Internal medicine
-
Cancer cachexia, which is characterized by weight loss and muscle weakness, is common in patients with pancreatic cancer. Anamorelin, a ghrelin receptor agonist, has shown potential for the management of cachexia in various cancers. ⋯ Cachexia's complex metabolic changes make treatment difficult; however, anamorelin's appetite and weight gain effects highlight its possible role in managing cachexia in pancreatic cancer. Therefore, further research is required in this regard.
-
Cardiac amyloidosis (CA), predominantly caused by amyloid transthyretin (ATTR) or immunoglobulin light chain (AL), has a poor prognosis, and a precise diagnosis is crucial because the optimal treatments differ between the two conditions. However, diagnosing AL-CA is challenging because of the unavailability of effective AL-detecting antibodies, particularly in cases with coexisting AL- and ATTR-CA. This report presents a successfully diagnosed case of complicated AL- and ATTR-CA that was successfully treated with tafamidis for ATTR-CA and combination chemotherapy for AL-CA. This case highlights the importance of a precise diagnosis of CA and supports the efficacy and safety of concurrent treatment for coexisting amyloidosis.
-
We describe the case of a 25-year-old male with Duchenne muscular dystrophy and acute kidney injury who was receiving mechanical ventilation. The patient's estimated glomerular filtration rate (eGFR) was assessed using formulas based on creatinine, cystatin C, and inulin levels over time during the recovery of his renal function. ⋯ The Cystatin C-based eGFR was also higher than the inulin clearance. These findings suggest that cystatin C-based eGFR may also exceed inulin clearance in patients with an extremely reduced fat mass, in addition to a reduced muscle mass.
-
In 2020, a 56-year-old woman with a history of Helicobacter pylori (H. pylori) eradication 9 years previously presented with a hemorrhagic hyperplastic polyp. Endoscopic and histological findings led to the diagnosis of advanced-stage autoimmune gastritis (AIG). ⋯ Together with the rapid growth of a hyperplastic polyp, these findings suggest a case of AIG that rapidly exacerbated after eradication. To our knowledge, this is the first case report of a rapidly developing hemorrhagic hyperplastic polyp associated with AIG after H. pylori eradication.
-
Fabry disease (FD) is a rare X-linked lysosomal storage disorder. Enzyme replacement therapies (ERT), such as agalsidase α and β, are available treatment options. ⋯ We report the case of a female patient with Fabry disease who developed unexpected hypotension after six years of stable treatment with agalsidase α, leading to a switch to agalsidase β. Continuous monitoring may be essential to identify potential IRRs in female patients with Fabry disease receiving long-term ERT.