MD Nivethietha Maniam, Ming Ta Michael Lee, MD Mihir M. Shah, MD Richard Alexander
Primary malignant peritoneal mesothelioma with clear cell subtype is a rare malignancy with few previously reported cases. We present a 63-year-old female who presented with abdominal distention and was diagnosed with clear cell mesothelioma of the peritoneum with an isolated metastasis to the liver. The patient underwent surgical resection of a greater than 50 cm mass with en-bloc partial liver and gastric resection with an uneventful post-operative course. There are established prognostic and treatment recommendations for peritoneal mesothelioma based on histological subtype and patient-specific factors, although they do not explicitly incorporate clear cell subtype. This case report describes the presentation, treatment and early outcome of a rare form of peritoneal mesothelioma.
{"title":"A Rare Presentation of a Clear Cell Variant of Peritoneal Mesothelioma","authors":"MD Nivethietha Maniam, Ming Ta Michael Lee, MD Mihir M. Shah, MD Richard Alexander","doi":"10.29046/tmf.022.1.014","DOIUrl":"https://doi.org/10.29046/tmf.022.1.014","url":null,"abstract":"Primary malignant peritoneal mesothelioma with clear cell subtype is a rare malignancy with few previously reported cases. We present a 63-year-old female who presented with abdominal distention and was diagnosed with clear cell mesothelioma of the peritoneum with an isolated metastasis to the liver. The patient underwent surgical resection of a greater than 50 cm mass with en-bloc partial liver and gastric resection with an uneventful post-operative course. There are established prognostic and treatment recommendations for peritoneal mesothelioma based on histological subtype and patient-specific factors, although they do not explicitly incorporate clear cell subtype. This case report describes the presentation, treatment and early outcome of a rare form of peritoneal mesothelioma.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114418583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael Dong, MD, Frances Mae West, MD, Jillian Cooper, MD, Jonathan Foster, MD, Rebecca Davis, MD
{"title":"A Guide to Point of Care Ultrasound Examination of a Pericardial Effusion","authors":"Michael Dong, MD, Frances Mae West, MD, Jillian Cooper, MD, Jonathan Foster, MD, Rebecca Davis, MD","doi":"10.29046/tmf.024.1.013","DOIUrl":"https://doi.org/10.29046/tmf.024.1.013","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133717412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can Our Hearts Take the New Guidelines?","authors":"E. Frankel","doi":"10.29046/tmf.020.1.017","DOIUrl":"https://doi.org/10.29046/tmf.020.1.017","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123576971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Harrison Bell, MD, Akash Patel, DO, Benjamin Tasevac, MD
{"title":"From the Editors","authors":"Harrison Bell, MD, Akash Patel, DO, Benjamin Tasevac, MD","doi":"10.29046/tmf.024.1.003","DOIUrl":"https://doi.org/10.29046/tmf.024.1.003","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"164 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122543874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chioma Nwonu, DO, Michael Dong, MD, Dan Kramer, MD
{"title":"An Educational Case for Applying the Alveolar- Arterial Gradient in Hypoxemia: An Underutilized and Underappreciated Clinical Tool","authors":"Chioma Nwonu, DO, Michael Dong, MD, Dan Kramer, MD","doi":"10.29046/tmf.024.1.006","DOIUrl":"https://doi.org/10.29046/tmf.024.1.006","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125384588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brendan Gleason, Lisa Matonti, PharmD, BCPS, Xuejun Alice Wang, MD, Bahar Dasgeb, MD
Bullous pemphigoid is an autoimmune blistering condition mediated by autoantibodies 1 . It is categorized as an uncommon disorder 2-4 , with an estimated incidence of 2.4-21.7 cases per million 2-6 but carries significant morbidity and mortality, warranting clinical awareness and investigation 7,8 . A number of medications have been implicated in the development of bullous pemphigoid including loop diuretics, ace inhibitors, and anti-epileptic drugs. This is a case report of carbamazepine-induced bullous pemphigoid in a 49-year-old male after taking the medication for almost 30 years. Diagnosis of bullous pemphigoid was based on biopsy histology and immunofluorescence, as well as the presence of BP 180 antibody. Clinical features of extensive rash and bullae were present on dermatological exam. Upon discontinuation of carbamazepine and appropriate treatment of bullous pemphigoid, the patient’s condition improved. A thorough analysis of the patient’s history and medications did not reveal any other potential triggers of bullous pemphigoid. The only two previous reports of an association between carbamazepine and bullous pemphigoid are limited by lack of immunologic evidence of diagnosis or the identification of a specific causative agent. To address these limitations, we describe what is to our knowledge, the first reported case of clearly documented association between carbamazepine and bullous pemphigoid.
