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M.E. is a 50-year-old Caucasian male, working as a Drum Dock Manager in a car manufacturing factory. On April 23, 2012, as he was unloading a forklift, the machine automatically engaged itself, speeding toward him and running him over. His quick-thinking co-workers positioned him flat on the floor with his head tilted to the left. M.E. was conscious and complaining of severe chest and pelvic pain. When emergency medical services arrived, he was stable. A decision was made to fly him to a nearby Trauma One Medical Center. He was diagnosed with seven left-sided rib fractures, transection of the pubic symphysis , and L 1 -L 3 transverse process fractures. There was blood at his urethral meatus, and after a retrograde urethrogram (RUG) with live fluoroscopy and without a hard copy print, a guide wire was placed through a cystoscope and into the bladder with fluoroscopic confirmation. M.E. later underwent orthopedic stabilization and repair of his pubis symphysis. His lumbar/sacral MRI redemonstrated the lumbar transverse fractures with moderate degenerative lumbar disc disease without nerve impingement . The RUG demonstrated bulbar extravasation, but a Council tip catheter was successfully guided into the bladder to determine urethral continuity. At 6 weeks, his RUG demonstrated a well-healed urethra. He was given multiple trials of voids after being able to ambulate well for one month, but in spite of a sensation to void, he could not generate a detrusor pressure, and no voiding occurred. He failed two more trials of void. A urodynamics study was then performed , demonstrating a first desire to void at 155 mls. Even at 550 mls, he experienced a strong desire to void but no detrusor pressure. The patient had good rectal sphincter tone and could volitionally tighten his rectum, so the pudendal nerve was assumed to be working well. We recommended a minimally invasive approach of sacral neuromodulation, which he successfully underwent 6 months after the accident. His bellows and ipsilateral plantar flexion were arrived at two volts on lead 0, 1 and 2, and at three volts on lead 3. Within six hours of surgery, he was emptying half his bladder, and post void residuals were 300 mls with straight catheterization. After 2 months of follow-up, he continued to urinate at maximum flows of 17.2 mls/sec but with 250–300 residual urines, so another sacral neuromodulation was performed on his contralateral side. He immediately improved to straight catheterization residual urine of 50–100 mls with a max flow of 16.8 mls/sec with 400 mls voided. Unfortunately 6 months later, after M.E. had returned to work, his uniform was irritating both of his implants, and within 3 weeks, he had a bilateral cellulitis with purulent drainage from both lead sites and implantable pulse generators. At surgery to remove each implants each buttock pocket wound culture grew non-methicillin resistant Staph aureus and he was subsequently treated with Ciprofloxin home intravenous therapy for six weeks and the resumption of clean intermittent catheterization. Three months later, re-examination revealed both sites to be well healed. Our next alternative was bilateral pudendal neuromodulation (Table 1 ), which would avoid placement near or cross over with the two formerly infected sites. Bilateral pudendal neuromodulation was performed with a right and left 0–3 lead result of 1,1,2,4, and 2,2,4,5 volts, and within six hours, the patient began to void without difficulty with a straight catheterization post-void residual urine of 0–50 mls and a max flow of 14.5 mls/sec. We then performed urodynamics, which demonstrated high pressure voiding with Pdet greater than 120 cm H2O. While having been on both tamsulosin and finesteride for more than 5 years, M.E. had failed medical therapy and was a high pressure voider. Sustained high pressure is well known to damage the bladder much like hypertension can damage the heart. To protect his bladder, we recommended a Green light transurethral resection of the prostate, which was performed on July 17, 2014. His subsequent straight catheterization post void residual urines had been 0–50 mls and his mean max flow was 22.6 mls/sec. With one-year of follow-up, his voiding parameters remain stable while his treatment power on both implantable pulse generators has been 2.8 volts on the right and 4.2 volts on the left. He feels perineal sensation and is without discomfort. We now follow the patient in 4-month intervals. Fig. 1 This plain film illustrates a right ischial pelvic fracture Fig. 2 This lateral lumbar Magnetic Resonance Image demonstrates severe degenerative disc disease with a few bulging intervertebral discs Fig. 3 The written report of this patient’s first multichannel urodynamics study Table 1 Multichannel urodynamics report 1 st Sensation 165 mls 1 st Desire to Void 389 mls Strong Desire to Void 510 mls P abd 51 cm H 2 O P det 0 cm H 2 O Max Flow 0 ml/sec Cough Leak Point Pressure No leak Rectal Tone Contracts external sphincter around a finger in his rectum, indicating that the pudendal nerve is working well
3.851563
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26581395
https://doi.org/10.1186/s12894-015-0108-4
[ "void", "well", "pressure", "bladder", "volts", "catheterization", "both", "without", "lumbar", "urodynamics" ]
[ { "code": "MF50.65", "title": "Straining to void" }, { "code": "EB30", "title": "Eosinophilic cellulitis" }, { "code": "QC2Y", "title": "Other specified contact with health services associated with the health of others" }, { "code": "4A60.1", "title": "Cryopyrin-associated periodic syndromes" }, { "code": "2D10.0", "title": "Follicular carcinoma of thyroid gland" }, { "code": "2B5H", "title": "Well differentiated lipomatous tumour, primary site" }, { "code": "EH90.Z", "title": "Pressure ulcer of unspecified grade" }, { "code": "MB23.L", "title": "Pressured speech" }, { "code": "MD30.Z", "title": "Chest pain, unspecified" }, { "code": "CB22.Y", "title": "Other specified diseases of mediastinum, not elsewhere classified" } ]
=== ICD-11 CODES FOUND === [MF50.65] Straining to void Definition: The need to strain or push in order to empty the bladder Also known as: Straining to void [EB30] Eosinophilic cellulitis Definition: Eosinophilic cellulitis (Wells syndrome) is characterised by a distinctive clinical picture resembling cellulitis, and a typical histology with tissue eosinophilia, oedema and ‘flame’ figures (clusters of eosinophils and histiocytes around a core of collagen and eosinophilic debris). It can affect either sex, usually in adult life. Any site may be involved, with single or multiple lesions, and recurrences are common. Initially, the lesions are itchy erythematous plaques with features resembling Also known as: Eosinophilic cellulitis | Wells' syndrome [QC2Y] Other specified contact with health services associated with the health of others Also known as: Other specified contact with health services associated with the health of others | Boarder in health-care facility other than healthy person accompanying sick person | Health supervision or care of other healthy infant or child | child in care | healthy infant receiving care [4A60.1] Cryopyrin-associated periodic syndromes Definition: CAPS is an autoinflammatory disease associated with gain of function changes in the cryopyrin protein, resulting in inflammasome activation and enhanced IL1 beta production. This results in clinical signs and symptoms of inflammation in the form of rash, fever, joint and eye symptoms with increased acute phase reactants. Also known as: Cryopyrin-associated periodic syndromes | CAPS - [Cryopyrin-associated periodic syndromes] | Cryopyrinopathies | Chronic infantile neurological, cutaneous and articular syndrome | Infantile-onset multisystem inflammatory disease Includes: Cryopyrinopathies [2D10.0] Follicular carcinoma of thyroid gland Definition: A differentiated adenocarcinoma arising from the follicular cells of the thyroid gland. The nuclear features which characterise the thyroid gland papillary carcinoma are absent. Radiation exposure is a risk factor and it comprises approximately 10% to 15% of thyroid cancers. Clinically, it usually presents as a solitary mass in the thyroid gland. It is generally unifocal and thickly encapsulated and shows invasion of the capsule or the vessels. Diagnostic procedures include: thyroid ultrasound a Also known as: Follicular carcinoma of thyroid gland | follicular carcinoma of unspecified site | follicular thyroid carcinoma | moderately differentiated follicular carcinoma of thyroid gland | pure follicle carcinoma of thyroid gland [2B5H] Well differentiated lipomatous tumour, primary site Also known as: Well differentiated lipomatous tumour, primary site | Atypical liposarcoma [EH90.Z] Pressure ulcer of unspecified grade Also known as: Pressure ulcer of unspecified grade | Pressure ulceration | pressure injury | pressure ulcer | decubitus ulcer [MB23.L] Pressured speech Definition: Speech in which the person feels undue pressure to get the words out. The person’s speech is usually rapid, loud, and emphatic and may be difficult or impossible to interrupt. Frequently, the person talks without any social stimulation and may continue to talk even though no one is listening. Also known as: Pressured speech Excludes: Schizophrenia or other primary psychotic disorders | Bipolar or related disorders [MD30.Z] Chest pain, unspecified Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure [CB22.Y] Other specified diseases of mediastinum, not elsewhere classified Also known as: Other specified diseases of mediastinum, not elsewhere classified | Hernia of mediastinum | mediastinal hernia | mediastinal herniation | Infectious mediastinitis === GRAPH WALKS === --- Walk 1 --- [MF50.65] Straining to void Def: The need to strain or push in order to empty the bladder... --PARENT--> [MF50.6] Other difficulties with micturition --CHILD--> [MF50.60] Hesitancy of micturition Def: Difficulty in beginning the flow of urine or maintaining a urinary stream... --- Walk 2 --- [MF50.65] Straining to void Def: The need to strain or push in order to empty the bladder... --PARENT--> [MF50.6] Other difficulties with micturition --CHILD--> [MF50.62] Splitting of urinary stream Def: A condition where the urine stream splits into two or more different directions... --- Walk 3 --- [EB30] Eosinophilic cellulitis Def: Eosinophilic cellulitis (Wells syndrome) is characterised by a distinctive clinical picture resembling cellulitis, and a typical histology with tissue eosinophilia, oedema and ‘flame’ figures (cluster... --PARENT--> [?] Inflammatory erythemas and other reactive inflammatory dermatoses Def: A heterogeneous group of disorders characterised by skin inflammation in response to known (usually infections or drugs) or unknown triggers... --RELATED_TO--> [?] Inflammatory dermatoses of the newborn Def: A range of inflammatory skin disorders presenting in the neonatal period.... --- Walk 4 --- [EB30] Eosinophilic cellulitis Def: Eosinophilic cellulitis (Wells syndrome) is characterised by a distinctive clinical picture resembling cellulitis, and a typical histology with tissue eosinophilia, oedema and ‘flame’ figures (cluster... --PARENT--> [?] Inflammatory erythemas and other reactive inflammatory dermatoses Def: A heterogeneous group of disorders characterised by skin inflammation in response to known (usually infections or drugs) or unknown triggers... --RELATED_TO--> [?] Pyodermatitis–pyostomatitis vegetans Def: This rare disorder, which may be confined to the oral mucosa (pyostomatitis vegetans) or may affect the skin as well (pyodermatitis vegetans) is strongly associated with inflammatory bowel disease, pa... --- Walk 5 --- [QC2Y] Other specified contact with health services associated with the health of others --PARENT--> [?] Contact with health services associated with the health of others --PARENT--> [?] Reasons for contact with the health services --- Walk 6 --- [QC2Y] Other specified contact with health services associated with the health of others --PARENT--> [?] Contact with health services associated with the health of others --CHILD--> [QC20] Person consulting on behalf of another person
[ "[MF50.65] Straining to void\n Def: The need to strain or push in order to empty the bladder...\n --PARENT--> [MF50.6] Other difficulties with micturition\n --CHILD--> [MF50.60] Hesitancy of micturition\n Def: Difficulty in beginning the flow of urine or maintaining a urinary stream...", "[MF50.65] Straining to void\n Def: The need to strain or push in order to empty the bladder...\n --PARENT--> [MF50.6] Other difficulties with micturition\n --CHILD--> [MF50.62] Splitting of urinary stream\n Def: A condition where the urine stream splits into two or more different directions...", "[EB30] Eosinophilic cellulitis\n Def: Eosinophilic cellulitis (Wells syndrome) is characterised by a distinctive clinical picture resembling cellulitis, and a typical histology with tissue eosinophilia, oedema and ‘flame’ figures (cluster...\n --PARENT--> [?] Inflammatory erythemas and other reactive inflammatory dermatoses\n Def: A heterogeneous group of disorders characterised by skin inflammation in response to known (usually infections or drugs) or unknown triggers...\n --RELATED_TO--> [?] Inflammatory dermatoses of the newborn\n Def: A range of inflammatory skin disorders presenting in the neonatal period....", "[EB30] Eosinophilic cellulitis\n Def: Eosinophilic cellulitis (Wells syndrome) is characterised by a distinctive clinical picture resembling cellulitis, and a typical histology with tissue eosinophilia, oedema and ‘flame’ figures (cluster...\n --PARENT--> [?] Inflammatory erythemas and other reactive inflammatory dermatoses\n Def: A heterogeneous group of disorders characterised by skin inflammation in response to known (usually infections or drugs) or unknown triggers...\n --RELATED_TO--> [?] Pyodermatitis–pyostomatitis vegetans\n Def: This rare disorder, which may be confined to the oral mucosa (pyostomatitis vegetans) or may affect the skin as well (pyodermatitis vegetans) is strongly associated with inflammatory bowel disease, pa...", "[QC2Y] Other specified contact with health services associated with the health of others\n --PARENT--> [?] Contact with health services associated with the health of others\n --PARENT--> [?] Reasons for contact with the health services", "[QC2Y] Other specified contact with health services associated with the health of others\n --PARENT--> [?] Contact with health services associated with the health of others\n --CHILD--> [QC20] Person consulting on behalf of another person" ]
MF50.65
Straining to void
[ { "from_icd11": "MF50.65", "icd10_code": "R3915", "icd10_title": "Urgency of urination" }, { "from_icd11": "MF50.65", "icd10_code": "R3911", "icd10_title": "Hesitancy of micturition" }, { "from_icd11": "MF50.65", "icd10_code": "R3914", "icd10_title": "Feeling of incomplete bladder emptying" }, { "from_icd11": "MF50.65", "icd10_code": "R3912", "icd10_title": "Poor urinary stream" }, { "from_icd11": "MF50.65", "icd10_code": "R39198", "icd10_title": "Other difficulties with micturition" }, { "from_icd11": "MF50.65", "icd10_code": "R3916", "icd10_title": "Straining to void" }, { "from_icd11": "MF50.65", "icd10_code": "R3919", "icd10_title": "Other difficulties with micturition" }, { "from_icd11": "MF50.65", "icd10_code": "R3913", "icd10_title": "Splitting of urinary stream" }, { "from_icd11": "MF50.65", "icd10_code": "R391", "icd10_title": "Other difficulties with micturition" }, { "from_icd11": "EB30", "icd10_code": "L983", "icd10_title": "Eosinophilic cellulitis [Wells]" }, { "from_icd11": "4A60.1", "icd10_code": "D8982", "icd10_title": "Autoimmune lymphoproliferative syndrome [ALPS]" }, { "from_icd11": "4A60.1", "icd10_code": "D89813", "icd10_title": "Graft-versus-host disease, unspecified" }, { "from_icd11": "4A60.1", "icd10_code": "D89810", "icd10_title": "Acute graft-versus-host disease" }, { "from_icd11": "4A60.1", "icd10_code": "D89811", "icd10_title": "Chronic graft-versus-host disease" }, { "from_icd11": "4A60.1", "icd10_code": "D8989", "icd10_title": "Other specified disorders involving the immune mechanism, not elsewhere classified" } ]
R3915
Urgency of urination
Patient 1 Patient 1 is a 65-year-old man with a history of antecedent low-risk MDS who underwent a bone marrow biopsy one year later that was concerning for chronic myelomonocytic leukemia. The marrow was hypercellular (80–90%) with 7–10% blasts, and cytogenetics demonstrated del 5q and trisomy 8. CBC at the time showed a WBC count of 25,500/ μ L (16% neutrophils, 49% lymphocytes, and 35% “mid” forms), hemoglobin 7.7 g/dL, and platelets 47,000/ μ L. The patient was started on 5-azacitadine shortly after this bone marrow biopsy but only received one cycle before he was admitted with neutropenic fever. While he was being treated for an indwelling venous catheter infection, he developed marked left lower extremity swelling with 3+ edema. He also had massive testicular edema. The patient underwent a Doppler ultrasound of his left lower extremity that revealed no clot. An MRI of the patient's left lower extremity revealed a large mass involving the medial upper thigh, 16 × 9 × 11 centimeters, extending into the inferior aspect of the left hip. It was felt to be compatible with large abscess formation or chronic hematoma. The patient was taken to surgery for exploration and drainage of the thigh wound but no infection was found. A drain was placed but was later removed because there was no significant drainage. Biopsy of the left thigh showed congested and edematous soft tissue with scattered atypical mononuclear cells, which were not felt to adequately explain the mass seen clinically. It was felt that the presence of atypical mononuclear cells was more likely to represent peripheral blood trafficking than a granulocytic sarcoma. The patient was discharged after a month-long hospitalization and presented to our institution as an outpatient. Upon presentation to our institution, the patient was noted to now have swelling of the contralateral (right) lower extremity and 3+ edema from his right foot to right thigh. There was induration on the medial aspect of his right groin and he could not stand up on his own because of leg pain. Complete blood count with differential was as follows: WBC 5,900/ μ L (20% neutrophils, 17% bands, 32% monocytes, 6% myelocytes, 2% promyelocytes, 3% blasts) hemoglobin 9.6 g/dL and platelets 52,000/ μ L. He was admitted to the hospital with extremity swelling concerning for cellulitis versus deep venous thrombosis (DVT). Doppler ultrasound of his right lower extremity showed no evidence of DVT. He was started empirically on antibiotics for cellulitis, but further investigation of the area of induration on his right thigh by punch biopsy demonstrated an inflammatory infiltrate more consistent with urticaria (focal spongiosis, superficial dermal edema and sparse perivascular lymphocytic infiltrate with mast cells and rare eosinophils). Purpuric lesions on the left thigh were shown to be consistent with leukocytoclastic vasculitis. Magnetic resonance imaging (MRI) of the right lower extremity and pelvis to further evaluate for abscess or fluid collection as a cause of the patient's right lower extremity swelling revealed only diffuse soft tissue edema consistent with anasarca. Laboratory studies on admission were notable for a ferritin of 13,520 ng/mL and an albumin of 1.4 g/dL. The ferritin was too high to be explained solely by the estimated >40 units of blood the patient had been transfused in the past year. Careful examination of a repeat bone marrow biopsy showed no evidence of hemophagocytic syndrome, so the high ferritin was felt to be reactive. Hypoalbuminemia was sufficient to explain his impressive scrotal edema and overall anasarca. 24-hour urine protein was 2.0 grams per total volume. His overall medical condition was felt to be too tenuous for renal biopsy to further characterize the nature of his protein losing nephropathy. He demonstrated mild renal insufficiency but did not develop acute kidney injury. A bone marrow biopsy was performed to assess for disease transformation. This showed an expansion of blasts (37%) with monocytic features consistent with AML M5 by French-American-British (FAB) classification or AML with myelodysplasia related changes by World Health Organization (WHO) classification. FLT3 mutation analysis was negative but the patient had a complex karyotype with more than ten cytogenetic abnormalities. The patient developed left elbow swelling with limited range of motion and a series of tests to look for rheumatologic or infectious causes of inflammation were run, but all were negative (ANA, antimitochondrial antibodies, ANCA, cryoglobulins, and HIV). A brief course of prednisone did not lead to improvement in his extremity swelling, anasarca, or nephropathy. His poor performance status precluded standard induction chemotherapy for AML or enrollment on a clinical trial, and the patient ultimately developed pneumonia with increasing oxygen requirement and associated sepsis. A decision was made to provide comfort measures rather than pursuing aggressive supportive care in the intensive care unit and the patient passed away 30 days into his hospitalization.
3.912109
0.983398
sec[1]/p[0]
en
0.999997
22928125
https://doi.org/10.1155/2012/582950
[ "extremity", "biopsy", "swelling", "edema", "thigh", "marrow", "felt", "bone", "consistent", "that" ]
[ { "code": "ND56.1", "title": "Open wound of unspecified body region" }, { "code": "LB9Z", "title": "Structural developmental anomalies of the skeleton, unspecified" }, { "code": "FB56.6", "title": "Other specified soft tissue disorders" }, { "code": "5B51&XS25", "title": "Severe wasting in infants, children or adolescents" }, { "code": "ND55", "title": "Other injuries of leg, level unspecified" }, { "code": "JA85.Y", "title": "Maternal care for other specified fetal abnormality or damage" }, { "code": "KD39.3", "title": "Fetus or newborn affected by complications of fetal surgery" }, { "code": "PK81.5", "title": "Biopsy procedure, not elsewhere classified, associated with injury or harm in therapeutic use" }, { "code": "PK81.4", "title": "Bone marrow aspiration or biopsy associated with injury or harm in therapeutic use" }, { "code": "PK98.0", "title": "Radiological devices associated with injury or harm, diagnostic or monitoring devices" } ]
=== ICD-11 CODES FOUND === [ND56.1] Open wound of unspecified body region Also known as: Open wound of unspecified body region | cut NOS | open wound NOS | penetrating wound NOS | Puncture wound with foreign body unspecified body region Excludes: Traumatic amputations involving multiple body regions | Open wounds involving multiple body regions | traumatic amputation NOS [LB9Z] Structural developmental anomalies of the skeleton, unspecified Also known as: Structural developmental anomalies of the skeleton, unspecified | Abnormal bone development | skeletal anomaly NOS [FB56.6] Other specified soft tissue disorders Also known as: Other specified soft tissue disorders | Fat necrosis | fatty necrosis | Profichet's disease | Sloughing of fascia [ND55] Other injuries of leg, level unspecified Also known as: Other injuries of leg, level unspecified | other injuries of lower limb, level unspecified | Superficial injury of leg, level unspecified | Abrasion of leg, level unspecified | Contusion of leg, level unspecified Excludes: Fracture of leg, level unspecified | Injuries involving multiple body regions [JA85.Y] Maternal care for other specified fetal abnormality or damage Also known as: Maternal care for other specified fetal abnormality or damage | Maternal care for damage to fetus from alcohol | suspected damage to fetus from maternal alcohol addiction affecting management of mother | pregnancy management affected by fetal damage from maternal alcohol addiction | maternal care for known or suspected damage to fetus from alcohol [KD39.3] Fetus or newborn affected by complications of fetal surgery Definition: A condition in the fetus due to an unfavourable evolution of a condition (complication) associated with a surgical health intervention applied to the fetus. Also known as: Fetus or newborn affected by complications of fetal surgery | Adverse outcome following fetal skin biopsy [PK81.5] Biopsy procedure, not elsewhere classified, associated with injury or harm in therapeutic use Also known as: Biopsy procedure, not elsewhere classified, associated with injury or harm in therapeutic use | complication during or following biopsy procedure, other than bone marrow Excludes: Bone marrow aspiration or biopsy associated with injury or harm in therapeutic use | Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm [PK81.4] Bone marrow aspiration or biopsy associated with injury or harm in therapeutic use Also known as: Bone marrow aspiration or biopsy associated with injury or harm in therapeutic use | complication during or following bone marrow aspiration or biopsy Excludes: Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm [PK98.0] Radiological devices associated with injury or harm, diagnostic or monitoring devices Also known as: Radiological devices associated with injury or harm, diagnostic or monitoring devices | Radiological devices associated with adverse incidents, malfunction of radiological apparatus | Radiological devices associated with adverse incidents, CT scanner or MRI causing physical injury | Radiological devices associated with adverse incidents, needles used in radiologically-guided biopsies Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm === GRAPH WALKS === --- Walk 1 --- [ND56.1] Open wound of unspecified body region --EXCLUDES--> [?] Traumatic amputations involving multiple body regions --EXCLUDES--> [?] Open wounds involving multiple body regions --- Walk 2 --- [ND56.1] Open wound of unspecified body region --EXCLUDES--> [?] Traumatic amputation of unspecified body region --PARENT--> [?] Injury of unspecified body region Def: Damage inflicted on the body in an unspecified area as the direct or indirect result of an external force, with or without disruption of structural continuity.... --- Walk 3 --- [LB9Z] Structural developmental anomalies of the skeleton, unspecified --PARENT--> [?] Structural developmental anomalies of the skeleton Def: A deformation established before birth of an anatomical structure of one or more bones.... --PARENT--> [?] Structural developmental anomalies primarily affecting one body system Def: A deformation established before birth of an anatomical structure.... --- Walk 4 --- [LB9Z] Structural developmental anomalies of the skeleton, unspecified --PARENT--> [?] Structural developmental anomalies of the skeleton Def: A deformation established before birth of an anatomical structure of one or more bones.... --CHILD--> [LB70] Structural developmental anomalies of cranium Def: Any condition caused by failure of the cranium to correctly develop during the antenatal period.... --- Walk 5 --- [FB56.6] Other specified soft tissue disorders --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone.... --CHILD--> [FB56.0] Foreign body granuloma of soft tissue, not elsewhere classified --- Walk 6 --- [FB56.6] Other specified soft tissue disorders --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone.... --CHILD--> [FB56.2] Myalgia Def: This is a disorder characterised by pain in a muscle or group of muscles....
[ "[ND56.1] Open wound of unspecified body region\n --EXCLUDES--> [?] Traumatic amputations involving multiple body regions\n --EXCLUDES--> [?] Open wounds involving multiple body regions", "[ND56.1] Open wound of unspecified body region\n --EXCLUDES--> [?] Traumatic amputation of unspecified body region\n --PARENT--> [?] Injury of unspecified body region\n Def: Damage inflicted on the body in an unspecified area as the direct or indirect result of an external force, with or without disruption of structural continuity....", "[LB9Z] Structural developmental anomalies of the skeleton, unspecified\n --PARENT--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....\n --PARENT--> [?] Structural developmental anomalies primarily affecting one body system\n Def: A deformation established before birth of an anatomical structure....", "[LB9Z] Structural developmental anomalies of the skeleton, unspecified\n --PARENT--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....\n --CHILD--> [LB70] Structural developmental anomalies of cranium\n Def: Any condition caused by failure of the cranium to correctly develop during the antenatal period....", "[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --CHILD--> [FB56.0] Foreign body granuloma of soft tissue, not elsewhere classified", "[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --CHILD--> [FB56.2] Myalgia\n Def: This is a disorder characterised by pain in a muscle or group of muscles...." ]
ND56.1
Open wound of unspecified body region
[ { "from_icd11": "ND56.1", "icd10_code": "T141", "icd10_title": "" }, { "from_icd11": "LB9Z", "icd10_code": "Q8789", "icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified" }, { "from_icd11": "LB9Z", "icd10_code": "Q8781", "icd10_title": "Alport syndrome" }, { "from_icd11": "LB9Z", "icd10_code": "Q742", "icd10_title": "Other congenital malformations of lower limb(s), including pelvic girdle" }, { "from_icd11": "LB9Z", "icd10_code": "Q749", "icd10_title": "Unspecified congenital malformation of limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q740", "icd10_title": "Other congenital malformations of upper limb(s), including shoulder girdle" }, { "from_icd11": "LB9Z", "icd10_code": "Q741", "icd10_title": "Congenital malformation of knee" }, { "from_icd11": "LB9Z", "icd10_code": "Q875", "icd10_title": "Other congenital malformation syndromes with other skeletal changes" }, { "from_icd11": "LB9Z", "icd10_code": "Q748", "icd10_title": "Other specified congenital malformations of limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q89", "icd10_title": "Other congenital malformations, not elsewhere classified" }, { "from_icd11": "LB9Z", "icd10_code": "Q65-Q79", "icd10_title": "" }, { "from_icd11": "LB9Z", "icd10_code": "Q73", "icd10_title": "Reduction defects of unspecified limb" }, { "from_icd11": "LB9Z", "icd10_code": "Q730", "icd10_title": "Congenital absence of unspecified limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q731", "icd10_title": "Phocomelia, unspecified limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q74", "icd10_title": "Other congenital malformations of limb(s)" } ]
T141
Case 1 was a 33-year-old Caucasian male. He was a pilot and flew routes between France, Guinea and the Republic of the Congo. In September 2016 he presented with fever, headaches and vomiting, and thereafter received treatment in Paris for severe malaria (positive thick drop for P. falciparum with 5 parasites/2 μL, positive HRP2 antigen test) with hepatic impairment (SGOT/SGPT 92/105 U/L and hyperbilirubinaemia (93 µmol/L, normal range < 25 µmol/L) but no neurologic involvement or any other severity criteria. The treatment regimen included intravenous artesunate (2.4 mg/kg, 5 doses for 3 days) then atovaquone/proguanil , and the patient improved quickly, both clinically and biologically (blood smear negative for P. falciparum on day 3). On day 7, he presented headaches and fever (38 °C) and on day 8 abdominal pain, nausea and vomiting. The renewed blood smear was negative. On day 10, the patient showed confusion, ataxia, tremor, and dysarthria, and his fever increased to 39 °C. On day 11, he was given ceftriaxone for presumed enteric fever. On day 12, he remained confused and started having visual hallucinations and urine incontinence. CSF analysis showed lymphocytic meningitis (Table 2 ), MRI was normal and EEG revealed asymmetric (right) frontal slowing. Laboratory results showed no inflammation, a slight hyperbilirubinaemia that diminished over the first days and a weak positive titre of anti-nuclear factor (1/80) with no positivity for anti-DNA. Thereafter, he was treated with cefotaxime and acyclovir from day 12–21 (until a second CSF analysis showed no viral or bacterial infection), and corticosteroids from day 15–30 (methylprednisolone 500 mg/od for 3 days then prednisone 1 mg/kg/od), with clinical improvement on day 19. The patient was discharged with only a slight residual cerebellar ataxia on day 29 and had fully recovered on day 60. Table 2 Biological and radiological features of PMNS post P . falciparum , P. vivax or mixed infection CSF (WBC/%L) CSF protein (g/L) CRP (mg/L) EEG MRI MRI matching ADEM or AIE P. falciparum infection Case 1 32/90 1.05 N Abnormal N – Case 2 82/87 2.41 N Abnormal Limbic and hippocampal hypersignal ADEM plausible Case 3 173/89 1.88 40 Abnormal N – Case 4 NA NA N NA NA Nguyen (N = 22) > 5 in 8/lymphocytic predominance > 0.5 in 13 NA NA NA O’Brien NA NA NA NA WM lesions in CH, brainstem, cerebellum, thalamus and basal ganglia ADEM plausible Zambito 20/100 0.86 NA Abnormal N – Mizuno 10/100 0.83 27 Abnormal N – Nayak N/N 0.66 NA NA NA Prendki 76/100 0.52 163 Abnormal N – Prendki 26/91 1.88 9 Abnormal N – Falchook NA NA N NA Pons, posterior internal capsule, thalamus, corona radiata, and periventricular hypersignal ADEM unlikely Matias N/N 1.83 N Abnormal Extensive demyelinating lesions (subcortical WM and cerebellum) ADEM or dysimmune plausible Markley 20/100 0.92 NA Abnormal N – Forestier 43/95 1.2 N Abnormal N – Rakoto. 31/98 2 N NA NA Pace NA NA 8 NA Brainstem and spinal cord high signal and swelling ADEM plausible Caetano 123/100 1.88 NA Normal N Mohsen 22/100 1.4 NA Abnormal Subcortical unilateral frontal and temporal, and cerebellar hypersignal with gadolinium enhancement ADEM unlikely but not impossible Schnorf 10/95 0.6 NA Abnormal Peri and supraventricular and cerebellar hypersignal ADEM plausible Schnorf 80/87 1.8 NA Abnormal N Agrawal 5/100 1.12 NA NA Asymmetric supraventricular, semi-ovale center, genu of corpus callosum WM hypersignal NA Rachita 7/100 1.25 NA NA Multifocal asymmetric diffuse WM hypersignal with small mass effect ADEM Lawn N/N 0.89 N NA N – Lawn 59/100 2.89 N Abnormal N – Total abnormal 25/42 33/42 5/14 14/15 9/21 % abnormal [95% CI] 59.5 [44.5–72.9] 78.6 [64.1–88.3] 35.7 [16.3–61.3] 93.3 [70.2–98.8] 42.8 [24.5–63.5] Mean WBC/%L (SD) 48 a /96 a (46)/(5.1) 1.4 b (0.6) 49.4 c (64.9) Median WBC/%L (min–max) 31 a /100 a (5–173)/(87–100) 1.2 b (0.5–2.9) 27 c (8–163) P. vivax infection Goyal 70/NA 0.5 NA NA Diffuse periventricular, deep and subcortical WM hypersignal Sidhu NA NA NA NA Subcortical, cortical, left parietal periventricular regions and pons hypersignal Kochar NA NA NA NA NA Kasundra 10/100 0.65 NA NA T1-weighted isointense and T2 and fluid-attenuated inversion recovery high signal in bilateral cerebellar hemispheres including vermis Mixed infection Koibuchi 30/NA 0.46 52 NA Asymmetric spotty mottled cortical and subcortical lesions Mani NA NA NA Multifocal confluent areas of demyelination in the corpus callosum and periventricular region, myelitis Meningitis is defined in the CSF by CSF WBC ≥ 5/mL. CSF Protein ≥ 0.5 g/L is considered abnormal. CRP normal value ≤ 5 mg/L CSF cerebrospinal fluid, WBC white blood count, %L proportion of lymphocytes, CRP c-reactive protein, WM white matter, NA not available, N normal, ADEM acute disseminated encephalomyelitis, AIE autoimmune encephalitis, LP lumbar puncture, SD standard deviation, [95% CI] 95% confidence interval a Calculated on abnormal and available figured data, n = 17 b Calculated on abnormal and available figured data, n = 20 c Calculated on abnormal and available figured data, n = 5
4.160156
0.966309
sec[2]/sec[0]/p[1]
en
0.999996
30367650
https://doi.org/10.1186/s12936-018-2542-8
[ "adem", "hypersignal", "infection", "plausible", "subcortical", "fever", "falciparum", "asymmetric", "cerebellar", "periventricular" ]
[ { "code": "8A42.Z", "title": "Acute disseminated encephalomyelitis, unspecified" }, { "code": "1H0Z", "title": "Infection, unspecified" }, { "code": "1G40", "title": "Sepsis without septic shock" }, { "code": "FA10.Z", "title": "Direct infections of joint, unspecified" }, { "code": "1D9Z", "title": "Unspecified viral infection of unspecified site" }, { "code": "1A40.Z", "title": "Infectious gastroenteritis or colitis without specification of infectious agent" }, { "code": "8B26.Y", "title": "Other specified vascular syndromes of brain in cerebrovascular diseases" }, { "code": "8B00.0", "title": "Deep hemispheric haemorrhage" }, { "code": "LA05.5Y", "title": "Other specified abnormal neuronal migration" }, { "code": "LD20.1", "title": "Syndromes with lissencephaly as a major feature" } ]
=== ICD-11 CODES FOUND === [8A42.Z] Acute disseminated encephalomyelitis, unspecified Also known as: Acute disseminated encephalomyelitis, unspecified | Acute disseminated encephalomyelitis | ADEM - [acute disseminated encephalomyelitis] [1H0Z] Infection, unspecified Also known as: Infection, unspecified | infection NOS | infectious disease NOS | infection unknown | infection process NOS [1G40] Sepsis without septic shock Definition: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Also known as: Sepsis without septic shock | sepsis without septic shock with known organism | Sepsis-associated hypotension | Unspecified sepsis | general septic intoxication Excludes: Septicaemia | Sepsis of fetus or newborn [FA10.Z] Direct infections of joint, unspecified Also known as: Direct infections of joint, unspecified | Direct infections of joint | septic arthritis | pyogenic arthritis | arthritis due to infection [1D9Z] Unspecified viral infection of unspecified site Also known as: Unspecified viral infection of unspecified site | viral infection NOS | viral disorder NOS | disease caused by virus | unspecified viremia [1A40.Z] Infectious gastroenteritis or colitis without specification of infectious agent Also known as: Infectious gastroenteritis or colitis without specification of infectious agent | Gastroenteritis or colitis without specification of infectious agent | diarrhoea and gastroenteritis of presumed infectious origin | diarrhoeal enteritis | GE - [gastroenteritis] [8B26.Y] Other specified vascular syndromes of brain in cerebrovascular diseases Also known as: Other specified vascular syndromes of brain in cerebrovascular diseases | Subcortical ischaemic stroke | subcortical infarction | Cortical ischaemic stroke | cortical infarction [8B00.0] Deep hemispheric haemorrhage Definition: Acute neurological dysfunction caused by haemorrhage localised to the subcortex, basal ganglia, and the diencephalon (thalamus). Also known as: Deep hemispheric haemorrhage | deep intracerebral haemorrhage | deep nontraumatic intracerebral haemorrhage | Pars basalis haemorrhage | Lenticular striate artery haemorrhage Includes: deep intracerebral haemorrhage [LA05.5Y] Other specified abnormal neuronal migration Also known as: Other specified abnormal neuronal migration | Nodular neuronal heterotopia | Periventricular nodular heterotopia | Sub-cortical nodular heterotopia | Subependymal nodular heterotopia [LD20.1] Syndromes with lissencephaly as a major feature Definition: The term lissencephaly covers a group of rare malformations sharing the common feature of anomalies in the appearance of brain convolutions (characterised by simplification or absence of folding) associated with abnormal organisation of the cortical layers as a result of neuronal migration defects during embryogenesis. Children with lissencephaly have feeding and swallowing problems, muscle tone anomalies (early hypotonia and subsequently limb hypertonia), seizures (in particular, infantile spas Also known as: Syndromes with lissencephaly as a major feature | Pachygyria | Agyria | Classic lissencephaly | Lissencephaly type 1 Includes: Agyria | Pachygyria === GRAPH WALKS === --- Walk 1 --- [8A42.Z] Acute disseminated encephalomyelitis, unspecified --PARENT--> [8A42] Acute disseminated encephalomyelitis Def: Acute disseminated encephalomyelitis is a demyelinating disorder of the central nervous system. It usually develops after acute viral or bacterial infection or vaccination, with a sudden onset of irri... --CHILD--> [8A42.Y] Other specified acute disseminated encephalomyelitis --- Walk 2 --- [8A42.Z] Acute disseminated encephalomyelitis, unspecified --PARENT--> [8A42] Acute disseminated encephalomyelitis Def: Acute disseminated encephalomyelitis is a demyelinating disorder of the central nervous system. It usually develops after acute viral or bacterial infection or vaccination, with a sudden onset of irri... --CHILD--> [8A42.Y] Other specified acute disseminated encephalomyelitis --- Walk 3 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --RELATED_TO--> [?] Infections of the fetus or newborn --- Walk 4 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --CHILD--> [?] Predominantly sexually transmitted infections --- Walk 5 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Sepsis of fetus or newborn --EXCLUDES--> [?] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --- Walk 6 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Septicaemia --EXCLUDES--> [?] Sepsis with septic shock Def: Septic shock is a subset of sepsis in which circulatory, cellular and metabolic abnormalities are profound enough to substantially increase mortality....
[ "[8A42.Z] Acute disseminated encephalomyelitis, unspecified\n --PARENT--> [8A42] Acute disseminated encephalomyelitis\n Def: Acute disseminated encephalomyelitis is a demyelinating disorder of the central nervous system. It usually develops after acute viral or bacterial infection or vaccination, with a sudden onset of irri...\n --CHILD--> [8A42.Y] Other specified acute disseminated encephalomyelitis", "[8A42.Z] Acute disseminated encephalomyelitis, unspecified\n --PARENT--> [8A42] Acute disseminated encephalomyelitis\n Def: Acute disseminated encephalomyelitis is a demyelinating disorder of the central nervous system. It usually develops after acute viral or bacterial infection or vaccination, with a sudden onset of irri...\n --CHILD--> [8A42.Y] Other specified acute disseminated encephalomyelitis", "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --RELATED_TO--> [?] Infections of the fetus or newborn", "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --CHILD--> [?] Predominantly sexually transmitted infections", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Sepsis of fetus or newborn\n --EXCLUDES--> [?] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Septicaemia\n --EXCLUDES--> [?] Sepsis with septic shock\n Def: Septic shock is a subset of sepsis in which circulatory, cellular and metabolic abnormalities are profound enough to substantially increase mortality...." ]
8A42.Z
Acute disseminated encephalomyelitis, unspecified
[ { "from_icd11": "8A42.Z", "icd10_code": "T880XXA", "icd10_title": "Infection following immunization, initial encounter" }, { "from_icd11": "8A42.Z", "icd10_code": "G0401", "icd10_title": "Postinfectious acute disseminated encephalitis and encephalomyelitis (postinfectious ADEM)" }, { "from_icd11": "8A42.Z", "icd10_code": "G0400", "icd10_title": "Acute disseminated encephalitis and encephalomyelitis, unspecified" }, { "from_icd11": "8A42.Z", "icd10_code": "G040", "icd10_title": "Acute disseminated encephalitis and encephalomyelitis (ADEM)" }, { "from_icd11": "8A42.Z", "icd10_code": "G36", "icd10_title": "Other acute disseminated demyelination" }, { "from_icd11": "8A42.Z", "icd10_code": "G368", "icd10_title": "Other specified acute disseminated demyelination" }, { "from_icd11": "8A42.Z", "icd10_code": "G369", "icd10_title": "Acute disseminated demyelination, unspecified" }, { "from_icd11": "8A42.Z", "icd10_code": "T880", "icd10_title": "Infection following immunization" }, { "from_icd11": "1H0Z", "icd10_code": "B999", "icd10_title": "Unspecified infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A312", "icd10_title": "Disseminated mycobacterium avium-intracellulare complex (DMAC)" }, { "from_icd11": "1H0Z", "icd10_code": "B998", "icd10_title": "Other infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A249", "icd10_title": "Melioidosis, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "R6511", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "R6510", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "A318", "icd10_title": "Other mycobacterial infections" } ]
T880XXA
Infection following immunization, initial encounter
We present a 28-year-old male patient with a history of Asperger's syndrome, moderate mental retardation, disruptive behavior disorder, and pharmacoresistant epilepsy. The patient’s first seizure occurred at three months old without any obvious cause. Brain MRI studies were without abnormalities. Ambulatory EEG recordings demonstrated generalized, 2–4 Hz epileptiform discharges seen throughout the various stages of wakefulness, drowsiness, and sleep; in addition, there were numerous generalized electrographic seizures of the same 3–4 Hz frequency suggesting absence type seizures. The patient was experiencing five to six generalized clonic-tonic seizures a week despite numerous medication trials; thus, VNS was implanted seven years ago. The VNS therapy was highly effective and the patient experienced only two seizures since the surgery until a year ago. Since then, the patient has had three episodes of generalized clonic-tonic seizures. Additionally, two months ago the patient began experiencing a stabbing pain at the IPG site four to five times a week, lasting up to 5 min. All this was suspicious for VNS system malfunction, but device interrogation was not concerning – it showed the Demipulse device (model 103) with normal output current set at 1.5 mA with 30 Hz frequency and 500 ms pulse width at 16% duty cycle (30 s on, 3 min off) with remaining battery 8–18% and with 2746 Ohm system impedance. A CT of the neck and chest was obtained and showed unusually tilted IPG but no obvious hardware or surrounding tissue problems . Additionally, plain radiographs were obtained and showed VNS contacts at C5 level without visible hardware discontinuities . Breakthrough seizures and stabbing pains prompted the consideration of VNS system exploration surgery. Worth noting, the patient had incomplete right bundle branch block on preoperative ECG , thus, preoperative cardiology evaluation was requested. However, our patient did not follow with this recommendation. Due to the fact that our patient already had VNS in place and it was highly effective, the decision was made to proceed with surgery. During the surgery the new IPG was implanted—AspireSR (model 106). The close inspection of the original VNS lead in the chest pocket revealed the ruptured insulation layer. Thus, the surgery was extended to the VNS lead replacement to the new PerenniaFLEX lead (model 304–30). Noteworthy, the new lead contacts were placed more distally (caudally) on the freshly dissected segment of the left vagus nerve as the old contacts were embedded in the tight epineurial scar and, thus, were left in situ. However, the intraoperative device interrogation with a standard 1 mA output resulted in immediate asystole for the duration of stimulation and it was reproducible until the output was decreased to 0.675 mA which is less than a half of the original output value (1.5 mA). In the postanesthesia recovery room, the patient was experiencing excessive coughing abolishable by prolonged magnet application over IPG. Therefore, further programming was performed with normal output current titration down to 0.25 mA, with signal frequency of 20 Hz, pulse width of 250 ms, on time of 30 s, and off time of 2 min with AutoStim output turned off. At 6 months after surgery, the normal output current was titrated to 0.5 mA without side effects. At 12-month postoperative follow up, the patient’s caregiver reported “small staring spells once every few days but no big seizures since surgery”. The plain radiograph of the neck showed the retained old VNS contacts at C5 level and the new VNS contacts more caudally . The upward titration of VNS output was arranged with live concomitant ECG, IV access, and atropine available. First, VNS was turned off and ECG was recorded to establish the baseline . Then the normal VNS output was gradually increased to 0.75 mA without any significant bradyarrhythmic changes on ECG . Further titration to 1 mA resulted in excessive coughing, thus, it was reverted to 0.75 mA. Three months later, the patient was seen again and VNS normal output was successfully increased to 1.0 mA without any significant ECG changes or clinical side effects. Fig. 2 Preoperative CT of the neck and chest demonstrating oblique positioning of IPG without other VNS hardware or surrounding tissue abnormalities Fig. 3 Preoperative plain radiograph of the neck demonstrating VNS electrode helical contacts at the C5 level and no visible VNS hardware discontinuity Fig. 4 Preoperative ECG demonstrating incomplete right bundle branch block Fig. 5 Postoperative plain radiograph of the neck demonstrating the retained old VNS electrode helical contacts (black arrows) at the C5 level as well as new VNS electrode helical contacts (red arrows) positioned more caudally Fig. 6 Postoperative ECG, 12 months after surgery - the normal VNS output was turned off (0 mA) and ECG was recorded to establish the baseline Fig. 7 Postoperative ECG, 12 months after surgery, the normal VNS output was gradually increased from 0 mA to 0.75 mA without any significant bradyarrhythmic changes
4.019531
0.977539
sec[1]/p[0]
en
0.999995
35246068
https://doi.org/10.1186/s12883-022-02585-6
[ "output", "without", "contacts", "seizures", "thus", "neck", "preoperative", "hardware", "plain", "lead" ]
[ { "code": "BD12", "title": "High output syndromes" }, { "code": "MF55", "title": "Polyuria" }, { "code": "MF51", "title": "Anuria or oliguria" }, { "code": "NE82.1Y", "title": "Other specified pacemaker or implantable cardioverter defibrillator dysfunction" }, { "code": "KB40.1", "title": "Neonatal cardiac failure due to decreased left ventricular output" }, { "code": "MH12.1", "title": "Death occurring less than 24 hours from onset of symptoms, not otherwise explained" }, { "code": "FA36.Y", "title": "Other specified effusion of joint" }, { "code": "3A51.1", "title": "Sickle cell disease without crisis" }, { "code": "QA50", "title": "Embolisation without injury or harm" }, { "code": "LB12.1Z", "title": "Atresia of oesophagus, unspecified" } ]
=== ICD-11 CODES FOUND === [BD12] High output syndromes Definition: Increased cardiac output above normal associated with anaemia, arteriovenous fistulas, thyrotoxicosis and other syndromes. May result in heart failure. Also known as: High output syndromes [MF55] Polyuria Definition: Polyuria is a condition defined as excessive or abnormally large production or passage of urine. Also known as: Polyuria | passes too much urine | polyuric state | urine output high | excessive urine discharge [MF51] Anuria or oliguria Definition: Anuria means nonpassage of urine, in practice is defined as passage of less than 50 millilitres of urine in a day. Oliguria is the low output of urine. It is clinically classified as an output below 300-500ml/day. Also known as: Anuria or oliguria | Anuria | suppression of urinary secretion | ischuria | Oliguria Excludes: Maternal care for other conditions predominantly related to pregnancy [NE82.1Y] Other specified pacemaker or implantable cardioverter defibrillator dysfunction Also known as: Other specified pacemaker or implantable cardioverter defibrillator dysfunction | Implantable cardioverter defibrillator high voltage component dysfunction | Inappropriate withholding of implantable cardioverter defibrillator therapy | Implantable cardioverter or defibrillator generator dysfunction | Pacemaker or implantable cardioverter defibrillator output failure [KB40.1] Neonatal cardiac failure due to decreased left ventricular output Also known as: Neonatal cardiac failure due to decreased left ventricular output [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained Also known as: Death occurring less than 24 hours from onset of symptoms, not otherwise explained | died without sign of disease | Death known not to be violent or instantaneous for which no cause can be discovered | death known not to be violent or instantaneous, cause unknown | Death without sign of disease Includes: Death known not to be violent or instantaneous for which no cause can be discovered | Death without sign of disease [FA36.Y] Other specified effusion of joint Also known as: Other specified effusion of joint | Non aspirated effusion of joint | Effusion of joint without blood | Effusion of joint, multiple sites | Effusion of joint, shoulder region [3A51.1] Sickle cell disease without crisis Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing. Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease] [QA50] Embolisation without injury or harm Definition: An embolisation without documented injury or harm occurs when a solid object within the venous or arterial circulation propagates to a distal location and becomes lodged there. Also known as: Embolisation without injury or harm | Embolic phenomenon without documented injury or harm | Air embolism without documented injury or harm | Injection of air without injury or harm Excludes: Embolisation, as mode of injury or harm [LB12.1Z] Atresia of oesophagus, unspecified Also known as: Atresia of oesophagus, unspecified | Atresia of oesophagus | atresia of esophagus | Atresia of oesophagus without fistula | congenital atresia of oesophagus === GRAPH WALKS === --- Walk 1 --- [BD12] High output syndromes Def: Increased cardiac output above normal associated with anaemia, arteriovenous fistulas, thyrotoxicosis and other syndromes. May result in heart failure.... --PARENT--> [?] Heart failure --CHILD--> [BD10] Congestive heart failure Def: A clinical syndrome characterised by abnormalities of ventricular function and neurohormonal regulation which are accompanied by effort intolerance and fluid retention.... --- Walk 2 --- [BD12] High output syndromes Def: Increased cardiac output above normal associated with anaemia, arteriovenous fistulas, thyrotoxicosis and other syndromes. May result in heart failure.... --PARENT--> [?] Heart failure --EXCLUDES--> [?] Other functional disturbances following cardiac surgery --- Walk 3 --- [MF55] Polyuria Def: Polyuria is a condition defined as excessive or abnormally large production or passage of urine.... --PARENT--> [?] Symptoms, signs or clinical findings involving the urinary system --PARENT--> [?] Symptoms, signs or clinical findings of the genitourinary system --- Walk 4 --- [MF55] Polyuria Def: Polyuria is a condition defined as excessive or abnormally large production or passage of urine.... --PARENT--> [?] Symptoms, signs or clinical findings involving the urinary system --PARENT--> [?] Symptoms, signs or clinical findings of the genitourinary system --- Walk 5 --- [MF51] Anuria or oliguria Def: Anuria means nonpassage of urine, in practice is defined as passage of less than 50 millilitres of urine in a day. Oliguria is the low output of urine. It is clinically classified as an output below 3... --EXCLUDES--> [?] Maternal care for other conditions predominantly related to pregnancy Def: Any reason for encounter to assess (or care for) a mother for other conditions predominantly related to pregnancy.... --CHILD--> [?] Pregnancy dermatoses Def: A group of skin disorders which are specific to pregnancy.... --- Walk 6 --- [MF51] Anuria or oliguria Def: Anuria means nonpassage of urine, in practice is defined as passage of less than 50 millilitres of urine in a day. Oliguria is the low output of urine. It is clinically classified as an output below 3... --EXCLUDES--> [?] Maternal care for other conditions predominantly related to pregnancy Def: Any reason for encounter to assess (or care for) a mother for other conditions predominantly related to pregnancy.... --CHILD--> [?] Pregnancy dermatoses Def: A group of skin disorders which are specific to pregnancy....
[ "[BD12] High output syndromes\n Def: Increased cardiac output above normal associated with anaemia, arteriovenous fistulas, thyrotoxicosis and other syndromes. May result in heart failure....\n --PARENT--> [?] Heart failure\n --CHILD--> [BD10] Congestive heart failure\n Def: A clinical syndrome characterised by abnormalities of ventricular function and neurohormonal regulation which are accompanied by effort intolerance and fluid retention....", "[BD12] High output syndromes\n Def: Increased cardiac output above normal associated with anaemia, arteriovenous fistulas, thyrotoxicosis and other syndromes. May result in heart failure....\n --PARENT--> [?] Heart failure\n --EXCLUDES--> [?] Other functional disturbances following cardiac surgery", "[MF55] Polyuria\n Def: Polyuria is a condition defined as excessive or abnormally large production or passage of urine....\n --PARENT--> [?] Symptoms, signs or clinical findings involving the urinary system\n --PARENT--> [?] Symptoms, signs or clinical findings of the genitourinary system", "[MF55] Polyuria\n Def: Polyuria is a condition defined as excessive or abnormally large production or passage of urine....\n --PARENT--> [?] Symptoms, signs or clinical findings involving the urinary system\n --PARENT--> [?] Symptoms, signs or clinical findings of the genitourinary system", "[MF51] Anuria or oliguria\n Def: Anuria means nonpassage of urine, in practice is defined as passage of less than 50 millilitres of urine in a day. Oliguria is the low output of urine. It is clinically classified as an output below 3...\n --EXCLUDES--> [?] Maternal care for other conditions predominantly related to pregnancy\n Def: Any reason for encounter to assess (or care for) a mother for other conditions predominantly related to pregnancy....\n --CHILD--> [?] Pregnancy dermatoses\n Def: A group of skin disorders which are specific to pregnancy....", "[MF51] Anuria or oliguria\n Def: Anuria means nonpassage of urine, in practice is defined as passage of less than 50 millilitres of urine in a day. Oliguria is the low output of urine. It is clinically classified as an output below 3...\n --EXCLUDES--> [?] Maternal care for other conditions predominantly related to pregnancy\n Def: Any reason for encounter to assess (or care for) a mother for other conditions predominantly related to pregnancy....\n --CHILD--> [?] Pregnancy dermatoses\n Def: A group of skin disorders which are specific to pregnancy...." ]
BD12
High output syndromes
[ { "from_icd11": "MF55", "icd10_code": "R351", "icd10_title": "Nocturia" }, { "from_icd11": "MF55", "icd10_code": "R358", "icd10_title": "Other polyuria" }, { "from_icd11": "MF55", "icd10_code": "R35", "icd10_title": "Polyuria" }, { "from_icd11": "MF51", "icd10_code": "R34", "icd10_title": "Anuria and oliguria" }, { "from_icd11": "MH12.1", "icd10_code": "R961", "icd10_title": "" }, { "from_icd11": "3A51.1", "icd10_code": "D571", "icd10_title": "Sickle-cell disease without crisis" }, { "from_icd11": "QA50", "icd10_code": "XXI", "icd10_title": "" } ]
R351
Nocturia
The simulations involved managing a pregnant patient with acquired heart disease, presenting with acute cardiac symptoms (chest pain and dyspnea) and hemodynamic instability in the third trimester of pregnancy (Table 1 ). The simulated patients were not in labor during the simulation. This content domain was chosen given the inherent need for multidisciplinary care from OBGYN and Cardiology and the known limited exposure to pregnant patients with heart disease during training . All simulations were conducted in a high-fidelity simulation centre, using SimMOM (Laederal Medical). SimMOM is a high-fidelity mannequin with vital signs, heart sounds, lung sounds, pulses, intravenous access, and fetal heart rate monitoring amongst other features. SimMOM’s voice was provided by an actor in the control room, which allowed for real-time responses to questions and therapeutic interventions. Table 1 Overview of simulation scenarios Scenario 1: Antepartum endocarditis Scenario 2: Antepartum spontaneous coronary artery dissection Summary Hypotension secondary to sepsis due to tricuspid valve endocarditis with septic emboli and gram-positive bacteremia in a person who uses intravenous drugs Pregnant patient with ischemic chest pain, anterior T-wave inversions, and positive troponin at 34 weeks. The patient developed ventricular fibrillation and a cardiac arrest. The scenario concludes 4 min after the cardiac arrest. Presenting information Becky Jones is a 36-year-old G5 P4 woman who estimates she is about 36 weeks GA. She presented with total body pain, non-productive cough and a fever that has been ongoing for the last day. No known COVID-positive contacts. Lives in shared housing. HR 110, 89/40 mmHg, RR 22, O2 sat 97% room air, temp 38.5 Fetal heart rate: 150 with moderate variability and no decelerations. Stephanie Barrow is a 34-year-old G1 P0 woman at 34 weeks GA. She developed crushing, retrosternal chest pain radiating to the left arm about 2 h prior to presentation. Her partner drove her to OB triage for further evaluation. She arrives at OB triage at 1 am. HR 100, 135/70 mmHg (equal in both extremities), RR 22, O2 sat 99% room air, temp 36.5 FHR 150 with moderate variability and no decelerations. Synopsis of Scenario Further history reveals current use of cocaine; no features of active labour. Physical exam demonstrates closed cervix and holosystolic murmur at the left lower sternal border. Investigations released upon request from the treating team reveal leukocytosis, elevated creatinine, elevated lactate, toxicology positive for cocaine, negative rapid COVID test, ECG demonstrating sinus tachycardia, chest X-ray demonstrating a right lower lobe infiltrate, and POCUS images demonstrating a large vegetation on the tricuspid valve with severe tricuspid regurgitation. Initial management includes initiation of intravenous fluidsbroad-spectrum antibiotics including MRSA coverage, consultation from infectious disease and/or cardiac surgery. If fluids are not given, the patient becomes progressively more hypotensive. Further history reveals no features concerning pulmonary embolism or neurologic symptoms. Physical exam reveals closed cervix and normal cardiovascular exam. Investigations released upon request reveal abnormal ECG with deep anterior T wave inversions. Expected initial management includes aspirin, initiation of heparin, initiation of nitroglycerin, and consideration of a second antiplatelet agent and coronary angiogram when the pain does not improve with nitroglycerin. The patient becomes unresponsive with rhythm revealing ventricular fibrillation, necessitating cardiopulmonary resuscitation with modifications for pregnant patients including lateral displacement of the uterus, early intubation, and consideration of resuscitative hysterotomy. Uncertainty prompts Patient statements: Patient asks: “What is going on?” “Do I need surgery on my heart?” “Can you make me feel better?” “What if I go into labour- do I need a C-section?” Complexity around diagnosis and management: Patient initially denies drug use Presence of murmur and intravenous drug use added complexity to the presentation of sepsis and symptoms of pneumonia Ambiguity around diagnosis and management: Investigations are only released when requested ECG, chest X-ray, and POCUS images needed to be interpreted by the treating team, no interpretation was provided with these tests. Patient statements: Patient asks: “Why are you calling a cardiologist?” “Are these medications safe during pregnancy?” Complexity around diagnosis and management: Scenario occurs overnight CT angiogram not available if requested to assess for pulmonary embolism Ambiguity around diagnosis and management: Investigations are only released when requested ECG findings could be due to anterior ischemia or pulmonary embolism, requiring prioritization of diagnosis based on clinical features. Management of spontaneous coronary artery dissection is ambiguous with the role of a second antiplatelet agent and angiography in a non-ST elevation myocardial infarction context debated.
3.990234
0.803223
sec[1]/sec[2]/p[0]
en
0.999996
38347654
https://doi.org/10.1186/s41077-024-00281-8
[ "heart", "chest", "pain", "scenario", "pregnant", "cardiac", "intravenous", "features", "investigations", "released" ]
[ { "code": "BE2Y", "title": "Other specified diseases of the circulatory system" }, { "code": "BC4Z", "title": "Diseases of the myocardium or cardiac chambers, unspecified" }, { "code": "BD1Z", "title": "Heart failure, unspecified" }, { "code": "LA8Z", "title": "Structural developmental anomaly of heart or great vessels, unspecified" }, { "code": "BA41.Z", "title": "Acute myocardial infarction, unspecified" }, { "code": "CB7Z", "title": "Diseases of the respiratory system, unspecified" }, { "code": "CB27", "title": "Pleural effusion" }, { "code": "CA44", "title": "Pyothorax" }, { "code": "MD30.Z", "title": "Chest pain, unspecified" }, { "code": "NA80.Y&XJ1C6", "title": "Thoracic haematoma" } ]
=== ICD-11 CODES FOUND === [BE2Y] Other specified diseases of the circulatory system Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart [BC4Z] Diseases of the myocardium or cardiac chambers, unspecified Also known as: Diseases of the myocardium or cardiac chambers, unspecified | Heart disease NOS | cardiac disease NOS [BD1Z] Heart failure, unspecified Also known as: Heart failure, unspecified | myocardial failure | cardiac decompensation | cardiac failure | cardiac failure NOS [LA8Z] Structural developmental anomaly of heart or great vessels, unspecified Also known as: Structural developmental anomaly of heart or great vessels, unspecified | Heart malformations | Cardiac malformations | congenital anomaly of heart | congenital heart disease [BA41.Z] Acute myocardial infarction, unspecified Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction [CB7Z] Diseases of the respiratory system, unspecified Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS [CB27] Pleural effusion Definition: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. Also known as: Pleural effusion | PE - [pleural effusion] | Pleurisy with effusion | pleurisy with effusion NOS | pleural effusion with transudate Includes: Pleurisy with effusion Excludes: Tuberculosis of the respiratory system | Chylous effusion | Pleurisy [CA44] Pyothorax Definition: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or penetrating trauma with a secondary infection. Also known as: Pyothorax | empyema | pyopneumothorax | Pyothorax with fistula | empyema with fistula Includes: empyema | pyopneumothorax Excludes: due to tuberculosis [MD30.Z] Chest pain, unspecified Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure === GRAPH WALKS === --- Walk 1 --- [BE2Y] Other specified diseases of the circulatory system --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --CHILD--> [?] Hypotension --- Walk 2 --- [BE2Y] Other specified diseases of the circulatory system --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --CHILD--> [?] Hypertensive diseases Def: Although a continuous association exists between higher blood pressure (BP) and increased cardiovascular disease risk, it is useful to categorize BP levels for clinical and public health decision maki... --- Walk 3 --- [BC4Z] Diseases of the myocardium or cardiac chambers, unspecified --PARENT--> [?] Diseases of the myocardium or cardiac chambers Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as... --CHILD--> [BC41] Acquired ventricular abnormality Def: A postnatal pathological change in form or function of a ventricle.... --- Walk 4 --- [BC4Z] Diseases of the myocardium or cardiac chambers, unspecified --PARENT--> [?] Diseases of the myocardium or cardiac chambers Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as... --CHILD--> [BC42] Myocarditis Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an... --- Walk 5 --- [BD1Z] Heart failure, unspecified --PARENT--> [?] Heart failure --CHILD--> [BD12] High output syndromes Def: Increased cardiac output above normal associated with anaemia, arteriovenous fistulas, thyrotoxicosis and other syndromes. May result in heart failure.... --- Walk 6 --- [BD1Z] Heart failure, unspecified --PARENT--> [?] Heart failure --EXCLUDES--> [?] Complications following abortion, ectopic or molar pregnancy Def: Any complication affecting pregnant females, caused by or subsequent to abortion, ectopic, and molar pregnancy....
[ "[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --CHILD--> [?] Hypotension", "[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --CHILD--> [?] Hypertensive diseases\n Def: Although a continuous association exists between higher blood pressure (BP) and increased cardiovascular disease risk, it is useful to categorize BP levels for clinical and public health decision maki...", "[BC4Z] Diseases of the myocardium or cardiac chambers, unspecified\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --CHILD--> [BC41] Acquired ventricular abnormality\n Def: A postnatal pathological change in form or function of a ventricle....", "[BC4Z] Diseases of the myocardium or cardiac chambers, unspecified\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --CHILD--> [BC42] Myocarditis\n Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an...", "[BD1Z] Heart failure, unspecified\n --PARENT--> [?] Heart failure\n --CHILD--> [BD12] High output syndromes\n Def: Increased cardiac output above normal associated with anaemia, arteriovenous fistulas, thyrotoxicosis and other syndromes. May result in heart failure....", "[BD1Z] Heart failure, unspecified\n --PARENT--> [?] Heart failure\n --EXCLUDES--> [?] Complications following abortion, ectopic or molar pregnancy\n Def: Any complication affecting pregnant females, caused by or subsequent to abortion, ectopic, and molar pregnancy...." ]
BE2Y
Other specified diseases of the circulatory system
[ { "from_icd11": "BC4Z", "icd10_code": "I5181", "icd10_title": "Takotsubo syndrome" }, { "from_icd11": "BC4Z", "icd10_code": "I5189", "icd10_title": "Other ill-defined heart diseases" }, { "from_icd11": "BC4Z", "icd10_code": "I519", "icd10_title": "Heart disease, unspecified" }, { "from_icd11": "BC4Z", "icd10_code": "I510", "icd10_title": "Cardiac septal defect, acquired" }, { "from_icd11": "BC4Z", "icd10_code": "I515", "icd10_title": "Myocardial degeneration" }, { "from_icd11": "BC4Z", "icd10_code": "I51", "icd10_title": "Complications and ill-defined descriptions of heart disease" }, { "from_icd11": "BC4Z", "icd10_code": "I516", "icd10_title": "" }, { "from_icd11": "BC4Z", "icd10_code": "I518", "icd10_title": "Other ill-defined heart diseases" }, { "from_icd11": "BD1Z", "icd10_code": "I5023", "icd10_title": "Acute on chronic systolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5030", "icd10_title": "Unspecified diastolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5031", "icd10_title": "Acute diastolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5022", "icd10_title": "Chronic systolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5084", "icd10_title": "End stage heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5020", "icd10_title": "Unspecified systolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5021", "icd10_title": "Acute systolic (congestive) heart failure" } ]
I5181
Takotsubo syndrome
Hugo Krayenbühl was the first neurosurgeon at the USZ. He had studied for over 15 years in Geneva, Zurich, Kiel, Paris, St. Gallen and Berlin. On his return from working with Hugh Cairns, with whom he had spent two additional years as a graduate student in London and maintained a life-long friendship , he performed six major neurosurgical operations at the end of 1936 (on four patients with brain tumours, one patient with trigeminal neuralgia and one with a traumatic intracranial haemorrhage) . Krayenbühl set up the new 12-bed neurosurgical clinic on 6 July 1937, under the patronage of his chief, the Professor of Surgery, Paul Clairmont, and injecting personal funds . Krayenbühl provided surgical instruments that he had bought in London, such as a surgical headlamp , retractor, tweezers, chisel, flexible spatulas, Pennybacker bone rongeur, nerve root hooks and angled scissors . The Rockefeller foundation donated an X-ray machine. The first intervention was a ventriculography performed on a 34-year-old man on 13 July 1937. Krayenbühl operated on the first brain tumour patient with the independent unit (a 37-year-old woman with sphenoid ridge meningioma) on 19 July 1937. This intervention took almost 9 h. It was performed under local anaesthesia. The long-term follow-up indicated that the patient was in good health for 30 years . By the end of 1937, a total of 60 patients had been hospitalised in the new neurosurgical unit, including 25 patients with brain tumours, of which 18 were treated surgically . Lumbar disc surgery was also performed on a regular basis from 1938 . From the 1940s onward and for operations in the prone position (posterior approach to the spine, cerebellar operations) in particular, Krayenbühl used the technique of endotracheal intubation. It is reported that he preferred to operate at night, as there were fewer distractions , and with the assistance of general surgeons or medical students that he selected during his lectures . He demanded that at the time of surgery, all relevant patient information was summarised on a red piece of paper that he considered an essential part of the patient file, attesting to his well-organised character. The chosen surgical approach and the intraoperative findings were often documented by drawings . Only recently have the hand-written notes of his Operationsbuch (= surgical records) been systematically reviewed . Supplementary Fig. S6 shows the rapid increase in the number of diagnostic and surgical interventions in the initial years between 1937 and 1945. Techniques enabling efficient and safe surgery were systematically introduced under his lead : cerebral angiography from 1937, intratracheal anaesthesia with nitrous oxide, enallylpropymal (Narconumal) and ether between 1938 and 1944, electroencephalography in 1948, stereotaxy in 1957, neuropsychology in 1966 and microneurosurgery in 1967. Fig. 2 Portrait of Hugo Krayenbühl. Black/white (b/w) print in photo album. Photograph: Hans Peter Weber. Zurich, 1965. Photo credit: Archiv für Medizingeschichte Universität Zürich (AfMZH) IN 37.02.01 . Published with permission Fig. 3 The first department of neurosurgery was situated in the Aussenstation Hegibach from 1937 to 1951. a View from the Heliosstrasse. b Outside view with garden. c Outside view near entrance. d Inside view depicting the patient dormitory. e Hugo Krayenbühl and Gerhard Weber operating. Series of eight b/w prints on carton (only five shown). Pressedokumentation , photographer unknown. Zurich, 1949. Photo credit: Archiv für Medizingeschichte Universität Zürich (AfMZH) PS_gf IN 37.01:002 . Published with permission Fig. 4 Hugo Krayenbühl operates on the brain ( gehirnoperation = brain surgery), assisted by two colleagues. For illumination, he often wore a headlamp with power connection, springy metal-buckle and padding, that he had brought from London. Pencil and ink painting. Artist: Werner Bärtschi, 1946. Photo credit: Archiv für Medizingeschichte Universität Zürich (AfMZH) Bsc 7–1. Published with permission Fig. 5 Hugo Krayenbühl (second from the right, wearing glasses) operating. B/w print on carton. Photographer: Hans Peter Weber. Neurochirurgie Kantonsspital, 1970s. Photo credit: Archiv für Medizingeschichte Universität Zürich (AfMZH) PS_gf PN 222. Published with permission Fig. 6 Examples of the illustrations that often accompanied surgical procedures. Patient name, disease, and date of surgery are given on the top of each figure (not shown). Illustrator: Hans Peter Weber. Image credit: Archiv für Medizingeschichte Universität Zürich (AfMZH) . Published with permission. a Case of a 57-year-old woman with an anterior communicating artery aneurysm . PN 222.02.01-1a. b Case of a 44-year-old man with a neurinoma between L2-L4 . PN 222.02.01-1c. c Case of a 35-year-old male with an ependymoma exiting through the left of the foramen of Luschkae . PN 222.02.01-2a. d Case of a 3 month-old boy with “hydrocephalus internus communicans congenitalis” receiving a lumbo- peritoneal anastomosis for cerebrospinal fluid diversion . PN 222.02.01-2d
3.916016
0.46167
sec[3]/p[0]
en
0.999997
29134341
https://doi.org/10.1007/s00701-017-3357-z
[ "that", "hugo", "brain", "photo", "credit", "archiv", "medizingeschichte", "afmzh", "published", "permission" ]
[ { "code": "8A80.Z", "title": "Migraine, unspecified" }, { "code": "QA76", "title": "Medication or substance that is known to be an allergen without injury or harm" }, { "code": "PL13.6", "title": "Medication or substance that is known to be an allergen, as mode of injury or harm" }, { "code": "9C40.A0", "title": "Papilloedema" }, { "code": "PA6Z", "title": "Unintentional fall from unspecified height" }, { "code": "8E7Y", "title": "Other specified diseases of the nervous system" }, { "code": "LA05.Z", "title": "Cerebral structural developmental anomalies, unspecified" }, { "code": "1D00.Z", "title": "Infectious encephalitis, unspecified" }, { "code": "LA00.0Z", "title": "Anencephaly, unspecified" }, { "code": "NA07.3Y", "title": "Other specified diffuse brain injury" } ]
=== ICD-11 CODES FOUND === [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS [8E7Y] Other specified diseases of the nervous system Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis [LA05.Z] Cerebral structural developmental anomalies, unspecified Also known as: Cerebral structural developmental anomalies, unspecified | Cerebral structural developmental anomalies | Malformations of brain | brain abnormality NOS | brain deformity NOS [1D00.Z] Infectious encephalitis, unspecified Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation [LA00.0Z] Anencephaly, unspecified Also known as: Anencephaly, unspecified | Anencephaly | anencephalic monster | anencephalus | brain absence [NA07.3Y] Other specified diffuse brain injury Also known as: Other specified diffuse brain injury | Brain contusion | Cerebral contusion NOS | Diffuse cortex contusion | diffuse cortical contusion === GRAPH WALKS === --- Walk 1 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --PARENT--> [?] Headache disorders --- Walk 2 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --EXCLUDES--> [?] Headache, not elsewhere classified Def: Headache with characteristic features suggesting that it is a unique diagnostic entity, a finding or complaint, but not fulfilling criteria for any of the headache disorders described above.... --- Walk 3 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 4 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 5 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --CHILD--> [PL13.1] Underdosing, as mode of injury or harm --- Walk 6 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --CHILD--> [PL13.1] Underdosing, as mode of injury or harm
[ "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --PARENT--> [?] Headache disorders", "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --EXCLUDES--> [?] Headache, not elsewhere classified\n Def: Headache with characteristic features suggesting that it is a unique diagnostic entity, a finding or complaint, but not fulfilling criteria for any of the headache disorders described above....", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.1] Underdosing, as mode of injury or harm", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.1] Underdosing, as mode of injury or harm" ]
8A80.Z
Migraine, unspecified
[ { "from_icd11": "8A80.Z", "icd10_code": "G43B0", "icd10_title": "Ophthalmoplegic migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43409", "icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A0", "icd10_title": "Cyclical vomiting, in migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D0", "icd10_title": "Abdominal migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43709", "icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A1", "icd10_title": "Cyclical vomiting, in migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43509", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43719", "icd10_title": "Chronic migraine without aura, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43501", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C0", "icd10_title": "Periodic headache syndromes in child or adult, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43401", "icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43419", "icd10_title": "Hemiplegic migraine, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43B1", "icd10_title": "Ophthalmoplegic migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C1", "icd10_title": "Periodic headache syndromes in child or adult, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D1", "icd10_title": "Abdominal migraine, intractable" } ]
G43B0
Ophthalmoplegic migraine, not intractable
Sharp recanalization usually is performed with small gauge, non-coring needles under US, fluoroscopy, or CBCT guidance. The needle length can be variable depending on patient size and distance from the access site to the occlusion (7 cm, 10 cm, 15 cm, or 65 cm). The planning venogram must be scrutinized for the best approach and direction to cross the occlusion: the length of occlusion, the trajectory, and any at risk adjacent structures while crossing the occluded portion of the vessel (lung, pericardium, bowel, etc). The needle can be guided through a direct percutaneous approach (through the skin into the patent vessel and across the occlusion) or via a catheter coaxially loaded into a vascular sheath (sheath into patent vein, catheter advanced to the site of occlusion, and needle through the catheter and eventually across the occlusion). If the direct percutaneous route is chosen for sharp recanalization, a 0.018″ or 0.014″ wire is directly passed into the central, patent vein . The percutaneous tract is then serially dilated until a sheath is able to be passed over a wire and the rest of the procedure performed. If the coaxial system is chosen for sharp recanalization, the needle is coaxially loaded through an angled catheter, directed towards the occlusion, and passed across . Typically, a loop snare is placed in the target vessel and once the needle is passed into the snare, the snare is tightened over the needle. The inner obturator is removed from the needle, a 0.018″ wire is passed through the needle, and the snare is then tightened around the wire. The wire is pulled into the snare catheter thereby establishing “flossed” access across the occlusion. A catheter or long tapered sheath is advanced across the wire through the occlusion, and then the wire can be exchanged to a larger, stiffer wire (Amplatz, Rosen, or Lunderquist Cook Bloomington, IN) if necessary. Fig. 6 5 y/o M with end stage renal disease requiring hemodialysis with very limited central venous access (left internal jugular occluded and left femoral vein occluded). His hemodialysis catheter was inadvertently pulled out and central venous access lost. a Initial venogram from the right neck demonstrates numerous cervical collateral vessels (solid arrow) with no opacification of the right internal jugular vein. Collateral vessels eventually drain into the patent mid SVC and azygous vein (dashed arrow). b 22G 10cm Chiba needle passed behind the clavicle (solid arrow) part way with ultrasound guidance and residual guidance with fluoroscopy. Patent SVC target is marked with angled catheter and wire (dashed arrow). c Wire is then passed from the neck to the IVC and safety wire from the groin is retracted. Eventually the wire from the neck was snared and “flossed” access was achieved. d Post recanalization venogram demonstrates patent but slightly narrowed SVC with limited cervical collateral filling. e Hemodialysis catheter placement with tip terminating in the right atrium and tunnel created over the shoulder to reduce the risk of inadvertent catheter removal in the future Fig. 7 4 y/o M with end stage renal disease requiring hemodialysis access and complete occlusion of the bilateral internal jugular veins and bilateral brachiocephalic veins. Hemodialysis access was from the right groin but he developed thrombus in that vessel and there was concern he would lose his ability for transplant consideration; thus access from the neck was desired. a Wire and sheath access from the right groin into the patent portion of the SVC. Snare and sheath access from a collateral vessel in the neck. Wire is also noted on the left periphery of the image marking the subclavian vein into the azygous vein. b A 22G 65 cm Chiba needle (solid arrow) was passed from the right groin sheath into the snare (dashed arrow) from the right neck venous access. c Inner obturator of needle was removed and replaced with a 0.018″ hydrophilic wire. Wire (solid arrow) was advanced centrally and snare tightened on wire (dashed arrow) while needle was retracted. d Sheath was advanced through the occlusion (dashed arrow) and venogram performed. Demonstrated numerous collateral venous vessels (upper solid arrow) with patent azygous vein (lower solid arrow) but no opacification of the occluded SVC. e Stent complex: balloon mounted Palmaz stent (Cordis Baar, Switzerland) deployed at the level of the complete occlusion (two solid arrows marking the cranial and caudal extent of the stent) and a self-expanding, Zilver 14 mm stent (Cook Bloomington, IN) deployed within the Palmaz stent. The stent complex connected the patent vessel lumens (two dashed arrows marking the cranial and caudal extent of the stent). Center of stent complex only ballooned to 10 mm due to size of patient native vasculature with intent of subsequent procedures to increase stent diameter as the patient grows. Dotted arrow marks the wire in the subclavian vein. f Final venogram status post recanalization, stenting, and balloon angioplasty. Contrast readily fills the right atrium with no extravasation present
4.140625
0.70166
sec[4]/p[2]
en
0.999998
32886283
https://doi.org/10.1186/s42155-020-00150-1
[ "wire", "needle", "occlusion", "arrow", "access", "catheter", "patent", "vein", "stent", "sheath" ]
[ { "code": "QB84", "title": "Follow-up care involving removal of fracture plate or other internal fixation device" }, { "code": "9B71.1&XS5S", "title": "Hypertensive Retinopathy, Stage 2, focal arteriolar narrowing, marked generalised arteriolar narrowing, arteriovenous nicking, opacity, “copper wiring” of arteriolar wall, or a combination of these signs" }, { "code": "MB40.3", "title": "Anaesthesia of skin" }, { "code": "PA83.2&XE8D1", "title": "Accidental contact with needle" }, { "code": "LD25.1", "title": "Fronto-otopalatodigital syndromes" }, { "code": "QA8F", "title": "Needle stick without injury or harm" }, { "code": "PK81.F", "title": "Needle stick associated with injury or harm in therapeutic use" }, { "code": "BE2Y", "title": "Other specified diseases of the circulatory system" }, { "code": "DB30.Y", "title": "Other specified obstruction of large intestine" }, { "code": "DA0C.Y", "title": "Other specified periodontal disease" } ]
=== ICD-11 CODES FOUND === [QB84] Follow-up care involving removal of fracture plate or other internal fixation device Also known as: Follow-up care involving removal of fracture plate or other internal fixation device | Change of internal fixation device | change of fixation device | change of Kirschner wire | Checking of internal fixation device Excludes: removal of external fixation device [MB40.3] Anaesthesia of skin Definition: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy. Also known as: Anaesthesia of skin | Hypoaesthesia of skin | Loss of cutaneous sensation | Numbness of skin | Loss of sensation Includes: Numbness of skin [LD25.1] Fronto-otopalatodigital syndromes Also known as: Fronto-otopalatodigital syndromes | Frontometaphyseal dysplasia | Melnick-Needles osteodysplasty | Otopalatodigital syndrome | Otopalatodigital syndrome type 1 [QA8F] Needle stick without injury or harm Also known as: Needle stick without injury or harm Excludes: Needle stick associated with injury or harm in therapeutic use [PK81.F] Needle stick associated with injury or harm in therapeutic use Also known as: Needle stick associated with injury or harm in therapeutic use [BE2Y] Other specified diseases of the circulatory system Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart [DB30.Y] Other specified obstruction of large intestine Also known as: Other specified obstruction of large intestine | Obstruction of large intestine due to compression or stenosis | Acute bowel obstruction, not elsewhere classified | Subacute bowel obstruction, not elsewhere classified | subacute intestinal obstruction NOS [DA0C.Y] Other specified periodontal disease Also known as: Other specified periodontal disease | Chronic periodontitis | Adult periodontitis | adult-onset periodontitis | chronic pericementitis === GRAPH WALKS === --- Walk 1 --- [QB84] Follow-up care involving removal of fracture plate or other internal fixation device --EXCLUDES--> [?] Follow-up care involving removal of external fixation device --PARENT--> [?] Contact with health services for specific surgical interventions --- Walk 2 --- [QB84] Follow-up care involving removal of fracture plate or other internal fixation device --EXCLUDES--> [?] Follow-up care involving removal of external fixation device --PARENT--> [?] Contact with health services for specific surgical interventions --- Walk 3 --- [MB40.3] Anaesthesia of skin Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy.... --PARENT--> [MB40] Sensation disturbance --PARENT--> [?] Symptoms or signs involving the nervous system --- Walk 4 --- [MB40.3] Anaesthesia of skin Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy.... --PARENT--> [MB40] Sensation disturbance --CHILD--> [MB40.1] Allodynia Def: Pain due to a normally non-painful stimulus... --- Walk 5 --- [LD25.1] Fronto-otopalatodigital syndromes --PARENT--> [LD25] Syndromes with face or limb anomalies as a major feature --CHILD--> [LD25.2] Acrofacial dysostoses Def: Any syndrome caused by failure of the face and limbs to correctly develop during the antenatal period.... --- Walk 6 --- [LD25.1] Fronto-otopalatodigital syndromes --PARENT--> [LD25] Syndromes with face or limb anomalies as a major feature --CHILD--> [LD25.2] Acrofacial dysostoses Def: Any syndrome caused by failure of the face and limbs to correctly develop during the antenatal period....
