Skip Navigation Links.
Collapse <span class="m110 colortj mt20 fontw700">Volume 12 (2024)</span>Volume 12 (2024)
Issue 3, Volume 12, 2024
Issue 2, Volume 12, 2024
Issue 1, Volume 12, 2024
Collapse <span class="m110 colortj mt20 fontw700">Volume 11 (2023)</span>Volume 11 (2023)
Issue 12, Volume 11, 2023
Issue 11, Volume 11, 2023
Issue 10, Volume 11, 2023
Issue 9, Volume 11, 2023
Issue 8, Volume 11, 2023
Issue 7, Volume 11, 2023
Issue 6, Volume 11, 2023
Issue 5, Volume 11, 2023
Issue 4, Volume 11, 2023
Issue 3, Volume 11, 2023
Issue 2, Volume 11, 2023
Issue 1, Volume 11, 2023
Collapse <span class="m110 colortj mt20 fontw700">Volume 10 (2022)</span>Volume 10 (2022)
Issue 12, Volume 10, 2022
Issue 11, Volume 10, 2022
Issue 10, Volume 10, 2022
Issue 9, Volume 10, 2022
Issue 8, Volume 10, 2022
Issue 7, Volume 10, 2022
Issue 6, Volume 10, 2022
Issue 5, Volume 10, 2022
Issue 4, Volume 10, 2022
Issue 3, Volume 10, 2022
Issue 2, Volume 10, 2022
Issue 1, Volume 10, 2022
Collapse <span class="m110 colortj mt20 fontw700">Volume 9 (2021)</span>Volume 9 (2021)
Issue 12, Volume 9, 2021
Issue 11, Volume 9, 2021
Issue 10, Volume 9, 2021
Issue 9, Volume 9, 2021
Issue 8, Volume 9, 2021
Issue 7, Volume 9, 2021
Issue 6, Volume 9, 2021
Issue 5, Volume 9, 2021
Issue 4, Volume 9, 2021
Issue 3, Volume 9, 2021
Issue 2, Volume 9, 2021
Issue 1, Volume 9, 2021
Collapse <span class="m110 colortj mt20 fontw700">Volume 8 (2020)</span>Volume 8 (2020)
Issue 12, Volume 8, 2020
Issue 11, Volume 8, 2020
Issue 10, Volume 8, 2020
Issue 9, Volume 8, 2020
Issue 8, Volume 8, 2020
Issue 7, Volume 8, 2020
Issue 6, Volume 8, 2020
Issue 5, Volume 8, 2020
Issue 4, Volume 8, 2020
Issue 3, Volume 8, 2020
Issue 2, Volume 8, 2020
Issue 1, Volume 8, 2020
Collapse <span class="m110 colortj mt20 fontw700">Volume 7 (2019)</span>Volume 7 (2019)
Issue 12, Volume 7, 2019
Issue 11, Volume 7, 2019
Issue 10, Volume 7, 2019
Issue 9, Volume 7, 2019
Issue 8, Volume 7, 2019
Issue 7, Volume 7, 2019
Issue 6, Volume 7, 2019
Issue 5, Volume 7, 2019
Issue 4, Volume 7, 2019
Issue 3, Volume 7, 2019
Issue 2, Volume 7, 2019
Issue 1, Volume 7, 2019
Collapse <span class="m110 colortj mt20 fontw700">Volume 6 (2018)</span>Volume 6 (2018)
Issue 12, Volume 6, 2018
Issue 11, Volume 6, 2018
Issue 10, Volume 6, 2018
Issue 9, Volume 6, 2018
Issue 8, Volume 6, 2018
Issue 7, Volume 6, 2018
Issue 6, Volume 6, 2018
Issue 5, Volume 6, 2018
Issue 4, Volume 6, 2018
Issue 3, Volume 6, 2018
Issue 2, Volume 6, 2018
Issue 1, Volume 6, 2018
Collapse <span class="m110 colortj mt20 fontw700">Volume 5 (2017)</span>Volume 5 (2017)
Issue 12, Volume 5, 2017
Issue 11, Volume 5, 2017
Issue 10, Volume 5, 2017
Issue 9, Volume 5, 2017
Issue 8, Volume 5, 2017
Issue 7, Volume 5, 2017
Issue 6, Volume 5, 2017
Issue 5, Volume 5, 2017
Issue 4, Volume 5, 2017
Issue 3, Volume 5, 2017
