BMJ Case Reports
1757-790X
Anh Quốc
Cơ quản chủ quản: BMJ Publishing Group
Lĩnh vực:
Medicine (miscellaneous)
Phân tích ảnh hưởng
Thông tin về tạp chí
BMJ Case Reports is an important educational resource offering a high volume of cases in all disciplines so that healthcare professionals, researchers and others can easily find clinically important information on common and rare conditions. All articles are peer reviewed and copy edited before publication. BMJ Case Reports is not an edition or supplement of the BMJ.
Các bài báo tiêu biểu
Pacemaker lead-associated thrombosis in cardiac resynchronisation therapy Pacemaker lead-associated thrombosis is a possible complication of any cardiac implantable electronic device. We present a case of a middle-aged woman with a history of ischaemic left ventricular failure, who presented with fever and other non-specific symptoms 4 months after cardiac resynchronisation therapy. A transoesophageal echocardiogram confirmed a vegetation-like structure originating from the pacemaker lead in the right atrium. The patient was treated with intravenous antibiotics followed by open heart surgery in order to remove this mass as well as the pacing device, including all three pacing leads. Histology and culture of the retrieved mass confirmed a sterile thrombus with no features to suggest an infected mass (vegetation). The patient made an uncomplicated recovery and there were no long-term sequelae on follow-up during the 2 years after the event.
- Trang bcr2015210314
Tumour thrombus of the inferior vena cava extending into the right atrium in the setting of colon cancer Tumour thrombus is seen in renal cell and hepatocellular carcinoma, but is rarely reported in colorectal cancer. A woman aged 46 years, with metastatic colonic adenocarcinoma, was found to have a large mass in the inferior vena cava (IVC) extending into the right atrium. Although this lesion was initially thought to be bland thrombus, imaging with contrast-enhanced CT scan and contrast-enhanced ultrasound supported the diagnosis of tumour thrombus. Despite the large size of the lesion, the patient was asymptomatic. Her lack of symptoms, and poor overall prognosis from her cancer led to the decision to avoid aggressive surgical or radiological interventions. Several months later, the patient passed away. At autopsy, there was no evidence of fatal embolisation from the pre-existing thrombus. Diagnosis of tumour thrombus in the IVC is difficult and management can be challenging due to the significant risks associated with treatment options.
- Trang bcr2016218107
Successful use of tocilizumab in polymyalgic onset biopsy positive GCA with large vessel involvement
Tập 2011 Số jun30 1 - Trang bcr0420114135-bcr0420114135 - 2011
Acute psychosis in a pregnant patient with Graves’ hyperthyroidism and anti-NMDA receptor encephalitis A previously healthy 36-year-old woman presented with visual hallucinations and acute psychosis manifested predominantly as hypersexuality. Laboratory testing demonstrated elevated free thyroxine levels, suppressed thyroid-stimulating hormone levels and presence of thyroid-stimulating immunoglobulin andthyroid peroxidase (TPO) antibodies consistent with Graves’ disease. Despite achieving biochemical euthyroidism, she remained profoundly hypersexual. She did not respond to additional treatment with antipsychotics and corticosteroids, prompting further evaluation. Cerebrospinal fluid analysis detected pleocytosis, elevated IgG, and presence of antibodies against anti-N-methyl-D-aspartate receptor (NMDAR), glutamic acid decarboxylase 65 and TPO. These results suggested a diagnosis of anti-NMDAR encephalitis. Prior to initiation of immunomodulator therapy, she was discovered to be pregnant with date of conception around the time of her original presentation. She received plasmapheresis with resolution of psychosis and decrease in free thyroxine levels. Graves’ disease remitted during the remainder of the pregnancy but relapsed 5 months post partum. She has not had further neuropsychiatric symptoms.
- Trang bcr2014208052
Steroid unresponsive anti-NMDA receptor encephalitis during pregnancy successfully treated with plasmapheresis Anti-N -methyl-d -aspartate (NMDA) receptor encephalitis is an autoimmune disorder resulting in neurological and psychiatric symptoms. It is rare during pregnancy and treatment is extremely challenging as little data exist to guide management. A 26-year-old woman presented at 22 weeks of gestation with intermittent headache and an acute episode of bizarre behaviour and grandiose delusions resulting in hospitalisation. The patient was worked up for encephalitis and was found to have anti-NMDA receptor antibody in cerebrospinal fluid as well as in serum. She was initially treated with high-dose steroids but failed to improve clinically and serologically. She was then treated with plasmapheresis and showed clinical and serological response. She had a successful delivery at 37 weeks and the baby did not show serological evidence of disease. This case adds to the sparse literature of anti-NMDA receptor encephalitis during pregnancy and adds to the differential diagnosis of new onset psychiatric symptoms during pregnancy.
- Trang bcr2014208823
Metastatic renal cell carcinoma presenting with mediastinal eggshell calcification An 81-year-old South Asian man normally resident in the UK presented with night sweats for over 2 months on a background of weight loss of 4 kg in 6 months. His medical history was significant for metastatic renal cell carcinoma treated 5 years previously with cytoreductive nephrectomy and adjuvant chemotherapy. Following an abnormal chest radiograph showing an ill-defined right paratracheal mass, a CT scan showed eggshell calcification (circumferential calcification) of enlarged low right paratracheal lymph nodes. An endobronchial ultrasound–guided transbronchial needle aspiration of an involved large paratracheal lymph node showed cytology consistent with metastatic renal cell carcinoma.
- Trang bcr2014209202
Unexpected pathogen presenting with purulent meningitis Herein we report a case of a 67-year-old man with chronic lymphocytic leukaemia who developed acute onset of fever and altered mental status while receiving ibrutinib therapy. He was eventually found to haveCapnocytophaga canimorsus meningitis. Timely diagnosis and appropriate antimicrobial therapy was associated with a favourable outcome. We describe challenges associated with appropriate identification of, and briefly review infections caused byCapnocytophaga sp. To our knowledge, this is the first case of invasiveC. canimorsus infection in the setting of ibrutinib therapy, and adds to the growing list of serious infections that have been associated with this agent.
Tập 13 Số 3 - Trang e231825 - 2020
An unusual complication of cardiac catheterisation during BMV
Tập 2011 Số mar05 1 - Trang bcr1220103595-bcr1220103595 - 2011
Paraneoplastic subacute sensory neuronopathy in association with adenocarcinoma of the prostate
Tập 2011 Số jul28 1 - Trang bcr0420114077-bcr0420114077 - 2011