ABSTRACT
We report a rare case of Wernicke encephalopathy (WE) in a 35-year-old woman with hyperemesis gravidarum (HG). Initially, the disease manifested as passivity, a loss of interest, sleeping too much, apathy and disorientation. The correct diagnosis was established after the detection of typical pathological findings of WE in the thalamus by magnetic resonance imaging (MRI), which was indicated for the appearance of eye symptomatology in the form of nystagmus. Subsequent treatment with thiamine led to rapid improvement in the patient's clinical status and a favorable course of pregnancy.
Subject(s)
Hyperemesis Gravidarum , Wernicke Encephalopathy , Adult , Diagnosis, Differential , Female , Humans , Hyperemesis Gravidarum/complications , Hyperemesis Gravidarum/diagnosis , Magnetic Resonance Imaging , Pregnancy , Thiamine/therapeutic use , Wernicke Encephalopathy/diagnosis , Wernicke Encephalopathy/drug therapy , Wernicke Encephalopathy/etiologyABSTRACT
Wilson's disease is a rare autosomal recessive disease, caused by impaired secretion of copper into bile due to a defective function of the ATPase 7B enzyme. Clinical manifestation is predominantly hepatic and neurological. Wilson's disease is traditionally considered a disease of children and young adults. It rarely manifests after 40 years of age. In our case report, we present a 67-year-old female in whom Wilson's disease manifested as tremors of the upper extremities and chin that were originally assessed as part of cerebral atherosclerosis and Parkinson's disease. Only the histological finding of liver steatofibrosis, performed due to suspected metastatic changes of the liver, led in the context of neurological symptoms to correct diagnosis and successful treatment.
ABSTRACT
Chronic lymphocytic leukemia (CLL) is a generalized malignancy of the lymphoid tissue characterized by an accumulation of monoclonal lymphocytes, usually of the B cell type. Involvement of the central nervous system is a rare complication, usually seen in T cell leukemias. We report a case of a 78-year-old woman with B cell CLL and meningeal infiltration by both B and T lymphocytes, although predominantly T lymphocytes. Neurological symptoms were the first manifestation of this disease. Computed tomography of the brain was negative. The diagnosis of leukemic meningitis was made on the basis of the examination of the cerebrospinal fluid, and which included cytological and flow cytometry analysis. The patient was given systemic chemotherapy in the form of chlorambucil and intrathecal administration of methotrexate and dexamethasone. After recovery, she had regular follow-up. We assume that this rare case of CLL might have been biclonal, with both B and T cell types.
