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Chen HF, Zhang ZJ, You CJ, Chen L. [A case of bromadiolone poisoning leading to digestive tract, abdominal hemorrhage and secondary paralytic ileus]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2022; 40:707-709. [PMID: 36229221 DOI: 10.3760/cma.j.cn121094-20210617-00295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Bromadiolone, commonly known as super warfarin, is a long-acting coumarin dicoumarin rodenticide. The mechanism of bromadiolone is mainly to inhibit vitamin K1 epoxide reductase and affect the synthesis of coagulation factors Ⅱ, Ⅶ, Ⅸ and Ⅹ, which causes blood coagulation dysfunction and systemic multiple organ hemorrhage. Here, we report of a case of bromadiolone poisoning patient who had digestive tract, abdominal hemorrhage, as well as secondary paralytic ileus. After blood product transfusion and vitamin K1 supplementation, the patient was discharged after the physical condition was improved. It's suggestied that clinicians should pay attention to rare complications to prevent missed diagnosis when treating other bromadiolone poisoning.
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Affiliation(s)
- H F Chen
- Emergency Department of Banan District People's Hospital of Chongqing, Chongqing 401320, China
| | - Z J Zhang
- Emergency Department of Banan District People's Hospital of Chongqing, Chongqing 401320, China Critical Care Medicine of Banan District People's Hospital of Chongqing, Chongqing 401320, China
| | - C J You
- Emergency Department of Banan District People's Hospital of Chongqing, Chongqing 401320, China
| | - L Chen
- Emergency Department of Banan District People's Hospital of Chongqing, Chongqing 401320, China
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You CJ, Zhang ZJ, Chen L. [A case of acute carbon monoxide poisoning with secondary intestinal obstruction and thrombosis]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2022; 40:380-382. [PMID: 35680585 DOI: 10.3760/cma.j.cn121094-20210420-00221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Acute carbon monoxide poisoning can cause multiple organ damage due to hypoxia. In severe cases, it can be life-threatening and has a high fatality rate. Intestinal obstruction and thrombosis are rare complications of carbon monoxide poisoning. A case of carbon monoxide poisoning was reported. In addition to the central nervous system lesion, intestinal obstruction and lower limb thrombosis were also found. In the treatment of carbon monoxide poisoning patients, the clinician was able to treat the common complications, attention should be paid to gastrointestinal tract, thrombotic disease and other rare complications, so as to avoid missed diagnosis.
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Affiliation(s)
- C J You
- Emergency Department of Banan District People's Hospital of Chongqing, Chongqing 401320, China
| | - Z J Zhang
- Emergency Department of Banan District People's Hospital of Chongqing, Chongqing 401320, China Critical Care Medicine, Chongqing Banan District People's Hospital, Chongqing 401320, China
| | - L Chen
- Emergency Department of Banan District People's Hospital of Chongqing, Chongqing 401320, China
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Abstract
BACKGROUND Nonketotic hyperglycemia (NKH) is characterized by hyperglycemia with little or no ketoacidosis. Diverse neurological symptoms have been described in NKH patients, including choreoathetosis, hemiballismus, seizures, and coma in severe cases. Homonymous hemianopia, with or without occipital seizures, caused by hyperglycemia is less readily recognized.
CASE SUMMARY We describe a 54-year-old man with NKH, who reported seeing round, colored flickering lights with right homonymous hemianopia. Cranial magnetic resonance imaging demonstrated abnormalities in the left occipital lobe, with decreased T2 signal of the white matter, restricted diffusion, and corresponding low signal intensity in the apparent diffusion coefficient map. He responded to rehydration and a low-dose insulin regimen, with improvements of his visual field defect.
CONCLUSION Patients with NKH may present focal neurologic signs. Hyperglycemia should be taken into consideration when making an etiologic diagnosis of homonymous hemianopia.