[ "[QB84] Follow-up care involving removal of fracture plate or other internal fixation device\n --EXCLUDES--> [?] Follow-up care involving removal of external fixation device\n --PARENT--> [?] Contact with health services for specific surgical interventions", "[QB84] Follow-up care involving removal of fracture plate or other internal fixation device\n --EXCLUDES--> [?] Follow-up care involving removal of external fixation device\n --PARENT--> [?] Contact with health services for specific surgical interventions", "[MB40.3] Anaesthesia of skin\n Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy....\n --PARENT--> [MB40] Sensation disturbance\n --PARENT--> [?] Symptoms or signs involving the nervous system", "[MB40.3] Anaesthesia of skin\n Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy....\n --PARENT--> [MB40] Sensation disturbance\n --CHILD--> [MB40.1] Allodynia\n Def: Pain due to a normally non-painful stimulus...", "[LD25.1] Fronto-otopalatodigital syndromes\n --PARENT--> [LD25] Syndromes with face or limb anomalies as a major feature\n --CHILD--> [LD25.2] Acrofacial dysostoses\n Def: Any syndrome caused by failure of the face and limbs to correctly develop during the antenatal period....", "[LD25.1] Fronto-otopalatodigital syndromes\n --PARENT--> [LD25] Syndromes with face or limb anomalies as a major feature\n --CHILD--> [LD25.2] Acrofacial dysostoses\n Def: Any syndrome caused by failure of the face and limbs to correctly develop during the antenatal period...." ]
QB84
Follow-up care involving removal of fracture plate or other internal fixation device
[ { "from_icd11": "QB84", "icd10_code": "Z4733", "icd10_title": "Aftercare following explantation of knee joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z4732", "icd10_title": "Aftercare following explantation of hip joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z472", "icd10_title": "Encounter for removal of internal fixation device" }, { "from_icd11": "QB84", "icd10_code": "Z471", "icd10_title": "Aftercare following joint replacement surgery" }, { "from_icd11": "QB84", "icd10_code": "Z4731", "icd10_title": "Aftercare following explantation of shoulder joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z4781", "icd10_title": "Encounter for orthopedic aftercare following surgical amputation" }, { "from_icd11": "QB84", "icd10_code": "Z4789", "icd10_title": "Encounter for other orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z47", "icd10_title": "Orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z470", "icd10_title": "" }, { "from_icd11": "QB84", "icd10_code": "Z478", "icd10_title": "Encounter for other orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z479", "icd10_title": "" }, { "from_icd11": "MB40.3", "icd10_code": "R200", "icd10_title": "Anesthesia of skin" }, { "from_icd11": "MB40.3", "icd10_code": "R201", "icd10_title": "Hypoesthesia of skin" }, { "from_icd11": "PA83.2&XE8D1", "icd10_code": "W461XXA", "icd10_title": "Contact with contaminated hypodermic needle, initial encounter" }, { "from_icd11": "PA83.2&XE8D1", "icd10_code": "W460XXA", "icd10_title": "Contact with hypodermic needle, initial encounter" } ]
Z4733
Aftercare following explantation of knee joint prosthesis
A 74-year-old female with a history of diabetes mellitus (DM) experienced two weeks of headache, appetite loss, and fatigue with unknown etiology. Then, the neurological onset was monoplegia of the right upper limb without ipsilateral lower limb involvement. About a week later, the patient developed tetraplegia, leading to hospitalization. Vital signs, including body temperature, were within the normal range. Magnetic resonance imaging (MRI) with contrast-enhanced fluid-attenuated inversion recovery (CE-FLAIR) showed several extending fused lesions appearing to arise from choroid plexus to the white matter of lateral ventricles with lymphoma-suggesting “C opening sign” . The surface lesions showed mass effects protruding to the lateral ventricle . Notably, there was a lesion growing from the skull dura mater, which was even the outside the brain parenchyma . All lesions exhibited high intensity on diffusion-weighted imaging (DWI), and low intensity on apparent diffusion coefficient (ADC) with mass effect . Laboratory testing showed a mild elevation of soluble interleukin 2 receptor (sIL2R) (515 U/mL), along with elevated transaminase, and hyperglycemia due to DM. Other tests to explain brain lesions were all within normal range, including the anti-myelin oligodendrocyte glycoprotein antibody, anti-aquaporin 4 antibody, anti-neutrophil cytoplasmic antibody, anti-nuclear antibody, angiotensin-converting enzyme, or tumor markers. Paraneoplastic syndrome and related antibodies were not evaluated due to the tumor-like mass effects on MRI. Cerebrospinal fluid (CSF) showed lymphocytic pleocytosis with elevated protein and a relatively decreased glucose (initial/final pressure 11/9.5 cm H 2 O, all mononuclear 54 cells/μL, protein 59 mg/dL, glucose 81 mg/dL, serum glucose for reference 194 mg/dL), and cytology showed class 3 without mitosis, suggestive of reactive lymphocyte . CSF also showed an oligoclonal band consisting of a single strong band with an extremely weak band (which appeared as if “mono”clonal band) . Whole-body computed tomography identified a small right thyroid papillary carcinoma (< 1.0 cm diameter), but it was considered an unlikely cause of central nervous system (CNS) lesions due to its static nature and absence of lymph node metastasis. In a few days after admission, lymphoma emerged as a most likely differential diagnosis, but CSF flow cytometry (requiring additional lumber puncture), brain biopsy, or empiric chemotherapy were not available, because of the worsening severe dysphagia, a drowsy state, and the patient's refusal of additional invasive procedures. Given these manifestations suggesting some malignancy like lymphoma and the patient's will, palliative radiation including whole brain and upper spinal cord (30 Gray/ 10 Fractions), steroids (dexamethasone 3.3 mg/day for 15 days), and intravenous morphine was administered. Following treatment, the patient's condition initially stabilized, but she eventually succumbed to severe aspiration pneumonia with worsening dysphagia and consciousness. In contrast to clinical diagnosis, histopathological observations at autopsy could not detect extending fused lesions with mass effect on MRI, such as malignancy (including lymphoma and thyroid carcinoma), infection like tuberculosis, or any granuloma. Instead, all brain and spinal cord lesions were pathologically diagnosed as Marburg variant of MS, with sharply margined myelin loss , myelin phagocyting , intact astrocytes with minor enlargement , and initial axonal damage despite demyelinating disease . In the lesion of myelin loss, no inflammatory cells were detected. All lesions of myelin loss were completely matched with DWI-high (and ADC-low) intensity lesions . In addition, most of the lesions appeared to grow from the brain surface, lateral and fourth ventricles, or spinal central canal , appearing as if via-CSF dissemination of the lesion. Fig. 1 CE-FLAIR MRI of the coronal section shows fused, clustered lesion with the C opening sign arising from choroid plexus (A), and several lesions protrude to the lateral ventricle (A, B, C, D). A lesion growing from the dura mater on the skull, which is not even the brain parenchyma, at the coronal and axial view (E, F). All lesions are high in DWI and low in ADC map (G, H). CSF shows class 3 in cytology, unlike MS (I), and oligoclonal band with strong single band (J). Fig. 1 Fig. 2 In pathology, there is no mass effect protruding to the lateral ventricle, or mass growing from the dura mater on the skull observed on MRI (K). KB and GFAP staining shows selective myelin damage without astrocytic involvement. Some astrocytes show enlargement (L, M, Q). The KB-unstained lesion is completely matched to the DWI-high lesion (with low ADC map lesion) on MRI (N, O). Myelin was phagocyted (P). The lesion is sharply marginated (R, yellow arrows). Initial axonal damages with swelling are shown in neurofilament staining (S). Most of the lesions of KB-unstained lesions appear to arise from the brain surface, fourth ventricle, or central canal (L, N, T). Fig. 2
4.152344
0.97168
sec[1]/p[0]
en
0.999998
39108350
https://doi.org/10.1016/j.ensci.2024.100515
[ "lesions", "lesion", "brain", "myelin", "band", "loss", "including", "lymphoma", "ventricle", "anti" ]
[ { "code": "FA5Z", "title": "Arthropathies, unspecified" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "ME60.Z", "title": "Skin lesion of unspecified nature" }, { "code": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "8E7Y", "title": "Other specified diseases of the nervous system" }, { "code": "LA05.Z", "title": "Cerebral structural developmental anomalies, unspecified" }, { "code": "1D00.Z", "title": "Infectious encephalitis, unspecified" }, { "code": "LA00.0Z", "title": "Anencephaly, unspecified" }, { "code": "NA07.3Y", "title": "Other specified diffuse brain injury" } ]
=== ICD-11 CODES FOUND === [FA5Z] Arthropathies, unspecified Also known as: Arthropathies, unspecified | Disorders affecting predominantly peripheral joints | Disorders affecting predominantly peripheral limb joints | arthropathy NOS | arthropathic [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [ME60.Z] Skin lesion of unspecified nature Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature [MD41] Clinical findings on diagnostic imaging of lung Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging. Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass [8E7Y] Other specified diseases of the nervous system Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis [LA05.Z] Cerebral structural developmental anomalies, unspecified Also known as: Cerebral structural developmental anomalies, unspecified | Cerebral structural developmental anomalies | Malformations of brain | brain abnormality NOS | brain deformity NOS [1D00.Z] Infectious encephalitis, unspecified Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation [LA00.0Z] Anencephaly, unspecified Also known as: Anencephaly, unspecified | Anencephaly | anencephalic monster | anencephalus | brain absence [NA07.3Y] Other specified diffuse brain injury Also known as: Other specified diffuse brain injury | Brain contusion | Cerebral contusion NOS | Diffuse cortex contusion | diffuse cortical contusion === GRAPH WALKS === --- Walk 1 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Osteoarthritis Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art... --- Walk 2 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Osteoarthritis Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art... --- Walk 3 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Monogenic autoinflammatory syndromes Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies.... --- Walk 4 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Nonorgan specific systemic autoimmune disorders --- Walk 5 --- [ME60.Z] Skin lesion of unspecified nature --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --- Walk 6 --- [ME60.Z] Skin lesion of unspecified nature --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not... --CHILD--> [ME60.0] Skin lesion of uncertain nature Def: This denotes the presence of a skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made....
[ "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Osteoarthritis\n Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art...", "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Osteoarthritis\n Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art...", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Monogenic autoinflammatory syndromes\n Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies....", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Nonorgan specific systemic autoimmune disorders", "[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....", "[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --CHILD--> [ME60.0] Skin lesion of uncertain nature\n Def: This denotes the presence of a skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made...." ]
FA5Z
Arthropathies, unspecified
[ { "from_icd11": "FA5Z", "icd10_code": "M00-M25", "icd10_title": "" }, { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "ME60.Z", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "MD41", "icd10_code": "R911", "icd10_title": "Solitary pulmonary nodule" }, { "from_icd11": "MD41", "icd10_code": "R91", "icd10_title": "Abnormal findings on diagnostic imaging of lung" }, { "from_icd11": "LA05.Z", "icd10_code": "Q048", "icd10_title": "Other specified congenital malformations of brain" }, { "from_icd11": "LA05.Z", "icd10_code": "Q043", "icd10_title": "Other reduction deformities of brain" }, { "from_icd11": "LA05.Z", "icd10_code": "Q049", "icd10_title": "Congenital malformation of brain, unspecified" }, { "from_icd11": "LA05.Z", "icd10_code": "Q04", "icd10_title": "Other congenital malformations of brain" }, { "from_icd11": "1D00.Z", "icd10_code": "G0490", "icd10_title": "Encephalitis and encephalomyelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0491", "icd10_title": "Myelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0430", "icd10_title": "Acute necrotizing hemorrhagic encephalopathy, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0431", "icd10_title": "Postinfectious acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0439", "icd10_title": "Other acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0481", "icd10_title": "Other encephalitis and encephalomyelitis" } ]
M00-M25
Three months later, he began to suffer from blurred vision, headache and appetite loss, and was admitted to the emergency department of our institution. His height and body weight were 164.8 cm and 76.3 kg, respectively. His vital signs were normal (blood pressure, 129/93 mmHg; pulse 82 bpm; body temperature 36.7 °C; SpO 2 96%) and he showed no abnormalities in neurological or physical examinations that we routinely perform in clinical practice. However, his serum sodium concentration was 106 mEq/L and plasma osmolality was 217 mOsm/kgH 2 O (Tables 1 and 2 ), and he was then hospitalized to our department. After hospitalization, his hyponatremia was corrected by intravenous and oral administration of sodium chloride, which, together with HC replacement from the 3rd day after hospitalization, improved his blurred vision, headache and appetite loss. In the morning of the 2nd day after hospitalization, levels of TSH, ACTH, GH, LH and FSH were low, and that of PRL was high (Table 3 ). On the 2nd day after hospitalization, his urinary cortisol was ≤15.5 μg/dL, while plasma levels of ACTH (pg/mL) and cortisol (μg/dL) were as follows: 8 am, 17.5 and 1.4; 2 pm, 13.7 and 1.0; 8 pm 14.1 and 1.1; and 11 pm 8.8 and 0.8, respectively. Little TSH and GH response was observed in TRH and GHRP-2 stimulation tests, respectively . Near normal LH and FSH responses were observed in GnRH stimulation test , but basal levels of LH and FSH were low (Table 3 ). Hyper ACTH response with low cortisol response was observed in CRH stimulation test . ACTH response was delayed with a low cortisol response and little GH response in insulin stimulation test . Peak cortisol level was < 18 μg/dL in ACTH rapid stimulation test, which was carried out ≥24 h after administration of 10 mg HC . These results indicated the presence of hypothalamic hypopituitarism and tertiary hypoadrenocorticism. The patient then experienced atypical visual field loss in his right eye. His MRI on day 14 after hospitalization revealed a rapidly growing tumor in the hypothalamus that was absent 1 year before. Endoscopic biopsy of the tumor using a ventriculoscope revealed a proliferation of atypical lymphocytes, which was positive for CD20 and CD79a as well as CD10 and Bcl-6 but negative for Bcl-2 (data not shown). The MIB-1 index was approximately 80% . These results together suggested B-cell lymphoma. His serum level of soluble IL-2 receptor was 436.0 U/mL (normal range, 122–496 U/mL), and examination of cerebrospinal fluid revealed no abnormalities. Table 1 Biochemistry and complete blood count upon admission to our emergency department Biochemistry Complete blood count Total protein 7.6 g/dL Cre 0.48 mg/dL WBC 5830 /μL Albumin 4.5 g/dL BUN 5.3 mg/dL Neutro 51.9% CPK 358 U/L Total-cho 171 mg/dL Mono 5.0% AST 46 U/L HDL-cho 30 mg/dL Lymph 34.0% ALT 77 U/L TG 205 mg/dL Eosino 8.6% LDH 211 U/L Na 106 mmol/L Baso 0.5% ALP 415 U/L K 4.2 mmol/L RBC 486× 10 4 / μL γ-GTP 115 U/L Cl 77 mmol/L Hb 14.6 g/dL CHE 275 U/L Ca 9.2 mg/dL Plt 29.5×104 /μL AMY 42 U/L IP 2.4 mg/dL UA 2.3 mg/dL BNP 42.9 pg/mL CRP 0.74 mg/dL Glu 127 mg/dL Table 2 Urinalysis upon admission to our emergency department Specific gravity 1.011 pH 6.0 Protein – Glucose – Ketone body + Blood + Osmolarity 439 mOsm/kgH 2 O Na 148 mEq/L K 36.6 mEq/L Cl 128 mEq/L Table 3 Basal levels of various hormones after normalization of hyponatremia TSH 0.06 μIU/mL PRL 28.9 ng/mL free T3 2.8 pg/mL LH ≤0.10 mIU/mL free T4 0.71 ng/dL FSH 0.44 mIU/mL ACTH 4.2 pg/mL PRA 0.9 ng/mL/hr Cortisol 7.9 μg/dL PAC 233.0 pg/mL GH 0.05 ng/mL IGF-1 88 ng/mL (−1.8 SD) Fig. 1 Results of endocrinological examinations. Various endocrinological stimulation tests suggest the presence of hypothalamic hypopituitarism and tertiary hypoadrenocorticism in the patient. a . TRH stimulation test. b . GnRH stimulation test. c . CRH stimulation test. d . GHRP2 stimulation test. e . Insulin tolerance test. f . ACTH stimulation test. Solid lines represent changes in hormone levels before the treatment of primary central nervous system lymphoma; dashed lines represent those after the treatment Fig. 2 Imaging analysis before and after the treatment of the central nervous system lymphoma. a , b . Gadolinium-enhanced magnetic resonance imaging (MRI) before and after the initial treatment of the patient’s central nervous system lymphoma. A 16 × 12 mm lobulated tumor mass in the hypothalamus that extends to the pituitary stalk and the right temporal lobe was detected as a low intensity mass in T2-weighted imaging, a faint high intensity mass in diffusion-weighted imaging, and fluid attenuated inversion recovery imaging ( a ). The mass was no longer detected after the treatment ( b ). T1, T1-weighted imaging; T2, T2-weighted imaging; DWI, diffusion-weighted imaging; FLAIR, fluid attenuated inversion recovery imaging; Sag, sagittal plane; Cor, coronal plane Fig. 3 Pathological analysis of the patient’s tumor. The analysis found proliferation of atypical lymphocytes that were positive for CD20 and CD79a. MIB-1 index was approximately 80%. Magnification × 400
4.128906
0.961914
sec[1]/p[1]
en
0.999998
33430828
https://doi.org/10.1186/s12902-020-00675-5
[ "stimulation", "imaging", "acth", "cortisol", "response", "that", "hospitalization", "weighted", "department", "blood" ]
[ { "code": "MB72", "title": "Results of function studies of the nervous system" }, { "code": "4A01.0Y", "title": "Other specified immunodeficiencies with predominantly antibody defects" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "8D85", "title": "Autonomic nervous system disorder due to substances" }, { "code": "6C46.3", "title": "Stimulant intoxication including amphetamines, methamphetamine or methcathinone" }, { "code": "5A74.Y", "title": "Other specified adrenocortical insufficiency" }, { "code": "MB27.3", "title": "Disturbance of body image" }, { "code": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "ME21", "title": "Clinical findings on diagnostic imaging of liver or biliary tract" }, { "code": "ME91", "title": "Clinical findings on diagnostic imaging of limbs" } ]
=== ICD-11 CODES FOUND === [MB72] Results of function studies of the nervous system Also known as: Results of function studies of the nervous system | Abnormal results of function studies of central nervous system | abnormal central nervous system function studies | Abnormal brain function studies | Abnormal EEG - [electroencephalogram] [4A01.0Y] Other specified immunodeficiencies with predominantly antibody defects Also known as: Other specified immunodeficiencies with predominantly antibody defects | Common variable immunodeficiency | B-cell activating factor receptor deficiency | BAFF - [ B-cell activating factor] receptor deficiency | Cluster of differentiation 19 deficiency [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [8D85] Autonomic nervous system disorder due to substances Also known as: Autonomic nervous system disorder due to substances | Serotonin syndrome | Seritonergic syndrome | Autonomic disorder due to stimulant intoxication | Autonomic disorder due to Wernicke-Korsakoff syndrome [6C46.3] Stimulant intoxication including amphetamines, methamphetamine or methcathinone Definition: Stimulant intoxication including amphetamines, methamphetamine and methcathinone but excluding caffeine, cocaine and synthetic cathinones is a clinically significant transient condition that develops during or shortly after the consumption of amphetamine or other stimulants that is characterised by disturbances in consciousness, cognition, perception, affect, behaviour, or coordination. These disturbances are caused by the known pharmacological effects of amphetamine or other stimulants and thei Also known as: Stimulant intoxication including amphetamines, methamphetamine or methcathinone | Amphetamine or certain specified stimulant intoxication | Amphetamine intoxication | Methamphetamine intoxication | Acute methamphetamine intoxication Excludes: amphetamine poisoning | Caffeine intoxication | Cocaine intoxication [5A74.Y] Other specified adrenocortical insufficiency Also known as: Other specified adrenocortical insufficiency | Congenital adrenocortical insufficiency | Congenital isolated ACTH deficiency | Familial adrenal hypoplasia | Familial hypoadrenocorticism [MB27.3] Disturbance of body image Definition: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it. Also known as: Disturbance of body image [MD41] Clinical findings on diagnostic imaging of lung Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging. Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass [ME21] Clinical findings on diagnostic imaging of liver or biliary tract Also known as: Clinical findings on diagnostic imaging of liver or biliary tract | Abnormal diagnostic imaging of liver | Nonvisualisation of gallbladder [ME91] Clinical findings on diagnostic imaging of limbs Also known as: Clinical findings on diagnostic imaging of limbs | abnormal diagnostic imaging of limbs === GRAPH WALKS === --- Walk 1 --- [MB72] Results of function studies of the nervous system --PARENT--> [?] Clinical findings in the nervous system --PARENT--> [?] Symptoms, signs or clinical findings of the nervous system --- Walk 2 --- [MB72] Results of function studies of the nervous system --PARENT--> [?] Clinical findings in the nervous system --PARENT--> [?] Symptoms, signs or clinical findings of the nervous system --- Walk 3 --- [4A01.0Y] Other specified immunodeficiencies with predominantly antibody defects --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects... --CHILD--> [4A01.01] Immunodeficiencies with severe reduction in at least two serum immunoglobulin isotypes with normal or low numbers of B cells Def: This refers to a nonfamilial type of primary immune deficiency disease characterised by a reduction in at least two serum immunoglobulin isotypes. Circulating B cells may be normal or low.... --- Walk 4 --- [4A01.0Y] Other specified immunodeficiencies with predominantly antibody defects --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects... --CHILD--> [4A01.00] Hereditary agammaglobulinaemia with profoundly reduced or absent B cells Def: This refers to a hereditary type of primary immune deficiency disease characterised by a reduction in all types of gamma globulins, and rare X-linked genetic disorder that affects the body's ability t... --- Walk 5 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Allergic or hypersensitivity conditions Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms. Hypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms... --PARENT--> [?] Diseases of the immune system --- Walk 6 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Allergic or hypersensitivity conditions Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms. Hypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms... --CHILD--> [?] Allergic or hypersensitivity disorders involving skin or mucous membranes Def: Allergic or hypersensitivity disorders involving the skin and mucous includes a heterogeneous group of disorders involving skin and mucous membranes in which either allergy or hypersensitivity play a ...
[ "[MB72] Results of function studies of the nervous system\n --PARENT--> [?] Clinical findings in the nervous system\n --PARENT--> [?] Symptoms, signs or clinical findings of the nervous system", "[MB72] Results of function studies of the nervous system\n --PARENT--> [?] Clinical findings in the nervous system\n --PARENT--> [?] Symptoms, signs or clinical findings of the nervous system", "[4A01.0Y] Other specified immunodeficiencies with predominantly antibody defects\n --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...\n --CHILD--> [4A01.01] Immunodeficiencies with severe reduction in at least two serum immunoglobulin isotypes with normal or low numbers of B cells\n Def: This refers to a nonfamilial type of primary immune deficiency disease characterised by a reduction in at least two serum immunoglobulin isotypes. Circulating B cells may be normal or low....", "[4A01.0Y] Other specified immunodeficiencies with predominantly antibody defects\n --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...\n --CHILD--> [4A01.00] Hereditary agammaglobulinaemia with profoundly reduced or absent B cells\n Def: This refers to a hereditary type of primary immune deficiency disease characterised by a reduction in all types of gamma globulins, and rare X-linked genetic disorder that affects the body's ability t...", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Allergic or hypersensitivity conditions\n Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms.\n\nHypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms...\n --PARENT--> [?] Diseases of the immune system", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Allergic or hypersensitivity conditions\n Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms.\n\nHypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms...\n --CHILD--> [?] Allergic or hypersensitivity disorders involving skin or mucous membranes\n Def: Allergic or hypersensitivity disorders involving the skin and mucous includes a heterogeneous group of disorders involving skin and mucous membranes in which either allergy or hypersensitivity play a ..." ]
MB72
Results of function studies of the nervous system
[ { "from_icd11": "MB72", "icd10_code": "R29818", "icd10_title": "Other symptoms and signs involving the nervous system" }, { "from_icd11": "MB72", "icd10_code": "R29810", "icd10_title": "Facial weakness" }, { "from_icd11": "MB72", "icd10_code": "R29898", "icd10_title": "Other symptoms and signs involving the musculoskeletal system" }, { "from_icd11": "MB72", "icd10_code": "R9402", "icd10_title": "Abnormal brain scan" }, { "from_icd11": "MB72", "icd10_code": "R9401", "icd10_title": "Abnormal electroencephalogram [EEG]" }, { "from_icd11": "MB72", "icd10_code": "R29890", "icd10_title": "Loss of height" }, { "from_icd11": "MB72", "icd10_code": "R9409", "icd10_title": "Abnormal results of other function studies of central nervous system" }, { "from_icd11": "MB72", "icd10_code": "R298", "icd10_title": "Other symptoms and signs involving the nervous and musculoskeletal systems" }, { "from_icd11": "MB72", "icd10_code": "R940", "icd10_title": "Abnormal results of function studies of central nervous system" }, { "from_icd11": "MB72", "icd10_code": "R941", "icd10_title": "Abnormal results of function studies of peripheral nervous system and special senses" }, { "from_icd11": "NE60", "icd10_code": "T50A95A", "icd10_title": "Adverse effect of other bacterial vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z15A", "icd10_title": "Adverse effect of immunoglobulin, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z95A", "icd10_title": "Adverse effect of other vaccines and biological substances, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A95S", "icd10_title": "Adverse effect of other bacterial vaccines, sequela" }, { "from_icd11": "NE60", "icd10_code": "T50B95A", "icd10_title": "Adverse effect of other viral vaccines, initial encounter" } ]
R29818
Other symptoms and signs involving the nervous system
In September 2020, a middle-aged male presented to the hospital with dizziness and headaches. Brain MRI revealed an abnormal mass in the brain, suggestive of a metastatic tumor. Apart from neurological symptoms, there is mild cough without sputum, no chest tightness or chest pain, no fever or sweating, no diarrhea or constipation. The patient has a history of hypertension for 10 years. The highest recorded blood pressure was 175/105mmHg. Currently, the patient is taking oral antihypertensive medication (Valsartan capsules, 80mg/d), and the blood pressure is controlled within the range of 130-140/90-100mmHg. No cerebrovascular diseases or coronary artery disease. The patient denies any infectious diseases such as hepatitis or enteritis. There is no history of trauma, surgery, or blood transfusion. No known food or drug allergies. The patient has a smoking history of 35 years, consuming 10 cigarettes per day. Occasional alcohol consumption.Vital signs are stable. Specifically:H 177cm, W 60kg, HR 91/min, BP 137/95mmHg.Laboratory tests: WBC 7.64×10 9 /L (4-10×10 9 /L), RBC 5.17×10 12 /L (4-5.5×10 12 /L), Hb 128g/L (120-160g/L), PLT 232×10 9 /L (100-300×10 9 /L), CEA 103.6ng/ml↑ (<3.4ng/ml), CA24-2 63U/ml↑ (<15U/ml), other tumor markers are within normal range. Further evaluation with whole-body PET/CT indicated a lesion in the left lung measuring 40×35mm, accompanied by lymph node and mediastinal metastasis, as well as multiple brain metastases. A CT-guided biopsy was performed on the lesion in the left lung, and the pathological analysis indicated poorly differentiated adenocarcinoma. A 10-gene test for lung cancer revealed a KRAS missense mutation (G13D, 13.91%), while no mutations were found in the remaining genes (EGFR, ALK, ROS1, BRAF, NRAS, HER2, PIK3CA, RET, MET). The PD-L1 positivity rate was 10%.The clinical stage is cT2N2M1, stage IV. A multidisciplinary consultation within the hospital was conducted, considering the patient’s current multiple brain metastases and significant symptoms. It was recommended to prioritize whole-brain radiation therapy (WBRT) and symptomatic treatments such as intracranial pressure reduction and nutritional support. After symptom control, systemic treatment and radiation therapy for the primary lesion were suggested. Consequently, from October 2020 to November 2020, the patient received WBRT using 6MV X-rays, delivering a dose of 30Gy/10f/2w to 95% of the planning target volume (PTV). During this period, treatment for dehydration and intracranial pressure reduction was administered. Following the completion of radiation therapy, the patient experienced a significant improvement in symptoms, including reduced dizziness and headaches. The ECOG PS improved from a score of 3 to 1.Although the patient was initially diagnosed with stage IV disease, distant metastases were limited to the intracranial region. After receiving cranial radiation therapy and supportive care, the intracranial lesions were well controlled, and the patient’s general condition remained good. The patient expressed a strong willingness for treatment. Taking reference from the KEYNOTE189 and CAMEL studies, after discussing with the patient, a systemic treatment regimen comprising platinum-based doublet chemotherapy in combination with PD-1 inhibitor was administered. From December 2020 to June 2021, the patient received 8 cycles of the PP regimen chemotherapy (Pemetrexed 500mg/m² iv day 1, Carboplatin AUC5 iv day 1, every 3 weeks) combined with PD-1 inhibitor therapy (Camrelizumab 200mg, every 3 weeks). During the second to fourth cycles of treatment, concurrent radiotherapy was administered. The specific radiotherapy plan consisted of 6MV X-rays, delivering a dose of 60Gy/30f/6w to 95% of the planning target volume (PTV), and the treatment toxicity was tolerable. Following the completion of concurrent chemoradiotherapy, the therapeutic evaluation of the primary lesion in the chest and intracranial lesions, according to RECIST v1.1 criteria, showed a partial response (PR). Maintenance treatment was initiated in July 2021, with the following regimen: Pemetrexed 500mg/m² iv day 1, Bevacizumab 500mg iv day 1, and Camrelizumab 200mg every 3 weeks. Regular follow-up examinations were conducted every 2 months, and the therapeutic evaluation remained stable disease (SD). In October 2022, a liver nodule was discovered in the left liver lobe on abdominal CT . A further ultrasound-guided biopsy was performed, and the pathological results confirmed hepatic cavernous hemangioma. Similar to the previous patient, a multidisciplinary consultation was conducted, and it was determined that the liver nodule was likely a drug reaction to Camrelizumab. Therefore, Camrelizumab was discontinued starting from November 2022, and maintenance treatment with Pemetrexed and Bevacizumab was initiated using the same dosage and cycle as before. Subsequently, the hepatic cavernous hemangioma disappeared , and no further drug-related adverse reactions occurred. The clinical response continued to be evaluated as stable disease (SD).
3.941406
0.980469
sec[1]/sec[1]/p[0]
en
0.999997
PMC10435320
https://doi.org/10.3389/fonc.2023.1221309
[ "brain", "intracranial", "pressure", "lesion", "radiation", "every", "camrelizumab", "chest", "blood", "within" ]
[ { "code": "8E7Y", "title": "Other specified diseases of the nervous system" }, { "code": "LA05.Z", "title": "Cerebral structural developmental anomalies, unspecified" }, { "code": "1D00.Z", "title": "Infectious encephalitis, unspecified" }, { "code": "LA00.0Z", "title": "Anencephaly, unspecified" }, { "code": "NA07.3Y", "title": "Other specified diffuse brain injury" }, { "code": "MB71.0", "title": "Intracranial space-occupying lesion" }, { "code": "NA07.Y", "title": "Other specified intracranial injury" }, { "code": "1D04.1Z", "title": "Intracranial granuloma, unspecified" }, { "code": "8D60.1", "title": "Cerebral oedema" }, { "code": "1D03.3Z", "title": "Intracranial abscess, unspecified" } ]
=== ICD-11 CODES FOUND === [8E7Y] Other specified diseases of the nervous system Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis [LA05.Z] Cerebral structural developmental anomalies, unspecified Also known as: Cerebral structural developmental anomalies, unspecified | Cerebral structural developmental anomalies | Malformations of brain | brain abnormality NOS | brain deformity NOS [1D00.Z] Infectious encephalitis, unspecified Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation [LA00.0Z] Anencephaly, unspecified Also known as: Anencephaly, unspecified | Anencephaly | anencephalic monster | anencephalus | brain absence [NA07.3Y] Other specified diffuse brain injury Also known as: Other specified diffuse brain injury | Brain contusion | Cerebral contusion NOS | Diffuse cortex contusion | diffuse cortical contusion [MB71.0] Intracranial space-occupying lesion Also known as: Intracranial space-occupying lesion | intracranial mass lesion | intracranial lesion [NA07.Y] Other specified intracranial injury Also known as: Other specified intracranial injury | Traumatic intracranial haemorrhage, not elsewhere classified | Traumatic cranium cavity haemorrhage | traumatic intracranium haemorrhage | Intracranial haematoma [1D04.1Z] Intracranial granuloma, unspecified Also known as: Intracranial granuloma, unspecified | Intracranial granuloma | cerebral granuloma [8D60.1] Cerebral oedema Definition: Is an excess accumulation of fluid in the intracellular and/or extracellular spaces of the brain. Also known as: Cerebral oedema | brain effusion | brain oedema | cerebral effusion | intracranial effusion Excludes: Traumatic cerebral oedema | Cerebral oedema due to birth injury [1D03.3Z] Intracranial abscess, unspecified Also known as: Intracranial abscess, unspecified | Intracranial abscess | abscess of brain | brain empyema | cranial abscess === GRAPH WALKS === --- Walk 1 --- [8E7Y] Other specified diseases of the nervous system --PARENT--> [08] Diseases of the nervous system Def: This is a group of conditions characterised as being in or associated with the nervous system.... --CHILD--> [?] Disorders with neurocognitive impairment as a major feature --- Walk 2 --- [8E7Y] Other specified diseases of the nervous system --PARENT--> [08] Diseases of the nervous system Def: This is a group of conditions characterised as being in or associated with the nervous system.... --CHILD--> [?] Multiple sclerosis or other white matter disorders Def: This is a group of conditions involving demyelination, damage to the myelin sheath which protects nerve axons and is responsible for neurotransmission.... --- Walk 3 --- [LA05.Z] Cerebral structural developmental anomalies, unspecified --PARENT--> [LA05] Cerebral structural developmental anomalies Def: Any condition caused by failure of the brain to correctly develop during the antenatal period.... --PARENT--> [?] Structural developmental anomalies of the nervous system Def: Any condition caused by failure of the nervous system to correctly develop during the antenatal period.... --- Walk 4 --- [LA05.Z] Cerebral structural developmental anomalies, unspecified --PARENT--> [LA05] Cerebral structural developmental anomalies Def: Any condition caused by failure of the brain to correctly develop during the antenatal period.... --CHILD--> [LA05.2] Holoprosencephaly Def: Holoprosencephaly is a brain malformation resulting from incomplete cleavage of the prosencephalon, occurring between the 18th and the 28th day of gestation and affecting both the forebrain and the fa... --- Walk 5 --- [1D00.Z] Infectious encephalitis, unspecified --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified Def: A disease of the brain, caused by an infection.... --CHILD--> [1D00.0] Bacterial encephalitis --- Walk 6 --- [1D00.Z] Infectious encephalitis, unspecified --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified Def: A disease of the brain, caused by an infection.... --CHILD--> [1D00.0] Bacterial encephalitis
[ "[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --CHILD--> [?] Disorders with neurocognitive impairment as a major feature", "[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --CHILD--> [?] Multiple sclerosis or other white matter disorders\n Def: This is a group of conditions involving demyelination, damage to the myelin sheath which protects nerve axons and is responsible for neurotransmission....", "[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies of the nervous system\n Def: Any condition caused by failure of the nervous system to correctly develop during the antenatal period....", "[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --CHILD--> [LA05.2] Holoprosencephaly\n Def: Holoprosencephaly is a brain malformation resulting from incomplete cleavage of the prosencephalon, occurring between the 18th and the 28th day of gestation and affecting both the forebrain and the fa...", "[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.0] Bacterial encephalitis", "[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.0] Bacterial encephalitis" ]
8E7Y
Other specified diseases of the nervous system
[ { "from_icd11": "LA05.Z", "icd10_code": "Q048", "icd10_title": "Other specified congenital malformations of brain" }, { "from_icd11": "LA05.Z", "icd10_code": "Q043", "icd10_title": "Other reduction deformities of brain" }, { "from_icd11": "LA05.Z", "icd10_code": "Q049", "icd10_title": "Congenital malformation of brain, unspecified" }, { "from_icd11": "LA05.Z", "icd10_code": "Q04", "icd10_title": "Other congenital malformations of brain" }, { "from_icd11": "1D00.Z", "icd10_code": "G0490", "icd10_title": "Encephalitis and encephalomyelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0491", "icd10_title": "Myelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0430", "icd10_title": "Acute necrotizing hemorrhagic encephalopathy, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0431", "icd10_title": "Postinfectious acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0439", "icd10_title": "Other acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0481", "icd10_title": "Other encephalitis and encephalomyelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G0489", "icd10_title": "Other myelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G04", "icd10_title": "Encephalitis, myelitis and encephalomyelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G048", "icd10_title": "Other encephalitis, myelitis and encephalomyelitis" }, { "from_icd11": "LA00.0Z", "icd10_code": "Q000", "icd10_title": "Anencephaly" }, { "from_icd11": "MB71.0", "icd10_code": "R900", "icd10_title": "Intracranial space-occupying lesion found on diagnostic imaging of central nervous system" } ]
Q048
Other specified congenital malformations of brain
Patient 1 (case 1, Table 1 ): A 67-year-old male complained of progressive dysphagia, diplopia, and gait instability for approximately one year, leading to admission to a neurological department. Neurological examination revealed double vision in both horizontal and upward directions along with mild limb ataxia. Brain MRI, videofluoroscopic swallow studies, and acetylcholine receptor antibodies were normal or negative. The patient was discharged with a clinical diagnosis of idiopathic dysphagia. Eight years later the patient was admitted to the Department of Neurology, Medical University of Vienna, because of hoarse voice and progressive dysphagia with aspiration of solid food. Furthermore, he complained of gait instability and recurrent falls. On admission, the patient showed a moderately broad-based and somewhat short-stepped gait, postural instability, with a positive retropulsion test, mild tremor of both hands, limb ataxia, hypometric horizontal saccades, gaze-evoked horizontal nystagmus and slowed downgaze saccades (see video, online resource). Furthermore, mild facial myokymias were observed. History revealed sleep disturbances including snoring and insomnia, nocturnal urge incontinence and signs of depression. Infectious, inflammatory, and metabolic causes were excluded by blood tests. Initial brain MRI showed mild cortical and subcortical atrophy, which progressed to mild atrophy of the corpus callosum, moderate enlargement of the third ventricle and insular cisterns and moderate midbrain atrophy during the course of the disease, suggesting a diagnosis of PSP . N-omega-fluoropropyl-2beta-carbomethoxy-3beta-4-iodophenyltropan single-photon emission computed tomography (FP-CIT SPECT) revealed a clear-cut reduction of striatal dopamine transporter binding, more prominent on the left side. A 18 F-fluorodeoxyglucose—positron emission tomography showed hypometabolism in the frontopolar and frontomesial regions. A lumbar puncture revealed clear CSF with 1 white cell per microliter, normal glucose and lactate levels, mild elevated protein (44.7 mg/dl, normal range 18-43 mg/dl) and immunoglobulins (IgG 5.16 mg/dl, normal range: 0–3.3 mg/dl; IgA 1.07 mg/d, normal range: 0–0.5 mg/dl) level. CSF oligoclonal bands were negative. A 14–3-3 assay was negative. Total tau was 273 pg/ml (normal < 450 pg/ml), phospho-tau 181P 41 pg/ml (normal < 61 pg/ml), and amyloid β 1–42 970 pg/ml (normal > 500 pg/ml). Treponema pallidum and Borrelia burgdorferi serologies in CSF were negative. Neurophysiological studies showed a normal repetitive stimulation of the facial and axillary nerves but a mixed sensorimotor polyneuropathy. Neuropsychological evaluation revealed mild cognitive impairment. During his hospital stay, the patient developed severe dysphagia and stridor resulting in hypoxemic episodes with blood oxygen levels at 60%, especially during the night requiring continuous positive airway pressure (CPAP) ventilation. A night-time apnea screening test revealed apneas of mainly central origin with an AHI (apnea-hypopnea index) of 10 (normal range: 0–5). A pneumological assessment showed hypercapnia and arterial resting hypoxemia with normal pulmonary function. Laryngoscopy revealed an impairment of vocal cord motility with decreased glottis widening during respiration, and oropharyngeal dysphagia with oral and pharyngeal retentions. Due to frequent hypoxemic episodes with massive stridor, the patient finally required tracheotomy. Overall, clinical features and ancillary investigations suggested a diagnosis of PSP. The patient was treated with levodopa, donepezil, and citalopram and discharged with a CPAP-ventilation mask. A few months later, he fell and deceased as a consequence of an extensive frontotemporal subdural haemorrhage at the age of 76 years. Five years after his death and after the first reports of IgLON5 disease, archival CSF from the patient that has been stored at -80 °C for 5 years was analysed for the presence of IgLON5 antibodies, and tested positive, leading to the retrospective diagnosis of anti-IgLON5 disease. Human leukocyte antigen testing revealed the HLA-DQB1*05:01 allele (HLA-DRB1*01:02; 03:01; HLA-DQB1*02:01; 05:01). The IgG subclass distribution and quantification were determined by flow cytometry analysis. In the CSF sample with IgLON5 antibodies, obtained 7 years after disease onset, IgG4 was the predominant subclass accounting for 80% of the total IgLON5 IgG. Serum was not available for IgLON5 antibody testing. Fig. 1 Brain MRI scan of patient 1 with PSP neuropathology. Brain MRI scan (axial, fluid-attenuated recovery sequences (FLAIR)) performed 8 years after symptom onset shows cortical and subcortical atrophy ( a ). Sagittal FLAIR image reveals reduced size of the mesencephalic tegmentum leading to the hummingbird appearance of brainstem ( b ; red arrow). Axial FLAIR image of the brainstem shows an increased signal hyperintensity of the periaqueductal grey matter ( c , white arrow). Furthermore, atrophy of the mesencephalic and pontine tegmentum is evident ( c , d ; red arrows)
4.105469
0.972656
sec[2]/sec[1]/p[0]
en
0.999997
37646790
https://doi.org/10.1007/s00401-023-02625-6
[ "dysphagia", "atrophy", "brain", "range", "gait", "instability", "leading", "horizontal", "antibodies", "furthermore" ]
[ { "code": "MD93", "title": "Dysphagia" }, { "code": "DD90.1", "title": "Functional swallowing disorder" }, { "code": "3A00.Y", "title": "Other specified iron deficiency anaemia" }, { "code": "FB32.Y", "title": "Other specified disorders of muscles" }, { "code": "BE2Y", "title": "Other specified diseases of the circulatory system" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "9C40.BZ", "title": "Optic atrophy, unspecified" }, { "code": "8E7Y", "title": "Other specified diseases of the nervous system" }, { "code": "LA05.Z", "title": "Cerebral structural developmental anomalies, unspecified" }, { "code": "1D00.Z", "title": "Infectious encephalitis, unspecified" } ]
=== ICD-11 CODES FOUND === [MD93] Dysphagia Definition: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the pharynx and upper oesophageal sphincter; and oesophageal dysphagia due to malfunction of the oesophagus. Also known as: Dysphagia | Difficulty in swallowing | difficulty swallowing | difficulty in swallowing NOS | swallowing problem Includes: Difficulty in swallowing Excludes: Functional swallowing disorder [DD90.1] Functional swallowing disorder Definition: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or passing abnormally through the oesophagus. Also known as: Functional swallowing disorder | Functional dysphagia | failure of swallowing function Includes: Functional dysphagia Excludes: dysphagia NOS [3A00.Y] Other specified iron deficiency anaemia Also known as: Other specified iron deficiency anaemia | Congenital iron deficiency anaemia | Constitutional anaemias due to iron metabolism disorder | Hereditary iron deficiency anaemia | Hereditary iron deficiency anaemia NOS [FB32.Y] Other specified disorders of muscles Also known as: Other specified disorders of muscles | Muscle wasting or atrophy, not elsewhere classified | muscle wasting | muscle wasting disorder | Sarcopenia [BE2Y] Other specified diseases of the circulatory system Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [9C40.BZ] Optic atrophy, unspecified Also known as: Optic atrophy, unspecified | Optic atrophy | optic nerve atrophy | Primary optic atrophy | OA - [optic atrophy] [8E7Y] Other specified diseases of the nervous system Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis [LA05.Z] Cerebral structural developmental anomalies, unspecified Also known as: Cerebral structural developmental anomalies, unspecified | Cerebral structural developmental anomalies | Malformations of brain | brain abnormality NOS | brain deformity NOS [1D00.Z] Infectious encephalitis, unspecified Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation === GRAPH WALKS === --- Walk 1 --- [MD93] Dysphagia Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar... --EXCLUDES--> [?] Functional swallowing disorder Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa... --PARENT--> [?] Functional oesophageal or gastroduodenal disorders Def: This group incorporates oesophageal and gastroduodenal disorders which principally present unpleasant upper gastrointestinal complaints without apparent morphological changes of oesophagus and gastrod... --- Walk 2 --- [MD93] Dysphagia Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar... --PARENT--> [?] Symptoms related to the upper gastrointestinal tract Def: Clinical symptoms presumed to be arising from disorders/diseases of upper GI tract.... --RELATED_TO--> [?] Haematemesis Def: Vomiting of blood that is either fresh bright red, or older "coffee-ground" in character. Vomiting blood is a regurgitation of blood through the upper gastrointestinal tract and it generally indicates... --- Walk 3 --- [DD90.1] Functional swallowing disorder Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa... --EXCLUDES--> [?] Dysphagia Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar... --EXCLUDES--> [?] Functional swallowing disorder Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa... --- Walk 4 --- [DD90.1] Functional swallowing disorder Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa... --EXCLUDES--> [?] Dysphagia Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar... --CHILD--> [?] Dysphagia, pharyngeal phase --- Walk 5 --- [3A00.Y] Other specified iron deficiency anaemia --PARENT--> [3A00] Iron deficiency anaemia Def: A disease caused by chronic or acute bleeding, excessive menstrual bleeding, inadequate intake, substances (in diet or drugs) interfering with iron absorption, malabsorption syndromes, inflammation, i... --CHILD--> [3A00.0] Acquired iron deficiency anaemia due to blood loss Def: Chronic blood loss is a possible cause in every case of iron-deficiency anaemia. Iron deficiency anaemia may be caused by acute bleeding in gastrointestinal tract, uterus or genitourinary system, copi... --- Walk 6 --- [3A00.Y] Other specified iron deficiency anaemia --PARENT--> [3A00] Iron deficiency anaemia Def: A disease caused by chronic or acute bleeding, excessive menstrual bleeding, inadequate intake, substances (in diet or drugs) interfering with iron absorption, malabsorption syndromes, inflammation, i... --CHILD--> [3A00.1] Acquired iron deficiency anaemia due to low intake Def: Iron deficiency is probably the most common nutritional deficiency disorder in the world. Iron deficiency anaemia during pregnancy increases perinatal risks for mothers and neonates; and increases ove...
[ "[MD93] Dysphagia\n Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...\n --EXCLUDES--> [?] Functional swallowing disorder\n Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...\n --PARENT--> [?] Functional oesophageal or gastroduodenal disorders\n Def: This group incorporates oesophageal and gastroduodenal disorders which principally present unpleasant upper gastrointestinal complaints without apparent morphological changes of oesophagus and gastrod...", "[MD93] Dysphagia\n Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...\n --PARENT--> [?] Symptoms related to the upper gastrointestinal tract\n Def: Clinical symptoms presumed to be arising from disorders/diseases of upper GI tract....\n --RELATED_TO--> [?] Haematemesis\n Def: Vomiting of blood that is either fresh bright red, or older \"coffee-ground\" in character. Vomiting blood is a regurgitation of blood through the upper gastrointestinal tract and it generally indicates...", "[DD90.1] Functional swallowing disorder\n Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...\n --EXCLUDES--> [?] Dysphagia\n Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...\n --EXCLUDES--> [?] Functional swallowing disorder\n Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...", "[DD90.1] Functional swallowing disorder\n Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...\n --EXCLUDES--> [?] Dysphagia\n Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...\n --CHILD--> [?] Dysphagia, pharyngeal phase", "[3A00.Y] Other specified iron deficiency anaemia\n --PARENT--> [3A00] Iron deficiency anaemia\n Def: A disease caused by chronic or acute bleeding, excessive menstrual bleeding, inadequate intake, substances (in diet or drugs) interfering with iron absorption, malabsorption syndromes, inflammation, i...\n --CHILD--> [3A00.0] Acquired iron deficiency anaemia due to blood loss\n Def: Chronic blood loss is a possible cause in every case of iron-deficiency anaemia. Iron deficiency anaemia may be caused by acute bleeding in gastrointestinal tract, uterus or genitourinary system, copi...", "[3A00.Y] Other specified iron deficiency anaemia\n --PARENT--> [3A00] Iron deficiency anaemia\n Def: A disease caused by chronic or acute bleeding, excessive menstrual bleeding, inadequate intake, substances (in diet or drugs) interfering with iron absorption, malabsorption syndromes, inflammation, i...\n --CHILD--> [3A00.1] Acquired iron deficiency anaemia due to low intake\n Def: Iron deficiency is probably the most common nutritional deficiency disorder in the world. Iron deficiency anaemia during pregnancy increases perinatal risks for mothers and neonates; and increases ove..." ]
MD93
Dysphagia
[ { "from_icd11": "MD93", "icd10_code": "R1312", "icd10_title": "Dysphagia, oropharyngeal phase" }, { "from_icd11": "MD93", "icd10_code": "R1319", "icd10_title": "Other dysphagia" }, { "from_icd11": "MD93", "icd10_code": "R1313", "icd10_title": "Dysphagia, pharyngeal phase" }, { "from_icd11": "MD93", "icd10_code": "R1314", "icd10_title": "Dysphagia, pharyngoesophageal phase" }, { "from_icd11": "MD93", "icd10_code": "R1311", "icd10_title": "Dysphagia, oral phase" }, { "from_icd11": "MD93", "icd10_code": "R130", "icd10_title": "Aphagia" }, { "from_icd11": "MD93", "icd10_code": "R1310", "icd10_title": "Dysphagia, unspecified" }, { "from_icd11": "MD93", "icd10_code": "R13", "icd10_title": "Aphagia and dysphagia" }, { "from_icd11": "DD90.1", "icd10_code": "K30", "icd10_title": "Functional dyspepsia" }, { "from_icd11": "FB32.Y", "icd10_code": "M6281", "icd10_title": "Muscle weakness (generalized)" }, { "from_icd11": "9C40.BZ", "icd10_code": "H47213", "icd10_title": "Primary optic atrophy, bilateral" }, { "from_icd11": "9C40.BZ", "icd10_code": "H47291", "icd10_title": "Other optic atrophy, right eye" }, { "from_icd11": "9C40.BZ", "icd10_code": "H47292", "icd10_title": "Other optic atrophy, left eye" }, { "from_icd11": "9C40.BZ", "icd10_code": "H4720", "icd10_title": "Unspecified optic atrophy" }, { "from_icd11": "9C40.BZ", "icd10_code": "H4722", "icd10_title": "Hereditary optic atrophy" } ]
R1312
Dysphagia, oropharyngeal phase
A 29-year-old pregnant woman, gravida 1, para 0, one previous artificial abortion, with regular menstrual cycle, was admitted via the emergency department on December 27 2021 with a history of 50-day amenorrhea and 7-day moderate to intermittent upper abdominal pain. She had no injury history or history of previous pelvic inflammatory diseases or gynecological surgery. Her vital signs were within normal range. General physical examination revealed nothing remarkable. Gynecological examination found no vaginal spotting, and the uterine cervix was smooth without tenderness upon palpation and movement; the uterine body was soft and enlarged equivalent to the size of 50-day-gestation; the right adnexa was slightly thickened without tenderness; and the left adnexa was unremarkable. The serum beta-human chorionic gonadotropin (β-hCG) value was 65,004 m-international units per milliliter (mIU/mL) on admission. Color transvaginal ultrasonography (TVS) of the pelvis demonstrated no intrauterine gestational sac but thicken endometrium of 1.7 centimeter (cm) , a right adnexal well-bounded, medially echoic mass approximately 2.3 × 2.0 × 2.0 cm in size with signs of blood supply; no fluid collection in the pouch of Douglas. Because the results of TVS were not parallel with the clinical characteristics and serum β-hCG level, a full transabdominal ultrasonography (TAS) was applied to extend the scan scope. TAS scan revealed a heterogeneous mass approximately 3.8 × 3.1 × 2.3 cm in size, which consisted of a gestational sac with an 4 mm embryo bud with positive cardiac pulsation . The pregnancy mass was tightly adjacent to the inferior vena cava and the abdominal aorta. We furtherly completed an abdominal contrast-enhanced computer tomography (CT), which showed the gestational sac with the embryo in the retroperitoneal space and detailed its tight link with the great vessels alongside . Highly suspected of rare REP and lack of experience in the diagnosis and treatment of this disease, a multidisciplinary consultation composed of a gynecologist, a vascular surgeon, a radiologist and an interventional physician was scheduled. For fear of vascular injury and unmanageable intraoperative bleeding potentially associated with excising this mass, the patients decided to administer systemic methotrexate (MTX) combined with local potassium chloride solution injection guided by ultrasonography. Daily 20-miligram(mg) intramuscular MTX for 5 consecutive days was initiated on December 28, 2021. And on the same day, ultrasound-guided paracentesis and local potassium chloride (KCl) injection into the embryo bud was operated successfully . On December 30 2021, serum β-hCG elevated to 79,382 mIU/ml, but a repeat TAS showed that though the size of REP mass didn’t change, the fetal heart beat was gone. The patient remained stable with close observation in the hospital. Then the medication therapy was continued. However, on December 31 2021, the patient reported worsening abdominal pain and her serum β-hCG level continued to increase (81,447 mIU/ml). Consequently, the patient agreed to undertake an exploratory laparotomy despite stable vital signs and no drop in hemoglobin level (Hb 118 g/L). This was accomplished through a midline incision about 20 cm in length under general anesthesia. While exploring the pelvic cavity, we found a slightly enlarged and soft uterus with bilateral intact fallopian tubes. The left ovary was completely normal while a corpus luteum about 2.0 × 2.0 cm in size was found in the right ovary without active bleeding. No evidence of lesion and pelvic adhesion was found. No fluid collected in the abdominopelvic cavity. Then an abdominal vascular surgeon joined the operation. Further exploration of the upper abdomen revealed a retroperitoneal mass measuring 4.5 × 4.0 × 3.0 cm, inferior the transverse mesentery and directly attached tightly to the surface of inferior vena cava and the left side of abdominal aorta, with a small amount of local retroperitoneal hemorrhage. The retroperitoneal space was entered. After the surrounding connective tissue was carefully dissociated and the communicating vessels between the mass and the inferior vena cava and abdominal aorta were ligated, the pregnancy mass was removed en bloc . No blood transfusion was required. The small wound surface on the inferior vena cava was sutured meticulously with absorbable suture to ensure sufficient hemostasis. No retroperitoneal drain was placed. The total blood loss was 50 millilitre (ml) and the operation time was 92 min. Fig.1 The imaging examination before the laparotomy. a Transvaginal ultrasonography (TVS) revealed a thicken endometrium without intrauterine gestational sac. b Transabdominal ultrasonography (TAS) revealed a retroperitoneal pregnancy mass. c Abdominal computer tomography (CT) showed the retroperitoneal gestational sac (red arrow) was tightly adherent to the inferior vena cava (blue arrow) and abdominal aorta (yellow arrow). d Ultrasound-guided paracentesis and local potassium chloride (KCl) injection into the embryo bud
4.011719
0.974609
sec[1]/p[0]
en
0.999996
PMC9175374
https://doi.org/10.1186/s12884-022-04799-5
[ "abdominal", "retroperitoneal", "ultrasonography", "gestational", "vena", "cava", "december", "without", "serum", "embryo" ]
[ { "code": "MD81.3", "title": "Acute abdomen" }, { "code": "JA01.0", "title": "Abdominal pregnancy" }, { "code": "ME04.Z", "title": "Ascites, unspecified" }, { "code": "NB51.0&XA3KX0", "title": "Laceration without foreign body of abdominal wall" }, { "code": "NB9Y", "title": "Other specified injuries to the abdomen, lower back, lumbar spine or pelvis" }, { "code": "DC5Z&XA6S21", "title": "Diseases of peritoneum, unspecified [Retroperitoneum]" }, { "code": "DC50.Z", "title": "Peritonitis, unspecified" }, { "code": "DC51.Y", "title": "Other specified disorders of peritoneum or retroperitoneum" }, { "code": "NB91.Y&XA6S21", "title": "Retroperitoneal laceration" }, { "code": "2F93", "title": "Neoplasms of unknown behaviour of retroperitoneum" } ]
=== ICD-11 CODES FOUND === [MD81.3] Acute abdomen Definition: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases Also known as: Acute abdomen | acute abdominal pain syndrome | surgical abdomen | abdominal acute syndrome | severe abdomen pain [JA01.0] Abdominal pregnancy Definition: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy. Also known as: Abdominal pregnancy | abdomen pregnancy | intraperitoneal pregnancy Excludes: Maternal care for viable fetus in abdominal pregnancy | Delivery of viable fetus in abdominal pregnancy [ME04.Z] Ascites, unspecified Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS [NB9Y] Other specified injuries to the abdomen, lower back, lumbar spine or pelvis Also known as: Other specified injuries to the abdomen, lower back, lumbar spine or pelvis | Abdominal wall trauma | Injury of pelvic floor | pelvic floor blunt injury | pelvic floor blunt trauma [DC50.Z] Peritonitis, unspecified Also known as: Peritonitis, unspecified | Peritonitis | peritoneum inflammation | peritonitis of undetermined cause | peritonitis of unspecified cause [DC51.Y] Other specified disorders of peritoneum or retroperitoneum Also known as: Other specified disorders of peritoneum or retroperitoneum | Abdominal granuloma | Peritoneal granuloma | Epiploic appendagitis | Male frozen pelvis [2F93] Neoplasms of unknown behaviour of retroperitoneum Also known as: Neoplasms of unknown behaviour of retroperitoneum | retroperitoneum tumour NOS === GRAPH WALKS === --- Walk 1 --- [MD81.3] Acute abdomen Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases... --PARENT--> [MD81] Abdominal or pelvic pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region.... --EXCLUDES--> [?] Flatulence and related conditions Def: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus and other conditions associated with the production or presence of gas in the GI tract.... --- Walk 2 --- [MD81.3] Acute abdomen Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases... --PARENT--> [MD81] Abdominal or pelvic pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region.... --PARENT--> [?] Symptoms or signs involving the digestive system or abdomen --- Walk 3 --- [JA01.0] Abdominal pregnancy Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy.... --EXCLUDES--> [?] Delivery of viable fetus in abdominal pregnancy Def: A condition caused by the development of a viable fetus to the culmination of the pregnancy period. This condition is characterised by parturition of a viable neonate from the abdominal cavity, at the... --PARENT--> [?] Other assisted single delivery --- Walk 4 --- [JA01.0] Abdominal pregnancy Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy.... --PARENT--> [JA01] Ectopic pregnancy Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy.... --CHILD--> [JA01.0] Abdominal pregnancy Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy.... --- Walk 5 --- [ME04.Z] Ascites, unspecified --PARENT--> [ME04] Ascites Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma... --CHILD--> [ME04.Z] Ascites, unspecified --- Walk 6 --- [ME04.Z] Ascites, unspecified --PARENT--> [ME04] Ascites Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma... --CHILD--> [ME04.0] Fluid in peritoneal cavity
[ "[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --EXCLUDES--> [?] Flatulence and related conditions\n Def: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus and other conditions associated with the production or presence of gas in the GI tract....", "[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --PARENT--> [?] Symptoms or signs involving the digestive system or abdomen", "[JA01.0] Abdominal pregnancy\n Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy....\n --EXCLUDES--> [?] Delivery of viable fetus in abdominal pregnancy\n Def: A condition caused by the development of a viable fetus to the culmination of the pregnancy period. This condition is characterised by parturition of a viable neonate from the abdominal cavity, at the...\n --PARENT--> [?] Other assisted single delivery", "[JA01.0] Abdominal pregnancy\n Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy....\n --PARENT--> [JA01] Ectopic pregnancy\n Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy....\n --CHILD--> [JA01.0] Abdominal pregnancy\n Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy....", "[ME04.Z] Ascites, unspecified\n --PARENT--> [ME04] Ascites\n Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...\n --CHILD--> [ME04.Z] Ascites, unspecified", "[ME04.Z] Ascites, unspecified\n --PARENT--> [ME04] Ascites\n Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...\n --CHILD--> [ME04.0] Fluid in peritoneal cavity" ]
MD81.3
Acute abdomen
[ { "from_icd11": "MD81.3", "icd10_code": "R100", "icd10_title": "Acute abdomen" }, { "from_icd11": "JA01.0", "icd10_code": "O0000", "icd10_title": "Abdominal pregnancy without intrauterine pregnancy" }, { "from_icd11": "JA01.0", "icd10_code": "O000", "icd10_title": "Abdominal pregnancy" }, { "from_icd11": "ME04.Z", "icd10_code": "R180", "icd10_title": "Malignant ascites" }, { "from_icd11": "ME04.Z", "icd10_code": "R18", "icd10_title": "Ascites" }, { "from_icd11": "DC50.Z", "icd10_code": "K651", "icd10_title": "Peritoneal abscess" }, { "from_icd11": "DC50.Z", "icd10_code": "K652", "icd10_title": "Spontaneous bacterial peritonitis" }, { "from_icd11": "DC50.Z", "icd10_code": "K654", "icd10_title": "Sclerosing mesenteritis" }, { "from_icd11": "DC50.Z", "icd10_code": "K653", "icd10_title": "Choleperitonitis" }, { "from_icd11": "DC50.Z", "icd10_code": "K659", "icd10_title": "Peritonitis, unspecified" }, { "from_icd11": "DC50.Z", "icd10_code": "K658", "icd10_title": "Other peritonitis" }, { "from_icd11": "DC50.Z", "icd10_code": "K650", "icd10_title": "Generalized (acute) peritonitis" }, { "from_icd11": "DC50.Z", "icd10_code": "K65", "icd10_title": "Peritonitis" }, { "from_icd11": "2F93", "icd10_code": "D483", "icd10_title": "Neoplasm of uncertain behavior of retroperitoneum" } ]
R100
Acute abdomen
A 53-year-old Chinese male patient presented to our hospital with ecchymosis and edema for more than 2 months. Routine blood tests showed a hemoglobin level of 62 g/L and platelet count of 10 × 10 9 /L. Suddenly, the patient appeared unconscious and recovered to normal approximately 3 hours later without any obvious abnormality on brain computed tomography (CT) and was then transferred to our hospital. This patient had no special medical history except for left leg trauma 30 years ago, and physical examination showed apathy, pale conjunctiva, and visible skin purpura. Laboratory tests indicated white blood cells 8.37 × 10 9 /L; hemoglobin, 53 g/L; platelet count, 3 × 10 9 /L; reticulocytes, 0.224 × 10 12 /L; total bilirubin 39.7 μmol/L, direct bilirubin 12.0 μmol/L, indirect bilirubin 27.7 μmol/L, lactate dehydrogenase, 1640 U/L, urea 18.75 mmol/L, creatinine 108 μmol/L (normal range 59-104 μmol/L), free hemoglobin (168 mg/L), and haptoglobin < 0.06 g/L. Direct Coombs test results were negative. Rheumatism tests showed that the antinuclear antibody nuclear particle type was 1:100, anti-SSA antibody was 7.1, and anti-SSB antibody was >8.0. Platelet alloantibodies were positive, and platelet autoantibodies were negative. Routine urine tests suggested urinary occult blood 3+, urine protein ±, blood urea 24.82 mmol/L, and creatinine 138 μmol/L. It was easy to see schistocytes on his peripheral blood smear, accounting for 21% of the cells. Bone marrow cytology was characterized by megakaryocytic hyperplasia, maturation disorder, and myeloid hyperplasia. The patient had intermittent fever up to 38°C, intermittent disturbance of consciousness, and transient renal dysfunction during the hospital stay. Based on the above clinical manifestations and laboratory findings, the patient was diagnosed with thrombotic thrombocytopenic purpura with a classic “pentad”, including thrombocytopenia, neurological involvement, microangiopathic hemolytic anemia (elevated indirect bilirubin and reticulocyte, presenting schistocytes on peripheral blood smear), renal impairment and fever, which was likely related to connective tissue disease (CTD). Before measuring the ADAMTS13 activity level, we calculated the PLASMIC score in this patient to predict ADAMTS13 activity. This score includes 7 indicators, with higher scores indicating more likely TTP. The patient had a score of 5 (platelet count <30 × 10 9 per L, hemolysis variable, no active cancer, no history of solid organ or stem cell transplantation, creatinine <2.0 mg/dL). Before we collected plasma samples for ADAMTS13 activity and inhibitors, he had been transfused with fresh frozen plasma and treated with glucocorticoids. Although the result of ADAMTS13 activity detected by a fluorescence energy transfer assay was 16%, experts with experience in management of TTP still believed that the patient should be diagnosed with TTP because of typical clinical manifestations and ADAMTS13 inhibitor positivity. He was treated with daily plasma exchange (9 times) at 1.0× patient plasma volume until the platelet count recovered to normal and was maintained for at least 2 days, and his clinical symptoms were relieved. In addition, the patient received high-dose glucocorticoids (methylprednisolone 500 mg/d) for 5 days, which was then gradually reduced to 48 mg/d; N -acetylcysteine for 17 days, and 3 once-weekly doses of rituximab (375 mg/m 2 ) . Lactate dehydrogenase gradually decreased, and ADAMTS13 activity gradually increased . Her platelet count returned to normal . On the 11th day after admission, the patient's blood pressure suddenly increased to 187/98 mm Hg, mainly at night and in the morning, without any other discomfort . Ambulatory blood pressure monitoring revealed high blood pressure and increased pulse pressure at night, accompanied by the disappearance of the circadian rhythm, while the adrenal enhanced CT scan showed no obvious abnormalities. On the 22nd day after admission, the patient experienced sudden chest pain with blood pressure up to 180/85 mm Hg. Chest and abdominal computed tomography angiography (CTA) was performed immediately, which suggested the existence of an AAD, with an incision in the descending thoracic aorta, involving the thoracic aorta , abdominal aorta , and bilateral common iliac arteries , confirming the appearance of acute type B aortic dissection. Subsequently, the patient was transferred to the cardiac aortic surgery department for TEVAR and discharged 13 days after the operation when the platelet count returned to normal, despite a transient decrease in platelet count that occurred during the aortic dissection. The platelet count remained stable after the patient was discharged. However, fever and pulmonary infections occurred later. Because the patient lived far away from our hospital, he underwent reexamination and anti-infection treatment at the local hospital. Unfortunately, 3 months after the operation, the patient experienced chest and back pain at home and died suddenly, which may have been caused by recurrence of the dissection.
4.1875
0.953125
sec[1]/p[0]
en
0.999998
34797341
https://doi.org/10.1097/MD.0000000000027898
[ "blood", "platelet", "count", "activity", "pressure", "bilirubin", "which", "plasma", "hemoglobin", "suddenly" ]
[ { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "3B62.Z", "title": "Qualitative platelet defects, unspecified" }, { "code": "3B63.1Z", "title": "Acquired thrombocytosis, unspecified" }, { "code": "3B64.Z", "title": "Thrombocytopenia, unspecified" }, { "code": "BD5Y", "title": "Other specified diseases of arteries or arterioles" }, { "code": "3B62.00", "title": "Alpha-granule diseases" } ]
=== ICD-11 CODES FOUND === [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood [3B62.Z] Qualitative platelet defects, unspecified Also known as: Qualitative platelet defects, unspecified | Qualitative platelet defects | Thrombocytopathy | platelet defect | platelet disorder [3B63.1Z] Acquired thrombocytosis, unspecified Also known as: Acquired thrombocytosis, unspecified | Acquired thrombocytosis | Idiopathic haemorrhagic thrombocythaemia | Essential thrombocythaemia | primary haemorrhagic thrombocythaemia [3B64.Z] Thrombocytopenia, unspecified Also known as: Thrombocytopenia, unspecified | Thrombocytopenia | low platelet count | low platelets | decreased platelets [BD5Y] Other specified diseases of arteries or arterioles Also known as: Other specified diseases of arteries or arterioles | Arterial or microvascular embolism classified by source | Cardiac embolism | heart embolism | Thrombotic cardiac embolism [3B62.00] Alpha-granule diseases Definition: A condition caused by determinants arising after birth, in the antenatal period. This condition is characterised by defects in the alpha granules in platelets leading to abnormalities in coagulation mechanisms. This condition may present with prolonged bleeding, epistaxis, menorrhagia, easy bruising, anaemia, fatigue or shortness of breath. Confirmation is by identification of platelet defects in a blood sample. Also known as: Alpha-granule diseases | Quebec platelet disorder | Factor V Quebec | Gray platelet syndrome === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --CHILD--> [?] Anaemias or other erythrocyte disorders --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Diseases of the immune system --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.1] Finding of cocaine in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.2] Finding of hallucinogen in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Anaemias or other erythrocyte disorders", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Diseases of the immune system", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.2] Finding of hallucinogen in blood" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
This patient was a 69-year-old woman who dropped out of high school and worked as a fashion model. Her past medical history included subarachnoid hemorrhage (SAH), symptomatic epilepsy following SAH, and hypertension. She had no family history of neuropsychiatric illness, nor did she have a history of substance abuse or heavy drinking. At the age of 60, she underwent clipping for SAH. At the age of 65, she began to have frequent visual hallucinations of people, although she had previously experienced visual hallucinations temporarily for a short period after the SAH clipping. She remembered the visual hallucinations she experienced after the clipping well, and these temporary visual hallucinations were not considered postoperative delirium. At the age of 67, she began to complain of visual illusions in which she mistook lint for insects. At the age of 69, she developed delusional infestation and saw insects crawling on her body. She had no insight into her symptoms and took various actions to get rid of these non-existent insects, including insecticide use, consulting an exterminator, moving to a different house, and visiting several dermatologists. Despite all evidence to the contrary, she had a fixed belief of being infested with insects. She also complained of mild amnesia. Her partner brought her to our psychiatric clinic for evaluation and treatment. Her delusion was severe. She stated, “There are white insects in my body. They come out of my skin,” “Sometimes I can see crawling insects. But I can’t see insects when they crawl in my clothes,” and “They crawled on the skin of my neck, trunk, and limbs. I felt tingling.” She showed us pictures of lint on her limbs, claiming they were pictures of insects . Her partner said, “When I pointed out that there were no insects, she disagreed with me and insisted that they were present.” Neurological examination revealed mild paralysis and sensory deficits in the left upper and lower limbs as sequelae of SAH, although she did not have parkinsonism. Her MMSE scores ranged from 21 to 26, reflecting her fluctuating cognition level. The blood and cerebral spinal fluid test results showed no abnormalities. An electroencephalogram showed sharp waves in the right frontal area, which was considered an effect of SAH, with no obvious slow wave. Cranial MRI revealed an old hemorrhagic lesion in the right putamen and right dominant bilateral diffuse atrophy with ischemic changes secondary to SAH . 123 I-IMP SPECT revealed hypoperfusion in the right basal ganglia and the frontal, temporal, and parietal lobes . Furthermore, cardiac 123 I-metaiodobenzylguanidine scintigraphy revealed reduced myocardial uptake . Considering the results of all examinations, the patient was diagnosed with mild cognitive impairment because she showed progressive cognitive decline that did not to interfere with her daily activities. She had two clinical features (fluctuating cognition level, visual hallucinations) and one indicative biomarker (abnormal cardiac 123 I metaiodobenzylguanidine scintigraphy) and was therefore diagnosed with prodromal DLB ( 12 ) in addition to SAH sequelae. We determined that her delusional infestation was caused by DLB rather than SAH sequelae based on the course of her symptoms. Seven days after the initiation of 3 mg/day of donepezil hydrochloride, she visited another hospital because she had burnt her own leg in an attempt to kill the non-existent insects. When she visited our outpatient clinic after treatment for her burns, we determined that her behavior was not due to drug-induced impulsivity related to donepezil hydrochloride, but rather to behavioralization associated with the delusional infestation with visual hallucinations. Therefore, donepezil hydrochloride was increased to 10 mg/day with the aim of improving her symptoms. After donepezil hydrochloride was increased to 10 mg/day, her visual hallucinations of people improved. However, the delusional infestation with visual illusions of insects continued. Therefore, she was admitted to our hospital for treatment of delusional infestation. She persistently complained of delusional infestation and repeatedly showed us lint that looked like insects to her. She was prescribed 12.5 mg/day of quetiapine, and her delusional infestation partially improved. Donepezil hydrochloride was reduced to 3 mg/day because of frequent urination. Ultimately, she was treated with a combination of 3 mg/day of donepezil hydrochloride and 12.5 mg/day of quetiapine. The delusional infestation partially improved, and she took no further action against non-existent insects until a year later at our last follow-up. At the follow-up examination 1 year later, her MMSE score was 25, which was not significantly difference from 1 year earlier, and her impairment regarding activities of daily living remained unchanged. Her partner expressed understanding regarding the cause of and treatment for delusional infestation, and stated that he had stopped to point out the absence of the insects because he found that this was ineffective.
3.974609
0.981934
sec[1]/sec[1]/p[0]
en
0.999996
PMC9686401
https://doi.org/10.3389/fpsyt.2022.1051067
[ "insects", "visual", "delusional", "infestation", "that", "hallucinations", "donepezil", "hydrochloride", "they", "because" ]
[ { "code": "ND30", "title": "Superficial injuries involving multiple body regions" }, { "code": "NE61", "title": "Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified" }, { "code": "EK50.02", "title": "Persistent insect bite reaction" }, { "code": "8D43.Y", "title": "Other specified neurological disorders due to toxicity" }, { "code": "EK50.0Z", "title": "Cutaneous insect bite reactions, unspecified" }, { "code": "9E1Z", "title": "Diseases of the visual system, unspecified" }, { "code": "MC1Y", "title": "Other specified symptoms or signs involving the visual system" }, { "code": "9D9Z", "title": "Vision impairment, unspecified" }, { "code": "9D90.2", "title": "Moderate vision impairment" }, { "code": "QA00.6Z", "title": "Examination of eyes or vision, unspecified" } ]
=== ICD-11 CODES FOUND === [ND30] Superficial injuries involving multiple body regions Also known as: Superficial injuries involving multiple body regions | Superficial injuries involving head with neck | multiple superficial injuries of head with neck | Superficial injuries of sites classifiable as injuries to the head and injuries to the neck | Superficial injuries involving thorax with abdomen, lower back or pelvis [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified Also known as: Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified | Harmful effects of or exposure to noxious substances chiefly nonmedicinal as to source, alcohols | alcohol poisoning | alcohol toxicity | Harmful effects of or exposure to noxious substances chiefly nonmedicinal as to source, Ethanol Excludes: corrosions | Bacterial foodborne intoxications [EK50.02] Persistent insect bite reaction Definition: Bite reactions lasting for months as inflamed papules and nodules, this is particularly likely to be seen with tick bites and mosquito bites. These may be confused with lymphoma histologically, with a dense inflammatory infiltrate of lymphoid cells, histiocytes, eosinophils and plasma cells together with the presence of atypical mononuclear cells. Also known as: Persistent insect bite reaction | Insect bite granuloma Includes: Insect bite granuloma [8D43.Y] Other specified neurological disorders due to toxicity Also known as: Other specified neurological disorders due to toxicity | Certain specified neurological disorders due to toxicity | Neurological disorder due to insect bite | Neurological disorder due to reptile bite | Encephalomyelopathy due to toxicity [EK50.0Z] Cutaneous insect bite reactions, unspecified Also known as: Cutaneous insect bite reactions, unspecified | Cutaneous insect bite reactions | bug bite | insect bite hypersensitivity NOS [9E1Z] Diseases of the visual system, unspecified Also known as: Diseases of the visual system, unspecified | eye diseases NOS | disorder of vision | visual disorder [MC1Y] Other specified symptoms or signs involving the visual system Also known as: Other specified symptoms or signs involving the visual system | Erythema of eyelid | Visual disturbances | disturbances of vision | difficulty seeing [9D9Z] Vision impairment, unspecified Also known as: Vision impairment, unspecified | sight impaired | blindness and low vision | impaired vision [9D90.2] Moderate vision impairment Also known as: Moderate vision impairment | low vision, both eyes | visual impairment category 2, in both eyes | Low vision | LW - [low vision] Includes: visual impairment category 2, in both eyes [QA00.6Z] Examination of eyes or vision, unspecified Also known as: Examination of eyes or vision, unspecified | Examination of eyes or vision | general eye examination | routine eye examination | vision examination === GRAPH WALKS === --- Walk 1 --- [ND30] Superficial injuries involving multiple body regions --PARENT--> [?] Injuries involving multiple body regions --CHILD--> [ND31] Open wounds involving multiple body regions --- Walk 2 --- [ND30] Superficial injuries involving multiple body regions --PARENT--> [?] Injuries involving multiple body regions --EXCLUDES--> [?] Frostbite Def: Frostbite is injury from ice formation within tissues resulting from contact with cold air, liquids or metals. It is most commonly due to excessive exposure of skin to sub-zero environmental temperatu... --- Walk 3 --- [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified --PARENT--> [?] Harmful effects of substances --CHILD--> [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --- Walk 4 --- [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified --EXCLUDES--> [?] Bacterial foodborne intoxications Def: Any condition caused by an intoxication due to a bacterial toxin. Intoxication is by ingestion of contaminated food.... --EXCLUDES--> [?] Infections due to other Salmonella --- Walk 5 --- [EK50.02] Persistent insect bite reaction Def: Bite reactions lasting for months as inflamed papules and nodules, this is particularly likely to be seen with tick bites and mosquito bites. These may be confused with lymphoma histologically, with a... --PARENT--> [EK50.0] Cutaneous insect bite reactions Def: Skin reactions to known or presumed insect bites. Commonly the nature of the insect responsible is unknown.... --CHILD--> [EK50.01] Bullous insect bite reaction Def: Cutaneous blisters resulting from a brisk immune response to insect bites. These are most common around the lower legs and ankles and in children rather than adults.... --- Walk 6 --- [EK50.02] Persistent insect bite reaction Def: Bite reactions lasting for months as inflamed papules and nodules, this is particularly likely to be seen with tick bites and mosquito bites. These may be confused with lymphoma histologically, with a... --PARENT--> [EK50.0] Cutaneous insect bite reactions Def: Skin reactions to known or presumed insect bites. Commonly the nature of the insect responsible is unknown.... --RELATED_TO--> [?] Cutaneous allergic or hypersensitivity reactions to Hymenoptera venom Def: Cutaneous reactions to Hymenoptera venom are hypersensitivity reactions classified into normal local reactions and large local reactions. Large local reaction is defined as a swelling exceeding a diam...
[ "[ND30] Superficial injuries involving multiple body regions\n --PARENT--> [?] Injuries involving multiple body regions\n --CHILD--> [ND31] Open wounds involving multiple body regions", "[ND30] Superficial injuries involving multiple body regions\n --PARENT--> [?] Injuries involving multiple body regions\n --EXCLUDES--> [?] Frostbite\n Def: Frostbite is injury from ice formation within tissues resulting from contact with cold air, liquids or metals. It is most commonly due to excessive exposure of skin to sub-zero environmental temperatu...", "[NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified\n --PARENT--> [?] Harmful effects of substances\n --CHILD--> [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified", "[NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified\n --EXCLUDES--> [?] Bacterial foodborne intoxications\n Def: Any condition caused by an intoxication due to a bacterial toxin. Intoxication is by ingestion of contaminated food....\n --EXCLUDES--> [?] Infections due to other Salmonella", "[EK50.02] Persistent insect bite reaction\n Def: Bite reactions lasting for months as inflamed papules and nodules, this is particularly likely to be seen with tick bites and mosquito bites. These may be confused with lymphoma histologically, with a...\n --PARENT--> [EK50.0] Cutaneous insect bite reactions\n Def: Skin reactions to known or presumed insect bites. Commonly the nature of the insect responsible is unknown....\n --CHILD--> [EK50.01] Bullous insect bite reaction\n Def: Cutaneous blisters resulting from a brisk immune response to insect bites. These are most common around the lower legs and ankles and in children rather than adults....", "[EK50.02] Persistent insect bite reaction\n Def: Bite reactions lasting for months as inflamed papules and nodules, this is particularly likely to be seen with tick bites and mosquito bites. These may be confused with lymphoma histologically, with a...\n --PARENT--> [EK50.0] Cutaneous insect bite reactions\n Def: Skin reactions to known or presumed insect bites. Commonly the nature of the insect responsible is unknown....\n --RELATED_TO--> [?] Cutaneous allergic or hypersensitivity reactions to Hymenoptera venom\n Def: Cutaneous reactions to Hymenoptera venom are hypersensitivity reactions classified into normal local reactions and large local reactions. Large local reaction is defined as a swelling exceeding a diam..." ]
ND30
Superficial injuries involving multiple body regions
[ { "from_icd11": "ND30", "icd10_code": "T00", "icd10_title": "" }, { "from_icd11": "ND30", "icd10_code": "T000", "icd10_title": "" }, { "from_icd11": "ND30", "icd10_code": "T001", "icd10_title": "" }, { "from_icd11": "ND30", "icd10_code": "T002", "icd10_title": "" }, { "from_icd11": "ND30", "icd10_code": "T003", "icd10_title": "" }, { "from_icd11": "ND30", "icd10_code": "T006", "icd10_title": "" }, { "from_icd11": "ND30", "icd10_code": "T008", "icd10_title": "" }, { "from_icd11": "ND30", "icd10_code": "T009", "icd10_title": "" }, { "from_icd11": "NE61", "icd10_code": "T5802XA", "icd10_title": "Toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T550X2A", "icd10_title": "Toxic effect of soaps, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T61781A", "icd10_title": "Other shellfish poisoning, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T551X2A", "icd10_title": "Toxic effect of detergents, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T5891XA", "icd10_title": "Toxic effect of carbon monoxide from unspecified source, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63711A", "icd10_title": "Toxic effect of contact with venomous marine plant, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63712A", "icd10_title": "Toxic effect of contact with venomous marine plant, intentional self-harm, initial encounter" } ]
T00
A 67-year-old man was referred to our hospital with suspicion of rectal tumor, hilar tumor, and urinary tumor. He had hyper urine acid and diabetes mellitus. There were no abnormal physical findings. Blood biochemistry showed slight increase of the CEA, CA19-9, and SPAN-1 levels to 6.7 ng/ml, 45.7 U/ml, and 33 U/ml, respectively. Computed tomography (CT) showed thickening of the hilar bile duct, dilatation of the bilateral intrahepatic bile duct, swelling of the para aortic lymph node, dilatation of the left renal pelvis, and thickening of the rectal wall. The pancreas was not enlarged . Colonoscopy revealed intermittent nodular lesions with redness in the rectum . They were atypical to primary rectal cancer. Histopathological examination suggested a well-differentiated adenocarcinoma. At this point, we suspected metastatic rectal cancer as diagnosis and conducted systemic examination continuously. Endoscopic retrograde cholangiopancreatography (ERCP) was performed. It showed narrowing of the bilateral intrahepatic bile duct, though biopsy of the bile duct was negative for malignant tumor . ERCP was reexamined 1 month later. The narrowing of the right intrahepatic bile duct improved except for slight segmental stricture of the peripheral bile duct . Brushing cytology of the bile duct was negative for malignant tumor. Magnetic resonance cholangiopancreatography (MRCP) showed narrowing of the bilateral intrahepatic bile duct and the main pancreatic duct . Positron emission tomography (PET) showed accumulation to the hilar bile duct, pancreatic body and tail, rectum and lymph nodes of the pulmonary hilar lesion, axilla, and para aorta . We considered possibility of the IgG4-related disease and measured the level of serum IgG4. Blood biochemistry showed high level of serum IgG4 up to 1140 mg/dl. The patient matched to the comprehensive diagnostic criteria for IgG4-related disease as a possible diagnostic case. He was finally diagnosed with rectal cancer with IgG4-related disease (sclerosing cholangitis and retroperitoneal fibrosis leading to hydronephrosis were suspected). We performed laparoscopic low anterior resection of the rectum with creation of ileostomy for rectal cancer. In the intraoperative findings, there was retroperitoneal fibrosis. The periarterial tissue, especially anterior tissue of the abdominal aorta, was hard. The tissue around the left ureter crossing the common iliac artery was also hard, and caliber change of the ureter was seen at the area. No evidence of urinary tumor was seen. The mesorectum was thick and edematous. The lateral tissue of rectum was also hard. The resected specimen revealed multiple nodular lesions in the rectum . Histologically, moderately differentiated adenocarcinoma cells were infiltrating through the rectal wall. Cancer cells spread horizontally at submucosal layer and subserosal layer. Massive lymph nodes involvement, lymphatic invasion, venous invasion, and perineural invasion were also revealed. There was marked infiltration of the plasma cells and lymphocytes at tumor stroma. In addition, infiltration of inflammatory cells containing plasma cells and fibrosis were also seen in the retroperitoneal tissue apart from the cancer lesion. Immunohistochemistrical findings revealed that more than half of the plasma cells infiltrating connective tissue were positive for IgG4 . The final stage of the rectal cancer was T3N2bM0 stage IIIC according to the TNM classification (UICC 7th edition). The postoperative course was uneventful except for paralytic bowel obstruction. For adjuvant therapy, the patient received modified FOLFOX6. After surgery, the level of serum IgG4 decreased to 597 mg/dl. Fig. 1 CT findings. Thickening of the hilar bile duct ( a : arrow ) and dilatation of the intrahepatic bile duct ( b : arrow ) were shown. The pancreas was not enlarged ( b : arrow ). Dilatation of the left renal pelvis ( c : arrow ) and thickening of the rectal wall ( d : arrow ) were shown Fig. 2 a , b Colonoscopic findings. Intermittent nodular lesions with redness in the rectum were seen Fig. 3 ERCP findings. a Narrowing of the bilateral intrahepatic bile duct was shown. b One month later, the narrowing of the right intrahepatic bile duct improved Fig. 4 MRCP findings. Narrowing of the bilateral intrahepatic bile duct and the main pancreatic duct was shown Fig. 5 PET findings. Accumulation to the hilar bile duct ( a : arrow ), pancreatic body and tail ( a : arrow ), and rectum ( b : arrow ) was shown Fig. 6 The resected specimen. Multiple nodular lesions in the rectum were shown Fig. 7 Histological findings. a Hematoxylin-eosin staining (×20), cancer cells spread horizontally at submucosal layer. b Hematoxylin-eosin staining (×100), marked infiltration of the plasma cells and lymphocytes was shown at tumor stroma. c Hematoxylin-eosin staining (×400), infiltration of plasma cells and fibrosis were shown in the retroperitoneal tissue. d IgG-immunostaining (×100) and e IgG4-immunostaining (×100), more than half of the infiltrating plasma cells were positive for IgG4
3.982422
0.980957
sec[1]/p[0]
en
0.999998
26943442
https://doi.org/10.1186/s40792-015-0120-7
[ "duct", "bile", "cells", "rectal", "tumor", "intrahepatic", "rectum", "cancer", "arrow", "shown" ]
[ { "code": "DC10.02", "title": "Obstruction of bile duct" }, { "code": "DC10.00", "title": "Obstruction of cystic duct" }, { "code": "DC13", "title": "Cholangitis" }, { "code": "LB20.23", "title": "Structural developmental anomalies of cystic duct" }, { "code": "DC10.2", "title": "Fistula of gallbladder or bile duct" }, { "code": "LB20.2Y", "title": "Other specified structural developmental anomalies of bile ducts" }, { "code": "ME24.35&XA6R80", "title": "Perforation of bile duct" }, { "code": "MF9Y", "title": "Other specified clinical findings on examination of urine, without diagnosis" }, { "code": "5C56.20", "title": "Mucolipidosis" }, { "code": "3A51.1", "title": "Sickle cell disease without crisis" } ]
=== ICD-11 CODES FOUND === [DC10.02] Obstruction of bile duct Also known as: Obstruction of bile duct | extrahepatic biliary obstruction | extrahepatic bile duct obstruction | bile duct obstruction | bile stasis Excludes: with cholelithiasis [DC10.00] Obstruction of cystic duct Also known as: Obstruction of cystic duct | cystic duct obstruction | cystic ductal obstruction | obstructed cystic duct | Acquired cystic duct atresia [DC13] Cholangitis Also known as: Cholangitis | acute cholangiolitis | ascending cholangitis | cholangiolitis | cholangitis NOS Excludes: chronic nonsuppurative destructive cholangitis | cholangitis with cholelithiasis | Primary sclerosing cholangitis [LB20.23] Structural developmental anomalies of cystic duct Also known as: Structural developmental anomalies of cystic duct | congenital deformity of cystic duct | cystic duct anomaly | cystic duct deformity | cystic duct distortion [DC10.2] Fistula of gallbladder or bile duct Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs. Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula [LB20.2Y] Other specified structural developmental anomalies of bile ducts Also known as: Other specified structural developmental anomalies of bile ducts | Anomalous arrangement of pancreatobiliary ducts | Aberrant hepatic duct | Accessory hepatic duct | accessory liver duct [MF9Y] Other specified clinical findings on examination of urine, without diagnosis Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine [5C56.20] Mucolipidosis Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2 Excludes: Sialidosis (mucolipidosis type 1) [3A51.1] Sickle cell disease without crisis Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing. Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease] === GRAPH WALKS === --- Walk 1 --- [DC10.02] Obstruction of bile duct --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --CHILD--> [?] Calculus of gallbladder or cystic duct with other cholecystitis Def: Stones in gallbladder or cystic duct present with inflammation of the gall bladder wall and cystic duct.... --- Walk 2 --- [DC10.02] Obstruction of bile duct --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --CHILD--> [?] Mirizzi syndrome Def: This is a rare complication in which a gallstone becomes impacted in the cystic duct or neck of the gallbladder causing compression of the common bile duct (CBD) or common hepatic duct, resulting in o... --- Walk 3 --- [DC10.00] Obstruction of cystic duct --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --- Walk 4 --- [DC10.00] Obstruction of cystic duct --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --- Walk 5 --- [DC13] Cholangitis --EXCLUDES--> [?] Primary biliary cholangitis Def: Primary biliary cholangitis is characterised by progressive destruction and disappearance of the intralobular bile duct epithelial cells leading to cholestasis (high alkaline phosphatase and GGT {gamm... --EXCLUDES--> [?] Primary sclerosing cholangitis Def: Primary sclerosing cholangitis is a chronic disease which shows focal or multifocal strictures of intra- and/or extra-hepatic bile ducts without any apparent causes, leading to cholestasis and ultimat... --- Walk 6 --- [DC13] Cholangitis --EXCLUDES--> [?] Primary sclerosing cholangitis Def: Primary sclerosing cholangitis is a chronic disease which shows focal or multifocal strictures of intra- and/or extra-hepatic bile ducts without any apparent causes, leading to cholestasis and ultimat... --CHILD--> [?] Primary sclerosing cholangitis without cirrhosis Def: Primary sclerosing cholangitis without cirrhosis is primary sclerosing cholangitis not complicated with liver cirrhosis....
