ABSTRACT
Gitelman syndrome is a condition caused by a mutation of the thiazide sensitive Na-Cl cotransporter gene on the distal convoluted tubule. It results in a variety of clinical features, including hypokalemia, hypomagnesemia, hypocalciuria, and metabolic alkalosis. It is often diagnosed in asymptomatic adults presented with unexplained hypokalemia; however, it is sometimes associated with muscular cramps, numbness, fatigue, weakness, or paralysis. We experienced a case of rheumatoid arthritis accompanied by Gitelman syndrome, presented with hand tremor. We diagnosed her using renal clearance study and genetic analysis. Here, we report our experiences regarding this case along with a literature review.
Subject(s)
Adult , Humans , Alkalosis , Arthritis, Rheumatoid , Fatigue , Furosemide , Genetic Testing , Gitelman Syndrome , Hand , Hypesthesia , Hypokalemia , Muscle Cramp , Paralysis , Solute Carrier Family 12, Member 3 , Thiazides , TremorABSTRACT
Cytomegalovirus (CMV) colitis, which is rare in an immunocompetent patient, was encountered in a 67-year-old man who was admitted due to persistent diarrhea. The first diagnostic tool was colonoscopy, which showed multiple ulcers from cecum to rectum. The secondary tool was CMV polymerase chain reaction, and CMV colitis was diagnosed. Intravenous ganciclovir therapy was administered, which resulted in improvement of diarrhea and ulcers throughout the colon were healed. Asymptomatic colon perforation was detected during diagnostic testing, which improved over the conventional treatment. CMV colitis is rare in immunocompetent patients, but it is essential for the differential diagnosis.
Subject(s)
Aged , Humans , Cecum , Colitis , Colon , Colonoscopy , Cytomegalovirus , Diagnosis, Differential , Diagnostic Tests, Routine , Diarrhea , Ganciclovir , Immunocompetence , Polymerase Chain Reaction , Rectum , UlcerABSTRACT
Gitelman syndrome is a condition caused by a mutation of the thiazide sensitive Na-Cl cotransporter gene on the distal convoluted tubule. It results in a variety of clinical features, including hypokalemia, hypomagnesemia, hypocalciuria, and metabolic alkalosis. It is often diagnosed in asymptomatic adults presented with unexplained hypokalemia; however, it is sometimes associated with muscular cramps, numbness, fatigue, weakness, or paralysis. We experienced a case of rheumatoid arthritis accompanied by Gitelman syndrome, presented with hand tremor. We diagnosed her using renal clearance study and genetic analysis. Here, we report our experiences regarding this case along with a literature review.
Subject(s)
Adult , Humans , Alkalosis , Arthritis, Rheumatoid , Fatigue , Furosemide , Genetic Testing , Gitelman Syndrome , Hand , Hypesthesia , Hypokalemia , Muscle Cramp , Paralysis , Solute Carrier Family 12, Member 3 , Thiazides , TremorABSTRACT
Cytomegalovirus (CMV) colitis, which is rare in an immunocompetent patient, was encountered in a 67-year-old man who was admitted due to persistent diarrhea. The first diagnostic tool was colonoscopy, which showed multiple ulcers from cecum to rectum. The secondary tool was CMV polymerase chain reaction, and CMV colitis was diagnosed. Intravenous ganciclovir therapy was administered, which resulted in improvement of diarrhea and ulcers throughout the colon were healed. Asymptomatic colon perforation was detected during diagnostic testing, which improved over the conventional treatment. CMV colitis is rare in immunocompetent patients, but it is essential for the differential diagnosis.
Subject(s)
Aged , Humans , Cecum , Colitis , Colon , Colonoscopy , Cytomegalovirus , Diagnosis, Differential , Diagnostic Tests, Routine , Diarrhea , Ganciclovir , Immunocompetence , Polymerase Chain Reaction , Rectum , UlcerABSTRACT
OBJECTIVE: Although previous trials suggested a relationship between neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic inflammatory response, clinical utility of NLR and PLR in rheumatoid arthritis (RA) is not well defined. This study was conducted to assess the efficiency of NLR and PLR as an inflammatory index in patients with RA. METHODS: A total of 107 patients with newly diagnosed RA who had never used steroid and a control group of 50 age- and gender-matched healthy subjects whose high sensitive C-reactive protein (hsCRP) was within normal range were included. Those with cerebrovascular diseases, diabetes, malignancies, or any cardiovascular diseases were excluded from both groups. The patients were divided into two groups according to the Disease Activity Score of 28 joints (DAS28). Group 1 included patients with a DAS28 score of 3.2 and lower (low disease activity) and group 2 included patients with a score higher than 3.2 (moderate to high disease activity). RESULTS: NLR and PLR in the patient group were 2.99±2.04, 170.90±86.49, significantly higher than that of the control group. NLR and PLR in group 2 were 4.16±2.50, 225.23±93.21, significantly higher than those of group 1 patients (2.26±1.22, 137.15±61.92). NLR and PLR both showed correlation with rheumatoid factor, hsCRP, serum albumin, Korean Heath Assesment Questionnaire, and DAS28. CONCLUSION: These data showed a positive correlation between NLR or PLR level and RA disease activity, suggesting that NLR or PLR can be used as an additional inflammatory marker in patients with RA.
Subject(s)
Humans , Arthritis, Rheumatoid , C-Reactive Protein , Cardiovascular Diseases , Equidae , Joints , Reference Values , Rheumatoid Factor , Serum AlbuminABSTRACT
Amyloidosis is characterized by the extracellular deposition of amyloid in various tissues and organs, particularly the kidney and heart. The estimated incidence of systemic amyloidosis is at least 8 per million population per year. However, few cases of systemic amyloidosis in renal allografts have been reported. A stable renal transplant recipient was admitted with proteinuria and dyspnea on exertion. The M-peak was found on serum and urine protein electrophoresis, and lambda (λ) dominance was confirmed by serum and urine free-light-chain test. The patient was diagnosed with systemic amyloidosis of a renal allograft, by allograft biopsy, at 22 years after renal transplantation. We report a case of AL amyloidosis in a stable renal allograft and review the medical literature.
Subject(s)
Humans , Allografts , Amyloid , Amyloidosis , Biopsy , Dyspnea , Electrophoresis , Heart , Immunoglobulin Light Chains , Incidence , Kidney , Kidney Transplantation , Proteinuria , Transplant RecipientsABSTRACT
Focal dystonia is a neurological condition affecting a muscle or group of muscles in a specific part of the body, leading to involuntary muscular contractions. This condition is often treated with medications including muscle relaxants and injections of botulinum toxin. However, some cases do not respond to normal modes of treatment. Deep brain stimulation (DBS) can be a therapeutic option for patients who are resistant to medical treatment. We report a case of fibromyalgia accompanied by focal hand dystonia, where unilateral DBS improved the patient's focal dystonic movement. We also present a review of the relevant literature.