ABSTRACT
The present article demonstrates an unusual case of bilateral lower extremity edema caused by neurogenic areflexic bladder as the first physical symptom of diabetes. A 52-year-old man presented to the emergency department because of massive edema of his lower limbs. The edema had been present for 2 weeks, was symmetrical, and was progressively covering the lower limbs up to the inguinal area, scrotal bag, and penis and was accompanied by dysuria and an interrupted urine stream. Laboratory findings revealed a serum glucose level of 657 mg/dL and glycated hemoglobin (HbA1c) level of 15.6%. Computed tomography (CT) of the abdomen and pelvis revealed marked enlargement of the bladder with bilateral hydronephrosis and hydroureter. In addition, CT demonstrated bilateral compression of the iliac veins caused by the enlarged bladder. This case highlights the importance of a broad differential diagnosis for patients with diabetes and extensive peripheral edema. Neurogenic bladder should be considered in the differential diagnosis, even in newly diagnosed diabetic patients.
Subject(s)
Humans , Male , Middle Aged , Abdomen , Blood Glucose , Diabetes Complications , Diabetes Mellitus, Type 2 , Diagnosis, Differential , Dysuria , Edema , Emergency Service, Hospital , Glycated Hemoglobin , Hydronephrosis , Iliac Vein , Lower Extremity , Pelvis , Penis , Rivers , Urinary Bladder , Urinary Bladder, NeurogenicABSTRACT
No abstract available.
Subject(s)
Humans , Hyperparathyroidism, Primary , Parathyroid Neoplasms , Schizophrenia , Thyroid Gland , Thyroid NeoplasmsABSTRACT
Postpartum thyroid dysfunction occurs in 5-10% of women within one year after delivery. Women with hypothyroidism antedating pregnancy are at high risk for postpartum thyroiditis and should be closely monitored during the first year post-partum. Here, we report a case of recurrent hyperthyroidism between two episodes of postpartum thyroiditis in a woman diagnosed with subclinical hypothyroidism prior to pregnancy. It is of particular interest that spontaneously remitting hyperthyroidism as a sequela of postpartum thyroiditis can occur.
Subject(s)
Female , Humans , Pregnancy , Hyperthyroidism , Hypothyroidism , Postpartum Period , Postpartum Thyroiditis , Thyroid Gland , ThyroiditisABSTRACT
Diabetes mellitus is a common disorder and presents in different ways. Shoulder pain is a common musculoskeletal complaint, especially in middle-aged or older-aged men. While it is widely accepted that diabetics have an increased propensity to develop infections, a diagnosis of osteomyelitis of the humerus as the etiology of constant shoulder pain might be delayed, as occurred in this case study, until patients' develop clear signs of infection. Here, we describe a case of subacute osteomyelitis as the first physical symptom of diabetes; the possibility of osteomyelitis should therefore be investigated in all patients with diabetes mellitus who develop joint or bone-related pain.
Subject(s)
Humans , Male , Diabetes Mellitus , Diagnosis , Humerus , Joints , Osteomyelitis , Shoulder PainABSTRACT
Medullary thyroid carcinomas (MTC) are rare tumors that account for approximately 5-10% of all thyroid malignancy in the West. The reported incidence of MTC is less than 5% in Korea. Its prognosis is relatively good with a 15-year survival rate of 64-84%. The incidence of thyroid cancer has been increasing rapidly worldwide and the overall survival of patients with thyroid cancer is excellent. The occurrence of second primary malignancy (SPM) among survivors of thyroid cancer is a concern, together with life expectancy. Recent studies reported a 6-45% increase in the risk of developing SPM after the diagnosis thyroid cancer. We reported a patient with prostate and colon cancer that were diagnosed 10 years after the diagnosis of medullary thyroid carcinoma.
Subject(s)
Aged , Humans , Colonic Neoplasms , Diagnosis , Incidence , Korea , Life Expectancy , Prognosis , Prostate , Prostatic Neoplasms , Survival Rate , Survivors , Thyroid Gland , Thyroid NeoplasmsABSTRACT
Bromate is an oxidizing agent used as a permanent wave neutralizer. Accidental or deliberate ingestion of bromate has rarely been reported, but is potentially severe. We report a 36-year-old female hairdresser, who was admitted due to nausea and vomiting after ingestion of sodium bromate. The patient was successfully treated with hemodialysis therapy and renal function recovered without any complication. The clinicians must remember that early therapeutic measures, including hemodialysis, should be taken as soon as possible to prevent irreversible hearing loss and renal failure.
Subject(s)
Adult , Female , Humans , Acute Kidney Injury , Bromates , Eating , Hearing Loss , Nausea , Renal Dialysis , Renal Insufficiency , Sodium , Sodium Compounds , VomitingABSTRACT
Thin basement membrane nephropathy (TBMN) is characterized by persistent hematuria, mild proteinuria, normal renal function and family history of hematuria. Many studies report that TBMN commonly occurs together with other glomerular diseases such as minimal change nephrotic syndrome, membranous nephropathy, IgA nephropathy and focal segmental glomerulosclerosis. Especially, the case of TBMN with minimal change nephrotic syndrome has been rare. We report a case of adult minimal change nephrotic syndrome with TBMN in a 44-year-old female with general edema and microscopic hematuria. On renal biopsy, electron microscopic examination demonstrated diffuse thinning of glomerular basement membrane with the thickness less than 250nm and diffuse foot process effacement. Treatment with corticosteroid resulted in complete remission of proteinuria.
Subject(s)
Adult , Female , Humans , Basement Membrane , Biopsy , Edema , Electrons , Foot , Glomerular Basement Membrane , Glomerulonephritis, IGA , Glomerulonephritis, Membranous , Glomerulosclerosis, Focal Segmental , Hematuria , Nephrosis, Lipoid , ProteinuriaABSTRACT
Renal involvement in systemic lupus erythematosus (SLE) is a typical manifestation of the disease. The occurrence of non-lupus nephritis, especially IgA nephropathy (IgAN), in patients with SLE has rarely been reported. We describe the case of a 21-year-old woman who was diagnosed with IgAN and subacute necrotizing lymphadenitis, and her renal lesion biopsy was typical of lupus nephritis (ISN/RPS Class III). Although IgAN and lupus nephritis share some common physiopathological characteristics, their laboratory, histopathologic findings, and the extra-renal clinical manifestations are different and support a different pathogenesis. Our case highlights the importance of a renal biopsy in patients with lupus and urinary alterations despite underlying IgAN. A correct diagnosis would permit the most appropriate immunosuppressive treatments to be considered.