[ "[DC10.02] Obstruction of bile duct\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...\n --CHILD--> [?] Calculus of gallbladder or cystic duct with other cholecystitis\n Def: Stones in gallbladder or cystic duct present with inflammation of the gall bladder wall and cystic duct....", "[DC10.02] Obstruction of bile duct\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...\n --CHILD--> [?] Mirizzi syndrome\n Def: This is a rare complication in which a gallstone becomes impacted in the cystic duct or neck of the gallbladder causing compression of the common bile duct (CBD) or common hepatic duct, resulting in o...", "[DC10.00] Obstruction of cystic duct\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...", "[DC10.00] Obstruction of cystic duct\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...", "[DC13] Cholangitis\n --EXCLUDES--> [?] Primary biliary cholangitis\n Def: Primary biliary cholangitis is characterised by progressive destruction and disappearance of the intralobular bile duct epithelial cells leading to cholestasis (high alkaline phosphatase and GGT {gamm...\n --EXCLUDES--> [?] Primary sclerosing cholangitis\n Def: Primary sclerosing cholangitis is a chronic disease which shows focal or multifocal strictures of intra- and/or extra-hepatic bile ducts without any apparent causes, leading to cholestasis and ultimat...", "[DC13] Cholangitis\n --EXCLUDES--> [?] Primary sclerosing cholangitis\n Def: Primary sclerosing cholangitis is a chronic disease which shows focal or multifocal strictures of intra- and/or extra-hepatic bile ducts without any apparent causes, leading to cholestasis and ultimat...\n --CHILD--> [?] Primary sclerosing cholangitis without cirrhosis\n Def: Primary sclerosing cholangitis without cirrhosis is primary sclerosing cholangitis not complicated with liver cirrhosis...." ]
DC10.02
Obstruction of bile duct
[ { "from_icd11": "DC10.02", "icd10_code": "K831", "icd10_title": "Obstruction of bile duct" }, { "from_icd11": "DC13", "icd10_code": "K8309", "icd10_title": "Other cholangitis" }, { "from_icd11": "DC13", "icd10_code": "K8301", "icd10_title": "Primary sclerosing cholangitis" }, { "from_icd11": "DC13", "icd10_code": "K830", "icd10_title": "Cholangitis" }, { "from_icd11": "DC10.2", "icd10_code": "K833", "icd10_title": "Fistula of bile duct" }, { "from_icd11": "DC10.2", "icd10_code": "K823", "icd10_title": "Fistula of gallbladder" }, { "from_icd11": "3A51.1", "icd10_code": "D571", "icd10_title": "Sickle-cell disease without crisis" } ]
K831
Obstruction of bile duct
A 47-year-old woman was admitted to our clinic with the complaints of nausea, intermittent vomiting, constipation, fatigue, and palpitation. She also had progressive weight loss of 10 kg since last 5 months. She had a history of bilateral surrenalectomy 3 years ago due to Cushing's syndrome associated with adrenocorticotropic hormone (ACTH) independent macronodular adrenal hyperplasia. The patient was taking prednisolone 7.5 mg and fludrocortisone 0.1 mg orally once a day. Her family history was significant for breast cancer in her mother, gastric cancer in her aunt, and coronary artery disease in her uncle. Physical examination revealed tachycardia, presence of lid lag, warm skin, and orthostatic hypotension. The thyroid gland was enlarged and had a bruit. Pertinent laboratory values included a serum thyroid stimulating hormone (TSH) of 0.005 mIU/L (normal, 0.4 to 4.2) with a free T4 value of 7.7 ng/dL (normal, 0.93 to 1.7) and free T3 value of 16 pg/mL (normal, 2 to 4.4). Thyroglobulin antibody (Anti TG) and thyroid receptor antibody (TRAB) were elevated (anti-TG 718 IU/mL (normal, 0 to 115) and TRAB 14.91 U/mL (normal, 0 to 1.1)). Thyroid scan showed bilateral mildly increased, diffuse, and homogenous uptake in the thyroid gland. Radioactive iodine uptake was calculated to be 19% at two hours and 39% at 24 hours. Thyroid ultrasonography revealed an enlarged and heterogeneous thyroid gland. The patient's serum calcium level was 16 mg/dL (normal, 8.4 to 10.2), serum phosphorus was 3.9 mg/dL (normal, 2.5 to 4.5), albumin level was in the normal range, and intact parathyroid hormone (iPTH) was found to be suppressed to the level of 7.99 pg/mL (normal, 15 to 65). The 25-OH vitamin D was slightly decreased (21 ng/dL (normal, 30 to 50)) and serum alkaline phosphatase was normal. Serum creatinine was in the normal range, serum sodium was 136 mmol/L (normal, 136 to 145), and potassium was 5.1 mmol/L (normal, 3.5 to 5.1). The electrocardiogram showed sinus tachycardia at a rate of 120 beat per minute (bpm) and shortened QT interval. In the lights of these initial physical and laboratory investigations, the diagnosis of thyrotoxicosis complicated by hypercalcemia and acute adrenal failure was confirmed. Emergent treatment with intravenous saline, methylprednisolone 20 mg intravenously 3 times a day, methimazole 10 mg orally 3 times a day, and propranolol 20 mg orally 2 times a day was started. Fludrocortisone at a dose of 0.1 mg orally was continued. After infusion of 2 liters of isotonic saline, furosemide was added to the therapy and saline infusion was continued at rate of 250 mL/hour. Zoledronic acid at a dose of 4 mg intravenously was also given to the patient. On the third day of the admission, the patient's calcium level was 9.5 mg/dL, and saline and furosemide infusion were stopped. The free T4 level was 4.67 ng/dL and free T3 level was 5.98 pg/mL. On the fourth day of admission, the patient complained of acute onset right upper quadrant pain. The laboratory examinations revealed that transaminase levels were elevated to approximately three times of the upper limit of normal. As her initial transaminase values were within the normal range, hepatotoxicity due to the methimazole administration was suspected and the drug was stopped. Hepatobiliary ultrasonography was consistent with acute hepatitis and viral serologic examinations were negative. After three days while off methimazole serum transaminase values were normalized and the patient had no more pain in the right upper quadrant, we started the patient on cholestyramine 8 g orally 3 times a day, lithium 600 mg orally 2 times a day, increased the propranolol dose to 40 mg 3 times a day, and continued methylprednisolone at the same dose. The investigations to rule out a possible malignancy including thorax and abdominal computed tomography (CT), bone marrow examination, gastroscopy, bone scan, gynecologic and mammographic examinations, and PET-CT were all negative. After being euthyroid the patient received 10 millicuries (mCi) radioactive iodine (RAI). The patient was discharged from the hospital with a steroid taper schedule aiming at 8 mg dose decrease every 5 days until the final dose of 7.5 mg per day of prednisolone was reached. Three months later, the patient was readmitted to the hospital with similar complaints and laboratory examinations revealed a mild thyrotoxicosis, mild hypercalcemia, hyponatremia, and hyperpotassemia. The clinical picture and laboratory findings of the patient were less remarkable at that time as she had increased the steroid dose one week before her admission. She was using prednisolone 5 mg orally three times a day and these supraphysiological doses of steroid may have potentially prevented the development of more severe adrenal failure and thus hypercalcemia. An additional dose of 15 mCi RAI was administered to the patient. She became hypothyroid and was started on levothyroxine replacement therapy 3 months later. At her last follow-up visit, she was euthyroid and normocalcemic and her iPTH was 41 pg/mL.
4.070313
0.974609
sec[1]/p[0]
en
0.999996
25878906
https://doi.org/10.1155/2015/684648
[ "times", "orally", "thyroid", "serum", "laboratory", "free", "saline", "examinations", "three", "hormone" ]
[ { "code": "PL13.52", "title": "Incorrect timing of drug or medicament, as mode of injury" }, { "code": "QF2A", "title": "Difficulty or need for assistance with community participation" }, { "code": "MF50.1", "title": "Pollakiuria" }, { "code": "JA25.3", "title": "Eclampsia, time period unspecified" }, { "code": "KD3B.Z", "title": "Unspecified time of fetal death, cause not specified" }, { "code": "MD11.8Z", "title": "Mouth breathing, unspecified" }, { "code": "DA01.00", "title": "Oral leukoplakia" }, { "code": "DA01.10", "title": "Oral aphthae or aphtha-like ulceration" }, { "code": "MD80.1", "title": "Symptom or complaint of the mouth, tongue or lip" }, { "code": "DA01.1Y", "title": "Other specified noninfectious erosive or ulcerative disorders of oral mucosa" } ]
=== ICD-11 CODES FOUND === [PL13.52] Incorrect timing of drug or medicament, as mode of injury Also known as: Incorrect timing of drug or medicament, as mode of injury | wrong timing of drug | timing error in giving drug | timing mistake in administration of drug | administration error involving timing of drug Excludes: Problem with delayed treatment | Overdose of substance, as mode of injury or harm [QF2A] Difficulty or need for assistance with community participation Also known as: Difficulty or need for assistance with community participation | difficulty with community participation | need for assistance with community participation | need for assistance with community, social and civic life | difficulty with community, social and civic life Includes: Lack of relaxation or leisure [MF50.1] Pollakiuria Also known as: Pollakiuria | pollakisuria | Daytime frequency of micturition [JA25.3] Eclampsia, time period unspecified Definition: Onset of convulsions in a woman with pre-eclampsia not attributable to other causes without a specific onset time. Also known as: Eclampsia, time period unspecified | Eclampsia NOS | eclamptic coma | eclamptic toxaemia | toxaemia with convulsions [KD3B.Z] Unspecified time of fetal death, cause not specified Also known as: Unspecified time of fetal death, cause not specified | Fetal death, cause not specified | stillbirth NOS | stillborn NOS | intrauterine fetal demise [MD11.8Z] Mouth breathing, unspecified Also known as: Mouth breathing, unspecified | Mouth breathing | breathing orally | mouth respiration [DA01.00] Oral leukoplakia Definition: Leukoplakia is a condition where areas of keratosis appear as adherent white patches on the mucous membranes of the oral cavity. Leukoplakia may affect other gastrointestinal tract mucosal sites, or mucosal surfaces of the urinary tract and genitals. Also known as: Oral leukoplakia | Leukoplakia of gingiva | leukoplakia of oral epithelium | leucoplakia of oral mucosa | leukokeratosis of oral mucosa Includes: Leukoplakia of gingiva Excludes: Hairy leukoplakia [DA01.10] Oral aphthae or aphtha-like ulceration Definition: This is a frequent small, shallow, painful ulceration in the oral mucosa. Recurrent oral ulceration that clinically resembles recurrent aphthous stomatitis but presents atypically, including commencement after adolescence, with fever, with a strong family history, or failing to resolve with age. Also known as: Oral aphthae or aphtha-like ulceration | Recurrent aphthous stomatitis | Recurrent oral aphthae | Major recurrent aphthous stomatitis | major aphthous stomatitis [MD80.1] Symptom or complaint of the mouth, tongue or lip Also known as: Symptom or complaint of the mouth, tongue or lip | Mouth swelling | mouth oedema | swollen mouth | Lip swelling [DA01.1Y] Other specified noninfectious erosive or ulcerative disorders of oral mucosa Also known as: Other specified noninfectious erosive or ulcerative disorders of oral mucosa | Oral ulceration due to immunobullous disease | Oral mucosal involvement by immunobullous disorder classified elsewhere | Oral ulceration due to physical injury | Mechanical oral ulceration === GRAPH WALKS === --- Walk 1 --- [PL13.52] Incorrect timing of drug or medicament, as mode of injury --EXCLUDES--> [?] Overdose of substance, as mode of injury or harm Def: Incorrect dose - too high... --EXCLUDES--> [?] Intentional self-harm by exposure to or harmful effects of drugs, medicaments or biological substances --- Walk 2 --- [PL13.52] Incorrect timing of drug or medicament, as mode of injury --PARENT--> [PL13.5] Incorrect administration of drug or medicament, as mode of injury --CHILD--> [PL13.50] Incorrect route of drug or medicament, as mode of injury --- Walk 3 --- [QF2A] Difficulty or need for assistance with community participation --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --CHILD--> [QF22] Difficulty or need for assistance with communication --- Walk 4 --- [QF2A] Difficulty or need for assistance with community participation --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --CHILD--> [QF20] Difficulty or need for assistance with learning --- Walk 5 --- [MF50.1] Pollakiuria --PARENT--> [MF50] Abnormal micturition --CHILD--> [MF50.0] Frequent micturition Def: Needing to urinate more often than normal.... --- Walk 6 --- [MF50.1] Pollakiuria --PARENT--> [MF50] Abnormal micturition --CHILD--> [MF50.2] Urinary incontinence Def: Any condition of the urinary system, caused by determinants arising during the antenatal period or after birth, leading to loss of voluntary control or support of the urethra. These conditions are cha...
[ "[PL13.52] Incorrect timing of drug or medicament, as mode of injury\n --EXCLUDES--> [?] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high...\n --EXCLUDES--> [?] Intentional self-harm by exposure to or harmful effects of drugs, medicaments or biological substances", "[PL13.52] Incorrect timing of drug or medicament, as mode of injury\n --PARENT--> [PL13.5] Incorrect administration of drug or medicament, as mode of injury\n --CHILD--> [PL13.50] Incorrect route of drug or medicament, as mode of injury", "[QF2A] Difficulty or need for assistance with community participation\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF22] Difficulty or need for assistance with communication", "[QF2A] Difficulty or need for assistance with community participation\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF20] Difficulty or need for assistance with learning", "[MF50.1] Pollakiuria\n --PARENT--> [MF50] Abnormal micturition\n --CHILD--> [MF50.0] Frequent micturition\n Def: Needing to urinate more often than normal....", "[MF50.1] Pollakiuria\n --PARENT--> [MF50] Abnormal micturition\n --CHILD--> [MF50.2] Urinary incontinence\n Def: Any condition of the urinary system, caused by determinants arising during the antenatal period or after birth, leading to loss of voluntary control or support of the urethra. These conditions are cha..." ]
PL13.52
Incorrect timing of drug or medicament, as mode of injury
[ { "from_icd11": "QF2A", "icd10_code": "Z7389", "icd10_title": "Other problems related to life management difficulty" }, { "from_icd11": "QF2A", "icd10_code": "Z7382", "icd10_title": "Dual sensory impairment" }, { "from_icd11": "QF2A", "icd10_code": "Z73", "icd10_title": "Problems related to life management difficulty" }, { "from_icd11": "QF2A", "icd10_code": "Z732", "icd10_title": "Lack of relaxation and leisure" }, { "from_icd11": "QF2A", "icd10_code": "Z738", "icd10_title": "Other problems related to life management difficulty" }, { "from_icd11": "QF2A", "icd10_code": "Z739", "icd10_title": "Problem related to life management difficulty, unspecified" }, { "from_icd11": "MF50.1", "icd10_code": "R351", "icd10_title": "Nocturia" }, { "from_icd11": "MF50.1", "icd10_code": "R358", "icd10_title": "Other polyuria" }, { "from_icd11": "MF50.1", "icd10_code": "R35", "icd10_title": "Polyuria" }, { "from_icd11": "JA25.3", "icd10_code": "O159", "icd10_title": "Eclampsia, unspecified as to time period" }, { "from_icd11": "KD3B.Z", "icd10_code": "P95", "icd10_title": "Stillbirth" }, { "from_icd11": "MD11.8Z", "icd10_code": "R065", "icd10_title": "Mouth breathing" }, { "from_icd11": "DA01.00", "icd10_code": "K1329", "icd10_title": "Other disturbances of oral epithelium, including tongue" }, { "from_icd11": "DA01.00", "icd10_code": "K1321", "icd10_title": "Leukoplakia of oral mucosa, including tongue" }, { "from_icd11": "DA01.00", "icd10_code": "K132", "icd10_title": "Leukoplakia and other disturbances of oral epithelium, including tongue" } ]
Z7389
Other problems related to life management difficulty
A 34 year-old male patient of Caucasian ethnicity was diagnosed with a 3 rd degree acute kidney injury (Acute Kidney Injury Network classification ) in a regional German hospital. Co-morbidities included arterial hypertension, obstructive sleep apnea, obesity (body-mass index: 40.4 kg/m 2 ), tobacco abuse, and chronic obstructive pulmonary disease (COPD). Based on an elevated serum cANCA titer, the diagnosis of GPA was established. A histological confirmation was obtained by kidney biopsy. Initially, seven sessions of plasmapheresis and induction immunosuppression (500 mg i.v. methylprednisolone for 3 days, steroid taper-off, 0.5 g cyclophosphamide i.v. twice within two months) were applied leading to a partial remission of GPA. However, a bronchoscopy-proven mycotic pneumonia ( aspergillus fumigatus) occurred following the second bolus of cyclophosphamide requiring antimycotic treatment (voriconacole 200 mg bid) for several months. Immunsuppressive induction therapy was stopped immediately. Hence, due to the halted immunosuppressive therapy, kidney function progressively deteriorated. Eleven months after onset of GPA, the patient had to be hospitalized for hemodialysis-access surgery and hemodialysis initiation. During the following 4 years, hemodialysis-fistula thrombosis and repeat catheter-associated bloodstream infections, episodes of exacerbated COPD and pneumonia occurred. The patient ignored recommendations regarding fluid intake. Because of respiratory symptoms related to overhydration and infections, the patient was deemed unfit to proceed with cyclophosphamide induction. A maintenance therapy with prednisolone (10 mg) was prescribed. Four years after GPA diagnosis, CRP and cANCA serum levels rose, and the patient had to be hospitalized three times within a year due to progressive dyspnea, cough and fever. During the last hospitalization one year before index hospitalization, bronchoscopy ruled out opportunistic infections. Mycophenolate mofetil was introduced as new maintenance immunosuppression for suspected smoldering disease activity in the lungs. Five years after first diagnosis of GPA, the patient received the third and forth intravenous bolus of cyclophosphamide (0.6 g each) within two months. Voriconacole (200 mg twice daily) and co-trimoxazole (960 mg/d) were added as prophylaxis for mycotic pneumonia and PCP. Within less than 24 hours following the 4 th cyclophosphamide bolus given after hemodialysis, the patient developed dyspnea at rest necessitating re-hospitalisation, endotracheal intubation and assisted mechanical ventilation. Echocardiography showed a pericardial effusion (end-diastolic: 2.5 cm), massive right-ventricular dilation and hypokinesia. New ECG changes triggered an immediate coronary angiography exam which excluded clogged coronaries. Right-ventricular catheterization showed an elevated pulmonary-artery pressure: 74/54/58 mmHg (systolic/diastolic/mean). There, pulmonary-artery embolism was excluded. Cardiac enzymes remained unrevealing. The pericardial effusion disappeared after one month. As another sign of cyclophosphamide toxicity, anemia and neutropenia occurred. Anemia had to be corrected by two packed erythrocyte concentrates. Neutropenia was complicated by sepsis with elevated procalcitonin (PCT: 13.6 ng/ml) and C-reactive protein (CRP: 259 mg/l) one week after the 4 th bolus of cyclophosphamide. The patient was again on assisted mechanical ventilation for 11 days. Thoracic computed tomography showed pulmonary infiltrates within large, partly calcified pulmonary cavernae (maximum 6 cm in diameter). Under intensified antibiosis guided by microbiologic findings from bronchoalveolar lavage, the sepsis subsided. Coincidentally, either GPA disease activity or late sequelae of cyclophosphamide, the patient had to be reanimated for third-degree atrioventricular block two weeks after the 4 th bolus of cyclophosphamide. The latter possibility appears to be more likely because cytoplasmic ANCA titer only was 1:20 seven days before. A permanent pacemaker was inserted, and the patient was discharged with p.o. antibiosis, p.o. prednisolone (10 mg/d), however, without voriconacole or co-trimoxazole three weeks after admission. Six weeks following discharge or 10 weeks after the fourth cyclophosphamide bolus, the patient was readmitted for suspected pneumogenic sepsis with worsening dyspnea and hypotension. At admission, the patient had to be transferred to an intensive-care unit (ICU) requiring catecholamine therapy and mechanical ventilation for five days. Blood cultures remained negative. Sputum revealed Pneumocystis jirovecii , Candida albicans , Peptostreptococcus micros , and Actinomyces israelii. Tuberculosis was ruled out using blood test and in culture of bronchoalveolar fluid following bronchoscopy. Both Cytomegalovirus (CMV) IgM and IgG were positive. However, weekly CMV PCR of serum samples remained negative. Both T-helper lymphocyte count (242/μl) and plasma immunoglobulin G level (6.4 g/l) were low indicative for a state of over-immunosuppression.
4.007813
0.976074
sec[1]/p[0]
en
0.999997
24495297
https://doi.org/10.1186/1471-2369-15-28
[ "cyclophosphamide", "bolus", "pulmonary", "within", "kidney", "hemodialysis", "serum", "induction", "immunosuppression", "however" ]
[ { "code": "GC00.Y", "title": "Other specified cystitis" }, { "code": "PB06", "title": "Unintentional threat to breathing by inhalation or ingestion of food" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "CA40.Z", "title": "Pneumonia, organism unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "NB32.3Y", "title": "Other injury of lung" }, { "code": "QE70.Z", "title": "Problems related to primary support group, including family circumstances, unspecified" }, { "code": "8D6Y", "title": "Other specified disorders of cerebrospinal fluid pressure or flow" }, { "code": "LA8E.1", "title": "Atrial septal defect within oval fossa" } ]
=== ICD-11 CODES FOUND === [GC00.Y] Other specified cystitis Also known as: Other specified cystitis | Noninfectious cystitis | Irradiation cystitis | radiation cystitis | Chemical cystitis [PB06] Unintentional threat to breathing by inhalation or ingestion of food Also known as: Unintentional threat to breathing by inhalation or ingestion of food | Inhalation and ingestion of food causing obstruction of respiratory tract | choked on food bolus | aspiration or inhalation of food NOS | aspiration of food bolus [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [CA40.Z] Pneumonia, organism unspecified Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [NB32.3Y] Other injury of lung Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung [QE70.Z] Problems related to primary support group, including family circumstances, unspecified Also known as: Problems related to primary support group, including family circumstances, unspecified | Problems related to primary support group, including family circumstances | family problem | problem related to primary support group | Problem related to gambling in the family [8D6Y] Other specified disorders of cerebrospinal fluid pressure or flow Also known as: Other specified disorders of cerebrospinal fluid pressure or flow | Cystic cerebrospinal fluid collection | Cerebrospinal fluid collection due to spinal intradural arachnoid cyst | Leptomeningeal cyst | Tarlov cyst [LA8E.1] Atrial septal defect within oval fossa Definition: A congenital cardiovascular malformation in which there is an interatrial communication confined to the region of the oval fossa (fossa ovalis), most commonly due to a deficiency of the primary atrial septum (septum primum) but deficiency of the septum secundum (superior interatrial fold) may also contribute. Also known as: Atrial septal defect within oval fossa | Ostium secundum atrial septal defect | Secundum atrial septal defect === GRAPH WALKS === --- Walk 1 --- [GC00.Y] Other specified cystitis --PARENT--> [GC00] Cystitis Def: A condition of the bladder, caused by infection, reaction to pharmacological agents, exposure to radiation therapy, or potential irritants. This condition is characterised by inflammation of the urina... --EXCLUDES--> [?] Prostatocystitis Def: A condition characterised by inflammation of the bladder, bladder neck, prostate, and prostatic urethra.... --- Walk 2 --- [GC00.Y] Other specified cystitis --PARENT--> [GC00] Cystitis Def: A condition of the bladder, caused by infection, reaction to pharmacological agents, exposure to radiation therapy, or potential irritants. This condition is characterised by inflammation of the urina... --RELATED_TO--> [?] Infections of bladder in pregnancy Def: Bladder infections occurring during pregnancy... --- Walk 3 --- [PB06] Unintentional threat to breathing by inhalation or ingestion of food --PARENT--> [?] Unintentional threat to breathing --CHILD--> [PB02] Unintentional threat to breathing by strangulation --- Walk 4 --- [PB06] Unintentional threat to breathing by inhalation or ingestion of food --PARENT--> [?] Unintentional threat to breathing --CHILD--> [PB00] Unintentional threat to breathing by suffocation from object covering mouth or nose --- Walk 5 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --CHILD--> [CB40.2] Pulmonary collapse --- Walk 6 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --CHILD--> [CB40.1] Young syndrome Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections....
[ "[GC00.Y] Other specified cystitis\n --PARENT--> [GC00] Cystitis\n Def: A condition of the bladder, caused by infection, reaction to pharmacological agents, exposure to radiation therapy, or potential irritants. This condition is characterised by inflammation of the urina...\n --EXCLUDES--> [?] Prostatocystitis\n Def: A condition characterised by inflammation of the bladder, bladder neck, prostate, and prostatic urethra....", "[GC00.Y] Other specified cystitis\n --PARENT--> [GC00] Cystitis\n Def: A condition of the bladder, caused by infection, reaction to pharmacological agents, exposure to radiation therapy, or potential irritants. This condition is characterised by inflammation of the urina...\n --RELATED_TO--> [?] Infections of bladder in pregnancy\n Def: Bladder infections occurring during pregnancy...", "[PB06] Unintentional threat to breathing by inhalation or ingestion of food\n --PARENT--> [?] Unintentional threat to breathing\n --CHILD--> [PB02] Unintentional threat to breathing by strangulation", "[PB06] Unintentional threat to breathing by inhalation or ingestion of food\n --PARENT--> [?] Unintentional threat to breathing\n --CHILD--> [PB00] Unintentional threat to breathing by suffocation from object covering mouth or nose", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.2] Pulmonary collapse", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.1] Young syndrome\n Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections...." ]
GC00.Y
Other specified cystitis
[ { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "CA40.Z", "icd10_code": "J189", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J181", "icd10_title": "Lobar pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J188", "icd10_title": "Other pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J168", "icd10_title": "Pneumonia due to other specified infectious organisms" }, { "from_icd11": "CA40.Z", "icd10_code": "J180", "icd10_title": "Bronchopneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J17", "icd10_title": "Pneumonia in diseases classified elsewhere" }, { "from_icd11": "CA40.Z", "icd10_code": "J182", "icd10_title": "Hypostatic pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J16", "icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified" }, { "from_icd11": "CA40.Z", "icd10_code": "J171", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J173", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J178", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J18", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" } ]
Q333
Agenesis of lung
In the questionnaire, we described a patient who received first-line chemotherapy for DLBCL in Group ML and a patient who received adjuvant chemotherapy for early breast cancer in Group BC. In the clinical scenarios, the patients suffer from low risk FN with The Multinational Association for Supportive Care in Cancer (MASCC) scores ≥21 and in Talcott group 4 . The questionnaire inquired about the management of FN and subsequent cycles of chemotherapy. The questions asked in the survey are listed in Table 1 . This survey was administered in Japanese. The surveillance period was from November 30 through December 11, 2012. Table 1 Questions asked in the survey Q. How old are you? 1. ≤29 2. 30–34 3. 35–39 4. 40–44 5. 45–49 6. 50–54 7. 55–59 8. ≥60 Q. In what decade did you receive your medical license? 1. 2000s 2. 1990s 3. 1980s 4. 1970s Q. Please select one of the following to indicate your area of specialty. (For Group ML) 1. Board-certified internist 2. Board-certified hematologist 3. Board-certified oncologist 4. Not applicable (For Group BC) 1. Board-certified surgeon 2. Board-certified breast surgeon 3. Board-certified oncologist 4. Board-certified internist 5. Not applicable Q. Please select one of the following to indicate your place of employment. 1. Academic medical center 2. Cancer center or public hospital 3. Private hospital 4. Other Diffuse large B-cell lymphoma (DLBCL) A 68-year-old woman was given a diagnosis of DLBCL, Stage IV A. There were hepatic metastases, but no bone marrow infiltration. She had no clinically significant past medical history. The International Prognostic Index was high-intermediate risk. Performance status (PS) was 0. Lactate dehydrogenase (LDH) was 1,250 IU/L. She was scheduled to receive six cycles of R-CHOP (rituximab 375 mg/m 2 on day 1 or day 2, cyclophosphamide 750 mg/m 2 on day 1, doxorubicin 50 mg/m 2 on day 1, vincristine 1.4 mg/m 2 on day 1 [max 2 mg], prednisone 100 mg on days 1–5) given every 21 days. Breast cancer A 68-year-old postmenopausal woman was given a diagnosis of right breast cancer, cT2N0M0 stage II A. She had no clinically significant past medical history. PS was 0. Right total mastectomy was performed. Pathological findings were as follows: pT 2.0 cm, grade 3, ly-, v-, pN1 (3/20), ER(-), PgR(-), HER2(-). She was scheduled to receive four cycles of TC (docetaxel 75 mg/m 2 on day 1, cyclophosphamide 600 mg/m 2 on day 1) given every 21 days. Q1. Would you manage low-risk febrile neutropenia in patients such as those describe above on an inpatient or outpatient basis? 1. Outpatient 2. Inpatient Q2. (For those who chose outpatient management) Which of the following choices do you feel most closely describes the treatment you usually provide to this type of patient? 1. Oral antibiotics only 2. Oral antibiotics and G-CSF 3. Observation 4. Other Q3. (For those who chose inpatient management) Which of the following choices do you feel most closely describes the treatment you usually provide to this type of patient? 1. Intravenous antibiotics 2. Intravenous antibiotics and G-CSF 3. Other [Clinical Course] On the tenth day of the first cycle, she presented with a fever of 39 °C. A systematic review was unrevealing. Dietary and fluid intake was sufficient. Blood pressure, 135/80 mmHg HEENT: She had a clear oropharynx. Chest: No rales or wheezes were present. Cardiac: Normal S1 and S2. There was no murmur. Abdomen: Soft and flat. Bowel sounds were normal. Laboratory data: WBC:1,200/mm 3 , ANC:400/mm 3 , Hb:11.4 g/dL, PLT:158,000, GOT:23 IU/L, Alb:3.6 g/dL, BUN:18.8 mg/dL, Cr:0.6 mg/dL, CRP:1.8 mg/dL Q4. How do you modify the dose of subsequent courses of chemotherapy after febrile neutropenia? Please select one of the following options. 1. Dose reduction is not required 2. Dose reduction is required if febrile neutropenia was treated by intravenous antibiotics 3. Dose reduction is required at any rate 4. Other Q5. How do you use antibiotics for the subsequent course of chemotherapy after febrile neutropenia? Please select one of the following options. 1. Antimicrobial prophylaxis deserves consideration 2. Antibiotics should be taken into account when the next episode of febrile neutropenia occurs 3. I typically do not administer antibiotics 4. Other Q6. How do you use G-CSF for the subsequent course of chemotherapy after febrile neutropenia? Please select one of the following options. 1. G-CSF prophylaxis deserves consideration 2. G-CSF should be taken into account when neutropenia occurs 3. G-CSF should be taken into account when the next episode of febrile neutropenia occurs 4. I typically do not administer G-CSF 5. Other Q7. Regarding systems for managing adverse effects of outpatient chemotherapy, please check all appropriate responses. 1. Emergency outpatient unit is open at all hours 2. Clinical laboratory is open at all hours 3. Diagnostic imaging unit is open at all hours 4. Hospital antibiogram is available 5. Health professionals provide patient and family education 6. Chemotherapy telephone helpline is available 7. Not applicable
3.984375
0.435059
sec[1]/p[1]
en
0.999995
26438185
https://doi.org/10.1186/s12885-015-1651-9
[ "chemotherapy", "neutropenia", "antibiotics", "board", "certified", "febrile", "please", "group", "cancer", "select" ]
[ { "code": "QB97", "title": "Contact with health services for chemotherapy session for neoplasm" }, { "code": "QC05.Y", "title": "Other specified prophylactic measures" }, { "code": "QB9Y", "title": "Other specified contact with health services for nonsurgical interventions not involving devices" }, { "code": "3B64.1Y", "title": "Other specified acquired thrombocytopenia" }, { "code": "QC48.Y", "title": "Other specified personal history of medical treatment" }, { "code": "4B00.0Z", "title": "Neutropaenia, unspecified" }, { "code": "4B00.00", "title": "Constitutional neutropaenia" }, { "code": "4B00.01", "title": "Acquired neutropaenia" }, { "code": "2A31", "title": "Refractory neutropaenia" }, { "code": "EC10", "title": "Genetic syndromes with poikiloderma" } ]
=== ICD-11 CODES FOUND === [QB97] Contact with health services for chemotherapy session for neoplasm Also known as: Contact with health services for chemotherapy session for neoplasm | antineoplastic chemotherapy regimen | cancer chemotherapy regimen | maintenance chemotherapy for neoplasm | neoplasm chemotherapy [QC05.Y] Other specified prophylactic measures Also known as: Other specified prophylactic measures | Other prophylactic chemotherapy | chemoprophylaxis | prophylactic chemotherapy | Systemic prophylactic chemotherapy [QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices Also known as: Other specified contact with health services for nonsurgical interventions not involving devices | Chemotherapy other than for neoplasm | admission for chemotherapy administration other than for neoplasm | chemotherapy regimen other than for neoplasm | drug therapy other than for neoplasm [3B64.1Y] Other specified acquired thrombocytopenia Also known as: Other specified acquired thrombocytopenia | Acquired thrombocytopenia specified as refractory | Chemotherapy thrombocytopaenia | Liver thrombocytopaenia [QC48.Y] Other specified personal history of medical treatment Also known as: Other specified personal history of medical treatment | Personal history of contraception | history of contraception | Personal history of long-term use of medicaments other than anticoagulants | personal history of long term current use of medicaments [4B00.0Z] Neutropaenia, unspecified Also known as: Neutropaenia, unspecified | Neutropenia | Disorders with decreased neutrophil counts | neutropaenic disorder | neutrophil count below reference range [4B00.00] Constitutional neutropaenia Definition: This is a granulocyte disorder characterised by an abnormally low number of neutrophils. Neutrophils usually make up 50-70% of circulating white blood cells and serve as the primary defence against infections by destroying bacteria in the blood. Also known as: Constitutional neutropaenia | congenital agranulocytosis and neutropaenia | congenital leukopaenia | Congenital neutropaenias | primary neutropaenia Excludes: Cartilage-hair hypoplasia [4B00.01] Acquired neutropaenia Also known as: Acquired neutropaenia | Immunologic neutropaenias | Acquired neutropaenia NOS | Adult idiopathic neutropaenia | Secondary agranulocytosis Includes: Adult idiopathic neutropaenia [2A31] Refractory neutropaenia Definition: A myelodysplastic syndrome characterised by the presence of at least 10% dysplastic neutrophils in the bone marrow or the peripheral blood. Also known as: Refractory neutropaenia [EC10] Genetic syndromes with poikiloderma Definition: Hereditary syndromes in which poikiloderma (cutaneous pigmentation, atrophy and telangiectasia) is a conspicuous feature. Also known as: Genetic syndromes with poikiloderma | Poikiloderma with neutropaenia | Poikiloderma with neutropaenia, Clericuzio type | Hereditary sclerosing poikiloderma | Hereditary sclerosing poikiloderma (MIM 173700) === GRAPH WALKS === --- Walk 1 --- [QB97] Contact with health services for chemotherapy session for neoplasm --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB90] Contact with health services for ear piercing --- Walk 2 --- [QB97] Contact with health services for chemotherapy session for neoplasm --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB91] Contact with health services for piercing of body site other than ear --- Walk 3 --- [QC05.Y] Other specified prophylactic measures --PARENT--> [QC05] Need for certain specified other prophylactic measures --CHILD--> [QC05.1] Prophylactic immunotherapy --- Walk 4 --- [QC05.Y] Other specified prophylactic measures --PARENT--> [QC05] Need for certain specified other prophylactic measures --EXCLUDES--> [?] Contact with health services for prophylactic surgery --- Walk 5 --- [QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB91] Contact with health services for piercing of body site other than ear --- Walk 6 --- [QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB92] Contact with health services for issue of repeat prescription
[ "[QB97] Contact with health services for chemotherapy session for neoplasm\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB90] Contact with health services for ear piercing", "[QB97] Contact with health services for chemotherapy session for neoplasm\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB91] Contact with health services for piercing of body site other than ear", "[QC05.Y] Other specified prophylactic measures\n --PARENT--> [QC05] Need for certain specified other prophylactic measures\n --CHILD--> [QC05.1] Prophylactic immunotherapy", "[QC05.Y] Other specified prophylactic measures\n --PARENT--> [QC05] Need for certain specified other prophylactic measures\n --EXCLUDES--> [?] Contact with health services for prophylactic surgery", "[QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB91] Contact with health services for piercing of body site other than ear", "[QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB92] Contact with health services for issue of repeat prescription" ]
QB97
Contact with health services for chemotherapy session for neoplasm
[ { "from_icd11": "QB97", "icd10_code": "Z5111", "icd10_title": "Encounter for antineoplastic chemotherapy" }, { "from_icd11": "QB97", "icd10_code": "Z5112", "icd10_title": "Encounter for antineoplastic immunotherapy" }, { "from_icd11": "QB97", "icd10_code": "Z511", "icd10_title": "Encounter for antineoplastic chemotherapy and immunotherapy" }, { "from_icd11": "QB97", "icd10_code": "Z51", "icd10_title": "Encounter for other aftercare and medical care" }, { "from_icd11": "QB9Y", "icd10_code": "Z5181", "icd10_title": "Encounter for therapeutic drug level monitoring" }, { "from_icd11": "QC48.Y", "icd10_code": "Z794", "icd10_title": "Long term (current) use of insulin" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7902", "icd10_title": "Long term (current) use of antithrombotics/antiplatelets" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7982", "icd10_title": "Long term (current) use of aspirin" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7984", "icd10_title": "Long term (current) use of oral hypoglycemic drugs" }, { "from_icd11": "QC48.Y", "icd10_code": "Z79899", "icd10_title": "Other long term (current) drug therapy" }, { "from_icd11": "4B00.00", "icd10_code": "D701", "icd10_title": "Agranulocytosis secondary to cancer chemotherapy" }, { "from_icd11": "4B00.00", "icd10_code": "D709", "icd10_title": "Neutropenia, unspecified" }, { "from_icd11": "4B00.00", "icd10_code": "D702", "icd10_title": "Other drug-induced agranulocytosis" }, { "from_icd11": "4B00.00", "icd10_code": "D703", "icd10_title": "Neutropenia due to infection" }, { "from_icd11": "4B00.00", "icd10_code": "D708", "icd10_title": "Other neutropenia" } ]
Z5111
Encounter for antineoplastic chemotherapy
Patient 1 had a clinical diagnosis of spondyloepiphyseal dysplasia tarda (SEDT; OMIM #313,400). SEDT is caused by heterozygous TRAPPC2 ( tracking protein particle complex subunit 2) variants. Several males across multiple generations had a similar diagnosis but no known genetic testing. At the time of diagnosis in patient 1 , TRAPPC2 testing was not readily available in the UK (except on a research basis) . Thus, WES was performed, with primary analysis directed towards TRAPPC2 . A pathogenic TRAPPC2 variant was identified (see Table 2 ). With many laboratories moving to WES and WGS, the availability of many single-gene tests is decreasing; thus, WES approaches with targeted analysis are becoming ubiquitous. It is therefore crucial that clinicians make a pre-test diagnosis to enable targeted analysis and prevent the generation of unwanted and unrelated variants. Table 2 Summary of patients with categorisation, features, and pre- and post-testing diagnosis Patient Sex Age Category Clinical presentation Variants Inheritance Studies Revised diagnosis 1 M 11y K–K Spondyloepiphyseal dysplasia tarda X- Linked Hemizygous deletion of TRAPPC2 exon 6 Maternally inherited Spondyloepiphyseal dysplasia tarda (X-Linked)† 2 F 10y K–K Spondyloepiphyseal dysplasia congenita Heterozygous SOX9 c.508C > T, p.(Pro170Ser) variant detected De-novo variant not present in parents Surviving campomelic dysplasia (CD)† 3 F 5 m K–K Syndromal proportional extreme short stature, Chiari malformation type I, growth hormone deficiency, hydrocephalus. Suspected Laron syndrome No pathogenic variants were detected Not applicable SD of unknown aetiology‡ 4 F 0-1y K–U Mild fibrochondrogenesis type 2. Post radiological review, changed to severe otospondylomegaepiphyseal dysplasia Heterozygous COL11A2 c.2542C > T p.(Gln848Ter) variant detected (mat) Heterozygous COL11A2 c.3151-2delA variant detected (pat)) AR—one variant inherited from each parent—trans Severe otospondylomegaepiphyseal dysplasia† 5 F 6y K–U Multiple epiphyseal dysplasia with non-specific myopathy, or metaphyseal dysplasia Heterozygous MATN3 c.400G > A p.(Glu134Lys) Variant not present in mother. Father not tested Multiple epiphyseal dysplasia† 6 F 8y K–U Intrauterine growth restriction (IUGR), failure to thrive, developmental delay, microcephaly, dysmorphisms, short stature. Type of microcephalic osteodysplastic primordial dwarfism Heterozygous PCNT c.5812C > T p. variant detected Heterozygous PCNT c.9273 + 1G > C variant detected AR—one variant inherited from each parent—trans Microcephalic osteodysplastic primordial dwarfism type II† 7 M 3y K–U Metaphyseal chondromatosis with D2-hydroxyglutaric aciduria Heterozygous IDH1 c.395G > A p.(Arg132His) variant detected De novo—variant not present in parents Metaphyseal chondromatosis with D2-hydroxyglutaric aciduria† 8 F 2y K–U Chondrodysplasia punctata. Query genetic or teratogen No pathogenic variants were detected Not applicable Possible acquired aetiology§ 9 F 11y K–U AR osteopetrosis (infantile onset) Heterozygous CLCN7 c.1468delC p.(Leu490fs) variant detected (pat) Heterozygous CLCN7 c.1853C > A p.(Ala618Asp) variant detected (mat), VUS AR—one variant inherited from each parent—trans AR osteopetrosis type 4 (infantile onset) † 10 M 12y K–U Acromesomelic dysplasia, Maroteaux type, or spondylarperipheral No pathogenic variants were detected Not applicable SD of unknown aetiology‡ 11 F 3y K–U Odontochondrodysplasia No pathogenic variants were detected Not applicable Odontochondrodysplasia¶ 12 M 1y U–U Disproportionate short stature, conductive hearing loss, percutaneous endoscopic gastrostomy fed, dysmorphisms No pathogenic variants were detected Not applicable SD of unknown aetiology‡ 13 F 2y U–U SD; congenital heart disease, hemimegaloencephaly, bilateral iris colobomata, hearing loss Heterozygous EXT2 c.237G > A p.(Trp79Ter) variant detected (mat) Heterozygous EXT2 c.1404 + 2 T > C variant detected (pat) AR—one variant inherited from each parent—trans Autosomal recessive exostosin glycosyltransferase 2 syndrome^ 14 M 7y U–U Query EDS (classic type/collagenopathy), or Mandibular acrodysplasia type A No pathogenic variants were detected Not applicable SD of unknown aetiology‡ 15 F 6y U–U Unknown SD, rule out bone marrow transplant-related short stature No pathogenic variants were detected Not applicable Bone marrow transplant-related short stature§ † Confirmed molecular diagnosis ‡ Unknown diagnosis § Possible acquired diagnosis ¶ Confirmed clinical diagnosis but nil molecular findings ^Possible molecular diagnosis K–K known condition–known condition; K–U known condition–unknown condition; U–U unknown condition–unknown condition; SD skeletal dysplasia; AR autosomal recessive; TRAPPC2 tracking protein particle complex, subunit 2; SOX6 sex determining region Y-box 6); COL11A2 collagen type XI alpha-2 chain; MATN3 matrilin-3; PCNT pericentrin; IDH1 isocitrate dehydrogenase 1; CLCN7 chloride voltage-gated channel 7; VUS variant of unknown significance; EXT2 exostosin glycosyltransferase 2; EDS Ehlers–Danlos syndrome
4.238281
0.487793
sec[3]/sec[0]/p[0]
en
0.999995
34092239
https://doi.org/10.1186/s12920-021-00993-0
[ "variant", "dysplasia", "heterozygous", "variants", "unknown", "type", "pathogenic", "applicable", "inherited", "short" ]
[ { "code": "4A00.0Y", "title": "Other specified functional neutrophil defects" }, { "code": "8A40.Y", "title": "Other specified multiple sclerosis" }, { "code": "8E4A.0", "title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord" }, { "code": "8E01.2", "title": "Variant Creutzfeldt-Jakob Disease" }, { "code": "5C56.00", "title": "Gangliosidosis" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "LA05.51", "title": "Cortical dysplasia" }, { "code": "LB30.1", "title": "Renal dysplasia" }, { "code": "DA07.3", "title": "Disturbances in tooth formation" }, { "code": "LA10.0", "title": "Microphthalmos" } ]
=== ICD-11 CODES FOUND === [4A00.0Y] Other specified functional neutrophil defects Also known as: Other specified functional neutrophil defects | Chronic granulomatous disease | Chronic septic granulomatosis | CGD - [chronic granulomatous disease] | chronic granulomatous disorder [8A40.Y] Other specified multiple sclerosis Also known as: Other specified multiple sclerosis | Certain specified rare variants of multiple sclerosis | Multiple sclerosis, Marburg variant | Myelinoclastic diffuse sclerosis | Schilder disease [8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Definition: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephalopathy, ataxia, myelopathy, myelitis) nervous system. In the paraneoplastic context, this attack is a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived from a systemic cancer. In the non-paraneoplastic context termed ‘autoimmune’ the etiology rem Also known as: Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord | Paraneoplastic encephalitis | Paraneoplastic encephalitis, neural autoantibody positive | Paraneoplastic encephalitis, neural autoantibody negative | Autoimmune encephalitis [8E01.2] Variant Creutzfeldt-Jakob Disease Definition: A disease of the brain, that is suspected to be caused by a prion associated with Bovine Spongiform Encephalopathy. This disease is characterised by a long incubation period, psychiatric symptoms followed by neurological deficits, and is fatal. Transmission may be by ingestion of food (with a bovine origin) contaminated with infected brain or spinal cord from an infected cow, or blood transfusion. Confirmation is by pathological examination of the brain. Also known as: Variant Creutzfeldt-Jakob Disease | vCJD - [Variant Creutzfeldt-Jakob Disease] [5C56.00] Gangliosidosis Also known as: Gangliosidosis | GM1 gangliosidosis | Landing disease | GM1 gangliosidosis type 1 | Generalised gangliosidosis [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [LA05.51] Cortical dysplasia Definition: A condition caused by failure of the cortex to correctly develop during the antenatal period, or by trauma. This condition is characterised by epileptic seizures. This condition may also present with learning impairments. Also known as: Cortical dysplasia | Focal cortical dysplasia | Focal cortical dysplasia type I | Focal cortical dysplasia type Ia | Focal cortical dysplasia type Ib [LB30.1] Renal dysplasia Definition: A condition characterised by abnormal development of one or both kidneys. Also known as: Renal dysplasia | congenital renal dysplasia | dysplasia of kidney | dysplastic kidney | Primary renal dysplasia Excludes: Autosomal dominant polycystic kidney disease [DA07.3] Disturbances in tooth formation Definition: A group of conditions characterised by disturbances in tooth formation. Also known as: Disturbances in tooth formation | disturbance of tooth formation | Dental dysplasia | disorder of tooth formation | Florid cemento-osseous dysplasia Includes: Dental dysplasia | Florid cemento-osseous dysplasia | Regional odontodysplasia Excludes: Hutchinson teeth and mulberry molars in congenital syphilis | mottled teeth [LA10.0] Microphthalmos Also known as: Microphthalmos | globe of eye small | Microphthalmia | small eyeball | Hypoplasia of eye Includes: Dysplasia of eye | Hypoplasia of eye | Rudimentary eye === GRAPH WALKS === --- Walk 1 --- [4A00.0Y] Other specified functional neutrophil defects --PARENT--> [4A00.0] Functional neutrophil defects --RELATED_TO--> [?] Haemolytic anaemia due to glucose-6-phosphate dehydrogenase deficiency Def: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common hereditary erythrocyte enzyme deficiency that can manifest with severe neonatal jaundice which can lead to serious neurological c... --- Walk 2 --- [4A00.0Y] Other specified functional neutrophil defects --PARENT--> [4A00.0] Functional neutrophil defects --RELATED_TO--> [?] Haemolytic anaemia due to glucose-6-phosphate dehydrogenase deficiency Def: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common hereditary erythrocyte enzyme deficiency that can manifest with severe neonatal jaundice which can lead to serious neurological c... --- Walk 3 --- [8A40.Y] Other specified multiple sclerosis --PARENT--> [8A40] Multiple sclerosis Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre... --CHILD--> [8A40.1] Primary progressive multiple sclerosis Def: Disease progression from onset, with occasional plateaus and temporary minor improvements allowed.... --- Walk 4 --- [8A40.Y] Other specified multiple sclerosis --PARENT--> [8A40] Multiple sclerosis Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre... --CHILD--> [8A40.2] Secondary progressive multiple sclerosis --- Walk 5 --- [8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal... --RELATED_TO--> [?] Autoimmune retinopathy Def: Autoimmune retinopathies are immune-mediated inflammatory disorders of the retina that differ from paraneoplastic retinopathies in the lack of association with cancer. Patients present with progressiv... --PARENT--> [?] Retinopathy --- Walk 6 --- [8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal... --RELATED_TO--> [?] Autoimmune retinopathy Def: Autoimmune retinopathies are immune-mediated inflammatory disorders of the retina that differ from paraneoplastic retinopathies in the lack of association with cancer. Patients present with progressiv... --PARENT--> [?] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal...
[ "[4A00.0Y] Other specified functional neutrophil defects\n --PARENT--> [4A00.0] Functional neutrophil defects\n --RELATED_TO--> [?] Haemolytic anaemia due to glucose-6-phosphate dehydrogenase deficiency\n Def: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common hereditary erythrocyte enzyme deficiency that can manifest with severe neonatal jaundice which can lead to serious neurological c...", "[4A00.0Y] Other specified functional neutrophil defects\n --PARENT--> [4A00.0] Functional neutrophil defects\n --RELATED_TO--> [?] Haemolytic anaemia due to glucose-6-phosphate dehydrogenase deficiency\n Def: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common hereditary erythrocyte enzyme deficiency that can manifest with severe neonatal jaundice which can lead to serious neurological c...", "[8A40.Y] Other specified multiple sclerosis\n --PARENT--> [8A40] Multiple sclerosis\n Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre...\n --CHILD--> [8A40.1] Primary progressive multiple sclerosis\n Def: Disease progression from onset, with occasional plateaus and temporary minor improvements allowed....", "[8A40.Y] Other specified multiple sclerosis\n --PARENT--> [8A40] Multiple sclerosis\n Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre...\n --CHILD--> [8A40.2] Secondary progressive multiple sclerosis", "[8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord\n Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal...\n --RELATED_TO--> [?] Autoimmune retinopathy\n Def: Autoimmune retinopathies are immune-mediated inflammatory disorders of the retina that differ from paraneoplastic retinopathies in the lack of association with cancer. Patients present with progressiv...\n --PARENT--> [?] Retinopathy", "[8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord\n Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal...\n --RELATED_TO--> [?] Autoimmune retinopathy\n Def: Autoimmune retinopathies are immune-mediated inflammatory disorders of the retina that differ from paraneoplastic retinopathies in the lack of association with cancer. Patients present with progressiv...\n --PARENT--> [?] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord\n Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal..." ]
4A00.0Y
Other specified functional neutrophil defects
[ { "from_icd11": "8E4A.0", "icd10_code": "G3183", "icd10_title": "Dementia with Lewy bodies" }, { "from_icd11": "8E4A.0", "icd10_code": "G2581", "icd10_title": "Restless legs syndrome" }, { "from_icd11": "8E4A.0", "icd10_code": "G3184", "icd10_title": "Mild cognitive impairment, so stated" }, { "from_icd11": "8E4A.0", "icd10_code": "G9349", "icd10_title": "Other encephalopathy" }, { "from_icd11": "8E4A.0", "icd10_code": "G0481", "icd10_title": "Other encephalitis and encephalomyelitis" }, { "from_icd11": "8E4A.0", "icd10_code": "G9589", "icd10_title": "Other specified diseases of spinal cord" }, { "from_icd11": "8E4A.0", "icd10_code": "G2589", "icd10_title": "Other specified extrapyramidal and movement disorders" }, { "from_icd11": "8E4A.0", "icd10_code": "G3189", "icd10_title": "Other specified degenerative diseases of nervous system" }, { "from_icd11": "8E4A.0", "icd10_code": "G2582", "icd10_title": "Stiff-man syndrome" }, { "from_icd11": "8E4A.0", "icd10_code": "G0489", "icd10_title": "Other myelitis" }, { "from_icd11": "8E4A.0", "icd10_code": "G9581", "icd10_title": "Conus medullaris syndrome" }, { "from_icd11": "8E4A.0", "icd10_code": "G3185", "icd10_title": "Corticobasal degeneration" }, { "from_icd11": "8E4A.0", "icd10_code": "G3181", "icd10_title": "Alpers disease" }, { "from_icd11": "8E4A.0", "icd10_code": "G3182", "icd10_title": "Leigh's disease" }, { "from_icd11": "8E4A.0", "icd10_code": "G992", "icd10_title": "Myelopathy in diseases classified elsewhere" } ]
G3183
Dementia with Lewy bodies
A 46-year-old Chinese man was admitted to our hospital due to abdominal distension in January 2009. It was the second time that he was as an inpatient of our hospital. The patient had a history of hepatitis B for approximately ten years. Moreover, his mother, two older brothers, and older sister had histories of hepatitis B. Among them, one older brother died from HCC three years ago. He began to notice his weight loss since June 2006, and performed a health examination in local hospital in August 2006. Laboratory test results included the following: white blood cell count, 4800/μl; hemoglobin, 10.3 g/dl; platelets, 84 × 10 3 /μl; aspartate aminotransferase, 42 U/L; alanine aminotransferase, 30 U/L (Table 1 ). Hepatitis B surface antigen, hepatitis B e antigen, and hepatitis B core antibody were positive. The level of serum alpha-fetoprotein (AFP) was elevated to 3350 ng/ml (normal level < 20 ng/ml), whereas serum carcinoembryonic antigen (CEA) and human chorionic gonadotropin (HCG) levels were within normal limits. Abdominal ultrasound examination revealed a solitary mass, which was determined to be HCC by liver needle biopsy. Sequentially, the patient underwent partial resection of the left anterior segment of the liver (about 2 cm in diameter) in local hospital in September 2006. After leaving the hospital, the patient received thymic peptide injections twice a week, but the dosage was not provided. About half a year after the initial operation, abdominal ultrasound examination revealed a mass in the right lobe of the liver, which was determined to be recurrent HCC . Thus, regular (one time/three months) radiofrequency ablation therapy (60W, 2 min/time; the total 3 times) and transarterial interventions (embolization or chemoembolization) were performed until September 2008. During therapy, the serum level of AFP was elevated (the details could be seen in table 1 ). However, abdominal ultrasound examination also revealed multiple solid occupation in the liver . Thus, the patient underwent partial resection of the right anterior segment for HCC recurrence in our hospital on September 20, 2008. After operation, the patient was not received any antitumoral therapy due to his weakness. On December 23, 2008, he went to see a doctor for abdominal distension in local hospital. Contrast-enhanced computed tomography (CT) of the pelvic cavity revealed a mass (5.0 cm in diameter) with homogeneous enhancement in the seminal vesicle. Transrectal needle biopsy revealed a poorly differentiated adenocarcinoma with histological characteristic similar to that of the original HCC. Considering the patient's history, the doctors diagnosed the mass in the seminal vesicle as a metastatic focus. Unfortunately, the CT image and biopsy were not obtained from the other hospital. In order to receive further treatment, he came to our hospital. During the operation, only a mass with the size of 4.8 cm in diameter was found in left seminal vesicle, but involved right seminal vesicle. Thus, bilateral seminal vesicle and prostate were resected. Macroscopically, the structure of the seminal vesicle was unclear and replaced by tumor tissues with hemorrhage. Histologically, the removed tumor was found to be compatible with the original HCC. Tumor cells arranged in trabecular, solid, or tubular patterns. Nuclei and nucleoli were prominent, and the cytoplasm was scanty and basophilic . Moreover, immunohistochemical examination demonstrated that the tumor cells were positive for glypican-3 (GPC3) , AFP , hepatocyte paraffin-1 (Hep Par 1), cytokeratin (CK)18, and hepatocyte antigen, but negative for CK7, CK20, placental alkaline phosphatase (PLAP), prostate-specific antigen (PSA), cancer antigen 125 (CA125), epithelial membrane antigen (EMA), cluster of differentiation (CD) 117, and CEA, which confirmed that the seminal vesicle tumor was metastatic HCC. In May 2009, a abdominal CT reviewing revealed multiple metastatic foci in the abdominal cavity in local hospital. Thus, the patient came to our hospital again in order to receive further therapy by the iatrotechnique of microwave. Two solid and bad mobility masses, with the size of 6 cm, were touched in the lower abdomen by physical examination. Laboratory test results included the following: white blood cell count, 4890/μl; red blood cell count, 4490 × 10 3 /μl; hemoglobin, 13.3 g/dl; platelets, 174 × 10 3 /μl; aspartate aminotransferase, 25 U/L; alanine aminotransferase, 19 U/L. The level of serum AFP was elevated to 4689 ng/ml (Table 1 ). Abdominal ultrasound examination revealed that there was a dense echo zone in right anterior lobe and right posterior lobe of the liver, respectively. Moreover, a low echo area with clear circumscription was found at the ahead of head of pancreas. Thus, all these foci were treated by microwaves. However, CT imaging revealed multiple metastatic foci in the abdominal and pelvic cavities in September 2009 . Of course, the Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
3.927734
0.97998
sec[1]/p[0]
en
0.999997
21443783
https://doi.org/10.1186/1471-2407-11-111
[ "abdominal", "antigen", "seminal", "vesicle", "that", "hepatitis", "liver", "thus", "tumor", "local" ]
[ { "code": "MD81.3", "title": "Acute abdomen" }, { "code": "JA01.0", "title": "Abdominal pregnancy" }, { "code": "ME04.Z", "title": "Ascites, unspecified" }, { "code": "NB51.0&XA3KX0", "title": "Laceration without foreign body of abdominal wall" }, { "code": "NB9Y", "title": "Other specified injuries to the abdomen, lower back, lumbar spine or pelvis" }, { "code": "1E51.Y", "title": "Other specified chronic viral hepatitis" }, { "code": "1E50.1", "title": "Acute hepatitis B" }, { "code": "MA14.1B", "title": "Prostate specific antigen positive" }, { "code": "9C61.22", "title": "Lens-induced secondary open-angle glaucoma" }, { "code": "4A01.11", "title": "Major histocompatibility complex class I deficiency" } ]
=== ICD-11 CODES FOUND === [MD81.3] Acute abdomen Definition: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases Also known as: Acute abdomen | acute abdominal pain syndrome | surgical abdomen | abdominal acute syndrome | severe abdomen pain [JA01.0] Abdominal pregnancy Definition: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy. Also known as: Abdominal pregnancy | abdomen pregnancy | intraperitoneal pregnancy Excludes: Maternal care for viable fetus in abdominal pregnancy | Delivery of viable fetus in abdominal pregnancy [ME04.Z] Ascites, unspecified Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS [NB9Y] Other specified injuries to the abdomen, lower back, lumbar spine or pelvis Also known as: Other specified injuries to the abdomen, lower back, lumbar spine or pelvis | Abdominal wall trauma | Injury of pelvic floor | pelvic floor blunt injury | pelvic floor blunt trauma [1E51.Y] Other specified chronic viral hepatitis Also known as: Other specified chronic viral hepatitis | Carrier of viral hepatitis (obsolete concept) | carrier of hepatitis virus | Hepatitis B surface antigen [HBsAg] carrier | carrier of hepatitis b surface antigen [1E50.1] Acute hepatitis B Definition: Acute liver injury and inflammation caused by recent and short-term (less than 6 months) infection with hepatitis B virus (HBV). Transmission is by sexual, blood and body fluid contamination (parenteral spread), and from mother to baby at the time of birth (vertical transmission). Diagnosis is confirmed by presence of recent acquisition of HBsAg, ideally with IgM-anti-HBc in serum. Clinical features, if they occur, are characterised by anorexia, nausea and fever, with jaundice in severe cases. Also known as: Acute hepatitis B | Acute hepatitis B virus infection | Acute hepatitis B with Hepatitis D virus co-infection | acute hepatitis B with delta-agent without hepatic coma | acute hepatitis type B, with delta-agent [MA14.1B] Prostate specific antigen positive Also known as: Prostate specific antigen positive | PSA - [prostate specific antigen] | elevated PSA | increased prostatic specific antigen | Abnormality of prostate-specific antigen [PSA] [9C61.22] Lens-induced secondary open-angle glaucoma Also known as: Lens-induced secondary open-angle glaucoma | Phacolytic glaucoma | Lens particle induced glaucoma | Phacoantigenic glaucoma [4A01.11] Major histocompatibility complex class I deficiency Also known as: Major histocompatibility complex class I deficiency | Bare lymphocyte syndrome type 1 | Immunodeficiency by defective expression of HLA - [human leukocyte antigen] class 1 | SCID - [severe combined immunodeficiency] due to absent class 2 HLA antigens | BLS - [bare lymphocyte syndrome] NOS === GRAPH WALKS === --- Walk 1 --- [MD81.3] Acute abdomen Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases... --PARENT--> [MD81] Abdominal or pelvic pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region.... --EXCLUDES--> [?] Spinal pain Def: This is a condition characterised by pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.... --- Walk 2 --- [MD81.3] Acute abdomen Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases... --PARENT--> [MD81] Abdominal or pelvic pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region.... --CHILD--> [MD81.0] Abdominal tenderness --- Walk 3 --- [JA01.0] Abdominal pregnancy Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy.... --EXCLUDES--> [?] Maternal care for viable fetus in abdominal pregnancy --PARENT--> [?] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --- Walk 4 --- [JA01.0] Abdominal pregnancy Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy.... --EXCLUDES--> [?] Delivery of viable fetus in abdominal pregnancy Def: A condition caused by the development of a viable fetus to the culmination of the pregnancy period. This condition is characterised by parturition of a viable neonate from the abdominal cavity, at the... --PARENT--> [?] Other assisted single delivery --- Walk 5 --- [ME04.Z] Ascites, unspecified --PARENT--> [ME04] Ascites Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma... --CHILD--> [ME04.Y] Other specified ascites --- Walk 6 --- [ME04.Z] Ascites, unspecified --PARENT--> [ME04] Ascites Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma... --PARENT--> [?] Symptoms related to the lower gastrointestinal tract or abdomen
[ "[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --EXCLUDES--> [?] Spinal pain\n Def: This is a condition characterised by pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine....", "[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --CHILD--> [MD81.0] Abdominal tenderness", "[JA01.0] Abdominal pregnancy\n Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy....\n --EXCLUDES--> [?] Maternal care for viable fetus in abdominal pregnancy\n --PARENT--> [?] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....", "[JA01.0] Abdominal pregnancy\n Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy....\n --EXCLUDES--> [?] Delivery of viable fetus in abdominal pregnancy\n Def: A condition caused by the development of a viable fetus to the culmination of the pregnancy period. This condition is characterised by parturition of a viable neonate from the abdominal cavity, at the...\n --PARENT--> [?] Other assisted single delivery", "[ME04.Z] Ascites, unspecified\n --PARENT--> [ME04] Ascites\n Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...\n --CHILD--> [ME04.Y] Other specified ascites", "[ME04.Z] Ascites, unspecified\n --PARENT--> [ME04] Ascites\n Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...\n --PARENT--> [?] Symptoms related to the lower gastrointestinal tract or abdomen" ]
MD81.3
Acute abdomen
[ { "from_icd11": "MD81.3", "icd10_code": "R100", "icd10_title": "Acute abdomen" }, { "from_icd11": "JA01.0", "icd10_code": "O0000", "icd10_title": "Abdominal pregnancy without intrauterine pregnancy" }, { "from_icd11": "JA01.0", "icd10_code": "O000", "icd10_title": "Abdominal pregnancy" }, { "from_icd11": "ME04.Z", "icd10_code": "R180", "icd10_title": "Malignant ascites" }, { "from_icd11": "ME04.Z", "icd10_code": "R18", "icd10_title": "Ascites" }, { "from_icd11": "1E50.1", "icd10_code": "B169", "icd10_title": "Acute hepatitis B without delta-agent and without hepatic coma" }, { "from_icd11": "1E50.1", "icd10_code": "B162", "icd10_title": "Acute hepatitis B without delta-agent with hepatic coma" }, { "from_icd11": "1E50.1", "icd10_code": "B161", "icd10_title": "Acute hepatitis B with delta-agent without hepatic coma" }, { "from_icd11": "1E50.1", "icd10_code": "B16", "icd10_title": "Acute hepatitis B" }, { "from_icd11": "1E50.1", "icd10_code": "B160", "icd10_title": "Acute hepatitis B with delta-agent with hepatic coma" }, { "from_icd11": "MA14.1B", "icd10_code": "R9720", "icd10_title": "Elevated prostate specific antigen [PSA]" }, { "from_icd11": "4A01.11", "icd10_code": "D816", "icd10_title": "Major histocompatibility complex class I deficiency" } ]
R100
Acute abdomen
A 36-yr-old, right-handed man, who had had a motorbike accident ten years ago, had total surgical amputation of the left arm. At the time of his arrival to our institute, he had perception of phantom limb and was experiencing severe phantom limb pain. This perception and pain have existed immediately after the amputation. The perception of phantom limb was always in the same position near the chest with the hand partially closed near the shoulder. The patient experienced pain like paresthesia, dysaesthesia and burning sensation especially in phantom thumb, index and medium, and in the total phantom limb too. The pain was present every day, always in wakefulness but not in sleep. Such pain persisted during the day and sometime became very intense for some seconds. In the past, the patient tried antiepileptic drugs, tricyclic and SSRI antidepressant, anti-inflammatory-analgesics, and opioids in order to relieve the pain. At the time of his arrival to our institute, he was having the best therapy that gave a partial relief to the pain. The therapy consisted in methadone 30 mg/day and pregabalin 300 mg/day. Neurological examination showed miosis and light ptosis in left eye, like Bernard-Horner syndrome which has existed immediately after the amputation. The examination also showed tactile hypoesthesia in the surgical scar, while the tactile stimulation of the area near the scar increased the pain in the phantom limb. The tactile stimulation of the left side of the face increased the pain in the phantom limb too. Chest MRI and CT with contrast excluded a peripheral component of pain due to a concomitant lesion of the inferior brachial plexus. The patient gave the written informed consent. At the baseline, at the end of every week, for three weeks during treatment and at the end of every week for three weeks after treatment, the following tests were administered: Hamilton Rating Scale for Depression (HAM-D), Hamilton Rating scale for Anxiety (HAM-A), Mania Rating Scale (MRS), CORSI TEST, Phonemic Verbal Fluency, and Visual Analogue Scale (VAS) for pain-0 (no pain) and 10 (maximal pain). The percentage of pain level modification was calculated from the VAS score by the following equation (post.rTMS – pre.rTMS pain scores) × 100/(pre.rTMS pain scores). Figure 1 below shows the reduction in percentage of pain in time. Clinical Global Impression-Improvement scale (CGI-I) was evaluated at the end of the third week of treatment. rTMS sessions were conducted in a laboratory staffed by physicians certified in basic life support and trained in the prompt recognition and treatment of seizures and other medical emergencies. Repetitive TMS was administered using a MAGSTIM rapid magnetic stimulator (Magstim Company, Ltd., Whitland, U.K.). We used a 70-mm figure eight-shaped coil. Patient sat in a reclining chair with a headrest for stabilization of the head and wore protective earplugs. Resting motor threshold (RMT) was defined as the intensity required eliciting at least five MEPs of 50 μ V in peak-to-peak amplitude with 10 consecutive stimulations, when the coil was placed over the optimal position to activate the abductor pollicis brevis muscle in right hand based on electromyographic recording . During treatment, the following were applied for 15 minutes, thirty 20-second trains at 1 Hz at 80% of RMT with a 10 seconds intertrain interval (a total of 600 stimuli per session were applied over the left motor cortex), these parameters are now widely considered safe . A full course comprised fifteen daily sessions administered on weekdays, beginning on Monday. At all times, the coil was held tangentially to the scalp, with the handle pointing back and away from the midline at 45°. During every session of stimulation the patient had the sensation that the phantom limb went away from the shoulder towards mid-line in the direction of the pelvis, and the intensity of phantom limb pain reduced. The patient experienced no adverse event during or after rTMS application. At the end of the third week of treatment, the pain was reduced about 33.3% , in fact VAS changed from 6 (pretreatment) to 4 (posttreatment), with CGI-I = 2 (much improved). In three weeks after treatment the percentage reduction of pain was reduced to 25% in the first week after the end of treatment and remained stable at about 16.6% in the second and in the third week after the end of treatment . During the three weeks of treatment and during the three weeks after treatment, Ham-D, Ham-A, and MRS all remained stable at ≤6. Also, score of the CORSI TEST remained stable at 5 and the score of the Phonemic Verbal Fluency remained stable at 17.6 and so these tests did not show cognitive impairment or improvement. RMT of unaffected hemisphere increased during treatment, in fact at baseline its value was 84% of Maximum Output of the Stimulator, after the first week of treatment, its value was 86% of Maximum Output of the Stimulator, and at the end of the second and third week of treatment its value was stable at 88% of Maximum Output of the Stimulator.
4.109375
0.93457
sec[1]/p[0]
en
0.999996
21629848
https://doi.org/10.1155/2011/130751
[ "pain", "phantom", "limb", "three", "scale", "rtms", "every", "stimulator", "remained", "total" ]
[ { "code": "MG3Z", "title": "Pain, unspecified" }, { "code": "8E43.Z", "title": "Pain disorders, unspecified" }, { "code": "MG31.Z", "title": "Acute pain, unspecified" }, { "code": "MG30.Z", "title": "Chronic pain, unspecified" }, { "code": "FB56.2", "title": "Myalgia" }, { "code": "8E43.00", "title": "Phantom limb syndrome" }, { "code": "ND56.1", "title": "Open wound of unspecified body region" }, { "code": "LB9Z", "title": "Structural developmental anomalies of the skeleton, unspecified" }, { "code": "FB56.6", "title": "Other specified soft tissue disorders" }, { "code": "5B51&XS25", "title": "Severe wasting in infants, children or adolescents" } ]
=== ICD-11 CODES FOUND === [MG3Z] Pain, unspecified Also known as: Pain, unspecified | pain observations | pain NOS | generalised pain | generalised pain, NOS [8E43.Z] Pain disorders, unspecified Also known as: Pain disorders, unspecified | Pain disorders [MG31.Z] Acute pain, unspecified Also known as: Acute pain, unspecified | Acute pain [MG30.Z] Chronic pain, unspecified Also known as: Chronic pain, unspecified | Chronic pain [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain [8E43.00] Phantom limb syndrome Definition: Phantom limb pain is the perception of sensations, including pain, in a limb that has been amputated or a body part that has been removed. These sensations may include a specific position, shape, or movement of the phantom, feelings of warmth or cold, itching, tingling, or electric sensations, and other paraesthesias. Also known as: Phantom limb syndrome | Phantom limb | Phantom limb syndrome with pain | chronic phantom pain | Phantom limb pain [ND56.1] Open wound of unspecified body region Also known as: Open wound of unspecified body region | cut NOS | open wound NOS | penetrating wound NOS | Puncture wound with foreign body unspecified body region Excludes: Traumatic amputations involving multiple body regions | Open wounds involving multiple body regions | traumatic amputation NOS [LB9Z] Structural developmental anomalies of the skeleton, unspecified Also known as: Structural developmental anomalies of the skeleton, unspecified | Abnormal bone development | skeletal anomaly NOS [FB56.6] Other specified soft tissue disorders Also known as: Other specified soft tissue disorders | Fat necrosis | fatty necrosis | Profichet's disease | Sloughing of fascia === GRAPH WALKS === --- Walk 1 --- [MG3Z] Pain, unspecified --PARENT--> [?] Pain --CHILD--> [MG30] Chronic pain Def: Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Chronic pain is pain that persists or recurs for longer t... --- Walk 2 --- [MG3Z] Pain, unspecified --PARENT--> [?] Pain --EXCLUDES--> [?] Abdominal or pelvic pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region.... --- Walk 3 --- [8E43.Z] Pain disorders, unspecified --PARENT--> [8E43] Pain disorders --PARENT--> [?] Certain disorders of the nervous system --- Walk 4 --- [8E43.Z] Pain disorders, unspecified --PARENT--> [8E43] Pain disorders --CHILD--> [8E43.0] Neuropathic pain Def: Neuropathic pain is described as electric, burning, or shock like, caused by metabolic, nutritional, infectious, genetic, autoimmune, and/or vasculitic processes. The pain may occur spontaneously, wit... --- Walk 5 --- [MG31.Z] Acute pain, unspecified --PARENT--> [MG31] Acute pain Def: Pain with a duration of less than 3 months. This code should be used only when there is no further specification of site.... --PARENT--> [?] Pain --- Walk 6 --- [MG31.Z] Acute pain, unspecified --PARENT--> [MG31] Acute pain Def: Pain with a duration of less than 3 months. This code should be used only when there is no further specification of site.... --CHILD--> [MG31.1] Acute headache, not elsewhere classified
[ "[MG3Z] Pain, unspecified\n --PARENT--> [?] Pain\n --CHILD--> [MG30] Chronic pain\n Def: Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Chronic pain is pain that persists or recurs for longer t...", "[MG3Z] Pain, unspecified\n --PARENT--> [?] Pain\n --EXCLUDES--> [?] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....", "[8E43.Z] Pain disorders, unspecified\n --PARENT--> [8E43] Pain disorders\n --PARENT--> [?] Certain disorders of the nervous system", "[8E43.Z] Pain disorders, unspecified\n --PARENT--> [8E43] Pain disorders\n --CHILD--> [8E43.0] Neuropathic pain\n Def: Neuropathic pain is described as electric, burning, or shock like, caused by metabolic, nutritional, infectious, genetic, autoimmune, and/or vasculitic processes. The pain may occur spontaneously, wit...", "[MG31.Z] Acute pain, unspecified\n --PARENT--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....\n --PARENT--> [?] Pain", "[MG31.Z] Acute pain, unspecified\n --PARENT--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....\n --CHILD--> [MG31.1] Acute headache, not elsewhere classified" ]
MG3Z
Pain, unspecified
[ { "from_icd11": "MG3Z", "icd10_code": "R52", "icd10_title": "Pain, unspecified" }, { "from_icd11": "MG3Z", "icd10_code": "R529", "icd10_title": "" }, { "from_icd11": "MG31.Z", "icd10_code": "R520", "icd10_title": "" }, { "from_icd11": "MG30.Z", "icd10_code": "R521", "icd10_title": "" }, { "from_icd11": "MG30.Z", "icd10_code": "R522", "icd10_title": "" }, { "from_icd11": "FB56.2", "icd10_code": "M7918", "icd10_title": "Myalgia, other site" }, { "from_icd11": "FB56.2", "icd10_code": "M7910", "icd10_title": "Myalgia, unspecified site" }, { "from_icd11": "FB56.2", "icd10_code": "M7912", "icd10_title": "Myalgia of auxiliary muscles, head and neck" }, { "from_icd11": "FB56.2", "icd10_code": "M791", "icd10_title": "Myalgia" }, { "from_icd11": "8E43.00", "icd10_code": "G546", "icd10_title": "Phantom limb syndrome with pain" }, { "from_icd11": "8E43.00", "icd10_code": "G547", "icd10_title": "Phantom limb syndrome without pain" }, { "from_icd11": "ND56.1", "icd10_code": "T141", "icd10_title": "" }, { "from_icd11": "LB9Z", "icd10_code": "Q8789", "icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified" }, { "from_icd11": "LB9Z", "icd10_code": "Q8781", "icd10_title": "Alport syndrome" }, { "from_icd11": "LB9Z", "icd10_code": "Q742", "icd10_title": "Other congenital malformations of lower limb(s), including pelvic girdle" } ]
R52
Pain, unspecified
A 66-year-old man with numerous inflammatory manifestations for over 20 years, including recurrent scleritis, relapsing polychondritis, Graves’ disease, bursitis, pyoderma gangrenosum, and leukocytoclastic vasculitis, was evaluated for pancytopenia notable for a white blood cell (WBC) count of 2030/uL with the absolute neutrophil count (ANC) count of 1430/uL, anemia with hemoglobin (Hgb) 9.1 g/dL, mean corpuscular volume of 115 fl and thrombocytopenia with a platelet (PLT) count of 119,000/uL. He had recurrent worsening pancytopenia during inflammatory crises presenting with persistent fatigue, shortness of breath, cough, and fever. On two occasions, his cytopenias worsened to the point of requiring transfusions (initially packed red blood cells (pRBCs), and two months later PLT), though this improved with steroids. For his autoimmune and inflammatory conditions, he had received multiple lines of therapy at an outside institution, including corticosteroids (consistently on prednisone >20 years), methotrexate, dapsone, hydroxychloroquine (several years), rituximab 1 g every two weeks for two courses, adalimumab for a few weeks, tocilizumab (received two monthly infusions but stopped due to worsening symptoms). Several bone marrow biopsies had been performed showing mild dyspoiesis and deletion 20q, increasing in number of cells involved over 10 years from 5% to 24.5%. A bone marrow biopsy was repeated and showed a hypercellular bone marrow with trilineage dyspoiesis, vacuolation of myeloid and erythroid precursor cells, and 1% blasts. Fluorescent in situ hybridization (FISH) and cytogenetics showed deletion 20q with otherwise normal male karyotype. Further testing confirmed a pathogenic Met41Thr (c.122 T>C) mutation in the UBA1 gene consistent with VEXAS Syndrome. Hypomethylating agent was considered but not given due to no increase in blast percentage. He was referred to our clinic for consideration of an allogeneic stem cell transplant. At that time, his Karnofsky Performance Status (KPS) score was 80%, and Eastern Cooperative Oncology Group (ECOG) Performance Status was 1, with no active inflammatory manifestations, apart from intermittent subcutaneous nodules. He remained on 20 mg of prednisone daily and was started on ruxolitinib 5 mg twice daily for systemic symptoms including rash and fever in anticipation of HSCT. His complete blood count was notable for Hgb 7.9 g/dL, PLT 63,000/uL, WBC 6420/uL with ANC 3420/uL. Non-myeloablative conditioning with fludarabine, cyclophosphamide, and total body irradiation (TBI) was planned, followed by HLA-haploidentical peripheral blood stem cell transplantation (PBSCT). After receiving two doses of 30 mg/m2 of fludarabine and cyclophosphamide 14.5 mcg/kg, the patient developed a neutropenic fever. Imaging revealed new ill-defined bilateral pulmonary nodules concerning for an opportunistic fungal infection, and his transplant plan was deferred. He was treated empirically with posaconazole and broad-spectrum antibiotics with the resolution of his fever. Extensive infectious workup was unrevealing. One month after treatment, his cytopenias remarkably improved to Hgb 13.9 g/dL, PLT 265,000/uL, and WBC 5.3 K/uL with ANC 4600 without G-CSF support. His performance status improved to KPS 90% and ECOG 0 with the resolution of all other symptoms while remaining off prednisone. Considering options for further treatment, the patient elected to proceed with haploidentical PBSCT. He underwent a bone marrow biopsy in preparation for HSCT two months after treatment, which demonstrated a complete response . The patient underwent a transplant with conditioning chemotherapy including 3 days of fludarabine 30 mg/m2, 2 days of cyclophosphamide 14.5 mcg/kg, and TBI with 400cGy. He achieved neutrophil engraftment on Day +22. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclophosphamide on Days +3-4, mycophenolate mofetil on Days +5-35, and tacrolimus starting Day +5. Due to suspicion of acute GVHD of the gastrointestinal (GI) tract, tacrolimus was continued beyond Day +60; however, it was stopped at Day +88 with concern for drug-induced thrombotic microangiopathy. Laboratory studies were notable for elevated CH50 and soluble C5b-9 consistent with activation of the terminal complement pathway. Eculizumab was cost-prohibitive, and the patient received narsoplimab via compassionate use. His cytopenias persisted and were not fully explained by major ABO incompatibility (donor AB positive, recipient A positive), vitamin B12 deficiency (206 pg/mL), or medications. The patient received a CD34+ stem cell boost at Day +178. His course was further complicated by chronic GVHD involving the mouth, GI tract, liver, eyes, and nails. This was managed with steroids causing severe steroid myopathy and then with belumosudil with suboptimal response, eventually transitioning to ruxolitinib with no further flares of GVHD symptoms. His 1-year posttransplant bone marrow showed complete response with cytogenetic remission, 0% blasts, and 100% donor cells on FISH for chimerism.
