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Ulcerative Type Pyoderma Gangrenosum in Primary Sjogren's Syndrome 原发性干燥综合征的溃疡型坏疽性脓皮病
Pub Date : 2018-01-01 DOI: 10.5336/CASEREP.2018-60781
Barış Gündoğdu, D. Cicek, S. Koca
A 63-year-old female patient with SjS was admitted to rheumatology department because of an ulcer in her left leg (Figure 1). The patient had applied to the rheumatology polyclinic with dry mouth, dry eyes, diffuse joint pain four years ago. She patient’s laboratory tests had revealed an increase in acute-phase response with the positivity for antinuclear antibody-indirect immunofluorescence (ANA-IFA) test (1/320 titre, speckled pattern) and anti-Sjogren’s syndrome antibody (anti-SSA) (3+, ELISA) test. Schirmer’s test had been bilaterally detected less than 5 mm. The minor salivary gland Turkiye Klinikleri J Case Rep 2018;26(4):223-6
63岁女性SjS患者因左腿溃疡入院风湿科(图1)。患者4年前以口干、眼干、弥漫性关节疼痛就诊于风湿科综合门诊。该患者的实验室检查显示急性期反应增加,抗核抗体间接免疫荧光(ANA-IFA)试验(1/320滴度,斑点型)和抗干燥综合征抗体(抗ssa) (3+, ELISA)试验阳性。Schirmer试验已检测到双侧小于5毫米。小唾液腺[J] .中华口腔医学杂志,2018;26(4):223-6
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引用次数: 1
Herpes Zoster Reacting with Short-Term Corticosteroid Therapy in a Healthy 8-Year-Old Girl 一名健康8岁女孩短期皮质类固醇治疗对带状疱疹的反应
Pub Date : 2018-01-01 DOI: 10.5336/CASEREP.2017-57616
R. Kutlu, Cennet Büyükyörük
94 aricella zoster virus (VZV) is a double helical DNA virus from herpes virus family. It is the factor of chickenpox and herpes zoster (HZ).1 Varicella, alias chickenpox, is a primary disease which develops after a nonimmunized person encounters the virus for the first time and which is characterized by widespread eczematous skin rashes and children have a mild form of it.2 The virus becomes latent in cerebral or posterior root ganglion after primary infection.3 Herpes zoster is a disease which develops as a result of the reactivation of the virus that remains latent after primary infection. It is characterized by vesicular lesions during unilateral dermatome. Chickenpox or HZ are often mild in healthy individuals. However, it can cause morbidity or mortality in patients with primary or acquired immunodeficiency, especially if cellular immunity is affected.2 The risk of having herpes zoster is 10-15% life-long in those who have chickenpox; 75% of them consist of the cases developing after 45 years of age. The incidence of HZ in children is very low and it is frequently seen in children who use immunosuppressive medicine and who have malignant disease and immune deficiency and a severe course of disease occurs. Herpes zoster, which is much less common in healthy children, is seen in children with chickenpox or contact history in the first year of life or in intrauterine period.1.3
水痘带状疱疹病毒(VZV)是一种来自疱疹病毒科的双螺旋DNA病毒。它是水痘和带状疱疹(HZ)的因子水痘,又名水痘,是一种原发疾病,在未接种疫苗的人第一次接触病毒后发展,其特征是广泛的湿疹性皮疹,儿童有轻微的形式原发感染后病毒潜伏于脑或后根神经节带状疱疹是由于原发感染后潜伏的病毒重新激活而发展的一种疾病。它的特点是单侧皮肤的水疱病变。水痘或HZ在健康人中通常是轻微的。然而,它可引起原发性或获得性免疫缺陷患者的发病或死亡,特别是当细胞免疫受到影响时水痘患者一生中患带状疱疹的风险为10-15%;其中75%是45岁以后发生的病例。HZ在儿童中的发病率很低,常见于使用免疫抑制药物、有恶性疾病和免疫缺陷且病程严重的儿童。带状疱疹在健康儿童中较不常见,常见于一岁或宫内有水痘或接触史的儿童
