Publications by authors named "Mehrnaz Asadi Gharabaghi"

26 Publications

  • Page 1 of 1

Constrictive Pericarditis Associated with Coronavirus Disease 2019 (COVID-19): A Case Report.

Infect Disord Drug Targets 2020 Dec 9. Epub 2020 Dec 9.

Department of Infectious Diseases, Imam Khomeini Hospital complex, Tehran University of Medical Sciences, Tehran. Iran.

Since December 2019, there has been an increasing number of patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) around the world. As of March 2020, the World Health Organization declared a global pandemic. To our best knowledge, this is the first report of a patient with SARS-CoV-2 infection presenting with constrictive pericarditis, possibly from the COVID infection. She was presented after a week of fever, persistent dry cough, and diarrhea. She received a single dose of hydroxychloroquine 400 mg, Oseltamivir 75 mg every 12 hours, lopinavir/ritonavir (Kaletra) 400/100 mg every 12 hours, and levofloxacin 750 mg daily. After 24 hours, she was immediately transferred to the Intensive Care Unit (ICU) because of dyspnea and progressive respiratory failure with a drop of the O2 saturation to 70%. After a week of progress, her respiratory condition deteriorated again. She was re-admitted to the ICU and she expired. She died due to isolated constrictive pericarditis, most probably caused by SARS-CoV-2.
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http://dx.doi.org/10.2174/1871526520666201209145001DOI Listing
December 2020

The diagnostic accuracy of prospective investigative study of acute pulmonary embolism diagnosis criteria for the detection of acute pulmonary thromboembolism in acutely ill patients.

World J Nucl Med 2020 Apr-Jun;19(2):137-140. Epub 2020 Jan 17.

Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.

The practical diagnostic performance of Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISAPED) criteria for the detection of acute pulmonary thromboembolism (APTE) in hospitalized patients is not yet well determined. This is the report of the initial results of our recently implemented protocol to employ PISAPED. One hundred and forty-seven pulmonary perfusion scans with 1-3 mCi Tc-MAA of patients of a single pulmonologist were included. Patients with suspicious perfusion defects underwent single-photon emission computed tomography. Interpretations were done by consensus of two nuclear medicine specialists. Comparisons were done with chest X-ray or chest computed tomography when available. The interpreters had access to the clinical records. The scans were reported based on the PISAPED criteria as negative or positive for APTE or indeterminate. Patients were followed up for 6.2 ± 5.3 months when the final diagnosis confirming or excluding APTE was achieved. Patients aged 55.9 (17.2) years; 78 (53.1%) of them were female and 64 (43.8%) had high Wells' score. The scans were positive, negative, and indeterminate in 17 (11.6%), 126 (85.7%), and 4 (2.7%) patients, respectively. In 6 out of 147 patients, follow-up was not completed and the final diagnosis was not achieved. APTE was finally diagnosed in 21 (14.3%) patients; 12 (57.1%) of them had positive scans. APTE was excluded in 116 (78.9%) patients; 112 (96.5%) of them had negative scans. The accuracy of the test for the diagnosis of APTE was 87.9%. Lung metastasis was the most frequent reason among false-negative cases. The lung perfusion scan using PISAPED criteria could be used with good accuracy in inpatient settings.
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http://dx.doi.org/10.4103/wjnm.WJNM_64_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478309PMC
January 2020

The Relationship Between Airway Occlusion Pressure and Severity of liver Cirrhosis in Candidates for Liver Transplantation.

Middle East J Dig Dis 2020 Apr;12(2):111-115

Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

BACKGROUND End-stage cirrhosis is an irreversible condition, and liver transplantation is the only treatment option in for the affected patients. Respiratory problems and abnormal breathing are common findings among these patients. In this study, for the first time, we examined the relationship between the severity of liver cirrhosis and respiratory drive measured by mouth occlusion pressure (P). METHODS This was a cross-sectional study conducted on 50 candidates for liver transplantation who were referred to the pulmonary clinic of Imam Khomeini Hospital for pre-operative pulmonary evaluations. Arterial blood gas analysis (ABG), pulmonary function tests, and measurement of P0.1 were performed for all patients. The severity of liver disease was assessed using the Model for End-Stage Liver Disease (MELD) score. RESULTS The median P was 5 cm H O. P was negatively associated with PaCO (r = -0.466, = 0.001) and HCO3 - (r = -0.384, = 0.007), and was positively correlated with forced expiratory volume at 1s (FEV1 )/ forced vital capacity (FVC) (r = 0.282, = 0.047). There was a strong correlation between P and MELD score (r = 0.750, < 0.001). Backward multivariate linear regression revealed that a higher MELD score and lower PaCO were associated with increased P. CONCLUSION High levels of P and strong direct correlation between P and MELD score observed in the present study are suggestive of the presence of abnormal increased respiratory drive in candidates for liver transplantation, which is closely related to their disease severity.
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http://dx.doi.org/10.34172/mejdd.2020.170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320985PMC
April 2020

