MyMedR

Serum creatine kinase: an adjunct biochemical index of subclinical thyrotoxicosis?

Wan Nazaimoon WM, Siaw FS, Sheriff IH, Faridah I, Khalid BA

Ann. Clin. Biochem., 2001 Jan;38(Pt 1):57-8.

PMID: 11270843

Matched MeSH terms: Diagnosis, Differential

Dengue infection associated hemophagocytic syndrome: Therapeutic interventions and outcome

Wan Jamaludin WF, Periyasamy P, Wan Mat WR, Abdul Wahid SF

J Clin Virol, 2015 Aug;69:91-5.

PMID: 26209387 DOI: 10.1016/j.jcv.2015.06.004

Infection associated hemophagocytic syndrome is increasingly recognized as a potentially fatal complication of dengue fever. It should be suspected with prolonged fever beyond seven days associated with hepatosplenomegaly, hyperferritinemia, worsening cytopenias and development of multiorgan dysfunction. Surge of similar pro-inflammatory cytokines observed in dengue associated hemophagocytic syndrome and multiorgan dysfunction may indicate they are part of related inflammatory spectrum. A proportion of patients recovered with supportive therapy, however most required interventions with corticosteroids, intravenous immunoglobulin or chemotherapy. We report three cases of dengue associated IAHS with good outcome following early recognition and treatment with dexamethasone and intravenous immunoglobulin.

Matched MeSH terms: Diagnosis, Differential

Extranodal NK/T-cell lymphoma mimicking Crohn's colitis

Wan Ahmad Kammal WS, Mohd Rose I, Md Zin RR, Raja Ali RA, Masir N

Malays J Pathol, 2019 Aug;41(2):195-199.

PMID: 31427556

INTRODUCTION: Extranodal NK/T cell lymphoma is a rare tumour, typically involving the upper aerodigestive tract. Even rarer is primary extranasal disease involving the skin, testis, soft tissue and gastrointestinal tract.

CASE REPORT: We report a case of a 46-year-old Chinese male who presented with six months history of abdominal pain, weight loss and rectal bleeding. Diagnostic colonoscopy revealed multiple aphthous ulcers within the ileo-caecal region and distal transverse colon, separated by normal mucosa, mimicking skip lesions of Crohn's colitis. Computer topography (CT) scan of the abdomen showed multiple circumferential thickenings involving predominantly the right colon. A clinical diagnosis of colonic Crohn's disease with possible perforation was made. An extended right hemicolectomy was performed due to uncontrolled rectal bleeding. Histopathology examination of the colon showed infiltration by malignant lymphoid cells associated with necrosis, angiocentricity and angiodestruction. Immunohistochemical studies confirmed T-cell monoclonality, presence of cytotoxic granules and Epstein-Barr virus (EBV) infection. A diagnosis of extranodal NK/T cell lymphoma of the colon was made.

DISCUSSION: These findings highlight that colonic NK/T cell lymphoma may clinically mimic other benign inflammatory lesions and should be one of the differential diagnoses in patients presenting with gastrointestinal lesions. The final diagnosis is only possible with appropriate histological and immunohistochemical studies.

Matched MeSH terms: Diagnosis, Differential

Identification of biomarkers and genetic approaches toward chronic obstructive pulmonary disease

Wadhwa R, Aggarwal T, Malyla V, Kumar N, Gupta G, Chellappan DK, et al.

J Cell Physiol, 2019 08;234(10):16703-16723.

PMID: 30912142 DOI: 10.1002/jcp.28482

Chronic obstructive pulmonary disease accounts as the leading cause of mortality worldwide prominently affected by genetic and environmental factors. The disease is characterized by persistent coughing, breathlessness airways inflammation followed by a decrease in forced expiratory volume1 and exacerbations, which affect the quality of life. Determination of genetic, epigenetic, and oxidant biomarkers to evaluate the progression of disease has proved complicated and challenging. Approaches including exome sequencing, genome-wide association studies, linkage studies, and inheritance and segregation studies played a crucial role in the identification of genes, their pathways and variation in genes. This review highlights multiple approaches for biomarker and gene identification, which can be used for differential diagnosis along with the genome editing tools to study genes associated with the development of disease and models their function. Further, we have discussed the approaches to rectify the abnormal gene functioning of respiratory tissues and various novel gene editing techniques like Zinc finger nucleases (ZFN), transcription activator-like effector nucleases (TALEN), and clustered regulatory interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9).

Matched MeSH terms: Diagnosis, Differential

The diagnostic utility of cytokeratin 19 in differentiating malignant from benign thyroid lesions

Wa Kammal WS, Yahaya A, Shah SA, Abdullah Suhaimi SN, Mahasin M, Mustangin M, et al.

Malays J Pathol, 2019 Dec;41(3):293-301.