4.066406
0.975586
sec[1]/p[0]
en
0.999996
38665946
https://doi.org/10.3389/fonc.2024.1383730
[ "count", "bone", "marrow", "inflammatory", "including", "blood", "cell", "fever", "cells", "cyclophosphamide" ]
[ { "code": "3B63.1Z", "title": "Acquired thrombocytosis, unspecified" }, { "code": "3B64.Z", "title": "Thrombocytopenia, unspecified" }, { "code": "4B0Z", "title": "Immune system disorders involving white cell lineages, unspecified" }, { "code": "4B03.Z", "title": "Eosinophilia, unspecified" }, { "code": "4B00.1Z", "title": "Neutrophilia, unspecified" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" } ]
=== ICD-11 CODES FOUND === [3B63.1Z] Acquired thrombocytosis, unspecified Also known as: Acquired thrombocytosis, unspecified | Acquired thrombocytosis | Idiopathic haemorrhagic thrombocythaemia | Essential thrombocythaemia | primary haemorrhagic thrombocythaemia [3B64.Z] Thrombocytopenia, unspecified Also known as: Thrombocytopenia, unspecified | Thrombocytopenia | low platelet count | low platelets | decreased platelets [4B0Z] Immune system disorders involving white cell lineages, unspecified Also known as: Immune system disorders involving white cell lineages, unspecified [4B03.Z] Eosinophilia, unspecified Also known as: Eosinophilia, unspecified | Eosinophilia | Disorders with increased eosinophil counts | Idiopathic hypereosinophilic syndrome [4B00.1Z] Neutrophilia, unspecified Also known as: Neutrophilia, unspecified | Neutrophilia | Disorders with increased neutrophil counts [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias === GRAPH WALKS === --- Walk 1 --- [3B63.1Z] Acquired thrombocytosis, unspecified --PARENT--> [3B63.1] Acquired thrombocytosis Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte... --CHILD--> [3B63.10] Secondary thrombocytosis --- Walk 2 --- [3B63.1Z] Acquired thrombocytosis, unspecified --PARENT--> [3B63.1] Acquired thrombocytosis Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte... --PARENT--> [3B63] Thrombocytosis Def: A disease caused by essential thrombocytosis or other myelo-proliferative disorders such as chronic myelogenous leukaemia, polycythaemia, myelofibrosis. This disease can also have secondary causes suc... --- Walk 3 --- [3B64.Z] Thrombocytopenia, unspecified --PARENT--> [3B64] Thrombocytopenia Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate... --CHILD--> [3B64.1] Acquired thrombocytopenia Def: A disease caused by determinants arising after birth, leading to low platelet count. This disease is characterised by low levels of platelets within the blood. This disease may present with increased ... --- Walk 4 --- [3B64.Z] Thrombocytopenia, unspecified --PARENT--> [3B64] Thrombocytopenia Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate... --RELATED_TO--> [?] Isolated thrombocytopenia --- Walk 5 --- [4B0Z] Immune system disorders involving white cell lineages, unspecified --PARENT--> [?] Immune system disorders involving white cell lineages --RELATED_TO--> [?] Immunodeficiencies with predominantly antibody defects Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects... --- Walk 6 --- [4B0Z] Immune system disorders involving white cell lineages, unspecified --PARENT--> [?] Immune system disorders involving white cell lineages --CHILD--> [4B02] Eosinopenia
[ "[3B63.1Z] Acquired thrombocytosis, unspecified\n --PARENT--> [3B63.1] Acquired thrombocytosis\n Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...\n --CHILD--> [3B63.10] Secondary thrombocytosis", "[3B63.1Z] Acquired thrombocytosis, unspecified\n --PARENT--> [3B63.1] Acquired thrombocytosis\n Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...\n --PARENT--> [3B63] Thrombocytosis\n Def: A disease caused by essential thrombocytosis or other myelo-proliferative disorders such as chronic myelogenous leukaemia, polycythaemia, myelofibrosis. This disease can also have secondary causes suc...", "[3B64.Z] Thrombocytopenia, unspecified\n --PARENT--> [3B64] Thrombocytopenia\n Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate...\n --CHILD--> [3B64.1] Acquired thrombocytopenia\n Def: A disease caused by determinants arising after birth, leading to low platelet count. This disease is characterised by low levels of platelets within the blood. This disease may present with increased ...", "[3B64.Z] Thrombocytopenia, unspecified\n --PARENT--> [3B64] Thrombocytopenia\n Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate...\n --RELATED_TO--> [?] Isolated thrombocytopenia", "[4B0Z] Immune system disorders involving white cell lineages, unspecified\n --PARENT--> [?] Immune system disorders involving white cell lineages\n --RELATED_TO--> [?] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...", "[4B0Z] Immune system disorders involving white cell lineages, unspecified\n --PARENT--> [?] Immune system disorders involving white cell lineages\n --CHILD--> [4B02] Eosinopenia" ]
3B63.1Z
Acquired thrombocytosis, unspecified
[ { "from_icd11": "3B63.1Z", "icd10_code": "D473", "icd10_title": "Essential (hemorrhagic) thrombocythemia" }, { "from_icd11": "3B64.Z", "icd10_code": "D6942", "icd10_title": "Congenital and hereditary thrombocytopenia purpura" }, { "from_icd11": "3B64.Z", "icd10_code": "D6941", "icd10_title": "Evans syndrome" }, { "from_icd11": "3B64.Z", "icd10_code": "D6949", "icd10_title": "Other primary thrombocytopenia" }, { "from_icd11": "3B64.Z", "icd10_code": "D696", "icd10_title": "Thrombocytopenia, unspecified" }, { "from_icd11": "3B64.Z", "icd10_code": "D69", "icd10_title": "Purpura and other hemorrhagic conditions" }, { "from_icd11": "3B64.Z", "icd10_code": "D694", "icd10_title": "Other primary thrombocytopenia" }, { "from_icd11": "4B0Z", "icd10_code": "D72829", "icd10_title": "Elevated white blood cell count, unspecified" }, { "from_icd11": "4B0Z", "icd10_code": "D72819", "icd10_title": "Decreased white blood cell count, unspecified" }, { "from_icd11": "4B0Z", "icd10_code": "D72818", "icd10_title": "Other decreased white blood cell count" }, { "from_icd11": "4B0Z", "icd10_code": "D72828", "icd10_title": "Other elevated white blood cell count" }, { "from_icd11": "4B0Z", "icd10_code": "D72823", "icd10_title": "Leukemoid reaction" }, { "from_icd11": "4B0Z", "icd10_code": "D72821", "icd10_title": "Monocytosis (symptomatic)" }, { "from_icd11": "4B0Z", "icd10_code": "D72825", "icd10_title": "Bandemia" }, { "from_icd11": "4B0Z", "icd10_code": "D72810", "icd10_title": "Lymphocytopenia" } ]
D473
Essential (hemorrhagic) thrombocythemia
A 68-year-old male patient was referred for assessment of photophobia and reduced visual acuity in both eyes, onset of which was sudden and occurred ten days before presentation to The Jikei University Katsushika Medical Center. He has never had any history of vision problems. One year before presentation, he had undergone sigmoid colectomy for cancer at the Department of Surgery of the same hospital. Liver metastasis was found 7 months after the surgery, and subsequently, the patient was diagnosed with stage IV colon cancer. Later, no medication was prescribed until the presentation. At presentation, we performed comprehensive ophthalmic examinations including electroretinography, although his general condition was poor. His decimal best-corrected visual acuity (BCVA) was 0.4 (Snellen equivalent 20/50) (spherical − 0.25 diopters [D]) in each eye. Slit-lamp examination showed no abnormal findings in the anterior segment and media except for mild age-related cataract. Dilated fundoscopy showed bull's eye-like maculopathy in both eyes . Horizontal cross-sectional retinal images (6.0 mm) acquired using spectral domain optical coherence tomography revealed thickened and elevated ellipsoid zone in the center of both maculae . OCT angiography 3 × 3-mm scan images showed that no flow was detected between the elevated ellipsoid zone and the retinal pigment epithelium , denying presence of abnormal retinal circulation or choroidal neovascularization. At this time, we suspected a retinal disease, such as macular/cone dystrophy or paraneoplastic retinopathy. Full-field electroretinography using a light-emitting diode built-in electrode was performed in accordance with the protocols of the International Society for Clinical Electrophysiology of Vision , except for a light intensity of 200 cd s/m 2 (DA 200) instead of DA 10.0 for bright (or strong)-flash electroretinography. The procedure and conditions have been previously reported [ 10 – 13 ]. This ERG system was approved by the Ministry of Health, Labor and Welfare of Japan on September 30, 2002 . All electroretinography responses of the patient were compared with those of previously reported controls ( n = 23) . The following are electroretinography findings: delayed and preserved b-wave responses in rod (DA 0.01) electroretinogram, delayed and preserved a- and b-waves [b/a ratio: 1.63 in the right eye (RE) and 1.64 in the left eye (LE)] in standard-flash (DA 3.0) electroretinogram, and decreased a-wave amplitudes with double troughs and increased b/a ratios (2.65 in RE and 2.21 in LE, the first trough of the a-waves was adopted) in bright-flash (DA 200) electroretinogram. Under LA conditions, cone (LA 3.0; background, 30 cd/m 2 ) and 30-Hz flicker (background, 30 cd/m 2 ) electroretinography was performed, which showed non-recordable responses , demonstrating some kind of cone dysfunction syndrome. Fig. 1 Fundus photographs Photographs in the right eye (left panel) and the left eye (right panel). a At presentation: bull's eye-like maculopathy can be observed in both eyes. b Magnified photographs of the macular areas at presentation. c Eight days after presentation: inconspicuousness of bull's eye-like maculopathy can be observed. d One month after presentation: absence of the bull's eye-like maculopathy can be observed Fig. 2 Optical coherence tomography. Horizontal cross-sectional retinal 6-mm images of the right eye (left panel) and the left eye (right panel). a At presentation: thickened and elevated ellipsoid zone can be observed at the center of both maculae. b Eleven days after presentation: improvement in the ellipsoid zone findings can be observed. c One month after presentation: preservation of the improved ellipsoid zone can be observed Fig. 3 Optical coherence tomography angiography. The 3 × 3-mm en face and cross-sectional images of the right eye (left panel) and the left eye (right panel). No flow is detected between the elevated ellipsoid zone and the retinal pigment epithelium in both eyes Fig. 4 Full-field electroretinograms. Full-field electroretinograms (ERG) in the patient and an age-matched control are shown. At presentation: dark-adapted (DA) 0.01 ERG showing delayed and preserved b-wave responses, DA 3.0 ERG showing delayed and preserved a- and b-waves [b/a ratio: 1.63 in the right eye (RE) and 1.64 in the left eye (LE)], and DA 200 ERG showing decreased a-wave amplitudes with double troughs (arrows) and increased b/a ratios (2.65 in RE and 2.21 in LE, the first trough of the a-waves is adopted). Under light-adapted (LA) conditions: LA 3.0 and 30-Hz flicker ERG show non-recordable responses. Eleven days after presentation: the implicit time of the preserved b-waves in DA 0.01 ERG is normal, while the implicit time of the preserved a-waves in DA 3.0 ERG is still prolonged but shorter than that at presentation. The a- and b-wave amplitudes of DA 200 are normal. The b/a ratios in DA 3.0 are 2.27 in RE and 2.06 in LE, whereas the b/a ratios in DA 200 are 1.76 in RE and 1.49 in LE. The LA 3.0 and 30-Hz flicker ERG become normal
4.242188
0.83252
sec[1]/p[1]
en
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33738644
https://doi.org/10.1007/s10633-021-09828-w
[ "both", "electroretinography", "retinal", "ellipsoid", "zone", "preserved", "waves", "panel", "responses", "wave" ]
[ { "code": "LB99.6", "title": "Acheiria" }, { "code": "MB51.Z", "title": "Diplegia of upper extremities, unspecified" }, { "code": "LB9A.4", "title": "Apodia" }, { "code": "LB51", "title": "Anorchia or microorchidia" }, { "code": "9D90.2", "title": "Moderate vision impairment" }, { "code": "9B7Z", "title": "Disorders of the retina, unspecified" }, { "code": "9B74.Z", "title": "Retinal vascular occlusions, unspecified" }, { "code": "9B73.4", "title": "Retinal breaks without detachment" }, { "code": "9B78.9", "title": "Retinal atrophy" }, { "code": "9B7Y", "title": "Other specified disorders of the retina" } ]
=== ICD-11 CODES FOUND === [LB99.6] Acheiria Definition: A condition caused by failure of one or both hands to develop during the antenatal period. Also known as: Acheiria | Congenital absence of hand | agenesis of hand | congenital absence of hand and finger | congenital absence of hand and wrist [MB51.Z] Diplegia of upper extremities, unspecified Also known as: Diplegia of upper extremities, unspecified | Diplegia of upper extremities | paralysis of both upper limbs | both upper extremity paralysis | diplegia of upper limbs [LB9A.4] Apodia Definition: A condition caused by failure of the foot to develop during the antenatal period. Also known as: Apodia | Congenital absence of foot | agenesis of foot | congenital absence of foot or toe | congenital absence of foot or toe, unspecified side [LB51] Anorchia or microorchidia Definition: A disorder affecting males, caused by an abnormality occurring in sex development during the antenatal period. This disorder is characterised by individuals who are born with absence of the testes, or with testes that are deficient in size and function. Confirmation is by physical examination, identification of low testosterone levels but elevated follicle stimulating hormone and luteinizing hormone levels in a blood sample, or imaging. Also known as: Anorchia or microorchidia | Absence or aplasia of testis, unilateral | congenital absence of testis, unilateral | congenital absent testicle | congenital absence of testis [9D90.2] Moderate vision impairment Also known as: Moderate vision impairment | low vision, both eyes | visual impairment category 2, in both eyes | Low vision | LW - [low vision] Includes: visual impairment category 2, in both eyes [9B7Z] Disorders of the retina, unspecified Also known as: Disorders of the retina, unspecified | retinal disease | retinal lesion NOS [9B74.Z] Retinal vascular occlusions, unspecified Also known as: Retinal vascular occlusions, unspecified | Retinal vascular occlusions | occlusion of retinal vessels | retinal obstruction [9B73.4] Retinal breaks without detachment Also known as: Retinal breaks without detachment | Retinal break NOS | ruptured retina | Horseshoe tear of retina without detachment | Round hole of retina without detachment Includes: Horseshoe tear of retina without detachment | Round hole of retina without detachment Excludes: Chorioretinal scars after surgery for detachment | peripheral retinal degeneration without break [9B78.9] Retinal atrophy Definition: This is a group of genetic diseases and is characterised by the bilateral degeneration of the retina, causing progressive vision loss culminating in blindness. Also known as: Retinal atrophy | atrophic retina [9B7Y] Other specified disorders of the retina Also known as: Other specified disorders of the retina | Åland Island eye disease | Cone dystrophy with supernormal rod response | Familial retinal arterial macroaneurysm | IRVAN syndrome === GRAPH WALKS === --- Walk 1 --- [LB99.6] Acheiria Def: A condition caused by failure of one or both hands to develop during the antenatal period.... --PARENT--> [LB99] Reduction defects of upper limb Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB99.0] Amelia of upper limb Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb.... --- Walk 2 --- [LB99.6] Acheiria Def: A condition caused by failure of one or both hands to develop during the antenatal period.... --PARENT--> [LB99] Reduction defects of upper limb Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB99.0] Amelia of upper limb Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb.... --- Walk 3 --- [MB51.Z] Diplegia of upper extremities, unspecified --PARENT--> [MB51] Diplegia of upper extremities Def: This is a loss of motor control in both arms.... --CHILD--> [MB51.Z] Diplegia of upper extremities, unspecified --- Walk 4 --- [MB51.Z] Diplegia of upper extremities, unspecified --PARENT--> [MB51] Diplegia of upper extremities Def: This is a loss of motor control in both arms.... --CHILD--> [MB51.Z] Diplegia of upper extremities, unspecified --- Walk 5 --- [LB9A.4] Apodia Def: A condition caused by failure of the foot to develop during the antenatal period.... --PARENT--> [LB9A] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB9A.1] Tibial hemimelia Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula.... --- Walk 6 --- [LB9A.4] Apodia Def: A condition caused by failure of the foot to develop during the antenatal period.... --PARENT--> [LB9A] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB9A.2] Fibular hemimelia Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone....
[ "[LB99.6] Acheiria\n Def: A condition caused by failure of one or both hands to develop during the antenatal period....\n --PARENT--> [LB99] Reduction defects of upper limb\n Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB99.0] Amelia of upper limb\n Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb....", "[LB99.6] Acheiria\n Def: A condition caused by failure of one or both hands to develop during the antenatal period....\n --PARENT--> [LB99] Reduction defects of upper limb\n Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB99.0] Amelia of upper limb\n Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb....", "[MB51.Z] Diplegia of upper extremities, unspecified\n --PARENT--> [MB51] Diplegia of upper extremities\n Def: This is a loss of motor control in both arms....\n --CHILD--> [MB51.Z] Diplegia of upper extremities, unspecified", "[MB51.Z] Diplegia of upper extremities, unspecified\n --PARENT--> [MB51] Diplegia of upper extremities\n Def: This is a loss of motor control in both arms....\n --CHILD--> [MB51.Z] Diplegia of upper extremities, unspecified", "[LB9A.4] Apodia\n Def: A condition caused by failure of the foot to develop during the antenatal period....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.1] Tibial hemimelia\n Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....", "[LB9A.4] Apodia\n Def: A condition caused by failure of the foot to develop during the antenatal period....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.2] Fibular hemimelia\n Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone...." ]
LB99.6
Acheiria
[ { "from_icd11": "LB99.6", "icd10_code": "Q7131", "icd10_title": "Congenital absence of right hand and finger" }, { "from_icd11": "LB99.6", "icd10_code": "Q7133", "icd10_title": "Congenital absence of hand and finger, bilateral" }, { "from_icd11": "LB99.6", "icd10_code": "Q7130", "icd10_title": "Congenital absence of unspecified hand and finger" }, { "from_icd11": "LB99.6", "icd10_code": "Q713", "icd10_title": "Congenital absence of hand and finger" }, { "from_icd11": "MB51.Z", "icd10_code": "G830", "icd10_title": "Diplegia of upper limbs" }, { "from_icd11": "LB9A.4", "icd10_code": "Q7231", "icd10_title": "Congenital absence of right foot and toe(s)" }, { "from_icd11": "LB9A.4", "icd10_code": "Q7230", "icd10_title": "Congenital absence of unspecified foot and toe(s)" }, { "from_icd11": "LB9A.4", "icd10_code": "Q723", "icd10_title": "Congenital absence of foot and toe(s)" }, { "from_icd11": "LB51", "icd10_code": "Q550", "icd10_title": "Absence and aplasia of testis" }, { "from_icd11": "LB51", "icd10_code": "Q55", "icd10_title": "Other congenital malformations of male genital organs" }, { "from_icd11": "9D90.2", "icd10_code": "H542", "icd10_title": "Low vision, both eyes" }, { "from_icd11": "9B7Z", "icd10_code": "H30-H36", "icd10_title": "" }, { "from_icd11": "9B7Z", "icd10_code": "H32", "icd10_title": "Chorioretinal disorders in diseases classified elsewhere" }, { "from_icd11": "9B7Z", "icd10_code": "H320", "icd10_title": "" }, { "from_icd11": "9B7Z", "icd10_code": "H328", "icd10_title": "" } ]
Q7131
Congenital absence of right hand and finger
Case 1 Mr. A. Y. a 57-year-old Togolese man was referred to the hematology unit in June 1999 for a chronic dry cough and a hypereosinophilia. His past medical and family history is negative for atopic diseases, diabetes, and hypertension. He carries the AC hemoglobin type and mentioned a hepatitis A infection in 1963 and two surgeries for a disc hernia. Since December 1998, he has been having a dry cough, refractory to cough suppressants. He was seen in cardiology in May 1999, where a clinical wokup was significant for an hypereosinophilia of 4680/mm 3 . His chest X-Ray and chemistry panel including BUN, creatinine, and blood glucose were negative. He was treated with antihistamine and expectorant agents without any success. He was referred to hematology in June 1999. He was well appearing with no acute distress. His vital signs and physical exam were within normal limits, mainly there were no hepatosplenogaly or lymphadenopathy. In addition to the tests performed in cardiology, a marrow aspiration showed a granular hyperplasia (82%) with a central hypereosinophilia of 37%. Investigations to detect a possible parasite infection or an atopic cause were negative. On his request, Mr. A. Y. was transferred in November 1999 in Paris for further testing. The search for parasites done in Lome was completed in Paris by series of serology which was negative for trichinosis, toxocariasis, anguillilosis, distomatosis, and filariasis. Tumor markers: ACE, CA-19.9, PSA, and alpha fetoprotein were within the normal ranges and the chest X-ray, EKG and echocardiogram, lung function tests, and CT of the chest and the abdomen were normal. The diagnosis of a myeloproliferative syndrome type hypereosinophilia was adopted and Mr. A. Y. was started on hydroxyurea one tablet of 500 mg a day and allopurinol 300 mg a day. On 8th May 2000, the patient was seen back in Lome with no change in the eosinophil count. It was agreed to increase the hydroxyurea to 2 tablets of 500 mg a day. This was of no effect on the eosinophil count but help to normalize transiently the patient's platelet count. Clinically, the patient stated that the cough did not improve; in fact, it was getting worse and was disturbing his sleep. On July 11th 2000, the hydroxyurea was changed to alter 2 or 3 tablets on days. In December 2000, the patient suffered from an oral mycosis and was treated with mouthwashes with a mixture of chlorexidine, amphotericin B and sodium bicarbonate solution. He also complained of a pruritis, and in January 2001, the patient had an onychomycosis due to trichophyton rubrum and which was treated with terbinafin, hexomedine, and colchicine. Following the dermatologists advice, the hydroxyurea was temporary discontinued. The CBC of February and April 2001 showed an eosinophil count of 7220 and 7880/mm 3 , respectively. The treatment with hydroxyurea was not resumed, because it was not efficient before the therapeutic window. The patient general condition did not improve; he was, in fact, loosing weigh and also because the subsequent CBCs showed an anemia on top of the hypereosinophilia. In February 2002, the patient present with an elbow mass of the size of a gulf ball, firm, associated with a right groin lymphadenopathy which was biopsied and the biopsy report concluded to a nonspecific adenitis. The molecular study was negative for a T lymphocytes clone; the marrow biopsy revealed an important fibroblastic hyperplasia and a diffuse increase of reticular network. A treatment with Alpha interferon at 3 IU three times a week was started on August 02, 2002. The CBC and the liver function tests were checked every week. After 2 weeks of treatment, Mr. A. Y. noticed an improvement of the cough but complained of tiredness. This treatment was continued until October despite episodes of bodyache and insomnia. A paper in Lancet has reported the efficacy of Imatinib mesylate in 5 patients with HES . After discussing, we proposed to our patient to try this medication. After one month on imatinib at 100 mg twice daily, eosinophilia passed from 3956/mm 3 to 78/mm 3 . The cough and the pruritis improved, but because of the low WBC, an antibiotic coverage was prescribed, and the imatinib discontinued. After 5 months, the patient reported a steady improvement of his symptoms and a better sleep quality. An article in the NEJM in Marsh 2003 by Cools et al. reported that a tyrosine kinase which results from the fusion of the PDGRA and FIP1L1 genes was the target of imitanib in patients with HSE. In blood sample molecular analysis of our patient, the PDGRA-FIP1L1 was found positive; this fitted our patient in the myeloproliferative PDGRA-FIP1L1 HES group as described by Cools et al. . Six subsequent evaluations for the fusion gene were negative, showing a complete cytogenetic remission. The last evaluation for the fusion gene 17 months was also negative. Actually, imatinib was reduced to 1 tablet a day. In conclusion, the diagnosis of PDGRA-FIP1L1 positive hypereosinophilic syndrome myeloproliferative subtype was made for this patient.
3.792969
0.98584
sec[1]/p[0]
en
0.999998
22135755
https://doi.org/10.5402/2011/974609
[ "cough", "hypereosinophilia", "hydroxyurea", "this", "which", "count", "imatinib", "pdgra", "chest", "treated" ]
[ { "code": "MD12", "title": "Cough" }, { "code": "1C12.Z", "title": "Whooping cough, unspecified" }, { "code": "CA20.10", "title": "Simple chronic bronchitis" }, { "code": "1C12.Y", "title": "Other specified whooping cough" }, { "code": "MD22", "title": "Haemoptysis" }, { "code": "4A01.10", "title": "Severe combined immunodeficiencies" }, { "code": "BB01.2/CB02.Z", "title": "Pulmonary hypertension due to lung disease or hypoxia [Pulmonary eosinophilia, unspecified]" }, { "code": "BB01.2/CB02.Y", "title": "Pulmonary hypertension due to lung disease or hypoxia [Other specified pulmonary eosinophilia]" }, { "code": "BB01.2/CB02.2", "title": "Pulmonary hypertension due to lung disease or hypoxia [Tropical pulmonary eosinophilia]" }, { "code": "BB01.2/CB02.0", "title": "Pulmonary hypertension due to lung disease or hypoxia [Asthmatic pulmonary eosinophilia]" } ]
=== ICD-11 CODES FOUND === [MD12] Cough Definition: Cough is an important natural defensive mechanism and protective reflex for clearing the upper and lower airways of excessive secretions such as mucus and inhaled particles. Cough is a common symptom of most respiratory disorders and may be indicative of trivial to very serious airway or lung pathology. Also known as: Cough | complaining of cough | coughing | finding of cough | observation of cough Excludes: cough with haemorrhage [1C12.Z] Whooping cough, unspecified Also known as: Whooping cough, unspecified | Whooping cough | bordetella infection | bordetellosis | pertussis [CA20.10] Simple chronic bronchitis Also known as: Simple chronic bronchitis | chronic catarrhal bronchitis | Smokers bronchitis | smokers cough [1C12.Y] Other specified whooping cough Also known as: Other specified whooping cough | Whooping cough due to other Bordetella species | Whooping cough due to Bordetella bronchiseptica | whooping cough due to b. bronchiseptica [MD22] Haemoptysis Definition: Expectoration or spitting of blood originating from any part of the respiratory tract, usually from haemorrhage in the lung parenchyma and the bronchial arteries. Also known as: Haemoptysis | blood streaked sputum | coughing up blood | Blood-stained sputum | Cough with haemorrhage Includes: Blood-stained sputum | Cough with haemorrhage [4A01.10] Severe combined immunodeficiencies Definition: Severe combined immunodeficiency (SCID) comprises a group of rare monogenic primary immunodeficiency disorders characterised by a lack of functional peripheral T lymphocytes resulting in early-onset severe respiratory infections and failure to thrive. Also known as: Severe combined immunodeficiencies | SCID - [Severe combined immunodeficiencies] | severe combined immunodeficiency disease | Severe combined immunodeficiency with reticular dysgenesis | Severe combined immunodeficiency with leukopenia === GRAPH WALKS === --- Walk 1 --- [MD12] Cough Def: Cough is an important natural defensive mechanism and protective reflex for clearing the upper and lower airways of excessive secretions such as mucus and inhaled particles. Cough is a common symptom ... --EXCLUDES--> [?] Haemoptysis Def: Expectoration or spitting of blood originating from any part of the respiratory tract, usually from haemorrhage in the lung parenchyma and the bronchial arteries.... --PARENT--> [?] Haemorrhage from respiratory passages Def: Haemorrhage from respiratory passages is the bleeding from upper respiratory tract or lower respiratory tract. The major passages and structures of the upper respiratory tract include the nose or nost... --- Walk 2 --- [MD12] Cough Def: Cough is an important natural defensive mechanism and protective reflex for clearing the upper and lower airways of excessive secretions such as mucus and inhaled particles. Cough is a common symptom ... --EXCLUDES--> [?] Haemoptysis Def: Expectoration or spitting of blood originating from any part of the respiratory tract, usually from haemorrhage in the lung parenchyma and the bronchial arteries.... --PARENT--> [?] Haemorrhage from respiratory passages Def: Haemorrhage from respiratory passages is the bleeding from upper respiratory tract or lower respiratory tract. The major passages and structures of the upper respiratory tract include the nose or nost... --- Walk 3 --- [1C12.Z] Whooping cough, unspecified --PARENT--> [1C12] Whooping cough Def: A disease of the upper respiratory tract, caused by an infection with the gram-negative bacteria Bordetella. This disease typically presents with paroxysmal cough, inspiratory whoop, and fainting or v... --CHILD--> [1C12.1] Whooping cough due to Bordetella parapertussis Def: A disease of the upper respiratory tract, caused by an infection of the gram-negative bacteria Bordetella parapertussis. This disease typically presents with a mild clinical presentation of paroxysmal... --- Walk 4 --- [1C12.Z] Whooping cough, unspecified --PARENT--> [1C12] Whooping cough Def: A disease of the upper respiratory tract, caused by an infection with the gram-negative bacteria Bordetella. This disease typically presents with paroxysmal cough, inspiratory whoop, and fainting or v... --CHILD--> [1C12.Y] Other specified whooping cough --- Walk 5 --- [CA20.10] Simple chronic bronchitis --PARENT--> [CA20.1] Chronic bronchitis --CHILD--> [CA20.11] Mucopurulent chronic bronchitis --- Walk 6 --- [CA20.10] Simple chronic bronchitis --PARENT--> [CA20.1] Chronic bronchitis --EXCLUDES--> [?] Certain specified chronic obstructive pulmonary disease
[ "[MD12] Cough\n Def: Cough is an important natural defensive mechanism and protective reflex for clearing the upper and lower airways of excessive secretions such as mucus and inhaled particles. Cough is a common symptom ...\n --EXCLUDES--> [?] Haemoptysis\n Def: Expectoration or spitting of blood originating from any part of the respiratory tract, usually from haemorrhage in the lung parenchyma and the bronchial arteries....\n --PARENT--> [?] Haemorrhage from respiratory passages\n Def: Haemorrhage from respiratory passages is the bleeding from upper respiratory tract or lower respiratory tract. The major passages and structures of the upper respiratory tract include the nose or nost...", "[MD12] Cough\n Def: Cough is an important natural defensive mechanism and protective reflex for clearing the upper and lower airways of excessive secretions such as mucus and inhaled particles. Cough is a common symptom ...\n --EXCLUDES--> [?] Haemoptysis\n Def: Expectoration or spitting of blood originating from any part of the respiratory tract, usually from haemorrhage in the lung parenchyma and the bronchial arteries....\n --PARENT--> [?] Haemorrhage from respiratory passages\n Def: Haemorrhage from respiratory passages is the bleeding from upper respiratory tract or lower respiratory tract. The major passages and structures of the upper respiratory tract include the nose or nost...", "[1C12.Z] Whooping cough, unspecified\n --PARENT--> [1C12] Whooping cough\n Def: A disease of the upper respiratory tract, caused by an infection with the gram-negative bacteria Bordetella. This disease typically presents with paroxysmal cough, inspiratory whoop, and fainting or v...\n --CHILD--> [1C12.1] Whooping cough due to Bordetella parapertussis\n Def: A disease of the upper respiratory tract, caused by an infection of the gram-negative bacteria Bordetella parapertussis. This disease typically presents with a mild clinical presentation of paroxysmal...", "[1C12.Z] Whooping cough, unspecified\n --PARENT--> [1C12] Whooping cough\n Def: A disease of the upper respiratory tract, caused by an infection with the gram-negative bacteria Bordetella. This disease typically presents with paroxysmal cough, inspiratory whoop, and fainting or v...\n --CHILD--> [1C12.Y] Other specified whooping cough", "[CA20.10] Simple chronic bronchitis\n --PARENT--> [CA20.1] Chronic bronchitis\n --CHILD--> [CA20.11] Mucopurulent chronic bronchitis", "[CA20.10] Simple chronic bronchitis\n --PARENT--> [CA20.1] Chronic bronchitis\n --EXCLUDES--> [?] Certain specified chronic obstructive pulmonary disease" ]
MD12
Cough
[ { "from_icd11": "MD12", "icd10_code": "R05", "icd10_title": "Cough" }, { "from_icd11": "1C12.Z", "icd10_code": "A3790", "icd10_title": "Whooping cough, unspecified species without pneumonia" }, { "from_icd11": "1C12.Z", "icd10_code": "A3791", "icd10_title": "Whooping cough, unspecified species with pneumonia" }, { "from_icd11": "1C12.Z", "icd10_code": "A30-A49", "icd10_title": "" }, { "from_icd11": "1C12.Z", "icd10_code": "A37", "icd10_title": "Whooping cough" }, { "from_icd11": "1C12.Z", "icd10_code": "A378", "icd10_title": "Whooping cough due to other Bordetella species" }, { "from_icd11": "1C12.Z", "icd10_code": "A379", "icd10_title": "Whooping cough, unspecified species" }, { "from_icd11": "CA20.10", "icd10_code": "J410", "icd10_title": "Simple chronic bronchitis" }, { "from_icd11": "MD22", "icd10_code": "R042", "icd10_title": "Hemoptysis" }, { "from_icd11": "4A01.10", "icd10_code": "D810", "icd10_title": "Severe combined immunodeficiency [SCID] with reticular dysgenesis" }, { "from_icd11": "4A01.10", "icd10_code": "D811", "icd10_title": "Severe combined immunodeficiency [SCID] with low T- and B-cell numbers" }, { "from_icd11": "4A01.10", "icd10_code": "D812", "icd10_title": "Severe combined immunodeficiency [SCID] with low or normal B-cell numbers" }, { "from_icd11": "4A01.10", "icd10_code": "D813", "icd10_title": "Adenosine deaminase [ADA] deficiency" }, { "from_icd11": "4A01.10", "icd10_code": "D822", "icd10_title": "Immunodeficiency with short-limbed stature" } ]
R05
Cough
An 11-year-old boy presented with a 7-day history of flu-like illness. During ad-mission, the boy was in a generally severe condition, weakened, and apathetic. Physical examination revealed pale skin, with numerous ecchymoses on the skin of the whole body. He had no family history of chronic disease or cancers. The laboratory test results showed the following: white blood cell, 605 × 10^3/µL; neutrophile, 0.0 g/dL; hemoglobin level, 9.4 g/dL; platelet count, 56 × 10^3/µL; hemoglobin, 9.9g/dL; hematocrit, 29%; and 97% blastic cells. The immunophenotypes of lymphoid blasts were CD 45+, CD34+, CD7+, CD3+, TdT+, CD99+, and CD8+. The immunophenotype test indicated precursor T-cell acute lymphoblastic leukemia. The basic genetic tests, including fluorescence in situ hybridization, were performed: BCR: ABL1 (−) and KTM2A (−) . Karyotype analysis showed a result of 48, XY, + mar1, + mar2 /46, XY . Additional genetic analysis microarray SNP indicated a complex karyotype: arr [GRCh37] 4p16.3p14 × 1 to 2, 5p15.33p12 × 4, 9p24.3p21..3 × 2 hmz, 9p21.3p13..3 × 2 hmz, 16p13.3p11..1 × 3 . The patient had Biallelic mutation in the serine protease 1 (PRSS1) gene. Mutation in the PRSS1 is a genetic risk factor for pancreatitis. However, taking into consideration laboratory tests on cancer cells, it would be necessary to repeat the test after treatment in order to confirm mutation in cells. The most reliable test would be the 1 carried before the disease. In the preliminary abdominal ultrasound, a slightly enlarged liver was observed with a significant degree of steatosis, without focal changes in the dimensions of the anterior axillary line at 160 mm . The patient’s induction therapy was started with prednisone intravenous (60 mg/m2/day), daunorubicin per infusionem (p.i. 30 mg/m2), vincristine intravenous (1.5 mg/m2), polyethylene glycol (PEG)-asparaginase p.i. , cyclophosphamide p.i. , and methotrexate intra thecal (12 mg) according to the AIEOP-BFM ALL 2017 protocol IAp (International Collaborative Treatment Protocol for Children and Adolescents with Acute Lymphoblastic Leukemia). In the same period, due to increasing hyperleukocytosis (up to 725 10^3/µL), the patient was treated with leukapheresis for 2 days, with a good effect. During the treatment, fungal pneumonia was diagnosed, which caused a 5-day break in chemotherapy. Furthermore, chemotherapy was complicated by a deep bone marrow aplasia. On day 8 of therapy, there was 16% blastic cells in the patient’s peripheral blood, and on day 15, flow cytometry-minimal residual disease was 4.43 and 2.0% blastic cells in the bone marrow. On day 33 of treatment, polymerase chain reaction-minimal residual after induction was 2 × 10-4 and there was 0.0% blastic cells in yhr bone marrow. In the following days, on day 37 of therapy, the child had dyspnea, stomach pain and vomiting. Laboratory tests presented deep bone marrow aplasia, red blood cell count of 2.73 × 10^6/µL, a white blood cell count of 190 × 10^3/µL, a platelets count of 29 × 10^3/µL, hypokalemia of 2.62 meet/L, aspartate aminotransferase of 49 IU/L, alanine aminotransferase of 65 IU/L, hypertriglyceridemia of 1910 mg/dL, increasing gamma-glutamyl transpeptidase up to 1745 U/L, bilirubin of 3.01 mg/dL, hyperlipasemia of 500 U/L, hyperamylasemia of 206 U/L, procalcitonin of 10.66 ng/mL and C-Reactive Protein of 12.93 mg/L. In the ultrasound (US) test, the gallbladder measured approximately 121 × 47 mm with a slightly echogenic bile and the presence of several stones, up to 7 mm long . Cholecystitis and hepatitis were diagnosed. Broad-spectrum antibiotic therapy, potassium supplementation and hepatoprotective treatment (including L-ornithine L-aspartate) were administered. After 2 days, a controlled US test showed that lesions had progressed . Due to the patient’s serious condition, cholecystostomy was postponed, and initially, percutaneous drainage of the gallbladder was performed. After this procedure, an increase in the parameters of inflammation, amylase, lipase and a further increase in bilirubin and gamma-glutamyl transpeptidase were observed. On physical examination, severe pain was observed in the abdomen and limbs. Periodic vomiting of bile with blood was also observed. In addition, it was necessary to modify the patient’s broad-spectrum antibiotic therapy because of his poor response. Likewise, analgesic treatment and immunoglobulin infusions were administered. Moreover, there were further complications due to pancreatitis , and the boy was started on par-enteral nutrition. On account of gastro-esophageal bleeding, the boy received infusions of somatostatin and omeprazole. Because of severe bone marrow aplasia, the patient received granulocyte growth factor and a transfusion of blood products. In the following days, the boy’s general condition improved. Controlled abdominal ultrasound showed improvement in the general condition of the patient . One month after the reported complaints, the patient underwent laparotomy cholecystectomy. The total interruption in chemotherapy was 74 days.
4.164063
0.959961
sec[0]/p[1]
en
0.999998
37682188
https://doi.org/10.1097/MD.0000000000034965
[ "blood", "cells", "bone", "marrow", "cell", "count", "blastic", "laboratory", "genetic", "mutation" ]
[ { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "MF9Y", "title": "Other specified clinical findings on examination of urine, without diagnosis" }, { "code": "5C56.20", "title": "Mucolipidosis" }, { "code": "3A51.1", "title": "Sickle cell disease without crisis" }, { "code": "9A96.3", "title": "Primary anterior uveitis" }, { "code": "3A61.Z", "title": "Acquired pure red cell aplasia, unspecified" } ]
=== ICD-11 CODES FOUND === [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood [MF9Y] Other specified clinical findings on examination of urine, without diagnosis Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine [5C56.20] Mucolipidosis Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2 Excludes: Sialidosis (mucolipidosis type 1) [3A51.1] Sickle cell disease without crisis Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing. Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease] [9A96.3] Primary anterior uveitis Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid. Also known as: Primary anterior uveitis | anterior chamber cell [3A61.Z] Acquired pure red cell aplasia, unspecified Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --CHILD--> [?] Anaemias or other erythrocyte disorders --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Diseases of the immune system --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --PARENT--> [MF50] Abnormal micturition --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Anaemias or other erythrocyte disorders", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Diseases of the immune system", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --PARENT--> [MF50] Abnormal micturition", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
A 68-year-old Japanese woman presented with a 2-cm mass in her lower left lung. Sixty-six months previously, she had undergone a curative esophagectomy via a right thoracotomy with three-field lymph node dissection for advanced esophageal cancer. A gastric tube was created during an open laparotomy and used as an esophageal substitute through the postmediastinal route. Pathological examination of the all-segmented tumor specimens revealed the proliferation of large squamoid cells with enlarged nuclei forming nests with a central necrosis, infiltrating throughout the esophageal wall . Some of the tumor nests exhibited ambiguous nuclear palisading arrangement in the peripheral region, in which deposition of hyaline-like materials was occasionally identified. These histological features were diagnostic of moderately differentiated SCC with a focal basaloid component. In accordance with the Union for International Cancer Control TNM staging system (7th edition), the tumor was classified as pT3N0M0, pStage IIA. Immunohistochemical examinations showed that the tumor cells were positive for p63 and p40 and negative for SP-A, TTF-1, chromogranin A, synaptophysin, S-100, and calponin. However, lymphatic and venous invasions were detected. She then received adjuvant chemotherapies combined with docetaxel (DOC; 40 mg/body) plus nedaplatin (CDGP; 40 mg/body). Routine follow-up chest x-rays and computed tomography (CT) scans showed no masses in the lungs or other abnormalities for more than 5 years after adjuvant chemotherapies. She never complained of gastrointestinal or pulmonary symptoms. However, at 66 months after the surgery, a chest CT detected a solitary, oval-shaped, 20 × 11-mm lesion in the left lung . An 18 F-fluorodeoxyglucose positron-emission tomography (FDG-PET)-CT scan revealed abnormal FDG uptake in the left lung, with a standardized uptake value of 9.58 . Pathological findings from a CT-guided biopsy specimen indicated the presence of BSCC components. As systemic examinations revealed no other metastases, we decided to remove it surgically and performed a partial resection of the lower left lobe via thoracoscopy. No pleural dissemination was observed intraoperatively. The postoperative course was uneventful. Histological features of the metastatic tumor were similar to the basaloid component of the primary tumor in the esophagus . Nests of polygonal cells of various sizes in an alveolar configuration showed a massively expansive-infiltrative growth pattern in a sheet formation with comedo necrosis. The presence of scant cytoplasm, round to oval nuclei, a high nuclear to cytoplasmic ratio, relativistic nuclear palisading arrangement in the marginal region of the tumor, and deposition of hyaline-like materials was compatible with BSCC of the esophagus. We also observed characteristic PAS-positive hyaline material in part of the alveolar interstitium. There was no existing bronchial/alveolar cavity in the metastatic cancer foci or alveolar replacement growth around the peripheral lung tumor. The immunohistochemical examination indicated that the tumor had metastasized from the primary esophageal SCC, because its cells were positive for p63 and p40 and negative for SP-A and TTF-1. Finally, we diagnosed the tumor as a metastasis from BSCC components of the esophagus. The patient was discharged from our hospital on postoperative day 9 and then received two courses of adjuvant chemotherapy of 5-fluorouracil (5-FU) and CDGP plus DOC (5-FU 450 mg/m 2 : Days 1–5, CDGP 20 mg/body: Days 1–5, DOC 80 mg/body: Day 1). Although the patient did well initially without any recurrence after the pulmonary metastasectomy, multiple lung and brain metastases were diagnosed 2 years later on follow-up chest/brain CT examinations. The patient died for 10 years and 6 months after the initial esophagectomy. Fig. 1 a Macroscopic appearance of the opened esophagus and stomach shows an ulcerative and infiltrative type tumor in the middle thoracic esophagus. Histopathologic examination of the resected specimen shows moderately differentiated squamous cell carcinoma ( b hematoxylin and eosin stain, ×100), with a focal basaloid component (square, c × 4 and d × 100). Immunohistochemical examinations show that the primary tumor cells are positive for e p63and f p40 (× 100) Fig. 2 a Chest computed tomography scan shows a solitary oval pulmonary lesion, approximately 20 × 11 mm, in the left lung. b Fluorodeoxyglucose positron emission tomography-computed tomography confirms the presence of one lesion in the lung and the absence of metastases in the lymph nodes or extrapulmonary sites Fig. 3 a Macroscopic observation of the resected left lung specimen shows a white nodule with irregular borders. b Histological evaluation of the pulmonary lesion, leading to diagnosis of metastasis of basaloid squamous cell carcinoma of the esophagus with deposition of hyaline-like material (hematoxylin and eosin stain, × 100). Immunohistochemical examinations show that the metastatic tumor cells are positive for c p63 and d p40 (× 100)
4.183594
0.958984
sec[1]/p[0]
en
0.999997
32757102
https://doi.org/10.1186/s40792-020-00957-z
[ "tumor", "lung", "cells", "esophagus", "examinations", "tomography", "esophageal", "hyaline", "basaloid", "immunohistochemical" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "CA40.Z", "title": "Pneumonia, organism unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "NB32.3Y", "title": "Other injury of lung" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [CA40.Z] Pneumonia, organism unspecified Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [NB32.3Y] Other injury of lung Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --PARENT--> [02] Neoplasms Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair.... --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Fatty apron --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Benign symmetrical lipomatosis Def: Benign symmetrical lipomatosis is an uncommon condition characterised by progressive symmetrical accumulation during adult life of adipose mass at the level of the head, neck and upper trunk . The con... --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Fatty apron", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Benign symmetrical lipomatosis\n Def: Benign symmetrical lipomatosis is an uncommon condition characterised by progressive symmetrical accumulation during adult life of adipose mass at the level of the head, neck and upper trunk . The con...", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
Our patient was a previously healthy 52-year-old slender yellow man who had no obvious medical history. About 26 years ago, he was involved in a traffic accident while riding a motorcycle and wearing a helmet, when he was hit by a car in the head. The patient recovered 3 days later, but sequela of severe, stabbing pain was reported between the right medial scapula and spine with radiation to the thorax occasionally thereafter. In the last 3 years, upper respiratory tract infection and productive cough were noted frequently, and the patient’s symptoms were aggravated by shortness of breath when his head was positioned below 90 degrees during squatting and hunching of the body. A chest x-ray revealed a 5.6 × 3.9-cm 2 mass at LMD (Local Medical Department) since then. In the meantime, the patient consulted various medical centers. During the spans of examination and watch, symptoms developed progressively with sharp pain at locations similar to the previous trauma. The patient had dyspnea, which was relieved temporarily by use of a bronchodilator. The patient manifested prone sleep with ashen complexion, and he had lost 3–4 kg of body weight over the 3 weeks before admission to our hospital. Chest x-ray and Virtual bronchoscopy with computer tomography (CT) revealed an 8.3 × 7.5 × 4-cm lobulated right upper mediastinal mass with amorphous calcification and severe, intricate airway compression . A creative mockup analogy module of the distorted trachea and tumor was generated by 3-D printing and reprogrammed by CT scan to streamline the sophisticated correlation (Additional file 1 : Video S1). Considering the cryptogenic nature of the tumor without the possibility of a percutaneous biopsy, we performed an airway stabilization procedure before performing the operation with the patient under general anesthesia. Initially, we applied local anesthetics to the neck wound with the head left-tilted at a 45-degree lateral decubitus position, and an anterior tracheal ring of 0.6 cm in diameter was removed by cautery. Intraoperative bronchoscopy unraveled a long, twisted segment of life-threatening compression with intact mucosa . We then used an innovative approach with the patient under general anesthesia to insert a T-tube (13 French, 0.5–7.5 cm, upper and lower arm) assisted by laryngoscopy . That allowed smooth procedures for a series of examinations, such as magnetic resonance angiography of the thorax, position emission tomography (PET), and thyroid scan with preparation for secondary operation of tumor removal. Three weeks later, thoracoscopy-assisted with intralesional surgery of lobulated, firm, gray-tan tumor was performed. The tumor weighed 205 g . Pathological findings confirmed a low-grade chondrosarcoma with < 1/10 mitotic high-power fields . The patient recovered uneventfully, and his trachea returned to normal size instantly with marked improvement in pulmonary function testing. Postoperative adjuvant radiotherapy was administered, and the patient stayed in healthy condition during a solid 2 years of follow-up. Fig. 1 Chest x-ray and the 3-D model of the trachea and chondrosarcoma before surgery. White arrow marks the chondrosarcoma Fig. 2 A noncontrast computed tomographic (CT) image shows severe compression of the esophagus and trachea by an approximately 8.3 × 7.5 × 4-cm lobulated tumor with multiple coarse calcifications at right upper mediastinum ( a – d ). Endoscopy shows a discrete compressed region of the trachea ( e , f ). The 3-D model of the trachea derived from CT images ( g ). The trachea moderately recovered after the insertion of a T-tube stent ( i ). CT scan and endoscopy of the trachea returned to normal after surgery ( h , j ). Empty red arrows mark the trachea; solid red arrows mark the chondrosarcoma; yellow arrows mark different sites of the trachea stenosis; blue arrow marks the site of tracheostomy Fig. 3 The wound recovered very well after surgery ( a ). Intraoperative photographs show the location of the chondrosarcoma ( b , c ) and the view after tumor resection ( d ). H&E staining shows the histology of the chondrosarcoma with low mitotic features ( e , H&E stain; original magnification × 40; f , H&E stain; original magnification × 400). Black solid arrow marks the wound of tracheostomy. Black dotted arrow marks the surgical wound of 7 cm in size. Yellow circles mark the location of the chondrosarcoma. Blue arrow marks the site of coagulation. Black circle marks the region after the tumor was removed Fig. 4 Magnetic resonance angiography demonstrates a hypovascular tumor in the right paratracheal space and compressing the esophagus and trachea. Thoracic angiography shows no significantly abnormal lymph adenopathy in the mediastinum and lower neck and no invasion of greater vessel ( a , b ). Whole-body positron emission tomographic scan showing a 18 F-fluorodeoxyglucose-avid area at the right lower paratracheal region (maximum standardized uptake value, 2.2/1 hour) ( c , d ). Tc-99m thyroid scan shows only cold nodule over right lobe of thyroid ( e , f )
3.951172
0.979004
sec[1]/p[0]
en
0.999995
31954403
https://doi.org/10.1186/s13256-019-2312-4
[ "trachea", "tumor", "chondrosarcoma", "marks", "scan", "arrow", "recovered", "wound", "mark", "yellow" ]
[ { "code": "CA05.1", "title": "Acute tracheitis" }, { "code": "CA0Y", "title": "Other specified upper respiratory tract disorders" }, { "code": "LA73.Z", "title": "Structural developmental anomalies of trachea, unspecified" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "LA73.0", "title": "Congenital stenosis of trachea" }, { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "2B50.Z", "title": "Chondrosarcoma of bone or articular cartilage of unspecified sites" } ]
=== ICD-11 CODES FOUND === [CA05.1] Acute tracheitis Definition: This condition refers to the acute inflammation of the trachea. Also known as: Acute tracheitis | acute tracheitis NOS | tracheitis NOS | tracheal inflammation | Acute catarrhal tracheitis Excludes: Chronic tracheitis [CA0Y] Other specified upper respiratory tract disorders Also known as: Other specified upper respiratory tract disorders | Acute adenoiditis | adenoid infection | Pharyngotonsillitis | tonsillopharyngitis [LA73.Z] Structural developmental anomalies of trachea, unspecified Also known as: Structural developmental anomalies of trachea, unspecified | Structural developmental anomalies of trachea | Malformations of trachea | tracheal deformity | tracheal anomaly [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [LA73.0] Congenital stenosis of trachea Definition: Tracheal stenosis is a fixed intrinsic narrowing of the trachea. The narrowing can be localised to a short or long tracheal segment, often due to a complete tracheal ring. Alternatively, the tracheal lumen may become progressively narrow caudally. Also known as: Congenital stenosis of trachea | tracheal atresia | Atresia of trachea | congenital trachea stricture Includes: Atresia of trachea [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [2B50.Z] Chondrosarcoma of bone or articular cartilage of unspecified sites Also known as: Chondrosarcoma of bone or articular cartilage of unspecified sites | Chondrosarcoma, primary site | chondrosarcoma of unspecified site | cartilage cancer | chondrosarcoma NOS === GRAPH WALKS === --- Walk 1 --- [CA05.1] Acute tracheitis Def: This condition refers to the acute inflammation of the trachea.... --PARENT--> [CA05] Acute laryngitis or tracheitis Def: Acute laryngitis and tracheitis are defined respectively as acute inflammation of larynx and trachea, with local findings of erythema, and oedema of laryngeal and tracheal mucosa. Acute laryngitis and... --EXCLUDES--> [?] Acute obstructive laryngitis or epiglottitis --- Walk 2 --- [CA05.1] Acute tracheitis Def: This condition refers to the acute inflammation of the trachea.... --RELATED_TO--> [?] Neonatal tracheitis Def: A disease of the trachea in neonates, caused by an infection with a bacterial, viral, or fungal source. This disease is characterised by stridor, or increased respiratory effort. Transmission is commo... --PARENT--> [?] Neonatal infections involving respiratory system --- Walk 3 --- [CA0Y] Other specified upper respiratory tract disorders --PARENT--> [?] Upper respiratory tract disorders Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ... --CHILD--> [CA00] Acute nasopharyngitis Def: A disease of the upper respiratory tract, caused by an infection with rhinovirus. This disease is characterised by pharyngitis, runny nose, stuffy nose, or cough. Transmission is by inhalation of infe... --- Walk 4 --- [CA0Y] Other specified upper respiratory tract disorders --PARENT--> [?] Upper respiratory tract disorders Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ... --CHILD--> [CA00] Acute nasopharyngitis Def: A disease of the upper respiratory tract, caused by an infection with rhinovirus. This disease is characterised by pharyngitis, runny nose, stuffy nose, or cough. Transmission is by inhalation of infe... --- Walk 5 --- [LA73.Z] Structural developmental anomalies of trachea, unspecified --PARENT--> [LA73] Structural developmental anomalies of trachea --CHILD--> [LA73.Y] Other specified structural developmental anomalies of trachea --- Walk 6 --- [LA73.Z] Structural developmental anomalies of trachea, unspecified --PARENT--> [LA73] Structural developmental anomalies of trachea --CHILD--> [LA73.Y] Other specified structural developmental anomalies of trachea
[ "[CA05.1] Acute tracheitis\n Def: This condition refers to the acute inflammation of the trachea....\n --PARENT--> [CA05] Acute laryngitis or tracheitis\n Def: Acute laryngitis and tracheitis are defined respectively as acute inflammation of larynx and trachea, with local findings of erythema, and oedema of laryngeal and tracheal mucosa. Acute laryngitis and...\n --EXCLUDES--> [?] Acute obstructive laryngitis or epiglottitis", "[CA05.1] Acute tracheitis\n Def: This condition refers to the acute inflammation of the trachea....\n --RELATED_TO--> [?] Neonatal tracheitis\n Def: A disease of the trachea in neonates, caused by an infection with a bacterial, viral, or fungal source. This disease is characterised by stridor, or increased respiratory effort. Transmission is commo...\n --PARENT--> [?] Neonatal infections involving respiratory system", "[CA0Y] Other specified upper respiratory tract disorders\n --PARENT--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...\n --CHILD--> [CA00] Acute nasopharyngitis\n Def: A disease of the upper respiratory tract, caused by an infection with rhinovirus. This disease is characterised by pharyngitis, runny nose, stuffy nose, or cough. Transmission is by inhalation of infe...", "[CA0Y] Other specified upper respiratory tract disorders\n --PARENT--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...\n --CHILD--> [CA00] Acute nasopharyngitis\n Def: A disease of the upper respiratory tract, caused by an infection with rhinovirus. This disease is characterised by pharyngitis, runny nose, stuffy nose, or cough. Transmission is by inhalation of infe...", "[LA73.Z] Structural developmental anomalies of trachea, unspecified\n --PARENT--> [LA73] Structural developmental anomalies of trachea\n --CHILD--> [LA73.Y] Other specified structural developmental anomalies of trachea", "[LA73.Z] Structural developmental anomalies of trachea, unspecified\n --PARENT--> [LA73] Structural developmental anomalies of trachea\n --CHILD--> [LA73.Y] Other specified structural developmental anomalies of trachea" ]
CA05.1
Acute tracheitis
[ { "from_icd11": "CA05.1", "icd10_code": "J0410", "icd10_title": "Acute tracheitis without obstruction" }, { "from_icd11": "CA05.1", "icd10_code": "J0411", "icd10_title": "Acute tracheitis with obstruction" }, { "from_icd11": "CA05.1", "icd10_code": "J041", "icd10_title": "Acute tracheitis" }, { "from_icd11": "LA73.Z", "icd10_code": "Q321", "icd10_title": "Other congenital malformations of trachea" }, { "from_icd11": "LA73.Z", "icd10_code": "Q32", "icd10_title": "Congenital malformations of trachea and bronchus" }, { "from_icd11": "2F91.1", "icd10_code": "D381", "icd10_title": "Neoplasm of uncertain behavior of trachea, bronchus and lung" }, { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" } ]
J0410
Acute tracheitis without obstruction
In February 2018, a 49-year-old male presented with an enlarged palpable mass in the proximal right lower extremity, accompanied by persistent dull pain and movement restriction. The patient did not have any previous significant medical conditions. The computed tomography (CT) revealed the shadow of a heterogeneous mass (89 × 42 mm) on the right intertrochanteric region of the femur , and the lesion was obviously strengthened unevenly after enhancement. Metastatic tumors were excluded according to the patient’s whole-body imaging findings. In August 2018, an excisional biopsy of the right intertrochanteric space-occupying lesion was performed, and the pathological evaluation demonstrated a right femoral intertrochanteric leiomyosarcoma. After two cycles of neoadjuvant doxorubicin–ifosfamide (AI) chemotherapy comprising doxorubicin 75 mg/m 2 given at day 1 and ifosfamide at 1.8 g/m 2 per day over 5 days every 3 weeks, the patient underwent extensive resection of femoral intertrochanteric leiomyosarcoma and total hip arthroplasty under general anesthesia on 5 December 2018. Macroscopic examination of the resected bone segment showed a grayish-yellow mass with a size of 8 cm × 7 cm × 6 cm in the bone marrow cavity and 9 cm from the broken end of talus tissue, which had a pattern of growth replacing the marrow and invading the surrounding soft tissues. The efficacy assessment of neoadjuvant chemotherapy revealed extensive necrosis in the tumor with a tumor necrosis rate of approximately 80%–90% compared with preliminary pathologic results. The final pathology of the post-operative specimens suggested spindle cell morphology with immunohistochemical results being positive for desmin, calponin, caldesmon, SMA, and MIB1 and negative for S100, CR, NF, and SATB2 and confirmed the diagnosis of left femoral intertrochanteric leiomyosarcoma, grade III (FNCLCC) . Three cycles of adjuvant AI regimen chemotherapy were given after surgery, followed by field adjuvant radiotherapy at a dose of 50 Gy until May 2019. Unfortunately, multiple newly bilateral pulmonary nodules were detected by the routine chest CT scan on April 2020 . Subsequently, the patient underwent first-line treatment with anlotinib (12 mg, d1–14) every 3 weeks for seven cycles from June to October 2020 and achieved a PFS of 4 months. Then, the number and size of bilateral pulmonary nodes increased, and the curative effect was evaluated as progression disease (PD) based on the RECIST criteria . Thus, the patient accepted second-line chemotherapy of gemcitabine at the dose of 1,000 mg/m 2 on days 1 and 8, combined with docetaxel at the dose of 75 mg/m 2 on day 8 for six cycles. After a PFS of 8 months, the patient began complaining of persistent epigastric abdominal sharp pain with the numeric rating scale score of 7, accompanied by fever, nausea, vomiting, abdominal distension, and diarrhea in May 2021. The patient was not presented with melena, swallowing difficulties, or shortness of breath. He was bedridden for the vast majority of the time with an ECOG performance status score of 3, which severely compromised his life quality. The follow-up imaginological examination revealed new metastases in bilateral erector spinae, left internal abdominal oblique muscle, L1 and L4 vertebra, and pancreas, along with acute necrotizing pancreatitis and pancreatic pseudocyst . At that time, the laboratory examination showed the abnormal elevation of serum amylase (up to 182 IU/L) and lipase (up to 325.4 IU/L) . After broad-spectrum antibiotics and other supportive treatments, the patient’s abdominal pain was significantly alleviated, and the levels of both serum amylase and lipase gradually declined but remained persistently above the normal reference range . Subsequently, the patient began to try third-line therapy with eribulin at the dose of 1.4 mg/m 2 administered intravenously on days 1 and 8 every 21 days from September 2021. However, the patient did not benefit from eribulin, with the disease being judged to progress after only two cycles . In December 2021, the patient received the combined treatment with penpulimab (200 mg IV infusion every 3 weeks), a humanized anti-PD-1 IgG1 antibody, plus the multikinase inhibitor lenvatinib (8 mg/day). The accompanying treatment plan consisted of denosumab (120 mg) injections every 4 weeks to prevent skeletal-related events. After two cycles, the physical conditions and life quality of the patient had improved significantly, with pain fading away, weight restoration, and the ECOG performance status score improving to 1. The level of serum amylase and lipase demonstrated a constant downward trend with complete normalization (14.39 U/mL) by the end of his six cycles of treatment . A CT re-examination in February 2022 indicated that tumors had shrunk along with the absorption of the inflammatory exudation around the pancreas and the recession of the pancreatic pseudocyst, and the efficacy evaluation was partial response (PR) . The PFS for this regimen was 8.4 months according to the iRECIST criteria.
4.046875
0.96875
sec[1]/p[0]
en
0.999998
PMC10665504
https://doi.org/10.3389/fphar.2023.1239699
[ "cycles", "intertrochanteric", "every", "pain", "chemotherapy", "abdominal", "femoral", "leiomyosarcoma", "line", "score" ]
[ { "code": "6A80.5", "title": "Rapid cycling" }, { "code": "PA03", "title": "Unintentional land transport traffic event injuring a motor cyclist" }, { "code": "5C50.AZ", "title": "Disorders of urea cycle metabolism, unspecified" }, { "code": "PA23", "title": "Unintentional land transport event unknown whether traffic or nontraffic injuring a motor cyclist" }, { "code": "PA02", "title": "Unintentional land transport traffic event injuring a pedal cyclist" }, { "code": "NC72.30", "title": "Intertrochanteric fracture of femur" }, { "code": "MG3Z", "title": "Pain, unspecified" }, { "code": "8E43.Z", "title": "Pain disorders, unspecified" }, { "code": "MG31.Z", "title": "Acute pain, unspecified" }, { "code": "MG30.Z", "title": "Chronic pain, unspecified" } ]
=== ICD-11 CODES FOUND === [6A80.5] Rapid cycling Definition: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood to the other, or the mood episodes may be demarcated by a period of remission. In individuals with a high frequency of mood episodes, some may have a shorter duration than those usually observed in bipolar type I or bipolar type II disorder. In particular, depressive periods may only last several da Also known as: Rapid cycling [PA03] Unintentional land transport traffic event injuring a motor cyclist Also known as: Unintentional land transport traffic event injuring a motor cyclist | motorcycle rider injured in transport accident | unintentional land transport accident motorbike | motorbike accident | motorbike traffic accident Excludes: Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle [5C50.AZ] Disorders of urea cycle metabolism, unspecified Also known as: Disorders of urea cycle metabolism, unspecified | Disorders of urea cycle metabolism | disorder of urea cycle | disorders of metabolism of ornithine, citrulline, argininosuccinic acid, arginine and ammonia | ammonia metabolic disorder [PA23] Unintentional land transport event unknown whether traffic or nontraffic injuring a motor cyclist Also known as: Unintentional land transport event unknown whether traffic or nontraffic injuring a motor cyclist | unintentional off-road crash injuring a motor cyclist, unknown whether on road | motor bike crash NOS | motor cycle crash NOS | Motorcycle rider injured in collision with railway train or railway vehicle [PA02] Unintentional land transport traffic event injuring a pedal cyclist Also known as: Unintentional land transport traffic event injuring a pedal cyclist | Pedal cyclist injured in collision with pedestrian or animal | Pedal cyclist injured in collision with pedestrian or animal, person injured while boarding or alighting | Pedal cyclist injured in collision with pedestrian or animal, driver injured in traffic accident | Pedal cyclist injured in collision with pedestrian or animal, passenger injured in traffic accident [NC72.30] Intertrochanteric fracture of femur Also known as: Intertrochanteric fracture of femur | femoral intertrochanteric fracture | femoral intertrochanter fracture | intertrochanteric hip fracture [MG3Z] Pain, unspecified Also known as: Pain, unspecified | pain observations | pain NOS | generalised pain | generalised pain, NOS [8E43.Z] Pain disorders, unspecified Also known as: Pain disorders, unspecified | Pain disorders [MG31.Z] Acute pain, unspecified Also known as: Acute pain, unspecified | Acute pain [MG30.Z] Chronic pain, unspecified Also known as: Chronic pain, unspecified | Chronic pain === GRAPH WALKS === --- Walk 1 --- [6A80.5] Rapid cycling Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ... --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di... --CHILD--> [6A80.2] Current depressive episode persistent Def: The diagnostic requirements for a depressive episode are currently met and have been met continuously for at least the past 2 years.... --- Walk 2 --- [6A80.5] Rapid cycling Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ... --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di... --CHILD--> [6A80.2] Current depressive episode persistent Def: The diagnostic requirements for a depressive episode are currently met and have been met continuously for at least the past 2 years.... --- Walk 3 --- [PA03] Unintentional land transport traffic event injuring a motor cyclist --EXCLUDES--> [?] Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle --CHILD--> [?] Occupant of three-wheeled motor vehicle injured in collision with two- or three-wheeled motor vehicle --- Walk 4 --- [PA03] Unintentional land transport traffic event injuring a motor cyclist --PARENT--> [?] Unintentional land transport road traffic injury event --CHILD--> [PA01] Unintentional land transport traffic event injuring the user of a pedestrian conveyance --- Walk 5 --- [5C50.AZ] Disorders of urea cycle metabolism, unspecified --PARENT--> [5C50.A] Disorders of urea cycle metabolism --EXCLUDES--> [?] Lysinuric protein intolerance Def: Lysinuric protein intolerance is a very rare inherited multisystem condition caused by disturbance in amino acid metabolism. Affected patients may present with vomiting, diarrhea, failure to thrive, h... --- Walk 6 --- [5C50.AZ] Disorders of urea cycle metabolism, unspecified --PARENT--> [5C50.A] Disorders of urea cycle metabolism --CHILD--> [5C50.A2] Argininaemia Def: Arginase deficiency is a rare autosomal recessive amino acid metabolism disorder characterised clinically by variable degrees of hyperammonemia, developing from about 3 years of age, and leading to pr...
[ "[6A80.5] Rapid cycling\n Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ...\n --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders\n Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di...\n --CHILD--> [6A80.2] Current depressive episode persistent\n Def: The diagnostic requirements for a depressive episode are currently met and have been met continuously for at least the past 2 years....", "[6A80.5] Rapid cycling\n Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ...\n --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders\n Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di...\n --CHILD--> [6A80.2] Current depressive episode persistent\n Def: The diagnostic requirements for a depressive episode are currently met and have been met continuously for at least the past 2 years....", "[PA03] Unintentional land transport traffic event injuring a motor cyclist\n --EXCLUDES--> [?] Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle\n --CHILD--> [?] Occupant of three-wheeled motor vehicle injured in collision with two- or three-wheeled motor vehicle", "[PA03] Unintentional land transport traffic event injuring a motor cyclist\n --PARENT--> [?] Unintentional land transport road traffic injury event\n --CHILD--> [PA01] Unintentional land transport traffic event injuring the user of a pedestrian conveyance", "[5C50.AZ] Disorders of urea cycle metabolism, unspecified\n --PARENT--> [5C50.A] Disorders of urea cycle metabolism\n --EXCLUDES--> [?] Lysinuric protein intolerance\n Def: Lysinuric protein intolerance is a very rare inherited multisystem condition caused by disturbance in amino acid metabolism. Affected patients may present with vomiting, diarrhea, failure to thrive, h...", "[5C50.AZ] Disorders of urea cycle metabolism, unspecified\n --PARENT--> [5C50.A] Disorders of urea cycle metabolism\n --CHILD--> [5C50.A2] Argininaemia\n Def: Arginase deficiency is a rare autosomal recessive amino acid metabolism disorder characterised clinically by variable degrees of hyperammonemia, developing from about 3 years of age, and leading to pr..." ]
6A80.5
Rapid cycling
[ { "from_icd11": "PA03", "icd10_code": "V299XXD", "icd10_title": "Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, subsequent encounter" }, { "from_icd11": "PA03", "icd10_code": "V234XXA", "icd10_title": "Motorcycle driver injured in collision with car, pick-up truck or van in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V299XXA", "icd10_title": "Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2940XA", "icd10_title": "Motorcycle driver injured in collision with unspecified motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V239XXD", "icd10_title": "Unspecified motorcycle rider injured in collision with car, pick-up truck or van in traffic accident, subsequent encounter" }, { "from_icd11": "PA03", "icd10_code": "V299XXS", "icd10_title": "Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, sequela" }, { "from_icd11": "PA03", "icd10_code": "V2988XA", "icd10_title": "Motorcycle rider (driver) (passenger) injured in other specified transport accidents, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2950XA", "icd10_title": "Motorcycle passenger injured in collision with unspecified motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2960XA", "icd10_title": "Unspecified motorcycle rider injured in collision with unspecified motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2949XS", "icd10_title": "Motorcycle driver injured in collision with other motor vehicles in traffic accident, sequela" }, { "from_icd11": "PA03", "icd10_code": "V234XXS", "icd10_title": "Motorcycle driver injured in collision with car, pick-up truck or van in traffic accident, sequela" }, { "from_icd11": "PA03", "icd10_code": "V235XXA", "icd10_title": "Motorcycle passenger injured in collision with car, pick-up truck or van in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V234XXD", "icd10_title": "Motorcycle driver injured in collision with car, pick-up truck or van in traffic accident, subsequent encounter" }, { "from_icd11": "PA03", "icd10_code": "V2949XA", "icd10_title": "Motorcycle driver injured in collision with other motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2949XD", "icd10_title": "Motorcycle driver injured in collision with other motor vehicles in traffic accident, subsequent encounter" } ]
V299XXD
Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, subsequent encounter
A 40‐year old previously healthy woman presented to the hospital with fatigue and incessant epistaxis in 2020. Physical examination revealed several hematomas. Thrombocytopenia, anemia, an elevated leukocyte count, and numerous large blast cells found in the peripheral blood raised the suspicion of acute leukemia. The subsequent bone marrow puncture showed an expansion (61%) of medium size and large vacuolated blast cells, which were characterized by flow cytometry as clonal (kappa light chain restriction), immature (CD45(+), HLA‐DR+, CD38+, CD10+, CD34−, TdT−) B cells (CD19+, CD20+, CD22(+), CD79a+, CD5−, cyIgM+). Histological examination of a bone marrow biopsy revealed a subtotal (> 95%) infiltration by an EBV‐negative high‐grade B cell lymphoma with a MYC‐rearrangement and an IGH‐BCL2 rearrangement . Additionally, a 13q14 deletion and a TP53/17p deletion were found. FDG–Positron emission tomography (FDG–PET) showed multiple hypermetabolic lesions in lymph nodes on both sides of the diaphragm, in the spleen, in the bone marrow, and the liver . No signs of central nervous system involvement emerged after Magnetic resonance imaging (MRI)‐imaging and cerebrospinal fluid examination. In aggregate, a diagnosis of mature B‐cell acute leukemia commonly referred to as BL was made in this patient. Therapeutically, chemotherapy according to the GMALL 2002 B‐NHL/ALL protocol was initiated . First, a prephase therapy (cyclophosphamide, prednisone, and intrathecal triple therapy with methotrexate (MTX), cytarabine and dexamethasone) and block A1 (rituximab, dexamethasone, vincristine, ifosfamide, high‐dose MTX, cytarabine, etoposide, and a twice intrathecal triple therapy) were administered. Fortunately, after the first cycle of chemotherapy, a bone marrow aspiration showed complete cytological remission. Thus, chemotherapy was resumed with block B1 (rituximab, dexamethasone, vincristine, cyclophosphamide, high‐dose MTX, doxorubicin and a twice intrathecal triple therapy) and after another bone marrow analysis, which additionally confirmed molecular CR, with block C1 (rituximab, high‐dose MTX, vindesine, etoposide, cytarabine). Next, the patient received block A2 (equal to block A1), block B2 (equal to block B1), and block C2 (equal to block C1). Bone marrow analysis after block A2 , and after six months of chemotherapy revealed ongoing CR. FDG–PET‐imaging showed complete regression of all metabolically active lesions. Three months after chemotherapy, the patient presented to the first follow‐up appointment without any subjective symptoms and with regular blood counts. However, FDG–PET‐imaging indicated BL relapse with metabolically active lesions in abdominal lymph nodes, both kidneys and the bone marrow . Moreover, the histological examination of the additionally performed bone marrow biopsy once again showed subtotal infiltration with lymphatic blasts confirming the diagnosis of BL relapse just three months after completing extensive chemotherapy . In this situation, the only curative option is conferred on by ASCT preceded by the remission‐inducing salvage therapy. On this account, the salvage therapy was attempted with rituximab‐DHAP . Strikingly, a bone marrow biopsy obtained after the very first cycle rituximab‐DHAP showed CR , and FDG–PET‐imaging showed clearance of all extramedullary lesions. Thus, the patient was prepared for ASCT while undergoing a second bridging cycle of rituximab‐DHAP. The final staging prior to ASCT confirmed the maintenance of CR. Afterward, matched unrelated donor ASCT could be performed. Molecular CR was confirmed two months after transplantation via bone marrow biopsy. Mild chronic skin GvHD arising during cyclosporine tapering was treated with prednisone. Five months after transplantation the patient was hospitalized for severe pain emanating from the bones. Flow cytometrical analysis of peripheral blood revealed BL relapse (blast percentage 6%). Based on the prior swift response to R‐DHAP, re‐induction chemotherapy was executed with R‐DHAC (exchange of cisplatin for carboplatin due to progressive renal insufficiency). Upon one cycle of R‐DHAC, the peripheral blood was cleared from BL blasts, and a second ASCT from the same donor was performed using cryopreserved stem cells. Acute skin GvHD grade two developed within a few weeks after the second ASCT and was treated with prednisolone. One month after the second ASCT, the patient was hospitalized for worsening general condition and acute kidney failure. Bone marrow biopsy once again revealed relapse of BL. Moreover, paralysis of the right leg prompted a diagnostic lumbar puncture, and analysis of cerebral spinal fluid revealed meningeosis leucemica. Despite immediate treatment with systemic dexamethasone and vindesine coupled with intrathecal injection of cytarabine, MTX and dexamethasone, the general condition as well as the vigilance of the patient deteriorated. Given the dismal prognosis, the treatment was switched to palliative care, and the patient died 20 months after receiving the diagnosis of BL.
4.179688
0.964355
sec[1]/p[0]
en
0.999995
PMC9422005
https://doi.org/10.1002/jha2.501
[ "bone", "marrow", "block", "chemotherapy", "asct", "rituximab", "biopsy", "imaging", "dexamethasone", "cells" ]
[ { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "3A70.Z", "title": "Aplastic anaemia, unspecified" }, { "code": "3C0Y", "title": "Other specified diseases of the blood or blood-forming organs" }, { "code": "3A70.12", "title": "Idiopathic aplastic anaemia" }, { "code": "NE84", "title": "Failure or rejection of transplanted organs or tissues" } ]
=== ICD-11 CODES FOUND === [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [3A70.Z] Aplastic anaemia, unspecified Also known as: Aplastic anaemia, unspecified | Aplastic anaemia | erythroid aplasia | AA - [aplastic anaemia] | haematopoietic aplasia [3C0Y] Other specified diseases of the blood or blood-forming organs Also known as: Other specified diseases of the blood or blood-forming organs | Congenital anomaly blood or lymph other | Blood dyscrasia | blood dyscrasia NOS | Bone marrow hyperplasia [3A70.12] Idiopathic aplastic anaemia Also known as: Idiopathic aplastic anaemia | Idiopathic bone marrow failure | idiopathic aplastic anaemia NOS [NE84] Failure or rejection of transplanted organs or tissues Also known as: Failure or rejection of transplanted organs or tissues | organ transplant rejection | transplant failure | transplant rejection | Bone-marrow transplant rejection === GRAPH WALKS === --- Walk 1 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Monogenic autoinflammatory syndromes Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies.... --- Walk 2 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --EXCLUDES--> [?] Endocrine, nutritional or metabolic diseases Def: This chapter includes endocrine diseases, nutritional diseases as well as metabolic diseases.... --- Walk 3 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --EXCLUDES--> [?] Infection of vertebra Def: A condition of the vertebrae, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition commonly presents with fever, chills, headache, weight loss, or may be asympto... --- Walk 4 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --EXCLUDES--> [?] Inflammatory conditions of jaws --- Walk 5 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopoikilosis --- Walk 6 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopetrosis Def: Osteopetrosis ('marble bone disease') is a descriptive term that refers to a group of rare, heritable disorders of the skeleton characterised by increased bone density on radiographs. Osteopetrotic co...
[ "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Monogenic autoinflammatory syndromes\n Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies....", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --EXCLUDES--> [?] Endocrine, nutritional or metabolic diseases\n Def: This chapter includes endocrine diseases, nutritional diseases as well as metabolic diseases....", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --EXCLUDES--> [?] Infection of vertebra\n Def: A condition of the vertebrae, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition commonly presents with fever, chills, headache, weight loss, or may be asympto...", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --EXCLUDES--> [?] Inflammatory conditions of jaws", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopoikilosis", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopetrosis\n Def: Osteopetrosis ('marble bone disease') is a descriptive term that refers to a group of rare, heritable disorders of the skeleton characterised by increased bone density on radiographs. Osteopetrotic co..." ]
FC0Z
Diseases of the musculoskeletal system or connective tissue, unspecified
[ { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X6", "icd10_title": "Other osteomyelitis, lower leg" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X9", "icd10_title": "Other osteomyelitis, unspecified sites" }, { "from_icd11": "FB84.Z", "icd10_code": "M8668", "icd10_title": "Other chronic osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M86662", "icd10_title": "Other chronic osteomyelitis, left tibia and fibula" }, { "from_icd11": "FB84.Z", "icd10_code": "M86151", "icd10_title": "Other acute osteomyelitis, right femur" }, { "from_icd11": "FB84.Z", "icd10_code": "M86141", "icd10_title": "Other acute osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M86641", "icd10_title": "Other chronic osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M8669", "icd10_title": "Other chronic osteomyelitis, multiple sites" } ]
XIII
Because of the rarity of this infection in the industrialized countries, considering patient's anamnesis (she referred to be a housewife with no recent travels in endemic regions) and complex clinical picture, this finding is worthy of an accurate analysis. Colorectal perforation may be due to neoplastic, inflammatory, or ischemic disease as well as traumatic injuries. Complicated diverticulitis and colorectal cancer are the most common causes. 9 , 10 , 11 However, several benign etiologies should be taken into account except for trauma perforation (which include iatrogenic perforations, blunt abdominal trauma, and stab wounds) 9 , 12 , 13 , 14 , 15 excluded by clinical history, Necrotic acute pancreatitis, ulcerative colitis, stenosis of colorectal anastomosis with obstruction and idiopathic large bowel perforation are rarely mentioned (5.1%). 9 , 16 , 17 Hepatic and intestinal schistosomiasis is the most common form of the chronic disease and usually results from heavy Schistosoma mansoni infection. 18 , 19 Egg‐laying worms are present in the intestinal microvessels especially in the distribution of the inferior mesenteric venous plexus. In the large intestine, Schistosoma eggs are mainly distributed in the loose submucosa and in the subserosa layer where infrequently make multiple granulomas. Subsequently, the infection involves the muscularis mucosa and the overlying mucosa is either denuded forming small superficial ulcers and hyperplastic changes. Sandy patches develop when the submucosa becomes thickened by fibrous tissue containing several calcified eggs; the overlying mucosa becomes atrophic and acquires a granular dirty yellowish appearance. 20 Colonic mucosa of affected patient is usually edematous and congested with petechial hemorrhage in acute schistosomal colitis cases. 21 Ulceration is common; the ulcerated areas appear blackish gray in color caused by superficial hemorrhage and are frequently secondarily infected. At this point, intestinal schistosomiasis can be diagnosed by finding eggs in tissue specimens from rectal and intestinal biopsies. 22 According to our macroscopic and microscopic report, we can attribute the perforation to parasitic large bowel infection. Ectopic schistosomiasis occurs when the parasite eggs or adult forms are located far from the portal system. Ectopic eggs deposition can lead to additional clinical syndromes, including involvement of skin, lungs, brain, muscles, adrenal glands, genitalia, and eyes. In this report, thanks to the CT‐images, we can support the hypothesis of a systemic case of chronic schistosomiasis. CT scan of the thorax detected two calcific nodules as unspecified opacities in the upper lobe of the right lung (10 and 5 mm diameter max). No history of dyspnea was referred with no significant findings at physical examination. Pulmonary schistosomiasis, although rare, can be divided into two categories: acute and chronic. Chronic and recurrent infection develops in persons living or traveling in endemic areas. 23 The common signs at the chest CT scan in pulmonary schistosomiasis are multiple small pulmonary nodules ranging from 2 to 15 mm with ground glass opacity halo such as in our case report. 24 This patient did not report gynecological history. Abdominal CT scan identified a small left ovarian cyst, with partially defined borders, calcific walls, and internal fluid. According to the data in literature, the ovaries are the most affected organs in case of female genital schistosomiasis via the rectovaginal septum blood flow. 25 , 26 The typical radiological presentation consists in calcific aspect of the mass due to the presence of schistosomal granulomas surrounding eggs of S mansoni with sovrafluid content forming by inflammatory response. 28 These signs are expected in cases of chronic genital schistosomiasis infection and were detected in our patient. Despite the age of the patient (63 years), we did not perform the left ovariectomy because the emergency surgical management was aimed to treat the acute condition and we thought to make the ovariectomy at the same time of recanalization. Abdominal CT scan showed adenoma‐like lesions in the right and left adrenal gland. 29 , 30 We did not find any previously reported cases of adrenal ectopic schistosomiasis but we can mention a single case report of an adrenal schistosomiasis incidentally diagnosed in association with adenoma. 36 In our case report, we do not have an histopatological examination of the adrenal gland because there is no indication to perform an adrenal biopsy or adrenalectomy in urgent setting with no specific diagnosis, but the association with the peculiar clinical presentation, the histological diagnosis of schistosomiasis and the CT scan findings can support the suspect of systemic schistosomiasis with probable adrenal involvement. In this case report, we treated an acute event, intestinal perforation, caused by systemic schistosomiasis. The preoperative suspicion, however, would not have changed our surgical management due to severe septic shock.
4.304688
0.651367
sec[2]/p[0]
en
0.999997
31110726
https://doi.org/10.1002/ccr3.2138
[ "schistosomiasis", "adrenal", "this", "infection", "eggs", "perforation", "intestinal", "scan", "common", "mucosa" ]
[ { "code": "1F86.Z", "title": "Schistosomiasis due to unspecified or unknown Schistosoma species" }, { "code": "1F86.1", "title": "Schistosomiasis due to Schistosoma mansoni" }, { "code": "1F86.0", "title": "Schistosomiasis due to Schistosoma haematobium" }, { "code": "1F86.2", "title": "Schistosomiasis due to Schistosoma japonicum" }, { "code": "1F86.3", "title": "Other schistosomiases" }, { "code": "5A76.Y", "title": "Other specified disorders of adrenal gland" }, { "code": "5A7Z", "title": "Disorders of the adrenal glands or adrenal hormone system, unspecified" }, { "code": "5A74.Z", "title": "Adrenocortical insufficiency, unspecified" }, { "code": "5A74.Y", "title": "Other specified adrenocortical insufficiency" }, { "code": "LC8Z", "title": "Structural developmental anomalies of the adrenal glands, unspecified" } ]
=== ICD-11 CODES FOUND === [1F86.Z] Schistosomiasis due to unspecified or unknown Schistosoma species Also known as: Schistosomiasis due to unspecified or unknown Schistosoma species | Schistosomiasis | Bilharziasis | snail fever | acute schistosomiasis [1F86.1] Schistosomiasis due to Schistosoma mansoni Definition: A disease caused by an infection with the parasitic worm Schistosoma mansoni. This disease commonly presents with Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fibrosis, or portal hypertension. This disease may also present with embolic egg granulomas in the brain or spinal cord. Transmission is by direct contact with freshwater that has been contaminated with Schistosoma mansoni eggs or snails that carry Schistosoma mansoni. Confirmation is by identificati Also known as: Schistosomiasis due to Schistosoma mansoni | schistosomiasis mansoni | schistosomiasis manson | Schistosomiasis due to Schistosoma mansoni [intestinal schistosomiasis] | intestinal schistosomiasis NOS [1F86.0] Schistosomiasis due to Schistosoma haematobium Definition: A disease caused by an infection with the parasitic worm Schistosoma haematobium. This disease is characterised by haematuria, scarring, calcification, or squamous cell carcinoma. This disease may also present with embolic egg granulomas in the brain or spinal cord. Transmission is by direct contact with freshwater that has been contaminated with Schistosoma haematobium eggs or snails that carry Schistosoma haematobium. Also known as: Schistosomiasis due to Schistosoma haematobium | genitourinary bilharziasis | genitourinary tract schistosomiasis | schistosoma haematobium infection | haematochyluria in schistosomiasis [1F86.2] Schistosomiasis due to Schistosoma japonicum Definition: A disease caused by an infection with the parasitic worm Schistosoma japonicum. This disease is characterised by Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fibrosis, or portal hypertension. This disease may also present with embolic egg granulomas in the brain or spinal cord. Transmission is by direct contact with freshwater that has been contaminated with Schistosoma japonicum eggs or snails that carry Schistosoma japonicum. Confirmation is by identific Also known as: Schistosomiasis due to Schistosoma japonicum | Asiatic schistosomiasis | eastern schistosomiasis | schistosoma japonicum infection | schistosomiasis japonicum Includes: Asiatic schistosomiasis [1F86.3] Other schistosomiases Also known as: Other schistosomiases | Schistosomiasis due to Schistosoma intercalatum | Schistosomiasis due to Schistosoma mekongi | Schistosomiasis bovi | Schistosomiasis mattheei [5A76.Y] Other specified disorders of adrenal gland Also known as: Other specified disorders of adrenal gland | Suprarenal gland abscess | Suprarenal abscess | Adrenal gland inflammation | adrenal glandular inflammation [5A7Z] Disorders of the adrenal glands or adrenal hormone system, unspecified Also known as: Disorders of the adrenal glands or adrenal hormone system, unspecified | Adrenal gland disease, not elsewhere classified | adrenal cortex disease | adrenal cortical disease | adrenal glandular disease [5A74.Z] Adrenocortical insufficiency, unspecified Also known as: Adrenocortical insufficiency, unspecified | Adrenocortical insufficiency | adrenal failure NOS | Hypoadrenocorticism | adrenocortical hypofunction [5A74.Y] Other specified adrenocortical insufficiency Also known as: Other specified adrenocortical insufficiency | Congenital adrenocortical insufficiency | Congenital isolated ACTH deficiency | Familial adrenal hypoplasia | Familial hypoadrenocorticism [LC8Z] Structural developmental anomalies of the adrenal glands, unspecified Also known as: Structural developmental anomalies of the adrenal glands, unspecified | adrenal anomaly | adrenal gland anomaly | congenital anomaly of adrenal gland | congenital malformation of adrenal gland === GRAPH WALKS === --- Walk 1 --- [1F86.Z] Schistosomiasis due to unspecified or unknown Schistosoma species --PARENT--> [1F86] Schistosomiasis Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder.... --CHILD--> [1F86.2] Schistosomiasis due to Schistosoma japonicum Def: A disease caused by an infection with the parasitic worm Schistosoma japonicum. This disease is characterised by Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fi... --- Walk 2 --- [1F86.Z] Schistosomiasis due to unspecified or unknown Schistosoma species --PARENT--> [1F86] Schistosomiasis Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder.... --CHILD--> [1F86.1] Schistosomiasis due to Schistosoma mansoni Def: A disease caused by an infection with the parasitic worm Schistosoma mansoni. This disease commonly presents with Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal f... --- Walk 3 --- [1F86.1] Schistosomiasis due to Schistosoma mansoni Def: A disease caused by an infection with the parasitic worm Schistosoma mansoni. This disease commonly presents with Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal f... --PARENT--> [1F86] Schistosomiasis Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder.... --CHILD--> [1F86.2] Schistosomiasis due to Schistosoma japonicum Def: A disease caused by an infection with the parasitic worm Schistosoma japonicum. This disease is characterised by Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fi... --- Walk 4 --- [1F86.1] Schistosomiasis due to Schistosoma mansoni Def: A disease caused by an infection with the parasitic worm Schistosoma mansoni. This disease commonly presents with Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal f... --PARENT--> [1F86] Schistosomiasis Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder.... --CHILD--> [1F86.2] Schistosomiasis due to Schistosoma japonicum Def: A disease caused by an infection with the parasitic worm Schistosoma japonicum. This disease is characterised by Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fi... --- Walk 5 --- [1F86.0] Schistosomiasis due to Schistosoma haematobium Def: A disease caused by an infection with the parasitic worm Schistosoma haematobium. This disease is characterised by haematuria, scarring, calcification, or squamous cell carcinoma. This disease may als... --PARENT--> [1F86] Schistosomiasis Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder.... --CHILD--> [1F86.0] Schistosomiasis due to Schistosoma haematobium Def: A disease caused by an infection with the parasitic worm Schistosoma haematobium. This disease is characterised by haematuria, scarring, calcification, or squamous cell carcinoma. This disease may als... --- Walk 6 --- [1F86.0] Schistosomiasis due to Schistosoma haematobium Def: A disease caused by an infection with the parasitic worm Schistosoma haematobium. This disease is characterised by haematuria, scarring, calcification, or squamous cell carcinoma. This disease may als... --PARENT--> [1F86] Schistosomiasis Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder.... --CHILD--> [1F86.1] Schistosomiasis due to Schistosoma mansoni Def: A disease caused by an infection with the parasitic worm Schistosoma mansoni. This disease commonly presents with Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal f...