Tracheopleural fistula after thoracoscopic esophagectomy: novel therapeutic approach with pericardial and intercostal muscle flaps.

J Surg Case Rep 2018 Oct 16;2018(10):rjy277. Epub 2018 Oct 16.

Department of Respiratory Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Tracheal rupture following thoracoscopic esophagectomy is a dangerous event requiring primary repair with flap reinforcement. If the injury is not diagnosed during the surgery, morbidity and mortality increase significantly. Meanwhile, primary repair in such cases is not feasible due to the inflammation and difficulty in approximating the defect. Here, we report a case of tracheal injury during thoracoscopic esophagectomy with primary repair failure. We successfully repaired the injury by covering the defect first by a pericardial flap, then reinforcing it with an intercostal muscle flap. To our knowledge, there are few reports of such novel surgical techniques.
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http://dx.doi.org/10.1093/jscr/rjy277DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189376PMC
October 2018

Squill Oxymel, a traditional formulation from Drimia Maritima (L.) Stearn, as an add-on treatment in patients with moderate to severe persistent asthma: A pilot, triple-blind, randomized clinical trial.

J Ethnopharmacol 2017 Jan 18;196:186-192. Epub 2016 Dec 18.

Department of Pulmonary Medicine, Imam Khomeini Hospital, Keshavarz Boulevard, Medical Sciences/Tehran University, Tehran, Iran. Electronic address:

Ethnopharmacological Relevance: In Traditional Iranian Medicine (TIM), Squill (Drimia maritima (L.) Stearn) Oxymel was utilized in the treatment of asthma. Squill has been reported to exert anti-inflammatory, anti-oxidant, anti-cholinergic, and mucus secretion modulating effects.

Objective: This study aimed to make a preliminary evaluation of the efficacy and safety of an add-on Squill Oxymel treatment in patients with moderate to severe persistent asthma.

Methods: In a 6-week, triple-blind, randomized, placebo-controlled trial, 60 patients with stable moderate to severe persistent asthma were randomly allocated to receive either 10ml syrup of Squill Oxymel, simple oxymel, or a placebo 2 times a day, as an add-on to their routine treatment (inhaled corticosteroids and β2 agonists). Spirometry and plethysmography were performed on patients to evaluate the effect of the treatment at baseline and end of intervention. Forced Expiratory Volume in first second (FEV1) was considered the primary outcome. St. George's respiratory questionnaire (SGRQ) was also used for the subjective evaluation of patients' responses.

Results: Fifty-four patients completed the study. The results showed significant improvement in spirometry parameters, especially FEV1 (1.54±.38 vs. 2.11±.49l), in the Squill Oxymel group compared with the other groups. The increases in FEV1 liter, FEV1%, FEV1/FVC%, and MEF 25-75% during the intervention were significantly higher in the Squill Oxymel group than in the other groups (p<.001). However, the improvement of plethysmographic parameters showed no significant difference between the study groups (p>.05). The SGRQ scores (symptoms, activity, and total score) were significantly improved after intervention in both the Squill Oxymel and the simple honey oxymel groups (p<.001), but not in the placebo group. Nausea and vomiting was reported in 5 patients in Squill oxymel and simple oxymel groups. No other serious adverse event was observed.

Conclusions: The results of the current study show preliminary evidence for the efficacy and safety of the add-on treatment of Squill Oxymel in patients with moderate to severe persistent asthma.
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http://dx.doi.org/10.1016/j.jep.2016.12.032DOI Listing
January 2017

Systemic Kikuchi-Fujimoto disease bordering lupus lymphadenitis: A fresh look?

