Internal medicine
-
Anti-GM1 antibodies are associated with Guillain-Barré syndrome (GBS), primarily peripheral neuropathy. However, there are cases of anti-GM1 IgG antibody-positive GBS with upper motor neuron (UMN) signs. We herein report a case of gastrointestinal infection followed by subacute gait disturbance with predominant signs of UMN on a neurological examination. ⋯ No MRI abnormalities were observed. The symptoms improved with treatment, which was accompanied by decreased antibody titers. This case highlights the fact that anti-GM1 IgG-associated disorders may present with predominant UMN involvement.
-
Erdheim-Chester disease (ECD) is a rare type of non-Langerhans cell histiocytosis, characterized by the infiltration of disease-specific foamy histiocytes, polymorphic granulomas, and fibrosis. Although cardiovascular involvement is observed radiologically in approximately half of ECD patients, only a few reports have described its pathological features. ⋯ Autopsy revealed the pathological association of coronary and renal arterial stenosis with the BRAFV600E gene mutation. BRAF mutations should be considered in patients with ECD, especially in those with arterial lesions.
-
Objective To determine the clinical background factors of patients with type 2 diabetes who showed deterioration of defecation status after hospitalization. Methods The defecation status of 128 patients with type 2 diabetes who were admitted to our department for diabetes education was evaluated for 7 days after hospitalization. New-onset constipation was diagnosed when patients without constipation before hospitalization met the criteria for constipation after hospitalization. ⋯ In the multivariate logistic regression analyses, albuminuria was the only factor that showed a significant association with the deterioration of defecation status after hospitalization. Conclusion Constipation is highly prevalent among hospitalized patients with type 2 diabetes. Paying attention to albuminuria is useful for facilitating an appropriate response to the deterioration of defecation status in patients with type 2 diabetes after hospitalization.
-
We herein report a 48-year-old man with neurosyphilis manifesting as limbic encephalitis, initially suspected to be autoimmune limbic encephalitis. The patient exhibited rapid behavioral changes, and magnetic resonance imaging showed high-intensity lesions in both medial temporal lobes. ⋯ This case highlights the diagnostic challenges in differentiating neurosyphilis from autoimmune limbic encephalitis, given the increasing atypical presentation. A markedly elevated immunoglobulin G index may serve as a valuable diagnostic indicator for neurosyphilis in such cases.
-
We herein report three patients with Fontan-associated liver disease (FALD) who developed hepatocellular carcinoma (HCC). All three patients had very high serum alpha-fetoprotein (AFP) concentrations, and their HCCs were located in the peripheral areas of the liver. ⋯ This review revealed that FALD-HCC is generally located in the peripheral areas of the liver and AFP concentrations are usually high. Thus, it is important that follow-up of patients with FALD include repeated AFP concentrations and abdominal imaging.