PMID: 31901914

INTRODUCTION: Thyroid carcinoma is classically diagnosed based on certain histological criteria. In some cases, definitive diagnoses may be challenging when morphological features are equivocal. This study evaluated the usefulness of Cytokeratin 19 (CK 19) as an immunohistochemical marker to differentiate the different histological types of malignant thyroid neoplasms, particularly papillary thyroid carcinoma (PTC) from benign thyroid lesions.

MATERIALS AND METHODS: We collected 54 malignant and 65 benign thyroid lesions diagnosed by histology in Universiti Kebangsaan Malaysia Medical Centre between January 2010 and December 2015. All cases were immunohistochemically stained with CK 19 and evaluated by 3 independent observers. The immunostaining patterns were scored based on the intensity and proportion of staining and finally graded as negative, weak positive, moderate positive or strong positive. In addition, the immunostaining scores of the malignant cases were correlated with their TNM pathological tumour stages.

RESULTS: Cytokeratin 19 staining expression was higher in malignant than benign thyroid lesions (p < 0.001) which was most prominent among classical PTC. The four PTC cases that showed negative or weak staining were all follicular variant of PTC. Benign conditions were mostly negative or showed weak positivity. There was no correlation between CK 19 expression and TNM primary tumour stage (pT).

CONCLUSION: Cytokeratin 19 is a useful marker in differentiating malignant from benign thyroid conditions particularly the classical PTC, provided its interpretation is by correlation with morphology and takes into consideration the intensity and proportion of positive staining.

Matched MeSH terms: Diagnosis, Differential

Fulltext Transmission potential of Wuchereria bancrofti by Culex quinquefasciatus in urban areas of Malaysia

Vythilingam I, Tan CH, Nazni WA

Trop Biomed, 2005 Jun;22(1):83-5.

PMID: 16880760 MyJurnal

Laboratory strain of the Malaysian Culex quinquefasciatus was susceptible to Wuchereria bancrofti. Thirty three percent of the Cx. quinquefasciatus that fed on W. bancrofti patient were infective after 12-14 days. There is a possibility for W. bancrofti to occur in the urban areas of the Malaysia in the near future.

Matched MeSH terms: Diagnosis, Differential

Fulltext Central nervous system Erdheim Chester disease presenting with raised intracranial pressure and cerebellar signs mimicking neurosarcoidosis with secondary cerebral venous thrombosis

Viswanathan S, Kadir NA, Lip AC, Rafia MH

Neurol India, 2014 Jul-Aug;62(4):446-8.

PMID: 25237960 DOI: 10.4103/0028-3886.141250

Matched MeSH terms: Diagnosis, Differential

Acute disseminated encephalomyelitis complicating dengue infection with neuroimaging mimicking multiple sclerosis: A report of two cases

Viswanathan S, Botross N, Rusli BN, Riad A

Mult Scler Relat Disord, 2016 Nov;10:112-115.

PMID: 27919476 DOI: 10.1016/j.msard.2016.10.001

Acute disseminated encephalomyelitis (ADEM) complicating dengue infection is still exceedingly rare even in endemic countries such as Malaysia. Here we report two such cases, the first in an elderly female patient and the second in a young man. Both presented with encephalopathy, brainstem involvement and worsening upper and lower limb weakness. Initial magnetic resonance imaging (MRI) of the brain was normal in the first case. Serum for dengue Ig M and NS-1 was positive in both cases. Cerebrospinal fluid (CSF) showed pleocytosis in both with Dengue IgM and NS-1 positive in the second case but not done in the first. MRI brain showed changes of perpendicular subcortical palisading white matter, callosal and brainstem disease mimicking multiple sclerosis (MS) in both patients though in the former case there was a lag between the onset of clinical symptoms and MRI changes which was only clarified on reimaging. The temporal evolution and duration of the clinical symptoms, CSF changes and neuroimaging were more suggestive of Dengue ADEM rather than an encephalitis though initially the first case began as dengue encephalitis. Furthermore in dengue encephalitis neuroimaging is usually normal or rarely edema, haemorrhage, brainstem, thalamic or focal lesions are seen. Therefore, early recognition of ADEM as a sequelae of dengue infection with neuroimaging mimicking MS and repeat imaging helped in identifying these two cases. Treatment with intravenous steroids followed by maintenance oral steroids produced good outcome in both patients.

Matched MeSH terms: Diagnosis, Differential

Fulltext Pneumonia presenting as acute abdomen in children: a report of three cases

Vendargon S, Wong PS, Tan KK

Med J Malaysia, 2000 Dec;55(4):520-3.