Intractable Rare Dis Res 2016 Nov;5(4):301-305

Lupus and Rheumatology department, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

A 31-year old woman with persistent fever for 6 weeks and unresponsive to antibiotic therapy came for rheumatologic investigation. After computed tomography (CT) studies of her neck, thorax and abdomen revealed bilateral cervical, axillary and retroperitoneal lymph node enlargements, histopathologic evaluation of the resected nodes showed features of histiocytic necrotizing lymphadenopathy suggestive of Kikuchi-Fujimoto's lymphadenopathy. Kikuchi-Fujimoto Disease (KFD) involving the retroperitoneal nodes is extremely unusual and even more challenging to diagnose when there are no early signs of extranodal involvement or abdominopelvic pain. We present a case of systemic KFD involving the cervical, axillary and retroperitoneal lymph nodes and emphasize the clinical interest to properly differentiate between the benign condition of KFD that requires no more than minimal to low dosage steroid therapy and the potentially life-threatening lupus lymphadenitis that mandates intensive immunosuppressive treatment.
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http://dx.doi.org/10.5582/irdr.2016.01055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116869PMC
November 2016

Diagnostic investigation of BIRC6 and SIRT1 protein expression level as potential prognostic biomarkers in patients with non-small cell lung cancer.

Clin Respir J 2018 Feb 20;12(2):633-638. Epub 2016 Nov 20.

Advanced Thoracic Research Center, Department of Pulmonary Diseases, Tehran University of Medical Sciences, Tehran, Iran.

Background/aim: Lung cancer is the major contributor to overall cancer-related mortality. Biomarkers are important in early detection and prognosis, in addition to developing treatment regimes, which may improve the patient survival rates. Therefore, the present study was designed to evaluate the prognostic and diagnostic value of SIRT1/BIRC6 expression in non-small cell lung cancer (NSCLC).

Methods: The data on the prognostic impact of SIRT1/BIRC6 in NSCLC were collected from September 11, 2006 to July 10, 2014. Immunoexpressions and real-time quantitative reverse transcription-PCR of SIRT1/BIRC6 were analyzed and the outcomes were correlated with clinicopathological features and patient survivals.

Results: MRNA level of SIRT1 was upregulated in NSCLC tissues as compared to normal tissues (3.18 ± 0.77 vs. 1.27 ± 0.62; P = .001). BIRC6 mRNA was upregulated in cancer tissues when compared with normal tissues (4.13 ± 0.91 vs. 1.51 ± 0.72; P = .001). SIRT1 protein was overexpressed in 27 patients (67.5%), while normal tissues showed weak or negative staining to SIRT1 (P = .002). Furthermore, these findings suggested that advanced pathological T stage, and poor differentiation were significantly associated with expression of SIRT1 (P < .05). Increased expression of BIRC6 was detected in 75% of patients, while weak or negative expression were detected in normal tissues (P = .001). Furthermore, increased expression of BIRC6 was linked to advanced pathological T stage, poor differentiation, and lymph node metastasis (P < .05).

Conclusions: SIRT1 and BIRC6 may be linked to tumor progression and could be useful for the treatment of NSCLC.
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http://dx.doi.org/10.1111/crj.12572DOI Listing
February 2018

Role of Hematocrit Concentration on Successful Extubation in Critically Ill Patients in the Intensive Care Units.

Anesth Pain Med 2016 Feb 16;6(1):e32904. Epub 2016 Jan 16.

Division of Respiratory Disease, Department of Internal Medicine, Imam Khomeini Hospital Complex, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Background: Hematocrit (Hct) is an important parameter for optimal oxygenation during discontinuation from ventilator, but there is no consensus about its concentration and effectiveness on successful extubation.

Objectives: The current study aimed to determine the role of Hct concentration on extubation failure in critically ill patients.

Patients And Methods: The current prospective cohort study investigated the effect of age, gender and Hct level on successful extubation of 163 mechanically ventilated patients in Imam Khomeini hospital intensive care units (ICUs), Tehran, Iran. Following successful weaning process, the patients were classified into two groups on the basis of Hct level; 62 with an Hct level of 21% - 27% and the other 101 patients with Hct levels above 27%. The data were analyzed by chi-square test and multiple logistic regressions. A probability value of less than 0.05 was considered significant.

Results: There was no significant association between the level of Hct concentration and extubation failure (8.9% vs. 9.2%, P = 0.507). Gender and age were significantly associated with extubation failure (OR = 9.1, P = 0.034, OR = 12.5, P = 0.014, respectively). Although the differences between, before and after extubation of PaO2 and P/F ratio, were of significant values between the two different groups of Hct (P = 0.001, P = 0.004 respectively), they had no effect on the failure of extubation (P= 0.259, P = 0.403, respectively).

