Acute inflammatory Demyelinating Polyneuropathy (AIDP) with hepatitis A (HA) is more likely to affect men, develop at a younger age, and have a better prognosis overall. The progression of the Hepatitis A Virus (HAV)-caused liver inflammation and the neurological difficulties could lead to AIDP in the early stages of the hepatitis signs and symptoms. The World Health Organization (WHO) estimates 1.5 million clinical HAV cases annually. Extrahepatic complications of this disease are rare. The etiology of HA associated AIDP remains unclear, with cross-reactive HA epitopes between the peripheral nervous system and other authors have hypothesized that the presence of CSF antibodies reflects direct entry into the central nervous system. Our patient presentations favored AIDP most commonly in HA. A 22-year-old man, with no prior significant medical history, presented to neurology emergency with a 3-day history of acute onset, had been complaining of nausea, general weakness, yellowing of the sclera and history of fever for 5 days. Further investigation revealed marked elevation of liver enzymes in a pattern suggestive of hepatocellular processes. Serum titres of hepatitis B, C, and E were negative, but IgM anti-HAV was positive (enzyme immunoassay). Elevation of Cerebrospinal fluid (CSF) protein and myelitis transversa shown by magnetic resonance imaging were established. The diagnosis as AIDP was taken and treated by symptomatic and neurology treatment. However, the patient regained strength and underwent physiotherapy during two weeks. Approximately 3 months after discharged, the patient's gait had nearly returned to baseline at follow-up and the symptoms slowly improved.
{"title":"Neurological Uniqueness: A Case Study of Hepatitis A-Induced Acute Inflammatory Demyelinating Polyneuropathy","authors":"Azzaki Abubakar, Murdia Murdia, Diana Diana","doi":"10.60084/ijcr.v1i1.68","DOIUrl":"https://doi.org/10.60084/ijcr.v1i1.68","url":null,"abstract":"Acute inflammatory Demyelinating Polyneuropathy (AIDP) with hepatitis A (HA) is more likely to affect men, develop at a younger age, and have a better prognosis overall. The progression of the Hepatitis A Virus (HAV)-caused liver inflammation and the neurological difficulties could lead to AIDP in the early stages of the hepatitis signs and symptoms. The World Health Organization (WHO) estimates 1.5 million clinical HAV cases annually. Extrahepatic complications of this disease are rare. The etiology of HA associated AIDP remains unclear, with cross-reactive HA epitopes between the peripheral nervous system and other authors have hypothesized that the presence of CSF antibodies reflects direct entry into the central nervous system. Our patient presentations favored AIDP most commonly in HA. A 22-year-old man, with no prior significant medical history, presented to neurology emergency with a 3-day history of acute onset, had been complaining of nausea, general weakness, yellowing of the sclera and history of fever for 5 days. Further investigation revealed marked elevation of liver enzymes in a pattern suggestive of hepatocellular processes. Serum titres of hepatitis B, C, and E were negative, but IgM anti-HAV was positive (enzyme immunoassay). Elevation of Cerebrospinal fluid (CSF) protein and myelitis transversa shown by magnetic resonance imaging were established. The diagnosis as AIDP was taken and treated by symptomatic and neurology treatment. However, the patient regained strength and underwent physiotherapy during two weeks. Approximately 3 months after discharged, the patient's gait had nearly returned to baseline at follow-up and the symptoms slowly improved.","PeriodicalId":491119,"journal":{"name":"Indonesian Journal of Case Reports","volume":"251 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135619075","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}
Foreign body aspiration in the lower airway is prevalent among children under 5 years old and rare among adults, except in cases of neurodegenerative or neuromuscular conditions. This condition is linked to substantial morbidity, necessitating awareness of potential complications. Flexible bronchoscopy stands as a primary method for foreign body removal. We present a case of a 56-year-old male who aspirated a denture 15 years ago. Recent symptoms encompassed persistent hemoptysis, worsening over two weeks, accompanied by mucopurulent sputum, fever, chest pain, and dyspnea. Physical examination indicated shortness of breath with positive rhonchi. X-ray revealed tubular opacities and atelectasis. Two days post-admission, flexible bronchoscopy exposed moderate mucopurulent secretion in both bronchial trees, with multifocal hyperemic edematous mucosal changes in the right bronchial tree. A denture was successfully extracted from the lower left lobe during the procedure. Treatment included antibiotics, bronchodilators, and mucolytics. Flexible fiberoptic bronchoscopy's adaptability allows local anesthesia usage, reducing costs and risks. The integration of high-definition imaging in flexible bronchoscopes enhances airway visualization and foreign body localization, ensuring precise and safe removal.
