Daily Archives: September 4, 2017

Question: A 60-year-old man with thalassemia presented with progressive right upper quadrant abdominal pain of 1 month’s duration. The pain was persistent, dullness and did not any radiate or migrate pain. There was no hepatitis B or C virus infectio… Continue reading →

We read with great interest the recent study by Hyams et al1 evaluating the risk of malignancy or hemophagocytic lymphohistiocytosis (HLH) in pediatric patients with inflammatory bowel disease (IBD) treated with infliximab. Although the authors demons… Continue reading →

Question: A 68-year-old woman was admitted to the internal medicine unit for exploration of chylous ascites and retroperitoneal fibrosis. She had no medical history except recurrent bronchitis. Her medical story began 3 months earlier with an acute ons… Continue reading →

We read with great interest the recent study by Hyams et al1 evaluating the risk of malignancy or hemophagocytic lymphohistiocytosis (HLH) in pediatric patients with inflammatory bowel disease (IBD) treated with infliximab. Although the authors demons… Continue reading →

Question: A 64-year-old, obese women with a history of schizophrenia and multiple bariatric surgeries had been attending clinics for 4 years for assessment and adjustment of her gastric band. The patient had largely been unsuccessful in losing weight a… Continue reading →

Question: A 20-year-old man presented to our clinic with a 3-year history of intermittent hematochezia, in addition to developmental delay. Laboratory analysis and physical examination were otherwise normal. Colonoscopy to investigate the cause of hematochezia revealed >100 tubular, tubulovillous, and villous adenomas throughout the colon, up to 2 cm in size (Figure A). Restorative proctocolectomy was performed and numerous polyps were found, but no evidence of invasive carcinoma was identified. The parents and the patient’s sibling were phenotypically normal, with no developmental delay and no family history of gastrointestinal cancer. Continue reading →

Question: A 31-year-old woman, born in Pakistan, presented with dysphagia and severe anemia. She had a 10-year history of iron deficiency anemia secondary to chronic menorrhagia. She initially received a red blood cell transfusion, but had no gynecologic explorations or follow-up. The patient complained of dysphagia for solids that had been worsening for the last 5 years associated with a weight loss of 10 kg, but not with odynophagia or dysphonia. At admission, her hemoglobin level was 55 g/L, with a low mean corpuscular volume (70 fL) and ferritin level (<10 μg/L). Continue reading →

Question: A 68-year-old woman was admitted to the internal medicine unit for exploration of chylous ascites and retroperitoneal fibrosis. She had no medical history except recurrent bronchitis. Her medical story began 3 months earlier with an acute ons… Continue reading →

Question: A 60-year-old man presented with substernal chest pain and dysphagia lasting 1 month. The intensity of substernal chest pain increased when swallowing food without chills and fever. He had lost about 4.0 kg in the past 2 months. Continue reading →

Question: A 60-year-old man with thalassemia presented with progressive right upper quadrant abdominal pain of 1 month’s duration. The pain was persistent, dullness and did not any radiate or migrate pain. There was no hepatitis B or C virus infectio… Continue reading →