Conclusions: Although some studies showed association between anemia and extubation failure, the current study could not confirm it. The study showed that males, regardless of the Hct level, had a better extubation success rate than those of females.
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http://dx.doi.org/10.5812/aapm.32904DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834742PMC
February 2016

Subsegmental pulmonary embolism: A narrative review.

Thromb Res 2016 Feb 8;138:55-60. Epub 2015 Dec 8.

Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Through the introduction of computed tomography pulmonary angiography (CTPA) for diagnosis of the pulmonary embolism (PE), the high sensitivity of this diagnostic tool led to detecting peripheral filling defects as small as 2-3mm, termed as subsegmental pulmonary embolism (SSPE). However, despite these substantial increases in diagnosis of small pulmonary embolism, there are minimal changes in mortality. Moreover, SSPE patients generally are hemodynamically stable with mild clinical presentation, lower serum level of biomarkers, lower incidence of associated proximal DVTs and less frequent echocardiographic changes compared to the patients with emboli located in more central pulmonary arteries. However, the pros and cons of anticoagulant therapy versus non-treating, monitoring protocol and exact long term outcome of these patients are still unclear. In this article we review existing evidence and provide an overview of what is known about the diagnosis and management of subsegmental pulmonary embolism.
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http://dx.doi.org/10.1016/j.thromres.2015.12.003DOI Listing
February 2016

Thyroglossal duct cyst presenting as a large isolated mass within the middle mediastinum.

BMJ Case Rep 2015 Apr 9;2015. Epub 2015 Apr 9.

Department of Pulmonary Medicine, Advanced Thoracic Research Center, Tehran University of Medical Sciences, Iran.

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http://dx.doi.org/10.1136/bcr-2015-209643DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401961PMC
April 2015

Primary pulmonary cryptococcosis.

BMJ Case Rep 2014 Apr 1;2014. Epub 2014 Apr 1.

Department of Respiratory Diseases, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.

Here, we report a case of primary cryptococcal pneumonia in a 25-year-old woman who presented with several weeks' history of cough, dyspnoea and night sweating. These symptoms started in the third trimester of her pregnancy. She was being treated for infertility and got pregnant with in vitro fertilisation. On chest imaging, there were bilateral air space consolidation and cavitary lesions. Fungal pulmonary infection was diagnosed after surgical lung biopsy. She received fluconazole 400 mg per day orally for 6 months and recovered completely.
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http://dx.doi.org/10.1136/bcr-2014-203821DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987628PMC
April 2014

Recruitment bronchoscopy by trans-glottic approach successfully treated lung collapse in an intubated mechanically ventilated patient.

BMJ Case Rep 2013 Aug 7;2013. Epub 2013 Aug 7.

Pulmonary and Critical Care Department, Advanced Thoracic Research Center, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.

Pulmonary lower lobe atelectasis/collapse is a common problem in patients undergoing mechanical ventilation. It also occurs in non-intubated patients with traumatic brain or spinal cord injuries, morbid obesities and chest wall disorders. Conventional manoeuvres such as chest physiotherapy, bronchodilators and positive-end expiratory pressure (PEEP) administration are frequently used in its management with variable success rates. However, despite the reported success of bronchoscopic recruitment manoeuvres, selective intrabronchial air insufflation during fiberoptic bronchoscopy to re-expand collapsed lungs is an underutilised practice. Here, we report an example of successful selective intrabronchial air insufflation in an intubated patient with bilateral lower lobe collapses after surgery for an incarcerated hernia. To our knowledge, this is the first successful report of recruitment manoeuvre by trans-glottic bronchoscopy in an intubated, mechanically ventilated patient.
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http://dx.doi.org/10.1136/bcr-2013-200177DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762542PMC
August 2013

Unicentric Castleman's disease: an uncommon cause of posterior mediastinal mass.

BMJ Case Rep 2013 Jun 11;2013. Epub 2013 Jun 11.

Department of Thoracic Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.