[ "[1F86.Z] Schistosomiasis due to unspecified or unknown Schistosoma species\n --PARENT--> [1F86] Schistosomiasis\n Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder....\n --CHILD--> [1F86.2] Schistosomiasis due to Schistosoma japonicum\n Def: A disease caused by an infection with the parasitic worm Schistosoma japonicum. This disease is characterised by Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fi...", "[1F86.Z] Schistosomiasis due to unspecified or unknown Schistosoma species\n --PARENT--> [1F86] Schistosomiasis\n Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder....\n --CHILD--> [1F86.1] Schistosomiasis due to Schistosoma mansoni\n Def: A disease caused by an infection with the parasitic worm Schistosoma mansoni. This disease commonly presents with Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal f...", "[1F86.1] Schistosomiasis due to Schistosoma mansoni\n Def: A disease caused by an infection with the parasitic worm Schistosoma mansoni. This disease commonly presents with Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal f...\n --PARENT--> [1F86] Schistosomiasis\n Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder....\n --CHILD--> [1F86.2] Schistosomiasis due to Schistosoma japonicum\n Def: A disease caused by an infection with the parasitic worm Schistosoma japonicum. This disease is characterised by Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fi...", "[1F86.1] Schistosomiasis due to Schistosoma mansoni\n Def: A disease caused by an infection with the parasitic worm Schistosoma mansoni. This disease commonly presents with Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal f...\n --PARENT--> [1F86] Schistosomiasis\n Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder....\n --CHILD--> [1F86.2] Schistosomiasis due to Schistosoma japonicum\n Def: A disease caused by an infection with the parasitic worm Schistosoma japonicum. This disease is characterised by Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fi...", "[1F86.0] Schistosomiasis due to Schistosoma haematobium\n Def: A disease caused by an infection with the parasitic worm Schistosoma haematobium. This disease is characterised by haematuria, scarring, calcification, or squamous cell carcinoma. This disease may als...\n --PARENT--> [1F86] Schistosomiasis\n Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder....\n --CHILD--> [1F86.0] Schistosomiasis due to Schistosoma haematobium\n Def: A disease caused by an infection with the parasitic worm Schistosoma haematobium. This disease is characterised by haematuria, scarring, calcification, or squamous cell carcinoma. This disease may als...", "[1F86.0] Schistosomiasis due to Schistosoma haematobium\n Def: A disease caused by an infection with the parasitic worm Schistosoma haematobium. This disease is characterised by haematuria, scarring, calcification, or squamous cell carcinoma. This disease may als...\n --PARENT--> [1F86] Schistosomiasis\n Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder....\n --CHILD--> [1F86.1] Schistosomiasis due to Schistosoma mansoni\n Def: A disease caused by an infection with the parasitic worm Schistosoma mansoni. This disease commonly presents with Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal f..." ]
1F86.Z
Schistosomiasis due to unspecified or unknown Schistosoma species
[ { "from_icd11": "1F86.Z", "icd10_code": "B659", "icd10_title": "Schistosomiasis, unspecified" }, { "from_icd11": "1F86.Z", "icd10_code": "B658", "icd10_title": "Other schistosomiasis" }, { "from_icd11": "1F86.Z", "icd10_code": "B65", "icd10_title": "Schistosomiasis [bilharziasis]" }, { "from_icd11": "1F86.1", "icd10_code": "B651", "icd10_title": "Schistosomiasis due to Schistosoma mansoni [intestinal schistosomiasis]" }, { "from_icd11": "1F86.0", "icd10_code": "B650", "icd10_title": "Schistosomiasis due to Schistosoma haematobium [urinary schistosomiasis]" }, { "from_icd11": "1F86.0", "icd10_code": "N220", "icd10_title": "" }, { "from_icd11": "1F86.2", "icd10_code": "B652", "icd10_title": "Schistosomiasis due to Schistosoma japonicum" }, { "from_icd11": "5A7Z", "icd10_code": "E2740", "icd10_title": "Unspecified adrenocortical insufficiency" }, { "from_icd11": "5A7Z", "icd10_code": "E2749", "icd10_title": "Other adrenocortical insufficiency" }, { "from_icd11": "5A7Z", "icd10_code": "E279", "icd10_title": "Disorder of adrenal gland, unspecified" }, { "from_icd11": "5A7Z", "icd10_code": "E27", "icd10_title": "Other disorders of adrenal gland" }, { "from_icd11": "5A7Z", "icd10_code": "E274", "icd10_title": "Other and unspecified adrenocortical insufficiency" }, { "from_icd11": "LC8Z", "icd10_code": "Q891", "icd10_title": "Congenital malformations of adrenal gland" } ]
B659
Schistosomiasis, unspecified
Prior to surgery, parts of the table top of the surgical table were removed and replaced by a non-metal containing insert which is part of our carefully selected table setup (Maquet, Getinge) for intraoperative imaging purposes . The patient was positioned in supine position as usual for abdominopelvic surgery using a median laparotomy with the pelvis located on the insert. Surgery was performed in our dedicated IOERT suite at the department of radiation oncology by a visceral surgeon specialized in the treatment of colorectal cancer. Gross total resection was achieved including partial resection of the directly adjacent right ureter, but margins to the pelvic side wall were very close according to the surgeons judgement. A circular shaped 30° beveled IOERT applicator (Polyoxymethylene, POM-C) of 6 cm diameter was placed to cover the tumor bed by the surgeon and the radiation oncologist together . Bladder, rectal stump and both ends of the right ureter were securely placed outside the irradiation area. All dispensable metal-containing surgical equipment was removed and the patient was wrapped with sterile covers . The mobile ImagingRing (medPhoton GmbH), which is a moveable cone-beam CT scanner with a large effective bore of 102 cm diameter capable of covering a field of view (FoV) of 49.1 × 49.1 × 25.4 cm 3 , was positioned around the patient above the applicator . The large FoV allows the mapping of the tumor bed, partially the IOERT applicator and the surrounding anatomical structures. Two orthogonal X-ray images were taken prior to 3-D imaging to define an appropriate elliptically shaped scanning volume, which is subsequently captured in the course of CBCT acquisition using the dynamically moveable independent arms and four independently moveable collimator jaws to accurately image the region of interest (ROI) from all encountered viewing angles. The image acquisition system is further equipped with a time-of-flight laser for collision detection. As the system cannot distinguish whether the obstacle of a possible collision is rigid or flexible, all sterile covers were placed inside the cylinder defined by the effective gantry bore and a dry run was performed prior to the essential imaging to prevent a stop in rotation during imaging. CBCT images were acquired via remote control from outside the operation room. They showed a slightly incorrect applicator position based on comparison with the preoperative imaging, therefore the applicator was moved accordingly . A second CBCT scan revealed a correct applicator position and was transferred to our treatment planning system (Radiance, GMV). Based on the surgeons assessment of a gross total resection and to prevent neuropathy in the directly adjacent sciatic nerve, the prescription dose was restricted to 12 Gy . The mobile ImagingRing features an automated scaling (heuristic object and head scatter correction as well as beam hardening correction) of Hounsfield Units (HU), which was checked for the used imaging preset prior to clinical introduction by suitable standardized phantoms with inserts of differing densities (Lung: − 774HU ± 90HU, soft tissue: − 43 ± 58, bone: 712HU ± 221HU). This allows the application of one density conversion table independent of imaging preset, geometry, and patient anatomy, for standard clinical cases (in particular predominantly water equivalent tissue and low artefact disturbance). Dose calculation in the TPS (Radiance) uses a Monte Carlo algorithm and is based on a beam model consisting of phase-space files (PSF) created from water phantom measurements. The PSF was shortened 4 cm in front of the end of the tube by the manufacturer to take into account the volume of tissue and air within the tube . In the current case, a dose distribution attempting to cover a tissue depth of 1 cm for the elliptic sectional plane under the tube with 12 Gy (corresponding to the 90% isodose) and the adequate monitor units using 9 MeV electrons was calculated . During dose calculation, the patient was moved beneath the linear accelerator (Mobetron, IntraOP) including all anesthesia equipment . After automated soft-docking, intraoperative irradiation was performed via remote control from outside the operation room, while the patient was monitored via video. After finishing the irradiation treatment, the patient was moved to the initial position and the applicator was removed from the patient. Surgery was finished by the visceral surgeons including a reconstruction of the partly resected ureter using the psoas-hitch technique by a urological surgeon. Fig. 4 Carefully selected operating table setup with fully X-rays capable part between table Column and leg positioning device Fig. 5 IOERT-Applicator placed in treatment position Fig. 6 Patient wrapped in sterile covers with mobile ImagingRing in image acquisition position Fig. 7 Cone-beam CT scans prior to and after correction of the applicator position Fig. 8 Dose distribution calculated on intraoperative cone-beam CT Fig. 9 Patient in treatment position after soft-docking
4.0625
0.450928
sec[1]/sec[0]/p[0]
en
0.999997
37950314
https://doi.org/10.1186/s13014-023-02374-6
[ "applicator", "position", "imaging", "beam", "which", "using", "ioert", "tissue", "intraoperative", "surgeon" ]
[ { "code": "EH70", "title": "Pigmentary abnormalities of skin due to drug" }, { "code": "PL11.Y", "title": "Other specified mode of injury or harm associated with a surgical or other medical procedure" }, { "code": "PJ47", "title": "Legal intervention involving application of physical force" }, { "code": "JB0D.7", "title": "Failed application of vacuum extractor or forceps, unspecified" }, { "code": "8A83", "title": "Other primary headache disorder" }, { "code": "MA14.14", "title": "Anti-nuclear antibody positive" }, { "code": "MA14.1E", "title": "Rheumatoid factor positive" }, { "code": "MA14.12", "title": "Anticitrullinated protein antibody positive" }, { "code": "MA14.10", "title": "Abnormal reaction to tuberculin test" }, { "code": "JA82.1", "title": "Maternal care for breech presentation" } ]
=== ICD-11 CODES FOUND === [EH70] Pigmentary abnormalities of skin due to drug Definition: Disturbances of skin colour due to an ingested or injected drug. These may result from a number of different mechanisms including the colour of the drug itself, disturbed melanisation of the skin or deposition of pigments by drug breakdown products. Also known as: Pigmentary abnormalities of skin due to drug | drug application site discolouration | discolouration of skin due to drug | Drug-induced hypermelanosis | Drug-induced hypomelanosis [PL11.Y] Other specified mode of injury or harm associated with a surgical or other medical procedure Also known as: Other specified mode of injury or harm associated with a surgical or other medical procedure | Other specified mode, as mode of injury or harm | Overdose of radiation given during therapy | overdose of radiation | radiation overdose [PJ47] Legal intervention involving application of physical force Also known as: Legal intervention involving application of physical force [JB0D.7] Failed application of vacuum extractor or forceps, unspecified Also known as: Failed application of vacuum extractor or forceps, unspecified | Failed application of ventouse or forceps, with subsequent delivery by forceps or caesarean section respectively Includes: Failed application of ventouse or forceps, with subsequent delivery by forceps or caesarean section respectively [8A83] Other primary headache disorder Definition: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attributed to direct physical but innocuous stimuli; epicranial headaches; and other miscellaneous primary headache disorders. Also known as: Other primary headache disorder | Primary cough headache | Primary exercise headache | Primary headache associated with sexual activity | Preorgasmic headache [MA14.14] Anti-nuclear antibody positive Also known as: Anti-nuclear antibody positive | ANA - [anti-nuclear antibody] positive [MA14.1E] Rheumatoid factor positive Also known as: Rheumatoid factor positive | RF- [rheumatoid factor] positive [MA14.12] Anticitrullinated protein antibody positive Also known as: Anticitrullinated protein antibody positive | ACPA - [anticitrullinated protein antibody] positive | CCP - [cyclic citrullinated peptide] antibody positive [MA14.10] Abnormal reaction to tuberculin test Also known as: Abnormal reaction to tuberculin test | Abnormal reaction to tuberculin test without active tuberculosis | Abnormal result of Mantoux test | abnormal mantoux test | PPD positive [JA82.1] Maternal care for breech presentation Also known as: Maternal care for breech presentation | breech fetal presentation | breech presentation | malposition of fetus in breech presentation | positions of breech presentation === GRAPH WALKS === --- Walk 1 --- [EH70] Pigmentary abnormalities of skin due to drug Def: Disturbances of skin colour due to an ingested or injected drug. These may result from a number of different mechanisms including the colour of the drug itself, disturbed melanisation of the skin or d... --RELATED_TO--> [?] Non-melanin pigmentation due to drug Def: Discolouration of the skin due to deposition of pigments from drugs or their metabolites, usually after long-term use. Well-known causes include minocycline, mepacrine, clofazimine and amiodarone.... --PARENT--> [?] Pigmentary abnormalities of skin due to drug Def: Disturbances of skin colour due to an ingested or injected drug. These may result from a number of different mechanisms including the colour of the drug itself, disturbed melanisation of the skin or d... --- Walk 2 --- [EH70] Pigmentary abnormalities of skin due to drug Def: Disturbances of skin colour due to an ingested or injected drug. These may result from a number of different mechanisms including the colour of the drug itself, disturbed melanisation of the skin or d... --RELATED_TO--> [?] Non-melanin pigmentation due to drug Def: Discolouration of the skin due to deposition of pigments from drugs or their metabolites, usually after long-term use. Well-known causes include minocycline, mepacrine, clofazimine and amiodarone.... --PARENT--> [?] Pigmentary abnormalities of skin due to drug Def: Disturbances of skin colour due to an ingested or injected drug. These may result from a number of different mechanisms including the colour of the drug itself, disturbed melanisation of the skin or d... --- Walk 3 --- [PL11.Y] Other specified mode of injury or harm associated with a surgical or other medical procedure --PARENT--> [PL11] Mode of injury or harm associated with a surgical or other medical procedure --CHILD--> [PL11.0] Cut, puncture or tear, as mode of injury or harm Def: The cut or puncture occurs when a solid organ or blood vessel or nerve is unintentionally lacerated or otherwise damaged during a surgical or medical procedure. The cut or puncture must not be require... --- Walk 4 --- [PL11.Y] Other specified mode of injury or harm associated with a surgical or other medical procedure --PARENT--> [PL11] Mode of injury or harm associated with a surgical or other medical procedure --EXCLUDES--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 5 --- [PJ47] Legal intervention involving application of physical force --PARENT--> [?] Legal intervention --CHILD--> [PJ42] Legal intervention involving blunt object --- Walk 6 --- [PJ47] Legal intervention involving application of physical force --PARENT--> [?] Legal intervention --CHILD--> [PJ40] Legal intervention involving projectile from firearm
[ "[EH70] Pigmentary abnormalities of skin due to drug\n Def: Disturbances of skin colour due to an ingested or injected drug. These may result from a number of different mechanisms including the colour of the drug itself, disturbed melanisation of the skin or d...\n --RELATED_TO--> [?] Non-melanin pigmentation due to drug\n Def: Discolouration of the skin due to deposition of pigments from drugs or their metabolites, usually after long-term use. Well-known causes include minocycline, mepacrine, clofazimine and amiodarone....\n --PARENT--> [?] Pigmentary abnormalities of skin due to drug\n Def: Disturbances of skin colour due to an ingested or injected drug. These may result from a number of different mechanisms including the colour of the drug itself, disturbed melanisation of the skin or d...", "[EH70] Pigmentary abnormalities of skin due to drug\n Def: Disturbances of skin colour due to an ingested or injected drug. These may result from a number of different mechanisms including the colour of the drug itself, disturbed melanisation of the skin or d...\n --RELATED_TO--> [?] Non-melanin pigmentation due to drug\n Def: Discolouration of the skin due to deposition of pigments from drugs or their metabolites, usually after long-term use. Well-known causes include minocycline, mepacrine, clofazimine and amiodarone....\n --PARENT--> [?] Pigmentary abnormalities of skin due to drug\n Def: Disturbances of skin colour due to an ingested or injected drug. These may result from a number of different mechanisms including the colour of the drug itself, disturbed melanisation of the skin or d...", "[PL11.Y] Other specified mode of injury or harm associated with a surgical or other medical procedure\n --PARENT--> [PL11] Mode of injury or harm associated with a surgical or other medical procedure\n --CHILD--> [PL11.0] Cut, puncture or tear, as mode of injury or harm\n Def: The cut or puncture occurs when a solid organ or blood vessel or nerve is unintentionally lacerated or otherwise damaged during a surgical or medical procedure. The cut or puncture must not be require...", "[PL11.Y] Other specified mode of injury or harm associated with a surgical or other medical procedure\n --PARENT--> [PL11] Mode of injury or harm associated with a surgical or other medical procedure\n --EXCLUDES--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[PJ47] Legal intervention involving application of physical force\n --PARENT--> [?] Legal intervention\n --CHILD--> [PJ42] Legal intervention involving blunt object", "[PJ47] Legal intervention involving application of physical force\n --PARENT--> [?] Legal intervention\n --CHILD--> [PJ40] Legal intervention involving projectile from firearm" ]
EH70
Pigmentary abnormalities of skin due to drug
[ { "from_icd11": "EH70", "icd10_code": "T788XXA", "icd10_title": "Other adverse effects, not elsewhere classified, initial encounter" }, { "from_icd11": "EH70", "icd10_code": "T788XXS", "icd10_title": "Other adverse effects, not elsewhere classified, sequela" }, { "from_icd11": "EH70", "icd10_code": "T788", "icd10_title": "Other adverse effects, not elsewhere classified" }, { "from_icd11": "JB0D.7", "icd10_code": "O665", "icd10_title": "Attempted application of vacuum extractor and forceps" }, { "from_icd11": "8A83", "icd10_code": "G44209", "icd10_title": "Tension-type headache, unspecified, not intractable" }, { "from_icd11": "8A83", "icd10_code": "G44221", "icd10_title": "Chronic tension-type headache, intractable" }, { "from_icd11": "8A83", "icd10_code": "G44229", "icd10_title": "Chronic tension-type headache, not intractable" }, { "from_icd11": "8A83", "icd10_code": "G44201", "icd10_title": "Tension-type headache, unspecified, intractable" }, { "from_icd11": "8A83", "icd10_code": "G44219", "icd10_title": "Episodic tension-type headache, not intractable" }, { "from_icd11": "8A83", "icd10_code": "G442", "icd10_title": "Tension-type headache" }, { "from_icd11": "MA14.10", "icd10_code": "R7611", "icd10_title": "Nonspecific reaction to tuberculin skin test without active tuberculosis" }, { "from_icd11": "MA14.10", "icd10_code": "R7612", "icd10_title": "Nonspecific reaction to cell mediated immunity measurement of gamma interferon antigen response without active tuberculosis" }, { "from_icd11": "MA14.10", "icd10_code": "R761", "icd10_title": "Nonspecific reaction to test for tuberculosis" }, { "from_icd11": "JA82.1", "icd10_code": "O321XX2", "icd10_title": "Maternal care for breech presentation, fetus 2" }, { "from_icd11": "JA82.1", "icd10_code": "O321XX1", "icd10_title": "Maternal care for breech presentation, fetus 1" } ]
T788XXA
Other adverse effects, not elsewhere classified, initial encounter
A 30-year-old male presented to our clinic with inability to extend all fingers at the metacarpophalangeal joints of the left hand. One year prior to his presentation, he was involved in a car accident and was treated at a local hospital. The medical report indicated that the injury involved the dorsal aspect of the hand, wrist and forearm. There was degloving of the skin without skin loss. However, there was extensor tendon loss of all fingers extending from the proximal one third of zone 6 to zone 8 (including the musculotendinous junctions). Other than debridement, nothing was done to the extensor tendons; and the skin was closed primarily. On examination, there was no active extension at the metacarpophalangeal joints. There was no stiffness with full passive extension at the metacarpophalangeal joints. There were no deficits in active wrist extension/ finger flexion. The overlying skin was scarred but was thought to be adequate for soft tissue coverage. Two-staged extensor tendon reconstruction was planned. However, clinical examination showed the absence of palmaris longus tendon bilaterally. Ultrasound examination also showed the absence of plantaris tendon bilaterally. The patient was counselled regarding choices of the other sources of tendon grafts including: multiple toe extensors, “split” tensor fascia lata, and “split” flexor carpi radialis. The latter option was chosen and surgery was planned. In the first stage, exploration confirmed the presence of extensor tendon defects from the proximal one third of zone 6 to zone 8; including the musculotendinous junctions . Four silicone rods were inserted. The rods were sutured distally to the remnants of the extensor tendons at the dorsum of the hand. All 4 rods were left free (un-sutured) in the distal forearm . the patient resumed passive exercises of the metacarpophalangeal joints post-operatively to prevent stiffness. The second stage was done five months later . The flexor carpi ulnaris tendon was cut near its insertion and was then transferred to the dorso-ulnar aspect of the forearm. The tendon of flexor carpi radialis was harvested as a tendon graft. The tendon graft was split distally in 4 slips on the operating table. The proximal tendon repair was done first between the transferred flexor carpi ulnaris tendon and the tendon graft using multiple figure-of-eight 3/0 polypropylene sutures. The splits of the flexor carpi radialis tendon graft were sutured to the proximal ends of the silicone rods. Each rod was then pulled out from the distal end; thereby introducing each slip into its corresponding pseudo-sheath induced by the rod. Each slip was then weaved through the corresponding remnant of the extensor tendon; and suturing was done using 4/0 polypropylene sutures . In order to adjust tension of the repair, the wrist was positioned in 30° of extension. Tightening of the distal tendon repair was then done so that the metacarpophalangeal joints were 20° short of the full extension. A plaster cast was applied to the hand and the wrist to protect the repair. The cast was removed at 5 weeks and physiotherapy exercises were started. There were no post-operative complications. At final follow up (1 year later), full active wrist extension/ finger flexion was maintained . Full active extension of the fingers at the metacarpophalangeal joints was demonstrated with slight wrist flexion . As expected, active wrist flexion was limited to 20° because of the harvesting of the both wrist flexors . Power grip was 83% of the contra-lateral hand. The patient was satisfied with the result and resumed his original job as a manual worker without any reported difficulties. Fig. 1 Exploration showing the extensor tendon defects in zone 6–8. Note that the extensor tendons are preserved in the distal two thirds of Zone 6 and then all tendons fade into a scar in the proximal part of Zone 6 (arrow). Also note the relatively preserved skin at the zone of injury because of the nature of original injury (skin degloving without skin loss). Fig. 1 Fig. 2 insertion of the four silicone rods. Note that the rods are sutured distally; but are left free (un-sutured) proximally. Fig. 2 Fig. 3 Diagrammatic demonstration of the second stage. The motor tendon is the transferred flexor carpi ulnaris. The tendon graft is the flexor carpi radialis tendon which is split distally to 4 slips (one slip to each finger). The proximal tendon repair is done first. Adjustment of tension is done during the distal tendon repair between the slips of the tendon graft and the remnants of the extensor tendons. Fig. 3 Fig. 4 functional outcome at 1 year: Full active wrist extension/ finger flexion was maintained (as pre-operatively). Note the scars in the forearm from the tendon transfer and the harvesting of the tendon graft. Fig. 4 Fig. 5 functional outcome at 1 year: Full active finger extension with simultaneous mild wrist flexion. Fig. 5 Fig. 6 the only deficit noted at 1 year: Limitation of active wrist flexion attributed to harvesting of both wrist flexors. Fig. 6
3.9375
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en
0.999997
30716711
https://doi.org/10.1016/j.ijscr.2019.01.023
[ "tendon", "wrist", "extensor", "extension", "zone", "active", "skin", "flexion", "flexor", "carpi" ]
[ { "code": "FB4Z", "title": "Disorders of synovium or tendon, unspecified" }, { "code": "FB55.Z", "title": "Enthesopathies, unspecified" }, { "code": "FB4Y", "title": "Other specified disorders of synovium or tendon" }, { "code": "FB40.Y", "title": "Other specified tenosynovitis" }, { "code": "ND56.6", "title": "Injury of muscles or tendons of unspecified body region" }, { "code": "QF00", "title": "Acquired absence of limb" }, { "code": "NC54.6Y", "title": "Sprain of other specified part of wrist" }, { "code": "NC51.1Y&XA2J63&XJ1C6", "title": "Haematoma of wrist" }, { "code": "FA31.3", "title": "Acquired wrist drop" }, { "code": "FA31.Y", "title": "Other specified acquired deformities of limbs" } ]
=== ICD-11 CODES FOUND === [FB4Z] Disorders of synovium or tendon, unspecified Also known as: Disorders of synovium or tendon, unspecified | Disorder of tendon | tendon disorder [FB55.Z] Enthesopathies, unspecified Also known as: Enthesopathies, unspecified | Certain specified enthesopathies | Enthesopathy of elbow | enthesopathy of elbow region | Adhesive capsulitis not elsewhere classified [FB4Y] Other specified disorders of synovium or tendon Also known as: Other specified disorders of synovium or tendon | Shortening of tendon | short tendon | Shortening of tibialis anterior | Contracture of tendon [FB40.Y] Other specified tenosynovitis Also known as: Other specified tenosynovitis | Other tenosynovitis or tendinitis | synovitis NOS | Bicipital tendinitis | biceps tendinitis [ND56.6] Injury of muscles or tendons of unspecified body region Also known as: Injury of muscles or tendons of unspecified body region | Injury of muscle not elsewhere classified | Injury of tendon not elsewhere classified | Avulsion of muscle or tendon | Division of muscle Excludes: multiple injuries of tendons and muscles NOS [QF00] Acquired absence of limb Also known as: Acquired absence of limb | post traumatic loss of limb | postoperative loss of limb | bilateral amputee | amputee Includes: postoperative loss of limb | post traumatic loss of limb Excludes: Other acquired deformities of limbs | Congenital absence of thigh or lower leg with foot present | Congenital absence of both lower leg and foot [NC54.6Y] Sprain of other specified part of wrist Also known as: Sprain of other specified part of wrist | Strain of wrist | Strain or sprain of metacarpal | Strain or sprain of scaphoid [FA31.3] Acquired wrist drop Also known as: Acquired wrist drop | carpoptosis | drop hand | dropping hand | dropping wrist [FA31.Y] Other specified acquired deformities of limbs Also known as: Other specified acquired deformities of limbs | Acquired deformity of forearm | Deflection of radius | Bowing of the radius | Bowing of forearm === GRAPH WALKS === --- Walk 1 --- [FB4Z] Disorders of synovium or tendon, unspecified --PARENT--> [?] Disorders of synovium or tendon Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons.... --CHILD--> [FB41] Spontaneous rupture of synovium or tendon Def: This is a spontaneous rupture to a fluid-filled sac containing viscous fluid which normally acts to decrease friction and also provides a cushion between bones and tendons and/or muscles around a join... --- Walk 2 --- [FB4Z] Disorders of synovium or tendon, unspecified --PARENT--> [?] Disorders of synovium or tendon Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons.... --CHILD--> [FB42] Certain specified disorders of synovium or tendon --- Walk 3 --- [FB55.Z] Enthesopathies, unspecified --PARENT--> [FB55] Certain specified enthesopathies --CHILD--> [FB55.2] Periarthritis of wrist Def: This disorder is characterised by inflammation of tissues around the joints of the wrist.... --- Walk 4 --- [FB55.Z] Enthesopathies, unspecified --PARENT--> [FB55] Certain specified enthesopathies --EXCLUDES--> [?] Bursitis related to use, overuse or pressure Def: This is a disorder of inflammation of one or more bursae (small sacs) of synovial fluid in the body which usually results in pain and is caused by repetitive use, overuse and pressure irritation.... --- Walk 5 --- [FB4Y] Other specified disorders of synovium or tendon --PARENT--> [?] Disorders of synovium or tendon Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons.... --PARENT--> [?] Soft tissue disorders --- Walk 6 --- [FB4Y] Other specified disorders of synovium or tendon --PARENT--> [?] Disorders of synovium or tendon Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons.... --CHILD--> [FB41] Spontaneous rupture of synovium or tendon Def: This is a spontaneous rupture to a fluid-filled sac containing viscous fluid which normally acts to decrease friction and also provides a cushion between bones and tendons and/or muscles around a join...
[ "[FB4Z] Disorders of synovium or tendon, unspecified\n --PARENT--> [?] Disorders of synovium or tendon\n Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons....\n --CHILD--> [FB41] Spontaneous rupture of synovium or tendon\n Def: This is a spontaneous rupture to a fluid-filled sac containing viscous fluid which normally acts to decrease friction and also provides a cushion between bones and tendons and/or muscles around a join...", "[FB4Z] Disorders of synovium or tendon, unspecified\n --PARENT--> [?] Disorders of synovium or tendon\n Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons....\n --CHILD--> [FB42] Certain specified disorders of synovium or tendon", "[FB55.Z] Enthesopathies, unspecified\n --PARENT--> [FB55] Certain specified enthesopathies\n --CHILD--> [FB55.2] Periarthritis of wrist\n Def: This disorder is characterised by inflammation of tissues around the joints of the wrist....", "[FB55.Z] Enthesopathies, unspecified\n --PARENT--> [FB55] Certain specified enthesopathies\n --EXCLUDES--> [?] Bursitis related to use, overuse or pressure\n Def: This is a disorder of inflammation of one or more bursae (small sacs) of synovial fluid in the body which usually results in pain and is caused by repetitive use, overuse and pressure irritation....", "[FB4Y] Other specified disorders of synovium or tendon\n --PARENT--> [?] Disorders of synovium or tendon\n Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons....\n --PARENT--> [?] Soft tissue disorders", "[FB4Y] Other specified disorders of synovium or tendon\n --PARENT--> [?] Disorders of synovium or tendon\n Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons....\n --CHILD--> [FB41] Spontaneous rupture of synovium or tendon\n Def: This is a spontaneous rupture to a fluid-filled sac containing viscous fluid which normally acts to decrease friction and also provides a cushion between bones and tendons and/or muscles around a join..." ]
FB4Z
Disorders of synovium or tendon, unspecified
[ { "from_icd11": "FB4Z", "icd10_code": "M65-M68", "icd10_title": "" }, { "from_icd11": "FB55.Z", "icd10_code": "M779", "icd10_title": "Enthesopathy, unspecified" }, { "from_icd11": "FB55.Z", "icd10_code": "M778", "icd10_title": "Other enthesopathies, not elsewhere classified" }, { "from_icd11": "FB55.Z", "icd10_code": "M77", "icd10_title": "Other enthesopathies" }, { "from_icd11": "ND56.6", "icd10_code": "T146", "icd10_title": "" }, { "from_icd11": "QF00", "icd10_code": "Z89412", "icd10_title": "Acquired absence of left great toe" }, { "from_icd11": "QF00", "icd10_code": "Z89611", "icd10_title": "Acquired absence of right leg above knee" }, { "from_icd11": "QF00", "icd10_code": "Z89421", "icd10_title": "Acquired absence of other right toe(s)" }, { "from_icd11": "QF00", "icd10_code": "Z89431", "icd10_title": "Acquired absence of right foot" }, { "from_icd11": "QF00", "icd10_code": "Z89522", "icd10_title": "Acquired absence of left knee" }, { "from_icd11": "QF00", "icd10_code": "Z89411", "icd10_title": "Acquired absence of right great toe" }, { "from_icd11": "QF00", "icd10_code": "Z89511", "icd10_title": "Acquired absence of right leg below knee" }, { "from_icd11": "QF00", "icd10_code": "Z89429", "icd10_title": "Acquired absence of other toe(s), unspecified side" }, { "from_icd11": "QF00", "icd10_code": "Z89422", "icd10_title": "Acquired absence of other left toe(s)" }, { "from_icd11": "QF00", "icd10_code": "Z89211", "icd10_title": "Acquired absence of right upper limb below elbow" } ]
M65-M68
After the patient was admitted to the hospital, the relevant auxiliary examination was completed, and the preliminary diagnosis was as follows: 1) Right side neck mass: thyroid cancer cannot be excluded; 2) Cause of leukopenia remains to be investigated; 3) Cause of thrombocytopenia remains to be investigated; 4) Mild anemia; and 5) Chronic pharyngitis. Although the patient’s thyroid nodules initially led to the consideration of PTC, and surgery was indicated, the patient’s blood routine examination suggested pancytopenia, which was a considerable risk for surgery. We performed bone marrow aspiration, Epstein–Barr virus PCR, human cytomegalovirus quantitative PCR, autoantibody spectrum, evaluation for anemia, and other tests, which showed no obvious abnormality was observed. Bone marrow biopsy implied that hematopoietic cell proliferation was extremely low, and only a few granulocytes and nucleated red cells were seen scattered; megakaryocytes were not seen, and nucleated cells accounted for less than 1% of the bone marrow cavity. No reticular fibrous hyperplasia was observed (MF-0) . Blood routine examination showed WBC levels of 2.89 × 10 9 /L, neutrophil levels of 1.30 × 10 9 /L, RBC levels of 3.75 × 10 12 /L, platelet count of 91 × 10 9 /L, hemoglobin level of 128 g/L, and reticulocyte rate (RETIC%) of 1.95%. Other laboratory tests revealed no obvious abnormalities. After consulting with the Hematology Department, we reflected that the patient may have AA. Accordingly, we revised the diagnosis as follows: 1) right neck mass: thyroid cancer cannot be excluded; 2) Suspicion of AA; 3) acute hematopoietic function inhibition; and 4) chronic pharyngitis. We treated the patient with Diyushengbai Tablets (composed of sanguisorbae Radix saponin), compound Zaofan pills (composed of ferrous sulfate, walnut kernels, jujubes, cinnamon, seahorses, and American ginseng), and Leucogen Tablets (2-thiazolidine-4-carboxylic acid). Meanwhile, we also administered intramuscular injection of recombinant human granulocyte colony-stimulating factor (rhG-CSF) and performed platelet transfusion. During treatment, we repeated blood routine examinations several times, but the levels of WBC and RBC and platelet counts were always lower than normal. As the patient had a surgical indication to remove the thyroid, we decided to treat the tumor first. After the preoperative preparation was completed, a total thyroidectomy, central compartment lymph node dissection, and lateral neck lymph node dissection were performed under general anesthesia on January 10, 2022, with intraoperative blood loss of approximately 100 mL. For the specimen obtained from the resection of the left thyroid lobe, it was diagnosed as PTC, with a tumor size of 0.6 × 0.5 × 0.5 cm 3 . There was no vascular infiltration, no intrathoracic dissemination within the thyroid, no thyroid capsule invasion, and no extrathyroidal capsule invasion. The remaining thyroid tissue exhibited changes of Hashimoto’s thyroiditis. Regarding the specimen obtained from the resection of the right thyroid lobe, it was diagnosed as PTC, with a maximum diameter of approximately 0.4 cm. There was no thyroid capsule invasion, no nerve invasion, and no vascular invasion. The surrounding thyroid tissue showed changes of Hashimoto’s thyroiditis. As for the lymph node metastasis situation, cancer metastasis was identified. Specifically, in the submitted “central region”, the metastasis rate was 5/10; in the “left lateral neck region”, it was 0/8; and in the “right lateral neck region”, it was 8/14. Immunohistochemical results of the right lobe of thyroid gland, among, TTF-1 (+), CK-19 (+), Galectin-3 (+), Ki-67 (+, 30%) . On post-operative Day-1, we reviewed the blood routine test results of the patient: WBC levels, 6.5 × 10 9 /L, neutrophil levels, 5.58 × 10 9 /L, RBC levels, 3.87 × 10 12 /L, platelet count, 103 × 10 9 /L, and hemoglobin levels, 126 g/L. Multiple blood routine examinations after surgery showed an increase in RBC and WBC levels and platelet count , compared with those before surgery. The patient was re-examined on post-operative Day-9, for blood routine tests, and the following was observed: WBC levels, 4.5 × 10 9 /L, neutrophil levels, 2.4 × 10 9 /L, RBC levels, 4.19 × 10 12 /L, platelet count, 143 × 10 9 /L, and hemoglobin level, 141 g/L. Subsequently, the patient recovered and was discharged from the hospital, and also received I131 treatment. After that, we conducted a long-term follow-up on the patient’s thyroid function and blood routine. The results of the thyroid function follow-up on May 7, 2022 were as follows: The FT3 level was 2.62 pg/ml, the FT4 level was 1.60 ng/dl, the TSH level was 1.945 mU/L, the TgAb level was 178.09 IU/mL, the TPOAb level was 33.11 IU/mL, and the thyroglobulin level was <0.04 ng/ml. We continue following up the patient, who was last reviewed in August 2024. The patient’s blood routine results were not significantly abnormal (WBC levels, 5.75 × 10 9 /L, RBC levels, 4.56 × 10 12 /L, platelet count, 125 × 10 9 /L).
4.007813
0.974121
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en
0.999997
39839771
https://doi.org/10.3389/fonc.2024.1443823
[ "thyroid", "blood", "routine", "platelet", "neck", "count", "invasion", "follows", "cancer", "bone" ]
[ { "code": "5A03.Z", "title": "Thyroiditis, unspecified" }, { "code": "5A0Z", "title": "Disorders of the thyroid gland or thyroid hormones system, unspecified" }, { "code": "5A03.Y", "title": "Other specified thyroiditis" }, { "code": "5A00.2Z", "title": "Acquired hypothyroidism, unspecified" }, { "code": "5A03.0", "title": "Acute thyroiditis" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" } ]
=== ICD-11 CODES FOUND === [5A03.Z] Thyroiditis, unspecified Also known as: Thyroiditis, unspecified | Thyroiditis | inflammation of thyroid | thyroiditis NOS [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified Also known as: Disorders of the thyroid gland or thyroid hormones system, unspecified [5A03.Y] Other specified thyroiditis Also known as: Other specified thyroiditis | Riedel thyroiditis | Chronic invasive fibrous thyroiditis | Ligneous thyroiditis | Riedel struma [5A00.2Z] Acquired hypothyroidism, unspecified Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea [5A03.0] Acute thyroiditis Definition: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial. Also known as: Acute thyroiditis | infectious thyroiditis | Acute thyroiditis due to bacterial infection | Acute thyroiditis due to fungal infection | Abscess of thyroid [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood === GRAPH WALKS === --- Walk 1 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --EXCLUDES--> [?] Thyrotoxicosis Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone... --- Walk 2 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.2] Autoimmune thyroiditis Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies.... --- Walk 3 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --PARENT--> [?] Endocrine diseases --- Walk 4 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A00] Hypothyroidism --- Walk 5 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.2] Autoimmune thyroiditis Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies.... --- Walk 6 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --EXCLUDES--> [?] Thyrotoxicosis Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone...
[ "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Thyrotoxicosis\n Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone...", "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.2] Autoimmune thyroiditis\n Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies....", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --PARENT--> [?] Endocrine diseases", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A00] Hypothyroidism", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.2] Autoimmune thyroiditis\n Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies....", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Thyrotoxicosis\n Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone..." ]
5A03.Z
Thyroiditis, unspecified
[ { "from_icd11": "5A03.Z", "icd10_code": "E069", "icd10_title": "Thyroiditis, unspecified" }, { "from_icd11": "5A03.Z", "icd10_code": "E064", "icd10_title": "Drug-induced thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E065", "icd10_title": "Other chronic thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E06", "icd10_title": "Thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E062", "icd10_title": "Chronic thyroiditis with transient thyrotoxicosis" }, { "from_icd11": "5A0Z", "icd10_code": "E0781", "icd10_title": "Sick-euthyroid syndrome" }, { "from_icd11": "5A0Z", "icd10_code": "E0789", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E079", "icd10_title": "Disorder of thyroid, unspecified" }, { "from_icd11": "5A0Z", "icd10_code": "E034", "icd10_title": "Atrophy of thyroid (acquired)" }, { "from_icd11": "5A0Z", "icd10_code": "E00-E07", "icd10_title": "" }, { "from_icd11": "5A0Z", "icd10_code": "E07", "icd10_title": "Other disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E078", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E35", "icd10_title": "Disorders of endocrine glands in diseases classified elsewhere" }, { "from_icd11": "5A00.2Z", "icd10_code": "E033", "icd10_title": "Postinfectious hypothyroidism" }, { "from_icd11": "5A03.0", "icd10_code": "E060", "icd10_title": "Acute thyroiditis" } ]
E069
Thyroiditis, unspecified
The pedigree underwent careful physical examination. The proband’s parents (I:1, I:2) were nonconsanguineous and both appeared normal. The proband (II:1) had frequently suffered from pneumonia since she was born, accompanied with shortness of breath much of the time . As a neonate, she presented laryngeal stridor and was diagnosed with laryngomalacia. She began to experience nausea and vomiting after being fed when she was 2 months old, and a gastrostomy tube was placed at that time. She presented considerable tympanites and gastrointestinal dysmotility with frequent vomiting. When she was 6 months old, she could raise her head. She could sit at the age of 10 months and stand at the age of 2 years. Developmental delay was obvious at the age of 4 years, when she reached a height of only 98cm (<2SD). Unfortunately, the patient suffered from motor retardation. Furthermore, she was unable to sit or stand without help, let alone walk. Moreover, muscular hypotonia and exercise intolerance was evident. Her motor development, speech, and social adaptation were assessed to be 2.5 years delayed. She only could communicate with her family by facial expressions, gestures, and simple sounds even though she had normal visual and auditory abilities. Recurrent seizures appeared with spastic diplegia at 5 years of age. A prominent fast wave in the frontal lobe was observed by electroencephalogram examination. Brain magnetic resonance imaging (MRI) showed a wide extracerebral space and thin corpus callosum . Muscle biopsy showed myopathic changes with different size and small diameter of muscle fibers , and increased lipid droplets . Additionally, hepatic biopsy followed by electron microscopy revealed abundant lipid droplets . Through light microscopy, diffuse hepatocellular steatosis was observed . Immunohistochemistry showed that the bile duct epithelium was positive for cytokeratin 19 and a few activated Kupffer cells were positive for CD68 , and Masson staining revealed fibrous hyperplasia in the portal area . Due to intracytoplasmic accumulation of glycogen, the periodic acid-Schiff (PAS) reaction was positive and the D-PAS reaction was negative . In addition, blood tests indicated mildly elevated alanine aminotransferase levels and a physical exam did not indicate hepatomegaly. There was an apparent renal defect with oliguria and elevated creatinine, urea nitrogen, and uric acid levels, so dialysis was employed. Inherited metabolic disorders were screened, and slightly elevated lactate levels in blood and urine were observed. Serum antibody tests for toxoplasma, rubella virus, cytomegalovirus, and herpes simplex virus were negative and the patient’s plasma ammonia levels, triglyceride levels, blood glucose levels, karyotype, auditory brainstem responses, and thyroid function were all normal. There was no cardiac involvement apart from tachycardia; cardiac troponin I and creatine kinase isoenzyme levels were also in the normal range (Table 2 ). The patient died from stroke and respiratory failure at the age of 5 years. According to the patient’s main symptoms, which were in accordance with the common features of COXPD26, a diagnosis of COXPD26 was made. Fig. 1 The clinical and histopathological examination. A Pneumonia indicated by X-ray result. B and C Abnormality in the brain with wider extracerebral space and thinner corpus callosum. D Myopathic changes with different size, small diameter of muscle fibers were observed by HE staining and E increased lipid droplets by oil staining (10×). F Hepatic biopsy showed abundant lipid droplets by electron microscopy. G Diffuse hepatocellular steatosis was observed in liver through light microscope; H Immunohistochemistry showed that the bile duct epithelium was positive for cytokeratin 19; I a few activated Kupffer cells were positive for CD68; J Masson staining showed fibrous hyperplasia in the portal area; K PAS reaction in liver was positive due to intracytoplasmic accumulation of glycogen; L D-PAS was negative in liver. All figures of liver by light microscope were showed with 20× Table 2 Laboratory results of the proband Test Results Chromosome karyotype 46 XX, normal Plasma ammonia normal Lactate elevated (2.4–4.7mmol/L, normal range: less than 2.2 mmol/L) TORCH negative Screening of genetic metabolism slightly elevated lactate in blood and urine Electroencephalogram abnormal (prominent fast wave indicated in frontal region) Auditory brain-stem responses normal Doppler ultrasound echocardiography normal Creatinine elevated (202 μmol/L, normal range:45-84μmol/L) Urea nitrogen 25.84 (2.9-8.2) mmol/L Uric Acid 828.4 (155-357) μmol/L Thyroid function normal Glutamic oxalacetic transaminase 396.7 (10-67) U/L Glutamic pyruvic transaminase 100.2 (5-35) U/L Bilirubin normal Cardiac troponin I 0.08(0.00-0.09) pg/ml Creatine kinase isoenzyme 2.5(0.0-3.7) ng/ml Myoglobin 77.4(11.6-73.0) ng/ml Triglyceride normal Blood glucose normal (4.7-7.5mmo/L) TORCH serum antibody tests for toxoplasma, rubella virus, cytomegalovirus, and herpes simplex virus
4.15625
0.944336
sec[1]/p[0]
en
0.999997
PMC8808961
https://doi.org/10.1186/s12887-022-03138-z
[ "blood", "lipid", "droplets", "staining", "virus", "liver", "proband", "that", "auditory", "brain" ]
[ { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "5C8Z", "title": "Unspecified disorders of lipoprotein metabolism or lipidaemias" }, { "code": "5C80.Z", "title": "Hyperlipoproteinaemia, unspecified" }, { "code": "5C52.Z", "title": "Inborn errors of lipid metabolism, unspecified" }, { "code": "5C52.Y", "title": "Other specified inborn errors of lipid metabolism" }, { "code": "LD27.Y", "title": "Other specified syndromes with skin or mucosal anomalies as a major feature" } ]
=== ICD-11 CODES FOUND === [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood [5C8Z] Unspecified disorders of lipoprotein metabolism or lipidaemias Also known as: Unspecified disorders of lipoprotein metabolism or lipidaemias | lipoprotein metabolism disorder | lipid abnormality | dyslipidaemia NOS | disorder of cholesterol metabolism [5C80.Z] Hyperlipoproteinaemia, unspecified Also known as: Hyperlipoproteinaemia, unspecified | Hyperlipoproteinaemia | Hyperlipidaemia | hyperlipemia | lipemia [5C52.Z] Inborn errors of lipid metabolism, unspecified Also known as: Inborn errors of lipid metabolism, unspecified | Inborn errors of lipid metabolism | Disorders of lipid metabolism | congenital disorders of lipid metabolism | inherited disorders of lipid metabolism [5C52.Y] Other specified inborn errors of lipid metabolism Also known as: Other specified inborn errors of lipid metabolism | Xanthoma in association with lipid storage diseases | Hereditary hyperlipidosis | Lipid storage disease, not elsewhere classified | lipid storage disorder [LD27.Y] Other specified syndromes with skin or mucosal anomalies as a major feature Also known as: Other specified syndromes with skin or mucosal anomalies as a major feature | Ascher syndrome | Blepharochalasia - double lip | Hereditary acrokeratotic poikiloderma, Weary type | H syndrome === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Certain conditions originating in the perinatal period Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later.... --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c... --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.4Z] Haematuria, unspecified --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.2] Finding of hallucinogen in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Certain conditions originating in the perinatal period\n Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later....", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] Haematuria, unspecified", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.2] Finding of hallucinogen in blood" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
A 71-year-old previously healthy man complained of cough and fever for 1 month. At first, he was evaluated at his local hospital, where he was believed to have pneumonia. During hospitalization, he got sudden chest pain and hemoptysis which were similar as the symptoms of the pulmonary embolism. However, lower extremity doppler ultrasound didn’t found any sign of thrombus. He presented to our hospital for a definite diagnosis. On day 1, his pulse rate was 106 beats/minute, blood pressure was 134/83 mmHg, and his temperature was 38.3 °C on examination. There were no murmurs on auscultation of the heart. Laboratory testing revealed a white blood cell count of 21,000/μL (neutrophils 74.5%), hemoglobin of 11.5 g/dL, and platelets of 192,000/μL. Also, the C-reactive protein level is 74 mg/L, and erythrocyte sedimentation rate is 66 mm/h. The coagulation function is normal. The electrocardiogram showed sinus tachycardia without other abnormalities. On day 2, transthoracic echocardiography (TTE) revealed the aneurysmal dilated CS (diameter: 38 mm) with the band medium-echo mobile structure in the parasternal left ventricle long-axis view . In the modified apical 4-chamber view, the band medium-echo mobile structure (40 × 12 mm) could be observed in the aneurysmal dilated CS . A sinus venosus atrial septal defect (ASD) with bi-directional shunt has been detected near the entrance of superior vena cava in the right atrium . Part of severe tricuspid regurgitation drained into the CS . The persistent left superior vena cava has been revealed in the suprasternal long axis view of aortic arch . Enlarged right heart, pericardial effusion, dilated inferior vena cava may indicate dysfunctional right heart. Moderate pulmonary artery hypertension also has been revealed. On day 4, blood cultures were positive for Staphylococcus aureus which is methicillin sensitive. We highly suspect that this is IE with CS vegetation. So, he got intravenous antibiotic therapy which lasted 2 weeks during hospitalization. Cloxacillin is given by intravenous injection as 12 g/day in 4–6 doses. However, on day 6, the patient had symptoms of dyspnea and chest pain. We repeated the blood cultures which were also positive. We believed these symptoms caused by recurrent septic lung emboli. Emergency thoracic contrast enhanced computed tomography was performed and revealed filling defects in the branches of the left lower pulmonary artery . Sinus venosus ASD has been confirmed . A persistent left superior vena cava drained into the right atrium through the aneurysmal dilated CS . On day 8, thoracotomy was performed . A photograph of the gross specimen showed a netlike vegetation which was removed from the CS . The vegetation was mixed with white and dark red. Histologic sectioning revealed that vegetation contained a large number of necrotic material . After surgery, his condition became stable. On day 18, the blood culture and other laboratory testing normalized. The patient was discharged with only mild cough. After he got home, he also had two-week antibiotherapy in his local hospital. Two months later, he came to the outpatient department for follow-up. He was doing well without any complications. TTE only revealed the dilated CS and pericardial effusion. Fig. 1 The aneurysmal dilated coronary sinus with the banded medium-echo mobile structure (yellow arrow). a in the parasternal left ventricle long-axis view. b In the modified apical 4-chamber view. CS: Coronary sinus; LA: Left atrium; LV: Left ventricle; PE: Pericardial effusion; RV: Right ventricle Fig. 2 Sinus venosus atrial septal defect. a The size of echo drop is 22.3 mm. b, c bi-directional shunt has been detected between right atrium and left atrium. LA: Left atrium; LV: Left ventricle; RA: Right atrium; RV: Right ventricle Fig. 3 Severe tricuspid regurgitation has been revealed, part of which drained into the coronary sinus. CS: Coronary sinus; RA: Right atrium; RV: Right ventricle Fig. 4 The persistent left superior vena cava has been revealed in the suprasternal long axis view of aortic arch. PLSVC: Persistent left superior vena cava Fig. 5 Emergency thoracic contrast enhanced computed tomography revealed pulmonary embolism. a , b filling defects in the branches of the left lower pulmonary artery (yellow arrow) Fig. 6 Emergency thoracic contrast enhanced computed tomography revealed cardiovascular anomalies. a Contrast agent slightly appeared in left atrium (yellow arrow) when the right heart was enhancing. b Interruption was visible between right atrium and left atrium. c A persistent left superior vena cava drained into the right atrium through the aneurysmal dilated coronary sinus Fig. 7 a Thoracotomy was performed to repair the atrial septum and remove the coronary sinus vegetation. b Photograph of the gross specimen showed a netlike vegetation which was removed from the coronary sinus. The vegetation was mixed with white and dark red. c Histologic sectioning revealed that vegetation contained a large number of necrotic material and neutrophils
3.970703
0.979492
sec[1]/p[0]
en
0.999996
29866073
https://doi.org/10.1186/s12872-018-0845-x
[ "atrium", "sinus", "vegetation", "which", "dilated", "ventricle", "vena", "cava", "coronary", "view" ]
[ { "code": "LA8E.Y", "title": "Other specified congenital anomaly of atrial septum" }, { "code": "LA8G.0", "title": "Divided left atrium" }, { "code": "LA8F", "title": "Congenital anomaly of right atrium" }, { "code": "LA8G.Z", "title": "Congenital anomaly of left atrium, unspecified" }, { "code": "LA8G.Y", "title": "Other specified congenital anomaly of left atrium" }, { "code": "CA0A.Z", "title": "Chronic rhinosinusitis, unspecified" }, { "code": "CA0Y&XA3523", "title": "Nasal sinus obstruction" }, { "code": "CA0J.Y", "title": "Other specified nasal polyp" }, { "code": "LB03.Y", "title": "Other specified structural developmental anomalies of umbilical cord" }, { "code": "DA09.61", "title": "Periapical abscess with sinus" } ]
=== ICD-11 CODES FOUND === [LA8E.Y] Other specified congenital anomaly of atrial septum Also known as: Other specified congenital anomaly of atrial septum | Aneurysm of the atrial septum | atrial septal aneurysm | Interatrial communication | Atrial septal defect [LA8G.0] Divided left atrium Definition: A congenital cardiac malformation in which there is a partition that divides the left atrium into a posterosuperior chamber that receives some or all of the pulmonary veins and an antero-inferior chamber that communicates with the left atrial appendage and atrioventricular junction (usually the mitral valve). Additional information: in differentiating 'Divided left atrium' from 'Congenital supravalvar or intravalvar mitral ring', in the latter, the antero-inferior compartment contains only the Also known as: Divided left atrium | Cor triatriatum sinistrum | Left cor triatriatum | Cor triatriatum sinister | left triatrial heart [LA8F] Congenital anomaly of right atrium Definition: A congenital cardiovascular malformation in which there is an abnormality of the right atrium. Also known as: Congenital anomaly of right atrium | Divided right atrium | Cor triatriatum dextrum | Right cor triatriatum | Cor triatriatum dexter [LA8G.Z] Congenital anomaly of left atrium, unspecified Also known as: Congenital anomaly of left atrium, unspecified | Congenital anomaly of left atrium [LA8G.Y] Other specified congenital anomaly of left atrium Also known as: Other specified congenital anomaly of left atrium | Right-sided juxtaposition of the atrial appendages [CA0A.Z] Chronic rhinosinusitis, unspecified Also known as: Chronic rhinosinusitis, unspecified | Chronic rhinosinusitis | Chronic sinusitis | chronic sinusitis NOS | unspecified sinusitis [CA0J.Y] Other specified nasal polyp Also known as: Other specified nasal polyp | Polyp of nasal cavity | Polyp of the nasopharynx | nasopharyngeal polyp | Polyp of adenoid tissue [LB03.Y] Other specified structural developmental anomalies of umbilical cord Also known as: Other specified structural developmental anomalies of umbilical cord | Umbilical cord calcifications | Omphalomesenteric duct remnants or cysts | Vitelline duct remnants and cysts | Persistent omphalomesenteric duct [DA09.61] Periapical abscess with sinus Also known as: Periapical abscess with sinus | Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus | periapical abscess fistula Includes: Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus === GRAPH WALKS === --- Walk 1 --- [LA8E.Y] Other specified congenital anomaly of atrial septum --PARENT--> [LA8E] Congenital anomaly of atrial septum Def: A congenital cardiovascular malformation in which there is an abnormality of the atrial septum.... --CHILD--> [LA8E.2] Sinus venosus defect Def: A congenital cardiovascular malformation in which there is a caval vein (vena cava) and/or pulmonary vein (or veins) that overrides the atrial septum or the septum secundum (superior interatrial fold)... --- Walk 2 --- [LA8E.Y] Other specified congenital anomaly of atrial septum --PARENT--> [LA8E] Congenital anomaly of atrial septum Def: A congenital cardiovascular malformation in which there is an abnormality of the atrial septum.... --CHILD--> [LA8E.0] Patent oval foramen Def: A congenital cardiovascular finding in which there is a small interatrial communication (or potential communication) confined to the region of the oval fossa (fossa ovalis) characterised by no deficie... --- Walk 3 --- [LA8G.0] Divided left atrium Def: A congenital cardiac malformation in which there is a partition that divides the left atrium into a posterosuperior chamber that receives some or all of the pulmonary veins and an antero-inferior cham... --PARENT--> [LA8G] Congenital anomaly of left atrium Def: A congenital cardiovascular malformation in which there is an abnormality of the left atrium.... --CHILD--> [LA8G.Z] Congenital anomaly of left atrium, unspecified --- Walk 4 --- [LA8G.0] Divided left atrium Def: A congenital cardiac malformation in which there is a partition that divides the left atrium into a posterosuperior chamber that receives some or all of the pulmonary veins and an antero-inferior cham... --PARENT--> [LA8G] Congenital anomaly of left atrium Def: A congenital cardiovascular malformation in which there is an abnormality of the left atrium.... --CHILD--> [LA8G.0] Divided left atrium Def: A congenital cardiac malformation in which there is a partition that divides the left atrium into a posterosuperior chamber that receives some or all of the pulmonary veins and an antero-inferior cham... --- Walk 5 --- [LA8F] Congenital anomaly of right atrium Def: A congenital cardiovascular malformation in which there is an abnormality of the right atrium.... --PARENT--> [?] Structural developmental anomaly of heart or great vessels Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart.... --RELATED_TO--> [?] Congenital cardiac tumor, not otherwise specified Def: A congenital malformation consisting of growth of abnormal tissue within the heart.... --- Walk 6 --- [LA8F] Congenital anomaly of right atrium Def: A congenital cardiovascular malformation in which there is an abnormality of the right atrium.... --PARENT--> [?] Structural developmental anomaly of heart or great vessels Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart.... --RELATED_TO--> [?] Congenital cardiac tumor, not otherwise specified Def: A congenital malformation consisting of growth of abnormal tissue within the heart....
