ABSTRACT
A plethora of paraneoplastic syndromes have been reported as remote effects of colorectal carcinoma (CRC). However, there is a dearth of data pertaining to the association of this cancer with demyelinating neuropathies. Herein, we describe the case of a young woman diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP). Treatment with intravenous immunoglobulins and prednisone did not improve her condition, and her neurological symptoms worsened. Subsequently, she was readmitted with exertional dyspnea, lightheadedness, malaise, and black stools. Colonoscopy revealed a necrotic mass in the ascending colon, which directly invaded the second part of the duodenum. Pathologic results confirmed the diagnosis of locally advanced CRC. Upon surgical resection of the cancer, her CIDP showed dramatic resolution without any additional therapy. Patients with CRC may develop CIDP as a type of paraneoplastic syndrome. Clinicians should remain cognizant of this potential association, as it is of paramount importance for the necessary holistic clinical management.
ABSTRACT
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, primarily arising from the stomach. With the widespread utilization of and technical advancements in endoscopy, gastric GISTs are being increasingly detected at an early stage, enabling complete endoscopic resection. Endoscopic full-thickness resection (EFTR) is an advanced technique that has been recognized as a treatment tool for neoplasms in the digestive tract in selected patients. Although a number of methods are available, closing large iatrogenic defects after EFTR can be a concern in clinical practice. If this potential problem is appropriately solved, patients with gastric GISTs would be suitable candidates for resection utilizing this technique. To our knowledge, this is the first study to propose omental patching and purse-string endosuture closure following EFTR as a feasible endoscopic option in patients with gastric GISTs.
Subject(s)
Humans , Endoscopy , Gastrointestinal Stromal Tumors , Gastrointestinal Tract , Omentum , StomachABSTRACT
Van der Knaap disease or megalencephalic leukoencephalopathy with subcortical cysts [MLC] is a rare, inherited, autosomal recessive disorder. It is characterised by macrocephaly and slowly progressive ataxia, spasticity, and cognitive decline. The usual age of onset is described from birth to infancy. MLC predominantly occurs in some ethnicities where consanguinity is common. This disease is caused by mutations in the gene, which encodes a novel protein, MLC1. The characteristic MRI findings include leukodystrophy and subcortical cysts that yield diagnostic clue in most of the cases. The diagnosis can be established prenatally and genetic counseling is usually offered for future pregnancies. Herein, we chronicle a case of Van der Knaap disease from Pakistan with the classical MRI features
ABSTRACT
Diabetic amyotrophy is a disabling syndrome that frequently has a difficult or delayed clinical recognition. It is characterised by lancinating pain followed by muscle weakness, usually in the hip and thigh. The disease predominantly occurs in elderly patients and causes significant morbidity. Although a detailed history and neurologic examinations are helpful, electrodiagnostic testing yields accurate diagnosis in most of the cases. Herein, we chronicle the case of a young patient who developed profound diabetic amyotrophy within five years after the onset of type 1 diabetes mellitus. Furthermore, this report highlights the preventive as well as therapeutic role of strict glycemic control, warranting population-based monitoring and education of patients for diabetic amyotrophy, especially in Pakistan
ABSTRACT
Dengue virus infection affects the heart structurally and functionally. Clinical manifestations of cardiac complications secondary to dengue virus infection vary from self-limiting arrhythmias to severe myocardial infarction, leading to hypotension, pulmonary edema, and cardiogenic shock. However, we report a case of dengue hemorrhagic fever (DHF) complicated by a complete heart block. A female with DHF due to dengue virus serotype 2, presented to the emergency department with fever, headache, rash, and fatigue followed by an episode of syncope. She was found to have a third-degree atrioventricular block, with pulseless polymorphic ventricular tachycardia. Patient was resuscitated and a temporary trans-venous pacemaker was placed. She reverted back to normal sinus rhythm after 4 days of syncope and was subsequently discharged from the hospital after complete resolution of symptoms, without the need for a permanent pacemaker. Physicians are warranted to have high index of suspicion for dengue virus infection as an etiology in patients with acute cardiovascular compromise, especially in tropical areas.