Medicine
-
Charcot-Marie-Tooth (CMT) disease, a hereditary motor and sensory neuropathy, presents with progressive chronic sensory and distal motor polyneuropathy. While sensorineural hearing loss and vestibular impairment have been documented in CMT patients, concurrent middle ear cholesteatoma and persistent direction-changing positional nystagmus have not. ⋯ This case highlights 3 key points: facial nerve hypertrophy in CMT requiring differentiation from schwannoma, the first reported instance of middle ear cholesteatoma in a CMT patient, and vertigo due to acute otitis media complicated by serous labyrinthitis, manifesting as direction-changing positional nystagmus. These findings underscore the need for thorough diagnosis and management in such presentations. This is the first report of concomitant middle ear cholesteatoma in a CMT patient, illustrating the complexity of diagnosis and treatment.
-
Horn pregnancy is a rare subtype of ectopic pregnancy that presents a diagnosis and treatment challenge due to its nonspecific symptoms and high risk of rupture. ⋯ This case highlights the success of combining low molecular weight heparin with traditional Chinese medicine in the treatment of cornual pregnancy. Factors affecting horn pregnancy, diagnostic challenges, and treatment considerations are discussed. Further research is necessary to determine the best management strategy and to ensure safe delivery for patients with impaired fertility but a strong desire to conceive.
-
Observational Study
What is the ideal thyroid-stimulating hormone (TSH) threshold value in congenital hypothyroidism screening? Twin study.
Congenital hypothyroidism is the most common preventable cause of intellectual disability. Therefore, the majority of developed countries have aimed to diagnose cases early through screening programs. In these screening programs, levels of thyroid-stimulating hormone (TSH) and free thyroxine are examined in dried blood spots taken between days 3 and 5 of life. ⋯ After that, they were evaluated by a child and adolescent psychiatry. Finally, the Denver Developmental Test was applied to the cases. There was no significant impairment in somatic growth, mental development, and neuromotor development in the long-term outcomes of cases with plasma TSH ≥ 8 mU/L compared to those with plasma TSH < 8 mU/L among the twins participating in our study.
-
Patients with chronic immune diseases, such as idiopathic thrombocytopenic purpura (ITP), should be alert for Guillain-Barre/acute transverse myelitis (GBS/ATM) overlap syndrome after infection with coronavirus disease 2019 (COVID-19). ⋯ COVID-19 infection can lead to secondary myelitis and GBS, and GBS/ATM overlap syndrome is rare, but patients are significantly better after immunization and hormone therapy.
-
Case Reports
Primary clear cell adenocarcinoma of the seminal vesicle with ovarian homology: A rare case report.
Primary seminal vesicle adenocarcinoma is a rare type of male reproductive system tumor, primarily manifesting as papillary adenocarcinoma. Meanwhile, clear cell adenocarcinoma (CCA) is a common malignancy in the female reproductive system. Therefore, the occurrence of CCA in the seminal vesicle, showing ovarian homology, is even rarer. This pathological type of seminal vesicle cancer has been seldom reported. ⋯ CCA occurring in the seminal vesicle is extremely rare, and radical surgical excision is the primary treatment method.