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Modern Rheumatology Case Reports Jul 2021Gastrointestinal involvement in systemic lupus erythematosus (SLE) usually occurs in the form of mesenteric vasculitis, protein-losing enteropathy, intestinal... (Review)
Review
Gastrointestinal involvement in systemic lupus erythematosus (SLE) usually occurs in the form of mesenteric vasculitis, protein-losing enteropathy, intestinal pseudo-obstruction, and pancreatitis. We describe a 23-year-old female, a known case of SLE presented with significant ascites and pleural effusion. Further evaluation showed elevated CA-125 levels without evidence of malignancy. The patient was treated with corticosteroids, hydroxychloroquine, and azathioprine resulting in the resolution of ascites in 2 weeks. The triad of ascites, pleural effusion, and increased CA-125 is known as pseudo-pseudo Meigs' syndrome, which is rarely reported in the literature. Clinicians should be aware of this entity while evaluating an SLE patient with low serum-ascites albumin gradient (SAAG) ascites.
Topics: Chronic Disease; Female; Humans; Lupus Erythematosus, Systemic; Meigs Syndrome; Young Adult
PubMed: 33970813
DOI: 10.1080/24725625.2021.1916160 -
Oncology Letters Dec 2022Ovarian collision tumors are uncommon and reports of their radiological appearance are even less frequent. The present study reported the world's first case of an...
Ovarian collision tumors are uncommon and reports of their radiological appearance are even less frequent. The present study reported the world's first case of an ovarian collision tumor consisting of an ovarian sclerosing stromal tumor and a mature cystic teratoma and its imaging presentation. When a cystic solid ovarian mass combined with ascites and elevated CA125 is encountered it is frequently diagnosed as a malignant tumor, but the present case was a benign tumor. Therefore, when encountering similar cases, clinicians should not limit the diagnosis to malignant tumors to avoid rashly expanding the surgery and causing unnecessary harm to the patient. The combination of computed tomography, magnetic resonance imaging and pathology findings presented in the current study enable radiologists to learn about this disease and further assist clinicians in developing the best treatment plan.
PubMed: 36420070
DOI: 10.3892/ol.2022.13563 -
The Journal of Clinical Endocrinology... Dec 2022
Response to Letter to the Editor From Nelson et al: "Understanding the Link Between Obesity and Severe COVID-19 Outcomes: Causal Mediation by Systemic Inflammatory Response".
Topics: Humans; COVID-19; SARS-CoV-2; Obesity; Causality; Systemic Inflammatory Response Syndrome
PubMed: 36300318
DOI: 10.1210/clinem/dgac620 -
Journal of Surgical Case Reports Mar 2023Meigs' syndrome is defined as a secondary triad of ascites, pleural effusion and benign ovarian tumor, usually fibroma. While pseudo-Meigs' syndrome is a rare condition...
Meigs' syndrome is defined as a secondary triad of ascites, pleural effusion and benign ovarian tumor, usually fibroma. While pseudo-Meigs' syndrome is a rare condition that is associated with benign ovarian tumor-other than fibroma-or even malignant. The case presented is a 40-year-old Saudi, nulliparous woman who was referred for precise diagnostic work-up as a case of huge pelvic-abdominal mass, tense ascites and pleural effusion. After further investigations cancer antigen-125 was found to be elevated. An abdominal CT scan revealed significant interval increase in the size of ascites, which cause huge abdominal distention, as well as a significant pleural effusion. Pathology of surgical specimens revealed a giant uterine leiomyoma, whereas the omentum excision surprisingly confirmed multiple disorganized arteries and veins, which resulted in omental arteriovenous malformation. To the best of our knowledge, this is the first reported case in the worldwide literature of two different rare conditions.
PubMed: 36937799
DOI: 10.1093/jscr/rjad080 -
Case Reports in Women's Health Oct 2022Thoracic endometriosis is an exceedingly rare condition characterized by the presence of endometriotic deposits on the diaphragm, lungs or pleural space. Patients may...
