Internal medicine
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Case Reports
Disturbance of consciousness associated with hypophosphatemia in a chronically alcoholic patient.
A 69-year-old man with chronic alcoholism was admitted to our hospital due to disturbance of consciousness and oliguria. Emergency laboratory examination revealed metabolic acidosis, hypoglycemia, hyponatremia, mild liver dysfunction, acute renal failure and rhabdomyolysis. ⋯ Since severe hypophosphatemia persisted, we administered adequate phosphates, and then his level of consciousness normalized. We discuss the relationships among alcohol abuse, hypophosphatemia and disturbance of consciousness, and recommend that hypophosphatemia be considered a potential cause of disturbance of consciousness in alcoholic patients.
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Case Reports Comparative Study
Pulmonary manifestations in cerebrotendinous xanthomatosis.
We investigated five cases with cerebrotendinous xanthomatosis (CTX) with particular reference to biochemical and pathological pulmonary disorders. To date, few reports discuss the pathophysiology of pulmonary disorders of CTX patients. This study is the first investigation of such pulmonary disorders. ⋯ Biochemically, cholestanol was found to be increased in the BAL fluid as well as in serum. Pathological findings of transbronchial lung biopsy (TBLB) samples disclosed foamy macrophages and small granulomas in alveolar septa. In conclusion, the lung was apparently involved in CTX, and the lesions were characterized with the accumulation of foamy and giant cells with a high concentration of cholestanol, which likely results in the formation of foreign body granulomas.
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We present a case of bilateral cheiro-oral syndrome with paresthesia in the right toes following pontine infarction. The causative lesions were situated in the bilateral paramedian pontine tegmentum (PPM). ⋯ The responsible lesion of complete bilateral cheiro-oral syndrome showing paresthesia in the hand and mouth region on both sides is in the bilateral PPM, while that of incomplete bilateral cheiro-oral syndrome showing paresthesia around both sides of the mouth and in the unilateral hand is in the PPM contralateral to the hand with paresthesia. Bilateral cheiro-oral sensory impairment can occur only in the brainstem.
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Editorial Comment Case Reports
Hypophosphatemia and encephalopathy in alcoholics.