Issue 2, Volume 5, 2017
Issue 1, Volume 5, 2017
Collapse <span class="m110 colortj mt20 fontw700">Volume 4 (2016)</span>Volume 4 (2016)
Issue 12, Volume 4, 2016
Issue 11, Volume 4, 2016
Issue 10, Volume 4, 2016
Issue 9, Volume 4, 2016
Issue 8, Volume 4, 2016
Issue 7, Volume 4, 2016
Issue 6, Volume 4, 2016
Issue 5, Volume 4, 2016
Issue 4, Volume 4, 2016
Issue 3, Volume 4, 2016
Issue 2, Volume 4, 2016
Issue 1, Volume 4, 2016
Collapse <span class="m110 colortj mt20 fontw700">Volume 3 (2015)</span>Volume 3 (2015)
Issue 12, Volume 3, 2015
Issue 11, Volume 3, 2015
Issue 10, Volume 3, 2015
Issue 9, Volume 3, 2015
Issue 8, Volume 3, 2015
Issue 7, Volume 3, 2015
Issue 6, Volume 3, 2015
Issue 5, Volume 3, 2015
Issue 4, Volume 3, 2015
Issue 3, Volume 3, 2015
Issue 2, Volume 3, 2015
Issue 1, Volume 3, 2015
Collapse <span class="m110 colortj mt20 fontw700">Volume 2 (2014)</span>Volume 2 (2014)
Issue 12, Volume 2, 2014
Issue 11, Volume 2, 2014
Issue 10, Volume 2, 2014
Issue 9, Volume 2, 2014
Issue 8, Volume 2, 2014
Issue 7, Volume 2, 2014
Issue 6, Volume 2, 2014
Issue 5, Volume 2, 2014
Issue 4, Volume 2, 2014
Issue 3, Volume 2, 2014
Issue 2, Volume 2, 2014
Issue 1, Volume 2, 2014
Collapse <span class="m110 colortj mt20 fontw700">Volume 1 (2013)</span>Volume 1 (2013)
Issue 1, Volume 1, 2013

Volume 9, Issue 3

A Rare Case of Combined Rocuronium Induced Malignant Hyperthermia and Propofol-Induced Lactic Acidosis
Letter To Editor
We report an unusual case of A 64-year-old female received rocuronium and propofol and subsequently developed malignant hyperthermia and particularly propofol-related infusion syndrome.
American Journal of Medical Case Reports. 2021, 9(3), 206-207. DOI: 10.12691/ajmcr-9-3-18
Pub. Date: January 14, 2021
2371 Views7 Downloads
Ventricular Tachycardia with ST Elevation in Lead aVR Associated with Normal Coronary Arteries: A Case Report and Review of Literature
Case Report
As per the 2013 guidelines of ACCF/AHA (American College of Cardiology Foundation/ American Heart Association), ST Elevation (STE) in lead augmented vector right (aVR), along with ST depression in multiple leads, is associated with critical stenosis of left main coronary artery (LMCA), left anterior descending artery (LAD) or a triple vessel disease (TVD). Early identification of ST-Elevation Myocardial Infarction (STEMI) is important as timely reperfusion with intervention can save myocardium and improve survival. We present a case of a 70 years old female, with cardiovascular risk factors, who presented to the emergency department with chest pain decompensating with ventricular tachycardia. On cardioversion, she was found to have ST elevation in aVR with ST depression in V4-V6, I, II, and aVL. However subsequent echocardiogram and coronary angiogram showed normal coronary arteries and left ventricular function.