{"title":"Optimal intervention: Flexible Fiberoptic Bronchoscopy’s Role in Chronic Aspiration Foreign Body Removal","authors":"Teuku Zulfikar, Syarial Akbar, Rifian Arnanda","doi":"10.60084/ijcr.v1i1.64","DOIUrl":"https://doi.org/10.60084/ijcr.v1i1.64","url":null,"abstract":"Foreign body aspiration in the lower airway is prevalent among children under 5 years old and rare among adults, except in cases of neurodegenerative or neuromuscular conditions. This condition is linked to substantial morbidity, necessitating awareness of potential complications. Flexible bronchoscopy stands as a primary method for foreign body removal. We present a case of a 56-year-old male who aspirated a denture 15 years ago. Recent symptoms encompassed persistent hemoptysis, worsening over two weeks, accompanied by mucopurulent sputum, fever, chest pain, and dyspnea. Physical examination indicated shortness of breath with positive rhonchi. X-ray revealed tubular opacities and atelectasis. Two days post-admission, flexible bronchoscopy exposed moderate mucopurulent secretion in both bronchial trees, with multifocal hyperemic edematous mucosal changes in the right bronchial tree. A denture was successfully extracted from the lower left lobe during the procedure. Treatment included antibiotics, bronchodilators, and mucolytics. Flexible fiberoptic bronchoscopy's adaptability allows local anesthesia usage, reducing costs and risks. The integration of high-definition imaging in flexible bronchoscopes enhances airway visualization and foreign body localization, ensuring precise and safe removal.","PeriodicalId":491119,"journal":{"name":"Indonesian Journal of Case Reports","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135619079","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}
A cataract is a condition characterized by clouding of the eye's lens. Senile cataracts progress through four stages: incipient, immature, mature, and hypermature. These stages are determined by the degree of lens cloudiness and the extent of lens mass involvement. In the hypermature stage, the entire lens capsule becomes wrinkled, and its contents become either solid and wrinkled or soft and liquid. An 83-year-old female patient presented to the Department of Ophthalmology at RSUD dr. Zainoel Abidin Banda Aceh with a gradual decrease in vision over the past four years. Ophthalmological examination using a slit lamp revealed cloudiness throughout the lens mass, a brownish-white lens color, wrinkling of the anterior capsule, and visible zonular dehiscence at approximately 90 degrees. The patient's left eye pressure measured 23 mmHg. A surgical plan for Intracapsular Cataract Extraction (ICCE) was made. Despite the surgery, the patient's visual function remained poor. Consequently, a second surgery for IOL insertion was scheduled six weeks after the initial procedure. The patient's visual function is anticipated to improve following the second IOL insertion surgery.
{"title":"Challenges in Hypermature Senile Cataract with Intracapsular Cataract Extraction for Wide Zonular Dehiscence: A Case Study","authors":"Eva Imelda, Raudhatul Jannah, Siti Rain Jannah, Sarra Mutiara Adev, Navneet Shamsundar Toshniwal","doi":"10.60084/ijcr.v1i1.70","DOIUrl":"https://doi.org/10.60084/ijcr.v1i1.70","url":null,"abstract":"A cataract is a condition characterized by clouding of the eye's lens. Senile cataracts progress through four stages: incipient, immature, mature, and hypermature. These stages are determined by the degree of lens cloudiness and the extent of lens mass involvement. In the hypermature stage, the entire lens capsule becomes wrinkled, and its contents become either solid and wrinkled or soft and liquid. An 83-year-old female patient presented to the Department of Ophthalmology at RSUD dr. Zainoel Abidin Banda Aceh with a gradual decrease in vision over the past four years. Ophthalmological examination using a slit lamp revealed cloudiness throughout the lens mass, a brownish-white lens color, wrinkling of the anterior capsule, and visible zonular dehiscence at approximately 90 degrees. The patient's left eye pressure measured 23 mmHg. A surgical plan for Intracapsular Cataract Extraction (ICCE) was made. Despite the surgery, the patient's visual function remained poor. Consequently, a second surgery for IOL insertion was scheduled six weeks after the initial procedure. The patient's visual function is anticipated to improve following the second IOL insertion surgery.","PeriodicalId":491119,"journal":{"name":"Indonesian Journal of Case Reports","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135876746","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}
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by production of autoantibodies that can affect multiorgan of the body, including the liver. Liver dysfunction is not part of the SLE classification criteria and rarely found compared to other organs. In patient with SLE with liver involvement signed by abnormal liver enzyme should consider whether it is SLE-associated hepatitis, known as lupus hepatitis, or cause by other entities such as drug-induced hepatitis, or a primary liver disease such as viral hepatitis and autoimmune hepatitis condition that coexisting with SLE. We are reporting a 13-year-old boy that has been diagnosed with SLE who had flare since he discontinued his medication by himself. He presented with jaundice, alopecia, oral ulcers, pale and malaise. Laboratory examination showed anemia, thrombocytopenia, elevated transaminases and bilirubin level. It is important to differentiate the cause of deranged liver function test in patient with SLE, because other entities may present similar to lupus hepatitis, but they have a different management and prognosis.