Thoracic endometriosis is an exceedingly rare condition characterized by the presence of endometriotic deposits on the diaphragm, lungs or pleural space. Patients may present with massive hemothorax, pneumothorax, hemoptysis or pulmonary nodules. It is a complex condition that often proves to be a diagnostic challenge, resulting in under-diagnosis, delays in treatment and significant morbidity in women of reproductive age. We report a case of endometriosis causing massive pleural effusion and ascites, with a left adnexal fibroid mass mimicking Meigs' syndrome in a nulliparous woman in her late 30s. The patient was successfully managed with hormonal therapy following fertility-sparing surgical treatment. This case highlights the diagnostic and therapeutic challenges associated with thoracic endometriosis because of its close resemblance to more sinister gynecological conditions. Hormonal therapy is the long-term treatment of choice in patients with thoracic endometriosis to reduce the risk of symptom recurrence and preserve fertility.
PubMed: 36246455
DOI: 10.1016/j.crwh.2022.e00452 -
Journal of Family Medicine and Primary... Sep 2022Systemic lupus erythematosus is a complex disease and can present with almost any organ involvement, including serosal inflammation. Our patient is not known to have any...
Systemic lupus erythematosus is a complex disease and can present with almost any organ involvement, including serosal inflammation. Our patient is not known to have any medical problems, presented for the first time with pseudo-pseudo Meigs' syndrome (PPMS), and after extensive workup to rule out other possibilities like infection and malignancy, she was found to have systemic lupus erythematosus. Several other cases have been reported in the literature; our patient had to have a pleural biopsy for completion of workup. She responded to prednisone and Immune suppression therapy (including mycophenolate mofetil (MMF) and Plaquenil).
PubMed: 36505592
DOI: 10.4103/jfmpc.jfmpc_101_22 -
Communications Medicine Oct 2023Precision prevention involves using the unique characteristics of a particular group to determine their responses to preventive interventions. This study aimed to...
BACKGROUND
Precision prevention involves using the unique characteristics of a particular group to determine their responses to preventive interventions. This study aimed to systematically evaluate the participant characteristics associated with responses to interventions in gestational diabetes mellitus (GDM) prevention.
METHODS
We searched MEDLINE, EMBASE, and Pubmed to identify lifestyle (diet, physical activity, or both), metformin, myoinositol/inositol and probiotics interventions of GDM prevention published up to May 24, 2022.
RESULTS
From 10347 studies, 116 studies (n = 40940 women) are included. Physical activity results in greater GDM reduction in participants with a normal body mass index (BMI) at baseline compared to obese BMI (risk ratio, 95% confidence interval: 0.06 [0.03, 0.14] vs 0.68 [0.26, 1.60]). Combined diet and physical activity interventions result in greater GDM reduction in participants without polycystic ovary syndrome (PCOS) than those with PCOS (0.62 [0.47, 0.82] vs 1.12 [0.78-1.61]) and in those without a history of GDM than those with unspecified GDM history (0.62 [0.47, 0.81] vs 0.85 [0.76, 0.95]). Metformin interventions are more effective in participants with PCOS than those with unspecified status (0.38 [0.19, 0.74] vs 0.59 [0.25, 1.43]), or when commenced preconception than during pregnancy (0.21 [0.11, 0.40] vs 1.15 [0.86-1.55]). Parity, history of having a large-for-gestational-age infant or family history of diabetes have no effect on intervention responses.
CONCLUSIONS
GDM prevention through metformin or lifestyle differs according to some individual characteristics. Future research should include trials commencing preconception and provide results disaggregated by a priori defined participant characteristics including social and environmental factors, clinical traits, and other novel risk factors to predict GDM prevention through interventions.
