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Poster Session : PS 0659 ; Rheumatology ; How a Diagnosis of Viral Exathem Changed to Sweet Syndrome
( Bashir Faisal Butt ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
30 yrs. old unmarried gentleman works as chef with no signifi cant past medical history presented with 4 days history of oral ulcers and rash that was started from face than spread to arms and later to involve trunk and legs.fever only develops on the day of presentation. No h/o recent sexual contact,travel history. No red fi ags no h/o weight loss. No family history of malignancy On examination he was febrile,tachycardiac with stable vitals. On examination he was having extensive cutaneous lesions it was tender with infi amed papeulse, plaques and nodules.also noted extensive oral ulcers over hard palate, tongue. Biopsy of the skin lesions shows netriphilic dermatosis (Sweet Syndrome) Patient was worked up to rule out hematological malignancy /solid organ malignancy Periperal blood smear does not shows any malignant cells Pan CT scan also negative for malignancy Autoimmune workup also negative. Patient was started on oral prednisolone and patient responded to treatment very well.
( Faisal Bashir Butt ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Objective: To report a very rare case of malignant pheochromocytoma presented with atypical symptoms of polyuria, polydipsia, weight loss and hypertension Case Report: 31 year old female patient know to have hypertension for the last 1 year under active follow up with general practitioner currently presented with 12 kg weight loss for the past 1 year, polyuria, polydipsia, diaphoresis, palpitations and with hypertensive urgency also diagnosed to have newly diagnosed diabetes mellitus. Investigations: she underwent usg abdomen that shows left adrenal mass that was confirmed by CT A/P and MRI abdomen that shows left adrenal mass and raised urine catecholamines, metanephrines; also diagnosed newly diagnosed diabetes mellitus. Progress: An open left adrenalectomy was done with clearance of enlarged lymph nodes and histological findings confirmed pheochromocytoma with metastasis to adjacent lymph nodes. Repeat urine catecholamines was markedly reduced and b.p improved and patient was off from diabetic medications. Conclusions: A total of 8 cases of malignant pheochromocytoma were reported in singapore itself during the period of 1993-2007.Although malignant pheochromocytoma is rare, pheochromocytoma can present as young hypertension and need to be investigated.