[ "[LA8E.Y] Other specified congenital anomaly of atrial septum\n --PARENT--> [LA8E] Congenital anomaly of atrial septum\n Def: A congenital cardiovascular malformation in which there is an abnormality of the atrial septum....\n --CHILD--> [LA8E.2] Sinus venosus defect\n Def: A congenital cardiovascular malformation in which there is a caval vein (vena cava) and/or pulmonary vein (or veins) that overrides the atrial septum or the septum secundum (superior interatrial fold)...", "[LA8E.Y] Other specified congenital anomaly of atrial septum\n --PARENT--> [LA8E] Congenital anomaly of atrial septum\n Def: A congenital cardiovascular malformation in which there is an abnormality of the atrial septum....\n --CHILD--> [LA8E.0] Patent oval foramen\n Def: A congenital cardiovascular finding in which there is a small interatrial communication (or potential communication) confined to the region of the oval fossa (fossa ovalis) characterised by no deficie...", "[LA8G.0] Divided left atrium\n Def: A congenital cardiac malformation in which there is a partition that divides the left atrium into a posterosuperior chamber that receives some or all of the pulmonary veins and an antero-inferior cham...\n --PARENT--> [LA8G] Congenital anomaly of left atrium\n Def: A congenital cardiovascular malformation in which there is an abnormality of the left atrium....\n --CHILD--> [LA8G.Z] Congenital anomaly of left atrium, unspecified", "[LA8G.0] Divided left atrium\n Def: A congenital cardiac malformation in which there is a partition that divides the left atrium into a posterosuperior chamber that receives some or all of the pulmonary veins and an antero-inferior cham...\n --PARENT--> [LA8G] Congenital anomaly of left atrium\n Def: A congenital cardiovascular malformation in which there is an abnormality of the left atrium....\n --CHILD--> [LA8G.0] Divided left atrium\n Def: A congenital cardiac malformation in which there is a partition that divides the left atrium into a posterosuperior chamber that receives some or all of the pulmonary veins and an antero-inferior cham...", "[LA8F] Congenital anomaly of right atrium\n Def: A congenital cardiovascular malformation in which there is an abnormality of the right atrium....\n --PARENT--> [?] Structural developmental anomaly of heart or great vessels\n Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....\n --RELATED_TO--> [?] Congenital cardiac tumor, not otherwise specified\n Def: A congenital malformation consisting of growth of abnormal tissue within the heart....", "[LA8F] Congenital anomaly of right atrium\n Def: A congenital cardiovascular malformation in which there is an abnormality of the right atrium....\n --PARENT--> [?] Structural developmental anomaly of heart or great vessels\n Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....\n --RELATED_TO--> [?] Congenital cardiac tumor, not otherwise specified\n Def: A congenital malformation consisting of growth of abnormal tissue within the heart...." ]
LA8E.Y
Other specified congenital anomaly of atrial septum
[ { "from_icd11": "LA8E.Y", "icd10_code": "Q211", "icd10_title": "Atrial septal defect" }, { "from_icd11": "LA8G.0", "icd10_code": "Q242", "icd10_title": "Cor triatriatum" }, { "from_icd11": "LA8F", "icd10_code": "Q208", "icd10_title": "Other congenital malformations of cardiac chambers and connections" }, { "from_icd11": "CA0A.Z", "icd10_code": "J329", "icd10_title": "Chronic sinusitis, unspecified" }, { "from_icd11": "CA0A.Z", "icd10_code": "J324", "icd10_title": "Chronic pansinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J320", "icd10_title": "Chronic maxillary sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J322", "icd10_title": "Chronic ethmoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J323", "icd10_title": "Chronic sphenoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J328", "icd10_title": "Other chronic sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J321", "icd10_title": "Chronic frontal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J30-J39", "icd10_title": "" }, { "from_icd11": "CA0A.Z", "icd10_code": "J32", "icd10_title": "Chronic sinusitis" }, { "from_icd11": "DA09.61", "icd10_code": "K046", "icd10_title": "Periapical abscess with sinus" } ]
Q211
Atrial septal defect
A 72-year-old woman with a history of Graves’ disease treated by radioiodine ablation and no smoking history presented with subacute proximal muscle weakness, accompanied by myalgia and a rash. Dermatologic examination was significant for non-pruritic, macular erythema over the posterior arms; discrete papules on the second and fourth distal interphalangeal joints of the left hand; dusky, reticulated erythema involving the proximal, lateral thighs (evoking the “holster sign” ); and linear, erythematous plaques extending inferiorly from the nape. Elevations were noted in the levels of creatine kinase (CK), aldolase, lactate dehydrogenase (LDH), aspartate transaminase (AST), and alanine transaminase (ALT). Suspicion for dermatomyositis prompted initiation of high-dose prednisone (1 mg/kg) on hospital day 2, in spite of which symptoms failed to improve and enzyme levels continued to rise, peaking on hospital day 8 . Immune serology studies, encompassing general and myositis-specific antibodies, were uniformly negative (ANA, Jo-1, PL-12, PL-7, EJ, OJ, Mi-2, SRP, Ku, U2 snRNP, PM/Scl). Electromyography revealed fibrillations and positive sharp waves, indicative of an irritative myopathic process affecting the proximal muscles. Muscle biopsy demonstrated immune myopathy with perimysial pathology (IMPP). Given the presumptive diagnosis of dermatomyositis, a malignancy work-up was initiated, and computed tomography (CT) of the thorax revealed a 2.1-cm subsolid nodule in the right middle lobe. Relative to a CT scan acquired four years earlier, the nodule was stable in size but had progressed in fractional solidity from 15% (i.e., predominantly ground-glass opacified) to 90% . PET/CT showed minimal 18 F-fluorodeoxyglucose (FDG) avidity (standardized uptake value (SUV) 1.3) in the right middle lobe lesion, consistent with its indolent nature, and no evidence of lymph node or metastatic disease. Given the refractoriness of symptoms to high-dose corticosteroids and biopsy evidence of a DM-spectrum process (IMPP), methotrexate (gradually dose-escalated from 7.5 to 15 mg weekly) and IVIG (2 g/kg monthly) were initiated on hospital day 11. Despite the indolence of the pulmonary lesion, the heightened risk of malignancy in the setting of presumed DM prompted thoracoscopic right middle lobectomy and mediastinal lymph node dissection, which the patient underwent on hospital day 16, after spirometry and diffusion capacity testing demonstrated satisfactory pulmonary function. Histopathologic analysis revealed a 2.1-cm, moderately differentiated, invasive adenocarcinoma, arranged in papillary (60%), acinar (30%), micropapillary (5%), and lepidic (5%) proliferative patterns. There was one intraparenchymal node involved by direct extension; level 4R, 7, and 11 lymph nodes were negative for malignancy. Her stage was pT1cN1M0 or IIB (AJCC 7 th edition ). Molecular studies of the tumor (specifically, short-read sequencing of a target-enriched library of 130 genes that are frequently mutated in solid tumors) disclosed a constitutively activating mutation of EGFR and a mutation of β -catenin (CTNNB1) within the GSK3 β (GSK3B) phosphorylation region (c.97T>C, p.S33P), with variant allele fractions of 23.5 and 8.6%, respectively. Following surgical excision of the lung tumor, the patient experienced a dramatic improvement in muscle strength and disappearance of the rash. Deltoid and hip-flexor strength increased from 5/10 at the time of surgery to 8/10 within a week. Her enzyme levels continued to decline and were all within the normal range at the time of discharge on hospital day 29. Upon discharge, the corticosteroid dose was tapered from 1 to 0.083 mg/kg/d over a one-month period and the methotrexate discontinued, without relapse of dermatomyositis symptoms; the corticosteroid and IVIG were both discontinued approximately one month thereafter. At the time of writing, the patient continued to show improvements in functional status, and had recently discontinued adjuvant chemotherapy with carboplatin and pemetrexed owing to toxicities. Fig. 1 Serum creatine kinase levels are displayed with respect to the duration of hospitalization. The upper limit of normal (200 U/L) is indicated by the dashed horizontal line, while the onset of an intervention is indicated by a dashed vertical line. High-dose prednisone (1 mg/kg/d) was started on hospital day 2; methotrexate (MTX, 7.5 mg/week) and intravenous immunoglobulin (IVIG, 2 g/kg/mo) began on hospital day 11; and right middle lobectomy and mediastinal lymph node dissection took place on hospital day 16. Not shown are escalations of the methotrexate dose to 10 mg/week (hospital day 18) and 15 mg/week (hospital day 25), as well as discharge and commencement of the steroid taper, which coincided on hospital day 29 Fig. 2 Slices from chest CT scans acquired four years prior to (left) and at the time of presentation (right), demonstrating an indolent, subsolid lesion in the right middle lobe, the solid fraction of which evolved from 15% (left) to 90% (right)
4.125
0.969727
sec[1]/p[0]
en
0.999998
29415746
https://doi.org/10.1186/s13019-018-0705-x
[ "middle", "which", "lymph", "node", "methotrexate", "time", "muscle", "dermatomyositis", "malignancy", "lobe" ]
[ { "code": "CB40.2", "title": "Pulmonary collapse" }, { "code": "LA8B.21", "title": "Coarctation of aorta" }, { "code": "AB0Z", "title": "Otitis media, unspecified" }, { "code": "AB1Y&XA0G74", "title": "Fistula of middle ear" }, { "code": "2F91.Y&XA0G74", "title": "Neoplasms of unknown behaviour of middle ear" }, { "code": "BD50.41", "title": "Abdominal aortic aneurysm with rupture" }, { "code": "EK91", "title": "Dermatoses which may presage cutaneous lymphoma" }, { "code": "MH12.1", "title": "Death occurring less than 24 hours from onset of symptoms, not otherwise explained" }, { "code": "8A44.3", "title": "Certain specified leukodystrophies" }, { "code": "BD9Z", "title": "Disorders of lymphatic vessels or lymph nodes, unspecified" } ]
=== ICD-11 CODES FOUND === [CB40.2] Pulmonary collapse Also known as: Pulmonary collapse | Atelectasis | lung collapse | pulmonary atelectasis | pulmonary collapse with atelectasis Includes: Atelectasis Excludes: Primary atelectasis of newborn | tuberculous atelectasis, not confirmed | tuberculous atelectasis, confirmed [LA8B.21] Coarctation of aorta Definition: A congenital cardiovascular malformation in which there is a discrete luminal narrowing of the junction between the aortic arch and the descending aorta. Additional information: 'Coarctation of the aorta' generally indicates a narrowing of the descending thoracic aorta just distal to the left subclavian artery. However, the term may also be accurately used to refer to a region of narrowing anywhere in the thoracic or abdominal aorta. Also known as: Coarctation of aorta | aortic coarctation | Preductal coarctation of aorta | Postductal coarctation of aorta | Descending thoracic or abdominal aortic coarctation [AB0Z] Otitis media, unspecified Also known as: Otitis media, unspecified | ear infection | middle ear infection | inflammation of the middle ear | middle ear catarrh [BD50.41] Abdominal aortic aneurysm with rupture Also known as: Abdominal aortic aneurysm with rupture | abdominal aorta aneurysm rupture | abdominal aorta aneurysm ruptured | abdominal aortic aneurysm which has ruptured | ruptured AAA [EK91] Dermatoses which may presage cutaneous lymphoma Definition: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature. Also known as: Dermatoses which may presage cutaneous lymphoma [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained Also known as: Death occurring less than 24 hours from onset of symptoms, not otherwise explained | died without sign of disease | Death known not to be violent or instantaneous for which no cause can be discovered | death known not to be violent or instantaneous, cause unknown | Death without sign of disease Includes: Death known not to be violent or instantaneous for which no cause can be discovered | Death without sign of disease [8A44.3] Certain specified leukodystrophies Also known as: Certain specified leukodystrophies | CACH syndrome | Vanishing white matter disease | Childhood ataxia with central nervous system hypomyelination | Congenital or early infantile CACH syndrome [BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified Also known as: Disorders of lymphatic vessels or lymph nodes, unspecified | Lymphatic system disorders | lymph disease NOS | lymph gland disease | Lymphatic system disease NOS === GRAPH WALKS === --- Walk 1 --- [CB40.2] Pulmonary collapse --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Pulmonary sporotrichosis Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. Symptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com... --- Walk 2 --- [CB40.2] Pulmonary collapse --EXCLUDES--> [?] Respiratory tuberculosis, not confirmed Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has not been confirmed. This disease is characterised by a chronic cough, and sputum prod... --CHILD--> [?] Tuberculosis of lung, bacteriologically or histologically negative Def: This is a common, and in many cases lethal, infectious disease of the lung caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is bacteriologically and histol... --- Walk 3 --- [LA8B.21] Coarctation of aorta Def: A congenital cardiovascular malformation in which there is a discrete luminal narrowing of the junction between the aortic arch and the descending aorta. Additional information: 'Coarctation of the a... --PARENT--> [LA8B.2] Congenital anomaly of aorta or its branches Def: A congenital cardiovascular malformation of the aorta and/or its branches.... --CHILD--> [LA8B.22] Interrupted aortic arch Def: A congenital cardiovascular malformation in which there is an absence of luminal continuity between the ascending and descending aorta. Additional information: this includes luminal atresia with disc... --- Walk 4 --- [LA8B.21] Coarctation of aorta Def: A congenital cardiovascular malformation in which there is a discrete luminal narrowing of the junction between the aortic arch and the descending aorta. Additional information: 'Coarctation of the a... --PARENT--> [LA8B.2] Congenital anomaly of aorta or its branches Def: A congenital cardiovascular malformation of the aorta and/or its branches.... --CHILD--> [LA8B.21] Coarctation of aorta Def: A congenital cardiovascular malformation in which there is a discrete luminal narrowing of the junction between the aortic arch and the descending aorta. Additional information: 'Coarctation of the a... --- Walk 5 --- [AB0Z] Otitis media, unspecified --PARENT--> [?] Otitis media --CHILD--> [?] Nonsuppurative otitis media --- Walk 6 --- [AB0Z] Otitis media, unspecified --PARENT--> [?] Otitis media --CHILD--> [?] Nonsuppurative otitis media
[ "[CB40.2] Pulmonary collapse\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Pulmonary sporotrichosis\n Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. \nSymptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...", "[CB40.2] Pulmonary collapse\n --EXCLUDES--> [?] Respiratory tuberculosis, not confirmed\n Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has not been confirmed. This disease is characterised by a chronic cough, and sputum prod...\n --CHILD--> [?] Tuberculosis of lung, bacteriologically or histologically negative\n Def: This is a common, and in many cases lethal, infectious disease of the lung caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is bacteriologically and histol...", "[LA8B.21] Coarctation of aorta\n Def: A congenital cardiovascular malformation in which there is a discrete luminal narrowing of the junction between the aortic arch and the descending aorta.\n\nAdditional information: 'Coarctation of the a...\n --PARENT--> [LA8B.2] Congenital anomaly of aorta or its branches\n Def: A congenital cardiovascular malformation of the aorta and/or its branches....\n --CHILD--> [LA8B.22] Interrupted aortic arch\n Def: A congenital cardiovascular malformation in which there is an absence of luminal continuity between the ascending and descending aorta.\n\nAdditional information: this includes luminal atresia with disc...", "[LA8B.21] Coarctation of aorta\n Def: A congenital cardiovascular malformation in which there is a discrete luminal narrowing of the junction between the aortic arch and the descending aorta.\n\nAdditional information: 'Coarctation of the a...\n --PARENT--> [LA8B.2] Congenital anomaly of aorta or its branches\n Def: A congenital cardiovascular malformation of the aorta and/or its branches....\n --CHILD--> [LA8B.21] Coarctation of aorta\n Def: A congenital cardiovascular malformation in which there is a discrete luminal narrowing of the junction between the aortic arch and the descending aorta.\n\nAdditional information: 'Coarctation of the a...", "[AB0Z] Otitis media, unspecified\n --PARENT--> [?] Otitis media\n --CHILD--> [?] Nonsuppurative otitis media", "[AB0Z] Otitis media, unspecified\n --PARENT--> [?] Otitis media\n --CHILD--> [?] Nonsuppurative otitis media" ]
CB40.2
Pulmonary collapse
[ { "from_icd11": "CB40.2", "icd10_code": "J9811", "icd10_title": "Atelectasis" }, { "from_icd11": "CB40.2", "icd10_code": "J9819", "icd10_title": "Other pulmonary collapse" }, { "from_icd11": "CB40.2", "icd10_code": "J981", "icd10_title": "Pulmonary collapse" }, { "from_icd11": "LA8B.21", "icd10_code": "Q251", "icd10_title": "Coarctation of aorta" }, { "from_icd11": "LA8B.21", "icd10_code": "Q251 ", "icd10_title": "" }, { "from_icd11": "AB0Z", "icd10_code": "H673", "icd10_title": "Otitis media in diseases classified elsewhere, bilateral" }, { "from_icd11": "AB0Z", "icd10_code": "H6690", "icd10_title": "Otitis media, unspecified, unspecified ear" }, { "from_icd11": "AB0Z", "icd10_code": "H6693", "icd10_title": "Otitis media, unspecified, bilateral" }, { "from_icd11": "AB0Z", "icd10_code": "H669", "icd10_title": "Otitis media, unspecified" }, { "from_icd11": "AB0Z", "icd10_code": "H67", "icd10_title": "Otitis media in diseases classified elsewhere" }, { "from_icd11": "AB0Z", "icd10_code": "H670", "icd10_title": "" }, { "from_icd11": "AB0Z", "icd10_code": "H671", "icd10_title": "Otitis media in diseases classified elsewhere, right ear" }, { "from_icd11": "AB0Z", "icd10_code": "H678", "icd10_title": "" }, { "from_icd11": "BD50.41", "icd10_code": "I713", "icd10_title": "Abdominal aortic aneurysm, ruptured" }, { "from_icd11": "EK91", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" } ]
J9811
Atelectasis
We herein report a case of heat stroke in a patient with bimodal rhabdomyolysis in the acute and recovery phases. We performed a PubMed search to identify any related articles using the key words “heat stroke” and “rhabdomyolysis”. As a result, we found 110 articles about heat stroke with rhabdomyolysis. Among these cases, we found 17 cases involving individuals with heat stroke complicated with rhabdomyolysis in which the time course of the CPK level was described [ 1 , 9 – 24 ]. We summarized these cases, including the present case, in Table 2 . Among them, only two reports from Japan showed bimodal rhabdomyolysis . In one of these two reports, Takahashi et al. described a 16-year-old male patient who experienced convulsions 3 days after living donor liver transplantation . After the convulsions on postoperative day 5, the patient’s CPK level, which had been showing a tendency to decrease, increased from 715 to 24,985 IU/L. Convulsions can cause rhabdomyolysis; thus, this case report was excluded from the studies that described the natural course of bimodal rhabdomyolysis induced by heat stroke . Two reports by Miura et al. described the case of 38-year-old man who experienced a life-threatening flare-up of rhabdomyolysis (CPK level of 84,612 IU/L on the third hospital day) and who was treated by plasma exchange, hemodiafiltration, steroid pulse therapy, and anticoagulant treatment . His general condition was initially thought to be improving; however, his smoldering rhabdomyolysis suddenly flared up with a marked increase in his CPK level (105,231 IU/L on the 18th day of hospitalization) when the steroid dosage was reduced and rehabilitation was initiated. Thereafter, his condition rapidly deteriorated and he eventually died, despite the provision of aggressive treatment. In addition, Fink et al. reported the case of a 16-year-old male athlete with heat stroke and rhabdomyolysis . The patient survived and was discharged on day 14, but his CPK level was more than 1000 IU/L for several weeks after his discharge. Their report did not indicate whether the patient’s rhabdomyolysis was bimodal. Similarly to our case, in the four Japanese reports of six patients who suffered bimodal rhabdomyolysis in the acute and recovery phases (more than 2 weeks after severe heat stroke), all of the patients could survive and start rehabilitation (Table 3 ) [ 26 – 29 ]. Accordingly, the authors’ hypothesized that during the recovery phase, the stress of rehabilitation exercises can cause collapsed muscles that are injured by heat stroke to repeatedly flared up. Drugs that are administered during intensive treatment in the acute phase may be involved in the occurrence of bimodal rhabdomyolysis. However, this possibility was considered to be unlikely in the present case because drug-induced rhabdomyolysis usually subsides when the drugs are stopped . In our search of the literature, heat stroke-induced bimodal rhabdomyolysis was only described in Japanese case reports; thus, genetic differences may affect this phenomenon. Table 2 A summary of the reports on heat stroke in which the time course of rhabdomyolysis was described No Reporter Year Age Sex Trigger 1st peak D CPK max HD Outcome Bimodal 2nd peak D CPK max Trigger 1 Wu 2015 27 Male Exercise 2 55,650 Yes Survival No 2 Asserraji 2014 35 Male Marathon 5 91,596 Yes Death No 3 Raj 2013 11 Male Jog 1 4326 Yes Survival No 4 Horseman 2013 22 Male Walking 1 649,530 Yes Survival No 5 Azzopardi 2012 25 Male Marathon 2 178,850 No Survival No 6 Muñiz 2012 15 Male Football 2 39,954 No Survival No 7 Trujillo 2011 14 Female Exercise 3 36,423 Yes Survival No 8 Lin 2011 11 Female Jogging 2 21,351 No Survival No 9 Miura 2010 38 Male Marathon 3 84,612 No Death Yes 18 105,231 Reha 10 Lee 2010 57 Male Kot spring 3 9565 Yes Death No 11 Niu 2009 47 Male Labor 1 4682 No Survival No 12 Akieda 2008 75 Male Bath 3 4299 No Survival No 13 Fink 2006 16 Male Football 3 90,720 No Survival ? >2 wks >1000 Discharge 14 Broessner 2005 38 Male Hiking 4 1024 No Survival No 15 Wakino 2005 23 Male Labor 5 620,920 Yes Survival No 16 Takahashi 2005 16 Male Rugby ? ? Yes Survival Yes 8 24,985 Convulsion 17 Pechlaner 2002 28 Male Labor 2 1920 No Survival No 18 Present 28 Male Marathon 5 8832 Yes Survival Yes 22 9230 Reha ? means not described, D day, Reha rehabilitation, wks weeks, CPK creatinine phosphokinesis, HD hemodialysis, max maximum Table 3 The Japanese reports of bimodal rhabdomyolysis after heat stroke No Reporter Year Age Sex Trigger 1st peak D CPK max HD Outcome Bimodal 2nd peak D CPK max Trigger 1 Suzuki 1996 23 Male Training 3 300,762 Yes Survival Yes 20 14,154 Reha 2 Kajiwara 1993 17 Male Jogging 3 >15,000 No Survival Yes 22 4500 Reha 3 Kuriyama 1990 19 Male Jogging 6 10,425 No Survival Yes 15 105,945 Reha 4 Nagao 1985 21 Male Jogging 6 5570 No Survival Yes 18 474 Reha 5 Nagao 1985 18 Male Jogging 5 4530 No Survival Yes 19 9800 Reha 6 Nagao 1985 16 Male Kendo 3 9410 No Death Yes 17 309,000 Reha D day, CPK creatinine phosphokinesis, HD hemodialysis, max maximum
4.332031
0.790039
sec[1]/sec[0]/p[0]
en
0.999998
27980788
https://doi.org/10.1186/s40560-016-0193-9
[ "survival", "rhabdomyolysis", "heat", "stroke", "bimodal", "reha", "jogging", "that", "rehabilitation", "trigger" ]
[ { "code": "KD3A", "title": "Termination of pregnancy, affecting surviving fetus or newborn" }, { "code": "FB32.20", "title": "Idiopathic rhabdomyolysis" }, { "code": "8C84", "title": "Secondary rhabdomyolysis" }, { "code": "NF01.Z", "title": "Effects of heat, unspecified" }, { "code": "QD71.1", "title": "Inadequate housing" }, { "code": "NF01.Y", "title": "Other specified effects of heat" }, { "code": "EE02.Y", "title": "Other specified forms of miliaria" }, { "code": "NF01.0", "title": "Heat stroke" }, { "code": "8B20", "title": "Stroke not known if ischaemic or haemorrhagic" }, { "code": "8B11.5Z", "title": "Cerebral ischaemic stroke, unspecified" } ]
=== ICD-11 CODES FOUND === [KD3A] Termination of pregnancy, affecting surviving fetus or newborn Definition: Termination of pregnancy (TOP) refers to a medically directed miscarriage, and this can be performed using pharmacological or surgical methods. Also known as: Termination of pregnancy, affecting surviving fetus or newborn | abortion of pregnancy, affecting surviving fetus or newborn | Termination of pregnancy with foeticide | Termination of pregnancy without foeticide Excludes: termination of pregnancy (affecting mother) [FB32.20] Idiopathic rhabdomyolysis Definition: Skeletal muscle breakdown with leakage of muscle contents, frequently accompanied by myoglobinuria, occurring in both adult and paediatric populations with no identifiable cause. The attacks are often recurrent. Renal failure due to tubular necrosis is a severe complication. Also known as: Idiopathic rhabdomyolysis | rhabdomyolysis NOS Excludes: Myasthenia gravis or certain specified neuromuscular junction disorders | Secondary myopathies [8C84] Secondary rhabdomyolysis Definition: Secondary rhabdomyolysis occurs when the primary effect of a aetiological factor results in a functional or biochemical state which is conducive to the development of ischemic, degenerative, necrotic or membrane destabilizing changes in muscle, producing the clinical and biochemical features of rhabdomyolysis. Most frequently, rhabdomyolysis is secondary to a metabolic derangement often genetic in nature, as result of abnormally excessive movement, excessive isometric tension by attempted moveme Also known as: Secondary rhabdomyolysis Excludes: Myasthenia gravis or certain specified neuromuscular junction disorders | Primary disorders of muscles [NF01.Z] Effects of heat, unspecified Also known as: Effects of heat, unspecified | Effects of heat | heat exhaustion | heat prostration NOS | effects of hot weather [QD71.1] Inadequate housing Also known as: Inadequate housing | lack of adequate housing | problem with inadequate housing | restriction of housing space | unsatisfactory surroundings Excludes: Problems associated with the natural environment or human-made changes to the environment [NF01.Y] Other specified effects of heat Also known as: Other specified effects of heat | Heat exhaustion due to salt depletion | salt deficiency causing heat exhaustion or prostration | sodium depletion causing heat exhaustion or prostration | effects of heat exhaustion due to salt depletion [EE02.Y] Other specified forms of miliaria Also known as: Other specified forms of miliaria | Miliaria crystallina | Sudamina | Miliaria rubra | Heat rash [NF01.0] Heat stroke Definition: Elevation of core body temperature above 40.6 degrees centigrade due to environmental heat exposure and a failure of thermoregulation. This is a potentially fatal disorder, particularly in infants and children. Also known as: Heat stroke | heat-induced hyperthermia | heat apoplexy | heat pyrexia | heat stress Excludes: Exertional heat stroke [8B20] Stroke not known if ischaemic or haemorrhagic Definition: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been determined by neuroimaging or other techniques. Also known as: Stroke not known if ischaemic or haemorrhagic | apoplexy | brain vascular accident | cerebral accident | cerebral apoplexy Excludes: sequelae of stroke [8B11.5Z] Cerebral ischaemic stroke, unspecified Also known as: Cerebral ischaemic stroke, unspecified | Cerebral ischaemic stroke of unknown cause | cryptogenic stroke | occlusion and stenosis of cerebral and precerebral arteries, resulting in cerebral infarction | cerebral infarct === GRAPH WALKS === --- Walk 1 --- [KD3A] Termination of pregnancy, affecting surviving fetus or newborn Def: Termination of pregnancy (TOP) refers to a medically directed miscarriage, and this can be performed using pharmacological or surgical methods.... --EXCLUDES--> [?] Induced abortion Def: Induced abortion (also referred to as Artificial termination of pregnancy) is a complete expulsion or extraction from a woman of an embryo or a fetus (irrespective of the duration of the pregnancy), f... --CHILD--> [?] Induced abortion, incomplete, complicated by embolism --- Walk 2 --- [KD3A] Termination of pregnancy, affecting surviving fetus or newborn Def: Termination of pregnancy (TOP) refers to a medically directed miscarriage, and this can be performed using pharmacological or surgical methods.... --PARENT--> [?] Certain disorders originating in the perinatal period Def: A group of any other paediatric conditions that occur during the period of time around childbirth, especially the five months before and one month after birth.... --RELATED_TO--> [?] Excessive crying of infant --- Walk 3 --- [FB32.20] Idiopathic rhabdomyolysis Def: Skeletal muscle breakdown with leakage of muscle contents, frequently accompanied by myoglobinuria, occurring in both adult and paediatric populations with no identifiable cause. The attacks are often... --EXCLUDES--> [?] Myasthenia gravis or certain specified neuromuscular junction disorders Def: Myasthenia gravis is the most common autoimmune disease affecting the neuromuscular junction and is characterised by painless fatigable muscle weakness. It is caused by autoantibodies against neuromus... --CHILD--> [?] Congenital myasthenic syndromes Def: Congenital myasthenic syndrome (CMS) is a heterogeneous group of genetically determined diseases. There are four well-defined categories: Congenital myasthenic syndrome with presynaptic defect, Synapt... --- Walk 4 --- [FB32.20] Idiopathic rhabdomyolysis Def: Skeletal muscle breakdown with leakage of muscle contents, frequently accompanied by myoglobinuria, occurring in both adult and paediatric populations with no identifiable cause. The attacks are often... --EXCLUDES--> [?] Myasthenia gravis or certain specified neuromuscular junction disorders Def: Myasthenia gravis is the most common autoimmune disease affecting the neuromuscular junction and is characterised by painless fatigable muscle weakness. It is caused by autoantibodies against neuromus... --CHILD--> [?] Congenital myasthenic syndromes Def: Congenital myasthenic syndrome (CMS) is a heterogeneous group of genetically determined diseases. There are four well-defined categories: Congenital myasthenic syndrome with presynaptic defect, Synapt... --- Walk 5 --- [8C84] Secondary rhabdomyolysis Def: Secondary rhabdomyolysis occurs when the primary effect of a aetiological factor results in a functional or biochemical state which is conducive to the development of ischemic, degenerative, necrotic ... --EXCLUDES--> [?] Myasthenia gravis or certain specified neuromuscular junction disorders Def: Myasthenia gravis is the most common autoimmune disease affecting the neuromuscular junction and is characterised by painless fatigable muscle weakness. It is caused by autoantibodies against neuromus... --CHILD--> [?] Myasthenia gravis Def: Myasthenia gravis is the most common acquired auto-antibody mediated neuromuscular transmission disorder. Prevalence is 1–2 per 10,000 persons. Fluctuating weakness increasing with repeated activity a... --- Walk 6 --- [8C84] Secondary rhabdomyolysis Def: Secondary rhabdomyolysis occurs when the primary effect of a aetiological factor results in a functional or biochemical state which is conducive to the development of ischemic, degenerative, necrotic ... --EXCLUDES--> [?] Primary disorders of muscles Def: Disorders in which the primary symptom of muscle weakness is secondary to a specific dysfunction of a muscle fiber.... --CHILD--> [?] Congenital myopathies
[ "[KD3A] Termination of pregnancy, affecting surviving fetus or newborn\n Def: Termination of pregnancy (TOP) refers to a medically directed miscarriage, and this can be performed using pharmacological or surgical methods....\n --EXCLUDES--> [?] Induced abortion\n Def: Induced abortion (also referred to as Artificial termination of pregnancy) is a complete expulsion or extraction from a woman of an embryo or a fetus (irrespective of the duration of the pregnancy), f...\n --CHILD--> [?] Induced abortion, incomplete, complicated by embolism", "[KD3A] Termination of pregnancy, affecting surviving fetus or newborn\n Def: Termination of pregnancy (TOP) refers to a medically directed miscarriage, and this can be performed using pharmacological or surgical methods....\n --PARENT--> [?] Certain disorders originating in the perinatal period\n Def: A group of any other paediatric conditions that occur during the period of time around childbirth, especially the five months before and one month after birth....\n --RELATED_TO--> [?] Excessive crying of infant", "[FB32.20] Idiopathic rhabdomyolysis\n Def: Skeletal muscle breakdown with leakage of muscle contents, frequently accompanied by myoglobinuria, occurring in both adult and paediatric populations with no identifiable cause. The attacks are often...\n --EXCLUDES--> [?] Myasthenia gravis or certain specified neuromuscular junction disorders\n Def: Myasthenia gravis is the most common autoimmune disease affecting the neuromuscular junction and is characterised by painless fatigable muscle weakness. It is caused by autoantibodies against neuromus...\n --CHILD--> [?] Congenital myasthenic syndromes\n Def: Congenital myasthenic syndrome (CMS) is a heterogeneous group of genetically determined diseases. There are four well-defined categories: Congenital myasthenic syndrome with presynaptic defect, Synapt...", "[FB32.20] Idiopathic rhabdomyolysis\n Def: Skeletal muscle breakdown with leakage of muscle contents, frequently accompanied by myoglobinuria, occurring in both adult and paediatric populations with no identifiable cause. The attacks are often...\n --EXCLUDES--> [?] Myasthenia gravis or certain specified neuromuscular junction disorders\n Def: Myasthenia gravis is the most common autoimmune disease affecting the neuromuscular junction and is characterised by painless fatigable muscle weakness. It is caused by autoantibodies against neuromus...\n --CHILD--> [?] Congenital myasthenic syndromes\n Def: Congenital myasthenic syndrome (CMS) is a heterogeneous group of genetically determined diseases. There are four well-defined categories: Congenital myasthenic syndrome with presynaptic defect, Synapt...", "[8C84] Secondary rhabdomyolysis\n Def: Secondary rhabdomyolysis occurs when the primary effect of a aetiological factor results in a functional or biochemical state which is conducive to the development of ischemic, degenerative, necrotic ...\n --EXCLUDES--> [?] Myasthenia gravis or certain specified neuromuscular junction disorders\n Def: Myasthenia gravis is the most common autoimmune disease affecting the neuromuscular junction and is characterised by painless fatigable muscle weakness. It is caused by autoantibodies against neuromus...\n --CHILD--> [?] Myasthenia gravis\n Def: Myasthenia gravis is the most common acquired auto-antibody mediated neuromuscular transmission disorder. Prevalence is 1–2 per 10,000 persons. Fluctuating weakness increasing with repeated activity a...", "[8C84] Secondary rhabdomyolysis\n Def: Secondary rhabdomyolysis occurs when the primary effect of a aetiological factor results in a functional or biochemical state which is conducive to the development of ischemic, degenerative, necrotic ...\n --EXCLUDES--> [?] Primary disorders of muscles\n Def: Disorders in which the primary symptom of muscle weakness is secondary to a specific dysfunction of a muscle fiber....\n --CHILD--> [?] Congenital myopathies" ]
KD3A
Termination of pregnancy, affecting surviving fetus or newborn
[ { "from_icd11": "KD3A", "icd10_code": "P964", "icd10_title": "" }, { "from_icd11": "FB32.20", "icd10_code": "M6282", "icd10_title": "Rhabdomyolysis" }, { "from_icd11": "NF01.Z", "icd10_code": "T678XXA", "icd10_title": "Other effects of heat and light, initial encounter" }, { "from_icd11": "NF01.Z", "icd10_code": "T675XXA", "icd10_title": "Heat exhaustion, unspecified, initial encounter" }, { "from_icd11": "NF01.Z", "icd10_code": "T67", "icd10_title": "Effects of heat and light" }, { "from_icd11": "NF01.Z", "icd10_code": "T672", "icd10_title": "Heat cramp" }, { "from_icd11": "NF01.Z", "icd10_code": "T674", "icd10_title": "Heat exhaustion due to salt depletion" }, { "from_icd11": "NF01.Z", "icd10_code": "T675", "icd10_title": "Heat exhaustion, unspecified" }, { "from_icd11": "NF01.Z", "icd10_code": "T677", "icd10_title": "Heat edema" }, { "from_icd11": "NF01.Z", "icd10_code": "T678", "icd10_title": "Other effects of heat and light" }, { "from_icd11": "NF01.Z", "icd10_code": "T679", "icd10_title": "Effect of heat and light, unspecified" }, { "from_icd11": "QD71.1", "icd10_code": "Z591", "icd10_title": "Inadequate housing" }, { "from_icd11": "NF01.0", "icd10_code": "T670XXA", "icd10_title": "" }, { "from_icd11": "NF01.0", "icd10_code": "T670", "icd10_title": "Heatstroke and sunstroke" }, { "from_icd11": "8B20", "icd10_code": "I64", "icd10_title": "" } ]
P964
The patient showed a rapid clinical response to therapy, with a reduction in the leg lesions within 4 weeks of starting treatment. However, she also experienced various toxicities, particularly joint pain and nausea. After 8 weeks of therapy, a CT scan showed the majority of pulmonary nodules and inguinal lymph nodes had either significantly shrunk or completely resolved. One nodule in the left lower lobe, however, had enlarged. A further CT scan after 16 weeks of therapy showed the left lower lobe pulmonary nodule remained unaltered with no new metastases. Clinically, the lesions in her left leg continued to shrink. However, by week 24 of therapy, she had lost 14 kg and developed grade 2 nausea and diarrhoea. Vemurafenib was ceased at this point. These toxicities quickly resolved, so therapy was restarted a week later at a lower dose of 720 mg BD. However, the patient again developed toxicity within less than 2 weeks. Treatment was again ceased for 1 week, before restarting at 480 mg BD. Treatment continued at this lower dose for 8 weeks, before a further 1-week cessation due to toxicities. This pattern continued, with toxicity settling whilst off treatment but quickly re-emerging on restarting therapy. So, in November 2012, 10 months after initially starting vemurafenib, with CT and clinical evidence of ongoing response, a decision was made to recommence vemurafenib on an intermittent regimen of 480 mg BD, 1 week on, 1 week off. As this could not be done within the expanded access programme, we applied for and received approval for this to be funded through the Cancer Drugs Fund. The lesions on the left leg continued to shrink on intermittent dosing, and 1 month later the leg was clear of all visible deposits. However, intermittent dosing was ceased in January 2013 because of grade 2 arthralgia in the patient’s hands. A CT scan performed 4 weeks after cessation of vemurafenib showed an ongoing response, with no evidence of any metastatic disease. The marker left inguinal lymph node remained unchanged in size. We planned to restart vemurafenib as and when the leg lesions recurred, but so far this has not occurred. As of February 2015, the patient is alive and clinically free of disease. She has not needed any other treatment for her metastatic melanoma. A summary of her clinical history is presented in Table 1 . Table 1 Chronological details of patient's treatment, disease state and toxicities Date Vemurafenib therapy Clinical disease status Radiological disease status Key toxicities (graded according to CTCAE v4.0) 19/01/2012 Multiple rapidly growing and painful lesions in left leg Multiple sub-cm lung nodules. Several enlarged left (L) inguinal LNs, largest 19 mm (SAD) 26/01/2012 Vem started at 960 mg BD continuous Leg lesions getting worse; nodules growing in size and bleeding - 23/02/2012 Week 4 Continued on Vem 960 mg BD continuous Good response, with decrease in size of lesions and pain - Nausea G1, Joint pain G1, Diarrhoea G1 15/03/2012 Week 7 Continued on Vem 960 mg BD continuous Ongoing response Lung nodules largely resolved. One nodule L lower lobe bigger. Decrease in L inguinal LNs. Largest 9 mm (SAD) Nausea G1, Joint pain G1, Diarrhoea G1 10/05/2012 Week 15 Continued on Vem 960 mg BD continuous Ongoing response L lower lobe nodule unchanged. No other lung nodules. Marker L inguinal LN 8 mm (SAD) Nausea G1, Joint pain G1, Diarrhoea G1, Skin toxicity G1 12/07/2012 Week 24 Vem stopped for 1 week Ongoing response Nausea G2, Diarrhoea G2, Vomiting G1, Joint pain G1, Skin toxicity G1, Fatigue G1 19/07/2012 Week 25 Vem restarted at 720 mg BD continuous Ongoing response Nausea G1 30/7/2012 Week 27 Vem stopped for 1 week Ongoing response Nausea G1, Anorexia G1 06/08/2012 Week 28 Vem restarted at 480 mg BD continuous Ongoing response Improvement whilst off Vem. Return of previous toxicities on restarting 29/8/12 Week 31 Continued on Vem 480 mg BD continuous Ongoing response No significant lung nodules. Marker L inguinal LN 8 mm (SAD) Joint pain G1, Skin toxicity G1, Fatigue G1 4/10/2012 Week 36 Vem stopped for 1 week Complete response (no visible lesions on leg) Joint pain G2, Fatigue G2, Skin toxicity G1 13/10/2012 Week 37 Vem restarted at 480 mg bd continuous Ongoing complete response Improvement whilst off Vem. Return of previous toxicities on restarting 16/11/2012 Week 43 Vem stopped for 1 week Ongoing complete response Nausea G1, Joint pain G1 Skin toxicity G1, Diarrhoea G1, Fatigue G1 23/11/2012 Week 44 Vem restarted at 480 mg BD intermittent Ongoing complete response No significant lung nodules. Marker left inguinal LN 7 mm (SAD) Improvement whilst off Vem 10/1/2013 Week 50 Vem discontinued Ongoing complete response Joint pain G2, Fatigue G2 07/02/2013 Ongoing complete response No significant lung nodules. Marker L inguinal LN 7 mm (SAD) Joint pain G1 20/09/2013 Ongoing complete response Resolution of all toxicity Abbreviations: BD twice-daily dosing, CTCAE common toxicity criteria for adverse events, LN lymph node, SAD short axis dimension, Vem vemurafenib
3.931641
0.942383
sec[1]/p[2]
en
0.999997
26857260
https://doi.org/10.1007/s11523-015-0410-9
[ "response", "ongoing", "pain", "joint", "nausea", "toxicity", "lesions", "nodules", "inguinal", "continuous" ]
[ { "code": "MB20.1", "title": "Coma" }, { "code": "4B4Z", "title": "Diseases of the immune system, unspecified" }, { "code": "MG46", "title": "Systemic inflammatory response syndrome of noninfectious origin" }, { "code": "MB72", "title": "Results of function studies of the nervous system" }, { "code": "MC81.0", "title": "Tachycardia, unspecified" }, { "code": "MG3Z", "title": "Pain, unspecified" }, { "code": "8E43.Z", "title": "Pain disorders, unspecified" }, { "code": "MG31.Z", "title": "Acute pain, unspecified" }, { "code": "MG30.Z", "title": "Chronic pain, unspecified" }, { "code": "FB56.2", "title": "Myalgia" } ]
=== ICD-11 CODES FOUND === [MB20.1] Coma Definition: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Motor responses to noxious stimulation are limited to reflexive behaviour. Etiologies include but are not limited to traumatic, anoxic, infectious, neoplastic, vascular, inflammatory and metabolic brain injuries. Also known as: Coma | comatose | exanimation | Coma, NOS | Unconsciousness, NOS Excludes: Diabetic coma | Hepatic coma | Neonatal coma [4B4Z] Diseases of the immune system, unspecified Also known as: Diseases of the immune system, unspecified | immunological defect NOS | immunity disorder NOS | immune mechanism disorder NOS | immune compromised NOS [MG46] Systemic inflammatory response syndrome of noninfectious origin Also known as: Systemic inflammatory response syndrome of noninfectious origin | systemic inflammatory response syndrome NOS | SIRS -[systemic inflammatory response syndrome] of noninfectious origin | SIRS NOS -[systemic inflammatory response syndrome not otherwise specified] Excludes: Systemic inflammatory response syndrome of infectious origin [MB72] Results of function studies of the nervous system Also known as: Results of function studies of the nervous system | Abnormal results of function studies of central nervous system | abnormal central nervous system function studies | Abnormal brain function studies | Abnormal EEG - [electroencephalogram] [MC81.0] Tachycardia, unspecified Also known as: Tachycardia, unspecified | heart rate fast | rapid heart | Rapid heart beat | increased heart rate [MG3Z] Pain, unspecified Also known as: Pain, unspecified | pain observations | pain NOS | generalised pain | generalised pain, NOS [8E43.Z] Pain disorders, unspecified Also known as: Pain disorders, unspecified | Pain disorders [MG31.Z] Acute pain, unspecified Also known as: Acute pain, unspecified | Acute pain [MG30.Z] Chronic pain, unspecified Also known as: Chronic pain, unspecified | Chronic pain [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain === GRAPH WALKS === --- Walk 1 --- [MB20.1] Coma Def: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Mot... --EXCLUDES--> [?] Hepatic encephalopathy Def: Hepatic encephalopathy is a complication of liver cirrhosis and a hallmark of acute liver failure, and is also observed in patients with portosystemic shunts without cirrhosis. Hepatic encephalopathy ... --PARENT--> [?] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --- Walk 2 --- [MB20.1] Coma Def: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Mot... --EXCLUDES--> [?] Hepatic encephalopathy Def: Hepatic encephalopathy is a complication of liver cirrhosis and a hallmark of acute liver failure, and is also observed in patients with portosystemic shunts without cirrhosis. Hepatic encephalopathy ... --CHILD--> [?] Hepatic encephalopathy, stage 3 --- Walk 3 --- [4B4Z] Diseases of the immune system, unspecified --PARENT--> [04] Diseases of the immune system --EXCLUDES--> [?] Developmental anomalies Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period.... --- Walk 4 --- [4B4Z] Diseases of the immune system, unspecified --PARENT--> [04] Diseases of the immune system --CHILD--> [4A20] Acquired immunodeficiencies --- Walk 5 --- [MG46] Systemic inflammatory response syndrome of noninfectious origin --EXCLUDES--> [?] Systemic inflammatory response syndrome of infectious origin --EXCLUDES--> [?] Sepsis --- Walk 6 --- [MG46] Systemic inflammatory response syndrome of noninfectious origin --EXCLUDES--> [?] Systemic inflammatory response syndrome of infectious origin --EXCLUDES--> [?] Sepsis
[ "[MB20.1] Coma\n Def: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Mot...\n --EXCLUDES--> [?] Hepatic encephalopathy\n Def: Hepatic encephalopathy is a complication of liver cirrhosis and a hallmark of acute liver failure, and is also observed in patients with portosystemic shunts without cirrhosis. Hepatic encephalopathy ...\n --PARENT--> [?] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....", "[MB20.1] Coma\n Def: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Mot...\n --EXCLUDES--> [?] Hepatic encephalopathy\n Def: Hepatic encephalopathy is a complication of liver cirrhosis and a hallmark of acute liver failure, and is also observed in patients with portosystemic shunts without cirrhosis. Hepatic encephalopathy ...\n --CHILD--> [?] Hepatic encephalopathy, stage 3", "[4B4Z] Diseases of the immune system, unspecified\n --PARENT--> [04] Diseases of the immune system\n --EXCLUDES--> [?] Developmental anomalies\n Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....", "[4B4Z] Diseases of the immune system, unspecified\n --PARENT--> [04] Diseases of the immune system\n --CHILD--> [4A20] Acquired immunodeficiencies", "[MG46] Systemic inflammatory response syndrome of noninfectious origin\n --EXCLUDES--> [?] Systemic inflammatory response syndrome of infectious origin\n --EXCLUDES--> [?] Sepsis", "[MG46] Systemic inflammatory response syndrome of noninfectious origin\n --EXCLUDES--> [?] Systemic inflammatory response syndrome of infectious origin\n --EXCLUDES--> [?] Sepsis" ]
MB20.1
Coma
[ { "from_icd11": "MB20.1", "icd10_code": "R402142", "icd10_title": "Coma scale, eyes open, spontaneous, at arrival to emergency department" }, { "from_icd11": "MB20.1", "icd10_code": "R402362", "icd10_title": "Coma scale, best motor response, obeys commands, at arrival to emergency department" }, { "from_icd11": "MB20.1", "icd10_code": "R402252", "icd10_title": "Coma scale, best verbal response, oriented, at arrival to emergency department" }, { "from_icd11": "MB20.1", "icd10_code": "R402412", "icd10_title": "Glasgow coma scale score 13-15, at arrival to emergency department" }, { "from_icd11": "MB20.1", "icd10_code": "R4020", "icd10_title": "Unspecified coma" }, { "from_icd11": "MB20.1", "icd10_code": "R402141", "icd10_title": "Coma scale, eyes open, spontaneous, in the field [EMT or ambulance]" }, { "from_icd11": "MB20.1", "icd10_code": "R402361", "icd10_title": "Coma scale, best motor response, obeys commands, in the field [EMT or ambulance]" }, { "from_icd11": "MB20.1", "icd10_code": "R402251", "icd10_title": "Coma scale, best verbal response, oriented, in the field [EMT or ambulance]" }, { "from_icd11": "MB20.1", "icd10_code": "R402413", "icd10_title": "Glasgow coma scale score 13-15, at hospital admission" }, { "from_icd11": "MB20.1", "icd10_code": "R402143", "icd10_title": "Coma scale, eyes open, spontaneous, at hospital admission" }, { "from_icd11": "MB20.1", "icd10_code": "R402243", "icd10_title": "Coma scale, best verbal response, confused conversation, at hospital admission" }, { "from_icd11": "MB20.1", "icd10_code": "R402363", "icd10_title": "Coma scale, best motor response, obeys commands, at hospital admission" }, { "from_icd11": "MB20.1", "icd10_code": "R402433", "icd10_title": "Glasgow coma scale score 3-8, at hospital admission" }, { "from_icd11": "MB20.1", "icd10_code": "R402212", "icd10_title": "Coma scale, best verbal response, none, at arrival to emergency department" }, { "from_icd11": "MB20.1", "icd10_code": "R402112", "icd10_title": "Coma scale, eyes open, never, at arrival to emergency department" } ]
R402142
Coma scale, eyes open, spontaneous, at arrival to emergency department
We describe a patient with natalizumab treatment who, based on findings on a routine MRI scan, was diagnosed with PML before any unambiguous clinical manifestations had emerged. PML is a serious adverse effect with high morbidity and mortality rates complicating natalizumab treatment. Clinical vigilance is always important for the diagnosis, but this case clearly illustrates the importance of an early detection with MRI and an adequate treatment to accomplish a favorable outcome. A few short case reports have recently been published of PML discovered by MRI in the presymptomatic phase . In these cases, clinical outcome was also favorable, but in our case poor prognosis would be predicted according to factors reported as associated with poorer survival, i.e., 1/older age at PML diagnosis, 2/higher pre-PML EDSS, and 3/widespread PML extension on MRI (Biogen Idec, data on file). This is in line with emerging evidence that early diagnosis of PML, before any symptoms develop, is of importance for the outcome . Thus, we are convinced that MRI scans (FLAIR) every 3 months after 24 months of natalizumab treatment, when risk to develop PML is increased, should be recommended in all JC virus positive MS patients (Table 1 ). It is probably even more important with frequent MRI scans among natalizumab treated MS patients with a high EDSS score, as shown in this case, while it is more difficult to discover a subtle clinical worsening among these patients. Our patient also had a prior use of immunosuppressant, which further emphasize the importance of frequent MRI scans in such cases. The importance of frequent MRI scans was also obvious in our first case of natalizumab-associated PML, which also was the first case described with natalizumab monotherapy . In that case, we could demonstrate that signs of PML on MRI was at hand already 3 months before any symptoms had appeared . In the present case, regular MRI scans every 3 months, most probably would have discovered the PML infection even earlier, which possibly would have led to an even more favorable outcome. The present case also demonstrates the importance of frequent SDMT, while the patient’s score was clearly lower at PML diagnosis compared to 6 months earlier. SDMT measures cognitive processing speed and visual working memory. It is a performance measure that requires patients to visually scan a key of number/symbol pairings and then voice the correct number for randomly presented symbols as rapidly as possible . The outcome measure is the number of correct responses in 90 s. SDMT is strongly associated with MS lesion burden and cortical and deep gray matter atrophy . However, there is often some variation in scores between tests in the same patient over time, which makes it difficult from one test to determine whether it is a temporary decline in score or a first indication of PML. A monthly assessment should then be necessary to screen for cognitive impairments, instead of the usually scheduled every 6 months. The sensitivity and specificity of SDMT with regard to early discovery of PML remains to be evaluated. The efficacy of plasma exchange in the treatment of natalizumab-associated PML has already been shown in several case reports . Also in the present case, plasma exchange was initiated immediately after diagnosis of PML to quickly remove natalizumab, and thus restore immune function. Mefloquine was given directly after plasma exchange. Mefloquine has been shown to inhibit JC viral replication in cells in vitro , and to exert beneficial clinical effects on PML infections . Treatment with mirtazapine (at a dose of 30 mg per day) was also initiated after plasma exchange to probably further inhibit viral spread by blocking the 5-HT2 receptor, the proposed viral coreceptor for cellular infection . Close clinical vigilance and frequent MRI scans was then performed in order to detect the first symptoms suggestive of IRIS. IRIS is a well known condition from patients with HIV infections suffering from PML, where it occurs in parallel with immune recovery after highly active antiretroviral therapy . It is caused by the presumed immune attack against the JC virus, resulting in an overwhelming inflammatory response. This inflammatory attack is then believed to increase the local damage. Thus, IRIS itself can probably cause significant morbidity and mortality and should be treated with steroids . However, the use of steroids for IRIS has been challenged . IRIS can be detected either by gadolinium enhancement on MRI or by a worsening of symptoms. In both this case and in our first case of natalizumab-associated PML , IRIS occurred within 1 month from plasma exchange and was accompanied by headache, possibly a consequence of meningeal irritation. In order not to interfere with the initial immune recovery, we waited with steroids until a presumed IRIS was at hand. The treatment with high dose steroids intravenously was followed by an oral steroid course for several months until PCR for JC virus DNA in CSF showed negative results.
4.289063
0.858887
sec[2]/p[0]
en
0.999997
23423248
https://doi.org/10.3389/fneur.2013.00011
[ "natalizumab", "iris", "scans", "this", "importance", "outcome", "associated", "that", "patients", "frequent" ]
[ { "code": "4B23", "title": "Immune reconstitution inflammatory syndrome" }, { "code": "LA11.3", "title": "Aniridia" }, { "code": "9A93", "title": "Adhesions or disruptions of iris or ciliary body" }, { "code": "9A90.2", "title": "Iris atrophy" }, { "code": "9A90.1", "title": "Degeneration of iris" }, { "code": "MB71.Y", "title": "Other specified clinical findings on diagnostic imaging of central nervous system" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "JA66.3", "title": "Abnormal ultrasonic finding on antenatal screening of mother" }, { "code": "PB28", "title": "Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance" }, { "code": "PC98", "title": "Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance" } ]
=== ICD-11 CODES FOUND === [4B23] Immune reconstitution inflammatory syndrome Definition: This is a condition seen in some cases of AIDS or immunosuppression, in which the immune system begins to recover, but then responds to a previously acquired opportunistic infection with an overwhelming inflammatory response that paradoxically makes the symptoms of infection worse. Also known as: Immune reconstitution inflammatory syndrome | Immune reconstitution syndrome | IRIS - [immune reconstitution inflammatory syndrome] | HIV-associated immune reconstitution inflammatory syndrome | Immune reconstitution inflammatory syndrome [IRIS], HIV-associated [LA11.3] Aniridia Definition: Aniridia is a congenital ocular malformation characterised by the complete or partial absence of the iris. It can be isolated or part of a syndrome (isolated and syndromic aniridia). Also known as: Aniridia | Absence of iris | agenesis of iris | aplasia of iris | congenital absence of iris [9A93] Adhesions or disruptions of iris or ciliary body Definition: This refers to adhesions and disruptions of the thin, circular structure in the eye, responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina. The colour of the iris is often referred to as "eye colour." It is also of the circumferential tissue inside the eye composed of the ciliary muscle and ciliary processes. It is triangular in horizontal section and is coated by a double layer, the ciliary epithelium. Also known as: Adhesions or disruptions of iris or ciliary body | Synechiae of iris NOS | synechia | Anterior synechiae, iris | anterior synechia Includes: Anterior synechiae, iris | Goniosynechiae | Iridodialysis Excludes: Corectopia [9A90.2] Iris atrophy Also known as: Iris atrophy | atrophic iris | essential iris atrophy | Progressive essential iris atrophy [9A90.1] Degeneration of iris Definition: This refers to the change of tissue to a lower or less functionally active form, of the thin, circular structure in the eye, responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina. The color of the iris is often referred to as "eye color." Also known as: Degeneration of iris | Pigmentary degeneration of iris | Acute bilateral depigmentation of iris | Translucency of iris [MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system Also known as: Other specified clinical findings on diagnostic imaging of central nervous system | Epidural haemorrhage, localised, no generalised mass effect or midline shift | Epidural haemorrhage, confined to a small region in relation to a fracture | Epidural haemorrhage, size less than 1 x 1 x 1 cm, not in relation to a fracture | Epidural haemorrhage, mass effect or midline shift less than 0.5 cm [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [JA66.3] Abnormal ultrasonic finding on antenatal screening of mother Definition: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother. Also known as: Abnormal ultrasonic finding on antenatal screening of mother | antenatal ultrasound scan abnormal [PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance Also known as: Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance | accidental overdose of other or unspecified drug, medicament or biological substance | accidental poisoning by other or unspecified drug, medicament or biological substance | other or unspecified drug, medicament or biological substance taken in error | accidental drug overdose [PC98] Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance Also known as: Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance | Intentional self-poisoning by and exposure to other or unspecified drug, medicament or biological substance | Intentional overdose of other or unspecified drug, medicament or biological substance | self-administered overdose by drugs | Intentional self-harm by exposure to or harmful effects of systemic antibiotics === GRAPH WALKS === --- Walk 1 --- [4B23] Immune reconstitution inflammatory syndrome Def: This is a condition seen in some cases of AIDS or immunosuppression, in which the immune system begins to recover, but then responds to a previously acquired opportunistic infection with an overwhelmi... --PARENT--> [?] Certain disorders involving the immune system Def: Disorders in which disturbed immune regulation plays an important part but which cannot be more precisely located elsewhere in the classification.... --EXCLUDES--> [?] Failure or rejection of transplanted organs or tissues --- Walk 2 --- [4B23] Immune reconstitution inflammatory syndrome Def: This is a condition seen in some cases of AIDS or immunosuppression, in which the immune system begins to recover, but then responds to a previously acquired opportunistic infection with an overwhelmi... --PARENT--> [?] Certain disorders involving the immune system Def: Disorders in which disturbed immune regulation plays an important part but which cannot be more precisely located elsewhere in the classification.... --RELATED_TO--> [?] Hereditary angioedema Def: Hereditary angioedema is caused in the majority of cases by genetically determined low absolute (type I) or functional (type II) levels of C1 inhibitor, a plasma proteinase inhibitor involved in regul... --- Walk 3 --- [LA11.3] Aniridia Def: Aniridia is a congenital ocular malformation characterised by the complete or partial absence of the iris. It can be isolated or part of a syndrome (isolated and syndromic aniridia).... --PARENT--> [LA11] Structural developmental anomalies of the anterior segment of eye Def: Any condition caused by failure of the anterior segment of the eye to correctly develop during the antenatal period.... --PARENT--> [?] Structural developmental anomalies of the eye, eyelid or lacrimal apparatus Def: Any condition caused by failure of the eye, eyelid and lacrimal apparatus to correctly develop during the antenatal period.... --- Walk 4 --- [LA11.3] Aniridia Def: Aniridia is a congenital ocular malformation characterised by the complete or partial absence of the iris. It can be isolated or part of a syndrome (isolated and syndromic aniridia).... --PARENT--> [LA11] Structural developmental anomalies of the anterior segment of eye Def: Any condition caused by failure of the anterior segment of the eye to correctly develop during the antenatal period.... --RELATED_TO--> [?] Developmental glaucoma --- Walk 5 --- [9A93] Adhesions or disruptions of iris or ciliary body Def: This refers to adhesions and disruptions of the thin, circular structure in the eye, responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina. Th... --EXCLUDES--> [?] Corectopia --PARENT--> [?] Structural developmental anomalies of the pupil --- Walk 6 --- [9A93] Adhesions or disruptions of iris or ciliary body Def: This refers to adhesions and disruptions of the thin, circular structure in the eye, responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina. Th... --PARENT--> [?] Disorders of the anterior uvea --CHILD--> [9A91] Cyst of iris or ciliary body
[ "[4B23] Immune reconstitution inflammatory syndrome\n Def: This is a condition seen in some cases of AIDS or immunosuppression, in which the immune system begins to recover, but then responds to a previously acquired opportunistic infection with an overwhelmi...\n --PARENT--> [?] Certain disorders involving the immune system\n Def: Disorders in which disturbed immune regulation plays an important part but which cannot be more precisely located elsewhere in the classification....\n --EXCLUDES--> [?] Failure or rejection of transplanted organs or tissues", "[4B23] Immune reconstitution inflammatory syndrome\n Def: This is a condition seen in some cases of AIDS or immunosuppression, in which the immune system begins to recover, but then responds to a previously acquired opportunistic infection with an overwhelmi...\n --PARENT--> [?] Certain disorders involving the immune system\n Def: Disorders in which disturbed immune regulation plays an important part but which cannot be more precisely located elsewhere in the classification....\n --RELATED_TO--> [?] Hereditary angioedema\n Def: Hereditary angioedema is caused in the majority of cases by genetically determined low absolute (type I) or functional (type II) levels of C1 inhibitor, a plasma proteinase inhibitor involved in regul...", "[LA11.3] Aniridia\n Def: Aniridia is a congenital ocular malformation characterised by the complete or partial absence of the iris. It can be isolated or part of a syndrome (isolated and syndromic aniridia)....\n --PARENT--> [LA11] Structural developmental anomalies of the anterior segment of eye\n Def: Any condition caused by failure of the anterior segment of the eye to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies of the eye, eyelid or lacrimal apparatus\n Def: Any condition caused by failure of the eye, eyelid and lacrimal apparatus to correctly develop during the antenatal period....", "[LA11.3] Aniridia\n Def: Aniridia is a congenital ocular malformation characterised by the complete or partial absence of the iris. It can be isolated or part of a syndrome (isolated and syndromic aniridia)....\n --PARENT--> [LA11] Structural developmental anomalies of the anterior segment of eye\n Def: Any condition caused by failure of the anterior segment of the eye to correctly develop during the antenatal period....\n --RELATED_TO--> [?] Developmental glaucoma", "[9A93] Adhesions or disruptions of iris or ciliary body\n Def: This refers to adhesions and disruptions of the thin, circular structure in the eye, responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina. Th...\n --EXCLUDES--> [?] Corectopia\n --PARENT--> [?] Structural developmental anomalies of the pupil", "[9A93] Adhesions or disruptions of iris or ciliary body\n Def: This refers to adhesions and disruptions of the thin, circular structure in the eye, responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina. Th...\n --PARENT--> [?] Disorders of the anterior uvea\n --CHILD--> [9A91] Cyst of iris or ciliary body" ]
4B23
Immune reconstitution inflammatory syndrome
[ { "from_icd11": "4B23", "icd10_code": "D893", "icd10_title": "Immune reconstitution syndrome" }, { "from_icd11": "LA11.3", "icd10_code": "Q131", "icd10_title": "Absence of iris" }, { "from_icd11": "9A93", "icd10_code": "H21561", "icd10_title": "Pupillary abnormality, right eye" }, { "from_icd11": "9A93", "icd10_code": "H21531", "icd10_title": "Iridodialysis, right eye" }, { "from_icd11": "9A93", "icd10_code": "H21549", "icd10_title": "Posterior synechiae (iris), unspecified eye" }, { "from_icd11": "9A93", "icd10_code": "H21542", "icd10_title": "Posterior synechiae (iris), left eye" }, { "from_icd11": "9A93", "icd10_code": "H21563", "icd10_title": "Pupillary abnormality, bilateral" }, { "from_icd11": "9A93", "icd10_code": "H21532", "icd10_title": "Iridodialysis, left eye" }, { "from_icd11": "9A93", "icd10_code": "H21539", "icd10_title": "Iridodialysis, unspecified eye" }, { "from_icd11": "9A93", "icd10_code": "H21509", "icd10_title": "Unspecified adhesions of iris and ciliary body, unspecified eye" }, { "from_icd11": "9A93", "icd10_code": "H215", "icd10_title": "Other and unspecified adhesions and disruptions of iris and ciliary body" }, { "from_icd11": "NE60", "icd10_code": "T50A95A", "icd10_title": "Adverse effect of other bacterial vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z15A", "icd10_title": "Adverse effect of immunoglobulin, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z95A", "icd10_title": "Adverse effect of other vaccines and biological substances, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A95S", "icd10_title": "Adverse effect of other bacterial vaccines, sequela" } ]
D893
Immune reconstitution syndrome
A 58-year-old man with a history of type 2 diabetes and hypertension was admitted in June 2013 because of headache, loss of appetite, constipation, and wide fluctuations in both blood glucose levels (3.3–25.2 mmol/L) and blood pressure (147–180/70–120 mmHg) during the past three months, despite treatment with insulin, metformin, and amlodipine, furthermore, he had undergone subtotal gastrectomy for a stomach ulcer 28 years ago. The patient had no family history of diabetes, hypertension, malignancies, or other related diseases. Physical examination revealed a blood pressure of 119/83 mmHg with no physical signs of moon facies, buffalo hump, truncal obesity, or purple abdominal striae. The CT image revealed a circular, solid, soft tissue mass measuring 30 × 38 mm with a clear boundary in the right side of the adrenal gland. On contrast enhancement, the lesion appeared heterogeneous, with no calcification or necrosis. Enhancement and hypervascularization also were observed (arrow). The radiodensity was 35 hounsfield units (HU) on unenhanced CT and 80 HU on contrast-enhanced CT. Continuous glucose monitoring showed wide fluctuations in blood glucose levels , and 24-h urine VMA levels were slightly elevated (Table 1 ). These clinical manifestations suggested the possibility of pheochromocytoma . Further workup revealed an abnormal circadian cortisol rhythm and cortisol levels that were not suppressed by dexamethasone (either 1 mg overnight or 2 mg every 6 h for 2 days), indicating the possibility of Cushing’s syndrome (Table 1 ). Other laboratory findings, such as plasma aldosterone, were normal (Table 1 ). The right adrenal lesion was resected laparoscopically after alpha-adrenergic receptor blockade. Postoperative immunohistochemical staining for SF-1 and CGA confirmed that the tumour was a corticomedullary mixed tumour. In order to analyse the tumorigenic mechanism of corticomedullary mixed tumour with distinct arrangement of the cortical and medullary layers, we stained the resected tissue for various tumour stem cell-specific markers, including ALDH1, CD44, CD133, Nestin, NGFR, and SOX9, and found short spindle-positive cells scattered within the tumour , suggesting the involvement of tumour stem cells. During 18 months of postoperative follow-up, the patient did not require hypoglycaemic or antihypertensive drugs and had stable blood glucose levels and blood pressure. Additionally, the cortisol rhythm and 24-h urine VMA level returned to normal (Table 1 ). Abdominal CT confirmed complete resection of the tumour , and metaiodobenzylguanidine and positron emission tomography-CT scans revealed no extra-adrenal lesion. Family history screening indicated that this was an isolated case . Fig. 1 CT and immunohistochemistry of the right adrenal lesion. a Abdominal CT image showing a right adrenal lesion ( arrow ). b Gross appearance of the resected right adrenal gland, and immunohistochemical double-staining for SF-1 and CGA: the adrenal capsule (ac), residual normal adrenal cortex (nac; stained brown for SF-1), tumour capsule (tc), cortical component of the tumour (cct; stained brown for SF-1), and medullary component of the tumour (mct; stained red for CGA) are visible (×200). c - h Immunohistochemical staining for the cancer stem cell-specific markers ALDH1 ( c ), CD44 ( d ), CD133 ( e ), Nestin ( f ), NGFR ( g ), and SOX9 ( h ) Fig. 2 Clinical follow-up datas. a A preoperative continuous glucose monitoring graph. b A postoperative continuous glucose monitoring graph. c A postoperative CT image showing absence of the right adrenal tumour ( arrow ). d A metaiodobenzylguanidine scan image. e A positron emission tomography-CT image. f A pedigree chart Table 1 The preoperative and postoperative endocrinological evaluation Parameter Values Reference Range Preoperative Postoperative ACTH (ng/L) 21.2 39.5 4.8–48.8 Cortisol (nmol/L) 290 392 176.6–579.4(8 am) 510 196 66–353(4 pm) 635 146 <100(0 am) LDDST Cortisol (nmol/L) 232 N/P <50 HDDST Cortisol (nmol/L) 679 N/P <145(50% baseline value) Aldosterone (pg/ml) 42.6 76.3 60–175 UVMA (mg/24h) 16.4 7.60 <13.6 GA (%) 21.64 14.52 11–16 HbA1c (%) 7.7 5.9 4.0–6.0 CPRT (ng/ml) 0 min 0.7 0.79 0.48–0.78 30 min 0.5 5.1 1.3–5.0 60 min 0.6 8.66 1.25–4.6 120 min 1.1 2.17 0.75–3.23 180 min 1.2 0.96 0.37–1.62 FT3 (pmol/L) 2.6 4.2 3.1–6.8 FT4 (pmol/L) 16.6 12.3 11–22 TSH (mIU/L) 1.05 3.96 0.468–4.68 FSH (mIU/ml) 12.29 10.59 0.95–11.95 TEST (nmol/L) 7.73 10.36 1.68–8.11 PROG (ng/ml) <0.1 0.2 <0.1–0.2 PRL (ng/ml) 8.62 26.14 3.46–19.4 E2 (pg/ml) 23 33 11–44 LH (mIU/ml) 4.51 8.88 1.14–8.75 ACTH adrenocorticotrophin, LDDST low-dose dexamethasone suppression test, HDDST high-dose dexamethasone suppression test, UVMA urinary vanillymandelic acid, GA glycosylated albumin, HbA1c glycosylated haemoglobin; CPRT C- peptide release test, FT3 free triiodothyronine, FT4 free thyroxine, TSH thyroid-stimulating hormone, FSH follicle-stimulating hormone, TEST testosterone, PROG progesterone, PRL prolactin, E2 estradiol, LH luteinizing hormone, N/P not performed
4.226563
0.937988
sec[1]/p[0]
en
0.999995
28193212
https://doi.org/10.1186/s12902-017-0157-7
[ "tumour", "adrenal", "blood", "glucose", "cortisol", "postoperative", "lesion", "stained", "nmol", "pressure" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "5A76.Y", "title": "Other specified disorders of adrenal gland" }, { "code": "5A7Z", "title": "Disorders of the adrenal glands or adrenal hormone system, unspecified" }, { "code": "5A74.Z", "title": "Adrenocortical insufficiency, unspecified" }, { "code": "5A74.Y", "title": "Other specified adrenocortical insufficiency" }, { "code": "LC8Z", "title": "Structural developmental anomalies of the adrenal glands, unspecified" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [5A76.Y] Other specified disorders of adrenal gland Also known as: Other specified disorders of adrenal gland | Suprarenal gland abscess | Suprarenal abscess | Adrenal gland inflammation | adrenal glandular inflammation [5A7Z] Disorders of the adrenal glands or adrenal hormone system, unspecified Also known as: Disorders of the adrenal glands or adrenal hormone system, unspecified | Adrenal gland disease, not elsewhere classified | adrenal cortex disease | adrenal cortical disease | adrenal glandular disease [5A74.Z] Adrenocortical insufficiency, unspecified Also known as: Adrenocortical insufficiency, unspecified | Adrenocortical insufficiency | adrenal failure NOS | Hypoadrenocorticism | adrenocortical hypofunction [5A74.Y] Other specified adrenocortical insufficiency Also known as: Other specified adrenocortical insufficiency | Congenital adrenocortical insufficiency | Congenital isolated ACTH deficiency | Familial adrenal hypoplasia | Familial hypoadrenocorticism [LC8Z] Structural developmental anomalies of the adrenal glands, unspecified Also known as: Structural developmental anomalies of the adrenal glands, unspecified | adrenal anomaly | adrenal gland anomaly | congenital anomaly of adrenal gland | congenital malformation of adrenal gland === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Benign symmetrical lipomatosis Def: Benign symmetrical lipomatosis is an uncommon condition characterised by progressive symmetrical accumulation during adult life of adipose mass at the level of the head, neck and upper trunk . The con... --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Fat pad Def: A condition characterised by a mass of closely packed adipose cells surrounded by fibrous tissue septa. When localised in the heel this condition may present with dull pain when pressure is applied.... --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --PARENT--> [02] Neoplasms Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair.... --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Benign symmetrical lipomatosis\n Def: Benign symmetrical lipomatosis is an uncommon condition characterised by progressive symmetrical accumulation during adult life of adipose mass at the level of the head, neck and upper trunk . The con...", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Fat pad\n Def: A condition characterised by a mass of closely packed adipose cells surrounded by fibrous tissue septa. When localised in the heel this condition may present with dull pain when pressure is applied....", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
Our patient is a 4-year-old Hispanic boy. He first presented at 6 months old to the Emergency Room with a chief complaint of left leg swelling and pain for a month. Further work-up including pelvic and thigh magnetic resonance imaging (MRI) revealed a heterogeneous partially cystic enhancing bilobed mass at the left side of the pelvis, measuring 5.7 × 4.3 × 4.0 cm . The left external iliac artery and vein coursed between the two lobes of the mass. In addition, multiple enlarged left inguinal lymph nodes were identified with solid and cystic appearance, suggestive of tumor metastasis. Diagnostic excisional inguinal lymph node biopsy was done. Sections revealed a distinct biphasic appearance by light microscopy and immunohistochemical analysis demonstrated both alveolar rhabdomyosarcoma-like (ARMS-like) and poorly differentiated neuroblastoma components. No evidence of residual lymph node was identified. The RMS component was composed of prominent spaces separated by fibrovascular septa ( Figure 2(a) ). The septa were lined by loosely cohesive primitive cells with hyperchromatic nuclei and variable amount of scant cytoplasm, imparting an alveolar pattern ( Figure 2(b) ). However, there were foci where tumor cells demonstrated nesting pattern within the fibrovascular septa with pleomorphic nuclei ( Figure 2(c) ). The neuroblastoma component showed schwannian stroma poor tumor with more primitive neuroblasts and scant amount of neuropil in a nodular growth pattern (Figures 3(a) and 3(b) ). Moreover, the neuroblastic tumor cells showed speckled salt and pepper nuclei, inconspicuous nucleoli, and little nuclear pleomorphism with a variable amount of scant cytoplasm. The mitotic-karyorrhectic index (MKI) was low (<2%) ( Figure 3(c) ). The RMS component was strongly positive for myogenin ( Figure 4(b) ) and desmin by immunohistochemical staining, while the neuroblastoma component was stained with neural markers such as PGP9.5 and tyrosine-hydroxylase (Figures 4(c) and 4(d) ), CD56, synaptophysin, and S100. Whole body work-up including MRI, positron emission tomography scan (PET scan), and bone marrow biopsy did not show any evidence of tumor involvement in other areas of the body including the central nervous system. Due to the extensive lymphadenopathy in the pelvic and inguinal area, the patient's tumor was considered to be metastatic and treated against RMS as it was the more aggressive component of the tumor. He received and completed national protocol chemotherapy for ARMS (COG-ARST08P1 protocol ), with significant reduction in his tumor burden. He was doing well and had been off of chemotherapy for about four months, when he became less active and showed ataxic gait with episodes of vomiting, 21 months after first presentation. MRI of the brain showed a 5.6 × 5.1 × 4.2 cm left cerebellar cystic mass with thick peripheral enhancement and some hemorrhage, consistent with metastasis . The tumor showed significant mass effect on the fourth ventricle and brain stem. There was no evidence of tumor recurrence or metastasis in other sites. Due to the location of the tumor, mass effect, and tumor size reduction, excisional surgery was done. The metastatic tumor displayed a more homogenous microscopic appearance with sheets of primitive tumor cells resembling a primary medulloblastoma ( Figure 6(a) ). Diagnostic areas of RMS and neuroblastoma were only identified by immunohistochemistry demonstrating strong positivity for myogenin, CD56, and tyrosine hydroxylase (Figures 6(b) – 6(d) ). However, neuroblastoma was the predominant component. Peripheral blood chromosome analysis revealed a normal male chromosome complement (46, XY) with no abnormalities. Molecular analysis utilizing reverse transcription polymerase chain reaction (RT-PCR) was performed on the cerebellar tumor and showed no evidence of a PAX3-FOXO1 t(2;13) (q35;q14) or a PAX7-FOXO1 t(1;13) (p36;q14) chromosomal translocation. Although fluorescence in situ hybridization (FISH) studies revealed FOXO1 (FKHR) gain on chromosome 13q14.11 in 75% of the tumor cells, there was no PAX-FOXO1 translocation. Tumor chromosome analysis showed complex karyotype with near-triploid cell line (71, XYY) and multiple chromosomal deletions (chromosomes 3 and 4) and duplications (chromosomes 5, 7, 19, and 22). After surgical resection, he received national chemotherapy protocol against the neuroblastoma component , which was the most prominent component of the metastatic tumor. In addition, he received adjuvant local radiation therapy. He completed his chemoradiation therapy with excellent tumor response. Currently he is not receiving any additional treatments for about 18 months and his most recent follow-up MRI and PET scan did not show any evidence of residual or metastatic tumor. We report another MEM case with cytogenetic analysis, as there are only 5 reported cases in the literature with these data. Moreover our case emphasizes the importance of multimodality treatment approach in prognosis, even in nonresectable primary tumors.
4.121094
0.970703
sec[1]/p[0]
en
0.999999
25405050
https://doi.org/10.1155/2014/792925
[ "tumor", "component", "neuroblastoma", "evidence", "cells", "metastatic", "chromosome", "including", "cystic", "inguinal" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "5B7Z", "title": "Unspecified undernutrition" }, { "code": "4A00.11", "title": "Immunodeficiency with a late component of complement deficiency" }, { "code": "LD27.2", "title": "Syndromic ichthyosis" }, { "code": "PL12.0", "title": "Structural device failure, as mode of injury or harm" }, { "code": "LD24.2Z", "title": "Bone diseases with disorganised development of skeletal components, unspecified" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [5B7Z] Unspecified undernutrition Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS [4A00.11] Immunodeficiency with a late component of complement deficiency Also known as: Immunodeficiency with a late component of complement deficiency | Deficiency of complement terminal pathway | Complement component C5 deficiency | Complement component C6 deficiency | Complement component C7 deficiency [LD27.2] Syndromic ichthyosis Definition: Hereditary disorders in which ichthyosis is associated with significant other abnormalities. Also known as: Syndromic ichthyosis | X-linked ichthyosis syndromes | Ichthyosis follicularis – atrichia – photophobia | IFAP - [Ichthyosis follicularis – atrichia – photophobia] syndrome | ichthyosis follicularis - alopecia - photophobia [PL12.0] Structural device failure, as mode of injury or harm Definition: Harm arising due to mechanical or material device failure not related to the installation of the device. Also known as: Structural device failure, as mode of injury or harm | part failure of a structural device as a mode of injury | structural device component failure as a mode of injury | structural device design failure as a mode of injury | manufacturing fault of a structural device as a mode of injury Includes: Leakage from device, as mode of injury or harm | Wear, breakage or breakdown of device, as mode of injury or harm | Breakdown of intraocular lens Excludes: Wear of articular bearing surface of joint prosthesis | Combination or interaction of operator error and device failure, as mode of injury or harm | Structural device failure without injury or harm [LD24.2Z] Bone diseases with disorganised development of skeletal components, unspecified Also known as: Bone diseases with disorganised development of skeletal components, unspecified | Bone diseases with disorganised development of skeletal components === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F92] Neoplasms of unknown behaviour of skin --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F92] Neoplasms of unknown behaviour of skin --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Fat pad Def: A condition characterised by a mass of closely packed adipose cells surrounded by fibrous tissue septa. When localised in the heel this condition may present with dull pain when pressure is applied.... --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Benign symmetrical lipomatosis Def: Benign symmetrical lipomatosis is an uncommon condition characterised by progressive symmetrical accumulation during adult life of adipose mass at the level of the head, neck and upper trunk . The con... --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F92] Neoplasms of unknown behaviour of skin", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F92] Neoplasms of unknown behaviour of skin", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Fat pad\n Def: A condition characterised by a mass of closely packed adipose cells surrounded by fibrous tissue septa. When localised in the heel this condition may present with dull pain when pressure is applied....", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Benign symmetrical lipomatosis\n Def: Benign symmetrical lipomatosis is an uncommon condition characterised by progressive symmetrical accumulation during adult life of adipose mass at the level of the head, neck and upper trunk . The con...", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
A 48-year-old female patient underwent her first work-up for possible liver disease 30 years ago. Based on findings of chronic active hepatitis in liver biopsy, autoimmune hepatitis was suspected, and treatment with prednisolone and azathioprine initiated. Seven years later, an endoscopic retrograde cholangiopancreatography (ERCP) showed a stricture in the common bile duct which was interpreted as possible extrahepatic PSC or tentatively an inborn anomaly of the common bile duct. After 20 years with fluctuating transaminases between 100 and 300 U/L and no recorded major clinical events, she developed general edema and thoracic spider nevi. A computed tomography (CT) scan revealed liver cirrhosis and portal hypertension with massive ascites. After an initial response to symptomatic treatment, she soon developed uncompensated liver failure with severe hepatic encephalopathy and was transferred to the national transplant unit for work-up and listing for liver transplantation. A few days later, an ABO-identical donor liver was available and LTX was performed with a duct-to-duct biliary anastomosis. The histopathological examination of the liver explant revealed cirrhosis and pathological changes typical for underlying PSC. Cholangiocarcinoma in situ was found in the common hepatic duct, the cystic duct, and the common bile duct, involving the resection margin. It was decided that the patient should be controlled with ERC with brush cytology from the duct-to-duct anastomosis after 6 months due to the histopathological findings. The brush cytology showed mild to moderate epithelial dysplasia in the common bile duct. After discussion in the multidisciplinary team, a pancreaticoduodenectomy (Whipple procedure) was decided due to the risk of development of cholangiocarcinoma. Ten months after LTX, the procedure was performed. Because of a possible increased risk of anastomotic leak due to immunosuppression, an enteropancreatic anastomosis was avoided and the pancreatic duct was occluded. The surgical specimen showed intestinal metaplasia in the common bile duct, but no dysplasia or carcinoma. She was then followed according to standard post-liver transplantation follow-up regimen. The patient developed insulin-dependent diabetes mellitus and received tuberculostatic treatment due to disseminated tuberculosis (pulmonary and meningeal), but the graft function remained good. At the 5-year post-transplantation control, recurrent PSC in the graft was diagnosed on liver biopsy. In addition, a 10 × 4 cm multicystic mass in the lower right abdominal quadrant was described on the routine abdominal ultrasound (US) exam. Upon reassessment, a CT scan of the abdomen performed before the Whipple procedure also showed a 10 × 5 cm multicystic mass in the same region. The lesion was asymptomatic, and based on imaging, the lesion was considered to be a benign gynecological cyst. Consequently, no further investigations were performed to establish the exact etiology. At 10 years of follow-up, the patient reported increasing abdominal distension, anorexia, weight loss, and fatigue for the past 6 to 8 months. Clinical examination revealed extensive sarcopenia, multiple spider nevi, and tense ascites. Biochemical tests showed an iron deficiency anemia with Hgb of 9.0 g/dL, moderately elevated liver function tests, inflammatory markers, and carcinoembryonic antigen (CEA). Imaging, including liver and abdominal US, abdominal and thoracic CT, CT enterography, and positron emission tomography (PET)-CT unveiled liver graft fibrosis/cirrhosis with features of portal hypertension, massive low-attenuating heterogeneous ascites, a focal wall thickening in the middle part of the jejunum, multiple focal lesions in both lungs, a focal lesion in the thyroid gland, and the previously described cystic mass in the lower right abdominal quadrant. Diagnostic abdominal paracentesis revealed thick gelatinous ascites, which was culture negative. The ascites was rich in mucin, but without neoplastic cells on repeated cytology examinations. The provisional primary diagnosis of graft fibrosis-related portal hypertension with ascites could not be supported. Further extensive diagnostic work-up did not confirm tentative diagnoses such as gastrointestinal tuberculosis, sarcoidosis, mucinous tumors of the ovaries, or other causes of peritoneal carcinomatosis. Bearing in mind the differential diagnosis of PMP as a rare, but relevant tentative cause of mucinous ascites, re-evaluation of the contrast-enhanced CT scan raised the suspicion of PMP and that the cystic lesion actually represented a mucinous cystadenoma of the appendix . Fig. 1 Development of pseudomyxoma peritonei (PMP). CT scans with coronal view before ( a ) and after ( b ) development of PMP. Mucinous cystadenoma of the appendix (asterisk) in a . Typical features of PMP ( b ): ruptured calcified appendix (short slim arrow), massive mucinous ascites (short thick arrow), central displacement of the small bowel, and visceral scalloping of the liver (double arrow)
3.992188
0.977051
sec[1]/p[0]
en
0.999996
30185175
https://doi.org/10.1186/s12957-018-1482-7
[ "liver", "duct", "ascites", "abdominal", "common", "bile", "mucinous", "graft", "lesion", "work" ]
[ { "code": "DB9Z", "title": "Diseases of liver, unspecified" }, { "code": "DB97.Z", "title": "Inflammatory liver disease, unspecified" }, { "code": "DB99.7", "title": "Hepatic failure without mention whether acute or chronic" }, { "code": "LB20.0Y", "title": "Other specified structural developmental anomalies of liver" }, { "code": "LB20.0Z", "title": "Structural developmental anomalies of liver, unspecified" }, { "code": "DC10.02", "title": "Obstruction of bile duct" }, { "code": "DC10.00", "title": "Obstruction of cystic duct" }, { "code": "DC13", "title": "Cholangitis" }, { "code": "LB20.23", "title": "Structural developmental anomalies of cystic duct" }, { "code": "DC10.2", "title": "Fistula of gallbladder or bile duct" } ]
=== ICD-11 CODES FOUND === [DB9Z] Diseases of liver, unspecified Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy [DB97.Z] Inflammatory liver disease, unspecified Also known as: Inflammatory liver disease, unspecified | Certain specified inflammatory liver diseases | Nonspecific reactive hepatitis | inflammatory liver disease | hepatitis NOS [DB99.7] Hepatic failure without mention whether acute or chronic Also known as: Hepatic failure without mention whether acute or chronic | liver decompensation | liver function failure | hepatic failure NOS | liver failure NOS [LB20.0Y] Other specified structural developmental anomalies of liver Also known as: Other specified structural developmental anomalies of liver | Alagille syndrome | Alagille-Watson syndrome | Arteriohepatic dysplasia | Syndromic bile duct paucity [LB20.0Z] Structural developmental anomalies of liver, unspecified Also known as: Structural developmental anomalies of liver, unspecified | Structural developmental anomalies of liver | Malformations of liver | congenital anomaly of liver | congenital malformation of liver [DC10.02] Obstruction of bile duct Also known as: Obstruction of bile duct | extrahepatic biliary obstruction | extrahepatic bile duct obstruction | bile duct obstruction | bile stasis Excludes: with cholelithiasis [DC10.00] Obstruction of cystic duct Also known as: Obstruction of cystic duct | cystic duct obstruction | cystic ductal obstruction | obstructed cystic duct | Acquired cystic duct atresia [DC13] Cholangitis Also known as: Cholangitis | acute cholangiolitis | ascending cholangitis | cholangiolitis | cholangitis NOS Excludes: chronic nonsuppurative destructive cholangitis | cholangitis with cholelithiasis | Primary sclerosing cholangitis [LB20.23] Structural developmental anomalies of cystic duct Also known as: Structural developmental anomalies of cystic duct | congenital deformity of cystic duct | cystic duct anomaly | cystic duct deformity | cystic duct distortion [DC10.2] Fistula of gallbladder or bile duct Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs. Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula === GRAPH WALKS === --- Walk 1 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --CHILD--> [DB91] Acute or subacute hepatic failure Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases.... --- Walk 2 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --RELATED_TO--> [?] Viral hepatitis Def: A group of liver diseases caused by infection with one or more of the five hepatitis viruses, hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus and hepatitis E viruses. The in... --- Walk 3 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --EXCLUDES--> [?] Acute or subacute hepatic failure Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases.... --- Walk 4 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --EXCLUDES--> [?] Drug-induced or toxic liver disease Def: Drug-induced or toxic liver disease is hepatotoxicity as injury to the liver that is associated with impaired liver function caused by exposure to a drug or another noninfectious agent.... --- Walk 5 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --EXCLUDES--> [?] Fibropolycystic liver disease --- Walk 6 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --RELATED_TO--> [?] Cirrhotic cardiomyopathy Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation...
[ "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --CHILD--> [DB91] Acute or subacute hepatic failure\n Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases....", "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Viral hepatitis\n Def: A group of liver diseases caused by infection with one or more of the five hepatitis viruses, hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus and hepatitis E viruses. The in...", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --EXCLUDES--> [?] Acute or subacute hepatic failure\n Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases....", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --EXCLUDES--> [?] Drug-induced or toxic liver disease\n Def: Drug-induced or toxic liver disease is hepatotoxicity as injury to the liver that is associated with impaired liver function caused by exposure to a drug or another noninfectious agent....", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --EXCLUDES--> [?] Fibropolycystic liver disease", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --RELATED_TO--> [?] Cirrhotic cardiomyopathy\n Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation..." ]
DB9Z
Diseases of liver, unspecified
[ { "from_icd11": "DB9Z", "icd10_code": "K7681", "icd10_title": "Hepatopulmonary syndrome" }, { "from_icd11": "DB9Z", "icd10_code": "K7689", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K769", "icd10_title": "Liver disease, unspecified" }, { "from_icd11": "DB9Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "DB9Z", "icd10_code": "K762", "icd10_title": "Central hemorrhagic necrosis of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K70-K77", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K778", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K72", "icd10_title": "Hepatic failure, not elsewhere classified" }, { "from_icd11": "DB9Z", "icd10_code": "K76", "icd10_title": "Other diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K768", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB97.Z", "icd10_code": "K7581", "icd10_title": "Nonalcoholic steatohepatitis (NASH)" }, { "from_icd11": "DB97.Z", "icd10_code": "K7589", "icd10_title": "Other specified inflammatory liver diseases" }, { "from_icd11": "DB97.Z", "icd10_code": "K759", "icd10_title": "Inflammatory liver disease, unspecified" }, { "from_icd11": "DB97.Z", "icd10_code": "K752", "icd10_title": "Nonspecific reactive hepatitis" }, { "from_icd11": "DB97.Z", "icd10_code": "K75", "icd10_title": "Other inflammatory liver diseases" } ]
K7681
Hepatopulmonary syndrome
Four days later, she was transferred to our hospital for further diagnosis and specialized treatment. On physical examination, malar rash, oral ulcers, discoid rash, and arthritis in her elbows and knees were observed . Urinalysis showed proteinuria and occult blood. Laboratory data around the time of presentation are shown in Table 1 and are significant for the following elevated values: C-reactive protein (CRP), 5.65 mg/dL (normal, < 0.20 mg/dL); aspirate transaminase (AST), 85 U/L (normal, < 30 U/L); and alanine transaminase (ALT), 154 U/L (normal, < 23 U/L). Results also showed leukopenia with a white blood cell (WBC) count of 1140/μL and thrombocytopenia with a platelet count of 9.7 × 10 4 /μL (normal, 15.0–35.0 × 10 4 /μL), elevated lactate dehydrogenase at 537 U/L (normal, 124–222 U/L), and ferritin at 622 ng/mL (normal, 6–138 ng/mL), in addition to low C4 and CH50 levels: complement C3, 111 mg/dL (normal, 68–144 mg/dL); complement C4, < 2 mg/dL (normal, 12–33 mg/dL); and complement, total (CH50), < 14.0 U/mL (normal, 30–46 U/mL). Assessment of autoantibodies was positive for antinuclear antibody (ANA) (1:80, nucleolar pattern, speckled pattern), anti-ribonucleoprotein antibody (14.2 U/mL; normal, < 10 U/mL), and anti-SS-A autoantibody (48,550 U/mL; normal, < 10 U/mL). Anti-double-stranded-DNA (anti-ds-DNA) antibody (immunoglobulin G) and anti-Smith antibody were negative. Bone marrow examination was performed to find the cause of cytopenia. Results showed no proliferation of blasts or tumor cells, but hemophagocytosis by macrophages was observed . Computed tomography showed obvious splenomegaly. A thorough examination of the organ lesions revealed lupus retinopathy and lupus nephritis. Based on the pathological findings, a pathologist (E.I.) confirmed the diagnosis of lupus nephritis class I according to the International Society of Nephrology/Renal Pathology Society classification . Based on the findings of positive ANA, fever, nonscarring alopecia, oral ulcers, malar rash, discoid rash, arthralgia, leukopenia, thrombocytopenia, hypocomplementemia, lupus retinopathy, and nephritis, she was diagnosed with SLE according to the 2019 European League Against Rheumatism/American College of Rheumatology classification criteria . Fig. 1 Cutaneous mucosal lesions before treatment: A malar rash; B oral ulcers; and C discoid rash Table 1 Laboratory data around the time of presentation Blood test Normal range Normal range WBC, /μL 1140 4700–8700 anti-nuclear Ab 1: 80 < 40 Stab, % 7.0 0.0–13.0 (staining patterns) nucleolar, speckled Seg, % 64.0 38.0–58.9 anti-ds-DNA Ab, IU/mL < 5.0 0.0–12.0 Eos, % 0.0 0.2–6.8 anti-Smith Ab, U/mL < 3.0 0.0–10.0 Baso, % 1.0 0.0–1.0 anti-RNP Ab, U/mL 14.2 0.0–10.0 Mono, % 8.0 2.3–7.7 anti-SS-A Ab, U/mL 48,550.0 0.0–10.0 Lym, % 19.0 26.0–46.6 anti-SS-B Ab, U/mL < 3.0 0.0–10.0 RBC, × 10^4/μL 456 370–490 Direct Coombs ( +) Hb, g/dL 12.5 11.0–15.0 Indirect Coombs (-) Hct, % 37.2 35.0–45.0 anti-platelet Ab (-) Plt, × 10^4/μL 9.7 15.0–35.0 PA-IgG, ng/10 7 cells 42.7 < 46 Lac, ratio 1.13 0.00–1.30 CRP, mg/dL 1.78 0.00–0.20 CL-IgG, U/mL < 8.0 0.0–10.0 TP, g/dL 7.6 6.5–8.2 CLβ2-GP1 Ab, U/mL < 0.7 0.0–3.5 Alb, g/dL 3.2 3.5–5.5 BUN, mg/dL 6.1 7.0–20.0 β-D glucan, pg/mL < 6.0 0.0–11.0 Cre, mg/dL 0.37 0.50–1.00 Procalcitonin, ng/mL 0.05 0.00–0.49 GOT, IU/L 85 13–30 HBs-Ag (-) GPT, IU/L 154 7–23 HCV-Ab (-) ALP, IU/L 108 106–322 EBV-VCA-IgG ( +) γ-GTP, IU/L 29 9–32 EBV-VCA-IgM (-) LDH, IU/L 537 124–222 EBV-EA-IgG (-) Amylase, U/L 51 44–132 EBV-EA-IgM (-) Ferritin, ng/mL 622 6.0–138 EBNA-Ab ( +) sIL-2R, U/mL 855 121–613 CMV-IgG ( +) IgA, mg/dL 570 114–435 CMV-IgM (-) IgG, mg/dL 2894 870–1700 CMV Ag (10, 11) (-) IgM, mg/dL 87 46–260 Parvovirus B19-IgM (-) C3, mg/dL 111 68–114 C4, mg/dL < 2 12–33 Urinalysis CH50, U/mL < 14 30–50 Protein ( ±) C1 inhibitor activity, % < 25 70–130 Protein, g/gCr 0.21 RBC (1 +) C1 inhibitor levels, mg/dL < 3 21–39 NAG, U/L 15.5 0.7–11.2 β2-microglobulin, µg/L 3259 0–250 PT-INR 0.93 0.85–1.15 APTT, sec 26.4 27.0–47.0 Fibrinogen, mg/dL 329 200–400 D-dimer, μg/mL 3.7 0.0–1.0 sIL-2R soluble interleukin-2 receptor, anti-ds-DNA Ab anti-double-stranded-DNA antibody, anti-RNP Ab anti-ribonucleoprotein antibody, PA-IgG platelet-associated immunoglobulin G, CL-IgG anti-cardiolipin immunoglobulin G, CLβ2-GP1 Ab anti-cardiolipin-beta2-glycoprotein I complex antibody, NAG N-acetyl-beta-glucosaminidase Fig. 2 Bone marrow aspirate (May-Grunwald Giemsa stain, × 400) shows hemophagocytosis by macrophages Fig. 3 Renal biopsy. A Light microscopy: A-1) periodic acid–Schiff stain; and A-2) periodic acid–methenamine–silver stain. No mesangial proliferation, double contour of the glomerular basement membranes, or irregular spike formations are noted. B Immunofluorescence study shows deposition of immunoglobulin (Ig) A, IgM, and complement C 1q and C3c in glomeruli. C Electron microscopy: C-1) tubuloreticular inclusions (yellow arrow) were seen in some endothelial cells; and C-2) subepithelial electron-dense deposits (yellow circle) were observed
4.113281
0.941406
sec[1]/p[3]
en
0.999997
PMC9484190
https://doi.org/10.1186/s13223-022-00725-8
[ "anti", "antibody", "rash", "complement", "immunoglobulin", "lupus", "malar", "oral", "ulcers", "discoid" ]
[ { "code": "JA86.Y", "title": "Maternal care for other specified fetal problems" }, { "code": "MB23.1", "title": "Antisocial behaviour" }, { "code": "3B4Z", "title": "Coagulation defects, unspecified" }, { "code": "4A45.Z", "title": "Antiphospholipid syndrome, unspecified" }, { "code": "4A43.Y", "title": "Other specified overlap non-organ specific systemic autoimmune disease" }, { "code": "MA14.14", "title": "Anti-nuclear antibody positive" }, { "code": "MA14.13", "title": "Anti-nuclear antibody negative" }, { "code": "JA86.0", "title": "Maternal care for red cell antibodies" }, { "code": "MA14.1C", "title": "Raised antibody titre" }, { "code": "ME66.6Z", "title": "Rash, unspecified" } ]
=== ICD-11 CODES FOUND === [JA86.Y] Maternal care for other specified fetal problems Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS [MB23.1] Antisocial behaviour Definition: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated. Also known as: Antisocial behaviour | Child or adolescent antisocial behaviour [3B4Z] Coagulation defects, unspecified Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality [4A45.Z] Antiphospholipid syndrome, unspecified Also known as: Antiphospholipid syndrome, unspecified | Antiphospholipid syndrome | Hughes syndrome | Anticardiolipin syndrome [4A43.Y] Other specified overlap non-organ specific systemic autoimmune disease Also known as: Other specified overlap non-organ specific systemic autoimmune disease | Antisynthetase syndrome | Reynolds syndrome | Syndromic multisystem autoimmune disease due to ITCH deficiency | Eosinophilia myalgia syndrome [MA14.14] Anti-nuclear antibody positive Also known as: Anti-nuclear antibody positive | ANA - [anti-nuclear antibody] positive [MA14.13] Anti-nuclear antibody negative Also known as: Anti-nuclear antibody negative | ANA - [anti-nuclear antibody] negative [JA86.0] Maternal care for red cell antibodies Definition: Maternal care for rhesus or other isoimmunization Also known as: Maternal care for red cell antibodies | Maternal care for rhesus isoimmunization | Rh factor immunization affecting management of pregnancy | Rh incompatibility | Rh incompatibility with hydrops fetalis [MA14.1C] Raised antibody titre Also known as: Raised antibody titre | antibody titre above reference range | high antibody titre | increased antibody titre Excludes: isoimmunization, in pregnancy affecting fetus or newborn [ME66.6Z] Rash, unspecified Also known as: Rash, unspecified | Rash | skin rash NOS === GRAPH WALKS === --- Walk 1 --- [JA86.Y] Maternal care for other specified fetal problems --PARENT--> [JA86] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --EXCLUDES--> [?] Labour or delivery complicated by fetal distress --- Walk 2 --- [JA86.Y] Maternal care for other specified fetal problems --PARENT--> [JA86] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --CHILD--> [JA86.1] Maternal care for hydrops fetalis --- Walk 3 --- [MB23.1] Antisocial behaviour Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated.... --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour --CHILD--> [MB23.2] Avoidance behaviour Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual.... --- Walk 4 --- [MB23.1] Antisocial behaviour Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated.... --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour --CHILD--> [MB23.2] Avoidance behaviour Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual.... --- Walk 5 --- [3B4Z] Coagulation defects, unspecified --PARENT--> [?] Coagulation defects --CHILD--> [?] Haemorrhagic diseases due to acquired coagulation factor defects Def: Any disease caused by determinants arising after birth. These diseases are characterised by abnormal coagulation of the blood.... --- Walk 6 --- [3B4Z] Coagulation defects, unspecified --PARENT--> [?] Coagulation defects --CHILD--> [?] Congenital or constitutional haemorrhagic condition Def: A condition caused by determinants arising during the antenatal period or genetically inherited factors, leading to defects in clotting mechanisms or abnormalities causing structural flaws in the bloo...
