COVID‐19 was found in a patient's cerebrospinal fluid who presented with a severe form of Guillain‐Barre syndrome; A successful Sudanese story: Case report

COVID‐19 is a mysterious disease presented in different ways, so we have to deal with each patient nowadays thoroughly, including COVID‐19 testing as routine test. The Case report discusses the rare finding of COVID‐19 in CSF of GBS patient.     

Stevens‐Johnson Syndrome due to COVID‐19 vaccination

As public COVID‐19 vaccination programs are being implemented, it is possible that more rare and serious adverse effects such as Stevens‐Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) may occur.     

Successful ruxolitinib administration for a patient with steroid‐refractory idiopathic pneumonia syndrome following hematopoietic stem cell transplantation: A case report and literature review

Idiopathic pneumonia syndrome (IPS) is an acute lung complication observed after the early posthematopoietic stem cell transplantation (HSCT) period. Ruxolitinib was effective for a patient with myelodysplastic syndrome who developed severe IPS after second HSCT. No severe adverse effects were observed. Ruxolitinib may be an alternative choice for HSCT‐related IPS.     

COVID‐19 vaccine causing Guillain‐Barre syndrome,a rare potential side effect

Patients with neurological symptoms should be enquired about recent vaccination history. It is important after the COVID‐19 mRNA vaccine, which is newly introduced as it might link to the development of a wider variety of neurological diseases.     

A 1‐year and 4‐month‐old child with mucopolysaccharidoses type II: A clinical case report from Ethiopia

Mucopolysaccharidoses (MPSs) are a class of lysosomal storage disorders resulting in progressive disease manifestations and are caused by pathogenic variants in genes coding for enzymes needed to degrade glycosaminoglycans. While most of the seven MPSs are autosomal recessive disorders, MPS II, also known as Hunter syndrome, is inherited in an X‐linked recessive manner and is the most common MPS. Here, we report a 1‐year and 4‐month‐old boy who presented with delayed developmental milestones, back deformity, and left scrotal swelling noticed by parents at one year of age. He has coarse facial appearance with macrocephaly, widened wrists, congenital dermal melanocytosis on his back, kyphotic deformity in the thoracolumbar area and left‐sided inguinal hernia all consistent with a suspected MPS II diagnosis. The MPS II diagnosis was subsequently confirmed with genetic testing of the IDS gene. To our knowledge, this is the first case of MPS II reported from Ethiopia. This case shows the importance of early clinical recognition of genetic conditions and the utility of genetic testing for confirmation. The diagnosis provided important surveillance and natural history information for the patient''s providers and family.     

Anticoagulated de novo atrial flutter complicated by transitory ischemic attack in fatal COVID‐19

SARS‐CoV‐2 may not only manifest as pneumonia (COVID‐19) but also in other organs, including the brain (neuro‐COVID). One of the cerebral complications of SARS‐CoV‐2 is ischemic stroke. Transitory ischemic attack (TIA) in a SARS‐CoV‐2 positive has not been reported. A 78‐year‐old poly‐morbid male (diabetes, hypertension, and coronary heart disease), admitted for COVID‐19, developed atrial flutter on hospital day (hd) 2. Anticoagulation with enoxaparin was started. On hd5, he experienced a TIA despite sufficient anticoagulation. The patient expired on hd28 due to multi‐organ failure from sepsis due to superinfection with staphylococcus aureus. Infection with SARS‐CoV‐2 may be complicated by atrial flutter. Atrial flutter may be complicated by TIA despite sufficient anticoagulation, suggesting that standard anticoagulation may be insufficient to meet SARS‐CoV‐2‐associated hypercoagulability syndrome. Forced anticoagulation and adequate antibiosis in poly‐morbid SARS‐CoV‐2‐infected patients with hypercoagulability and cytokine storm are warranted.     

Novel splicing‐site mutation in DCAF17 gene causing Woodhouse‐Sakati syndrome in a large consanguineous family

BackgroundWoodhouse‐Sakati syndrome is a rare autosomal recessive disease with endocrine and neuroectodermal aberrations with heterogeneous phenotypes and disease course. The most common phenotypes of the disease are progressive sensorineural hearing loss and alopecia, mild‐to‐moderate mental retardation and hypogonadism. The disease results from mutations in the DCAF17 gene.MethodHere, we reported a large consanguineous pedigree with multiple affected individuals with Woodhouse‐Sakati syndrome phenotypes. Laboratory tests confirmed the endocrine perturbance in affected individuals. To find out the underlying genetic change, whole‐exome sequencing was carried out.ResultAnalysis of the exome data identified a splicing‐site deletion {"type":"entrez-nucleotide","attrs":{"text":"NM_025000.3","term_id":"259906387","term_text":"NM_025000.3"}}NM_025000.3:c.1423‐1_1425delGACA in DCAF17 gene. Sanger sequencing confirmed the co‐segregation of the variant with the disease phenotypes in the family.ConclusionThe variant is predicted to cause aberrant splicing, i.e., exon skipping, resulting in the translation of a truncated functionless protein which results in appearance of typical phenotypic features and clinical laboratory findings of Woodhouse‐Sakati syndrome in affected members of the family.     

Guillain‐Barré syndrome associated with inappropriate secretion of antidiuretic hormone following SARS‐CoV‐2 infection: A case‐report

In a system already preconditioned by previous damage, as results of the cytokine release syndrome complicating the COVID‐19 disease, a small trigger may be sufficient to develop a SIADH complicating a GBS, even without a poor outcome.     

