Internal medicine
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We studied the clinical features of minocycline-induced pneumonitis in seven patients. Acute symptoms included fever, dry cough and dyspnea, indicating acute respiratory failure. ⋯ Cessation of minocycline led to rapid remission with no treatment or only short-term steroid therapy. The lymphocyte stimulation test for minocycline with peripheral blood lymphocytes was not found to be useful for diagnosis.
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We describe a case with chronic bronchial foreign body presenting with recurrent hemoptysis mimicking a peripheral lung tumor, and the outcome of surgical resection. A 61-year-old female with recurrent hemoptysis had a peripheral nodule in the right lower lobe. ⋯ Surgical removal of the nodule contained a small branch of a white cedar. Chronic bronchial foreign body, while rare in adults, should be considered in the differential diagnosis of peripheral lung tumors associated with recurrent hemoptysis.
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We present a case of adenoid cystic carcinoma of the trachea. The tumor could not be resected due to extensive progression but it was effectively treated endoscopically with a Nd-YAG Laser followed by 70 Gy of conventional radiotherapy. Histologically-confirmed complete remission was achieved, and the patient has lived for nearly 9 years without recurrence of disease.
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Case Reports
Wegener's granulomatosis with multiple cranial nerve involvements as the initial clinical manifestations.
Wegener's granulomatosis (WG) is a disease of unknown origin characterized by necrotizing granulomas of both the upper and lower respiratory tracts and glomerulonephritis. A 62-year-old woman presenting unusual neurological manifestations is reported. The patient suffered from palsies of multiple cranial nerves without manifestation of respiratory tracts in the initial clinical course. ⋯ A diagnosis was made by a needle biopsy of the lung. Palsies of cranial nerves suspected to be due to meningeal involvement of WG. During the entire clinical course, no finding of glomerulonephritis was observed.
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Review Case Reports
Primary hyperparathyroidism associated with multiple myeloma.
A 73-year-old woman was diagnosed as primary hyperparathyroidism. Hypercalcemia recurred after parathyroidectomy, though serum calcium concentration temporarily resumed to normal. ⋯ In spite of the frequent association of hypercalcemia with malignant disease and the relative frequency of primary hyperparathyroidism as a cause of hypercalcemia, primary hyperparathyroidism accompanied by multiple myeloma has been considered in only a limited number of reports. Here, the cases in the literature are reviewed and discussed.