{"title":"Carbamazepine Induced Bullous Pemphigoid in a 49 Year Old Male","authors":"Brendan Gleason, Lisa Matonti, PharmD, BCPS, Xuejun Alice Wang, MD, Bahar Dasgeb, MD","doi":"10.29046/tmf.022.1.009","DOIUrl":"https://doi.org/10.29046/tmf.022.1.009","url":null,"abstract":"Bullous pemphigoid is an autoimmune blistering condition mediated by autoantibodies 1 . It is categorized as an uncommon disorder 2-4 , with an estimated incidence of 2.4-21.7 cases per million 2-6 but carries significant morbidity and mortality, warranting clinical awareness and investigation 7,8 . A number of medications have been implicated in the development of bullous pemphigoid including loop diuretics, ace inhibitors, and anti-epileptic drugs. This is a case report of carbamazepine-induced bullous pemphigoid in a 49-year-old male after taking the medication for almost 30 years. Diagnosis of bullous pemphigoid was based on biopsy histology and immunofluorescence, as well as the presence of BP 180 antibody. Clinical features of extensive rash and bullae were present on dermatological exam. Upon discontinuation of carbamazepine and appropriate treatment of bullous pemphigoid, the patient’s condition improved. A thorough analysis of the patient’s history and medications did not reveal any other potential triggers of bullous pemphigoid. The only two previous reports of an association between carbamazepine and bullous pemphigoid are limited by lack of immunologic evidence of diagnosis or the identification of a specific causative agent. To address these limitations, we describe what is to our knowledge, the first reported case of clearly documented association between carbamazepine and bullous pemphigoid.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"31 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120822740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steven Manobianco, MD, William Bradford, MD, Ida Micaily, MD, Adam Binder, MD
HLH is a severe inflammatory syndrome characterized by primary or secondary immune dysregulation causing excess activation of macrophages and cytotoxic lymphocytes, leading to multi-system dysfunction. Diagnosing and managing HLH can be challenging for clinicians, with HLH-2004 criteria for diagnosis requiring a molecular diagnosis or the presence of at least five of the following: fever, splenomegaly, cytopenia involving two or more cell lineages, hypertriglyceridemia and/or hypofibrinogenemia, hemophagocytosis in the bone marrow, spleen or lymph nodes with no evidence of malignancy, low or no NK cell activity, elevated ferritin, or elevated soluble IL-2 receptor. These criteria have been utilized to develop the HScore, a tool used to assist in determining the probability of HLH based on the aforementioned abnormalities. After diagnosis, treatment typically includes chemotherapy and immunosuppression, followed by allogeneic bone marrow transplant.
{"title":"A Slow Burning Diagnosis: A Case Report of Hemophagocytic Lymphohistiocytosis Preceding the Diagnosis of Subcutaneous Panniculitis-Like T-Cell Lymphoma","authors":"Steven Manobianco, MD, William Bradford, MD, Ida Micaily, MD, Adam Binder, MD","doi":"10.29046/tmf.022.1.013","DOIUrl":"https://doi.org/10.29046/tmf.022.1.013","url":null,"abstract":"HLH is a severe inflammatory syndrome characterized by primary or secondary immune dysregulation causing excess activation of macrophages and cytotoxic lymphocytes, leading to multi-system dysfunction. Diagnosing and managing HLH can be challenging for clinicians, with HLH-2004 criteria for diagnosis requiring a molecular diagnosis or the presence of at least five of the following: fever, splenomegaly, cytopenia involving two or more cell lineages, hypertriglyceridemia and/or hypofibrinogenemia, hemophagocytosis in the bone marrow, spleen or lymph nodes with no evidence of malignancy, low or no NK cell activity, elevated ferritin, or elevated soluble IL-2 receptor. These criteria have been utilized to develop the HScore, a tool used to assist in determining the probability of HLH based on the aforementioned abnormalities. After diagnosis, treatment typically includes chemotherapy and immunosuppression, followed by allogeneic bone marrow transplant.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116665694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Heart Failure with Preserved Ejection Fraction: A Review of the ACC/AHA Guidelines and Evidence-Based Management Strategy","authors":"V. Sunder","doi":"10.29046/TMF.020.1.019","DOIUrl":"https://doi.org/10.29046/TMF.020.1.019","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125718859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic intestinal pseudo-obstruction (CIPO) is a rare gastrointestinal motility disorder that presents with symptoms, physical exam, and imaging findings of mechanical bowel obstruction without an anatomical obstruction. Multiple etiologies, including enteric or extr insic neuropathic dysfunction, myopathic dysfunction, or dysfunction of the interstitial cells of Cajal, cause CIPO’s pathogenesis. The presentation of CIPO may be idiopathic or caused by underlying diseases. The most common presentation is abdominal pain, bloating, and distension. Here, we present a patient with an end-stage case of CIPO who failed medical therapy. Her distension progressed over a decade, requiring emergency surgery due to intestinal pneumatosis.
{"title":"End-Stage Chronic Intestinal Pseudo-Obstruction Resulting in Intestinal Pneumatosis","authors":"Justin Bilello, MD, Amman Bhasin, MD, Phoebe Chun, MD, Aaron Martin, MD","doi":"10.29046/tmf.024.1.009","DOIUrl":"https://doi.org/10.29046/tmf.024.1.009","url":null,"abstract":"Chronic intestinal pseudo-obstruction (CIPO) is a rare gastrointestinal motility disorder that presents with symptoms, physical exam, and imaging findings of mechanical bowel obstruction without an anatomical obstruction. Multiple etiologies, including enteric or extr insic neuropathic dysfunction, myopathic dysfunction, or dysfunction of the interstitial cells of Cajal, cause CIPO’s pathogenesis. The presentation of CIPO may be idiopathic or caused by underlying diseases. The most common presentation is abdominal pain, bloating, and distension. Here, we present a patient with an end-stage case of CIPO who failed medical therapy. Her distension progressed over a decade, requiring emergency surgery due to intestinal pneumatosis.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129055392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：