Castleman's disease is a rare lymphoproliferative disease that may be unicentric or multicentric in presentation. It may develop anywhere along with the lymphatic system such as the abdomen, neck and thoracic cavity. However, mediastinum is the most common location for unicentric disease. Here, we discuss a unicentric Castleman's disease in a 28-year-old woman who presented with cough, mild dysphagia and a large posterior mediastinal mass.
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http://dx.doi.org/10.1136/bcr-2012-008522DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3702804PMC
June 2013

Tricky brucellosis.

BMJ Case Rep 2013 May 24;2013. Epub 2013 May 24.

Department of Infectious Diseases, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.

We present a 23-year-old woman who was admitted due to fever, palpitation, musculoskeletal pain and a transient bout of sudden-onset left-sided hemiparesis. She had also myopericarditis according to echocardiography findings. After comprehensive diagnostic work-up for infectious and immunologic disorders, brucellosis was confirmed by bone marrow aspiration culture. She received doxycycline, rifampin and trimethoprim-sulfamethoxazole for 3 months. The treatment was continued with doxycycline and rifampin for another 6 months. By the end of treatment, she recovered completely with no evidence of persistent neurological or cardiac complications.
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http://dx.doi.org/10.1136/bcr-2013-009522DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3669881PMC
May 2013

Hypoadrenal syndrome in a patient with amyloidosis secondary to familial Mediterranean fever.

BMJ Case Rep 2013 Jan 29;2013. Epub 2013 Jan 29.

Department of Pulmonary Medicine, Tehran University of Medical Sciences, Iran.

Amyloidosis is a common complication of poorly controlled familial Mediterranean fever (FMF). A variety of organs including kidneys, heart, liver, thyroid and adrenal glands may be clinically affected. However, involvement of adrenal glands leading to significant inefficiency is rarely seen in FMF patients with amyloidosis. The impairment of neuroendocrine immune system in FMF together with proteinuria in renal amyloidosis is a challenge while interpreting adrenal function tests. Here we present a case report of a 42-year-old man with FMF and renal failure due to amyloidosis whose disease course was complicated by adrenal insufficiency.
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http://dx.doi.org/10.1136/bcr-2012-007991DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3604423PMC
January 2013

Cardio-vocal syndrome.

BMJ Case Rep 2013 Jan 2;2013. Epub 2013 Jan 2.

Department of Pulmonary Medicine, Tehran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1136/bcr-2012-007633DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3604563PMC
January 2013

Empyema caused by foreign body aspiration.

BMJ Case Rep 2012 Dec 17;2012. Epub 2012 Dec 17.

Department of Pulmonary Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.

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http://dx.doi.org/10.1136/bcr-2012-007760DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544960PMC
December 2012

Lung hydatid cysts.

BMJ Case Rep 2012 Sep 3;2012. Epub 2012 Sep 3.

Department of Pulmonary Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.

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http://dx.doi.org/10.1136/bcr-2012-006551DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544180PMC
September 2012

Cutaneous tuberculosis caused by isoniazid-resistant Mycobacterium tuberculosis.

BMJ Case Rep 2012 Jul 3;2012. Epub 2012 Jul 3.

Department of Respiratory Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Cutaneous tuberculosis constitutes an uncommon presentation of extrapulmonary tuberculosis, especially among immune-competent patients. Here, there is a report of a 38-year-old man who presented with non-pruritic skin plaques, caused by isoniazid-resistant Mycobacterium tuberculosis, over his buttock, inguinal area and earlobe.
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http://dx.doi.org/10.1136/bcr-2012-006253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4542998PMC
July 2012

Community acquired Pseudomonas pneumonia in an immune competent host.

BMJ Case Rep 2012 May 26;2012. Epub 2012 May 26.

Department of Pulmonary Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Pseudomonas aeruginosa is an uncommon cause of community-acquired pneumonia in immune-competent hosts. It is commonly seen in patients with structural lung abnormality such as cystic fibrosis or in immune compromised hosts. Here, the authors report a case of community-acquired Pseudomonas pneumonia in a 26-year old healthy man who presented with 8-week history of malaise and cough.
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http://dx.doi.org/10.1136/bcr.01.2012.5673DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369319PMC
May 2012

Cardiac disease in a case of precursor B acute lymphoblastic leukaemia with eosinophilia(ALL/Eo).

BMJ Case Rep 2012 Jan 20;2012. Epub 2012 Jan 20.

Department of Medicine, Imam Khomeini Hospital Complex, Tehran, Iran, Islamic Republic of Iran.