American Journal of Medical Case Reports. 2021, 9(3), 201-205. DOI: 10.12691/ajmcr-9-3-17
Pub. Date: January 14, 2021
3245 Views8 Downloads
Guillain-Barré Syndrome in a COVID-19 Patient: A Case Report and Review of Management Strategies
Case Report
Guillain-Barré syndrome (GBS) in an immune mediated disease that affects peripheral nerves with possible life-threatening complications. GBS has multiple subtypes including acute inflammatory demyelinating polyradiculoneuropathy (AIDP), acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN), which can make GBS difficult to diagnose. GBS commonly presents after viral infections such as influenza virus, campylobacter jejuni, and zika virus. GBS commonly presents with a prolonged clinical course leading to increased morbidity among affected patients. It is not surprising that COVID-19 has been connected with multiple cases of GBS, which may alter the recovery course for several patients post-COVID. In this report, we present a case of 69-year-old-female who presented with progressive motor weakness and loss of sensation in her extremities after testing positive for antibodies to COVID-19 one-month prior to presentation. Her presentation and treatment of GBS in the setting of COVID-19 is an example of one of the many COVID-19 complications and sheds light on the prolonged recovery course that we may experience as clinicians in the wake of this pandemic.
American Journal of Medical Case Reports. 2021, 9(3), 198-200. DOI: 10.12691/ajmcr-9-3-16
Pub. Date: January 14, 2021
2414 Views8 Downloads
NON-ST-Segment Elevation Myocardial Infarction Associated with Inadvertent Thyroid Hormone Overdose
Case Report
Thyroid hormone has a major role in cardiovascular function and cardiac hemodynamics. A slight change in thyroid affects ventricular function, serum cholesterol levels, increases the risk of coronary artery disease as well as cardiovascular mortality. In this report, we present a 62-year-old female with history significant for ischemic heart disease who was admitted for acute coronary syndrome (ACS) with persistent tachycardia, requiring urgent cardiac catheterization. Complete cardiac workup revealed that the patient had most likely suffered from vasospastic angina secondary to inadvertent overdose of her prescribed levothyroxine. This report emphasizes the significant cardiac complications caused by a deluged hyperadrenergic state secondary to overt hyperthyroidism. We conclude that thyrotoxicosis is a significant risk factor for cardiovascular disease and should be considered as a cause of life-threatening myocardial ischemia, especially in patients with known ischemic heart disease and thyroid disorders.
American Journal of Medical Case Reports. 2021, 9(3), 194-197. DOI: 10.12691/ajmcr-9-3-15
Pub. Date: January 14, 2021
3014 Views4 Downloads
Inferior ST-segment Elevation Myocardial Infarction due to a Proximal “Wrap around” Left Anterior Descending Coronary Artery Occlusion: A Case Report
Case Report
Inferior ST-segment myocardial infarction (STEMI) is often due to acute occlusion of the right coronary artery (RCA) or left circumflex artery (LCx). Anatomically, distal occlusion of a dominant left anterior descending artery (LAD) wrapping around the apex supplying posterior descending artery (PDA) can also lead to inferior wall MI. The occurrence of inferior MI with LAD occlusion is underappreciated. We are presenting a case of proximal LAD occlusion leading to inferior wall MI in the presence of non-occlusive right coronary artery (RCA). Physicians should keep in mind the possibility of inferior myocardial infarction with LAD occlusion and interventional cardiologists should perform a complete angiogram to identify the faulty lesion in inferior STEMI before deciding on a RCA or LCx as the culprit artery. Isolated IWMI (inferior wall myocardial infarction) from proximal occlusion of the wrapped around LAD as noted in our patient is a rare occurrence.