[ "[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --EXCLUDES--> [?] Labour or delivery complicated by fetal distress", "[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --CHILD--> [JA86.1] Maternal care for hydrops fetalis", "[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --CHILD--> [MB23.2] Avoidance behaviour\n Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual....", "[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --CHILD--> [MB23.2] Avoidance behaviour\n Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual....", "[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [?] Haemorrhagic diseases due to acquired coagulation factor defects\n Def: Any disease caused by determinants arising after birth. These diseases are characterised by abnormal coagulation of the blood....", "[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [?] Congenital or constitutional haemorrhagic condition\n Def: A condition caused by determinants arising during the antenatal period or genetically inherited factors, leading to defects in clotting mechanisms or abnormalities causing structural flaws in the bloo..." ]
JA86.Y
Maternal care for other specified fetal problems
[ { "from_icd11": "JA86.Y", "icd10_code": "O26841 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26843 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26849 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O3680X0 ", "icd10_title": "" }, { "from_icd11": "3B4Z", "icd10_code": "D688", "icd10_title": "Other specified coagulation defects" }, { "from_icd11": "3B4Z", "icd10_code": "D689", "icd10_title": "Coagulation defect, unspecified" }, { "from_icd11": "3B4Z", "icd10_code": "D699", "icd10_title": "Hemorrhagic condition, unspecified" }, { "from_icd11": "3B4Z", "icd10_code": "D698", "icd10_title": "Other specified hemorrhagic conditions" }, { "from_icd11": "3B4Z", "icd10_code": "D65-D69", "icd10_title": "" }, { "from_icd11": "3B4Z", "icd10_code": "D69", "icd10_title": "Purpura and other hemorrhagic conditions" }, { "from_icd11": "4A45.Z", "icd10_code": "D6861", "icd10_title": "Antiphospholipid syndrome" }, { "from_icd11": "4A45.Z", "icd10_code": "D6869", "icd10_title": "Other thrombophilia" }, { "from_icd11": "4A45.Z", "icd10_code": "D6862", "icd10_title": "Lupus anticoagulant syndrome" }, { "from_icd11": "4A45.Z", "icd10_code": "D686", "icd10_title": "Other thrombophilia" }, { "from_icd11": "JA86.0", "icd10_code": "O360930", "icd10_title": "Maternal care for other rhesus isoimmunization, third trimester, not applicable or unspecified" } ]
O26841
We present the case of a 63-year-old post-menopausal G3P3003 Caucasian female presenting with complaints of progressively increased hair growth, deepening voice, and a receding hairline over the past year. She also complained of some pelvic discomfort that resembled menstrual cramps, but denied overt vaginal bleeding. Her past medical history was significant for osteoporosis diagnosed twelve years prior. She denied any history of ovarian or adrenal disease. She denied any use of medications. The patient’s age of menarche was at 12 years and menopause at the age of 50 years. The patient’s last Pap smear was a year ago which was normal and she also reported no history of abnormal pap smears. The patient reported three normal pregnancies with uneventful cesarean sections and three living healthy children. Surgical history was remarkable for tonsillectomy and rhinoplasty. She was a happily married homemaker and exercised regularly. Interestingly, she noted an increased exercise tolerance and reported that she could easily double her normal biking routine. She also reported an increased libido. She denied tobacco, alcohol, or intravenous drug use. Family history was significant for hypertension in her mother and cardiovascular disease in her father. The subject provided written informed consent for us to use un-identifying photos of her affected areas. Physical exam was notable for marked facial stubble subsequent to shaving and diffuse terminal hair across her chest and abdomen. There was also some regression in the patient’s hairline . There was no acanthosis nigricans present. Physical exam also revealed unique changes in 8 of her fingernails (described below), however the toenails were normal. Cliteromegaly measuring 2 cm was observed on pelvic exam. The remainder of the physical exam was otherwise unremarkable. Laboratory studies showed an extremely high total testosterone and androstenedione level at 742 ng/dl (reference range: < 62 ng/dL) and 339.0 ng/dL (20-75 ng/dL) respectively. Serum DHEA sulfate 174.2 mcg/dL (<15 - 157 mcg/dL), TSH 1.6 μIU/mL (0.5 - 4.70 μIU/mL), calcium 9.9 mg/dL (8.8 - 10.3 mg/dL), and parathyroid hormone levels 44.2 pg/ml (11 - 54 pg/ml) were all within normal reference range. The serum estradiol level was slightly elevated at 54 pg/mL (0 to 30 pg/mL; postmenopausal) (Table 1 ). A computed tomography (CT) scan of the abdomen and pelvis showed a 3.5 cm left ovarian mass with normal appearing adrenal glands. This was subsequently confirmed by ultrasound which revealed an enlarged hypoechoic left ovarian mass of 3.6 × 3.5× 3.6 cm, and normal right ovary measuring 1.9 × 2.1 × 1.7 cm. Her uterus was normal in size, measuring 5.8 × 2.6 × 4.8 cm. But, the endometrial lining was heterogeneous and thickened, measuring at 9 mm. Preoperative and intraoperative consultation with our gynecological oncology team was conducted. The patient was referred for surgical removal of the ovarian mass. Laparoscopic bilateral salpingo-oophorectomy, peritoneal washings, and dilation and curettage were performed. At the time of surgery, ovaries, fallopian tubes, and uterine cutterings were sent for intra-operative frozen section pathology consultation. The frozen section of the left ovary revealed features of a “sex cord stromal tumor”. The right ovary was atrophic measuring 1.9 × 2.1 × 1.7 cm. The frozen section analysis of uterine curettings revealed no signs of atypia or malignancy. Lymph node dissection was not warranted based on preoperative and intraoperative evaluation as well as frozen section histological consultation showing a well-contained lesion within the ovary. Figure 1 Hairline changes. A) Time of surgery hairline (receded) B) Hairline by 5 months post-surgery C) Hairline improvement by 8 months post-surgery D) Hairline improvement by 12 months post- surgery. Figure 2 Facial hair changes. A) Time of Surgery - visible hair stubs B) Five months post- surgery C) Eight months post-surgery. Figure 3 Unique nail signs. A) Al-Hendy Nail Sign (Red Arrows) Nails appear flattened with concave spoon shaped ends even 5 months post-surgery. B) Nail sign resolving (Yellow Arrows) by 8 months post-surgery C) Nail Sign resolved (White Arrows) on most fingers by one year post-surgery. Table 1 Serum parameter: pre- and post-surgery Serum parameter (reference range) 1 st visit 1 hour prior to surgery 1 week post surgery 5 months post- surgery 8 months post surgery 1 year post surgery Total testosterone (< 62 ng/dL) 742 <20 <20 Free testosterone (0.8 - 10 ng/dL) 455 ng/dL <10 ng/dL <10 ng/dL Anderostendione (<2 ng/ml) 3.390 0.285 0.259 0.474 0.319 Progesterone (< 1.0 ng/mL) 0.97 0.44 0.37 Estradiol (0 to 30 pg/mL, postmenopausal) 54 <12 <12 <12 <12 FSH (25.8 - 134.8 mIU/ml, postmenopausal) 47.9 95.1 106.9 95 99.4 LH (14.2- to 52.3 mIU/mL, post-menopausal) 16.3 33.8 40.9 41.8 38.6 DHEA-SO4 (<15-157 μg/dL) 174.2 102 21.1 24.5 24.3 36.1 Ca (8.8 - 10.3 mg/dL) 9.9 TSH (0.5 - 4.70 μIU/mL) 1.6 Hgb (12.1 to 15.1 g/dL, female) 13.1 16.1 Ferritin (12-150 ng/mL, female) 65.1
4.132813
0.973633
sec[1]/p[0]
en
0.999997
25296983
https://doi.org/10.1186/s13048-014-0083-5
[ "hairline", "measuring", "hair", "denied", "ovarian", "exam", "serum", "ovary", "frozen", "section" ]
[ { "code": "QC05.Z", "title": "Prophylactic measures, unspecified" }, { "code": "QC05.Y", "title": "Other specified prophylactic measures" }, { "code": "QB95.3", "title": "Drug rehabilitation" }, { "code": "QC48.Y", "title": "Other specified personal history of medical treatment" }, { "code": "QB95.2", "title": "Alcohol rehabilitation" }, { "code": "5A44", "title": "Insulin-resistance syndromes" }, { "code": "EM0Y", "title": "Other specified diseases of the skin" }, { "code": "ED7Y", "title": "Other specified disorders of hair" }, { "code": "EC21.0", "title": "Genetic defects of the hair shaft" }, { "code": "ED73.10", "title": "Premature canities" } ]
=== ICD-11 CODES FOUND === [QC05.Z] Prophylactic measures, unspecified Also known as: Prophylactic measures, unspecified | Need for certain specified other prophylactic measures | prophylactic measure [QC05.Y] Other specified prophylactic measures Also known as: Other specified prophylactic measures | Other prophylactic chemotherapy | chemoprophylaxis | prophylactic chemotherapy | Systemic prophylactic chemotherapy [QB95.3] Drug rehabilitation Definition: Drug rehabilitation is defined as the process that begins when drug users come into contact with a health provider or service, and continues through a succession of specific interventions until the highest attainable level of health and well-being is reached. Also known as: Drug rehabilitation | drug abuse rehabilitation | rehabilitation measures for drug use | drug abuse detoxification therapy | drug abuse rehabilitation measures Excludes: Tobacco rehabilitation [QC48.Y] Other specified personal history of medical treatment Also known as: Other specified personal history of medical treatment | Personal history of contraception | history of contraception | Personal history of long-term use of medicaments other than anticoagulants | personal history of long term current use of medicaments [QB95.2] Alcohol rehabilitation Definition: Alcohol rehabilitation is defined as the process that begins when alcohol users come into contact with a health provider or service, and continues through a succession of specific interventions until the highest attainable level of health and well-being is reached. Also known as: Alcohol rehabilitation | alcohol detoxification therapy | alcohol abuse rehabilitation measures | admission for alcohol rehabilitation [5A44] Insulin-resistance syndromes Also known as: Insulin-resistance syndromes | Insulin-resistance syndrome type A | Insulin-resistance syndrome type B | Rabson-Mendenhall syndrome | Laminopathy type Decaudain-Vigouroux [EM0Y] Other specified diseases of the skin Also known as: Other specified diseases of the skin | Adverse cutaneous effects of healthcare related interventions | Cutaneous complications of surgical, laser or other interventional procedures | Postprocedural cutaneous complications of surgical, laser or other interventions | Cutaneous complications of surgical procedures [ED7Y] Other specified disorders of hair Also known as: Other specified disorders of hair [EC21.0] Genetic defects of the hair shaft Also known as: Genetic defects of the hair shaft | Genetic defects of the hair shaft with increased fragility | Monilethrix | Beaded hair | Pili torti Excludes: Menkes' kinky hair syndrome [ED73.10] Premature canities Definition: Premature greying of the hair, usually taken to mean before the age of 20 in Caucasians and before the age of 30 in Africans. Also known as: Premature canities | Greying of hair | Gray hair | Grey hair | Premature greying of hair Includes: Premature greying of hair === GRAPH WALKS === --- Walk 1 --- [QC05.Z] Prophylactic measures, unspecified --PARENT--> [QC05] Need for certain specified other prophylactic measures --CHILD--> [QC05.1] Prophylactic immunotherapy --- Walk 2 --- [QC05.Z] Prophylactic measures, unspecified --PARENT--> [QC05] Need for certain specified other prophylactic measures --EXCLUDES--> [?] Contact with health services for prophylactic surgery --- Walk 3 --- [QC05.Y] Other specified prophylactic measures --PARENT--> [QC05] Need for certain specified other prophylactic measures --CHILD--> [QC05.Y] Other specified prophylactic measures --- Walk 4 --- [QC05.Y] Other specified prophylactic measures --PARENT--> [QC05] Need for certain specified other prophylactic measures --PARENT--> [?] Contact with health services related to immunizations or certain other prophylactic measures --- Walk 5 --- [QB95.3] Drug rehabilitation Def: Drug rehabilitation is defined as the process that begins when drug users come into contact with a health provider or service, and continues through a succession of specific interventions until the hi... --EXCLUDES--> [?] Tobacco rehabilitation --PARENT--> [?] Care involving use of rehabilitation procedures --- Walk 6 --- [QB95.3] Drug rehabilitation Def: Drug rehabilitation is defined as the process that begins when drug users come into contact with a health provider or service, and continues through a succession of specific interventions until the hi... --EXCLUDES--> [?] Tobacco rehabilitation --PARENT--> [?] Care involving use of rehabilitation procedures
[ "[QC05.Z] Prophylactic measures, unspecified\n --PARENT--> [QC05] Need for certain specified other prophylactic measures\n --CHILD--> [QC05.1] Prophylactic immunotherapy", "[QC05.Z] Prophylactic measures, unspecified\n --PARENT--> [QC05] Need for certain specified other prophylactic measures\n --EXCLUDES--> [?] Contact with health services for prophylactic surgery", "[QC05.Y] Other specified prophylactic measures\n --PARENT--> [QC05] Need for certain specified other prophylactic measures\n --CHILD--> [QC05.Y] Other specified prophylactic measures", "[QC05.Y] Other specified prophylactic measures\n --PARENT--> [QC05] Need for certain specified other prophylactic measures\n --PARENT--> [?] Contact with health services related to immunizations or certain other prophylactic measures", "[QB95.3] Drug rehabilitation\n Def: Drug rehabilitation is defined as the process that begins when drug users come into contact with a health provider or service, and continues through a succession of specific interventions until the hi...\n --EXCLUDES--> [?] Tobacco rehabilitation\n --PARENT--> [?] Care involving use of rehabilitation procedures", "[QB95.3] Drug rehabilitation\n Def: Drug rehabilitation is defined as the process that begins when drug users come into contact with a health provider or service, and continues through a succession of specific interventions until the hi...\n --EXCLUDES--> [?] Tobacco rehabilitation\n --PARENT--> [?] Care involving use of rehabilitation procedures" ]
QC05.Z
Prophylactic measures, unspecified
[ { "from_icd11": "QC05.Z", "icd10_code": "Z298", "icd10_title": "Encounter for other specified prophylactic measures" }, { "from_icd11": "QC05.Z", "icd10_code": "Z29", "icd10_title": "Encounter for other prophylactic measures" }, { "from_icd11": "QC05.Z", "icd10_code": "Z292", "icd10_title": "" }, { "from_icd11": "QC05.Z", "icd10_code": "Z299", "icd10_title": "Encounter for prophylactic measures, unspecified" }, { "from_icd11": "QB95.3", "icd10_code": "Z503", "icd10_title": "" }, { "from_icd11": "QC48.Y", "icd10_code": "Z794", "icd10_title": "Long term (current) use of insulin" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7902", "icd10_title": "Long term (current) use of antithrombotics/antiplatelets" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7982", "icd10_title": "Long term (current) use of aspirin" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7984", "icd10_title": "Long term (current) use of oral hypoglycemic drugs" }, { "from_icd11": "QC48.Y", "icd10_code": "Z79899", "icd10_title": "Other long term (current) drug therapy" }, { "from_icd11": "QB95.2", "icd10_code": "Z502", "icd10_title": "" }, { "from_icd11": "5A44", "icd10_code": "E10-E14", "icd10_title": "" }, { "from_icd11": "EM0Y", "icd10_code": "L918", "icd10_title": "Other hypertrophic disorders of the skin" }, { "from_icd11": "EM0Y", "icd10_code": "L988", "icd10_title": "Other specified disorders of the skin and subcutaneous tissue" }, { "from_icd11": "EC21.0", "icd10_code": "Q841", "icd10_title": "Congenital morphological disturbances of hair, not elsewhere classified" } ]
Z298
Encounter for other specified prophylactic measures
Ours is a rare and extreme case, and only six similar cases are in the literature. Nonetheless, there are more published milder cases of likely central nervous neurotoxicity occurring after spinal anesthesia . Published cases are usually the tip of the iceberg. As mentioned in the background, this single case had a big negative impact on the Sri Lankan healthcare system, Sri Lankan society and the reputation of pharmaceutical industry . All considered, it is crucial to do further studies on the broad subject. Also, it is essential to take actions to prevent recurrences considering existing evidence. We do not know whether the impurity detected in ZUPIVAC H has epileptogenic properties when injected into the CSF. Extraction of the impurity, identification and test injection to laboratory animals CSF may be helpful to determine whether that was responsible for seizures in our patient. Early spinal anesthetic agents have not undergone considerable controlled testing for neurotoxicity according to a review article . Such studies done according to present standards on spinal anesthetic agents used currently, especially bupivacaine, may throw light on the pathophysiology of similar cases and potential treatments. Previously, we discussed possible mechanisms that can result in cases like ours. We hope that will give a good idea to investigators of future cases where to focus their attention. If an international body takes the initiative to introduce clear consensus definitions to common terms like drug toxicity, LAST and direct neurotoxicity by local anesthetics, that would benefit the medical community. Initiation of a discussion among anesthesiology community to categorize CNS toxicity after subarachnoid injection of local anesthetics as a special category of side effects is worthy. The risk of similar incidents is not mentioned in some manufacturers’ literature. There is no manufacturer’s literature leaflet in the five ampoule packs of ZUPIVAC H. We think the availability of manufacturer’s literature and mentioning the remote risk of such side effects in the manufacturer’s literature of heavy bupivacaine are essential. Although we are from a different country, TGA-Australia kindly analyzed our ZUPIVAC H samples generating information that would be valuable to healthcare community worldwide. It is a good example of the usefulness of international cooperation in investigating such cases. One recent study shows that impurities (contamination) are the commonest cause of defective medicines in Sri Lanka . Continuous maintenance of a strict quality control process from raw materials to the end product level and adherence to good manufacturing practice protocols by manufacturers can prevent impurities from contaminating bupivacaine. Enhancement of capabilities and effectiveness of the National Medicines Regulatory Authority (NMRA) of Sri Lanka and fully implementation of quality assurance mechanisms always (even during emergency drug procurements and accepting donations of medicines by the Health Ministry) would be useful to ensure the quality, safety and efficacy of bupivacaine at hospitals . Strengthening post marketing surveillance work on anesthetic drugs by NMRA-Sri Lanka is also worthy. Looking for impurities in heavy bupivacaine in the case of an incident like our case is not in the USP monographs for quality tests. We believe if relevant authorities can consider the inclusion of testing for impurities for quality tests it would be worthy. Administration of 20% fat emulsion to act as an intravenous sink to remove bupivacaine from neurons was one therapy we could have used and that had been used to manage similar cases . 20% fat emulsion was unavailable locally. We suggest to keep at least one bottle of 20% fat emulsion in every operating theater to be used in cases like this. Some readers may think that we could have used propofol to induce and maintain general anesthesia because that contains lipid as well. However, reported cases of seizures due to propofol came to the minds of the team members desperately managing status epilepticus at that time and we used time tested thiopentone (thiopental) . Propofol was used to manage several similar patients who survived [ 1 – 5 , 14 ]. Thus, we retrospectively think that its benefits might outweigh the risk of aggravated seizures. However, one case treated with thiopentone also survived . Further studies may clarify this issue. Research to develop an antidote for bupivacaine neurotoxicity with better efficacy would be meritorious. During our literature survey, we noticed that several similar cases (seizures) and several deaths had occurred related to spinal anesthesia by accidental administration of tranexamic acid instead of bupivacaine . We have excluded that possibility in our case. However, we would like to draw the attention of the anesthesiology community to that issue and reiterate the importance of always adhering to standard safety procedures when administering spinal anesthesia to avoid such medication errors.
4.121094
0.462402
sec[2]/sec[7]/p[0]
en
0.999996
PMC10998312
https://doi.org/10.1186/s12871-024-02485-x
[ "that", "cases", "bupivacaine", "used", "similar", "literature", "spinal", "like", "quality", "neurotoxicity" ]
[ { "code": "8A80.Z", "title": "Migraine, unspecified" }, { "code": "QA76", "title": "Medication or substance that is known to be an allergen without injury or harm" }, { "code": "PL13.6", "title": "Medication or substance that is known to be an allergen, as mode of injury or harm" }, { "code": "9C40.A0", "title": "Papilloedema" }, { "code": "PA6Z", "title": "Unintentional fall from unspecified height" }, { "code": "JB20.Z", "title": "Single spontaneous delivery, unspecified" }, { "code": "QA48.0", "title": "Care or examination immediately after delivery" }, { "code": "QE11.Z", "title": "Hazardous drug use, unspecified" }, { "code": "6C4Z", "title": "Disorders due to substance use, unspecified" }, { "code": "QE11.3", "title": "Hazardous use of cocaine" } ]
=== ICD-11 CODES FOUND === [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS [JB20.Z] Single spontaneous delivery, unspecified Also known as: Single spontaneous delivery, unspecified | Single spontaneous delivery | spontaneous delivery NOS | normal delivery NOS | uncomplicated delivery [QA48.0] Care or examination immediately after delivery Also known as: Care or examination immediately after delivery | care and observation in uncomplicated delivery cases | postpartum care immediately after delivery | postpartum examination immediately after delivery | Postpartum care after hospital delivery Excludes: Complications predominantly related to the puerperium [QE11.Z] Hazardous drug use, unspecified Also known as: Hazardous drug use, unspecified | Hazardous drug use | chronic drug use NOS | chronic IV substance use | drug use nos [6C4Z] Disorders due to substance use, unspecified Also known as: Disorders due to substance use, unspecified | Disorders due to substance abuse | drug use disorder | Bad trips due to drugs [QE11.3] Hazardous use of cocaine Definition: A pattern of cocaine use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health professionals. The increased risk may be from the frequency of cocaine use, from the amount used on a given occasion, from risky behaviours associated with cocaine use or the context of use, from a harmful route of administration, or from a combination of these. The risk may be related to short-term eff Also known as: Hazardous use of cocaine | cocaine use | intravenous cocaine use | Hazardous use of crack cocaine | crack cocaine use Excludes: Disorders due to use of cocaine === GRAPH WALKS === --- Walk 1 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --CHILD--> [8A80.2] Chronic migraine Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse... --- Walk 2 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --CHILD--> [8A80.2] Chronic migraine Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse... --- Walk 3 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 4 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm --CHILD--> [QA70] Overdose of substance without injury or harm Def: Overdose of a substance occurs when a patient is given more of a prescribed drug or other substance than is intended. Can be the result of inaccurate measurement of drug, including oral administration... --- Walk 5 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm Def: Incorrect dose - too high... --- Walk 6 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --CHILD--> [PL13.1] Underdosing, as mode of injury or harm
[ "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.2] Chronic migraine\n Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...", "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.2] Chronic migraine\n Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm\n --CHILD--> [QA70] Overdose of substance without injury or harm\n Def: Overdose of a substance occurs when a patient is given more of a prescribed drug or other substance than is intended. Can be the result of inaccurate measurement of drug, including oral administration...", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high...", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.1] Underdosing, as mode of injury or harm" ]
8A80.Z
Migraine, unspecified
[ { "from_icd11": "8A80.Z", "icd10_code": "G43B0", "icd10_title": "Ophthalmoplegic migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43409", "icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A0", "icd10_title": "Cyclical vomiting, in migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D0", "icd10_title": "Abdominal migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43709", "icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A1", "icd10_title": "Cyclical vomiting, in migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43509", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43719", "icd10_title": "Chronic migraine without aura, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43501", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C0", "icd10_title": "Periodic headache syndromes in child or adult, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43401", "icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43419", "icd10_title": "Hemiplegic migraine, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43B1", "icd10_title": "Ophthalmoplegic migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C1", "icd10_title": "Periodic headache syndromes in child or adult, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D1", "icd10_title": "Abdominal migraine, intractable" } ]
G43B0
Ophthalmoplegic migraine, not intractable
In 2015, a 36 year-old woman was admitted to the rheumatology department of Strasbourg University Hospital (CHU) suffering from lumbar pain (or low back pain) with hyperalgesia and addiction to painkillers. A divorced mother of a child, the patient had been employed until 2008. Her medical history included chronic spinal pain over a one-year period, two cases of deep vein thrombophlebitis , pulmonary embolism , a transient ischaemic attack with negative blood test results, and an appendectomy . Owing to the functional consequences of left wrist surgery following a work accident, she left her job and received disability benefits. In 2014, she received opioid treatment and 3 epidural infiltrations for lumbar and radicular pain. As an outpatient, she was treated with pregabalin combined with transcutaneous electrical nerve stimulation (TENS), but the hospital then lost track of her. Her psychiatric and addictological record contained reports of an episode of depression, a morphine overdose-induced coma, hospitalization for opioid withdrawal, and an addiction to tobacco. When admitted to the rheumatology department in 2015, her treatment consisted of diazepam 10 mg three times per day, hydroxyzine 100 mg twice daily, venlafaxine 150 mg in the morning, oxycontin® extended-release 60 mg twice daily, oxycodone 10 mg every 4 h, and acetaminophen/codeine 300 mg/25 mg 6 times per day. She abused oxycodone and codeine, and her physicians refused to prescribe opioid treatment in such high dosages. Her medical examination revealed lumbosacral pain with intermittent irradiation towards the posterior side of her thigh down to the top of her left knee, painful limitation of flexion, extension, right rotation of the spine, limited flexion in both directions. The patient also reported pain upon palpation of the left pelvic-trochanter region, and cellulalgia in the dorso-lumbar region. She was suffering from dysuria and constipation due to opioid treatment. Biological investigations, CT-scan and X-ray results were normal. A spinal MRI scan found lumbar degenerative disc disease (L4-L5 and L5-S1). Rheumatologists asked for a specialist opinion from a pain specialist, who, in view of the patient’s prior psychiatric history, decided to contact psychiatrists and addictologists for their opinion. The patient presented with a histrionic personality (eg. need to be the center of attention, dramatization within the therapeutic relationship, reactivity of mood, excessive sensitivity to criticism or disapproval, inappropriate seductive appearance, rapidly shifting emotional states that may appear superficial and rash decision-making according to DSM-5 ). She also presented with some borderline traits (eg. unstable interpersonal relationships alternating idealization/devaluation, identity disturbance with unstable sense of self, difficulty controlling anger, transient paranoid ideations). Given the patient’s psychiatric symptoms and the fact that she wanted to withdraw opioid treatment by herself and attempted to do so, the physicians proposed she be admitted to the hospital’s psychiatry department to be treated for opioid withdrawal with the administration of ketamine to manage lombo-sciatic pain. She was informed of the side effects of ketamine and of the need to follow the protocol correctly and to report any opioid withdrawal symptoms. Faced with the fact that no physician could prescribe such high dosages of opioid medication, the patient agreed to be transferred to the psychiatric department. There she received ketamine oral solution (5 mg/ml, magistral formulae) 1 mg/kg, and two days after ketamine initiation her opioid treatment was gradually reduced (10 % reduction in the initial dosage each two days). The patient reported no withdrawal symptoms (Clinical Opioid Withdrawal Symptoms score of 0/11 in the first and seconds week after the physician started reducing her opioid medication), pain or cravings while her opioid treatment was being reduced. She complained of no side effects of ketamine other than an unusual weakness. However, because of her borderline and histrionic traits, the reduction in opioid treatment took longer, and we had to extend the period of ketamine treatment. In fact, the patient’s need to be at the center of attention caused many problems with other patients and with nurses, who found her demands difficult to deal with. As she presented with emotional and paranoid reactions, the medical staff proposed a long weekend break, thus interrupting her care and delaying her treatment. Although we had to extend the hospitalization period and ketamine treatment, in the end ketamine withdrawal was achieved without withdrawal symptoms, and the patient was discharged from the hospital. She consulted her addictologist and psychiatrist. She now takes very small dosage of opioids for pain relief (codeine 50 mg three times per day). To control administration of the remaining opioid medication, it is administered at home by a nurse. Functional re-education was also organized.
3.921875
0.980469
sec[1]/p[0]
en
0.999995
27832755
https://doi.org/10.1186/s12888-016-1112-2
[ "opioid", "pain", "ketamine", "withdrawal", "department", "lumbar", "psychiatric", "period", "times", "codeine" ]
[ { "code": "6C43.2Z", "title": "Opioid dependence, unspecified" }, { "code": "6C43.3", "title": "Opioid intoxication" }, { "code": "6C43.4", "title": "Opioid withdrawal" }, { "code": "6C43.Z", "title": "Disorders due to use of opioids, unspecified" }, { "code": "6C43.1Z", "title": "Harmful pattern of use of opioids, unspecified" }, { "code": "MG3Z", "title": "Pain, unspecified" }, { "code": "8E43.Z", "title": "Pain disorders, unspecified" }, { "code": "MG31.Z", "title": "Acute pain, unspecified" }, { "code": "MG30.Z", "title": "Chronic pain, unspecified" }, { "code": "FB56.2", "title": "Myalgia" } ]
=== ICD-11 CODES FOUND === [6C43.2Z] Opioid dependence, unspecified Also known as: Opioid dependence, unspecified | Opioid dependence | opioid addiction | opiate dependence | opium dependence [6C43.3] Opioid intoxication Definition: Opioid intoxication is a clinically significant transient condition that develops during or shortly after the consumption of opioids that is characterised by disturbances in consciousness, cognition, perception, affect, behaviour, or coordination. These disturbances are caused by the known pharmacological effects of opioids and their intensity is closely related to the amount of opioids consumed. They are time-limited and abate as opioids are cleared from the body. Presenting features may includ Also known as: Opioid intoxication | heroin intoxication | bad trip due to opioids | Acute intoxication due to fentanyl | Fentanyl and despropionyl fentanyl intoxication Excludes: opioid poisoning | Possession trance disorder | fentanyl poisoning [6C43.4] Opioid withdrawal Definition: Opioid withdrawal is a clinically significant cluster of symptoms, behaviours and/or physiological features, varying in degree of severity and duration, that occurs upon cessation or reduction of use of opioids in individuals who have developed Opioid dependence or have used opioids for a prolonged period or in large amounts. Opioid withdrawal can also occur when prescribed opioids have been used in standard therapeutic doses. Presenting features of Opioid withdrawal may include dysphoric mood, Also known as: Opioid withdrawal | Opioid withdrawal, uncomplicated | Opioid withdrawal, with seizures | Codeine withdrawal | Heroin withdrawal [6C43.Z] Disorders due to use of opioids, unspecified Also known as: Disorders due to use of opioids, unspecified | Disorders due to use of opioids | Disorders due to abuse of opioids | opioid use disorder [6C43.1Z] Harmful pattern of use of opioids, unspecified Also known as: Harmful pattern of use of opioids, unspecified | Harmful pattern of use of opioids | opioid abuse | Methadone abuse [MG3Z] Pain, unspecified Also known as: Pain, unspecified | pain observations | pain NOS | generalised pain | generalised pain, NOS [8E43.Z] Pain disorders, unspecified Also known as: Pain disorders, unspecified | Pain disorders [MG31.Z] Acute pain, unspecified Also known as: Acute pain, unspecified | Acute pain [MG30.Z] Chronic pain, unspecified Also known as: Chronic pain, unspecified | Chronic pain [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain === GRAPH WALKS === --- Walk 1 --- [6C43.2Z] Opioid dependence, unspecified --PARENT--> [6C43.2] Opioid dependence Def: Opioid dependence is a disorder of regulation of opioid use arising from repeated or continuous use of opioids. The characteristic feature is a strong internal drive to use opioids, which is manifeste... --CHILD--> [6C43.22] Opioid dependence, sustained partial remission Def: After a diagnosis of Opioid dependence, and often following a treatment episode or other intervention (including self-help intervention), there is a significant reduction in opioid consumption for mor... --- Walk 2 --- [6C43.2Z] Opioid dependence, unspecified --PARENT--> [6C43.2] Opioid dependence Def: Opioid dependence is a disorder of regulation of opioid use arising from repeated or continuous use of opioids. The characteristic feature is a strong internal drive to use opioids, which is manifeste... --EXCLUDES--> [?] Harmful pattern of use of opioids Def: A pattern of use of opioids that has caused damage to a person’s physical or mental health or has resulted in behaviour leading to harm to the health of others. The pattern of opioid use is evident ov... --- Walk 3 --- [6C43.3] Opioid intoxication Def: Opioid intoxication is a clinically significant transient condition that develops during or shortly after the consumption of opioids that is characterised by disturbances in consciousness, cognition, ... --PARENT--> [6C43] Disorders due to use of opioids Def: Disorders due to use of opioids are characterised by the pattern and consequences of opioid use. Opioids is a generic term that encompasses the constituents or derivatives of the opium poppy Papaver s... --CHILD--> [6C43.1] Harmful pattern of use of opioids Def: A pattern of use of opioids that has caused damage to a person’s physical or mental health or has resulted in behaviour leading to harm to the health of others. The pattern of opioid use is evident ov... --- Walk 4 --- [6C43.3] Opioid intoxication Def: Opioid intoxication is a clinically significant transient condition that develops during or shortly after the consumption of opioids that is characterised by disturbances in consciousness, cognition, ... --EXCLUDES--> [?] Possession trance disorder Def: Possession trance disorder is characterised by trance states in which there is a marked alteration in the individual’s state of consciousness and the individual’s customary sense of personal identity ... --EXCLUDES--> [?] Acute and transient psychotic disorder Def: Acute and transient psychotic disorder is characterised by acute onset of psychotic symptoms that emerge without a prodrome and reach their maximal severity within two weeks. Symptoms may include delu... --- Walk 5 --- [6C43.4] Opioid withdrawal Def: Opioid withdrawal is a clinically significant cluster of symptoms, behaviours and/or physiological features, varying in degree of severity and duration, that occurs upon cessation or reduction of use ... --PARENT--> [6C43] Disorders due to use of opioids Def: Disorders due to use of opioids are characterised by the pattern and consequences of opioid use. Opioids is a generic term that encompasses the constituents or derivatives of the opium poppy Papaver s... --CHILD--> [6C43.0] Episode of harmful use of opioids Def: An episode of opioid use that has caused damage to a person’s physical or mental health or has resulted in behaviour leading to harm to the health of others. Harm to health of the individual occurs du... --- Walk 6 --- [6C43.4] Opioid withdrawal Def: Opioid withdrawal is a clinically significant cluster of symptoms, behaviours and/or physiological features, varying in degree of severity and duration, that occurs upon cessation or reduction of use ... --PARENT--> [6C43] Disorders due to use of opioids Def: Disorders due to use of opioids are characterised by the pattern and consequences of opioid use. Opioids is a generic term that encompasses the constituents or derivatives of the opium poppy Papaver s... --PARENT--> [?] Disorders due to substance use Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to...
[ "[6C43.2Z] Opioid dependence, unspecified\n --PARENT--> [6C43.2] Opioid dependence\n Def: Opioid dependence is a disorder of regulation of opioid use arising from repeated or continuous use of opioids. The characteristic feature is a strong internal drive to use opioids, which is manifeste...\n --CHILD--> [6C43.22] Opioid dependence, sustained partial remission\n Def: After a diagnosis of Opioid dependence, and often following a treatment episode or other intervention (including self-help intervention), there is a significant reduction in opioid consumption for mor...", "[6C43.2Z] Opioid dependence, unspecified\n --PARENT--> [6C43.2] Opioid dependence\n Def: Opioid dependence is a disorder of regulation of opioid use arising from repeated or continuous use of opioids. The characteristic feature is a strong internal drive to use opioids, which is manifeste...\n --EXCLUDES--> [?] Harmful pattern of use of opioids\n Def: A pattern of use of opioids that has caused damage to a person’s physical or mental health or has resulted in behaviour leading to harm to the health of others. The pattern of opioid use is evident ov...", "[6C43.3] Opioid intoxication\n Def: Opioid intoxication is a clinically significant transient condition that develops during or shortly after the consumption of opioids that is characterised by disturbances in consciousness, cognition, ...\n --PARENT--> [6C43] Disorders due to use of opioids\n Def: Disorders due to use of opioids are characterised by the pattern and consequences of opioid use. Opioids is a generic term that encompasses the constituents or derivatives of the opium poppy Papaver s...\n --CHILD--> [6C43.1] Harmful pattern of use of opioids\n Def: A pattern of use of opioids that has caused damage to a person’s physical or mental health or has resulted in behaviour leading to harm to the health of others. The pattern of opioid use is evident ov...", "[6C43.3] Opioid intoxication\n Def: Opioid intoxication is a clinically significant transient condition that develops during or shortly after the consumption of opioids that is characterised by disturbances in consciousness, cognition, ...\n --EXCLUDES--> [?] Possession trance disorder\n Def: Possession trance disorder is characterised by trance states in which there is a marked alteration in the individual’s state of consciousness and the individual’s customary sense of personal identity ...\n --EXCLUDES--> [?] Acute and transient psychotic disorder\n Def: Acute and transient psychotic disorder is characterised by acute onset of psychotic symptoms that emerge without a prodrome and reach their maximal severity within two weeks. Symptoms may include delu...", "[6C43.4] Opioid withdrawal\n Def: Opioid withdrawal is a clinically significant cluster of symptoms, behaviours and/or physiological features, varying in degree of severity and duration, that occurs upon cessation or reduction of use ...\n --PARENT--> [6C43] Disorders due to use of opioids\n Def: Disorders due to use of opioids are characterised by the pattern and consequences of opioid use. Opioids is a generic term that encompasses the constituents or derivatives of the opium poppy Papaver s...\n --CHILD--> [6C43.0] Episode of harmful use of opioids\n Def: An episode of opioid use that has caused damage to a person’s physical or mental health or has resulted in behaviour leading to harm to the health of others. Harm to health of the individual occurs du...", "[6C43.4] Opioid withdrawal\n Def: Opioid withdrawal is a clinically significant cluster of symptoms, behaviours and/or physiological features, varying in degree of severity and duration, that occurs upon cessation or reduction of use ...\n --PARENT--> [6C43] Disorders due to use of opioids\n Def: Disorders due to use of opioids are characterised by the pattern and consequences of opioid use. Opioids is a generic term that encompasses the constituents or derivatives of the opium poppy Papaver s...\n --PARENT--> [?] Disorders due to substance use\n Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to..." ]
6C43.2Z
Opioid dependence, unspecified
[ { "from_icd11": "6C43.2Z", "icd10_code": "F1120", "icd10_title": "Opioid dependence, uncomplicated" }, { "from_icd11": "6C43.2Z", "icd10_code": "F1123", "icd10_title": "Opioid dependence with withdrawal" }, { "from_icd11": "6C43.2Z", "icd10_code": "F11221", "icd10_title": "Opioid dependence with intoxication delirium" }, { "from_icd11": "6C43.2Z", "icd10_code": "F1121", "icd10_title": "Opioid dependence, in remission" }, { "from_icd11": "6C43.2Z", "icd10_code": "F11229", "icd10_title": "Opioid dependence with intoxication, unspecified" }, { "from_icd11": "6C43.2Z", "icd10_code": "F11288", "icd10_title": "Opioid dependence with other opioid-induced disorder" }, { "from_icd11": "6C43.2Z", "icd10_code": "F1129", "icd10_title": "Opioid dependence with unspecified opioid-induced disorder" }, { "from_icd11": "6C43.2Z", "icd10_code": "F11220", "icd10_title": "Opioid dependence with intoxication, uncomplicated" }, { "from_icd11": "6C43.2Z", "icd10_code": "F1124", "icd10_title": "Opioid dependence with opioid-induced mood disorder" }, { "from_icd11": "6C43.2Z", "icd10_code": "F11250", "icd10_title": "Opioid dependence with opioid-induced psychotic disorder with delusions" }, { "from_icd11": "6C43.2Z", "icd10_code": "F11222", "icd10_title": "Opioid dependence with intoxication with perceptual disturbance" }, { "from_icd11": "6C43.2Z", "icd10_code": "F11259", "icd10_title": "Opioid dependence with opioid-induced psychotic disorder, unspecified" }, { "from_icd11": "6C43.2Z", "icd10_code": "F11281", "icd10_title": "Opioid dependence with opioid-induced sexual dysfunction" }, { "from_icd11": "6C43.2Z", "icd10_code": "F11282", "icd10_title": "Opioid dependence with opioid-induced sleep disorder" }, { "from_icd11": "6C43.2Z", "icd10_code": "F112", "icd10_title": "Opioid dependence" } ]
F1120
Opioid dependence, uncomplicated
A 62-year-old Afro-Caribbean woman was diagnosed as having bilateral carcinoma of the breast in 2004. Her past medical history included hypertension, controlled by amlodipine and losartan, in addition to diabetes on treatment with metformin. She underwent bilateral mastectomy and axillary node clearance with immediate implant-based reconstruction. The pathology revealed multifocal disease on the right, T2N0(0/20)M0 grade 1 and 2 invasive ductal carcinoma (IDC), and on the left side, T3N1(2/18)M0 grade 1 IDC. The disease was estrogen receptor (ER)-positive, weak progesterone receptor (PR)-positive, and human epidermal growth factor receptor 2 (HER2)-negative. Surgery was followed by adjuvant chemotherapy, consisting of the 5-fluorouracil, epirubicin, and cyclophosphamide (FEC) regimen and regional radiotherapy. Hormonal therapy initially consisted of 20 mg daily of tamoxifen. After 3 years this was switched to an aromatase inhibitor (anastrozole 1 mg daily) until 2009 when she completed 5 years of adjuvant endocrine therapy. She then subsequently relapsed with metastatic disease with lung nodules in 2008 and bone metastases were noted on a bone scan 4 years later. She was commenced on 25 mg once a day of exemestane and 4 mg intravenously administered monthly injections of zoledronic acid in early 2014. Due to disease progression, capecitabine 1250 mg/m 2 (based on total body surface area) twice daily was commenced until after six cycles when it was discontinued due to capecitabine-related toxicity and she was started on 2.5 mg once a day of letrozole and 150 mg once a day of ibandronic acid. In February 2016 she presented with neck swelling with intermittent neck discomfort without airway pressure symptoms. On clinical examination she was found to have cervical lymphadenopathy. Laboratory findings revealed a white cell count of 5.2 × 10 9 /L, hemoglobin of 115 g/L, and normal liver and renal function with an estimated glomerular filtration rate of 67 ml/minute/1.73 m 2 . The neck swelling was investigated with an ultrasound and confirmed both lateral cervical nodal disease in levels II to IV and a goiter with left-sided dominance. The fine-needle aspiration cytology (FNAC) of her thyroid was reported as in keeping with a papillary thyroid cancer; however, the cytology of the left lateral nodal disease was described as more suggestive of a breast malignancy. She had no personal or familial risk factors for thyroid malignancy. Staging investigations including magnetic resonance imaging (MRI) of her spine demonstrated stable deposits involving C2, C5, T4, and L1 without neural compromise and computed tomography (CT) of her thorax demonstrated no change in the lung nodules . Since the diagnosis was not clear, following a multidisciplinary team discussion the decision was made to proceed with a total thyroidectomy and a clearance of the central compartment lymph nodes coupled with an excision biopsy of the laterocervical lymph nodes. Histopathological analysis of the specimen demonstrated an ill-circumscribed white tumor at the posterior margin of the left lobe measuring 1.2 × 0.9 × 1.5 cm. On immunocytochemistry the tumor cells were positive for carcinoembryonic antigen (CEA), synaptophysin, GATA3, and ER (5/8), focally positive for cytokeratin (CK) 7 and gross cystic disease fluid protein 15 (GCDFP-15), and negative for thyroid transcription factor 1 (TTF-1), calcitonin, thyroglobulin, CK20, PR, and HER2. The overall appearances were consistent with metastatic breast cancer with no evidence of a primary thyroid malignancy. The level IV and level VI lymph nodes contained metastatic breast cancer. She was discharged on daily 125 mcg of levothyroxine. The chemotherapy was switched to 500 mg intramuscular monthly injections of fulvestrant and she continues to take the ibandronic acid. Currently, 14 months following the thyroidectomy, she remains clinically stable. She developed local recurrences in the level II to IV lymph nodes in her neck and a recent MRI of her spine showed stable spinal metastatic disease. Fig. 1 T2-weighted sagittal magnetic resonance image demonstrating the deposits in C5 and T4. They appeared confined to the vertebral body with no evidence of vertebral body collapse Fig. 2 Computed tomography of the thorax demonstrating a small (5 mm in diameter) subpleural nodule within the anterior left upper lobe, which remained unchanged since the previous scan Fig. 3 Hematoxylin and eosin stain at × 100 magnification demonstrating solid nests of atypical epithelial cells among normal colloid-filled thyroid follicles Fig. 4 Immunoperoxidase for thyroglobulin showing the solid nests, which are negative while the follicles are positive, including a small trapped microfollicle within the larger nest of metastatic cells. Thyroid transcription factor 1 and calcitonin were equally negative; however, cytokeratin 7 was focally positive and synaptophysin was expressed by the majority of cells. This raises the possibility of a carcinoma with neuroendocrine features
4.019531
0.977539
sec[1]/p[0]
en
0.999998
28934992
https://doi.org/10.1186/s13256-017-1441-x
[ "thyroid", "metastatic", "breast", "daily", "neck", "lymph", "nodes", "cells", "carcinoma", "receptor" ]
[ { "code": "5A03.Z", "title": "Thyroiditis, unspecified" }, { "code": "5A0Z", "title": "Disorders of the thyroid gland or thyroid hormones system, unspecified" }, { "code": "5A03.Y", "title": "Other specified thyroiditis" }, { "code": "5A00.2Z", "title": "Acquired hypothyroidism, unspecified" }, { "code": "5A03.0", "title": "Acute thyroiditis" }, { "code": "2D4Z", "title": "Unspecified malignant neoplasms of unspecified sites" }, { "code": "5C64.5", "title": "Disorders of calcium metabolism" }, { "code": "2E2Z", "title": "Malignant neoplasm metastasis, unspecified" }, { "code": "2E03", "title": "Malignant neoplasm metastasis in bone or bone marrow" }, { "code": "2D70", "title": "Malignant neoplasm metastasis in lung" } ]
=== ICD-11 CODES FOUND === [5A03.Z] Thyroiditis, unspecified Also known as: Thyroiditis, unspecified | Thyroiditis | inflammation of thyroid | thyroiditis NOS [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified Also known as: Disorders of the thyroid gland or thyroid hormones system, unspecified [5A03.Y] Other specified thyroiditis Also known as: Other specified thyroiditis | Riedel thyroiditis | Chronic invasive fibrous thyroiditis | Ligneous thyroiditis | Riedel struma [5A00.2Z] Acquired hypothyroidism, unspecified Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea [5A03.0] Acute thyroiditis Definition: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial. Also known as: Acute thyroiditis | infectious thyroiditis | Acute thyroiditis due to bacterial infection | Acute thyroiditis due to fungal infection | Abscess of thyroid [2D4Z] Unspecified malignant neoplasms of unspecified sites Also known as: Unspecified malignant neoplasms of unspecified sites | malignancy of unspecified site | malignancy unspecified primary site | malignant growth of unspecified site | malignant mass of unspecified site [5C64.5] Disorders of calcium metabolism Definition: This refers to disorders in the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcaemia or hypocalcaemia, both of which can have important consequences for health. Also known as: Disorders of calcium metabolism | Calcinosis | general calcification | heterotopic calcification | metastatic calcification Excludes: Hyperparathyroidism | Chondrocalcinosis [2E2Z] Malignant neoplasm metastasis, unspecified Also known as: Malignant neoplasm metastasis, unspecified | secondary malignant neoplasm | metastasis | metastases | disseminated metastases [2E03] Malignant neoplasm metastasis in bone or bone marrow Definition: The spread of a malignant neoplasm from a primary site to the skeletal system. The majority of metastatic neoplasms to the bone are carcinomas. Also known as: Malignant neoplasm metastasis in bone or bone marrow | bone metastasis | bony metastasis | osseous metastasis | secondary cancer of bone [2D70] Malignant neoplasm metastasis in lung Also known as: Malignant neoplasm metastasis in lung | metastasis in lung | pulmonary metastasis | secondary cancer in lung | secondary malignant tumour in lung Excludes: Malignant neoplasms of bronchus or lung === GRAPH WALKS === --- Walk 1 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --RELATED_TO--> [?] Postpartum thyroiditis Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp... --- Walk 2 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --EXCLUDES--> [?] Acquired hypothyroidism Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth.... --- Walk 3 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A00] Hypothyroidism --- Walk 4 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A01] Nontoxic goitre Def: Enlargement of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis... --- Walk 5 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --RELATED_TO--> [?] Postpartum thyroiditis Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp... --- Walk 6 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --RELATED_TO--> [?] Postpartum thyroiditis Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp...
[ "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --RELATED_TO--> [?] Postpartum thyroiditis\n Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp...", "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Acquired hypothyroidism\n Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A00] Hypothyroidism", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A01] Nontoxic goitre\n Def: Enlargement of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis...", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --RELATED_TO--> [?] Postpartum thyroiditis\n Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp...", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --RELATED_TO--> [?] Postpartum thyroiditis\n Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp..." ]
5A03.Z
Thyroiditis, unspecified
[ { "from_icd11": "5A03.Z", "icd10_code": "E069", "icd10_title": "Thyroiditis, unspecified" }, { "from_icd11": "5A03.Z", "icd10_code": "E064", "icd10_title": "Drug-induced thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E065", "icd10_title": "Other chronic thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E06", "icd10_title": "Thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E062", "icd10_title": "Chronic thyroiditis with transient thyrotoxicosis" }, { "from_icd11": "5A0Z", "icd10_code": "E0781", "icd10_title": "Sick-euthyroid syndrome" }, { "from_icd11": "5A0Z", "icd10_code": "E0789", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E079", "icd10_title": "Disorder of thyroid, unspecified" }, { "from_icd11": "5A0Z", "icd10_code": "E034", "icd10_title": "Atrophy of thyroid (acquired)" }, { "from_icd11": "5A0Z", "icd10_code": "E00-E07", "icd10_title": "" }, { "from_icd11": "5A0Z", "icd10_code": "E07", "icd10_title": "Other disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E078", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E35", "icd10_title": "Disorders of endocrine glands in diseases classified elsewhere" }, { "from_icd11": "5A00.2Z", "icd10_code": "E033", "icd10_title": "Postinfectious hypothyroidism" }, { "from_icd11": "5A03.0", "icd10_code": "E060", "icd10_title": "Acute thyroiditis" } ]
E069
Thyroiditis, unspecified
As the patient’s condition did not improve, she was transferred to our hospital. Physical examination on admission revealed comatose state (Glasgow Coma Scale [GCS] 3), stiff neck, and no voluntary movements. In terms of laboratory findings on admission, routine blood, general hematological and biochemical tests showed no abnormalities, and inflammatory markers, such as erythrocyte sedimentation rate, were normal. A lumbar puncture was performed. The cerebral spinal fluid (CSF) opening pressure was 85 mmH 2 O. Routine and biochemical testing of CSF identified the following: proteins 0.55 g/l (0.20–0.40); leukocytes 1 × 10 6 /l (0.0–15.0); glucose 3.2 mmol/l (2.50–4.50); chlorine 131.9 mmol/l (120–132). CSF cytology showed abnormal cytology, with the presence of 35 lymphocytes and a monocyte. Epileptiform abnormal discharge and diffuse slow wave was observed by electroencephalogram. The patient’s condition deteriorated rapidly. As her oxygen saturation continued to decline, she was placed on a mechanical ventilator via intratracheal intubation. Since the patient’s condition failed to improve, she was transferred to the neurological intensive care unit. Meningoencephalitis was suspected, so she was treated with foscarnet sodium (3 g, daily), methylprednisolone pulse therapy (500 mg, daily for 5 days), intravenous immunoglobulin (20 g, daily for 5 days) and other supportive treatments. However, the patient’s condition remained refractory to treatment. Computed tomography (CT) of the brain revealed hypodense lesions in the bilateral insula and bilateral frontal cortex, corresponding with limbic encephalitis . Laboratory examination revealed autoimmune encephalitis and paraneoplastic syndrome-related tests in both serum and CSF to be normal. Polymerase chain reaction (PCR) assay for herpes simplex virus type 1 and herpes simplex virus type 2 DNA came back negative in CSF. Considering the poor effect of antiviral treatment, next-generation sequencing (NGS) of CSF was used for the detection of pathogens. In total, 5.5 million reads were obtained by NGS, of which 837 were identified as viral, with a detection time of 48 h. HSV-1 DNA was identified in the CSF. The number of identified unique reads mapped on the HSV-1 genome sequence was 826, making up 98.7% of the viral reads. The coverage of the identified HSV-1 genome was 44%, with depth values of 1. The number and percentage of unique reads, coverage, and depth of the identified HSV-1 DNA sequences are presented in Fig. 3 a, b. Upon diagnosis with HSV-1 encephalitis, the patient was started on intravenous acyclovir (500 mg, three times daily) and foscarnet sodium (3 g, three times daily). A repeated CT scan of the brain showed multiple hypodense lesions in the right frontal lobe, right insula, bilateral temporal lobe, and left basal ganglia, including right frontal lesion hemorrhage. On the 14th day after admission , in view of her deteriorating condition, she was again treated with intravenous immunoglobulin (20 g daily for 5 days). A repeated CT scan of the brain, performed approximately 20 days later, showed the range of the hypodense lesion in the bilateral temporal lobes was increased, and hemorrhage within the left lower temporal lobe hypodense lesion, compared with the previous CT scan . After active treatments, the patient’s condition was not markedly improved. On the 28th day after admission, a repeated CT scan of the brain showed the following: 1, the hemorrhages and densities in right frontal lobe and left temporal lobe were decreased; 2, a new massive brain hemorrhage in the left occipitoparietal and left basal ganglia, and hematoma broken into side ventricles were observed; 3, the midline deviated from the falx cerebri to the right side; 4, subarachnoid hemorrhage . Family members abandoned treatment on day 46 after admission, and the patient died after discharge. Fig. 2 Computed tomography of the brain revealed hypodense lesions in the bilateral insula and bilateral frontal cortex, corresponding with limbic encephalitis Fig. 3 a , b NGS results of pathogen identification. In our patient, 98.7% of viral reads corresponded to HSV-1, with coverage of 44% Fig. 4 a CT scan of the brain showed multiple hypodense lesions (white arrows) in the right frontal lobe, right insula, bilateral temporal lobe and left basal ganglia, including right frontal lesion hemorrhage (black arrow). b CT scan of the brain showed the range of hypodense lesions in bilateral temporal lobes (white arrows) had increased, and hemorrhage within the left lower temporal lobe hypodense lesion (black arrow) Fig. 5 a , b A repeated CT scan of the brain showed the following: 1. The hemorrhages and densities (white arrow) in the right frontal lobe and left temporal lobe were decreased; 2. A new massive brain hemorrhage (black arrow) can be seen in the left occipitoparietal and left basal ganglia, and hematoma broken into side ventricles; 3. The midline deviated from the falx cerebri to the right side; 4. Subarachnoid hemorrhage was apparent
4.203125
0.873535
sec[1]/p[1]
en
0.999996
31419985
https://doi.org/10.1186/s12985-019-1205-x
[ "brain", "lobe", "hypodense", "frontal", "temporal", "hemorrhage", "scan", "daily", "lesions", "reads" ]
[ { "code": "8E7Y", "title": "Other specified diseases of the nervous system" }, { "code": "LA05.Z", "title": "Cerebral structural developmental anomalies, unspecified" }, { "code": "1D00.Z", "title": "Infectious encephalitis, unspecified" }, { "code": "LA00.0Z", "title": "Anencephaly, unspecified" }, { "code": "NA07.3Y", "title": "Other specified diffuse brain injury" }, { "code": "CB40.2", "title": "Pulmonary collapse" }, { "code": "LA75.0", "title": "Accessory lobe of lung" }, { "code": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "JA8A.1", "title": "Malformation of placenta" } ]
=== ICD-11 CODES FOUND === [8E7Y] Other specified diseases of the nervous system Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis [LA05.Z] Cerebral structural developmental anomalies, unspecified Also known as: Cerebral structural developmental anomalies, unspecified | Cerebral structural developmental anomalies | Malformations of brain | brain abnormality NOS | brain deformity NOS [1D00.Z] Infectious encephalitis, unspecified Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation [LA00.0Z] Anencephaly, unspecified Also known as: Anencephaly, unspecified | Anencephaly | anencephalic monster | anencephalus | brain absence [NA07.3Y] Other specified diffuse brain injury Also known as: Other specified diffuse brain injury | Brain contusion | Cerebral contusion NOS | Diffuse cortex contusion | diffuse cortical contusion [CB40.2] Pulmonary collapse Also known as: Pulmonary collapse | Atelectasis | lung collapse | pulmonary atelectasis | pulmonary collapse with atelectasis Includes: Atelectasis Excludes: Primary atelectasis of newborn | tuberculous atelectasis, not confirmed | tuberculous atelectasis, confirmed [LA75.0] Accessory lobe of lung Definition: An extra lobe of lung beyond the 3 on the right and the 2 on the left Also known as: Accessory lobe of lung | supernumerary lung lobe | azygos lobe of lung | azygos lobe fissure of lung | azygos lobe [MD41] Clinical findings on diagnostic imaging of lung Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging. Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [JA8A.1] Malformation of placenta Also known as: Malformation of placenta | variation of placenta form | deformity of placenta | placental deformity | Abnormal placenta NOS === GRAPH WALKS === --- Walk 1 --- [8E7Y] Other specified diseases of the nervous system --PARENT--> [08] Diseases of the nervous system Def: This is a group of conditions characterised as being in or associated with the nervous system.... --RELATED_TO--> [?] Syndromes with central nervous system anomalies as a major feature --- Walk 2 --- [8E7Y] Other specified diseases of the nervous system --PARENT--> [08] Diseases of the nervous system Def: This is a group of conditions characterised as being in or associated with the nervous system.... --CHILD--> [?] Multiple sclerosis or other white matter disorders Def: This is a group of conditions involving demyelination, damage to the myelin sheath which protects nerve axons and is responsible for neurotransmission.... --- Walk 3 --- [LA05.Z] Cerebral structural developmental anomalies, unspecified --PARENT--> [LA05] Cerebral structural developmental anomalies Def: Any condition caused by failure of the brain to correctly develop during the antenatal period.... --CHILD--> [LA05.0] Microcephaly Def: A condition caused by failure of the head to correctly develop during the antenatal period. This condition is characterised by a head size that is significantly smaller than normal for their age and s... --- Walk 4 --- [LA05.Z] Cerebral structural developmental anomalies, unspecified --PARENT--> [LA05] Cerebral structural developmental anomalies Def: Any condition caused by failure of the brain to correctly develop during the antenatal period.... --CHILD--> [LA05.1] Megalencephaly Def: A condition caused by failure of the brain to correctly develop during the antenatal period. This condition is characterised by increased size or weight of an otherwise correctly formed brain. This co... --- Walk 5 --- [1D00.Z] Infectious encephalitis, unspecified --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified Def: A disease of the brain, caused by an infection.... --CHILD--> [1D00.1] Fungal encephalitis --- Walk 6 --- [1D00.Z] Infectious encephalitis, unspecified --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified Def: A disease of the brain, caused by an infection.... --CHILD--> [1D00.1] Fungal encephalitis
[ "[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --RELATED_TO--> [?] Syndromes with central nervous system anomalies as a major feature", "[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --CHILD--> [?] Multiple sclerosis or other white matter disorders\n Def: This is a group of conditions involving demyelination, damage to the myelin sheath which protects nerve axons and is responsible for neurotransmission....", "[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --CHILD--> [LA05.0] Microcephaly\n Def: A condition caused by failure of the head to correctly develop during the antenatal period. This condition is characterised by a head size that is significantly smaller than normal for their age and s...", "[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --CHILD--> [LA05.1] Megalencephaly\n Def: A condition caused by failure of the brain to correctly develop during the antenatal period. This condition is characterised by increased size or weight of an otherwise correctly formed brain. This co...", "[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.1] Fungal encephalitis", "[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.1] Fungal encephalitis" ]
8E7Y
Other specified diseases of the nervous system
[ { "from_icd11": "LA05.Z", "icd10_code": "Q048", "icd10_title": "Other specified congenital malformations of brain" }, { "from_icd11": "LA05.Z", "icd10_code": "Q043", "icd10_title": "Other reduction deformities of brain" }, { "from_icd11": "LA05.Z", "icd10_code": "Q049", "icd10_title": "Congenital malformation of brain, unspecified" }, { "from_icd11": "LA05.Z", "icd10_code": "Q04", "icd10_title": "Other congenital malformations of brain" }, { "from_icd11": "1D00.Z", "icd10_code": "G0490", "icd10_title": "Encephalitis and encephalomyelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0491", "icd10_title": "Myelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0430", "icd10_title": "Acute necrotizing hemorrhagic encephalopathy, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0431", "icd10_title": "Postinfectious acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0439", "icd10_title": "Other acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0481", "icd10_title": "Other encephalitis and encephalomyelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G0489", "icd10_title": "Other myelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G04", "icd10_title": "Encephalitis, myelitis and encephalomyelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G048", "icd10_title": "Other encephalitis, myelitis and encephalomyelitis" }, { "from_icd11": "LA00.0Z", "icd10_code": "Q000", "icd10_title": "Anencephaly" }, { "from_icd11": "CB40.2", "icd10_code": "J9811", "icd10_title": "Atelectasis" } ]
Q048
Other specified congenital malformations of brain
A 44-year-old Japanese female with a medical history of untreated hypertension presented to our emergency department with right-side paralysis and dysarthria and was admitted with a diagnosis of pontine haemorrhage. On the fifth day after admission, she developed a fever (37.5–38°C) that lasted for several days but was subsequently diagnosed with central hyperthermia. On the 15th day, ceftriaxone (2 g/day) was administrated for urinary tract infection; nevertheless, on the 25th day, she developed chest pain and dyspnoea. Physical examination revealed the following: blood pressure, 94/45 mmHg; pulse rate, 102 b.p.m. (regular); and oxygen saturation, 96% (O 2 1 L/min). The jugular venous pressure was observed to be elevated; however, no cardiac murmur, abnormal lung sounds, or pericardial rub were detected. The electrocardiogram showed normal sinus rhythm and ST-segment elevation (1 mm) in the inferior leads. Chest radiography showed cardiomegaly and bilateral pleural effusion. The white blood cell count (WBC) was 10 000/mm . Further biochemical analysis revealed the following: no evidence of elevated myocardial enzymes, C-reactive protein, 7.4 mg/dL (reference, 0–0.14 mg/dL); N-terminal pro-B-type natriuretic peptide, 8138 pg/mL (reference, ≤55 pg/mL); and creatinine, 3.38 mg/dL (reference, 0.65–1.07 mg/dL). Plain chest CT showed bilateral pleural effusions, large pericardial effusion, splenic infarction, and consolidation and cavity lesions in the upper left lung zones . Transthoracic echocardiography revealed normal biventricular function but a large circumferential pericardial effusion, inferior vena cava dilation, and right ventricular (RV) collapse. Pulsed-wave Doppler echocardiogram showed a 25% decrease in the E-wave velocity of the LV inflow during inspiration, while the E-wave velocity of the RV inflow increased by 76% during inspiration, which was determined to be the signs of cardiac tamponade . The patient was referred to our department, where an emergency pericardiocentesis was performed for suspected cardiac tamponade due to acute pericarditis. A pericardial drainage tube was placed, obtaining 750 mL of blood-stained fluid. Subsequent TTE showed mild residual pericardial fluid in the posterior LV wall; however, the drain was removed 24 h later due to haemodynamic improvement and minimal output. Pericardial fluid cytometry revealed an elevated count of inflammatory cells with no malignant cells. Blood and pericardial fluid cultures were positive for S. aureus , sensitive to ceftriaxone. Transoesophageal echocardiography showed no evidence of infective endocarditis and bidirectional shunt flow through patent foramen ovale . Considering these results, acute purulent pericarditis due to hospital-acquired pneumonia caused by S. aureus infection was diagnosed. The patient was treated with intravenous ceftriaxone (2 g/day); nonetheless, on the 49th day after admission, she became febrile again and had elevated inflammatory markers (WBC, 13 000/mm; C-reactive protein, 6.97 mg/dL). Computed tomography showed increased pericardial effusion . Transthoracic echocardiography revealed dyskinesis and a pseudoaneurysm on the inferior LV wall and a large pericardial effusion located behind the inferior LV wall (see Supplementary material online , Video S1 ), with blood flow from the pseudoaneurysm into the pericardial space (see Supplementary material online , Videos S2 and S3 ). Contrast-enhanced chest CT showed a large, moderately dense pericardial effusion and a pseudoaneurysm on the inferior LV wall . Emergency coronary angiography performed to identify ischaemic heart disease did not show stenosis or any evidence of myocardial infarction. Preoperative TEE also showed a pseudoaneurysm in the inferior LV wall, a large pericardial effusion behind the inferior LV wall, and blood flow from the pseudoaneurysm into the pericardial space (see Supplementary material online , Video S4 ). Cardiac rupture with ongoing purulent pericarditis was suspected, and urgent surgical intervention was conducted. Preoperative cerebral angiography revealed no abnormal findings. After consultation with the neurosurgeon, anticoagulation therapy was administered as usual during surgery. After sternotomy, the tense pericardium was incised, and bloody pericardial fluid was detected. A cardiopulmonary bypass was established, and the ascending aorta was clamped. A 2 cm-sized myocardial defect and myocardial thinning had developed at the posterior LV wall. The defect was closed using a 5 cm large glutaraldehyde-treated bovine pericardial patch . Ceftriaxone was continued for 3 weeks postoperatively. Diuretic therapy (torasemide, 2 mg/day) was required to manage right heart failure caused by moderate or more severe tricuspid regurgitation, and the patient’s condition was stable. She was transferred to a rehabilitation hospital after 108 days of hospitalization. Approximately 18 months post-surgery, subsequent clinical and echocardiographic examinations indicated a stable patient condition.
4.074219
0.972168
sec[2]/p[0]
en
0.999998
PMC10681738
https://doi.org/10.1093/ehjcr/ytad584
[ "pericardial", "effusion", "wall", "blood", "large", "fluid", "pseudoaneurysm", "ceftriaxone", "chest", "cardiac" ]
[ { "code": "BB2Z", "title": "Pericarditis, unspecified" }, { "code": "LA8D", "title": "Congenital pericardial anomaly" }, { "code": "BB2Y", "title": "Other specified pericarditis" }, { "code": "BB22", "title": "Constrictive pericarditis" }, { "code": "GA10.E&XA2XU0", "title": "Endometriosis of pericardium" }, { "code": "FA36.Z", "title": "Effusion of joint, unspecified" }, { "code": "1D01.Z", "title": "Infectious meningitis, unspecified" }, { "code": "FA36.Y", "title": "Other specified effusion of joint" }, { "code": "8D60.1", "title": "Cerebral oedema" }, { "code": "ME04.0", "title": "Fluid in peritoneal cavity" } ]
=== ICD-11 CODES FOUND === [BB2Z] Pericarditis, unspecified Also known as: Pericarditis, unspecified | pericarditis NOS | pericardial inflammation | pericardium inflammation [LA8D] Congenital pericardial anomaly Definition: A congenital cardiovascular malformation in which there is a structural and/or functional abnormality of the pericardium. Also known as: Congenital pericardial anomaly | malformations of pericardium | structural developmental anomalies of the pericardium | congenital anomaly of pericardium | structural developmental anomaly of the pericardium [BB2Y] Other specified pericarditis Also known as: Other specified pericarditis | Certain diseases of pericardium | Chronic adhesive pericarditis | adherent pericarditis | adherent pericardium [BB22] Constrictive pericarditis Definition: Chronic fibrous pericarditis due to the presence of dense fibrous tissue between the parietal and visceral layers of pericardium and neighbouring structures. Also known as: Constrictive pericarditis | pericarditis calculosa | Hutinel-Pick syndrome | chronic tamponade | chronic pericardial constriction Includes: concretio cordis [FA36.Z] Effusion of joint, unspecified Also known as: Effusion of joint, unspecified | Effusion of joint | effusion into joint | effusion of joint, site unspecified | hydrarthrosis [1D01.Z] Infectious meningitis, unspecified Also known as: Infectious meningitis, unspecified | Infectious meningitis, not elsewhere classified | acute meningomyelitis | septic meningitis NOS | infectious meningitis NEC [FA36.Y] Other specified effusion of joint Also known as: Other specified effusion of joint | Non aspirated effusion of joint | Effusion of joint without blood | Effusion of joint, multiple sites | Effusion of joint, shoulder region [8D60.1] Cerebral oedema Definition: Is an excess accumulation of fluid in the intracellular and/or extracellular spaces of the brain. Also known as: Cerebral oedema | brain effusion | brain oedema | cerebral effusion | intracranial effusion Excludes: Traumatic cerebral oedema | Cerebral oedema due to birth injury [ME04.0] Fluid in peritoneal cavity Also known as: Fluid in peritoneal cavity | chronic peritoneal effusion | hydroperitoneum | hydroperitonia | peritoneal cavity fluid Excludes: Malignant ascites === GRAPH WALKS === --- Walk 1 --- [BB2Z] Pericarditis, unspecified --PARENT--> [?] Pericarditis --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --- Walk 2 --- [BB2Z] Pericarditis, unspecified --PARENT--> [?] Pericarditis --CHILD--> [BB20] Acute pericarditis Def: Acute pericarditis is defined as pericardial inflammation of no more than 1 to 2 weeks duration.... --- Walk 3 --- [LA8D] Congenital pericardial anomaly Def: A congenital cardiovascular malformation in which there is a structural and/or functional abnormality of the pericardium.... --PARENT--> [?] Structural developmental anomaly of heart or great vessels Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart.... --PARENT--> [?] Structural developmental anomalies of the circulatory system --- Walk 4 --- [LA8D] Congenital pericardial anomaly Def: A congenital cardiovascular malformation in which there is a structural and/or functional abnormality of the pericardium.... --PARENT--> [?] Structural developmental anomaly of heart or great vessels Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart.... --RELATED_TO--> [?] Congenital great vessel related acquired abnormality Def: Any postnatal pathological change in form or function of the heart and/or great vessels consequent to the presence of congenital cardiovascular disease.... --- Walk 5 --- [BB2Y] Other specified pericarditis --PARENT--> [?] Pericarditis --CHILD--> [BB22] Constrictive pericarditis Def: Chronic fibrous pericarditis due to the presence of dense fibrous tissue between the parietal and visceral layers of pericardium and neighbouring structures.... --- Walk 6 --- [BB2Y] Other specified pericarditis --PARENT--> [?] Pericarditis --RELATED_TO--> [?] Acute rheumatic pericarditis Def: A disease of the pericardium, caused by acute rheumatic fever. This disease is characterised by fever, dry cough, rapid heart rate, fatigue, or low blood pressure. Confirmation is by echocardiography,...
[ "[BB2Z] Pericarditis, unspecified\n --PARENT--> [?] Pericarditis\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...", "[BB2Z] Pericarditis, unspecified\n --PARENT--> [?] Pericarditis\n --CHILD--> [BB20] Acute pericarditis\n Def: Acute pericarditis is defined as pericardial inflammation of no more than 1 to 2 weeks duration....", "[LA8D] Congenital pericardial anomaly\n Def: A congenital cardiovascular malformation in which there is a structural and/or functional abnormality of the pericardium....\n --PARENT--> [?] Structural developmental anomaly of heart or great vessels\n Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....\n --PARENT--> [?] Structural developmental anomalies of the circulatory system", "[LA8D] Congenital pericardial anomaly\n Def: A congenital cardiovascular malformation in which there is a structural and/or functional abnormality of the pericardium....\n --PARENT--> [?] Structural developmental anomaly of heart or great vessels\n Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....\n --RELATED_TO--> [?] Congenital great vessel related acquired abnormality\n Def: Any postnatal pathological change in form or function of the heart and/or great vessels consequent to the presence of congenital cardiovascular disease....", "[BB2Y] Other specified pericarditis\n --PARENT--> [?] Pericarditis\n --CHILD--> [BB22] Constrictive pericarditis\n Def: Chronic fibrous pericarditis due to the presence of dense fibrous tissue between the parietal and visceral layers of pericardium and neighbouring structures....", "[BB2Y] Other specified pericarditis\n --PARENT--> [?] Pericarditis\n --RELATED_TO--> [?] Acute rheumatic pericarditis\n Def: A disease of the pericardium, caused by acute rheumatic fever. This disease is characterised by fever, dry cough, rapid heart rate, fatigue, or low blood pressure. Confirmation is by echocardiography,..." ]
BB2Z
Pericarditis, unspecified
[ { "from_icd11": "BB2Z", "icd10_code": "I314", "icd10_title": "Cardiac tamponade" }, { "from_icd11": "BB2Z", "icd10_code": "I319", "icd10_title": "Disease of pericardium, unspecified" }, { "from_icd11": "BB2Z", "icd10_code": "I310", "icd10_title": "Chronic adhesive pericarditis" }, { "from_icd11": "BB2Z", "icd10_code": "I318", "icd10_title": "Other specified diseases of pericardium" }, { "from_icd11": "BB2Z", "icd10_code": "I31", "icd10_title": "Other diseases of pericardium" }, { "from_icd11": "LA8D", "icd10_code": "Q248", "icd10_title": "Other specified congenital malformations of heart" }, { "from_icd11": "BB22", "icd10_code": "I311", "icd10_title": "Chronic constrictive pericarditis" }, { "from_icd11": "FA36.Z", "icd10_code": "M25471", "icd10_title": "Effusion, right ankle" }, { "from_icd11": "FA36.Z", "icd10_code": "M25461", "icd10_title": "Effusion, right knee" }, { "from_icd11": "FA36.Z", "icd10_code": "M25462", "icd10_title": "Effusion, left knee" }, { "from_icd11": "FA36.Z", "icd10_code": "M25431", "icd10_title": "Effusion, right wrist" }, { "from_icd11": "FA36.Z", "icd10_code": "M25472", "icd10_title": "Effusion, left ankle" }, { "from_icd11": "FA36.Z", "icd10_code": "M25451", "icd10_title": "Effusion, right hip" }, { "from_icd11": "FA36.Z", "icd10_code": "M2548", "icd10_title": "Effusion, other site" }, { "from_icd11": "FA36.Z", "icd10_code": "M25411", "icd10_title": "Effusion, right shoulder" } ]
I314
Cardiac tamponade
Biochemical control has been shown to provide improvements in several comorbidities of acromegaly, especially cardiomyopathy, sleep apnea, and arthralgia, but also hypertension and dyslipidemia . In one study involving 30 patients with newly diagnosed acromegaly, 12 months of SSA therapy decreased joint thickness in all cases, but the reduction was greater in those with controlled disease, among whom 61 % had normalization of shoulder thickening and 89 % had normalization of knee thickening . Similarly, successful biochemical control after 12 months of SSA therapy has been shown to normalize left ventricular (LV) hypertrophy in 100 % and LV ejection fraction in 80 % of patients under 40 years of age (but only 50 % of patients over 40 years of age for either measure) . These results are supported by a meta-analysis of 18 SSA trials, which found a significant reduction in LV mass and several functional hemodynamic parameters . In a recent study, LV mass regression was reported in men (but not women) and there were also significant improvements in arterial stiffness and endothelial function after 24 weeks of SSA therapy . In the same study, 61 % of the 30 patients exhibited an improvement in sleep apnea, but 30 % experienced worsening and 9 % had no change . Thus, effective biochemical control does not always result in effective control of these comorbidities and improvements may be limited, in spite of normalized GH levels . Additional therapies are, therefore, frequently required to treat comorbid conditions in acromegaly. In particular, effective control of diabetes, hypertension and dyslipidemia is essential in order to reduce the increased vascular morbidity and mortality associated with these key cardiovascular risk factors . Fortunately, good glycemic control can be achieved in the majority of acromegalic patients with type 2 diabetes using standard approaches, such as lifestyle intervention, oral glucose-lowering agents and insulin . Hypertension in acromegaly is also easily controlled with standard antihypertensive medications . Regarding dyslipidemia, statin therapy has been shown to provide significant improvements in atherogenic lipid profile and reduce calculated coronary heart disease risk in patients with acromegaly . Case study: Addressing multiple comorbidities in a patient with acromegaly (Lucio Vilar, MD, PhD) A 40 year-old female was referred to the endocrinologist in April 2008 due to amenorrhea over the previous 10 months Symptoms Increased shoe size (from 35 to 38) Oily skin, excessive sweating Excessive snoring Amenorrhea (10 months) Polyarthralgia Signs Height: 1.56 m Weight: 66.3 kg Blood Pressure (BP): 160/100 mmHg Enlarged hands and feet Macroglossia, diastema Prognathism, dental malocclusion No goiter Personal and family history No family history of diabetes, cancer, thyroid disease or pituitary disease The last medical evaluation was made in 2004; no biochemical abnormality was found Lab tests GH (ICMA): 23.8 μg/L IGF-1 (ICMA): 960 μg/L (normal 101–267 μg/L) GH nadir during OGTT: 6.3 μg/L Prolactin and thyroid function tests: normal Estradiol: 46 pmol/L (12.6 pg/mL) FSH: 0.8 IU/L Fasting plasma glucose: 7.6 mmol/L (137 mg/dL) HbA 1c = 7.4 % Serum calcium: normal Triglycerides: 5.5 mmol/L (487 mg/dL) HDL cholesterol: 0.8 mmol/L (31 mg/dL) Diagnosis Acromegaly caused by a GH-secreting pituitary macroadenoma MRI Macroadenoma (2.3 × 1.8 cm), with infrasellar, parasellar and suprasellar extension Computerized visual field testing ⇒ Normal Echocardiogram Marked left ventricular (LV) hypertrophy No valvular abnormalities Treatment Patient was submitted to transsphenoidal surgery in Sept 2008, which was not curative IGF-1: 802 μg/L (normal 101–267 μg/L) GH: 13.6 μg/L GH nadir: 3.7 μg/L SSA was started in March 2009, followed by a higher dose in May 2009 followed by SSA + cabergoline 3 mg/week IGF-1 response to medical treatment showed improvement to normal range (101–267 μg/L) with sequential medical therapy from 780 μg/L to 253 μg/L Thyroid ultrasound June 2008: normal January 2011: 1.7 cm hypoechoic solid nodule with increased blood flow in right lobe FNA biopsy ⇒ Papillary thyroid carcinoma March 2011 ⇒ Total thyroidectomy Thyroid histology ⇒ BRAF V600E -positive tall cell variant papillary thyroid carcinoma Patient’s comorbidities Thyroid carcinoma Diabetes mellitus Dyslipidemia Left ventricular hypertrophy Polyarthralgias Central hypogonadism Excessive snoring (sleep apnea?) Effect of treatment on comorbidities Thyroid carcinoma ⇒ No evidence of disease recurrence or metastasis after total thyroidectomy and 131 I abalation therapy Diabetes ⇒ Metformin XR (750 mg/d) required to control blood glucose and HbA 1c levels Dyslipidemia ⇒ resolved with the improvement of diabetes and normalization of GH and IGF-1 levels Hypertension ⇒ BP control achieved with losartan + amlodipine + indapamide Central hypogonadism/excessive snoring ⇒ resolved with GH/IGF-1 normalization LV hypertrophy ⇒ improvement after BP control and hormonal normalization
4.425781
0.518066
sec[4]/p[1]
en
0.999995
24272033
https://doi.org/10.1007/s11102-013-0536-7
[ "control", "thyroid", "acromegaly", "patients", "diabetes", "comorbidities", "dyslipidemia", "normalization", "biochemical", "improvements" ]
[ { "code": "6C01.Z", "title": "Encopresis, unspecified" }, { "code": "6C00.Z", "title": "Enuresis, unspecified" }, { "code": "MF50.2Z", "title": "Urinary incontinence, unspecified" }, { "code": "5A14", "title": "Diabetes mellitus, type unspecified" }, { "code": "6C0Z", "title": "Elimination disorders, unspecified" }, { "code": "5A03.Z", "title": "Thyroiditis, unspecified" }, { "code": "5A0Z", "title": "Disorders of the thyroid gland or thyroid hormones system, unspecified" }, { "code": "5A03.Y", "title": "Other specified thyroiditis" }, { "code": "5A00.2Z", "title": "Acquired hypothyroidism, unspecified" }, { "code": "5A03.0", "title": "Acute thyroiditis" } ]
=== ICD-11 CODES FOUND === [6C01.Z] Encopresis, unspecified Also known as: Encopresis, unspecified | Encopresis | Problems of bowel control | encopresis of nonorganic origin | faecal incontinence of nonorganic origin [6C00.Z] Enuresis, unspecified Also known as: Enuresis, unspecified | Enuresis | Functional enuresis | Problems of bladder control | enuresis NOS [MF50.2Z] Urinary incontinence, unspecified Also known as: Urinary incontinence, unspecified | Urinary incontinence | urinary incontinence, NOS | bladder incontinence NOS | absence of bladder continence [5A14] Diabetes mellitus, type unspecified Also known as: Diabetes mellitus, type unspecified | diabetes NOS | DM - [diabetes mellitus] NOS | severe diabetes mellitus | sudden-onset diabetes mellitus Excludes: Idiopathic Type 1 diabetes mellitus | Type 2 diabetes mellitus | Diabetes mellitus, other specified type [6C0Z] Elimination disorders, unspecified Also known as: Elimination disorders, unspecified | Problems of bowel or bladder control [5A03.Z] Thyroiditis, unspecified Also known as: Thyroiditis, unspecified | Thyroiditis | inflammation of thyroid | thyroiditis NOS [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified Also known as: Disorders of the thyroid gland or thyroid hormones system, unspecified [5A03.Y] Other specified thyroiditis Also known as: Other specified thyroiditis | Riedel thyroiditis | Chronic invasive fibrous thyroiditis | Ligneous thyroiditis | Riedel struma [5A00.2Z] Acquired hypothyroidism, unspecified Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea [5A03.0] Acute thyroiditis Definition: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial. Also known as: Acute thyroiditis | infectious thyroiditis | Acute thyroiditis due to bacterial infection | Acute thyroiditis due to fungal infection | Abscess of thyroid === GRAPH WALKS === --- Walk 1 --- [6C01.Z] Encopresis, unspecified --PARENT--> [6C01] Encopresis Def: Encopresis is the repeated passage of faeces in inappropriate places. Encopresis should be diagnosed if inappropriate passage of faeces occurs repeatedly (e.g., at least once per month over a period o... --CHILD--> [6C01.1] Encopresis without constipation or overflow incontinence Def: Encopresis is the repeated passage of faeces in inappropriate places occurring repeatedly (e.g., at least once per month over a period of several months) in an individual who has reached the developme... --- Walk 2 --- [6C01.Z] Encopresis, unspecified --PARENT--> [6C01] Encopresis Def: Encopresis is the repeated passage of faeces in inappropriate places. Encopresis should be diagnosed if inappropriate passage of faeces occurs repeatedly (e.g., at least once per month over a period o... --CHILD--> [6C01.Z] Encopresis, unspecified --- Walk 3 --- [6C00.Z] Enuresis, unspecified --PARENT--> [6C00] Enuresis Def: Enuresis is the repeated voiding of urine into clothes or bed, which may occur during the day or at night, in an individual who has reached a developmental age when urinary continence is ordinarily ex... --CHILD--> [6C00.0] Nocturnal enuresis Def: Nocturnal enuresis refers to repeated voiding of urine into clothes or bed that occurs only during sleep (i.e., during the night) in an individual who has reached a developmental age when urinary cont... --- Walk 4 --- [6C00.Z] Enuresis, unspecified --PARENT--> [6C00] Enuresis Def: Enuresis is the repeated voiding of urine into clothes or bed, which may occur during the day or at night, in an individual who has reached a developmental age when urinary continence is ordinarily ex... --EXCLUDES--> [?] Functional urinary incontinence Def: Urinary incontinence due to cognitive impairment, or severe physical disability or immobility... --- Walk 5 --- [MF50.2Z] Urinary incontinence, unspecified --PARENT--> [MF50.2] Urinary incontinence Def: Any condition of the urinary system, caused by determinants arising during the antenatal period or after birth, leading to loss of voluntary control or support of the urethra. These conditions are cha... --EXCLUDES--> [?] Proteinuria Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc... --- Walk 6 --- [MF50.2Z] Urinary incontinence, unspecified --PARENT--> [MF50.2] Urinary incontinence Def: Any condition of the urinary system, caused by determinants arising during the antenatal period or after birth, leading to loss of voluntary control or support of the urethra. These conditions are cha... --CHILD--> [MF50.22] Mixed incontinence
[ "[6C01.Z] Encopresis, unspecified\n --PARENT--> [6C01] Encopresis\n Def: Encopresis is the repeated passage of faeces in inappropriate places. Encopresis should be diagnosed if inappropriate passage of faeces occurs repeatedly (e.g., at least once per month over a period o...\n --CHILD--> [6C01.1] Encopresis without constipation or overflow incontinence\n Def: Encopresis is the repeated passage of faeces in inappropriate places occurring repeatedly (e.g., at least once per month over a period of several months) in an individual who has reached the developme...", "[6C01.Z] Encopresis, unspecified\n --PARENT--> [6C01] Encopresis\n Def: Encopresis is the repeated passage of faeces in inappropriate places. Encopresis should be diagnosed if inappropriate passage of faeces occurs repeatedly (e.g., at least once per month over a period o...\n --CHILD--> [6C01.Z] Encopresis, unspecified", "[6C00.Z] Enuresis, unspecified\n --PARENT--> [6C00] Enuresis\n Def: Enuresis is the repeated voiding of urine into clothes or bed, which may occur during the day or at night, in an individual who has reached a developmental age when urinary continence is ordinarily ex...\n --CHILD--> [6C00.0] Nocturnal enuresis\n Def: Nocturnal enuresis refers to repeated voiding of urine into clothes or bed that occurs only during sleep (i.e., during the night) in an individual who has reached a developmental age when urinary cont...", "[6C00.Z] Enuresis, unspecified\n --PARENT--> [6C00] Enuresis\n Def: Enuresis is the repeated voiding of urine into clothes or bed, which may occur during the day or at night, in an individual who has reached a developmental age when urinary continence is ordinarily ex...\n --EXCLUDES--> [?] Functional urinary incontinence\n Def: Urinary incontinence due to cognitive impairment, or severe physical disability or immobility...", "[MF50.2Z] Urinary incontinence, unspecified\n --PARENT--> [MF50.2] Urinary incontinence\n Def: Any condition of the urinary system, caused by determinants arising during the antenatal period or after birth, leading to loss of voluntary control or support of the urethra. These conditions are cha...\n --EXCLUDES--> [?] Proteinuria\n Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...", "[MF50.2Z] Urinary incontinence, unspecified\n --PARENT--> [MF50.2] Urinary incontinence\n Def: Any condition of the urinary system, caused by determinants arising during the antenatal period or after birth, leading to loss of voluntary control or support of the urethra. These conditions are cha...\n --CHILD--> [MF50.22] Mixed incontinence" ]
6C01.Z
Encopresis, unspecified
[ { "from_icd11": "6C01.Z", "icd10_code": "F981", "icd10_title": "Encopresis not due to a substance or known physiological condition" }, { "from_icd11": "6C00.Z", "icd10_code": "F980", "icd10_title": "Enuresis not due to a substance or known physiological condition" }, { "from_icd11": "MF50.2Z", "icd10_code": "N39498", "icd10_title": "Other specified urinary incontinence" }, { "from_icd11": "MF50.2Z", "icd10_code": "N3941", "icd10_title": "Urge incontinence" }, { "from_icd11": "MF50.2Z", "icd10_code": "N3946", "icd10_title": "Mixed incontinence" }, { "from_icd11": "MF50.2Z", "icd10_code": "N3945", "icd10_title": "Continuous leakage" }, { "from_icd11": "MF50.2Z", "icd10_code": "N3944", "icd10_title": "Nocturnal enuresis" }, { "from_icd11": "MF50.2Z", "icd10_code": "N39490", "icd10_title": "Overflow incontinence" }, { "from_icd11": "MF50.2Z", "icd10_code": "N3943", "icd10_title": "Post-void dribbling" }, { "from_icd11": "MF50.2Z", "icd10_code": "N3942", "icd10_title": "Incontinence without sensory awareness" }, { "from_icd11": "MF50.2Z", "icd10_code": "R32", "icd10_title": "Unspecified urinary incontinence" }, { "from_icd11": "MF50.2Z", "icd10_code": "N394", "icd10_title": "Other specified urinary incontinence" }, { "from_icd11": "5A14", "icd10_code": "E14", "icd10_title": "" }, { "from_icd11": "5A14", "icd10_code": "E140", "icd10_title": "" }, { "from_icd11": "5A14", "icd10_code": "E141", "icd10_title": "" } ]
F981
Encopresis not due to a substance or known physiological condition
A 55-year-old Turkish man presented with swelling in the anterior of his neck and dyspnea for 3 to 4 days. His past medical history was significant for hypertension, hyperlipidemia and a hip prosthesis. He was treated with atenolol, quinapril-hydrochlorothiazide combination and atorvastatin tablets. He had a 50-pack year history of cigarette smoking. His blood pressure was 140/88mmHg, pulse 96 beats per minute and respiratory rate 16 per minute. A chest X-ray showed a mediastinal mass. Computed tomography (CT) of his thorax showed a 10.6×9.7×10.8cm mediastinal mass encasing superior vena cava, causing stenosis of the lumen and deviation of his trachea, esophagus and vascular structures. The mass also reached to the right pulmonary hilus. The presence of lymph node metastasis was not clearly discernible from the images, because the mass appeared somewhat homogeneous . Subcarinal lymphadenopathy was evident . In retrospect, we think that the mass was intermingled with multiple lymph node metastases, because they regressed with chemotherapy and radiotherapy. The thyroid appeared normal on CT of his chest. He exhibited clinical features of superior vena cava syndrome. The staging was done by CT of his chest and abdomen. Positron emission tomography-CT and endobronchial ultrasound were not performed. There was no evidence of liver or pancreatic metastases on the initial CT of his abdomen. He had a 15mm hypodense nodule in his left adrenal gland that was not biopsied and remained stable in size during follow-up. A bronchoscopic biopsy showed small cell carcinoma of the lung . Immunohistochemical staining with synaptophysin, pan cytokeratin and chromogranin were positive. A diagnosis of limited stage small cell lung carcinoma was made and he was started on chemotherapy with cisplatin and etoposide. When his tumor diminished in size and fitted to the radiotherapy field, external radiotherapy was instituted. The clinical course showed refractoriness to treatment. He developed radiation pneumonitis and later fibrosis in his right lung. Six months after the presentation, a right thyroid nodule was detected on CT of his chest and multiple brain metastases were detected on magnetic resonance imaging of his brain. Chemotherapy was changed to topotecan. Cranial irradiation was given. He developed pancytopenia. Ten months after the presentation, the patient’s oncologist (second author Gülistan Köksal, MD) was alerted by the finding of the size progression of the right thyroid nodule on a CT scan of the patient’s chest . On physical examination, a right thyroid nodule was palpable. Thyroid function tests were within normal limits at that time, as well as antithyroglobulin and antithyroid peroxidase antibodies, which were performed at a later date. Tests revealed: free thyroxine (T4) 1.32ng/ml (normal range 0.8 to 1.81), free triiodothyronine (T3) 2.35pg/ml (normal range 2.30 to 4.40), thyroid-stimulating hormone 0.313μIU/ml (normal range 0.27 to 4.20), antithyroid peroxidase antibody 1.1IU/ml (normal range <12), and antithyroglobulin antibody 5.9IU/ml (normal range <34). Thyroid ultrasonography showed a 26.2×16.8×15.7mm hypoechoic solid nodule with irregular borders in his right thyroid lobe . An ultrasonography-guided thyroid fine-needle aspiration biopsy showed metastasis from small cell lung carcinoma . His cranial metastases worsened. There was no size reduction of the initially detected metastatic thyroid nodule and two new hypoechoic nodules of 4.2×4.7×2.5mm and 4.2×3.4×3.4mm with blurred borders were detected by thyroid ultrasonography performed 4.5 months after the diagnosis of the thyroid metastasis by fine-needle aspiration biopsy. He developed right cervical lymph node, hepatic, pancreatic and meningeal metastases and expired 15 months after the initial presentation and 9 months after the detection of thyroid metastasis on CT of his chest. Fig. 1 Computed tomography image of the mediastinal mass intermingled with mediastinal lymphadenopathy Fig. 2 Computed tomography image of subcarinal lymphadenopathy Fig. 3 Oil immersion, high power hematoxylin and eosin staining of bronchial biopsy. Small cell carcinoma cells are seen in the lamina propria juxtaposed to red blood cells. Small cell carcinoma cells are characterized by hyperchromatic nuclei, high nuclear to cytoplasmic ratio and nuclear molding Fig. 4 Immunohistochemical (×400 magnification) chromogranin staining ( brown ) as a marker for neuroendocrine differentiation in bronchial biopsy Fig. 5 Computed tomography image of the thyroid gland and right thyroid nodule Fig. 6 Thyroid ultrasonography image of right thyroid lobe Fig. 7 Oil immersion, high power Diff-Quick staining of thyroid fine-needle aspiration biopsy. Small cell carcinoma cells are characterized by hyperchromatic nuclei, coarse chromatin, salt and pepper appearance, high nuclear to cytoplasmic ratio and nuclear membrane irregularities. No thyroid follicular cells are seen. Small cell carcinoma cells are much larger than thyroid follicular cells
3.875
0.982422
sec[1]/p[0]
en
0.999997
26445938
https://doi.org/10.1186/s13256-015-0707-4
[ "thyroid", "nodule", "small", "cell", "carcinoma", "cells", "chest", "biopsy", "tomography", "metastases" ]
[ { "code": "5A03.Z", "title": "Thyroiditis, unspecified" }, { "code": "5A0Z", "title": "Disorders of the thyroid gland or thyroid hormones system, unspecified" }, { "code": "5A03.Y", "title": "Other specified thyroiditis" }, { "code": "5A00.2Z", "title": "Acquired hypothyroidism, unspecified" }, { "code": "5A03.0", "title": "Acute thyroiditis" }, { "code": "2E88", "title": "Benign endometrial stromal nodule" }, { "code": "FA20.0", "title": "Seropositive rheumatoid arthritis" }, { "code": "1F20.Z", "title": "Aspergillosis, unspecified" }, { "code": "MF30", "title": "Breast lump or mass female" }, { "code": "5A01.1", "title": "Nontoxic single thyroid nodule" } ]
=== ICD-11 CODES FOUND === [5A03.Z] Thyroiditis, unspecified Also known as: Thyroiditis, unspecified | Thyroiditis | inflammation of thyroid | thyroiditis NOS [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified Also known as: Disorders of the thyroid gland or thyroid hormones system, unspecified [5A03.Y] Other specified thyroiditis Also known as: Other specified thyroiditis | Riedel thyroiditis | Chronic invasive fibrous thyroiditis | Ligneous thyroiditis | Riedel struma [5A00.2Z] Acquired hypothyroidism, unspecified Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea [5A03.0] Acute thyroiditis Definition: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial. Also known as: Acute thyroiditis | infectious thyroiditis | Acute thyroiditis due to bacterial infection | Acute thyroiditis due to fungal infection | Abscess of thyroid [2E88] Benign endometrial stromal nodule Also known as: Benign endometrial stromal nodule | benign endometrial stromal tumour | Endometrial node | Stromal nodule [FA20.0] Seropositive rheumatoid arthritis Also known as: Seropositive rheumatoid arthritis | high positive rheumatoid factor | low positive rheumatoid factor | high positive anticitrullinated protein antibody | low positive anticitrullinated protein antibody [1F20.Z] Aspergillosis, unspecified Also known as: Aspergillosis, unspecified | Aspergillosis | aspergilloma | aspergillus nodule | simple aspergilloma [MF30] Breast lump or mass female Also known as: Breast lump or mass female | breast irregular nodularity | breast node | lump in breast | lump or mass in breast NOS [5A01.1] Nontoxic single thyroid nodule Definition: Single tumour of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis Also known as: Nontoxic single thyroid nodule | colloid goitre (in part) | follicular goitre | struma follicularis | parenchymatous goitre === GRAPH WALKS === --- Walk 1 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --EXCLUDES--> [?] Thyrotoxicosis Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone... --- Walk 2 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.1] Subacute thyroiditis Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection.... --- Walk 3 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A02] Thyrotoxicosis Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone... --- Walk 4 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A02] Thyrotoxicosis Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone... --- Walk 5 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.0] Acute thyroiditis Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial.... --- Walk 6 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --EXCLUDES--> [?] Acquired hypothyroidism Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....
