and overtreatment. The aim of this case report and review is to improve our understanding of the clinical features and management of NCL. ⋯ ANCL typically presents with the clinical triad of refractory seizures, progressive cognitive decline, and movement disorders. Neuroimaging often reveals progressive brain atrophy on magnetic resonance imaging, while electroencephalograms frequently show epileptiform discharges. The prognosis is generally poor. Improved understanding of ANCL from both clinical and radiological perspectives, coupled with early consideration of differential diagnoses, could minimize unnecessary interventions and optimize patient care.
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Review Case Reports
Cronkhite-Canada syndrome: A case report and literature review.
Cronkhite-Canada syndrome (CCS) is a nonhereditary, rare polyposis condition, first documented by Cronkhite and Canada in 1955. The primary distinct features of this syndrome include ectodermal abnormalities and diffuse gastrointestinal polyp changes accompanied by protein loss. The primary clinical manifestations of CCS include hair loss, excessive pigmentation of the skin, and malnourishment of fingernails or toenails. Other notable symptoms include weight loss, protein-losing enteropathy, diarrhea, abdominal pain, nausea, vomiting, taste abnormalities, and atrophic glossitis, which predominantly occur in middle-aged and older males. CCS is characterized by an extremely rare, nonfamilial hamartomatous polyposis syndrome, in which polyps are distributed in the stomach and colon (90%), small intestine(80%), and rectum (67%), while sparing the esophagus. ⋯ In this case, from the lower esophageal sphincter to the rectum, there is an increasing trend of eosinophil and mast cell infiltration. These lesions can cause a positive IgG result. Pathological analysis indicates that the extent and severity of lesions in the middle and lower gastrointestinal tract are more substantial than in the upper tract. During treatment, endoscopic observations reveal that lesions in the middle and lower tract tend to resolve faster than those in the upper tract. Hormone therapy has demonstrated significant efficacy in treating this disease. Early treatment and regular follow-up for this disease can reduce the risk of cancerous changes and related complications.
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Review Case Reports
Ovarian carcinosarcoma with lung metastasis characterized by persistent fever: A case report and literature review.
Ovarian carcinosarcoma (OCS) is a rare malignant tumor prone to distant metastasis. Primary manifestations include pelvic and/or abdominal pain, bloating, and compression. Nevertheless, it is uncommon for OCS to present primarily with persistent fever. This is the first reported case of OCS with lung metastasis characterized by persistent fever. ⋯ This study suggests that, for patients with pelvic and/or abdominal pain, bloating, and pelvic masses, especially those with suspicious lesions in other organs accompanied by fever of unknown origin, a diagnosis of cancer or sarcoma with metastasis should be considered after ruling out infectious fever.
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Review Case Reports
Cytologic features of gastric-type endocervical adenocarcinoma: Three cases report and literature review.
Cervical gastric-type adenocarcinoma shows gastric differentiation, and the tumor cell morphology appears benign and unrelated to human papillomavirus, which makes cervical gastric-type adenocarcinoma highly susceptible to misdiagnosis as normal glandular epithelium in cytologic diagnosis. ⋯ The "drunken honeycomb" cell arrangement is diagnostically important in liquid-based cytology, especially when three-dimensional spheroids are present, and may be a characteristic cytological finding of well-differentiated cervical gastric-type adenocarcinoma.
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Review Case Reports
Polymyalgia rheumatica following COVID-19 vaccination: Case series of 3 patients and literature review on polymyalgia rheumatica induced by various vaccines.
Since the onset of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic in 2019, considerable resources have been devoted to developing vaccines to reduce related deaths and the burden of disease. Various vaccine formulations eventually became available and were approved for clinical use. In this article, we have conducted a review of polymyalgia rheumatica (PMR) cases induced by different COVID-19 vaccines [Pfizer: BNT162b2, AstraZeneca: ChAdOx1-S, Moderna: mRNA-1273, and Janssen: Ad26.COV2.S)], as well as non-COVID-19 vaccines, such as influenza, zoster, hepatitis B, and tetanus vaccines. Additionally, this article investigates 3 cases with clinical presentations suggestive of PMR following COVID-19 mRNA vaccination. This study aims to offer valuable insights through sharing diagnostic and therapeutic experiences. ⋯ Although direct causality was not definitively established in this article, the BNT162b2 COVID-19 mRNA vaccine, similar to other vaccines, might be considered a potential trigger for PMR. This raises the need for further research into this issue and potentially other immunological outcomes.