American Journal of Medical Case Reports. 2021, 9(3), 190-193. DOI: 10.12691/ajmcr-9-3-14
Pub. Date: January 14, 2021
3813 Views7 Downloads
Percutaneous Closure of Post-infarction and Iatrogenic Ventricular Septal Ruptures Using Amplatzer Occluder®: A Systematic Review
Literature Review
Ventricular septal rupture (VSR) is a rare complication of myocardial infarction (MI), open heart surgery, and cardiac-based procedures, such as septal myectomy and valve replacement. VSR is associated with high mortality rates and the reported 30-day survival rate is less than 10% without any interventional therapy. Hence, prompt diagnosis and aggressive medical treatment with appropriate surgical intervention are necessary to improve survival. Immediate surgical intervention which is the standard treatment of VSR has a mortality rate of 19-60%. Due to persistent high mortality rate and challenging management of VSR, alternatives to surgical repair has been proposed; transcatheter approach as a new alternative method has been used for the closure of post-surgery residual defects or as a bridge to surgery and in some cases as a definitive therapy instead of surgical repair. Amplatzer Occluder® (AO), a type of transcatheter closure devices, is an approved method of repairing congenital atrial septal defects and it is being used as an alternative method of treatment in VSR. In this systemic review, we assessed the cases of VSR who underwent septal repair by using AO. The study shows that the total mortality rate of percutaneous VSR repair with AO is 20% which is comparable to 19-60% rate of death in patients who undergo surgery. While early intervention is necessary to prevent biventricular dysfunction, immediate surgical intervention on soft and friable tissue surrounding the infarction increases the risk of residual shunt and reoperation. However, this study reveals that the mortality rate of primary percutaneous VSR closure within 7 days of VSR detection was 37 % which is significantly lower than 60% in surgical repair in the same period. In conclusion, given that the prevalence of residual leak in both interventions are similar and close to 20%, percutaneous VSR closure with AO device could be superior to the surgical repair as a primary intervention in unstable or high-risk surgical patients.
American Journal of Medical Case Reports. 2021, 9(3), 184-189. DOI: 10.12691/ajmcr-9-3-13
Pub. Date: January 14, 2021
2393 Views9 Downloads
Stanford Type a Aortic Dissection Presenting with Dyspnea: A Case Report
Case Report
Acute Aortic dissection is relatively uncommon but can lead to fatal outcome due to misdiagnosis and/or delay treatment [1]. In this report we present a case of a 45-year-old man presenting with chief complaint of substernal chest pain with no remarkable laboratory and echocardiography finding. He was admitted to the cardiology service with clinical suspicion of acute coronary syndrome (ACS). However, further evaluation led to the diagnosed of acute aortic dissection and referral for urgent repair. Aortic dissection could mimic other disorders such as ACS and pulmonary embolism due to variation in the presenting symptoms [1]. Therefore, high clinical suspicious could lead to timely diagnosis and initiation of life-saving therapeutic interventions.
American Journal of Medical Case Reports. 2021, 9(3), 180-183. DOI: 10.12691/ajmcr-9-3-12
Pub. Date: January 14, 2021
2921 Views2 Downloads
Marijuana and Coronary Dissection: A Case Report and Review of Literature
Original Research
Spontaneous coronary artery dissection (SCAD) is a cardiac emergency and an uncommon cause of acute coronary syndrome (ACS) with a higher predominance in younger women. It is a non-traumatic, non-atherosclerotic lesion found to be associated with pregnancy, inflammatory disorders, connective tissue diseases and substance abuse. Our patient was a young woman with a chronic marijuana smoking history who was found to have a NSTEMI. Initial angiogram showed triple vessel disease involving left anterior descending artery (LAD), left circumflex artery (LCX) and obtuse marginal artery (OM). A repeat angiogram notably showed spontaneous progression with dissection in all three vessels attributable to substance abuse. We present you this rare occurrence of triple vessel SCAD secondary to marijuana with a literature review and discussion.
