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Query: UMLS:C1762617 (
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37,932
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Fever of unknown origin (FUO) is a challenging diagnosis. Recently, 18F-fluorodeoxyglucose positron-emission tomography (FDG-PET) has emerged as an useful exam to its diagnosis. The authors present a case of a 64-years-old woman with an aortic mechanical valve that was admitted to the internal medicine department because of fever,
weakness
and weight loss of 2 months duration. Her physical examination was unremarkable. Laboratory findings showed microcytic anemia, no leukocytosis, and elevated C-reactive protein and erythrocyte sedimentation rate. Microbiology, immunology and imaging studies were normal. A
FDG
-PET was performed, which showed 18F-
FDG
uptake in aorta and its branches arterial wall. Treatment with corticosteroids was started with good response. This exam, although not sensitive for temporal arteritis when only smaller vessels are involved, permits the diagnosis of large vessel vasculitis with involvement of arteries that can not be biopsied.
...
PMID:[Large vessel vasculitis in a patient with fever of unknown origin]. 2035 Apr 72
We report a case of paraneoplastic neurological syndrome with anti-neuronal antibodies, namely anti-Hu and anti-GluR epsilon 2 antibodies in sera. A 72-year-old male had a transient history of eye movement disorder and sensory neuropathy, which improved spontaneously. Two years later, he was admitted to another hospital because of gait disturbance, numbness of the hands and an attack of unconsciousness with generalized convulsion. He was admitted to our hospital with prolonged consciousness disturbance and muscular
weakness
of all extremities. On admission his consciousness deteriorated slightly without neck stiffness. His cranial nervous system was normal except for incomplete abduction and elevation of both eyes. The patient had severe distal dominant
weakness
and atrophy in the muscles of all four limbs. Muscle tonus was decreased and hyporeflexia was noted in the four extremities. Plantar response was extensor. Neither sensory disturbance nor ataxia was observed. Cranial MRI showed T2-weighted high intensity lesions in the bilateral mesial temporal lobes, including the hippocampi. A nerve conduction study revealed motor-dominant peripheral neuropathy with prolonged latency; the amplitudes of compound muscle action potentials were severely reduced in all four limbs and those of sensory nerve action potentials were moderately reduced in the right upper and lower extremities. We also found a left hilar lymphadenopathy showing accumulation of
FDG
on PET, suggesting a possibility of malignancy. Anti-Hu and anti-GluR epsilon 2 antibodies were detected in sera but not in CSF. We diagnosed him with limbic encephalitis and peripheral neuropathy due to paraneoplastic neurological syndrome and treated him with two courses of intravenous immunoglobulin (IVIg) (400 mg/kg, 5 days). The consciousness disturbance, and prolonged distal latency revealed by motor nerve conduction studies improved slightly. Although the roles of anti-neuronal antibodies in paraneoplastic conditions remain unknown, we consider that IVIg may be worth using to treat cases with anti-Hu and anti-GluR epsilon 2 antibodies.
...
PMID:[A case of anti-Hu antibody- and anti-GluR epsilon2 antibody-positive paraneoplastic neurological syndrome presenting with limbic encephalitis and peripheral neuropathy]. 2068 Dec 63
A 74-year-old woman was admitted with muscle
weakness
and sharp pain in her upper limbs. On (18)
FDG
-PET, abnormal accumulation was noted on both sides of the brachial plexus at the cervical spinal cord. A diagnosis of primary peripheral nerve neurolymphomatosis was made based on biopsy of the third cervical nerve. Following R-CHOP therapy, the abnormal accumulation of (18)
FDG
-PET scan disappeared. However, disturbance of consciousness occurred 6 months later and recurrence as multiple brain tumors was detected. Although salvage chemotherapy was performed, the patient died of overwhelming sepsis. Primary peripheral nerve neurolymphomatosis is extremely rare. Early distinct diagnosis using (18)
FDG
-PET and combination chemotherapy of rituximab and high dose methotrexate may improve the outcome for such patients.
...
PMID:[Primary neurolymphomatosis of the cervical nerve root]. 2069 78
A 37-years old patient of south Indian origin presented with pain in his right scapular region radiating to the right arm, numbness and muscular
weakness
of the fourth and fifth finger. Computed tomography (CT) revealed a mass at the right pleural dome with arrosion of the first rib (Pancoast presentation), an osteolytic process in the fourth rib and in the right hip. All three lesions had a high
FDG
uptake in the PET/CT suggestive for lung cancer metastases in this smoker. Surprisingly, the CT-guided fine needle biopsy revealed no malignancy, but granulomatous inflammation and epitheloid cells. Microscopy for acid-fast bacilli (AFB) was negative, but the culture was positive for AFB. The HIV-negative patient received a regular antituberculous chemotherapy. His condition as well as the radiological findings improved gradually. In the majority of cases, space occupying masses in the upper sulcus are caused by non-small cell lung cancers. Extrapulmonal tuberculosis infection presenting as a Pancoast syndrome is a curiosity. However, with respect to the patients ethnical background this diagnosis should have been considered earlier.
...