PMID: 11221169

From 10th September 1998 till 5th June 1999, the Paediatric and Cardiothoracic Surgery Units of Sultanah Aminah Hospital Johor Bahru managed three children with lung collapse secondary to pneumonia. The dominant initial clinical presentation in all three cases was acute abdominal pain. Basal pneumonia was diagnosed in two cases post-operatively after surgical contributory causes were excluded intra-operatively. Thoracotomy, evacuation of infected debris and decortication of the collapsed lung was done in all three cases. In children presenting with acute abdominal pain, basal pneumonia should be considered as a possible contributory cause.

Matched MeSH terms: Diagnosis, Differential

Fulltext A rare case of middle mediastinal thymoma mimicking left lower lobe lung tumor

Venayaga K, Ooi JSM, Shabir B

Med J Malaysia, 2005 Oct;60(4):508-10.

PMID: 16570719

Matched MeSH terms: Diagnosis, Differential

Fulltext Compensated polarised microscopy: a simple and cheap modification

Veerapen K, Ch'ng SL

Med J Malaysia, 1987 Sep;42(3):217-8.

PMID: 3509837

Matched MeSH terms: Diagnosis, Differential

Fulltext Painful Lytic Lesions of the Foot: A Case Report

Vaishya R, Vijay V, Ghogare P, Vaish A

Malays Orthop J, 2015 Mar;9(1):35-37.

PMID: 28435595 DOI: 10.5704/MOJ.1503.005

The presence of lytic lesions in the bones of foot raises a number of diagnostic possibilities ranging from infection, inflammatory pathology to neoplastic conditions. Although the radiological picture is not pathognomonic of any pathology, clinical history and histopathological examination can help to clinch the diagnosis. We present a case of multiple lytic lesions of the foot and discuss possible differential diagnoses. The patient was diagnosed as a case of madura foot and the lesions responded to surgical debridement and anti-fungal treatment with a good functional outcome. Madura foot is an uncommon, chronic granulomatous fungal or bacterial infection with a predilection in people who walk barefoot. Although known for a specific geographical distribution, madura foot should be kept as a possible diagnosis in patients presenting with lytic lesions of the foot due to population emigration across the world.

Matched MeSH terms: Diagnosis, Differential

Fulltext Masquerade syndrome: an ocular involvement of lung cancer

Umi Kalthum, M. N., Wan Haslina Wah

Medicine & Health, 2013;8(1):47-51.

MyJurnal

We report a case of a 37-year-old smoker who presented with painless and sudden onset of loss of upper field vision of the right eye, associated with one month history of dry cough which was unresponsive to antibiotic and subsequent anti- tuberculosis therapy. Visual acuity at presentation was counting finger. There was bullous retinal detachment on examination. Radiological imaging revealed multiple lung opacities, involving the brain and the right orbit. Bronchoscopy and biopsy confirmed the diagnosis of adenocarcinoma of the lung. This case illustrates masquerade syndrome of which a lung carcinoma harbours behind a seemingly innocent retinal detachment. It also highlights the importance of entertaining lung carcinoma as a differential diagnosis in suspected tuberculosis among heavy smokers.

Matched MeSH terms: Diagnosis, Differential

Fulltext Agenesis of the gall bladder with duplication cysts of the hepatic flexure--a case report and literature review

Toufeeq Khan TF, Baqai FU

Singapore Med J, 1993 Apr;34(2):181-2.

PMID: 8266167

A 24-year-old lady with recurrent upper abdominal pain, underwent surgery for cholelithiasis based on imaging diagnosis by ultrasound scanning. At laparotomy, the gall bladder could not be found either in its normal or ectopic locations. The diagnosis of agenesis of the gall bladder was confirmed by operative cholangiography. Duplication cysts of the hepatic flexure were discovered in the position normally occupied by the gall bladder. The stony hard faeces in the cysts were probably interpreted as gallstones on ultrasound. This rare condition is discussed and the importance of intraoperative cholangiography is stressed.

Matched MeSH terms: Diagnosis, Differential

Fulltext Addison's disease presenting with hyperpigmentation

Tong CV, Ooi XY

BMJ Case Rep, 2021 Aug 17;14(8).

PMID: 34404673 DOI: 10.1136/bcr-2021-245610

Matched MeSH terms: Diagnosis, Differential

SPTAN1 encephalopathy: distinct phenotypes and genotypes

Tohyama J, Nakashima M, Nabatame S, Gaik-Siew C, Miyata R, Rener-Primec Z, et al.

J Hum Genet, 2015 Apr;60(4):167-73.