Acute lymphoblastic leukaemia (ALL) is the most common paediatric malignancy. However, it may rarely associate with eosinophilia. Patients with ALL associated with eosinophilia (ALL/ Eo) have a grave prognosis and higher incidence of cardiac complications compared to standard lymphoblastic leukaemia. Reports of ALL/Eo disclosed a few case with cardiac involvement early in the course of leukaemia. Here, the authors report a case of 13-year-old boy who presented with peripheral eosinophilia, chest pain and a large left ventricular mass early in the course of precursor B- cell ALL associated with eosinophilia. He received multi-agent chemotherapy but succumbed to death 25 days after chemotherapy due to a refractory cardio respiratory failure.
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http://dx.doi.org/10.1136/bcr.04.2011.4128DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263020PMC
January 2012

Splenic vein aneurysm.

BMJ Case Rep 2012 Feb 21;2012. Epub 2012 Feb 21.

Department of Respiratory Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1136/bcr.10.2011.5007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291015PMC
February 2012

Systemic lupus erythematosus presenting with eosinophilic enteritis: a case report.

J Med Case Rep 2011 Jun 25;5:235. Epub 2011 Jun 25.

Department of General Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Systemic lupus erythematosus (SLE) is a multisystem disorder that may present with various symptoms. It may involve the gastrointestinal tract in a variety of ways; some of the most well-known ones are transaminitis, lupus mesenteric vasculitis, lupus enteritis and mesenteric vascular leakage. We describe a case of a patient with SLE who presented with a five-month history of diarrhea caused by eosinophilic enteritis. To the best of our knowledge, there are few cases reported in the literature of patients with SLE who initially present with chronic diarrhea due to eosinophilic enteritis.

Case Presentation: A 38-year-old Persian Iranian woman was admitted with a five-month history of diarrhea and abdominal pain. A physical examination showed nothing abnormal. Initially, she had only lymphopenia and mild eosinophilia. No autoimmune or infectious etiology was detected to justify these abnormalities. A thorough evaluation was not helpful in finding the etiology, until she developed a scalp lesion similar to discoid lupus erythematosus. Computed tomography showed small bowel wall thickening. Briefly, she manifested full-blown SLE, and it was revealed that the diarrhea was caused by eosinophilic enteritis.

Conclusion: Considering SLE in a patient who presents with chronic diarrhea and lymphopenia may be helpful in earlier diagnosis and therapy. This is an original case report of interest to physicians who practice internal medicine, family medicine and gastroenterology.
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http://dx.doi.org/10.1186/1752-1947-5-235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143100PMC
June 2011

A rare disorder: tumoral calcinosis and cirrhosis.

BMJ Case Rep 2011 Aug 17;2011. Epub 2011 Aug 17.

Medicine Department, Imam Khomeini Hospital Complex, Tehran, Iran.

Tumoral calcinosis is a rare disease characterised by deposition of calcified mass near the joints. The pathogenesis of this disease is not exactly defined. A disorder of calcium and inorganic phosphate metabolism may play a role. Here, we report a case of 19-year-old girl who had both cryptogenic cirrhosis and idiopathic tumoral calcinosis. To our knowledge, there is few report of such concurrence.
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http://dx.doi.org/10.1136/bcr.06.2010.3082DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171058PMC
August 2011

Severe Crimean-Congo haemorrhagic fever presented with massive retroperitoneal haemorrhage that recovered without antiviral treatment.

BMJ Case Rep 2011 Aug 19;2011. Epub 2011 Aug 19.

Department of Medicine, Imam Khomeini hospital complex, Tehran University of Medical Sciences, Tehran, Iran.

Crimean-Congo haemorrhagic fever (CCHF) is a tickborne viral zoonosis with up to 50% mortality in humans caused by CCHF virus belonging to the genus Nairovirus, family Bunyaviridae. The geographical distribution of CCHF cases corresponds closely with the distribution of principle tick vectors that is species of Hyaloma. The disease presents with non-specific febrile symptoms, but progress to a serious haemorrhagic syndrome that, soon after, a full blown multi organ failure may develop with prominent features of liver damage and bleeding diathesis. The authors present a case of a 39-year-old man with severe CCHF with retroperitoneal haemorrhage that recovered without ribavirin administration. The case was confirmed for CCHF by serological and molecular tests.
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http://dx.doi.org/10.1136/bcr.10.2010.3408DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171037PMC
August 2011
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