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Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

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Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
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Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
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臨床症状

Swathi T1, Thamil Pavai Swathi2

  • 1Kauvery hospital, Chennai, Tamil nadu, India.

Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 25, 2025
PubMed
まとめ

本症例は、非ホジキンリンパ腫(NHL)治療3年後に認知症として発症した進行性多巣性白質脳症(PML)を報告するものである。JCウイルスDNAによりPMLを確認、化学療法による稀な晩期合併症である。

科学分野:

  • 神経科学
  • 腫瘍学
  • 感染症学

背景:

  • 進行性多巣性白質脳症(PML)は、悪性腫瘍患者や化学療法を受けている患者を含む免疫不全患者における既知の合併症である。
  • 本研究は、非ホジキンリンパ腫(NHL)の治療後数年して発症したPMLの稀な症例に焦点を当てている。

研究 の 目的:

  • 非ホジキンリンパ腫(NHL)治療3年後に認知症として発症したPMLの稀な症例を報告する。
  • 化学療法によるPMLの診断上の課題と晩期発症を強調する。

主な方法:

  • 脊椎NHLに対し放射線療法およびR-CHOP化学療法を受けた33歳男性が、神経学的症状のため評価された。
  • 診断学的評価には、MRI脳およびJCウイルスDNAに対する脳脊髄液(CSF)分析が含まれた。

主要な成果:

  • 患者は運動失調、記憶障害、行動変化を呈した。MRIで白質高信号が明らかになり、CSF検査でJCウイルスDNAが陽性となり、PMLと確定診断された。鑑別診断には中枢神経系リンパ腫、傍腫瘍症候群、プリオン病が含まれた。
  • MRIで白質高信号が明らかになり、CSF検査でJCウイルスDNAが陽性となり、PMLと確定診断された。鑑別診断には中枢神経系リンパ腫、傍腫瘍症候群、プリオン病が含まれた。

結論:

キーワード:
進行性多巣性白質脳症非ホジキンリンパ腫化学療法晩期合併症認知症JCウイルス

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  • 本症例は、NHLに対する化学療法後3年で発生したPMLの稀な例である。
  • 認知症は、治療完了後数年経っていても、PMLの顕在化しうる症状となりうる。
  • この所見は、神経学的衰弱を呈する免疫不全患者における晩期発症PMLの考慮の重要性を強調するものである。