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引用次数: 0
Finger Jammed in a Door Knob 手指卡在门把手上
Pub Date : 2018-01-01 DOI: 10.5336/caserep.2018-60114
Hanifi Üçpunar, M. Baydar, Kahraman Ozturk
216 inger jammed in a ring or a circular metal piece may lead to a variety of injuries from simple dermabrasion to amputation. Classifications particularly based on the type of vascular injury are still in use today.1 In absence of an avulsion and presence of adequate blood supply to the finger, primary repair of the soft tissues may be performed, whereas vascular grafting may be necessary in case of arterial or venous circulation failure. The main reason here lies behind the presence of a bigger injury than it looks and the occurrence of vascular injury on a longer segment of the vein. Another repair in addition to the arterial and venous repair in avulsion injuries that requires grafting is the skin repair. This, in turn, additionally creates morbidity in the donor site. An accompanying severe soft tissue damage (avulsion or degloving) or amputation may present a challenge for the reimplantation technique, however, is also directly associated with the rate of success.2 While avulsion injuries are usually experienced in the work place, primary dermabrasion injuries or those which occur as a result of removing a ring from an edematous finger are encountered at home. The most important stage of the treatment in these injuries relies on the comfortable removal of the ring, causing minimum soft tissue injury possible. In our study, Finger Jammed in a Door Knob
夹在环形或圆形金属件中的手指可能导致从简单的磨皮到截肢的各种伤害。特别是基于血管损伤类型的分类至今仍在使用在没有撕脱和手指有足够血液供应的情况下,可以进行软组织的初步修复,而在动脉或静脉循环失败的情况下,血管移植可能是必要的。这里的主要原因是存在比它看起来更大的损伤和血管损伤发生在更长的静脉段。在撕脱伤中,除了需要移植的动脉和静脉修复外,另一种修复是皮肤修复。这反过来又增加了供体部位的发病率。伴随严重的软组织损伤(撕脱或脱手套)或截肢可能对再植技术提出挑战,然而,这也与成功率直接相关虽然撕脱伤通常发生在工作场所,但原发性磨皮损伤或因从肿胀的手指上取下戒指而发生的损伤则发生在家中。治疗这些损伤最重要的阶段是舒适地取出环,尽可能减少软组织损伤。在我们的研究中,手指卡在门把手上
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引用次数: 0
Disseminated Anaplastic Meningioma Before Local Recurrence 局部复发前播散性间变性脑膜瘤
Pub Date : 2018-01-01 DOI: 10.5336/caserep.2017-57550
S. Arslan, İ. Aral, Nuran Süngü, Mine Şalk
The patient died 12 months after the primary surgery.
患者在初次手术后12个月死亡。
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引用次数: 0
Persistent Diuresis Associated Dapagliflozin Treatment 持续性利尿相关的达格列净治疗
Pub Date : 2018-01-01 DOI: 10.5336/CASEREP.2018-61023
A. Gülmez, Tuğba Kandemir Gülmez
Diabetic ketoacidosis is a clinical entity characterized by high blood sugar, ketone positivity and high anion gap metabolic acidosis. In these patients; polyuria is commonly detected due to hyperglycemia. Polyuria-induced dehydration may even be seen, especially in elderly patients. Polyuria is not expected to continue after hyperglycemia has resolved. We reported in this article; a 55 years old man with type-2 diabetes mellitus who was treated with a sodium-glucose cotransporter 2 (SGLT2) inhibitor (dapagliflozin) who developed diabetic ketoacidosis and persistent diuresis in the post-treatment normoglycemic period.
