Praxis最新文献

Introduction: Chronic hand eczema is a common inflammatory skin disease that significantly impairs quality of life and affects approximately 10 % of the population. Common causes include occupational exposure to chemicals or wet work (irritant or allergic contact dermatitis) as well as endogenous factors such as atopic diathesis. Diagnosis is based on medical history, clinical examination, and, if necessary, further testing (e. g., patch testing). Treatment involves a holistic approach consisting of avoidance of triggers, intensive skin care and the application of topical corticosteroids, calcineurin inhibitors, or newer treatments such as topical JAK inhibitors. In severe cases, systemic therapies may be necessary. Early diagnosis and treatment are essential to prevent chronicity, improve patients' quality of life, and maintain their ability to work.

Introduction: We present a case study of a patient with paroxysmal nocturnal haemoglobinuria (PNH) which first presented clinically as a haemolytic crisis, potentially triggered by a SARS-CoV-2 infection. This case highlights the diagnostic challenges involved in distinguishing between PNH and thrombotic microangiopathy (TMA), particularly in emergency situations. Administering eculizumab early on, as it is effective in treating both diseases, was crucial in stabilising the patient before a definitive diagnosis could be confirmed.

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Introduction: We describe the case of a 51-year-old patient with acute lower abdominal pain, in whom CT imaging revealed thrombosis of the superior mesenteric vein. Due to nephrotic proteinuria, elevated free lambda light chains, and echocardiographic findings consistent with cardiac amyloidosis, a bone marrow biopsy was performed. Collectively, the findings established a diagnosis of multiple myeloma with AL amyloidosis and subsequent nephrotic syndrome as the primary cause of the splanchnic thrombosis.

Introduction: Thyroid storm is an acute, life-threatening exacerbation of hyperthyroidism. It is crucial that patients receive immediate intensive medical care. In this case, we were initially misled by the patient's drug history, the paramedics' report and our own experience. It is important not to let yourself be biased by a history of drug abuse. Had the diagnosis in this patient been missed for longer, the outcome could have been fatal.

Introduction: This case describes an 80-year-old patient with long-lasting urinary symptoms that did not respond to treatment with alpha-blockers. A detailed examination ultimately revealed a rare combination of a prostate syndrome and an ectopically draining ureter into the prostate, leading to ectasia of the cranial part of the renal pelvicalyceal system on the right side - an unusual diagnosis, especially at this age. This case demonstrates how seemingly benign Lower Urinary Tract Symptoms (LUTS) can sometimes conceal a complex pathology that requires specialized diagnostics. After successful transurethral resection of the prostate (TUR-P), significant improvement of the symptoms was achieved. Additionally, the renal pelvicalyceal system was no longer ectatic.

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Introduction: Alveolar echinococcosis remains a rare parasitic disease, but the number of cases in Western Europe is increasing. Diagnosis is difficult due to a long incubation period and non-specific symptoms. Curative treatment can only be achieved through R0 resection. Suppressive therapy with albendazole can now achieve good long-term survival even in cases where surgery is not possible.

Introduction: A 51-year-old patient presented to the Memory Clinic with difficulty finding words that had been increasing over the course of months. This could not be objectified in the anamnesis interview, but the CERAD test battery revealed slight abnormalities in naming and verbal memory. MR tomography showed discrete hippocampal hypotrophy on the right. Because depression existed at the same time, the symptoms were associated with this, especially since the symptoms also improved with treatment of the depression. Only further MR tomographic imaging and FDG-PET, as well as questioning of handedness, finally led to the diagnosis of semantic dementia.

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