PubMed: 37794119
DOI: 10.1038/s43856-023-00366-x -
JACC. Case Reports Jul 2023Meigs syndrome is an uncommon entity associated with benign ovarian tumor, pleural effusion, and ascites. Its association with pericardial effusion is extremely rare. We...
Meigs syndrome is an uncommon entity associated with benign ovarian tumor, pleural effusion, and ascites. Its association with pericardial effusion is extremely rare. We report a case of Meigs syndrome associated with recurrent pericardial effusion that resolved after surgical resection of the ovarian tumor. ().
PubMed: 37545678
DOI: 10.1016/j.jaccas.2023.101927 -
Annals of Medicine and Surgery (2012) Dec 2023Demons-Meigs syndrome is a rare condition characterized by the presence of a benign fibroma of the ovary, ascites, and pleural effusion. It is very uncommon, and the...
INTRODUCTION AND IMPORTANCE
Demons-Meigs syndrome is a rare condition characterized by the presence of a benign fibroma of the ovary, ascites, and pleural effusion. It is very uncommon, and the diagnosis is made with difficulty based on symptoms that usually mimic disseminated malignancy or tuberculosis, but imaging may confirm the diagnosis. The definitive treatment is laparotomy, after which the symptoms resolve.
CASE PRESENTATION
We present a 36-year-old female with Demons-Meigs' syndrome with severe dyspnea who underwent an abdominal surgical exploration, which revealed ascites of 1500 ml and an ovarian fibroma weighing 7.5 kg and measuring 12 cm in length. There were no postoperative complications. CA-125 was undetectable at 3 months post-procedure.
CLINICAL DISCUSSION
The most common symptoms are dyspnea, fever, fatigue, and weight loss. In low- and middle-income countries, patients usually present with late-stage disease. The treatment of choice for Demons-Meigs' syndrome is exploratory laparotomy.
CONCLUSION
This tumor is often misdiagnosed as a uterine myoma on sonography. The symptoms resolved, and the patient became asymptomatic after laparotomy and thoracocentesis. For this reason, when patients present with effusion and an abdominal mass, a thorough assessment should be done to confirm if it is Demons-Meigs' syndrome, which can be completely cured by the removal of the tumor.
PubMed: 38098603
DOI: 10.1097/MS9.0000000000001424 -
Pediatric Nephrology (Berlin, Germany) Mar 2024Acute kidney injury (AKI) is independently associated with increased morbidity and mortality across the life course, yet care for AKI remains mostly supportive. Raising...
BACKGROUND
Acute kidney injury (AKI) is independently associated with increased morbidity and mortality across the life course, yet care for AKI remains mostly supportive. Raising awareness of this life-threatening clinical syndrome through education and advocacy efforts is the key to improving patient outcomes. Here, we describe the unique roles education and advocacy play in the care of children with AKI, discuss the importance of customizing educational outreach efforts to individual groups and contexts, and highlight the opportunities created through innovations and partnerships to optimize lifelong health outcomes.
METHODS
During the 26th Acute Disease Quality Initiative (ADQI) consensus conference, a multidisciplinary group of experts discussed the evidence and used a modified Delphi process to achieve consensus on recommendations on AKI research, education, practice, and advocacy in children.
RESULTS
The consensus statements developed in response to three critical questions about the role of education and advocacy in pediatric AKI care are presented here along with a summary of available evidence and recommendations for both clinical care and research.
CONCLUSIONS
These consensus statements emphasize that high-quality care for patients with AKI begins in the community with education and awareness campaigns to identify those at risk for AKI. Education is the key across all healthcare and non-healthcare settings to enhance early diagnosis and develop mitigation strategies, thereby improving outcomes for children with AKI. Strong advocacy efforts are essential for implementing these programs and building critical collaborations across all stakeholders and settings.
Topics: Humans; Child; Acute Disease; Educational Status; Acute Kidney Injury; Consensus
PubMed: 37934273
DOI: 10.1007/s00467-023-06180-w