糖尿病酮症酸中毒是一种以高血糖、酮阳性、高阴离子间隙代谢性酸中毒为特征的临床实体。在这些病人中;多尿症通常是由高血糖引起的。多尿引起的脱水甚至可以看到,特别是在老年患者中。高血糖消退后,预计不会继续出现多尿症。我们在这篇文章中报道过;1例55岁男性2型糖尿病患者,接受钠-葡萄糖共转运蛋白2 (SGLT2)抑制剂(达格列净)治疗,在治疗后血糖正常期出现糖尿病酮症酸中毒和持续性利尿。
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引用次数: 0
A Case with Renal Glycosuria 肾性糖尿1例
Pub Date : 2018-01-01 DOI: 10.5336/CASEREP.2018-61441
K. Kaynar, C. Şehit, A. Coşar, Gül Cebecioğlu Hasançebi
thesizing glucose via gluconeogenesis and preventing urinary glucose loss via tubulary glucose reabsorption.1 Reabsorption of glucose which is freely filtered in the glomeruli almost completely occur in proximal tubules only. This glucose reabsorption is mostly (90%) carried out by sodium-glucose cotransporters type 2 (SGLT-2) and glucose transporters 2 (GLUT2). So in patients with normal kidney function, significant glycosuria does not generally occur until the plasma glucose concentration exceeds 180 mg/dL (10 mmol/L).2
通过糖异生和通过小管葡萄糖重吸收防止尿糖丢失在肾小球中自由过滤的葡萄糖的重吸收几乎完全发生在近端小管中。这种葡萄糖重吸收主要(90%)由钠-葡萄糖共转运蛋白2型(SGLT-2)和葡萄糖转运蛋白2 (GLUT2)进行。因此,在肾功能正常的患者中,通常在血浆葡萄糖浓度超过180 mg/dL (10 mmol/L)时才会出现明显的糖尿
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引用次数: 0
The Coexistence of Systemic Lupus Erythematosus and Rheumatoid Arthritis in a Young Male Patient; A Rare Clinical Condition: Rhupus Syndrome 年轻男性系统性红斑狼疮合并类风湿关节炎1例一种罕见的临床病症:鲁普斯综合征
Pub Date : 2018-01-01 DOI: 10.5336/CASEREP.2017-58968
C. Özişler
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引用次数: 0
Surgical Management of Inguinal Hernia in a Newborn with ARCL2B 新生儿ARCL2B腹股沟疝的外科治疗
Pub Date : 2018-01-01 DOI: 10.5336/CASEREP.2017-56866
E. Aydın, Burak Ayan
world with an incidence of 1 in 1 million and is equally distributed in both sexes.1 It may be congenital or acquired. It affects connective tissue that supports the body’s framework which provides structure and strength to the muscles, joints, organs, and skin. The underlying pathology is related with elastin fibers. It results in skin manifestations such as the aged face, loose redundant skin, and reduced elasticity; and extracutaneous manifestations such as diverticula at the gastrointestinal system or urinary system, gastroesophageal reflux, diaphragmatic atonia or a hernia, umbilical or an inguinal hernia and hypoplasia of corpus callosum.2-4 In the literature, there are many reports about cutis laxa and its comorbidities but none is related with per operative management of the patient. To our knowledge, this will be the first case that discusses the surgical management of an autosomal recessive cutis laxa (ARCL2B) patient in English literature.
发病率为百万分之一,男女平均分布它可能是先天性的,也可能是后天的。它影响支撑身体框架的结缔组织,为肌肉、关节、器官和皮肤提供结构和力量。基础病理与弹性蛋白纤维有关。它导致皮肤表现为面部老化,皮肤松弛多余,弹性降低;以及皮外表现,如胃肠道或泌尿系统憩室,胃食管反流,膈肌张力不全或疝,脐或腹股沟疝和胼胝体发育不全。2-4在文献中,有许多关于皮肤松弛症及其合并症的报道,但没有一个与患者的每次手术处理有关。据我们所知,这将是英语文献中第一例讨论常染色体隐性皮肤松弛症(ARCL2B)患者的手术治疗的病例。
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引用次数: 0
A Case of Advanced Hepatocellular Carcinoma Presenting with Hypoglysemic Coma 晚期肝癌伴低血糖昏迷1例
Pub Date : 2018-01-01 DOI: 10.5336/CASEREP.2018-59736
Attila Önmez, Kürşad Öneç, S. Torun, A. Nalbant, O. Eşbah
AABBSS TTRRAACCTT Hypoglycemia is often associated with pancreatic tumors (eg, insulinoma). However, the association of paraneoplastic hypoglycemia with non-islet cell tumors is less frequent. In a patient who has not yet been diagnosed with hepatocellular carcinoma, it is a quite rare case that the first sign is coma due to hypoglycemia. Following is a 76-year-old male patient who has no disease history except essential hypertension and chronic obstructive pulmonary disease and has no symp- tom caused by prior hepatic lesion or failure. Below, it is aimed to present that how the patient's hypoglycaemic episodes were controlled in the follow-up period and to present the diagnosis process of advanced hepatocellular carcinoma which was diagnosed after several application to emergency room with a severe hypoglycemic coma due to recurrent symptomatic hypoglycemia lasting few months.
