by Damilola A. Jesuyajolu, Abdulhafeez Mohammed, Charles Okeke and Armstrong Nicholas
Case Report
Not much has been reported about Idiopathic Postprandial syndrome, especially in Africa. Many cases are often wrongly diagnosed as reactive hypoglycemia. Idiopathic postprandial syndrome refers to signs and symptoms of hypoglycemia in the absence of low blood sugar occurring after meals and is of unknown cause. We report a case of Idiopathic Postprandial Syndrome in a 44-year old woman living in Nigeria. We present a 44-year-old woman who has been having recurrent hypoglycemic symptoms, which include dizziness, body weakness, lightheadedness, restlessness, headaches, and fatigue after she eats a meal (Post-prandial) for a year. Blood glucose is normal during episodes, and extensive examinations and investigations yielded no other cause. Idiopathic postprandial syndrome (IPS) is a condition in which an individual experiences symptoms of hypoglycemia without having biochemical evidence. The major difference between idiopathic postprandial syndrome (IPS) and hypoglycemia is that IPS may present with only symptoms of low blood sugar without the other components of Whipple’s triad. These symptoms usually occur within a few hours of eating and the exact cause is not known. Managing the possible identified triggers, dietary modification and the use of alpha-glucosidase inhibitors have been seen to improve the condition. Much work still needs to be done to identify the exact etiology of the syndrome.
American Journal of Medical Case Reports. 2022, 10(2), 42-44. DOI: 10.12691/ajmcr-10-2-6
Pub. Date: February 11, 2022
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by Luis M. Nieto, Sharon Narvaez, Sanskriti Sharma and Luther Burse
Case Report
A 49-year-old African American male with history of diverticulitis presented to the ED with abdominal pain and feculent discharge from the umbilicus. CT scan of the abdomen showed a fistulous tract from the sigmoid colon to the umbilicus. Labs revealed a markedly elevated fecal calprotectin level and colonoscopy demonstrated friable-appearing mucosa of the sigmoid colon. Segmental colitis associated with diverticulosis (SCAD) refers to a chronic, localized, nongranulomatous inflammation, usually in the sigmoid colon. SCAD spares the rectum and the proximal colon endoscopically and histologically. We present a case of diverticular disease associated with an unusual fistula and features of SCAD.
American Journal of Medical Case Reports. 2022, 10(2), 39-41. DOI: 10.12691/ajmcr-10-2-5
Pub. Date: January 25, 2022
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by Takeshi Koga, Moe Yoshimura, Sakiko Kubo, Miki Nagai, Katsuhiko Tabata, Hiromi Teranishi, Misato Fujino, Hiroshi Kawana, Ikuma Musha and Yuko Akioka
Case Report
Our case report presents a young patient vaccinated for coronavirus disease 2019 (COVID-19) who developed multisystem inflammatory syndrome in children (MIS-C), which was later confirmed to be multisystem inflammatory syndrome after vaccination (MIS-V). 15-year-old boy previously infected by COVID-19 who received the first dose of COVID-19 vaccine 50 days later and developed fever, lethargy, headache, diarrhea, nausea, lip swelling, neck pain, and dysphagia. Contrast-enhanced computed tomography revealed a low absorption area with no contrast effect was observed in the posterior pharyngeal gap suggesting retropharyngeal phlegmon. He was diagnosed to be MIS-V level 2 based on the Brighton Collaboration Case Definition and improved by Intravenous immunoglobulin (IVIG). The frequency of neck symptoms in MIS-V is higher than in other febrile diseases, and many cases of retropharyngeal phlegmon are observed. In addition, pediatric COVID-19 is mostly asymptomatic or mild; therefore, it is predicted that children who are unaware of their history of COVID-19 before vaccination are not rare. Therefore, after vaccination, extra care should be required to development of MIS-V in children.
American Journal of Medical Case Reports. 2022, 10(2), 35-38. DOI: 10.12691/ajmcr-10-2-4
Pub. Date: January 23, 2022
3345 Views3 Downloads
by Adegoke Oluwakemi T, Bamigboye-Taiwo Olukemi T, Afeniforo Olufunke G, Okeniyi John A, Omotoye Babatunde S, Olorunmoteni Oluwatosin E and Adegoke Adedokun I
Case Report
COVID-19 is a disease which originated in China in 2019 and has rapidly spread to become a pandemic. COVID-19 is less common in children and young adults and cases among this group of individuals are usually not as severe as in the elderly, the immunocompromised or those with co-morbidities. Research of COVID-19 in children is not as robust as in adults probably due to the aforementioned reason. We report four cases of COVID-19 in children who had mild to severe disease course. These children had other co-morbid illnesses such as malaria, bacterial sepsis and rheumatic heart disease. Two of these children had rarer severe complications of the disease hardly reported in children, these were; pleural effusion and cholestatic liver disease. It may be important to screen every child that requires hospital admission for COVID-19 in order to make early diagnosis of the disease and to commence appropriate therapy where necessary. This may forestall development of complications including death in such children.
American Journal of Medical Case Reports. 2022, 10(2), 29-34. DOI: 10.12691/ajmcr-10-2-3
Pub. Date: January 23, 2022
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by Sepehr Sadafi, Farhad Amirian, Seyed Hamid Madani and Mazaher Ramezani
Case Report
Primary pancreatic lymphoma (PPL) is a very rare malignancy. The diagnosis of PPL is challenging because of similar manifestations to pancreatic adenocarcinoma or other diseases of the pancreas. It is mainly seen in men and the 5th or 6th decades of life. Here we report a 60-year-old lady with pancreatic mass, presented with abdominal pain, weight loss, and GI disturbance. An abdominal CT scan showed a homogenous mass, measured 60mm, in the lesser sac with the probable origin of the pancreatic body and a mass-like lesion on the head of the pancreas. Endoscopic ultrasound-assisted fine needle aspiration (EUS-FNA) was done and cell block was prepared for histopathology and immunohistochemistry evaluation. The final diagnosis of Large B cell lymphoma was made. The patient received an R-CHOP chemotherapy regimen with a good therapeutic response. Accurate diagnosis is important, due to response to chemotherapy and avoidance of unnecessary radical surgery.
American Journal of Medical Case Reports. 2022, 10(2), 26-28. DOI: 10.12691/ajmcr-10-2-2
Pub. Date: January 20, 2022
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by Carlos E. Gonzalez, Luis A. Gonzalez, Luis A. Cesenas and Olga G. Cantu
Case Report
Thrombotic Microangiopathy (TMA) has been described as a rare paraneoplastic syndrome. We present a patient with Coombs-negative hemolytic anemia and schistocytes in a peripheral blood smear, fulfilling diagnosis criteria for TMA. After patients death, an autopsy report revealed bone infiltrating signet ring cell carcinoma, identifying the lung as the primary tumor origin.
American Journal of Medical Case Reports. 2022, 10(2), 22-25. DOI: 10.12691/ajmcr-10-2-1
Pub. Date: January 11, 2022
3262 Views2 Downloads