1/35. Toxic epidermal necrolysis and graft vs. host disease: a clinical spectrum but a diagnostic dilemma.We describe a 53-year-old man who developed partial and full thickness skin loss associated with pyrexia, diarrhoea, liver, renal and bone marrow failure, during treatment for an aggressive B cell lymphoblastic lymphoma. The clinical features and histology were compatible with both toxic epidermal necrolysis and graft vs. host disease, causing a diagnostic and therapeutic dilemma. We discuss the possibility that methotrexate was the causative drug, with review of its cutaneous side-effects. Histologically our patient demonstrated the sparse dermal infiltrate with full thickness epidermal necrosis typical of toxic epidermal necrolysis and graft vs. host disease. We discuss this finding with respect to the pathogenesis of toxic epidermal necrolysis.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
2/35. Diagnosis and treatment of an unusual cause of metabolic acidosis: ethylene glycol poisoning.ethylene glycol intoxication is a rare but dangerous type of poisoning. It causes a severe acidosis with high anion and osmolal gaps. Clinical manifestations of the ethylene glycol intoxication can be divided in three phases: a neurologic stage, with hallucinations, stupor and coma; the second stage is cardiovascular with cardiac failure. Renal failure characterizes the third stage, due to acute tubular necrosis. After aggressive gastric emptying, the main treatment is ethanol or 4-methypyrazole, which can be given either orally or intravenous, with supportive measures for all symptoms or diseased organ.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
3/35. Bone marrow hypoplasia associated with acute viral hepatitis in four children.Four cases of children, aged 2 to 11 years, with acute viral hepatitis and bone marrow hypoplasia are reported. Three patients presented only jaundice and hepatomegaly; one also had liver failure. All the four patients underwent bone marrow aspiration which showed bone marrow aplasia. In two of the four patients a liver biopsy revealed patchy necrosis with inflammatory mononuclear cell infiltrate. Half of the patients received a bone marrow transplantation; the remaining patients were treated by intravenous infusion of immunoglobulins, growth factors and steroids. The main epidemiological and etiological features of such association are also reported.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
4/35. Metastatic bone tumor mimicking spontaneous osteonecrosis of the medial condyle of the femur: misleading appearance on MR imaging.We report a case of a metastatic bone tumor that mimicked spontaneous osteonecrosis of the medial condyle of the femur on magnetic resonance imaging.- - - - - - - - - - ranking = 5keywords = necrosis (Clic here for more details about this article) |
5/35. Elevated levels of lipoprotein(a) in familial bone marrow edema syndrome of the hip.There is controversy whether bone marrow edema syndrome represents a distinct transient disease or reflects an early reversible phase of spontaneous osteonecrosis of the hip. Hypofibrinolysis on the basis of elevated plasma levels of plasminogen activator inhibitor or lipoprotein(a) or both has been reported to favor the development of bone marrow edema syndrome and nontraumatic avascular necrosis. The current authors report on the familial occurrence of transient bone marrow edema syndrome of the hip in three female family members. plasma concentrations of lipoprotein(a) were elevated in all three patients, whereas serum levels of plasminogen activator inhibitor were within normal ranges. This first familial description of transient bone marrow edema syndrome of the hip strongly suggests that a genetically determined elevation of lipoprotein(a) may be an important predisposing factor in these patients.- - - - - - - - - - ranking = 2keywords = necrosis (Clic here for more details about this article) |
6/35. Bone marrow necrosis and refractory hellp syndrome in a patient with catastrophic antiphospholipid antibody syndrome.We describe a 22-year-old woman who developed extensive and fatal bone marrow necrosis along with involvement of liver, lung, and central nervous system during pregnancy in the background of very high titers of antiphospholipid and anti-beta2 glycoprotein antibodies. This case illustrates a rarely recognized, potentially fatal complication of aPL in the setting of pregnancy.- - - - - - - - - - ranking = 5keywords = necrosis (Clic here for more details about this article) |
7/35. Increased perfusion of the femoral head in transient bone marrow edema syndrome.The pathophysiology of transient bone marrow edema syndrome is not known. ischemia has been suggested as the pathophysiologic factor, because the histologic findings are similar to those of early stage osteonecrosis. Angiographic studies of osteonecrotic femoral heads have shown arterial interruption and impaired perfusion. The current report describes the angiographic and scintigraphic findings of transient bone marrow edema syndrome of the hip in a 45-year-old man. The nutrient arteries were dilated, and the femoral head perfusion was increased compared with the unaffected contralateral side. These findings suggest that a vasomotor response plays a role in the pathogenesis of transient bone marrow edema syndrome. The disease might be a reversible process after temporary ischemia of the femoral head.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
8/35. Bone marrow necrosis in paediatric patients.Necrosis of bone marrow is a very rare condition with a prevalence ranging from 0.15 to 7 percent. It is mostly not compatible with life. We diagnosed four cases of necrotic marrow out of 830 bone marrow aspirations done in last five years of time. All were paediatric patients having peripheral pancytopenia. Three out of four patients expired within one month of diagnosis.- - - - - - - - - - ranking = 4keywords = necrosis (Clic here for more details about this article) |
9/35. Bone marrow edema syndrome of the knee: a case report and review of the literature.The authors present a 45-year-old man with bone marrow edema syndrome (BMES) of the medial condyle of the knee. early diagnosis of BMES was based upon clinical, bone scintigraphy and magnetic resonance (MRI) findings. After failure of the conservative treatment, core decompression was performed. Histological examination showed no evidence of osteoporosis or osteonecrosis. Within 2 months after the operation, the patient was pain-free and he resumed his previous activities. At 1-year follow-up examination, MRI showed complete resolution of all signal abnormalities; at 3-year follow-up the patient remained symptom-free and with no functional limitations.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
10/35. Transient bone marrow edema syndrome progressing to avascular necrosis of the hip - a case report and review of the literature.Transient bone marrow edema syndrome (TMES) is a rare disease of unknown etiology. Diagnosis is made by exclusion. There is still controversy as to whether TMES is considered to be a reversible form of avascular necrosis (AVN), a disease entity of its own or a form of non-traumatic algodystrophy. We here describe the extremely rare occurrence of three cases of TMES that progressed to AVN.- - - - - - - - - - ranking = 5keywords = necrosis (Clic here for more details about this article) |
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