PMID:[Be cautious with a prognosis!]. 2110 84
A 78-year-old man with complaints of appetite loss and weight loss visited our hospital in November 2006. Positron-emission tomography and computed tomography (PET/CT) showed swollen lymph nodes in the abdominal para-aorta, mediastinum and neck, with intense
FDG
accumulation. The pathological findings of the cervical lymph nodes revealed small-cell cancer. We diagnosed extensive small-cell lung cancer (SCLC), which occurred primarily in the left upper lobe. As subsequent CT revealed spontaneous shrinkage of the pulmonary nodule and swollen lymph nodes, the clinical course was monitored without anticancer therapy. In February 2007, progressive muscle
weakness
of the lower extremities developed. In July he was admitted with respiratory failure and required mechanical ventilation. Although we did not administer anticancer therapy due to his poor performance status, he survived for 30 months receiving mechanical ventilation, and the tumors continued to grow moderately. We diagnosed Lambert-Eaton myasthenic syndrome (LEMS) based on the clinical symptoms, the presence of anti-VGCC antibodies and waxing phenomenon on electromyography obtained in April 2009. Chemotherapy with amrubicin shrank the tumors, but his muscle
weakness
did not improve. Previous reports showed that a prognosis of SCLC with LEMS was better than that without LEMS. In this case, the tumors showed spontaneous regression without any anticancer therapy, and then increased moderately. The immune response was considered to have affected tumor growth.
...
PMID:[Long-term survival case of small-cell lung cancer with Lambert-Eaton myasthenic syndrome without anticancer therapy]. 2122 98
Epilepsia partialis continua (EPC) is clinically defined as a syndrome of continuous focal jerking of a body part, usually a distal limb, occurring over hours, days, or even years. It is considered the status epilepticus equivalent of simple partial motor seizures. A 48-year-old right-handed man with a history of traumatic intracranial hemorrhage was admitted for right-sided hemiplegia and drowsiness after complex partial status epilepticus. An EEG showed periodic lateralized epileptiform discharges over the left hemisphere. Brain MRI revealed extensive multifocal encephalomalaciac changes in the left temporo-parieto-occpital lobe and both frontal lobes with some hemorrhagic residual change. After administration of a loading dose of intravenous phenytoin, his mental status returned to normal. However, his
weakness
only partially improved. [(18)F]Fluorodeoxyglucose PET (FDG-PET) demonstrated severe hypometabolism in the left cerebral hemisphere, including the basal ganglia and thalamus, with cerebellar diaschisis. At the 3-month follow-up, he complained of symptoms of alien hand phenomenon. Follow-up MRI revealed more extensive encephalomalaciac changes in previously noted regions with thinning of the posterior end of the body of the corpus callosum. Moreover,
FDG
-PET demonstrated persistent severe hypometabolism over the left cerebral hemisphere. We suggest that the alien hand phenomenon was a result of thinning of the corpus callosum related to EPC.
...
PMID:Alien hand syndrome after epilepsia partialis continua: FDG PET and MRI studies. 2210 67
Addisonian crisis as a first manifestation of metastatic disease secondary to cancer is uncommon. We report a 63-year-old man with a history of one year of fatigue,
weakness
, weight loss and repeated symptomatic hypoglycemia. The cortisol stimulation test with ACTH confirmed primary adrenal insufficiency. While receiving adequate treatment with oral hydrocortisone, he presented an adrenal crisis that was treated properly. A CT scan of the lung demonstrated a nodule in the upper right lobe and bilateral adrenal tumors. The biopsy of the lesion revealed a lung adenocarcinoma. The staging with positron emission tomography using 18 fluoroglucose (PET/CT18F-
FDG
) showed hypermetabolic uptake in the primary lung tumor and in both adrenal glands, suggesting metastatic implants.
...
PMID:[Addisonian crisis caused by metastatic lung cancer. Report of one case]. 2221
Dermatomyositis is an inflammatory myopathy that has an association with malignancy in adults. We present a patient who initially presented with adenopathy and progressive muscular
weakness
and was diagnosed with dermatomyositis and lung carcinoma on further investigation. Whole-body PET/CT scan revealed diffuse proximal muscle hypermetabolism representing the inflammatory nature of dermatomyositis, and an intensely
FDG
-avid primary right lower lung small cell lung carcinoma and metastatic thoracic lymphadenopathy. PET/CT imaging may offer an "all-in-one" procedure as an alternative to other diagnostic procedures, reducing the number of unnecessary investigations in patients presenting with paraneoplastic syndromes searching for underlying malignancy.
...
PMID:18F-FDG PET detection of unknown primary malignancy in dermatomyositis. 2278 28
A 35-year-old man presented with right lower extremity numbness and
weakness
. CT demonstrated an irregular left parietal hypoattenuation with a punctuate calcification. MRI revealed a T1 low signal and T2 high signal lesion with extensive surrounding edema. Gadolinium-enhanced MRI showed an irregular enhancing lesion. F-
FDG
and C-methionine PET both demonstrated high uptake in the left parietal lesion. Lesion SUV was 7.5 for F-
FDG
and 3.0 for C-methionine. Surgical pathology demonstrated cerebral sparganosis.
...
PMID:Combined (11)C-methionine and 18F-FDG PET imaging in a case of cerebral sparganosis. 2315 80
A 56-year-old woman with weight loss, facial pain, and
weakness
underwent
FDG
PET/CT to detect a tumor of unknown origin. The images did not detect any lesion typical of malignancy. However, elevated
FDG
activity in several cranial and peripheral nerves was noted and suggestive of multiple neuritis. Following therapy for neuritis, the patient's symptoms improved.
...
PMID:Findings of multiple neuritis on FDG PET/CT imaging. 2324 55
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