Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An 18-year-old girl was diagnosed as "bronchiectasis" for hemoptysis and treated by using embolization intervention 19 months ago. Two months ago she was diagnosed as iron-deficiency anaemia for fatigue. Eight days ago she was diagnosed again as hypertension for headache, anxiety, frowsty, nausea, vomiting and blood pressure 180/70 mmHg. In order to know the etiology of hypertension she was sent to our hospital. Vascular murmur was heard in bilateral carotid, subclavian and the back. 4 / 6 pan systolic murmur and stronger heart sound were heard in each valve auscultation area. Bilateral radial artery pulsations were symmetrical, but bilateral femoral, popliteal and dorsal arteries of foot were weakened. The results of hemoglobin (HB), globulin, creaction protein (CRP) and erythrocyte sedimentation rate (ESR) were abnormal. Thicker wall and narrower lumen in decreasing aorta were found by aorta CTA scanning. The aorta arteritist was clearly diagnosed and treated by hormone until ESR returned to normal. Finally, artificial vascular was replaced successfully by surgery. Now the patient is fine and has already been working for a year. This case gives us the inspiration: A detailed examination to patient is very important, which avoid missed diagnosis or misdiagnosis and missed the best opportunity for treatment.
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PMID:Aortic Isthmus Arteritis: Report of One Case. 2835

BACKGROUND Myasthenia gravis (MG) is an autoimmune disease characterized by antibodies binding skeletal muscle acetylcholine receptors (AChR). Rarely does the disease manifest with orolaryngeal symptoms before ocular ones. We present a case of MG that on initial presentation had symptoms of cranial nerves (CN) IX and X weakness, including dysphagia and dysphonia. CASE REPORT A 51-year-old woman with panic attacks presented to the Emergency Department (ED) with complaints of her throat closing, swallowing difficulty, and hoarse voice. Multiple ED visits revealed no etiology. However, she developed stridor, which prompted further evaluation. Laryngoscopy and imaging studies revealed no gross abnormalities; therefore, her symptoms of dysphonia and difficulty breathing were attributed to anxiety. Her hospital course was complicated by a cardiac arrest requiring intubation. ECHO, CTA chest, and MRI brain were unremarkable. Her cardiac arrest was hypothesized as being secondary to laryngeal spasm. During her ICU course, she failed extubation multiple times due to acute respiratory failure. An autoimmune etiology was suspected, prompting a paraneoplastic screen, which revealed elevated levels of AChR antibodies at 124 mmol/L. MG was diagnosed and treatment with plasmapheresis and steroids was initiated. However, complications of thrombocytopenia, anemia, and ARDS ensued, so MG treatment was discontinued. The patient was eventually transferred to a LTACH. Thereafter, at outpatient followup, her MG was treated with mycophenolate and prednisone, which led to significant symptom improvement. CONCLUSIONS MG commonly presents in the third decade with clinical features of ptosis, diplopia, and facial weakness. However, initial and isolated symptoms of dysphagia and dysphonia are rare, leading to missed diagnoses. Our case of a middle-aged woman posed a diagnostic challenge because of her uncommon presentation and comorbidities of panic attacks and obesity. This case highlights the crucial need for a high index of clinical suspicion for MG in any patient presenting with symptoms of CN IX and X weakness.
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PMID:Cranial Nerve IX and X Weakness: An Unusual Initial Presentation of Myasthenia Gravis. 3277 33