The American journal of the medical sciences
-
Spider angioma refers to a type of telangiectasis that presents slightly beneath the skin surface on the face, neck, arms or upper trunk, often manifesting with a central red spot and reddish extensions that radiate outwards like a spider's web. The cutaneous spider angioma may be benign but it often indicates abnormal liver function, especially in patients with chronic cirrhosis. ⋯ Here, we report two rare multiple and giant spider angioma cases in patients with HIV/AIDS who developed chronic cirrhosis. In addition, we comprehensively reviewed related literatures and evaluated the existing possible mechanisms of spider angioma.
-
Review Case Reports
Sclerosing cholangitis may mimic radiological pattern of cholangiocarcinoma: Case report, differential diagnosis and review of literature.
IgG4 related sclerosing cholangitis (IgG4-SC) is a chronic cholestatic autoimmune liver disease, characterized by obstruction of the biliary tract due to IgG4-positive plasma cell infiltrations associated with fibrosis, phlebitis and presence of eosinophils. The diagnosis of the disease is supported by elevation in serum IgG4, radiological imaging and histology. ⋯ Here we are describing a case of a male patient admitted to our hospital for jaundice. The stenosis of biliary ducts shown by radiologic imaging suggested Cholangiocarcinoma but, in the patient, IgG4-SC was definitely diagnosed.
-
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the ongoing pandemic of coronavirus disease 2019 (COVID-19), which presented as not only respiratory symptoms, but various digestive manifestations including pancreatic injury and acute pancreatitis (AP). The underlying mechanism is still unclear. Hypertriglyceridemia has become one of the leading causes of AP in recent years and hyperlipidemia is highly reported in COVID-19 cases. ⋯ Hyperlipidemia was common in COVID-19 patients with a pooled incidence of 32.98%. Hyperlipidemia could be a mediating factor in the pathogenesis of AP in COVID-19 patients. Further studies are warranted to clarify the relationship among AP, lipid metabolism disorders and COVID-19.
-
Review Case Reports
A common presentation - turning out as uncommon diagnosis: from hip pain to Langerhans cell histiocytosis: Adult High-Risk Multi-System Langerhans Cell Histiocytosis.
Langerhans cell histiocytosis (LCH) is an uncommon clonal proliferation of myeloid progenitor cells, it is especially rare in adults. We present a case of multi-system LCH in a 53-year-old woman, the sole symptom of which was prolonged, non-resolving hip pain for 18 months prior to the diagnosis. Initial evaluation included imaging studies aimed at identifying a presumed local etiology. ⋯ After non-invasive investigations failed to reveal the underlying etiology, a biopsy was performed, revealing cores of Langerhans cells that stained positive for both CD1a and langerin. These findings verified the surprising, uncommon diagnosis of LCH. A comprehensive workup was conducted in order to determine the extent of the disease and its molecular nature - revealing a BRAFV600E-positive, high-risk, multi-system LCH with skeletal, lung and liver involvement.
-
Infection with COVID-19 has resulted in over 276,000 deaths in the United States and over 1.5 million deaths globally, with upwards of 15% of patients requiring hospitalization. Severe COVID-19 infection is, in essence, a microvascular disease. This contention has been emphasized throughout the course of the pandemic, particularly due to the clinical manifestation of severe infection. ⋯ Initially thought to be isolated to the pulmonary system and resulting in ARDS, patients with COVID-19 have been observed to have acute cardiac, renal, and thrombolytic complications. Therefore, severe COVID-19 is a vascular disease that has systemic implications. The objective of this review is to provide a mechanistic background for the microvascular nature of severe COVID-19 infection, with a particular emphasis on dysfunction of the endothelial glycocalyx and nitric oxide mediated pathogenesis.