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Affiliation(s)
- Xiao-Hui Xiang
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
| | - Jia-Jia Fang
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
| | - Mi Yang
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
| | - Guo-Hua Zhao
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
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Shen H, Zhao Y, Shi Y, Sun J, Zhou D, Li L, Ye X, Xie W. The diagnostic and prognostic value of MRI in central nervous system involvement of acute myeloid leukemia: a retrospective cohort of 84 patients. ACTA ACUST UNITED AC 2020; 25:258-263. [PMID: 32567523 DOI: 10.1080/16078454.2020.1781500] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ABSTRACT Objective: To assess the diagnostic and prognostic value of magnetic resonance imaging (MRI) in Acute Myeloid Leukemia (AML) complicated with central nervous system leukemia (CNSL). Methods: A total of 84 patients with AML and confirmed of CNSL from January 2010 to September 2019 were selected and underwent MRI scan. We retrospectively analyzed their MRI findings, summarized the imaging features of AML central infiltration, and assessed the guiding significance of MRI on diagnosis and prognosis of this disease. Results: A total of 52 patients (61.90%, 52/84) had abnormal MRI findings, of which 31 cases clearly indicated intracranial infiltration of leukemia. Among the 31 patients, the most common site of infiltration is parenchyma (19/31). Most MRI of these patients showed multiple lesions with low T1 signal and high T2 signal, which were more obvious on enhanced scan. Sensitivity of MRI in diagnosing AML central infiltration was 36.90%. Despite of its low sensitivity, it still had superior diagnostic value on some patients with false-negative CSF. The median disease-free survival (DFS) and overall survival (OS) time of patients with MRI clearly indicated central invasion were 4 and 9 months, respectively. But there was no significant difference in survival analysis compared with MRI negative patients (including abnormal but non-invasive). Conclusion: MRI manifestation of central infiltration in AML patients has certain characteristic findings, which is helpful to improve the diagnostic efficiency. Prognosis of MRI positive patients is relatively worse than that of MRI negative patients however there is no siginificant difference.
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Affiliation(s)
- Huafei Shen
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, People's Republic of China
| | - Yanchun Zhao
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, People's Republic of China
| | - Yuanfei Shi
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, People's Republic of China
| | - Jianai Sun
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, People's Republic of China
| | - De Zhou
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, People's Republic of China
| | - Li Li
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, People's Republic of China
| | - Xiujin Ye
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, People's Republic of China
| | - Wanzhuo Xie
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, People's Republic of China
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Li XY, Shi ZH, Guan YL, Ji Y. Anti-N-methyl-D-aspartate-receptor antibody encephalitis combined with syphilis: A case report. World J Clin Cases 2020; 8:2603-2609. [PMID: 32607338 PMCID: PMC7322422 DOI: 10.12998/wjcc.v8.i12.2603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis is a common type of autoimmune encephalitis characterized by complex clinical signs and variable imaging manifestations. The pathogenesis of the disease is unclear. Syphilis is an infectious disease caused by Treponema pallidum that can invade the nervous and immune systems and cause systemic symptoms. There are few reports of anti-NMDAR encephalitis with syphilis, and the association between them is unknown; both diseases are related to immune system damage. We report a case of anti-NMDAR encephalitis with syphilis.
CASE SUMMARY A 32-year-old man was admitted to our hospital with complaints of cognitive decline, diplopia, and walking instability during the previous 6 mo. He developed dysarthria, difficulty swallowing, and involuntary shaking of his head, neck, and limbs during the month prior to presentation. Cranial magnetic resonance imaging showed symmetrical abnormal signals in the pons, midbrain, and bilateral basal ganglia, and inflammatory demyelination was considered. The diagnosis of syphilis was confirmed based on the syphilis diagnosis test and the syphilis rapid test. He was given anti-syphilis treatment, but the above symptoms gradually worsened. Anti-NMDAR antibody was positive in cerebrospinal fluid but was negative in serum. Due to the cerebrospinal fluid findings, anti-NMDAR encephalitis was a consideration. According to the patient’s weight, he was treated with intravenous methylprednisolone 1 g QD for 5 d, with the dose gradually decreased for 6 mo, and immunoglobulin 25 g QD for 5 d; his symptoms improved after treatment.
CONCLUSION This case shows that anti-NMDAR encephalitis may be combined with syphilis, which should be recognized to avoid misdiagnosis and treatment delay.