American Journal of Medical Case Reports. 2021, 9(3), 172-179. DOI: 10.12691/ajmcr-9-3-11
Pub. Date: January 14, 2021
3391 Views4 Downloads
Remdesivir induced Liver Injury in a Patient with Coronavirus Disease 2019
Letter To Editor
Remdesivir, is a broad-spectrum antiviral medication that has been used recently for COVID-19 patients. Herein, we report a case of COVID-19 who developed liver injury following administration of remdesivir.
American Journal of Medical Case Reports. 2021, 9(3), 170-171. DOI: 10.12691/ajmcr-9-3-10
Pub. Date: January 13, 2021
2477 Views12 Downloads
Light Chain Cast Nephropathy in an African-American Woman with Waldenström’s Macroglobulinemia
Case Report
Waldenström's macroglobulinemia (WM) is a rare cancer of the lymphatic system due to excess IgM monoclonal protein with a rare renal involvement. We describe a case of MW presenting with acute renal failure. A 63-year-old female who was admitted to our hospital for influenza B complicated by acute renal failure during the hospital stay, with creatinine up to 6 mg/dL, despite adequate hydration. Electrophoresis revealed a monoclonal component in the gamma region, which was classified as an IgM k. A kidney biopsy was performed, showing light cast chains suggested the possibility of myeloma kidney. Furthermore, bone marrow histology was performed, revealing lymphoplasmacytic lymphoma. The patient was treated with bortezomib, dexamethasone, and cyclophosphamide, with complete recovery of renal function (creatinine 1.1 mg/dL).
American Journal of Medical Case Reports. 2021, 9(3), 167-169. DOI: 10.12691/ajmcr-9-3-9
Pub. Date: January 13, 2021
2633 Views9 Downloads
Acute Decompensated Heart Failure in a Young Patient Infected with COVID-19
Case Report
While patients with severe COVID-19 infection often have cardiovascular comorbidities, there is a paucity of literature outlining the potential of this novel coronavirus to trigger acute decompensated heart failure. To date, there is limited understanding of the pathophysiology of heart failure in COVID-19; some suggest decompensation is a result of an incident episode of myocarditis as seen with other respiratory viruses. Here we present a case of a 25 year old man with no known cardiovascular disease, who presented with acute decompensated heart failure found to have an ejection fraction of ten percent in the setting of COVID-19 infection and subsequently had multiple admissions for heart failure decompensation. An extensive work-up was performed and ruled out cardiovascular and rheumatological causes of heart failure, making COVID-19 infection a plausible etiologic factor for heart failure.
American Journal of Medical Case Reports. 2021, 9(3), 163-166. DOI: 10.12691/ajmcr-9-3-8
Pub. Date: January 13, 2021
3589 Views2 Downloads
Lemierre’s Syndrome with Severe Thrombocytopenia without Disseminated Intravascular Coagulation: A Case Report and Literature Review
Case Report
Lemierre’s syndrome (LS) is an uncommon clinical entity characterized by a primary oropharyngeal infection with subsequent septic thrombophlebitis. Diagnosis is made with clinical or radiographic evidence of internal jugular vein (IJV) thrombosis, along with metastatic focus such as lungs or joints. Life threatening thrombocytopenia in Lemierre’s syndrome in the absence of disseminated intravascular coagulation (DIC) is rarely reported. We present a case of a 41-year-old woman with Lemierre’s syndrome caused by beta-hemolytic group C streptococci and fusobacterium species manifested as worsening pharyngitis, IJV thrombosis, and complicated by severe thrombocytopenia.
