Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) in Diabetes Mellitus: A Diagnostic Dilemma.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neurological disorder of the peripheral nerves which can lead to gradually increasing motor and sensory loss. It can be a difficult entity to diagnose, particularly in elderly patients with a history of Diabetes Mellitus due to their overlapping neuropathic syndromes. Reported is a case of CIDP in an elderly female who manifested multiple sensory, motor, and autonomic complaints. A compilation of clinical features, neuroimaging, lumbar puncture, electromyography, nerve conduction studies, and nerve biopsy were used to reach the diagnosis. Highlighted is a clinical approach to identifying CIDP that can cause neuropathy in the setting of other potential confounding disorders namely Diabetes Mellitus.

Congenital Pulmonary Airway Malformation in an Adult Male Presenting With Hemoptysis.

Congenital pulmonary airway malformations (CPAMs) are rarely encountered in the adult population. Although they are typically diagnosed in the prenatal period, some may not cause symptoms and go unnoticed until adulthood. Patients with CPAM are at risk of developing pneumonia, hemorrhage, pneumothorax, and malignancy. There is a paucity of evidence regarding the management and prognostication of adults with CPAM. Patients often need to undergo surgical resection to prevent further episodes of infection, bleeding, or malignant transformation. Here, we present the case of an adult male with a CPAM who presented with frank hemoptysis. Computed tomography scan and bronchoscopy localized the lesion to the lingula. The patient underwent elective surgical resection of the lesion by video-assisted thoracoscopy and did not suffer any adverse outcomes. Surgical resection is generally recommended and appears to be a safe and effective approach to treating patients with symptomatic CPAMs. Inhaled tranexamic acid and bronchial artery embolization are valuable interventions in our armamentarium for managing hemoptysis but should not replace a definite surgical intervention due to the risk of recurrence.

Blasting Into Acute Coronary Syndrome.

Acute coronary syndrome (ACS) is a condition that develops from reduced blood flow and oxygen delivery through the coronary arteries which leads to cardiac ischemia. In the case presented here, the patient's ACS was precipitated by his underlying condition of chronic myelogenous leukemia (CML). Several complications can arise in patients with CML, one of them being blast crisis. Blast crisis is defined by 20% or greater blasts in the peripheral blood, or extramedullary proliferation of blasts. There is a known phenomenon of blood hyperviscosity that can develop in such patients which can lead to complications of stroke-like symptoms, congestive heart failure, and acute respiratory failure. In such cases, leukostasis rarely leads to myocardial ischemia. We present a challenging case of a patient with an acute coronary syndrome (ACS) precipitated by a blast crisis. This case highlights a potentially life-threatening cardiac complication of CML in patients with coronary artery disease and aimed to provide an optimal treatment strategy to improve outcomes.