PMID: 25631096 DOI: 10.1038/jhg.2015.5

Recent progress in genetic analysis reveals that a significant proportion of cryptogenic epileptic encephalopathies are single-gene disorders. Mutations in numerous genes for early-onset epileptic encephalopathies have been rapidly identified, including in SPTAN1, which encodes α-II spectrin. The aim of this review is to delineate SPTAN1 encephalopathy as a distinct clinical syndrome. To date, a total of seven epileptic patients with four different in-frame SPTAN1 mutations have been identified. The major clinical features of SPTAN1 mutations include epileptic encephalopathy with hypsarrhythmia, no visual attention, acquired microcephaly, spastic quadriplegia and severe intellectual disability. Brainstem and cerebellar atrophy and cerebral hypomyelination, as observed by magnetic resonance imaging, are specific hallmarks of this condition. A milder variant is characterized by generalized epilepsy with pontocerebellar atrophy. Only in-frame SPTAN1 mutations in the last two spectrin repeats in the C-terminal region lead to dominant negative effects and these specific phenotypes. The last two spectrin repeats are required for α/β spectrin heterodimer associations and the mutations can alter heterodimer formation between the two spectrins. From these data we suggest that SPTAN1 encephalopathy is a distinct clinical syndrome owing to specific SPTAN1 mutations. It is important that this syndrome is recognized by pediatric neurologists to enable proper diagnostic work-up for patients.

Matched MeSH terms: Diagnosis, Differential

Fulltext A young woman with hypogonadism, hypertension and hypokalaemia

Toh VK, Yung CH

Med J Malaysia, 2009 Sep;64(3):242-3.

PMID: 20527279 MyJurnal

We report a case of a 16 years old girl who presented sequentially with primary amenorrhoea, hypertension and hypokalaemia. Eight years later, she was finally diagnosed with 17alpha-hydroxylase deficiency congenital adrenal hyperplasia. Previous antihypertensive medications were stopped. Hydrocortisone alone successfully maintained normotension and normokalaemia.

Matched MeSH terms: Diagnosis, Differential

Fulltext Vertebrae Destruction with Cauda Equina Syndrome Secondary to Spinal Gouty Arthritis: A Case Report

Thuraikumar K, Wan KL, Ong KL, Lim SW

Malays Orthop J, 2020 Jul;14(2):141-144.

PMID: 32983391 DOI: 10.5704/MOJ.2007.024

Gouty arthritis commonly affects peripheral joints and is associated with hyperuricaemia. Spinal manifestations of gouty arthritis are not common, and majority of published articles worldwide were case reports. This is a case report of spinal gouty arthritis that presented with spinal vertebrae destruction and cauda equina syndrome. The magnetic resonance imaging (MRI) showed destruction of L5/S1end plates with cystic collection mimicking infective changes. The tissue histological examination confirmed presence of urate crystal needles that displayed negative double refraction on light microscopy. Spinal gouty arthritis is part of the differential diagnoses in gouty arthritis patients.

Matched MeSH terms: Diagnosis, Differential

Fulltext Benign Lymphoepithelial Cyst: An Unusual Cause of Parotid Swelling in Two Immunocompetent Patients

Thong HK, Athar PPSH, Mustaffa WMW

Open Access Maced J Med Sci, 2019 Jul 15;7(13):2142-2145.

PMID: 31456841 DOI: 10.3889/oamjms.2019.577

BACKGROUND: Lymphoepithelial cysts, which are benign and slow-growing tumours, usually involve the head and neck regions. Benign lymphoepithelial cysts (BLECs) are the most common cause of parotid swelling in human immunodeficiency virus (HIV)-positive patients and are less common in immunocompetent patients.

CASE PRESENTATION: Here, we present two cases of immunocompetent patients with long-standing, progressively enlarging parotid swelling. Postoperative histopathological examination of these patients revealed features of BLEC.

CONCLUSION: Wide surgical excision is the gold standard for treatment and recurrences is rare. These cases are of particular interest because of the rarity of BLEC in HIV-negative patients and highlight an important differential diagnosis of parotid swelling.

Matched MeSH terms: Diagnosis, Differential

A Challenge in Diagnosis and Management: Uterine Torsion in Childhood

Thever Ramasamy V, Sivapatham L, Grover SR, Shanmugam SS, Ganesalingam M

J Pediatr Adolesc Gynecol, 2021 Feb;34(1):61-64.

PMID: 33010465 DOI: 10.1016/j.jpag.2020.09.003

BACKGROUND: Uterine torsion is a rare event, which mostly reported in females with a gravid uterus and is exceptionally rare in children.

CASE: A 9-year-old girl presented with 3 days of intermittent lower abdominal pain. Ultrasound revealed an ovarian mass, but laparotomy revealed an ischemic enlarged ovary and uterus rotated 180°. No reperfusion occurred after 60 minutes. A subtotal hysterectomy and right salpingoophorectomy were thus performed.

CONCLUSION: Uterine and adnexal torsion presents with symptoms similar to those of adnexal torsion. Delays in diagnosis and referral continue to be an issue, resulting in suboptimal outcomes. Uterine torsion, although exceedingly rare in childhood, appears to occur only in the setting of ovarian masses, which provide the impetus for the rotational force to the elongated cervix of the prepubertal uterus.

Matched MeSH terms: Diagnosis, Differential

Displaying publications 61 - 80 of 808 in total