American Journal of Medical Case Reports. 2021, 9(3), 158-162. DOI: 10.12691/ajmcr-9-3-7
Pub. Date: January 13, 2021
2804 Views5 Downloads
Acute Severe Thrombocytopenia Event Associated with Trimethoprim/Sulfamethoxazole Use
Case Report
Objective: To report a case of life-threatening thrombocytopenia associated with the use of trimethoprim/sulfamethoxazole (TMP/SMX) therapy. Report of the case: 50-year-old woman with no significant past medical history who presented with one day of petechial rash on her arms, chest and legs. Patient reports that she had just completed a 7- day course of TMP/SMX (1-double strength tablet twice a day) for uncomplicated UTI by her PMD. On admission, the patient was hemodynamically stable, and complete blood cell count revealed a platelet count of 2000/uL. TMP/SMX was believed to be the most likely cause of thrombocytopenia. After discontinuation of TMP/SMX and treatment with 2 units of platelets, 1gm intravenous immunoglobulin (IVIG) and oral dexamethasone, repeat CBC showed a stable platelet count of 90,000/uL. Patient was successfully discharged on hospital day 3 with outpatient follow up with the hematology clinic for further monitoring. Conclusion and Discussion: Differential diagnosis of severe thrombocytopenia include drug induced thrombocytopenia (DITP), thrombotic thrombocytopenic purpura (TTP), post transfusion purpura (PTP), immune thrombocytopenic purpura (ITP), heparin induced thrombocytopenia (HIT), or catastrophic antiphospholipid antibody syndrome (APS). Drug-dependent antibodies are an unusual class of antibodies that bind firmly to specific epitopes on platelet surface glycoproteins only in the presence of the sensitizing drugs. DITP typically has an abrupt onset of severe thrombocytopenia, usually less than 20,000/uL. Thrombocytopenia usually begins to recover within 1-2 days after the offending drug is discontinued and platelet levels usually normalize within one week as demonstrated in our case report. Pharmacological treatment can include platelet transfusions in case of severe, overt bleeding, corticosteroids or IVIG administration. In most cases, however, discontinuation of the offending drug is sufficient.
American Journal of Medical Case Reports. 2021, 9(3), 155-157. DOI: 10.12691/ajmcr-9-3-6
Pub. Date: January 13, 2021
2694 Views9 Downloads
Lacosamide Induced Bradycardia
Letter To Editor
Lacosamide (LCM)is an anti-epileptic drug associated with a serious cardiac event. Herein, we report a case of a 45-year-old male patient with lacosamide induced-bradycardia.
American Journal of Medical Case Reports. 2021, 9(3), 153-154. DOI: 10.12691/ajmcr-9-3-5
Pub. Date: January 04, 2021
3046 Views9 Downloads
A Case of Erythroplasia of Queyrat Complicated with Verrucous Carcinoma
Case Report
Erythroplasia of Queyrat is a rare squamous cell carcinoma that occurs in middle-aged, uncircumcised men, and usually involves the glans. The cause of this disease is still unclear, although it may be related to a redundant prepuce, phimosis, and human papillomavirus infection, and may develop into squamous cell carcinoma. A case of Erythroplasia of Queyrat, complicated by verrucous carcinoma, is reported in this paper.
American Journal of Medical Case Reports. 2021, 9(3), 150-152. DOI: 10.12691/ajmcr-9-3-4
Pub. Date: January 03, 2021
3480 Views3 Downloads
A Rare Presentation of COVID-19 Associated Thrombotic Thrombocytopenic Purpura; Therapeutic Challenges
Case Report
Since COVID-19 has been declared a global pandemic, variable clinical presentations have been reported, most commonly with respiratory symptoms and less commonly gastrointestinal or neurological symptoms. Hematologic disorders in the form of thrombotic microangiopathies (TMA) such as immune thrombocytopenic purpura (ITP), thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), and microangiopathic hemolytic anemia (MAHA) were also linked to the COVID-19 positive population. Many studies have proposed several possible theories, including viral-mediated, endothelial related, immune triggered, and consumptive mechanisms. In most of the literature, the severity of the disease is associated with more severe thrombocytopenia, with lower levels being associated with higher mortality. We herein report a case of a patient who tested positive for COVID-19 and went on to develop severe thrombocytopenia. Workup of the thrombocytopenia revealed that he had developed acquired Thrombotic thrombocytopenic purpura (TTP). Our case report highlights the need for early recognition, prompt diagnosis, and the subsequent initiation of urgent treatment.
