Internal medicine
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An 85-year-old woman with diffuse large B-cell lymphoma developed severe hypophosphatemia (serum phosphate 0.3 mg/dL) concomitant with acute kidney injury (serum creatinine 2.05 mg/dL) following chemotherapy. Because urine phosphate was undetectable, hypophosphatemia was likely due to the vigorous uptake of phosphate into the rapidly proliferating tumor cells, also known as tumor genesis syndrome (TGS), and acute kidney injury was potentially attributed to the antibiotics sulfamethoxazole/trimethoprim. ⋯ This case was unusual, as tumorigenesis syndrome is seldom seen in patients with lymphoma, and acute kidney injury usually leads to hyperphosphatemia. The present case emphasizes the importance of vigilance in hypophosphatemia due to TGS during chemotherapy.
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Pott's puffy tumor is a rare complication of frontal sinusitis characterized by frontal bone osteomyelitis with a subperiosteal abscess typically presenting with forehead swelling. We herein report a 21-year-old man with Pott's puffy tumor presenting as eyelid swelling on the opposite side of the sinusitis, without typical forehead swelling. Initially treated for sinusitis and pre-septal cellulitis with poor response, head magnetic resonance imaging revealed bilateral subdural abscesses and osteomyelitis of the frontal and bilateral parietal bones, leading to the diagnosis. When frontal sinusitis and eyelid swelling are unresponsive to antibiotics, Pott's puffy tumor should be considered, even in the absence of forehead swelling.
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Calpainopathy is primarily an autosomal recessive inherited myopathy; however, dominantly inherited cases with a pathogenic variant of c.1333G>A have been reported. A 13-year-old Japanese girl presented with toe walking and elevated serum creatine kinase levels. ⋯ A genetic analysis of her parents revealed the possibility that c.1333G>A was de novo. In this patient, the onset age was earlier than that of the reported autosomal dominant cases, suggesting the influence of the novel variant in the contralateral allele.
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A Southeast Asian man in his 30s residing in Japan developed severe disseminated strongyloidiasis during long-term steroid therapy. Initially misdiagnosed as gastroenteritis, his condition was later identified as strongyloidiasis by fecal smears and endoscopy. ⋯ This case underscores the importance of considering the patient's geographical background and immunosuppressive history in medical assessments. It further highlights the need for early and proactive diagnostic approaches, such as stool testing and gastrointestinal endoscopy, to effectively detect and treat imported infectious diseases.
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Comparative Study
A Study of the Risk Factors for 402 Patients with Esophageal Squamous Cell Carcinoma - A Retrospective Comparison with Health Checkup Participants.
Objective Esophageal cancer is a gastrointestinal cancer with a poor prognosis. However, it is curable and can be treated endoscopically if it is detected at an early stage. The objective of this study was to identify the factors that contribute to early detection. ⋯ Comparing early and advanced cancers, a history of endoscopic screening was the only factor involved in early detection (OR, 7.93; 95% CI, 4.480-14.000). Conclusion The factors associated with ESCC include alcohol consumption, smoking, concomitant cancer of other organs, and a low BMI. Endoscopy in subjects with these factors may therefore be recommended for the early detection of ESCC.