Internal medicine
-
A formerly healthy 32-year-old woman was hospitalized for a closer examination of undiagnosed fever with mild headache. Despite lack of distinct findings on physical and laboratory examinations at admission, she suddenly developed anuresis due to acontractile neurogenic bladder. ⋯ While aseptic meningitis subsided within 3 weeks, about 10 weeks, including a 26-day period of anuria, was necessary for complete restoration of normal voiding function, necessitating intermittent self-catheterization. Acute urinary retention should be considered an uncommon but critical manifestation of aseptic meningitis.
-
There is clinical and pathological evidence of thrombosis in pulmonary vessels of patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to investigate the presence of hypercoagulability and determine the extent of this abnormality in COPD patients. ⋯ Our results showed an enhanced prothrombotic process in COPD patients, which could potentially account for the increased thrombosis in pulmonary vessels in these patients.
-
Case Reports
Treatment of bronchorrhea by corticosteroids in a case of bronchioloalveolar carcinoma producing CA19-9.
A case of gastrointestinal cancer-associated antigen (CA19-9)-positive bronchioloalveolar carcinoma accompanied by bronchorrhea and respiratory failure successfully treated with corticosteroids is reported. The patient was treated with pulse methylprednisolone at a dose of 1,000 mg/day for three days, followed by oral prednisolone (60 mg/day). ⋯ The levels of CA19-9 in the serum and the sputum were extremely high and an immunocytochemical study showed that the tumor cells were stained by CA19-9 antibody. This case demonstrates the therapeutic value of corticosteroids in the treatment of bronchorrhea in subjects with bronchioloalveolar carcinoma.
-
Review Case Reports
Two cases of Sjögren's syndrome with multiple bullae.
Here, we report two rare female cases of Sjögren's syndrome with multiple bullae, involving a 66- and a 51-year-old. Neither had any obvious pulmonary complaint. Chest radiographs and high-resolution CT (HRCT) scans showed interstitial linear and nodular opacities and multiple bullae. ⋯ In the first case the bullae decreased in size with corticosteroid treatment. Airway narrowing due to peribronchiolar mononuclear cell infiltration causes a check-valve mechanism, which may lead to bullae formation. Although a rare occurrence, it is important to recognize that cystic or bullous lung disease can accompany Sjögren's syndrome.
-
Case Reports
Systemic lupus erythematosus complicated by cytomegalovirus-induced hemophagocytic syndrome and colitis.
Here, we report a case of systemic lupus erythematosus (SLE) complicated by cytomegalovirus (CMV)-induced hemophagocytic syndrome (HPS) and colitis. A 44-year-old woman with SLE was treated with corticosteroid and cyclophosphamide for lupus nephritis. Although her lupus nephritis improved, fever, progressive pancytopenia and intestinal bleeding were observed. ⋯ Furthermore, a large number of CMV antigen-positive leukocytes was detected, suggesting an active CMV infection. CMV infection is serious in compromised hosts. Therefore clinicians should be aware of the clinical settings in which this infection can arise and the target organs potentially affected in order to initiate the appropriate intervention.