Ruled out of preeclampsia‐like syndrome due to COVID‐19: A case study

Coronavirus disease (COVID‐19) is an infectious disease. In this study, we report a 28‐year‐old pregnant woman who had a postpartum seizure with a background of HELLP syndrome and a proven COVID‐19 infection. Her child survived, and at 12‐week postpartum, all maternal COVID‐19–related symptoms vanished, and she was cured.     

Beckwith‐Wiedemann syndrome with macroglossia as the most significant manifestation: A case report

Beckwith‐Wiedemann syndrome is a complex multisystem disorder that requires collaboration of medical and dental teamfor its diagnosis and management. We present a dental overview and an update of the clinical and molecular diagnoses of Beckwith‐Wiedemann syndrome and its management with emphasis on macroglossia.     

A case of paroxysmal complete atrioventricular block in a COVID‐19 patient

Many types of cardiac arrhythmias can occur in people with COVID‐19, and these arrhythmias can affect the patient''s outcomes. We have experienced paroxysmal complete atrioventricular block in a patient with COVID‐19 and would like to share the course of treatment.     

Surgical repair of a giant congenital right atrial aneurysm concomitant with Wolff‐Parkinson‐White syndrome: A case report and literature review

Congenital right atrial aneurysms (RAA) have a wide range of clinical presentations and leads to various complications. Depending on the initial presentation and associated complications, a conservative or surgical approach may be considered. A patient suffering from a giant RAA associated with the Wolff‐Parkinson‐White syndrome, who underwent successful surgical treatment, is presented here.     

Guillain‐Barré syndrome associated with Coronavirus disease 2019: A case from Nepal

Coronavirus disease 2019 (COVID‐19) has now spread widely after the outbreak since December 31, 2019. Guillain‐Barré syndrome is an immunological postinfectious neuropathy, which has been reported to be a rare but possible complication COVID‐19. We report a case of Guillain‐Barré syndrome associated with COVID‐19 in Nepal.     

Delayed COVID‐19‐induced cytokine storm after root canal therapy with favorable response to plasmapheresis,tocilizumab, and methylprednisolone pulses therapy: A case report

COVID‐19 showed different characteristics, and many cases showed clinical manifestations that could not be attributed to other conditions. We present a 22‐year‐old woman who had an uneventful recovery from COVID‐19, and after that, she developed a cytokine storm and a worsening clinical condition 2 days after dental root canal therapy.     

Higher‐risk myelodysplastic syndrome in an elderly patient: Long‐term partial remission with low‐dose prednisone,G‐CSF,and epoetin alfa

Currently, most patients with higher‐risk MDS are treated with 5‐azacitidine or decitabine. These agents are toxic. The treatment described here is safe, devoid of toxicity, fosters improved quality of life, and helps reduce transfusion requirements.     

A case of post COVID‐19 multisystem inflammatory syndrome and Bell's palsy in a young adult

The clinician should put MIS‐A at the top of differential diagnoses of a patient with febrile illness and multiple organ dysfunction during the early post‐COVID‐19 period. Also, facial nerve palsy might follow COVID‐19, related to the autoimmune phenomenon.     

Extraoral exanthem revealing Gianotti‐Crosti syndrome in a young child: A case report

We reported a case of a 14‐month‐old girl with erythematous and papulovesicular pink to red lesions on the face, the upper and the lower limbs. The history and the morphological features confirmed the diagnosis of Gianotti‐Crosti syndrome.     

Age‐group‐specific reference intervals for anti‐Müllerian hormone and its diagnostic performance for polycystic ovary syndrome in a Korean population

BackgroundWe established age‐group‐specific reference intervals for serum anti‐Müllerian hormone (AMH) levels in a Korean population and investigated the effectiveness of AMH assay for polycystic ovary syndrome (PCOS) diagnosis.MethodsWe analyzed serum levels of AMH, follicle‐stimulating hormone (FSH), and luteinizing hormone (LH) from 1540 Korean women. Subjects were divided into three groups: healthy, benign gynecologic diseases, and PCOS. Age‐group‐specific reference intervals and AMH diagnostic performance were estimated.ResultsThe PCOS group had a median AMH level of 7.0 µg/L, which was higher than for the healthy (1.8 µg/L) and the benign gynecologic diseases (2.7 µg/L) groups. The upper 97.5% reference limits for age groups 12–20 years, 21–34 years, and 35–46 years were 13.2 µg/L, 15.8 µg/L, and 6.6 µg/L, respectively. The area under the curve (AUC) values to estimate AMH ability to discriminate PCOS from healthy women for each age group were 0.741, 0.785, and 0.789, respectively. AUCs for LH/FSH were 0.719, 0.672, and 0.590.ConclusionsThe better diagnostic ability of AMH over LH/FSH in women of late childbearing ages indicates that age and other clinical characteristics should be considered when interpreting these test results.     

Carotid access for percutaneous coronary intervention

Transcarotid percutaneous coronary intervention is feasible and safe and can be considered as an ultimate alternative in cases where conventional peripheral vascular access is unavailable.     

Rare complication of a commonly used antihypertensive agent: A case of hydralazine‐induced ANCA‐associated vasculitis presenting as rapidly progressive glomerulonephritis

Hydralazine‐induced ANCA‐associated vasculitis is a rare clinical entity, with complications including rapidly progressive glomerulonephritis, pulmonary hemorrhage, and pulmonary‐renal syndrome. We present this case to highlight the clinical features that support this challenging diagnosis and to emphasize the importance of prompt recognition and aggressive intervention given its significant morbidity and mortality.