American Journal of Medical Case Reports. 2021, 9(3), 147-149. DOI: 10.12691/ajmcr-9-3-3
Pub. Date: December 30, 2020
4932 Views8 Downloads
Hepatic Sclerosing Hemangioma Mimicking Malignancy: A Case and Literature Review
Case Report
Background: Sclerosing hemangiomas of the liver are rare, benign tumors with degenerative changes. These degenerative changes, however, often obscure the true, benign nature of the tumor and give them features indistinguishable from other malignant processes, thus making the diagnosis difficult. Case presentation: A 70-year-old male without any previously diagnosed liver disease or malignant process presented with incidental right hepatic mass in ultrasonography and weight loss. Physical exam was unremarkable. The labs were significant for mild pancytopenia, elevated total bilirubin and slightly decreased transferrin. Follow-up triple phase-contrast CT scan of the abdomen revealed a lobulated, poorly demarcated lesion measuring 4.8 x 4.5 cm, located in segment V of the liver with encasement of the left portal branch. The overall picture was indeterminate but highly suspicious for malignancy. A decision was made to perform a CT-guided biopsy which revealed sclerosing hemangioma of the liver. Conclusion: It is challenging to differentiate sclerosing hepatic hemangioma from atypical hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and metastatic tumors utilizing only imaging modalities. The diagnostic workup should include biopsy of the atypical liver lesion which unveils the final diagnosis and avoid subjecting the patient to an extensive, and invasive surgical resection.
American Journal of Medical Case Reports. 2021, 9(3), 144-146. DOI: 10.12691/ajmcr-9-3-2
Pub. Date: December 30, 2020
3025 Views10 Downloads
Hearing Loss with Diffuse Meningeal Enhancement: A Rare Initial Presentation of Sarcoidosis
Original Research
Background: Sarcoidosis is a systemic disease that can affect almost any organ system, with lungs being the most commonly involved. Other organ systems that may be affected include the skin, eyes, joints, heart, kidneys, or the gastrointestinal tract. Symptoms of sarcoidosis depend on the organ system involved. For instance, pulmonary involvement usually presents with cough and shortness of breath. Involvement of the joint usually presents with joint pain. Neurological manifestation, termed as neurosarcoidosis, is a relatively uncommon initial presentation of sarcoidosis. Patients with neurosarcoidosis can be asymptomatic or have multiple neurological findings such as numbness, paresthesias, hearing loss, vision changes, headaches etc. Case Report: We report a case of a young African American male who presented with hearing loss and bilateral lower extremity paresthesias. Subsequent imaging of his brain and spinal cord showed diffuse meningeal enhancement of the cerebrum, thoracolumbar spine, and cranial nerves (CN) V, VII, and VIII. Biopsy of calcified subcarinal lymph nodes seen on imaging showed non-caseating granulomas, consistent with the diagnosis of sarcoidosis. Conclusion: Neurosarcoidosis can present in many different ways, making it difficult to diagnose. There have been multiple studies that tried to find a pattern to this disease in order to make the diagnosis easier. However, no specific or sensitive findings to neurosarcoidosis could be concluded from those studies. To our knowledge, such a diffuse involvement of sarcoidosis in the nervous system has so far not been reported. Our case demonstrates yet another way neurosarcoidosis can present and the importance of keeping this diagnosis on the differential when dealing with patients presenting with similar symptoms.
American Journal of Medical Case Reports. 2021, 9(3), 140-143. DOI: 10.12691/ajmcr-9-3-1
Pub. Date: December 27, 2020
3516 Views6 Downloads