A Case of Oxalate Nephropathy Associated With Prolonged Cholecystostomy Tube Placement.

Oxalate nephropathy is a rare pathology that can be difficult to diagnose. It results from calcium oxalate crystals that are deposited in the renal interstitium or renal tubules. Once the deposition ensues, a multitude of complications can occur, including renal failure. One etiology for oxalate nephropathy is a lack of biliary acid. The diagnosis of oxalate nephropathy is typically based on visualization of oxalate crystals in the renal tubules on biopsy, and treatment based on the etiology can range from simple removal of the offending agent or a change in diet to liver/kidney transplant in the setting of primary hyperoxaluria. This report discusses a case of severe oxalate nephropathy related to long-term cholecystostomy tube placement resulting in a deficiency of biliary acid.

Global Transient Amnesia as the Predominant Symptom of Cardiac Myxoma: A Case Report.

BACKGROUND The most common neurological symptoms from cardiac myxoma-induced stroke include territories of middle cerebral arteries, rendering posterior stroke less common. Although transient global amnesia usually has a benign prognosis, amnesia in the setting of concerning cerebellar symptoms should raise the suspicion for posterior circulation involvement. These benign-appearing symptoms can be manifestations of an acute cerebrovascular accident (CVA). This unusual presentation can delay workup for underlying pathology. CASE REPORT A 67-year-old woman presented to the local emergency department after an episode of global amnesia that lasted about 15 minutes and was associated with some dizziness. The patient also reported a history of chronic disequilibrium. The head CT scan was negative for any acute findings. A follow-up MRI of the brain demonstrated acute small lacunar infarcts within the left cerebellum and right parietal lobe. An echocardiogram was performed due to concern for the cardioembolic source, which revealed left atrial myxoma. She was transferred to a tertiary center for immediate surgical intervention due to the high risk of embolization associated with the condition. The patient subsequently underwent successful surgical excision of the lesion. CONCLUSIONS Cardiac myxoma, although a rare cause of posterior stroke, needs prompt intervention as it is associated with a high risk of systemic embolization, including recurrent CVA. Transient global amnesia is an atypical presentation of cardiac myxoma that can easily be overlooked, delaying timely diagnosis and prompt intervention. Early recognition and surgical resection are crucial to prevent potentially life-threatening consequences.

A Case of Suspected Statin-Related Delayed Onset Necrotizing Myositis.

Statin-induced necrotizing myositis is a rare subtype of idiopathic inflammatory myopathies due to the production of an antibody to the 200/100 kDA protein complex which was subsequently found to be directed against 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR). Similar to other auto-immune necrotizing myopathies, the disease is characterized by proximal muscle weakness, significant serum creatine kinase elevations, and histological evidence of necrosis of myocytes. However, there is often little to no infiltration of inflammatory cells noted on muscle biopsy. As the name implies, this subtype of idiopathic inflammatory myopathy is provoked by statin use which may be a helpful finding during the history-taking process when developing a differential diagnosis. Below, we discuss a case of a 52-year-old female with delayed-onset immune-mediated necrotizing myopathy secondary to statin use.

Correction: A Case of Suspected Statin-Related Delayed Onset Necrotizing Myositis.

[This corrects the article DOI: 10.7759/cureus.22893.].

Descending paralysis as an atypical presentation of Guillain-Barré Syndrome.

We herein report a case of a 55-year-old man with an unusual case of Guillain-Barré Syndrome. Its presentation is usually a progression of symmetric muscle weakness that is ascending from the lower extremities making its way more proximal and accompanied by absent or depressed tendon reflexes. Here, the patient exhibited a rare presentation of Guillain-Barré syndrome, where the weakness was ascending upper extremity and descending lower extremity paralysis. The objective of this clinical case report is to highlight this extremely rare descending paralysis presentation of Guillain-Barré Syndrome.