ABSTRACT
Polymyositis is characterized by symmetrical proximal muscle weakness, nonsuppurative inflammation of skeletal muscle, elevation of muscle enzyme levels, and abnormality of electromyographical change. Its pathogenesis is unclear. Paraneoplastic syndromes are caused by malignant tumors, although not through direct effects of the primary tumor or its metastases. Several paraneoplastic syndromes, including erythrocytosis, hypoglycemia, and hypercholesterolemia, have been reported in patients with hepatocellular carcinoma. A few cases of polymyositis associated with hepatocellular carcinoma and one case of combined hepatocellular-cholangiocarcinoma associated with polymyositis and chronic hepatitis B virus infection have been reported. Skeletal muscle injuries without trauma, including metabolic myopathy, effects of certain drugs and toxins, infection, electrolyte imbalances, and endocrine disorders, may cause rhabdomyolysis. We present here a case of primary liver cancer associated with polymyositis and rhabdomyolysis.
Subject(s)
Humans , Carcinoma, Hepatocellular , Hepatitis B, Chronic , Hypercholesterolemia , Hypoglycemia , Inflammation , Liver , Liver Neoplasms , Muscle Weakness , Muscle, Skeletal , Muscles , Muscular Diseases , Neoplasm Metastasis , Paraneoplastic Syndromes , Polycythemia , Polymyositis , Rhabdomyolysis , VirusesABSTRACT
Polymyositis is characterized by symmetrical proximal muscle weakness, nonsuppurative inflammation of skeletal muscle, elevation of muscle enzyme levels, and abnormality of electromyographical change. Its pathogenesis is unclear. Paraneoplastic syndromes are caused by malignant tumors, although not through direct effects of the primary tumor or its metastases. Several paraneoplastic syndromes, including erythrocytosis, hypoglycemia, and hypercholesterolemia, have been reported in patients with hepatocellular carcinoma. A few cases of polymyositis associated with hepatocellular carcinoma and one case of combined hepatocellular-cholangiocarcinoma associated with polymyositis and chronic hepatitis B virus infection have been reported. Skeletal muscle injuries without trauma, including metabolic myopathy, effects of certain drugs and toxins, infection, electrolyte imbalances, and endocrine disorders, may cause rhabdomyolysis. We present here a case of primary liver cancer associated with polymyositis and rhabdomyolysis.
Subject(s)
Humans , Carcinoma, Hepatocellular , Hepatitis B, Chronic , Hypercholesterolemia , Hypoglycemia , Inflammation , Liver , Liver Neoplasms , Muscle Weakness , Muscle, Skeletal , Muscles , Muscular Diseases , Neoplasm Metastasis , Paraneoplastic Syndromes , Polycythemia , Polymyositis , Rhabdomyolysis , VirusesABSTRACT
Osler-Weber-Rendu disease is characterized by epistaxis, cutaneous telangiectasia, and visceral arteriovenous malformations (AVMs). A 65-year-old male with recurrent epistaxis, old infarction and recent multiple rib fractures caused by a bicycle accident had middle cerebral thromboembolic infarctions when he stopped taking clopidogrel due to massive epistaxis and hemopneumothorax. On examinations, there was no focal cerebral stenosis, but there were telangiectasia, pulmonary and hepatic AVMs. A suspicious Osler-Weber-Rendu disease patient should be evaluated by proper screening and regular follow-up to minimize serious sequelae such as thromboembolic stroke.
Subject(s)
Aged , Humans , Male , Arteriovenous Malformations , Cerebral Infarction , Constriction, Pathologic , Epistaxis , Follow-Up Studies , Hemopneumothorax , Infarction , Infarction, Middle Cerebral Artery , Mass Screening , Middle Cerebral Artery , Rib Fractures , Stroke , TelangiectasisABSTRACT
Only a few case studies describe reversible parkinsonism after organophosphate poisoning and their brain imagings are found to be normal. However, we experienced chronic, irreversible parkinsonism by acute organophosphate poisoning with bilateral basal ganglia lesions found on a brain MRI. We suggest that brief, large amounts of organophosphate intoxication can produce irreversible parkinsonism according to individual susceptibility and further studies including the investigation of insecticides as an environmental factor of parkinsonism should be done using neuroimagings.