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Affiliation(s)
- Xi-Yu Li
- Graduate School, Tianjin Medical College, Tianjin 300070, China
| | - Zhi-Hong Shi
- Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin 300350, China
| | - Ya-Lin Guan
- Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin 300350, China
| | - Yong Ji
- Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin 300350, China
- China National Clinical Research Center for Neurological Diseases, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
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Ouyang A, Su X, Li S, Li K, Wang J. Imaging manifestations of intravascular leiomyoma involving the right atrium: a case report and literature review. Int J Clin Exp Med 2015; 8:11602-11606. [PMID: 26379990 PMCID: PMC4565373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 06/24/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study is to investigate the imaging features of intravascular leiomyoma (IVL) involving the heart and the imaging techniques in the diagnosis of this disease. The imaging features of contrast-enhanced computed tomography (CT), the clinical data and the pathological data of a case of IVL involving the right atrium were retrospectively analyzed and the literatures were reviewed. A 42-year-old woman was admitted to Jinan Central Hospital with a 7-day history of lower extremity weakness, chest tightness and short breath. Contrast-enhanced CT scanning revealed that there was a mass in the inferior vena cava and right atrium, which was heterogeneously enhanced. There was a gap between the vessel wall and the mass. Spiral CT scanning with multiplanner reformation (MPR) reconstruction revealed the morphology, scope and extension pathways of the tumor clearly. Ultrasonography (US) and magnetic resonance imaging (MRI) also played important roles in the diagnosis and differential diagnosis of IVL. To the patients with a history of uterine fibroids, spiral CT scanning, US and MRI could be used to improve the correct diagnosis rates of IVL before surgery.
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Affiliation(s)
- Aimei Ouyang
- Medical Imaging Center, Jinan Central Hospital Affiliated to Shandong University Jinan 250013, Shandong Provine, P.R. China
| | - Xinyou Su
- Medical Imaging Center, Jinan Central Hospital Affiliated to Shandong University Jinan 250013, Shandong Provine, P.R. China
| | - Shujing Li
- Medical Imaging Center, Jinan Central Hospital Affiliated to Shandong University Jinan 250013, Shandong Provine, P.R. China
| | - Kun Li
- Medical Imaging Center, Jinan Central Hospital Affiliated to Shandong University Jinan 250013, Shandong Provine, P.R. China
| | - Jian Wang
- Medical Imaging Center, Jinan Central Hospital Affiliated to Shandong University Jinan 250013, Shandong Provine, P.R. China
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Li YJ, Liu WY, Liu L, Zhou G, Fang MY. Diagnosis and treatment of hepatic angioleiomyolipoma: A case report and literature review. Shijie Huaren Xiaohua Zazhi 2014; 22:2946-2951. [DOI: 10.11569/wcjd.v22.i20.2946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the clinical features, imaging manifestations, pathological characteristics, differential diagnosis, treatment and prognosis of hepatic angiomyolipoma (HAML).
METHODS: A case of HAML diagnosed at our hospital is reported. A review of the literature was performed to retrospectively analyze 540 cases reported in China between 1987 and 2014.
RESULTS: HAML was more frequently found in females (2.7:1). Most of the patients (66.7%) presented no significant symptoms, and tumor marks were negative in all the patients. CT performed better for preoperative diagnosis than MRI (CT vs MRI: χ2 = 11.321, P = 0.001) and ultrasound. Immunohistochemical analyses revealed that the positive expression rates of human melanoma black-45 antigen (HMB-45), smooth muscle actin (SMA), Vimentin, CD34 and CD117 in HAML were 97.8% (357/365), 93.7% (207/221), 62.5% (30/48), 40.5% (51/126) and 39.0% (48/123), respectively. The expression of HMB-45 was considered to have great significance in confirming the diagnosis. Of all the patients, 521 (96.3%) underwent surgical intervention, and recurrence or metastasis was found in only 3 patients during follow-up.
CONCLUSION: HAML lacks specific symptoms or signs, has diverse imaging manifestations, and can be easily misdiagnosed. Pathological and immunohistochemical analyses are essential for diagnosis, and surgical treatment has a good prognosis.
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