Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Known as systemic sclerosis (SSc), this autoimmune rheumatic disease has vast pathogenesis on many organs, including kidneys. It can lead to the point where the patient's survival relies entirely on dialysis. This report has basically focused on scleroderma renal crisis (SRC), which is the most serious renal manifestation of SSc, characterized by renal failure and sudden onset of hypertension. A 44-year-old man was hospitalized with hypertension, headache, vertigo, nausea, rhinorrhea, reflux, dysphagia, dyspnea (Fc II), visual impairment, mechanical arthralgia, and edema (+3) accompanied by a rare skin lesion. Raynaud's phenomenon was also remarkable in fingers and toes. According to signs and symptoms, SSc diagnosed and the proper treatment was applied. It is of great importance that in the case of malignant hypertension in patients with scleroderma, renal crisis always be kept in mind.
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PMID:Systemic Sclerosis with Focus on Scleroderma Renal Crisis. 3120 94

Amyloid goiter (AG) is characterized by the presence of deposits of amyloid protein in the thyroid tissue in sufficient amounts to produce enlargement of the gland, accompanied by fat deposition or thyrolipomatosis. It can be seen in long-standing inflammatory disorders, with the common characteristic of amyloidotic renal failure. In daily practice, practitioners should pay attention to the differential diagnosis in patients with suggestive co-morbidities for amyloidosis. The clinic is a progressive increase of the thyroid gland with compressive symptomatology (dyspnea, dysphagia, and changes in the voice). The main imaging finding is diffuse fatty infiltration of the thyroid. The amyloid goitre was most probably in the general context of amyloidosis, regardless of the other complications. We present a case of a 48-years-old female with amyloid goiter secondary to rheumatoid arthritis and renal failure.
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PMID:An Unusual Amyloid Goiter in a 48-Year-Old Woman with Rheumatoid Arthritis, Secondary Amyloidosis and Renal Failure. 3195 49

Purpose: Radioactive iodine therapy with 131I is standard of care for treatment for many patients with differentiated thyroid cancer. Typically, 131I is administered as a pill, and much of its radioactivity gets excreted via the urine. This can present challenges in patients who are unable to swallow pills, absorb iodine via the gastrointestinal tract, or eliminate radioiodine via the urine (i.e. dialysis patients and patients with renal failure). In this case series, we present three cases in which the standard 131I treatment protocol for thyroid cancer could not be executed due to these challenges, and discuss the strategies to overcome these challenges. Results: Case 1 was a 4-year-old male with Noonan syndrome, dysphagia, and metastatic papillary thyroid cancer. He was unable to swallow the standard 131I pill due to the dysphagia. After a multi-disciplinary discussion between healthcare staff, a joint decision was made to proceed with liquid 131I therapy. The system, which was used to orally administer 75 mCi (2775 MBq) of Na131I in a liquid form, involved a vial provided to allow for mixing in grape juice. Case 2 was a 45 year-old male patient with significant scleroderma, severe gastric motility disorder, and papillary thyroid carcinoma. His severe gastric motility and malabsorption disorder precluded oral treatment due to risks of vomiting. Per discussions and collaborations with the patient's gastroenterologist, the decision was made to proceed with intravenous 131I therapy, which was successfully performed after approval from the Radiological Health Branch of California. Case 3 was a 59 year-old male patient on hemodialysis with diabetes, hypertension, and follicular thyroid cancer. The challenge, in addition to waste disposal and dosimetry, was ensuring radiation protection for everyone present, given the risks of occupational exposures from radioactive iodine contaminating the dialysis machine. The radiation safety team monitored all healthcare workers and equipment involved, as per a joint decision by healthcare providers. Additionally, the planned dose was reduced from 50 mCi (1850 MBq) to 30 mCi (1110 MBq). None of the cases reported further disease progression since 131I treatment. Conclusion: These cases highlight unique challenges that can be encountered during radioactive iodine administration and approaches that can overcome these challenges. We conclude that provider collaboration and treatment customization are critical to overcome patient-specific challenges.
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PMID:Management of challenging radioiodine treatment protocols: a case series and review of the literature. 3321 59


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