低血糖常与胰腺肿瘤(如胰岛素瘤)相关。然而,副肿瘤低血糖与非胰岛细胞肿瘤的关联并不常见。在尚未确诊为肝细胞癌的患者中,出现低血糖引起的昏迷是非常罕见的。以下是一位76岁男性患者,除原发性高血压和慢性阻塞性肺疾病外,无其他病史,既往无肝病变或肝功能衰竭引起的症状。下面我们将介绍患者在随访期间低血糖发作是如何得到控制的,并介绍该患者因反复出现症状性低血糖持续数月,经多次申请急诊诊断为晚期肝细胞癌的诊断过程。
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引用次数: 0
A Rare Case Report: Oropharyngeal Foreign Body in an Alzheimer Patient 阿尔茨海默病患者口咽异物一例报告
Pub Date : 2018-01-01 DOI: 10.5336/CASEREP.2018-59981
Ayşegül Şule Altindal
challenging otolaryngology emergencies. Foreign body aspiration is usually a serious condition that is most common among the pediatric age group, and rare in adults.1,2 The etiology of foreign body aspiration is often peanuts, which may be radiopaque on X-ray.3 Fish bone is the most common foreign body (FB) encountered in the pharynx.4-7 Most Pharyngeal foreign bodies (PFBs) are removed in the outpatient department. Only a few patient may have lack of cooperation and need extracting FBs in the hospital under general anesthesia. In clinical practice, many PFBs in patients are dislodged spontaneously before presentation. However, many reports have been associated with complications of PFBs, such as infections of the pharyngeal wall, retropharyngeal abscess, migration of FB, and even death.8-11 The majority of patients present with acute symptoms, like cough, dyspnea and hemoptysis, while others present with chronic symptoms.2-12 Most patients have an underlying disease, such as mental retardation, abnormal swallowing reflex, or neurological problems.13 In some adult patients, especially when Alzheimer disease is present, aspiration may be tolerated for a long time. Diagnosis must be established by means of symptoms, radiography, oropharyngeal examination and nasopharyngoscopy. Treatment is removal of the foreign body from the airway tract.2 Oropharyngeal wet wipes are very rare causes of pharyngeal foreign bodies around the world. Turkiye Klinikleri J Case Rep 2018;26(4):205-8
挑战耳鼻喉科急症。异物吸入通常是一种严重的疾病,在儿科年龄组中最常见,在成人中很少见。1,2异物吸入的病因常为花生,在x线上可能不透光鱼骨是咽部最常见的异物。4-7大多数咽异物(PFBs)是在门诊清除的。只有少数患者可能缺乏配合,需要在全麻情况下在医院取出FBs。在临床实践中,许多患者的PFBs在发病前自发移位。然而,许多报道与PFBs的并发症有关,如咽壁感染、咽后脓肿、FB迁移,甚至死亡。8-11大多数患者表现为急性症状,如咳嗽、呼吸困难和咯血,而其他患者表现为慢性症状。大多数患者有潜在疾病,如智力迟钝、吞咽反射异常或神经系统问题在一些成年患者中,特别是当存在阿尔茨海默病时,可能长期耐受误吸。诊断必须通过症状、x线摄影、口咽检查和鼻咽镜来确定。治疗方法是将异物从气道中清除口咽湿巾在世界范围内是引起咽异物的非常罕见的原因。中华医学杂志,2018;26(4):205-8
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引用次数: 0
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Türkiye Klinikleri Journal of Case Reports
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