Conservative management of neurocysticercosis in a patient with hematopoietic stem cell transplantation: a case report and review.

Neurocysticercosis, an infection of the central nervous system with the larval stage of the cestode Taenia solium, is common in developing countries but its occurrence and management in allogeneic hematopoietic stem cell transplantation (HSCT) has not been reported previously, to our knowledge. We report the case of an immigrant female patient who underwent a matched-related allogeneic HSCT for acute lymphoblastic leukemia and was incidentally found to have a solitary viable neurocysticercosis lesion. However, despite severe immunosuppression, the size of the cyst did not increase. More importantly, restoration of the immune system did not induce significant inflammation or seizures. Subsequent follow-up demonstrated complete resolution of the neurocysticercosis lesion. Thus, in the setting of HSCT, an asymptomatic patient with a single neurocysticercosis lesion was successfully managed without the use of anthelmintics, steroids, or anti-epileptics.

Hypercalcaemia secondary to hypervitaminosis a in a patient with chronic renal failure.

Vitamin A toxicity is a well-described medical condition with a multitude of potential presenting signs and symptoms. It can be divided into acute and chronic toxicity. Serum vitamin A concentrations are raised in chronic renal failure even with ingestion of less than the usual toxic doses. Hypercalcaemia can occasionally be associated with high levels of vitamin A but it is rare. In this report, we describe a 67- year old female patient with chronic kidney disease who was taking vitamin A supplements for approximately 10 years. The patient had worsening of her chronic kidney disease over the last years and developed chronic hypercalcaemia. Her vitamin A level was elevated with a daily intake of 7000 IU. The vitamin A supplement was stopped. A few months later, vitamin A level diminished substantially and serum calcium levels returned to normal.

Hypercalcaemia secondary to Hypervitaminosis A in a patient with chronic renal failure / Hipercalcemia secundaria a la Hipervitaminosis A en un paciente con insuficiencia renal crónica

Vitamin A toxicity is a well-described medical condition with a multitude of potential presenting signs and symptoms. It can be divided into acute and chronic toxicity. Serum vitamin A concentrations are raised in chronic renal failure even with ingestion of less than the usual toxic doses. Hypercalcaemia can occasionally be associated with high levels of vitamin A but it is rare. In this report, we describe a 67-year old female patient with chronic kidney disease who was taking vitamin A supplements for approximately 10 years. The patient had worsening of her chronic kidney disease over the last years and developed chronic hypercalcaemia. Her vitamin A level was elevated with a daily intake of 7000 IU. The vitamin A supplement was stopped. A few months later, vitamin A level diminished substantially and serum calcium levels returned to normal.

La toxicidad de la vitamina A es una condición médica bien descrita que presenta un sinnúmero de potenciales signos y síntomas. Puede ser dividida en toxicidad aguda y crónica. Las concentraciones séricas de vitamina A se elevan con la insuficiencia renal crónica, incluso con la ingestión de dosis tóxicas por debajo de lo habitual. En ocasiones, la hipercalcemia puede estar asociada con altos niveles de vitamina A, pero esto raramente ocurre. En este informe, describimos a una paciente de 67 años de edad con enfermedad renal crónica, que estuvo tomando suplementos de vitamina A por aproximadamente 10 años. La paciente sufrió un empeoramiento de su enfermedad renal crónica en los últimos años, y desarrolló hipercalcemia crónica. Su nivel de vitamina A se elevó con una ingesta diaria de 7000 UI. El suplemento de vitamina A fue suspendido. Unos meses más tarde, el nivel de vitamina A nivel disminuyó sustancialmente, y los niveles de calcio sérico volvieron a la normalidad.

[Imaging features of retained surgical foreign bodies]. / Aspects radiologiques des textilomes.

