Internal medicine
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Case Reports
The Early Onset of Levodopa-induced Dyskinesia in a Patient with Multiple System Atrophy.
Multiple system atrophy (MSA) is a neurodegenerative disorder characterized by Parkinsonism, cerebellar ataxia, and autonomic dysfunction. While less frequent than Parkinson's disease, MSA patients with a beneficial levodopa response may occasionally present with levodopa-induced dyskinesia (LID). We herein report a 50-year-old woman diagnosed with MSA-parkinsonism who developed LID in the unilateral lower extremity 10 months after the start of levodopa treatment. In this case, the distribution of LID, the timing of its onset, and the presence of LID despite relatively poor levodopa responsiveness were distinctive.
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The misdiagnosis of intestinal tuberculosis (ITB), such as Crohn's disease (CD), and subsequent treatment with immunosuppressive therapies can lead to severe outcomes. However, the differential diagnosis between these two conditions can be challenging. ⋯ In the international medical community, we encounter patients from countries, such as Myanmar, where tuberculosis is endemic. Therefore, it is necessary to understand the epidemiological background of each country to accurately distinguish between CD and ITB.