{"title":"Liver Involvement During Flare-ups in Pediatric SLE: Lupus Hepatitis vs. Other Causes","authors":"Adelia Anggraini Utama, Priyanti Kisworini, Raihan Raihan","doi":"10.60084/ijcr.v1i1.48","DOIUrl":"https://doi.org/10.60084/ijcr.v1i1.48","url":null,"abstract":"Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by production of autoantibodies that can affect multiorgan of the body, including the liver. Liver dysfunction is not part of the SLE classification criteria and rarely found compared to other organs. In patient with SLE with liver involvement signed by abnormal liver enzyme should consider whether it is SLE-associated hepatitis, known as lupus hepatitis, or cause by other entities such as drug-induced hepatitis, or a primary liver disease such as viral hepatitis and autoimmune hepatitis condition that coexisting with SLE. We are reporting a 13-year-old boy that has been diagnosed with SLE who had flare since he discontinued his medication by himself. He presented with jaundice, alopecia, oral ulcers, pale and malaise. Laboratory examination showed anemia, thrombocytopenia, elevated transaminases and bilirubin level. It is important to differentiate the cause of deranged liver function test in patient with SLE, because other entities may present similar to lupus hepatitis, but they have a different management and prognosis.","PeriodicalId":491119,"journal":{"name":"Indonesian Journal of Case Reports","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596420","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}
Erythroderma or generalized exfoliating dermatitis is an inflammatory disease characterized by erythema and thickened scales. A woman, 34 years old, was consulted with complaints of red spots accompanied by blisters and peeling skin almost all over her body for 4 days. Complaints are accompanied by itching and burning sensations. The patient had experienced complaints like this 5 months ago and had been treated at three different hospitals. Physical examination found in the facial region, thorax, superior and inferior right and left extremities, erythematous patches with diffuse borders, thick scales, erosions, and a generalized distribution. The patient's fingernails were found to have a change in shape (pitting nails). Examination of the ANA profile was negative, IgE atopy did not show an allergic reaction to a specific allergen, and histopathological examination was within normal limits. The patient was diagnosed with erythroderma based on psoriasis vulgaris. Treatment includes injection of methylprednisolone, cetirizine 10 mg tablets, and wound care with wet gauze and topical cream. After giving therapy, the patient's clinical improvement. Erythroderma occurs because of an underlying condition and cannot be prevented by itself. Erythroderma because of an underlying inflammatory skin condition usually resolves with treatment but can recur at any time. Overall, the prognosis for erythroderma depends on the underlying cause and is generally good if the underlying disease can be treated effectively.
{"title":"An Intriguing Case of Erythroderma Possibly Related to Psoriasis Vulgaris","authors":"Nanda Earlia, Menul Ayu Umborowati, Aqil Yuniawan Tasrif, Aldilla Pradistha, Mahda Rizki Liana, Mikyal Bulqiah","doi":"10.60084/ijcr.v1i1.56","DOIUrl":"https://doi.org/10.60084/ijcr.v1i1.56","url":null,"abstract":"Erythroderma or generalized exfoliating dermatitis is an inflammatory disease characterized by erythema and thickened scales. A woman, 34 years old, was consulted with complaints of red spots accompanied by blisters and peeling skin almost all over her body for 4 days. Complaints are accompanied by itching and burning sensations. The patient had experienced complaints like this 5 months ago and had been treated at three different hospitals. Physical examination found in the facial region, thorax, superior and inferior right and left extremities, erythematous patches with diffuse borders, thick scales, erosions, and a generalized distribution. The patient's fingernails were found to have a change in shape (pitting nails). Examination of the ANA profile was negative, IgE atopy did not show an allergic reaction to a specific allergen, and histopathological examination was within normal limits. The patient was diagnosed with erythroderma based on psoriasis vulgaris. Treatment includes injection of methylprednisolone, cetirizine 10 mg tablets, and wound care with wet gauze and topical cream. After giving therapy, the patient's clinical improvement. Erythroderma occurs because of an underlying condition and cannot be prevented by itself. Erythroderma because of an underlying inflammatory skin condition usually resolves with treatment but can recur at any time. Overall, the prognosis for erythroderma depends on the underlying cause and is generally good if the underlying disease can be treated effectively.","PeriodicalId":491119,"journal":{"name":"Indonesian Journal of Case Reports","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135747010","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}
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