PURPOSE: To study the clinical and radiological manifestations in patients with retained surgical foreign bodies. PATIENTS AND METHODS: Over the last five years, seven patients were found to have retained surgical foreign bodies after abdominal surgery. An analysis of the clinical signs, laboratory findings and imaging features was performed. RESULTS: The clinical and laboratory data were non-specific. The diagnosis of textiloma was suggested based on imaging findings and surgical history before surgical exploration. The characteristic imaging findings at ultrasound and computed tomography consisted of a fluid collection with internal wavy structures. The differential diagnosis includes pyogenic abscesses, hematomas and ruptured hydatid cysts. CONCLUSION: Ultrasonography and computed tomography are essential for the diagnosis and management of retained surgical foreign bodies after abdominal surgery.

Nasoseptal variation in relation to sinusitis. A computerized tomographic evaluation.

Paraseptal structural abnormalities are common in patients with sinusitis. They may coexist with radiographic changes suggestive of sinusitis. Their etiological role in patients with no history of sinus disease is still controversial. In this study, computerized tomographic scan of orbits of 89 cases with no history of sinusitis were reviewed between 1996 and 1998. The incidence of septal deviation, concha bullosa and paradoxical middle turbinates was looked at. Their correlation with sinusitis was analyzed using CM-square statistical method. Results showed that the presence of these anatomical abnormalities is not associated with an increased incidence of sinusitis as shown radiologically. We conclude that the presence of septal deviation or large middle turbine on routine rhinoscopy does not mandate further radiological evaluation of the sinuses in the absence of history of sinusitis.

Unenhanced spiral CT scan in the initial evaluation of renal colic: AUBMC experience.

BACKGROUND AND OBJECTIVE: Until recently, intravenous urography and ultrasonography have been the standard diagnostic modalities in the initial evaluation of acute flank pain. However, since 1995 the role of non-enhanced CT scan (NECT) has become more important in establishing the diagnosis of renal colic. In this retrospective descriptive study, we evaluated the usefulness of NECT in the diagnosis and management of patients with suspected urinary tract stones at the American University of Beirut-Medical Center (AUBMC). MATERIALS AND METHODS: We reviewed the records of 102 patients who presented to AUBMC over a period of two years for flank pain with or without hematuria. NECT were obtained in all patients. We studied the images for the presence of stones and frequency of associated urinary findings. Incidental abdominal and pelvic abnormalities were recorded. RESULTS: Fifty-four patients were found to have positive CT examinations for the presence of urinary tract stones on the ipsilateral side of the flank pain. Twenty-two stones were present in the kidneys, 23 in the ureters and 16 at the ureterovesical junction (UVJ). In these 54 patients with stone disease, 31 had associated pelvicalyceal dilatation (57%), and 16 had perinephric streaking (29.6%). In the 39 patients with ureteral and UVJ stones, 26 had ureteral dilatation (66.6%), and 17 had periureteral streaking (43.5%). In the 23 patients with only ureteral stones, 10 had a positive rim sign (43.4%). CONCLUSION: A diagnosis of urinary tract stone is not always readily apparent on the basis of physical exam and laboratory studies. NECT is now universally accepted as a preferred method for the evaluation of ureteral and kidney stones in patients with suspected renal colic.

Aberrant cervical thymus in an infant: an unusual cause of stridor.

We report an 8-month-old infant presenting with stridor caused by a nonpalpable neck mass discovered at imaging and surgery. The diagnosis of aberrant thymic tissue was confirmed at histopathology. The authors reviewed the literature and discuss the embryology, imaging findings and differential diagnosis of this rare disorder.

Intraabdominal panniculitis. Report of three cases and review of the literature.

Intraabdominal panniculitis is a rare, benign idiopathic disorder of the mesentery. Patients usually present with abdominal pain and a palpable mass. The cross-sectional imaging findings are characteristic and consist of a fibrofatty central mesenteric mass lesion encapsulating the mesenteric vessels with displacement of the bowel loops, that can suggest the diagnosis. Imaging is also important to establish a definitive diagnosis by an image-guided percutaneous biopsy, assess extent of the disease for selection of appropriate therapy, exclude associated abnormalities namely malignancies, and for follow-up.