[ "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Thyrotoxicosis\n Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone...", "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.1] Subacute thyroiditis\n Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection....", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A02] Thyrotoxicosis\n Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone...", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A02] Thyrotoxicosis\n Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone...", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.0] Acute thyroiditis\n Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial....", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Acquired hypothyroidism\n Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth...." ]
5A03.Z
Thyroiditis, unspecified
[ { "from_icd11": "5A03.Z", "icd10_code": "E069", "icd10_title": "Thyroiditis, unspecified" }, { "from_icd11": "5A03.Z", "icd10_code": "E064", "icd10_title": "Drug-induced thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E065", "icd10_title": "Other chronic thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E06", "icd10_title": "Thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E062", "icd10_title": "Chronic thyroiditis with transient thyrotoxicosis" }, { "from_icd11": "5A0Z", "icd10_code": "E0781", "icd10_title": "Sick-euthyroid syndrome" }, { "from_icd11": "5A0Z", "icd10_code": "E0789", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E079", "icd10_title": "Disorder of thyroid, unspecified" }, { "from_icd11": "5A0Z", "icd10_code": "E034", "icd10_title": "Atrophy of thyroid (acquired)" }, { "from_icd11": "5A0Z", "icd10_code": "E00-E07", "icd10_title": "" }, { "from_icd11": "5A0Z", "icd10_code": "E07", "icd10_title": "Other disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E078", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E35", "icd10_title": "Disorders of endocrine glands in diseases classified elsewhere" }, { "from_icd11": "5A00.2Z", "icd10_code": "E033", "icd10_title": "Postinfectious hypothyroidism" }, { "from_icd11": "5A03.0", "icd10_code": "E060", "icd10_title": "Acute thyroiditis" } ]
E069
Thyroiditis, unspecified
A 70-year-old Japanese man with neovascular glaucoma due to diabetic retinopathy in his right eye (OD) underwent implantation of an Ahmed Glaucoma (AGV) (model FP-7, JFC Sales plan Co. Ltd., Tokyo, Japan) to reduce the intraocular pressure (IOP). Simultaneously, pars plana vitrectomy (PPV) and epiretinal membrane (ERM) peeling, along with removal of proliferative membrane were performed. Preoperatively, the IOP and best corrected visual acuity (BCVA) were 23 mmHg and 0.6, respectively, OD with the use of topical prostaglandin, beta-blocker and carbonic anhydrase inhibitor. The AGV plate was positioned in the superotemporal quadrant by placing the sutures at 8.5 mm from the corneal limbus, and the tube was inserted 3.5 mm away from the corneal limbus into the vitreous cavity, covered with an autologous scleral flap. The surgery concluded without complications. Preoperatively, 1.5% levofloxacin eye drops were used for 3 days, and postoperatively, 1.5% levofloxacin eye drops and 0.1% betamethasone eye drops were used for about 3 weeks. At the end of surgery, about 10 mg of triamcinolone was injected around the AGV plate. No antifibrotic agent was used during and after the surgery. Thirteen days post-surgery, IOP and BCVA were 9 mmHg and 0.8, respectively, OD. After two months, the IOP and BCVA were 24 mmHg and 0.8, respectively, OD, and the patient began experiencing double vision. Slit lamp examination displayed no abnormality beyond the typical findings after AGV implantation combined with PPV . The Hess chart exhibited esotropia and hypotropia OD upon comparison to the position of the central point in the left eye (OS), limited infraduction and adduction OD and compensatory enhanced infraduction and abduction OS . For further assessment, orbital magnetic resonance imaging (MRI) was conducted. T2-weighted orbital MRI, 5 revealed a posterior cystic fluid accumulation surrounding the AGV in the superotemporal quadrant, leading to displacement of the right eyeball. Axial view (T2-weighted orbital MRI) anterior displacement of eyeball due to a giant bleb enlarged posteriorly was seen OD . Coronal view of the T2-weighted orbital MRI displayed inferior displacement of eyeball due to an enlarged superiorly extending bleb . Based on these findings, the patient underwent surgical intervention involving excision of the bleb wall (Video 1). No glaucoma medications were used preoperatively. The procedure began by debriding the bleb wall, separating it from the conjunctival tissue , followed by incision of the bleb wall to drain its contents . Subsequently, the anterior bleb wall was excised , and the bleb wall and conjunctiva were sutured separately. No antifibrotic agent was used during and after the revision surgery. The day after the procedure, the IOP was 8 mmHg OD. Topical application of levofloxacin 1.5% (Nipro, Osaka, Japan) and betamethasone 0.1% (Sanbetason, Santen Pharmaceutical, Osaka, Japan) four times daily for three weeks was prescribed. Aqueous suppression was not used after the surgery. By three weeks after surgery, the double vision had resolved . At the two-month follow-up, the IOP and BCVA were 17 mmHg and 0.7, respectively, OD. Slit lamp examination revealed a normal bleb . Fig. 1 Case 1, OD. Slit lamp findings (A, B) 2 months after the AGV implantation. (A) AGV tube tip inserted via pars plana is seen behind the IOL (white arrow). (B) Superficial examination of superotemporal quadrant, where the plate of the AGV is implanted. No enlarged bleb is observed anterior to the front edge of AGV plate. Fig. 1 Fig. 2 Case 1. Hess chart (A) and MRI of the orbit (B, C) findings 2 months after the AGV implantation surgery. (A) Hess chart evaluation shows the internal and inferior deviations OD in a primary eye position, restricted inferior an internal movements OD and the upgraded inferior and external compensated movements OS. (B) Axial view, T2-weighted orbital MRI, showing anterior displacement of eyeball due to a posteriorly enlarged giant bleb in OD. Aqueous humor appears as high intensity; AGV plate as low intensity (arrowhead), and the dotted line represents the posterior border of the eyeball OS. (C) Coronal view, T2-weighted orbital MRI illustrating inferior displacement of the eyeball due to a superiorly enlarged giant bleb in OD. Aqueous humor appears as high intensity; AGV plate as low intensity (arrowhead), and dotted line represents the superior border of the eyeball OS. Fig. 2 Fig. 3 Case 1. Findings during surgery (A, B, C) and 3 weeks after surgery (D, E). (A) Debriding of the bleb wall is seen, with separation from conjunctival tissue (arrow) (B) An incision is made over the bleb wall to drain its content, with liquid beginning to flow out (arrow). (C) Excision of the anterior bleb wall (arrow), showing part of the AGV plate (arrowhead). (D) Slit lamp evaluation of the superotemporal quadrant of the ocular surface with the implanted plate shows normal bleb formation. (E) Hess chart evaluation demonstrates almost bilateral orthophoria. Fig. 3
4.035156
0.967285
sec[1]/sec[0]/p[0]
en
0.999997
38374947
https://doi.org/10.1016/j.ajoc.2024.102008
[ "bleb", "plate", "wall", "eyeball", "used", "orbital", "mmhg", "weighted", "displacement", "enlarged" ]
[ { "code": "CA21.Y", "title": "Other specified emphysema" }, { "code": "CA21.Z", "title": "Emphysema, unspecified" }, { "code": "9C21.Y", "title": "Other specified endophthalmitis" }, { "code": "9D23", "title": "Conjunctival blebitis after glaucoma surgery" }, { "code": "LC51", "title": "Developmental venous malformations involving the skin" }, { "code": "QB84", "title": "Follow-up care involving removal of fracture plate or other internal fixation device" }, { "code": "FB82.Y", "title": "Other specified chondropathies" }, { "code": "QB51.Y", "title": "Presence of other specified devices other than cardiac or vascular implants" }, { "code": "EE10.2", "title": "Onycholysis" }, { "code": "FA85.Z", "title": "Spinal endplate defects, unspecified" } ]
=== ICD-11 CODES FOUND === [CA21.Y] Other specified emphysema Also known as: Other specified emphysema | Airway obstruction with emphysema | chronic obstructive pulmonary emphysema | obstructive emphysema | obstructive lung or pulmonary emphysema [CA21.Z] Emphysema, unspecified Also known as: Emphysema, unspecified | Emphysema | emphysema of lung | pulmonary emphysema | pulmonary emphysema NOS [9C21.Y] Other specified endophthalmitis Also known as: Other specified endophthalmitis | Other endophthalmitis | Parasitic endophthalmitis | Bleb associated endophthalmitis | Iridochoroiditis [9D23] Conjunctival blebitis after glaucoma surgery Also known as: Conjunctival blebitis after glaucoma surgery | postprocedural blebitis | inflammation or infection of postprocedural bleb | Inflammation or infection of postprocedural bleb, stage 1 | Inflammation or infection of postprocedural bleb, stage 2 [LC51] Developmental venous malformations involving the skin Definition: Certain genetically-determined syndromes presenting with venous anomalies in the skin Also known as: Developmental venous malformations involving the skin | Blue rubber bleb naevus syndrome | Bean syndrome (MIM 112200) | Mucocutaneous venous malformations | Glomuvenous malformation [QB84] Follow-up care involving removal of fracture plate or other internal fixation device Also known as: Follow-up care involving removal of fracture plate or other internal fixation device | Change of internal fixation device | change of fixation device | change of Kirschner wire | Checking of internal fixation device Excludes: removal of external fixation device [FB82.Y] Other specified chondropathies Also known as: Other specified chondropathies | Certain specified osteochondropathies | disease of bone or cartilage | disorder of bone or cartilage, unspecified | Lethal chondrodysplasia [QB51.Y] Presence of other specified devices other than cardiac or vascular implants Also known as: Presence of other specified devices other than cardiac or vascular implants | Presence of bone or tendon implants other than orthopaedic joint implants | replacement of tendon by artificial or mechanical device or prosthesis | presence of tendon implant | Presence of skull plate [EE10.2] Onycholysis Also known as: Onycholysis | Detachment of nail | Separation of nail plate | Photo-onycholysis | Traumatic onycholysis [FA85.Z] Spinal endplate defects, unspecified Also known as: Spinal endplate defects, unspecified | Spinal endplate defects === GRAPH WALKS === --- Walk 1 --- [CA21.Y] Other specified emphysema --PARENT--> [CA21] Emphysema Def: Emphysema is defined by abnormal and permanent enlargement of the airspaces that are distal to the terminal bronchioles. This is accompanied by destruction of the airspace walls, without obvious fibro... --EXCLUDES--> [?] Compensatory emphysema Def: Compensatory emphysema is a condition in which one portion of the lung increases in size and function, when another portion is destroyed or temporarily useless. It occurs, for instance, in association... --- Walk 2 --- [CA21.Y] Other specified emphysema --PARENT--> [CA21] Emphysema Def: Emphysema is defined by abnormal and permanent enlargement of the airspaces that are distal to the terminal bronchioles. This is accompanied by destruction of the airspace walls, without obvious fibro... --CHILD--> [CA21.0] MacLeod syndrome Def: Decrease in size of one lung due to obliterating bronchiolitis, a congenital abnormality of other disorder resulting in hyperinflation of the normal lung.... --- Walk 3 --- [CA21.Z] Emphysema, unspecified --PARENT--> [CA21] Emphysema Def: Emphysema is defined by abnormal and permanent enlargement of the airspaces that are distal to the terminal bronchioles. This is accompanied by destruction of the airspace walls, without obvious fibro... --EXCLUDES--> [?] Chronic respiratory conditions due to chemicals, gases, fumes or vapours Def: This refers to chronic conditions affecting the organs and tissues that make gas exchange possible in higher organisms, due to inhalation of chemicals, gases, fumes, and vapours.... --- Walk 4 --- [CA21.Z] Emphysema, unspecified --PARENT--> [CA21] Emphysema Def: Emphysema is defined by abnormal and permanent enlargement of the airspaces that are distal to the terminal bronchioles. This is accompanied by destruction of the airspace walls, without obvious fibro... --EXCLUDES--> [?] Compensatory emphysema Def: Compensatory emphysema is a condition in which one portion of the lung increases in size and function, when another portion is destroyed or temporarily useless. It occurs, for instance, in association... --- Walk 5 --- [9C21.Y] Other specified endophthalmitis --PARENT--> [9C21] Endophthalmitis --CHILD--> [9C21.Z] Endophthalmitis, unspecified --- Walk 6 --- [9C21.Y] Other specified endophthalmitis --PARENT--> [9C21] Endophthalmitis --CHILD--> [9C21.0] Sympathetic uveitis
[ "[CA21.Y] Other specified emphysema\n --PARENT--> [CA21] Emphysema\n Def: Emphysema is defined by abnormal and permanent enlargement of the airspaces that are distal to the terminal bronchioles. This is accompanied by destruction of the airspace walls, without obvious fibro...\n --EXCLUDES--> [?] Compensatory emphysema\n Def: Compensatory emphysema is a condition in which one portion of the lung increases in size and function, when another portion is destroyed or temporarily useless. It occurs, for instance, in association...", "[CA21.Y] Other specified emphysema\n --PARENT--> [CA21] Emphysema\n Def: Emphysema is defined by abnormal and permanent enlargement of the airspaces that are distal to the terminal bronchioles. This is accompanied by destruction of the airspace walls, without obvious fibro...\n --CHILD--> [CA21.0] MacLeod syndrome\n Def: Decrease in size of one lung due to obliterating bronchiolitis, a congenital abnormality of other disorder resulting in hyperinflation of the normal lung....", "[CA21.Z] Emphysema, unspecified\n --PARENT--> [CA21] Emphysema\n Def: Emphysema is defined by abnormal and permanent enlargement of the airspaces that are distal to the terminal bronchioles. This is accompanied by destruction of the airspace walls, without obvious fibro...\n --EXCLUDES--> [?] Chronic respiratory conditions due to chemicals, gases, fumes or vapours\n Def: This refers to chronic conditions affecting the organs and tissues that make gas exchange possible in higher organisms, due to inhalation of chemicals, gases, fumes, and vapours....", "[CA21.Z] Emphysema, unspecified\n --PARENT--> [CA21] Emphysema\n Def: Emphysema is defined by abnormal and permanent enlargement of the airspaces that are distal to the terminal bronchioles. This is accompanied by destruction of the airspace walls, without obvious fibro...\n --EXCLUDES--> [?] Compensatory emphysema\n Def: Compensatory emphysema is a condition in which one portion of the lung increases in size and function, when another portion is destroyed or temporarily useless. It occurs, for instance, in association...", "[9C21.Y] Other specified endophthalmitis\n --PARENT--> [9C21] Endophthalmitis\n --CHILD--> [9C21.Z] Endophthalmitis, unspecified", "[9C21.Y] Other specified endophthalmitis\n --PARENT--> [9C21] Endophthalmitis\n --CHILD--> [9C21.0] Sympathetic uveitis" ]
CA21.Y
Other specified emphysema
[ { "from_icd11": "CA21.Z", "icd10_code": "J439", "icd10_title": "Emphysema, unspecified" }, { "from_icd11": "CA21.Z", "icd10_code": "J438", "icd10_title": "Other emphysema" }, { "from_icd11": "CA21.Z", "icd10_code": "J43", "icd10_title": "Emphysema" }, { "from_icd11": "LC51", "icd10_code": "Q278", "icd10_title": "Other specified congenital malformations of peripheral vascular system" }, { "from_icd11": "QB84", "icd10_code": "Z4733", "icd10_title": "Aftercare following explantation of knee joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z4732", "icd10_title": "Aftercare following explantation of hip joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z472", "icd10_title": "Encounter for removal of internal fixation device" }, { "from_icd11": "QB84", "icd10_code": "Z471", "icd10_title": "Aftercare following joint replacement surgery" }, { "from_icd11": "QB84", "icd10_code": "Z4731", "icd10_title": "Aftercare following explantation of shoulder joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z4781", "icd10_title": "Encounter for orthopedic aftercare following surgical amputation" }, { "from_icd11": "QB84", "icd10_code": "Z4789", "icd10_title": "Encounter for other orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z47", "icd10_title": "Orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z470", "icd10_title": "" }, { "from_icd11": "QB84", "icd10_code": "Z478", "icd10_title": "Encounter for other orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z479", "icd10_title": "" } ]
J439
Emphysema, unspecified
LLG was considered in all cases during preoperative planning (including Collis gastroplasty in a patient undergoing paraesophageal hernia repair) and was discussed with patients; however, in all cases, decision for LLG was ultimately made during surgery after contemplating other surgical options. LLG was performed over a 44 French bougie creating a wide sleeve, with the staple line being oversewn with running 3–0 silk. Intraoperative endoscopy was performed in three out of the four patients. Case 1. A 75-year-old severely obese female (BMI 35 kg/m 2 ) with stage IV renal failure (Cr 2.8 mg/dL), congestive heart failure, and coronary artery disease on clopidogrel (75 mg daily) presented to the emergency room (ER) with haematemesis and melena. She was hypotensive, and hemoglobin was 7 mg/dL. After a fluid bolus and blood transfusions, she stabilised in the ER; proton pump inhibitor infusion was started. She underwent emergent endoscopic clipping of an actively bleeding fundus Dieulafoy lesion ( Figure 1(a) ). Massive rebleed occurred after 72 hours, and octreotide (50 microgram per hour) was started. On EGD, a large blood clot hindered visualisation. During emergent laparoscopy, the upper portion of the larger curvature of the blood-filled stomach was devascularised. A large blood vessel originating from the splenic artery was clipped ( Figure 1(b) ), and a LLG was performed. The clipped Dieulafoy lesion was identified in the specimen ( Figure 1(c) ). The patient had an uneventful postoperative course, her BMI decreased to 26 kg/m 2 , but she was noncompliant with follow-up and refused to come to office visits. She had no reported symptoms from the sleeve gastrectomy but regained weight and died two years later from a stroke. Case 2. During laparoscopic paraesophageal hernia repair ( Figure 2(a) ) in an 80-year-old female, the gastric fundus was found to be thickened and immobile making a fundoplication impossible. Intraoperative gastroscopy showed the entire fundus and proximal body occupied by innumerable polyps. After hiatal closure, a wide LLG was performed and a percutaneous endoscopic gastrostomy (PEG) tube was placed in the distal stomach. The specimen showed fundic gland polyposis ( Figure 2(b) ) which was confirmed on histopathology. Her postoperative course was uneventful. The PEG tube was removed after six weeks, she was followed up annually by her gastroenterologist, had no complications from her sleeve gastrectomy, and maintained a stable weight. The patient remained well after 5 years. Case 3 . A 67-year-old male with a history of metastatic leiomyosarcoma on chemotherapy presented with LUQ pain, and a CT scan showed a mass close to the left adrenal gland. The patient had undergone a trauma splenectomy 40 years ago. During laparoscopic resection of the mass, the stomach was mobilised exposing multiple nodules along the larger curvature, which were suspected to be leiomyosarcoma metastases. The main mass was resected, and thereafter, an LLG was performed. Pathology revealed that the main mass and the gastric implants were splenic tissue that had been growing for extramedullary hemopoesis due to bone marrow toxicity from the chemotherapeutic agents. The patient had an uneventful recovery. He is followed up by oncology, has no complications reported from the sleeve gastrectomy, and has a stable weight. He is alive on chemotherapy for metastatic disease after 4 years. Case 4. A 72-year-old cachexic male (BMI 14 kg/m 2 ), who had a partial colectomy for large bowel perforation >20 years ago, presented with weight loss, worsening dysphagia, and recurrent regurgitation and aspiration for one year. Barium swallow showed organoaxial gastric volvulus ( Figure 3(a) ). He was a heavy smoker suffering from coronary artery disease and severe chronic obstructive pulmonary disease (COPD). During exploratory laparoscopy, extensive lysis of adhesions exposed a massively distended, atonic stomach. LLG created a relatively long and angled gastric remnant ( Figure 3(b) ). Postoperative swallow studies indicated delayed oesophageal but prompt transit of dye through the stomach and duodenum. Following discharge on full liquids, he resumed smoking and did not follow dietary recommendations. He returned to the ER after two weeks with dysphagia. Imaging revealed an alpha-loop in the distal stomach ( Figure 3(c) ) managed by endoscopic stenting. He tolerated a diet and gained weight until stent migration after four weeks ( Figure 3(d) ). The device was retrieved laparoscopically from the jejunum ( Figure 3(e) ). By creation of a side-side stapled gastrogastrostomy, the alpha-loop was straightened allowing the endoscope to pass without resistance into the duodenum and a PEG tube was placed. The patient tolerated oral and tube feeds, gained weight, and his quality of life significantly improved. He was followed up by a bariatric surgeon and a nutritionist but remained dependent on tube overnight feeds. He continued smoking and died after one year from COPD exacerbation.
3.996094
0.967773
sec[2]/p[1]
en
0.999997
34035960
https://doi.org/10.1155/2021/9962130
[ "stomach", "weight", "tube", "sleeve", "blood", "gastric", "artery", "endoscopic", "fundus", "large" ]
[ { "code": "DA4Z", "title": "Diseases of stomach, unspecified" }, { "code": "DA60.Z", "title": "Gastric ulcer, unspecified" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "LB13.Z", "title": "Structural developmental anomalies of stomach, unspecified" }, { "code": "DA42.73", "title": "Chronic atrophic gastritis of unknown aetiology" }, { "code": "MG43.5", "title": "Excessive weight loss" }, { "code": "MG43.6", "title": "Excessive weight gain" }, { "code": "MG44.11", "title": "Failure to thrive in infant or child" }, { "code": "5B80.0Z", "title": "Overweight, unspecified" }, { "code": "JA65.2", "title": "Excessive weight gain in pregnancy" } ]
=== ICD-11 CODES FOUND === [DA4Z] Diseases of stomach, unspecified Also known as: Diseases of stomach, unspecified | disorder of stomach | gastropathy NOS | gastric disease NOS | stomach disease NOS [DA60.Z] Gastric ulcer, unspecified Also known as: Gastric ulcer, unspecified | Gastric ulcer | stomach ulcer | Cushings ulcer | cushing's ulcer of stomach [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [LB13.Z] Structural developmental anomalies of stomach, unspecified Also known as: Structural developmental anomalies of stomach, unspecified | Structural developmental anomalies of stomach | Malformations of stomach [DA42.73] Chronic atrophic gastritis of unknown aetiology Definition: Persistent or recurrent inflammation of the gastric mucosa with atrophy leading to decreased hydrochloric acid concentration in the gastric juice. Atrophic gastritis frequently progresses from chronic gastritis. Also known as: Chronic atrophic gastritis of unknown aetiology | Gastric atrophy | atrophic gastritis | AG - [atrophic gastritis] | CAG - [chronic atrophic gastritis] Includes: Gastric atrophy [MG43.5] Excessive weight loss Definition: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health. Also known as: Excessive weight loss | abnormal decrease in weight | abnormal weight loss | unintended weight loss | weight loss NOS [MG43.6] Excessive weight gain Definition: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantity or rate to create risk to the individual’s health. Also known as: Excessive weight gain | abnormal increase in weight | abnormal weight gain | unintended weight gain Excludes: Obesity [MG44.11] Failure to thrive in infant or child Definition: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender. Also known as: Failure to thrive in infant or child | failure to gain weight | failure to thrive NOS | FTT - [failure to thrive] syndrome Excludes: Failure to thrive in newborn | Anorexia Nervosa | Avoidant-restrictive food intake disorder [5B80.0Z] Overweight, unspecified Also known as: Overweight, unspecified | Overweight [JA65.2] Excessive weight gain in pregnancy Definition: Any reason for encounter to assess (or care for) a mother for excessive weight gain during pregnancy. Also known as: Excessive weight gain in pregnancy | excessive weight gain in pregnancy, unspecified trimester | maternal obesity syndrome | maternal obesity without hypertension | abnormal weight gain in pregnancy Excludes: Gestational oedema without hypertension === GRAPH WALKS === --- Walk 1 --- [DA4Z] Diseases of stomach, unspecified --PARENT--> [?] Diseases of stomach Def: This is a group of conditions characterised as being in or associated with the stomach.... --EXCLUDES--> [?] Gastrostomy malfunction --- Walk 2 --- [DA4Z] Diseases of stomach, unspecified --PARENT--> [?] Diseases of stomach Def: This is a group of conditions characterised as being in or associated with the stomach.... --CHILD--> [DA41] Gastroduodenal motor or secretory disorders Def: This group incorporates disorders due to abnormalities of gastroduodenal motor function and gastroduodenal secretory function, often resulting in the disturbance of transportation and/or digestion of ... --- Walk 3 --- [DA60.Z] Gastric ulcer, unspecified --PARENT--> [DA60] Gastric ulcer Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th... --EXCLUDES--> [?] Acute haemorrhagic gastritis of unknown aetiology Def: Rapid onset inflammation of the mucosal lining of the stomach with associated bleeding or abnormal blood flow.... --- Walk 4 --- [DA60.Z] Gastric ulcer, unspecified --PARENT--> [DA60] Gastric ulcer Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th... --CHILD--> [DA60.2] Helicobacter pylori associated and drug-induced gastric ulcer --- Walk 5 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --EXCLUDES--> [?] Postsurgical asplenia Def: A disease caused by underlying diseases, splenectomy or splenic rupture from trauma. This disease is characterised by absence of normal spleen function. This disease may present with increased suscept... --- Walk 6 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --CHILD--> [QF01.Y] Other specified acquired absence of organs
[ "[DA4Z] Diseases of stomach, unspecified\n --PARENT--> [?] Diseases of stomach\n Def: This is a group of conditions characterised as being in or associated with the stomach....\n --EXCLUDES--> [?] Gastrostomy malfunction", "[DA4Z] Diseases of stomach, unspecified\n --PARENT--> [?] Diseases of stomach\n Def: This is a group of conditions characterised as being in or associated with the stomach....\n --CHILD--> [DA41] Gastroduodenal motor or secretory disorders\n Def: This group incorporates disorders due to abnormalities of gastroduodenal motor function and gastroduodenal secretory function, often resulting in the disturbance of transportation and/or digestion of ...", "[DA60.Z] Gastric ulcer, unspecified\n --PARENT--> [DA60] Gastric ulcer\n Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th...\n --EXCLUDES--> [?] Acute haemorrhagic gastritis of unknown aetiology\n Def: Rapid onset inflammation of the mucosal lining of the stomach with associated bleeding or abnormal blood flow....", "[DA60.Z] Gastric ulcer, unspecified\n --PARENT--> [DA60] Gastric ulcer\n Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th...\n --CHILD--> [DA60.2] Helicobacter pylori associated and drug-induced gastric ulcer", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --EXCLUDES--> [?] Postsurgical asplenia\n Def: A disease caused by underlying diseases, splenectomy or splenic rupture from trauma. This disease is characterised by absence of normal spleen function. This disease may present with increased suscept...", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --CHILD--> [QF01.Y] Other specified acquired absence of organs" ]
DA4Z
Diseases of stomach, unspecified
[ { "from_icd11": "DA60.Z", "icd10_code": "K259", "icd10_title": "Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K255", "icd10_title": "Chronic or unspecified gastric ulcer with perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K254", "icd10_title": "Chronic or unspecified gastric ulcer with hemorrhage" }, { "from_icd11": "DA60.Z", "icd10_code": "K257", "icd10_title": "Chronic gastric ulcer without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K250", "icd10_title": "Acute gastric ulcer with hemorrhage" }, { "from_icd11": "DA60.Z", "icd10_code": "K256", "icd10_title": "Chronic or unspecified gastric ulcer with both hemorrhage and perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K253", "icd10_title": "Acute gastric ulcer without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K252", "icd10_title": "Acute gastric ulcer with both hemorrhage and perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K251", "icd10_title": "Acute gastric ulcer with perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K25", "icd10_title": "Gastric ulcer" }, { "from_icd11": "QF01.Y", "icd10_code": "Z9049", "icd10_title": "Acquired absence of other specified parts of digestive tract" }, { "from_icd11": "LB13.Z", "icd10_code": "Q402", "icd10_title": "Other specified congenital malformations of stomach" }, { "from_icd11": "LB13.Z", "icd10_code": "Q403", "icd10_title": "Congenital malformation of stomach, unspecified" }, { "from_icd11": "DA42.73", "icd10_code": "K2940", "icd10_title": "Chronic atrophic gastritis without bleeding" }, { "from_icd11": "DA42.73", "icd10_code": "K2941", "icd10_title": "Chronic atrophic gastritis with bleeding" } ]
K259
Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation
A 71-year-old woman with a history of hypertension, hyperlipemia, and angina was admitted to our Department of Neurology for tinnitus in the head. On physical examination, bilateral hearing impairment was found. The cerebral magnetic resonance imaging (MRI) detected signal changes consisted with multiple cerebral infarctions and bilateral demyelination in the centrum semiovale. And the cerebral MRA detected atherosclerotic cerebral arteries and bilateral stenosis of the middle cerebral arteries . For further diagnosis, the patient underwent DSA subsequently. The total amount of iopamidol (Bracco Imaging Italia S.r.L.) administered during the procedure was 110 ml. The DSA showed that the patient had bilateral embryonic posterior cerebral arteries, 40% stenosis of the left middle cerebral artery and tortuous vertebral arteries bilaterally. There was no obvious calcification of the aortic arch; angiography of the arch using 25 ml iopamidol was performed only once. Ten minutes after the aortic arch angiography, the patient experienced mild headache. The pain was bearable, and the patient could cooperate during the remainder of the procedure. The DSA was completed 20 min later. No haemorrhage or vasospasm was detected during the procedure. The headache was continuous, and the patient suffered nausea and vomiting. The immediate physical examination showed no obvious abnormal sign. The patient was treated with 8 mg ramosetron and 10 mg dexamethasone. After 20 min of observation, the symptoms were relieved. Her cerebral CT scan at the time was normal . Two hours later, the patient manifested dizziness with nausea and vomiting and was treated with 8 mg ondansetron and 20 mg diphenhydramine. Meanwhile, compound sodium chloride injection was used to facilitate the elimination of the contrast agent. The treatment alleviated her symptoms. Four hours after the procedure, the patient re-experienced dizziness; thus 5 mg dexamethasone was administered but resulted in no alleviation until after 11 h wherein dizziness was relived but her blood pressure was 183/92 mmHg. The patient was drowsy but could answer questions correctly. The pupil were symmetric and reactive, and limb movements were preserved. To manage hypertension, 30 mg nimodipine tablets were used. Fourteen hours after the procedure, the patient fell asleep, but at 17 h, respiratory failure progressed and oxygen saturation dropped to 88%. The patient was in a coma state, with sighing respiration. Anisocoria with non-reactive pupils developed, limb drop test was positive along with flexor plantar and Babinski sign was negative. Therefore, cerebral hernia was considered. The patient was treated with 20% mannitol, nikethamide, lobeline and diprophylline, and was transferred to the intensive care unit for further treatment after cardio-pulmonary resuscitation, endotracheal intubation and mechanical ventilation. Two days after the procedure, cerebral CT scan indicated diffuse cerebral oedema, loss of grey-white differentiation, effacement of the cerebral sulci and decrease in cerebrospinal fluid space . The patient was treated with dehydration, mechanical ventilation, and anti-infectious agent, but the diffuse cerebral oedema did not improve. Nine days after the procedure, the third cerebral CT scan showed that the cerebral oedema had become much more severe, the ventricles had disappeared and there was hyperdense signal in the subarachnoid space, which was considered to be indicative of a pseudo-subarachnoid haemorrhage due to the severe cerebral oedema . Fifteen days after the procedure, the cerebral CT scan detected unrelieved diffuse cerebral oedema, and the hyperdense signal in the subarachnoid space persisted . None of these cerebral CT scans showed intracerebral haemorrhage or infarct in this patient. The patient remained in a continuous deep coma state, and the brainstem reflexes had disappeared; she died 56 days after that sudden deterioration. Fig. 1 The cerebral MRA detected atherosclerotic cerebral arteries and bilateral stenosis of the middle cerebral arteries ( a , b arrowheads), the stenosis of the left middle cerebral artery was serious Fig. 2 Cerebral CT immediately after DSA did not indicate any obvious abnormal sign ( a , b , c ); 2 days after the procedure, a repeat cerebral CT revealed diffuse cerebral oedema, loss of grey-white differentiation, effacement of the cerebral sulci and decrease in cerebrospinal fluid space ( d , e , f ); 9 days after the procedure, the cerebral CT showed more severe diffuse oedema of the brain, loss of grey-white differentiation, effacement of the cerebral sulci and subarachnoid space, disappearance of the cerebral ventricles, enhancement of the subarachnoid space, and darkened brain tissue in Hounsfield units ( g , h , i ); 15 days after the procedure, the cerebral CT showed persistent diffuse oedema of the brain with effacement of the cerebral ventricles and sulci, darkened brain tissue in Hounsfield units, and enhancement of the subarachnoid space ( j , k , l )
3.882813
0.97998
sec[1]/p[0]
en
0.999996
30922249
https://doi.org/10.1186/s12883-019-1279-5
[ "cerebral", "oedema", "space", "arteries", "subarachnoid", "stenosis", "middle", "treated", "scan", "effacement" ]
[ { "code": "1D00.Z", "title": "Infectious encephalitis, unspecified" }, { "code": "8E7Y", "title": "Other specified diseases of the nervous system" }, { "code": "8B20", "title": "Stroke not known if ischaemic or haemorrhagic" }, { "code": "8B1Z", "title": "Cerebral ischaemia, unspecified" }, { "code": "8B11.5Z", "title": "Cerebral ischaemic stroke, unspecified" }, { "code": "MG29.Z", "title": "Oedema, unspecified" }, { "code": "5B7Z", "title": "Unspecified undernutrition" }, { "code": "FA36.Z", "title": "Effusion of joint, unspecified" }, { "code": "JA22.1", "title": "Gestational oedema without hypertension" }, { "code": "MG29.1", "title": "Generalised oedema" } ]
=== ICD-11 CODES FOUND === [1D00.Z] Infectious encephalitis, unspecified Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation [8E7Y] Other specified diseases of the nervous system Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis [8B20] Stroke not known if ischaemic or haemorrhagic Definition: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been determined by neuroimaging or other techniques. Also known as: Stroke not known if ischaemic or haemorrhagic | apoplexy | brain vascular accident | cerebral accident | cerebral apoplexy Excludes: sequelae of stroke [8B1Z] Cerebral ischaemia, unspecified Also known as: Cerebral ischaemia, unspecified | brain ischaemia | cerebrovascular ischaemic disease | cerebrovascular ischaemia | cerebral anaemia [8B11.5Z] Cerebral ischaemic stroke, unspecified Also known as: Cerebral ischaemic stroke, unspecified | Cerebral ischaemic stroke of unknown cause | cryptogenic stroke | occlusion and stenosis of cerebral and precerebral arteries, resulting in cerebral infarction | cerebral infarct [MG29.Z] Oedema, unspecified Also known as: Oedema, unspecified | Oedema | dropsy | hydrops | Fluid retention NOS [5B7Z] Unspecified undernutrition Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS [FA36.Z] Effusion of joint, unspecified Also known as: Effusion of joint, unspecified | Effusion of joint | effusion into joint | effusion of joint, site unspecified | hydrarthrosis [JA22.1] Gestational oedema without hypertension Also known as: Gestational oedema without hypertension | oedema of pregnancy [MG29.1] Generalised oedema Also known as: Generalised oedema | anasarca === GRAPH WALKS === --- Walk 1 --- [1D00.Z] Infectious encephalitis, unspecified --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified Def: A disease of the brain, caused by an infection.... --PARENT--> [?] Non-viral and unspecified infections of the central nervous system Def: Any condition of the nervous system, caused by an infection with a bacterial, fungal, parasitic or unspecified source.... --- Walk 2 --- [1D00.Z] Infectious encephalitis, unspecified --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified Def: A disease of the brain, caused by an infection.... --CHILD--> [1D00.2] Parasitic or protozoal encephalitis Def: A disease of the brain, caused by an infection with a parasitic or protozoal source.... --- Walk 3 --- [8E7Y] Other specified diseases of the nervous system --PARENT--> [08] Diseases of the nervous system Def: This is a group of conditions characterised as being in or associated with the nervous system.... --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ... --- Walk 4 --- [8E7Y] Other specified diseases of the nervous system --PARENT--> [08] Diseases of the nervous system Def: This is a group of conditions characterised as being in or associated with the nervous system.... --RELATED_TO--> [?] Structural developmental anomalies of the nervous system Def: Any condition caused by failure of the nervous system to correctly develop during the antenatal period.... --- Walk 5 --- [8B20] Stroke not known if ischaemic or haemorrhagic Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ... --EXCLUDES--> [?] Late effects of stroke not known if ischaemic or haemorrhagic Def: Late effects occurring 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episodes.... --PARENT--> [?] Late effects of cerebrovascular disease Def: Effects of cerebrovascular disease 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episo... --- Walk 6 --- [8B20] Stroke not known if ischaemic or haemorrhagic Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ... --PARENT--> [?] Cerebrovascular diseases Def: This is a group of brain dysfunctions related to disease of the blood vessels supplying the brain. This includes “stroke”, which includes the following entities: Intracerebral haemorrhage; Subarachnoi... --EXCLUDES--> [?] Intracranial injury Def: Damage inflicted on the tissues of the brain as the direct or indirect result of an external force, with or without disruption of structural continuity....
[ "[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --PARENT--> [?] Non-viral and unspecified infections of the central nervous system\n Def: Any condition of the nervous system, caused by an infection with a bacterial, fungal, parasitic or unspecified source....", "[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.2] Parasitic or protozoal encephalitis\n Def: A disease of the brain, caused by an infection with a parasitic or protozoal source....", "[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...", "[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --RELATED_TO--> [?] Structural developmental anomalies of the nervous system\n Def: Any condition caused by failure of the nervous system to correctly develop during the antenatal period....", "[8B20] Stroke not known if ischaemic or haemorrhagic\n Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ...\n --EXCLUDES--> [?] Late effects of stroke not known if ischaemic or haemorrhagic\n Def: Late effects occurring 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episodes....\n --PARENT--> [?] Late effects of cerebrovascular disease\n Def: Effects of cerebrovascular disease 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episo...", "[8B20] Stroke not known if ischaemic or haemorrhagic\n Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ...\n --PARENT--> [?] Cerebrovascular diseases\n Def: This is a group of brain dysfunctions related to disease of the blood vessels supplying the brain. This includes “stroke”, which includes the following entities: Intracerebral haemorrhage; Subarachnoi...\n --EXCLUDES--> [?] Intracranial injury\n Def: Damage inflicted on the tissues of the brain as the direct or indirect result of an external force, with or without disruption of structural continuity...." ]
1D00.Z
Infectious encephalitis, unspecified
[ { "from_icd11": "1D00.Z", "icd10_code": "G0490", "icd10_title": "Encephalitis and encephalomyelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0491", "icd10_title": "Myelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0430", "icd10_title": "Acute necrotizing hemorrhagic encephalopathy, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0431", "icd10_title": "Postinfectious acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0439", "icd10_title": "Other acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0481", "icd10_title": "Other encephalitis and encephalomyelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G0489", "icd10_title": "Other myelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G04", "icd10_title": "Encephalitis, myelitis and encephalomyelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G048", "icd10_title": "Other encephalitis, myelitis and encephalomyelitis" }, { "from_icd11": "8B20", "icd10_code": "I64", "icd10_title": "" }, { "from_icd11": "8B1Z", "icd10_code": "I67848", "icd10_title": "Other cerebrovascular vasospasm and vasoconstriction" }, { "from_icd11": "8B1Z", "icd10_code": "I6789", "icd10_title": "Other cerebrovascular disease" }, { "from_icd11": "8B1Z", "icd10_code": "I6782", "icd10_title": "Cerebral ischemia" }, { "from_icd11": "8B1Z", "icd10_code": "I6781", "icd10_title": "Acute cerebrovascular insufficiency" }, { "from_icd11": "8B1Z", "icd10_code": "I67841", "icd10_title": "Reversible cerebrovascular vasoconstriction syndrome" } ]
G0490
Encephalitis and encephalomyelitis, unspecified
A healthy 9-year-old Japanese girl presented to a clinic with left hip joint pain without apparent cause for 1 month. She was diagnosed as having coxitis simplex. Although she had taken anti-inflammatory drugs, her pain did not change for 1 year. She was then sent to another hospital, where OO in her left acetabulum was suspected. As a result, she was referred to our hospital approximately 1 year after her first symptom presentation, where she presented with severe left hip pain and was completely unable to walk. Radiographs of her left hip showed no obvious osseous abnormality . In contrast, CT examinations revealed a well-demarcated 5 mm mass with limited bone sclerosis in her left acetabulum . The mass was characterized by low intensity on T1 and high intensity on T2 magnetic resonance imaging (MRI) images. MRI also revealed joint effusion . Clinical and radiological findings were consistent with OO of the left acetabulum. She underwent CT-guided resection of the nidus and ablation using a standard electrosurgical generator at a power output of 15 W for 60-seconds duration . This procedure was performed under total anesthesia and in the prone position. We identified the positional relationship between the nidus, triradiate cartilage, and sciatic nerve using a CT marker. After making a small 3-cm long incision while avoiding her sciatic nerve, a guide pin was inserted. A 5.0 mm cannulated drill was inserted over the guide pin to remove the nidus, which was then sent for histological examination. Next, ablation using a standard electrosurgical generator was performed to completely destroy any residual tumors. To preserve her triradiate cartilage, the position of the electrode tip was confirmed on intraoperative images during each step. The technical tips and pearls of CT-guided resection are summarized in Table 1 . A histological examination confirmed the characteristic appearance of OO . Complete pain relief was achieved beginning on the first postoperative day. Our patient could walk without any pain at the final follow-up 1 year post-treatment, and no local recurrence was observed. Fig. 1 Patient radiographs on admission. Anteroposterior ( left ) and lateral ( right ) radiographs showing no obvious osseous abnormality Fig. 2 Patient computed tomography images on admission. Coronal view ( left ) and axial view ( right ) of computed tomography examinations showing a well-demarcated 5 mm mass surrounded by bone sclerosis ( arrows ) in the left acetabulum adjacent to the triradiate cartilage Fig. 3 Patient magnetic resonance images. Coronal T1 ( left ) and T2 magnetic resonance images ( right ) showing that the mass was characterized by low intensity on T1 images and high intensity on T2 images ( arrows ). Magnetic resonance imaging also showed joint effusion ( long arrow ). Together with clinical findings and computed tomography images, the small lesion was diagnosed as osteoid osteoma of the acetabulum Fig. 4 Intraoperative findings. In order to resect and ablate the nidus, a computed tomography-guided procedure was selected to minimize the invasiveness of surgery. First, the positional relationship between the nidus, triradiate cartilage, and sciatic nerve was identified using a computed tomography marker ( left ). After making a small incision to avoid the sciatic nerve, a guide pin was inserted toward the nidus. A 5.0 mm cannulated drill was inserted over the guide pin to remove the lesion and the specimen which resided in the cannulated drill was sent for histological study. Subsequently, heat ablation was performed using a standard electrosurgical generator to destroy any residual tumors ( middle ). To preserve the triradiate cartilage, the position of the electrode tip was confirmed during each step using intraoperative images ( right ) Table 1 The technical tips and pearls of computed tomography-guided resection Number Step Tips 1 Approach Preoperative planning to assess the optimal approach to the nidus. It should be the shortest route to the bone surface and must avoid the neurovascular bundle. 2 Position Patient must be positioned to allow easy access to the bone. 3 Incision Blunt dissection should be performed to the bone to protect nerves and vessels. A small incision may be needed if an important structure is nearby. 4 Drilling Drill hole perpendicular to the bone surface. Contralateral cortex should not be compromised to allow through ablation after resection of the nidus. 5 Fluoroscopy Computed tomography usage should be minimized. Fluoroscopy is utilized to check the positioning of the guide pin and drill. 6 Diagnosis The specimen inside the cannulated drill is important because it can be used to make a histological diagnosis. 7 Ablation Standard electrosurgical generator is placed at the site of the lesion for 60 seconds under 15 W to ablate the possible remaining tumor cells. Fig. 5 Histological findings. Histological findings showing random reticular osteoid formation within a fibrovascular stroma, consistent with osteoid osteoma
3.972656
0.975586
sec[1]/p[0]
en
0.999997
27912788
https://doi.org/10.1186/s13256-016-1136-8
[ "nidus", "computed", "tomography", "bone", "using", "drill", "histological", "pain", "acetabulum", "ablation" ]
[ { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" }, { "code": "QE11.Z", "title": "Hazardous drug use, unspecified" }, { "code": "6C4Z", "title": "Disorders due to substance use, unspecified" }, { "code": "QE11.3", "title": "Hazardous use of cocaine" }, { "code": "QE11.2", "title": "Hazardous use of sedatives, hypnotics or anxiolytics" }, { "code": "QE11.1", "title": "Hazardous use of cannabis" } ]
=== ICD-11 CODES FOUND === [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias [QE11.Z] Hazardous drug use, unspecified Also known as: Hazardous drug use, unspecified | Hazardous drug use | chronic drug use NOS | chronic IV substance use | drug use nos [6C4Z] Disorders due to substance use, unspecified Also known as: Disorders due to substance use, unspecified | Disorders due to substance abuse | drug use disorder | Bad trips due to drugs [QE11.3] Hazardous use of cocaine Definition: A pattern of cocaine use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health professionals. The increased risk may be from the frequency of cocaine use, from the amount used on a given occasion, from risky behaviours associated with cocaine use or the context of use, from a harmful route of administration, or from a combination of these. The risk may be related to short-term eff Also known as: Hazardous use of cocaine | cocaine use | intravenous cocaine use | Hazardous use of crack cocaine | crack cocaine use Excludes: Disorders due to use of cocaine [QE11.2] Hazardous use of sedatives, hypnotics or anxiolytics Definition: A pattern of use of sedatives, hypnotics or anxiolytics that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health professionals. The increased risk may be from the frequency of use of sedatives, hypnotics or anxiolytics, from the amount used on a given occasion, from risky behaviours associated with use of sedatives, hypnotics or anxiolytics or the context of use, from a harmful route Also known as: Hazardous use of sedatives, hypnotics or anxiolytics | Hazardous use of anxiolytics | Hazardous use of hypnotics | hypnotic use | Hazardous use of sedatives Excludes: Disorders due to use of sedatives, hypnotics or anxiolytics [QE11.1] Hazardous use of cannabis Definition: A pattern of cannabis use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health professionals. The increased risk may be from the frequency of cannabis use, from the amount used on a given occasion, from risky behaviours associated with cannabis use or the context of use, from a harmful route of administration, or from a combination of these. The risk may be related to short-term Also known as: Hazardous use of cannabis | marijuana use | cannabis use Excludes: Disorders due to use of cannabis === GRAPH WALKS === --- Walk 1 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --CHILD--> [?] Arthropathies --- Walk 2 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system --- Walk 3 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --CHILD--> [FB84.2] Subacute osteomyelitis --- Walk 4 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --PARENT--> [?] Osteopathies or chondropathies --- Walk 5 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopoikilosis --- Walk 6 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopoikilosis
[ "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --CHILD--> [?] Arthropathies", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --CHILD--> [FB84.2] Subacute osteomyelitis", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --PARENT--> [?] Osteopathies or chondropathies", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopoikilosis", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopoikilosis" ]
FC0Z
Diseases of the musculoskeletal system or connective tissue, unspecified
[ { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X6", "icd10_title": "Other osteomyelitis, lower leg" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X9", "icd10_title": "Other osteomyelitis, unspecified sites" }, { "from_icd11": "FB84.Z", "icd10_code": "M8668", "icd10_title": "Other chronic osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M86662", "icd10_title": "Other chronic osteomyelitis, left tibia and fibula" }, { "from_icd11": "FB84.Z", "icd10_code": "M86151", "icd10_title": "Other acute osteomyelitis, right femur" }, { "from_icd11": "FB84.Z", "icd10_code": "M86141", "icd10_title": "Other acute osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M86641", "icd10_title": "Other chronic osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M8669", "icd10_title": "Other chronic osteomyelitis, multiple sites" } ]
XIII
A 66-year-old female presented with easy fatigability and jaundice. Investigations at admission revealed a serum bilirubin of 6.8 mg/dl with no evidence of cholangitis. Clinical variables have been delineated in Table 1 . Contrast enhanced CT (CECT) and magnetic resonance cholangiopancreatography (MRCP) showed an irregular enhancing wall thickening of the sub hilar region extending distally. She had preoperative biliary drainage by endoscopic nasobiliary drainage (ENBD). Endoscopic retrograde cholangiography (ERC) with multiple biopsies for tumor mapping revealed that the adenocarcinoma of common bile duct including intrapancreatic bile duct that was extended to the left hepatic duct (LHD) . Hence, tumor was designated as DSBDC with Bismuth-Corlette type IIIA, which involved the right anterior bile duct (RAD) and junction of the right posterior bile duct (RPD) and the LHD, and extended to the intrapancreatic bile duct. Once her serum bilirubin dropped to < 3 mg/dl, CT with drip infusion cholecystocholangiography (DIC-CT) was done. 3D integrated visualization reconstructed by CECT and DIC-CT data revealed that she had independent configuration of the right antero-ventral portal branch and antero-dorsal portal branch . The right antero-ventral bile duct (RAVD) confluent to the right hepatic duct (RHD) and the right antero-dorsal bile duct (RADD) independently confluent to RPD with a supra-portal course. Therefore, images showed tumor extended to the RAVD, but the RADD was intact because it was confluent to the distal side of the RPD. A modified central hepatectomy including resection of the segments IV and I, and right antero-ventral segment was done concomitantly with PD, and R0 resection was achieved. CT volumetry findings have been discussed in Table 2 . Postoperative functional assessment of liver is included in Table 1 . She underwent staged pancreato-jejunostomy 6 months later. She is doing well without recurrence at 17 postoperative months. Table 1 Characteristics of patients and laboratory findings Variables Case 1 Case 2 Age (years) 66 67 Sex female male BMI (kg/m 2 ) 22.0 23.8 ECOG Performance Status 0 0 Serum bilirubin level at admission (mg/dL) 6.8 14.9 AST (IU/L) 27 268 ALT (IU/L) 25 514 Biliary anatomy Right antero-ventral bile duct confluent to the right hepatic duct and the right antero-dorsal bile duct independently confluent to the right posterior bile duct Right posterior bile duct draining into the left hepatic duct Bismuth-Corlette type IIIA IIIA Serum bilirubin level a day prior to resection (mg/dL) 0.8 1.6 Cumulative Pringle time in operation (min) 62 75 Operative blood loss (mL) 291 890 Total operation time (min) 1158 970 Serum bilirubin (POD 5) (mg/dL) 1.8 1.1 Serum AST/ ALT (POD 5) (mg/dL) 39/137 16/66 PT-INR (POD 5) 0.94 1.0 Clavien-Dindo grading of morbidity Nil Grade II—POPF Staging AJCC (8th edition) BpBd, flat-infiltrating type, circ, 1.2 × 1.0 × 3.5 cm, pT2, por2, ly(0), v1, ne1, pN0, pDM0, pHM0, pEM0, pPV0, pA0, R0, M0 Stage II BpBd, papillary invasive type, circ, 1.2 × 0.6 × 7.0 cm, pT1, pap, ly0, v0, ne0, pN0, pDM0, pHM0, pEM0, pPV0, pA0, R0, M0 Stage I BMI body mass index, ECOG Eastern Cooperative Oncology Group, AST asparate aminotransferase, ALT alanine aminotransferase, POD post operative day, PT-INR prothrombin time international normalized ratio, POPF post operative pancreatic fistula, AJCC American Joint Committee on Cancer Fig. 1 ERC image showing tissue sampling of the case 1. Arrows show the negative sampling biopsy of the right posterior bile duct and B2 + B3. Arrow heads show adenocarcinoma of the right antero-ventral bile duct, left hepatic duct, and common bile duct including intrapancreatic bile duct. RAVD the right antero-ventral bile duct. RADD the right antero-dorsal bile duct. RPD the right posterior bile duct, B2 the segment II bile duct, B3 the segment III bile duct, B4 the segment IV bile duct, GB gall bladder Fig. 2 Cranial-dorsal view of the integrated 3D images of vessels (surface rendering). The right antero-ventral and antero-dorsal portal vein were independently configurated. The right antero-ventral bile duct confluent to the right hepatic duct and the antero-dorsal bile duct independently confluent to the right posterior bile duct. The broken lines show the transection of the right antero-dorsal bile duct and right posterior bile duct, also of the common duct for the segment II and III. RAVD the right antero-ventral bile duct, RADD the right antero-dorsal bile duct, RAVP the right antero-ventral portal vein, RADP the right antero-dorsal bile duct, RPP the right posterior portal vein, RHV the right hepatic vein Table 2 Volumetry data and functional assessment of liver Case TLV (ml) FLR in left trisegmentectomy (ml/% of TLV) FLR in right trisegmentectomy (ml/% of TLV) FLR in central hepatectomy (ml/% of TLV) Parenchymal sparing achieved (ml/% of TLV) 1 1055 172/16.3% 193/18.2% 764/72.4% 581/55.1% 2 1629 499/30.7% 318/19.5% 817/50.2% 408/25.0% TLV total liver volume, FLR future liver remnant
4.117188
0.959473
sec[1]/sec[0]/p[0]
en
0.999997
33407366
https://doi.org/10.1186/s12893-020-01012-2
[ "duct", "bile", "antero", "hepatic", "confluent", "serum", "portal", "bilirubin", "segment", "type" ]
[ { "code": "DC10.02", "title": "Obstruction of bile duct" }, { "code": "DC10.00", "title": "Obstruction of cystic duct" }, { "code": "DC13", "title": "Cholangitis" }, { "code": "LB20.23", "title": "Structural developmental anomalies of cystic duct" }, { "code": "DC10.2", "title": "Fistula of gallbladder or bile duct" }, { "code": "LB20.2Y", "title": "Other specified structural developmental anomalies of bile ducts" }, { "code": "ME24.35&XA6R80", "title": "Perforation of bile duct" }, { "code": "BA41.Z&XA7RE3", "title": "Anterolateral myocardial infarction" }, { "code": "LB70.0Y", "title": "Other specified craniosynostosis" }, { "code": "LA88.40", "title": "Trabecular muscular ventricular septal defect" } ]
=== ICD-11 CODES FOUND === [DC10.02] Obstruction of bile duct Also known as: Obstruction of bile duct | extrahepatic biliary obstruction | extrahepatic bile duct obstruction | bile duct obstruction | bile stasis Excludes: with cholelithiasis [DC10.00] Obstruction of cystic duct Also known as: Obstruction of cystic duct | cystic duct obstruction | cystic ductal obstruction | obstructed cystic duct | Acquired cystic duct atresia [DC13] Cholangitis Also known as: Cholangitis | acute cholangiolitis | ascending cholangitis | cholangiolitis | cholangitis NOS Excludes: chronic nonsuppurative destructive cholangitis | cholangitis with cholelithiasis | Primary sclerosing cholangitis [LB20.23] Structural developmental anomalies of cystic duct Also known as: Structural developmental anomalies of cystic duct | congenital deformity of cystic duct | cystic duct anomaly | cystic duct deformity | cystic duct distortion [DC10.2] Fistula of gallbladder or bile duct Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs. Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula [LB20.2Y] Other specified structural developmental anomalies of bile ducts Also known as: Other specified structural developmental anomalies of bile ducts | Anomalous arrangement of pancreatobiliary ducts | Aberrant hepatic duct | Accessory hepatic duct | accessory liver duct [LB70.0Y] Other specified craniosynostosis Also known as: Other specified craniosynostosis | Monosutural craniosynostosis | Scaphocephaly | Dolichocephaly | dolichocephalia [LA88.40] Trabecular muscular ventricular septal defect Definition: A congenital cardiac malformation in which there is a ventricular septal defect within the trabeculated component of the ventricular septum. Additional information: the codes specifying defects within the trabecular part of the ventricular septum should not be used to code inlet or outlet muscular defects, as there are specific codes for these entities. Also known as: Trabecular muscular ventricular septal defect | Type 4 ventricular septal defect | Trabecular muscular ventricular septal defect midseptal | Muscular ventricular septal defect in mid trabecular septum | trabecular muscular ventricular septal defect, mid === GRAPH WALKS === --- Walk 1 --- [DC10.02] Obstruction of bile duct --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --CHILD--> [?] Calculus of gallbladder or cystic duct with other cholecystitis Def: Stones in gallbladder or cystic duct present with inflammation of the gall bladder wall and cystic duct.... --- Walk 2 --- [DC10.02] Obstruction of bile duct --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --- Walk 3 --- [DC10.00] Obstruction of cystic duct --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --CHILD--> [DC10.02] Obstruction of bile duct --- Walk 4 --- [DC10.00] Obstruction of cystic duct --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --PARENT--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile.... --- Walk 5 --- [DC13] Cholangitis --PARENT--> [?] Diseases of gallbladder or biliary tract Def: This is a group of conditions characterised as being in or associated with the gallbladder (an organ) and the biliary tract (the passageways for bile).... --CHILD--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile.... --- Walk 6 --- [DC13] Cholangitis --EXCLUDES--> [?] Primary biliary cholangitis Def: Primary biliary cholangitis is characterised by progressive destruction and disappearance of the intralobular bile duct epithelial cells leading to cholestasis (high alkaline phosphatase and GGT {gamm... --EXCLUDES--> [?] Primary sclerosing cholangitis Def: Primary sclerosing cholangitis is a chronic disease which shows focal or multifocal strictures of intra- and/or extra-hepatic bile ducts without any apparent causes, leading to cholestasis and ultimat...
[ "[DC10.02] Obstruction of bile duct\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...\n --CHILD--> [?] Calculus of gallbladder or cystic duct with other cholecystitis\n Def: Stones in gallbladder or cystic duct present with inflammation of the gall bladder wall and cystic duct....", "[DC10.02] Obstruction of bile duct\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...", "[DC10.00] Obstruction of cystic duct\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --CHILD--> [DC10.02] Obstruction of bile duct", "[DC10.00] Obstruction of cystic duct\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --PARENT--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts\n Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile....", "[DC13] Cholangitis\n --PARENT--> [?] Diseases of gallbladder or biliary tract\n Def: This is a group of conditions characterised as being in or associated with the gallbladder (an organ) and the biliary tract (the passageways for bile)....\n --CHILD--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts\n Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile....", "[DC13] Cholangitis\n --EXCLUDES--> [?] Primary biliary cholangitis\n Def: Primary biliary cholangitis is characterised by progressive destruction and disappearance of the intralobular bile duct epithelial cells leading to cholestasis (high alkaline phosphatase and GGT {gamm...\n --EXCLUDES--> [?] Primary sclerosing cholangitis\n Def: Primary sclerosing cholangitis is a chronic disease which shows focal or multifocal strictures of intra- and/or extra-hepatic bile ducts without any apparent causes, leading to cholestasis and ultimat..." ]
DC10.02
Obstruction of bile duct
[ { "from_icd11": "DC10.02", "icd10_code": "K831", "icd10_title": "Obstruction of bile duct" }, { "from_icd11": "DC13", "icd10_code": "K8309", "icd10_title": "Other cholangitis" }, { "from_icd11": "DC13", "icd10_code": "K8301", "icd10_title": "Primary sclerosing cholangitis" }, { "from_icd11": "DC13", "icd10_code": "K830", "icd10_title": "Cholangitis" }, { "from_icd11": "DC10.2", "icd10_code": "K833", "icd10_title": "Fistula of bile duct" }, { "from_icd11": "DC10.2", "icd10_code": "K823", "icd10_title": "Fistula of gallbladder" } ]
K831
Obstruction of bile duct
Nocardia sinusitis is a very rare diagnosis in the literature, as a literature review returned only seven cases of Nocardia sinusitis summarized in Table 3 . In most of these cases (five out of seven studies), a previous disorder such as diabetes, cancer, or human immunodeficiency virus (HIV) had weakened the immune system . Similarly, in this case, the patient had CLL, which induces humeral immunodeficiency and further cellular immunodeficiency in later stages. Thus, rare infectious diseases and other complications in immunocompromised patients [including patients who received chemotherapeutic agents, diabetes mellitus, patients with HIV/acquired immunodeficiency syndrome (AIDS), etc.] should always be considered by physicians. In these case reports, only a limited number of sinuses were involved, but in the present case report, the patient developed pansinusitis. Furthermore, he received fludarabine, which suppresses cellular immunity. Additionally, cyclophosphamide, by inhibiting both cell-mediated and humoral immune responses, has extensive effects on the immune system . Rituximab in this regimen suppresses humeral immunity and immune system activity . Gram staining and imaging helped the authors reach the final diagnosis. On the basis of previous case reports, the core standard management and treatment of nocardia sinusitis is co-trimoxazole . Other antibiotics including imipenem, amikacin, erythromycin, or third-generation cephalosporins could be added to this regimen. However, antibiotic susceptibility testing is an important part of the treatment, as in recent years, Nocardia resistance to multiple antibiotics has been reported . As mentioned before, in parallel with other studies, we initiated cotrimoxazole and added carbapenem (meropenem) to this regimen, and after discharge, oral cotrimoxazole continued for 3 months. Table 3 Case reports of Nocardia sinusitis Gender/age Past medical history Clinical presentation/imaging Other localization Diagnosis Species Treatment/outcome Reference Female/72 years Diabetes, breast cancer Severe left frontotemporal headache and left trigeminal neuralgia along with increase of CRP (223)/CT scan indicated an abscess in the left pterygoid muscles and osteolysis of the greater wing of the left sphenoid bone with meningeal reaction and dissemination to the infratemporal fossa Infratemporal fossa Nocardia nova sphenoid sinusitis and infratemporal fossa abscess Nocardia nova Oral trimethoprim-sulfamethoxazole two tablets twice per day along with folic acid resulted in complete resolution of the infection, confirmed by neck, chest, and sinus CT at 6-month follow-up Male/6 years – Headache, increased drowsiness, and double vision/ right orbital subperiosteal abscess and right maxillary and ethmoid sinusitis Right orbital fossa Bilateral maxillary and right ethmoid sinusitis Nocardia asteroides Trimethoprim-sulfamethoxazole 20 mg/kg/day orally every 6 hours, therapy for 7 months, and remained well 20 years after this disease Male/43 years Diabetes type 1 Nose block and a watery, non-foul smelling nasal discharge/HRCT of paranasal sinuses showed pansinusitis with left DNS with bony septal spur - Nocardia nova chronic maxillary sinusitis Nocardia nova Trimethoprim-sulfamethoxazole (TMP-SMX) for 6 weeks, which resulted in improvement of symptoms Male/40 years HIV Chronic nasal obstruction/CT showed pansinusitis with a cyst in the left maxillary sinus - Nocardia asteroids sinusitis Nocardia asteroides Trimethoprim and sulfamethoxazole (TMP/SMX) for 2 months with an excellent outcome Female/42 years Recurrent episodes of maxillary sinusitis Iridocyclitis, left maxillary sinusitis/CT scan showed mucosal hypertrophy of the left maxillary antrum, with an air-fluid level in this cavity – Nocardia nova maxillary sinusitis Nocardia nova A 6-week course of trimethoprim-sulfamethoxazole [two tablets (160/800 mg) every 12 hours] was begun and substituted with a 6-week course of erythromycin (every 6 hours) Male/35 years Renal transplant for reflux nephropathy Headache, diplopia, increasing lacrimation, and nausea/soft tissue mass filling the sphenoid sinus and extending to the nasoethmoidal region on the left along with pituitary fossa and suprasellar cistern Nasoethmoidal region on the left, pituitary fossa, and suprasellar cistern Nocardia asteroids sphenoidal sinusitis Nocardia asteroides Oral sulfadimidine 1.5 g every 8 hours, amikacin (500 mg intravenously every 12 hours), co-trimoxazole , and imipenem (1.0 g intravenously every 8 hours) for a week, followed by 8 weeks of only imipenem; patient discharged with erythromycin changed to roxithromycin (300 mg twice daily) continued for 17 months and symptoms were improved Female/39 years – Fever, rigors, diaphoresis, and night sweats/X-ray showed opacification of left maxillary sinus – Nocardia asteroids maxillary sinusitis Nocardia asteroides Oral sulfadazine, 1.5 g every 6 hours, and sodium bicarbonate, 650 mg four times daily for 5 months, resulted in improvement of symptoms
4.203125
0.632813
sec[1]/p[3]
en
0.999997
PMC11748329
https://doi.org/10.1186/s13256-025-05037-0
[ "nocardia", "sinusitis", "maxillary", "every", "hours", "this", "fossa", "nova", "trimethoprim", "sulfamethoxazole" ]
[ { "code": "1C1B.Z", "title": "Nocardiosis, unspecified" }, { "code": "1C1B.1", "title": "Cutaneous nocardiosis" }, { "code": "1C1B.Y", "title": "Other specified forms of nocardiosis" }, { "code": "1C43", "title": "Actinomycetoma" }, { "code": "CA0A.Z", "title": "Chronic rhinosinusitis, unspecified" }, { "code": "CA01", "title": "Acute sinusitis" }, { "code": "1E32", "title": "Influenza, virus not identified" }, { "code": "CA0A.Y&XA91G8", "title": "Chronic frontal sinusitis" }, { "code": "CA0A.Y&XA1R64", "title": "Chronic maxillary sinusitis" }, { "code": "DA06.Z", "title": "Diseases of jaws, unspecified" } ]
=== ICD-11 CODES FOUND === [1C1B.Z] Nocardiosis, unspecified Also known as: Nocardiosis, unspecified | Nocardiosis | nocardiasis | nocardia infection | nocardiosis NOS [1C1B.1] Cutaneous nocardiosis Definition: Cutaneous nocardiosis may be due to direct infection of the skin where it presents either as a solitary cold abscess or as a lymphangitic process in which infection spreads up lymphatic channels to form a linear array of suppurative nodules. Skin involvement is also present in a third of cases of systemic nocardiosis. Also known as: Cutaneous nocardiosis | nocardia abscess Excludes: Actinomycetoma due to Nocardia species [1C1B.Y] Other specified forms of nocardiosis Also known as: Other specified forms of nocardiosis | Encephalitis due to Nocardia species | Meningitis due to Nocardia species [1C43] Actinomycetoma Definition: Actinomycetoma is a chronic progressive subcutaneous infection caused by implantation of aerobic branching actinomycetes through a skin wound. These organisms are filamentous bacteria which live as saprophytes in soil or on plants; the commonest infecting agents are Nocardia brasiliensis, Actinomadura madurae and Streptomyces somaliensis. The earliest stage of infection is a firm painless nodule but with time the whole area becomes hard and swollen with multiple papules, pustules and draining si Also known as: Actinomycetoma | Actinomycotic Madura foot | Actinomycotic mycetoma | Mycetoma due to filamentous bacteria | Actinomycetoma due to Actinomadura species Includes: Mycetoma due to filamentous bacteria Excludes: Eumycetoma [CA0A.Z] Chronic rhinosinusitis, unspecified Also known as: Chronic rhinosinusitis, unspecified | Chronic rhinosinusitis | Chronic sinusitis | chronic sinusitis NOS | unspecified sinusitis [CA01] Acute sinusitis Definition: Recent onset and/or short duration inflammation of the mucosa in one or more of the paranasal sinuses (maxillary, ethmoid, frontal and sphenoid) arising from infection or other causes such as caries or injury to the teeth. Purulent discharge can be seen at the middle meatus and olfactory cleavage and patients complain of dysosmia, stuffy nose, fever, or localised tenderness or pain. Allergic rhinitis, nasal septum deformity or hypertrophic rhinitis are underlying diseases that may induce acute s Also known as: Acute sinusitis | acute infection of sinus | acute inflammation of sinus | acute sinusitis NOS | acute rhinosinusitis Excludes: sinusitis, chronic or NOS [1E32] Influenza, virus not identified Definition: Any disease of the respiratory system, caused by an unidentified strain of influenza virus. These diseases are characterised by fever, cough, headache, myalgia, arthralgia, or malaise. Transmission is by inhalation of infected respiratory secretions. Also known as: Influenza, virus not identified | flu | Influenza NOS | Viral influenza specific virus not stated to have been identified | Influenza specific virus not stated to have been identified Includes: Influenza specific virus not stated to have been identified | Viral influenza specific virus not stated to have been identified Excludes: Haemophilus influenzae [H. influenzae] meningitis | Haemophilus influenzae [H. influenzae] pneumonia [DA06.Z] Diseases of jaws, unspecified Also known as: Diseases of jaws, unspecified | Diseases of jaws | disease of jaw | diseases of the jaws | disorder of jaw === GRAPH WALKS === --- Walk 1 --- [1C1B.Z] Nocardiosis, unspecified --PARENT--> [1C1B] Nocardiosis Def: A disease caused by an infection with the gram-positive bacteria Nocardia. This disease presents with symptoms depending on the site of infection (commonly lung, brain, or skin). Transmission is by in... --CHILD--> [1C1B.0] Pulmonary nocardiosis Def: A disease of the respiratory system, caused by an infection with the gram-positive bacteria Nocardia. This disease is characterised by chest pain, haemoptysis, fever, weight loss, and cough. Transmiss... --- Walk 2 --- [1C1B.Z] Nocardiosis, unspecified --PARENT--> [1C1B] Nocardiosis Def: A disease caused by an infection with the gram-positive bacteria Nocardia. This disease presents with symptoms depending on the site of infection (commonly lung, brain, or skin). Transmission is by in... --CHILD--> [1C1B.0] Pulmonary nocardiosis Def: A disease of the respiratory system, caused by an infection with the gram-positive bacteria Nocardia. This disease is characterised by chest pain, haemoptysis, fever, weight loss, and cough. Transmiss... --- Walk 3 --- [1C1B.1] Cutaneous nocardiosis Def: Cutaneous nocardiosis may be due to direct infection of the skin where it presents either as a solitary cold abscess or as a lymphangitic process in which infection spreads up lymphatic channels to fo... --EXCLUDES--> [?] Actinomycetoma due to Nocardia species Def: Actinomycetoma due to infection with Nocardia bacteria. This organism is the commonest causative agent of actinomycetoma in the Western hemisphere.... --PARENT--> [?] Actinomycetoma Def: Actinomycetoma is a chronic progressive subcutaneous infection caused by implantation of aerobic branching actinomycetes through a skin wound. These organisms are filamentous bacteria which live as sa... --- Walk 4 --- [1C1B.1] Cutaneous nocardiosis Def: Cutaneous nocardiosis may be due to direct infection of the skin where it presents either as a solitary cold abscess or as a lymphangitic process in which infection spreads up lymphatic channels to fo... --EXCLUDES--> [?] Actinomycetoma due to Nocardia species Def: Actinomycetoma due to infection with Nocardia bacteria. This organism is the commonest causative agent of actinomycetoma in the Western hemisphere.... --PARENT--> [?] Actinomycetoma Def: Actinomycetoma is a chronic progressive subcutaneous infection caused by implantation of aerobic branching actinomycetes through a skin wound. These organisms are filamentous bacteria which live as sa... --- Walk 5 --- [1C1B.Y] Other specified forms of nocardiosis --PARENT--> [1C1B] Nocardiosis Def: A disease caused by an infection with the gram-positive bacteria Nocardia. This disease presents with symptoms depending on the site of infection (commonly lung, brain, or skin). Transmission is by in... --CHILD--> [1C1B.1] Cutaneous nocardiosis Def: Cutaneous nocardiosis may be due to direct infection of the skin where it presents either as a solitary cold abscess or as a lymphangitic process in which infection spreads up lymphatic channels to fo... --- Walk 6 --- [1C1B.Y] Other specified forms of nocardiosis --PARENT--> [1C1B] Nocardiosis Def: A disease caused by an infection with the gram-positive bacteria Nocardia. This disease presents with symptoms depending on the site of infection (commonly lung, brain, or skin). Transmission is by in... --CHILD--> [1C1B.1] Cutaneous nocardiosis Def: Cutaneous nocardiosis may be due to direct infection of the skin where it presents either as a solitary cold abscess or as a lymphangitic process in which infection spreads up lymphatic channels to fo...
[ "[1C1B.Z] Nocardiosis, unspecified\n --PARENT--> [1C1B] Nocardiosis\n Def: A disease caused by an infection with the gram-positive bacteria Nocardia. This disease presents with symptoms depending on the site of infection (commonly lung, brain, or skin). Transmission is by in...\n --CHILD--> [1C1B.0] Pulmonary nocardiosis\n Def: A disease of the respiratory system, caused by an infection with the gram-positive bacteria Nocardia. This disease is characterised by chest pain, haemoptysis, fever, weight loss, and cough. Transmiss...", "[1C1B.Z] Nocardiosis, unspecified\n --PARENT--> [1C1B] Nocardiosis\n Def: A disease caused by an infection with the gram-positive bacteria Nocardia. This disease presents with symptoms depending on the site of infection (commonly lung, brain, or skin). Transmission is by in...\n --CHILD--> [1C1B.0] Pulmonary nocardiosis\n Def: A disease of the respiratory system, caused by an infection with the gram-positive bacteria Nocardia. This disease is characterised by chest pain, haemoptysis, fever, weight loss, and cough. Transmiss...", "[1C1B.1] Cutaneous nocardiosis\n Def: Cutaneous nocardiosis may be due to direct infection of the skin where it presents either as a solitary cold abscess or as a lymphangitic process in which infection spreads up lymphatic channels to fo...\n --EXCLUDES--> [?] Actinomycetoma due to Nocardia species\n Def: Actinomycetoma due to infection with Nocardia bacteria. This organism is the commonest causative agent of actinomycetoma in the Western hemisphere....\n --PARENT--> [?] Actinomycetoma\n Def: Actinomycetoma is a chronic progressive subcutaneous infection caused by implantation of aerobic branching actinomycetes through a skin wound. These organisms are filamentous bacteria which live as sa...", "[1C1B.1] Cutaneous nocardiosis\n Def: Cutaneous nocardiosis may be due to direct infection of the skin where it presents either as a solitary cold abscess or as a lymphangitic process in which infection spreads up lymphatic channels to fo...\n --EXCLUDES--> [?] Actinomycetoma due to Nocardia species\n Def: Actinomycetoma due to infection with Nocardia bacteria. This organism is the commonest causative agent of actinomycetoma in the Western hemisphere....\n --PARENT--> [?] Actinomycetoma\n Def: Actinomycetoma is a chronic progressive subcutaneous infection caused by implantation of aerobic branching actinomycetes through a skin wound. These organisms are filamentous bacteria which live as sa...", "[1C1B.Y] Other specified forms of nocardiosis\n --PARENT--> [1C1B] Nocardiosis\n Def: A disease caused by an infection with the gram-positive bacteria Nocardia. This disease presents with symptoms depending on the site of infection (commonly lung, brain, or skin). Transmission is by in...\n --CHILD--> [1C1B.1] Cutaneous nocardiosis\n Def: Cutaneous nocardiosis may be due to direct infection of the skin where it presents either as a solitary cold abscess or as a lymphangitic process in which infection spreads up lymphatic channels to fo...", "[1C1B.Y] Other specified forms of nocardiosis\n --PARENT--> [1C1B] Nocardiosis\n Def: A disease caused by an infection with the gram-positive bacteria Nocardia. This disease presents with symptoms depending on the site of infection (commonly lung, brain, or skin). Transmission is by in...\n --CHILD--> [1C1B.1] Cutaneous nocardiosis\n Def: Cutaneous nocardiosis may be due to direct infection of the skin where it presents either as a solitary cold abscess or as a lymphangitic process in which infection spreads up lymphatic channels to fo..." ]
1C1B.Z
Nocardiosis, unspecified
[ { "from_icd11": "1C1B.Z", "icd10_code": "A438", "icd10_title": "Other forms of nocardiosis" }, { "from_icd11": "1C1B.Z", "icd10_code": "A439", "icd10_title": "Nocardiosis, unspecified" }, { "from_icd11": "1C1B.Z", "icd10_code": "A30-A49", "icd10_title": "" }, { "from_icd11": "1C1B.Z", "icd10_code": "A43", "icd10_title": "Nocardiosis" }, { "from_icd11": "1C1B.1", "icd10_code": "A431", "icd10_title": "Cutaneous nocardiosis" }, { "from_icd11": "1C43", "icd10_code": "B471", "icd10_title": "Actinomycetoma" }, { "from_icd11": "CA0A.Z", "icd10_code": "J329", "icd10_title": "Chronic sinusitis, unspecified" }, { "from_icd11": "CA0A.Z", "icd10_code": "J324", "icd10_title": "Chronic pansinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J320", "icd10_title": "Chronic maxillary sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J322", "icd10_title": "Chronic ethmoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J323", "icd10_title": "Chronic sphenoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J328", "icd10_title": "Other chronic sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J321", "icd10_title": "Chronic frontal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J30-J39", "icd10_title": "" }, { "from_icd11": "CA0A.Z", "icd10_code": "J32", "icd10_title": "Chronic sinusitis" } ]
A438
Other forms of nocardiosis
A 37-year-old woman was referred to our institute (Gynaecology Department) due to persistent metrorrhagia and raised serum β-HCG levels . Patient gynaecological and obstetrical history was characterized by one prior term birth in 2012 and a spontaneous miscarriage at seven gestational weeks in 2016. The suspicion of gestational choriocarcinoma was raised as a highly vascularized uterine mass was detected at computed tomography. Gestational Choriocarcinoma is a highly malignant neoplasm of trophoblastic origin, characterized by rapid growth and high tendency to develop hematogenous metastases. Diagnosis is more commonly based on β-HCG serum levels and clinical presentation rather than on histopatological analysis (due to the high risk of bleeding following bioptical procedures). Thanks to its high chemosensitivity, gestational choriocarcinoma is usually associated with a good prognosis and high cure rates. The patient was submitted to a total body triphasic contrast-enhanced Multi Detector Computed Tomography (MDCT) confirming the presence of choriocarcinoma, but also showing a giant pelvic aneurysm suspecious for AVF , lung metastases and pulmonary thrombo-embolisms. The diagnosis of AVF was confirmed by a Color Doppler Ultrasound examination showing a typical arterialized, low-resistance blood flow of the pelvic veins . The case was discussed within a multidisciplinary gynaecological and radiological meeting. Following this, an angiography was planned in order to confirm the AVF diagnosis and to perform an embolization to stop the bleeding trying to occlude the fistula despite its large size. The decision on the opportunity to place a filter to prevent further episodes of pulmonary embolism was postponed until diagnostic angiograpy and embolization were completed. In an emergency setting, the patient was submitted to a diagnostic angiography initially using a right femoral transarterial and right femoral transvenous approach. Diagnostic arteriography confirmed the presence of a giant AVF sustained by branches of both hypogastric arteries with early opacification of the right gonadal vein and the inferior vena cava . After selective catheterization of right and left hypogastric arteries, using a coaxial microcatheter (Carnelian 2.2, Tokai, Medical Products, Sarayashiki Taraga Kasugay-city, Japan), the afferent branches to AVF were subsequently embolized using first detachable coils (Interlock, Boston Scientific, Natick, MA, USA) of variable diameter (6–14 mm) and length (10–40 cm), after poly vinyl alcohol (PVA) particles (Contour Embolization particles 500–710 μ, Boston Scientific, Natick, MA, USA) and finally also an ethylene-vinyl alcohol copolymer (EVOH)-based liquid embolic agent (Squid-peri 12, Emboflu, Gland, Switzerland) in order to reduce AVF in-flow . A transfemoral phlebography with selective catheterization of the right gonadal vein showed multiple thrombi , leading to the pulmonary embolism previously detected at the contrast-enhanced MDCT. Using a right transjugular approach, an Amplatzer plug was finally placed at the confluence of the right gonadal vein in the vena cava , not only to reduce AVF out-flow but also to occlude the right gonadal vein, preventing further episodes of pulmonary embolism. Metrorrhagia almost disappeared after the procedure. A contrast-enhanced MDCT examination performed 24 h after the embolization confirmed the correct placement of the plug and the significant reduction in volume and enhancement of the AVF. No further pulmonary embolism was demonstrated at MDCT performed during follow-up. A second transarterial embolization using the same embolic agents (PVA particles, coils and Squid) was performed six months later. The second embolization, combined with a complete response to systemic chemotherapy confirmed by β-HCG levels normalization with disappearance of pulmonary metastases, determined the complete AVF resolution . Currently the patient is aymptomatic and enjoys full well-being of health. Fig. 1 Contrast-enhanced MDCT shows (a) a suspicious giant pelvic AVF (arrows), (b) confirmed by Color Doppler Fig. 2 Diagnostic arteriography from the right hypogastric artery shows (a) a giant AVF with early opacification of the right gonadal vein and the inferior vena cava. DSA performed with a microcatheter shows peripheral arterial branches sustaining the fistula (b) , embolized using coils (c) and PVA particles (d) Fig. 3 DSA shows branches of the left hypogastric artery sustaining the AVF (a) , embolized also using Squid (arrow) (b) Fig. 4 Diagnostic phlebography via trans-femoral of the right gonadal vein shows (a) multiple thrombi (arrows). Amplatzer plug placement (arrows) via trans-jugular to occlude the right gonadal vein (b) to simultaneously reduce AVF-outflow and avoid pulmonary embolism. Contrast-enhanced MDCT after 24 h confirms (c) the correct placement of the plug (arrows) Fig. 5 After the second arterial embolization performed 6 months later, the final aortography shows the complete AVF occlusion
4.160156
0.957031
sec[1]/p[0]
en
0.999998
30652161
https://doi.org/10.1186/s42155-018-0039-8
[ "pulmonary", "embolization", "using", "gonadal", "vein", "mdct", "contrast", "enhanced", "embolism", "gestational" ]
[ { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "CA40.Z", "title": "Pneumonia, organism unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "NB32.3Y", "title": "Other injury of lung" }, { "code": "DD30.Z", "title": "Acute vascular disorders of intestine, unspecified" }, { "code": "JB42.2", "title": "Obstetric blood-clot embolism" }, { "code": "NF0A.0", "title": "Air embolism, traumatic, not elsewhere classified" }, { "code": "BA41.Z", "title": "Acute myocardial infarction, unspecified" }, { "code": "BB00.Z", "title": "Pulmonary thromboembolism, unspecified" } ]
=== ICD-11 CODES FOUND === [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [CA40.Z] Pneumonia, organism unspecified Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [NB32.3Y] Other injury of lung Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung [DD30.Z] Acute vascular disorders of intestine, unspecified Also known as: Acute vascular disorders of intestine, unspecified | Acute vascular disorders of intestine | acute intestinal ischemia NOS | acute intestinal ischemic syndrome | acute ischaemic bowel disease [JB42.2] Obstetric blood-clot embolism Definition: A condition characterised by the lodging of a blood clot (a specific type of embolus known as a thrombus) in the bloodstream, which can cause a blockage associated with the physiological and other changes that occur during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after delivery during which the uterus returns to the original size (puerperium). Also known as: Obstetric blood-clot embolism | obstetrical blood-clot embolism | blood clot embolism in pregnancy, childbirth or puerperium | puerperal embolism | Puerperal embolism NOS [NF0A.0] Air embolism, traumatic, not elsewhere classified Also known as: Air embolism, traumatic, not elsewhere classified | pulmonary air embolism | air embolism | arterial air embolism | arterial air embolus Excludes: air embolism complicating abortion or ectopic or molar pregnancy | air embolism complicating pregnancy, childbirth and the puerperium [BA41.Z] Acute myocardial infarction, unspecified Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction [BB00.Z] Pulmonary thromboembolism, unspecified Also known as: Pulmonary thromboembolism, unspecified | Pulmonary thromboembolism | pulmonary thromboembolus | pulmonary embolism NOS | pulmonary embolus === GRAPH WALKS === --- Walk 1 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Alpha-1-antitrypsin deficiency Def: Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterised by low serum leve... --- Walk 2 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality --- Walk 3 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.2] Congenital hypoplasia of lung --- Walk 4 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.0] Accessory lobe of lung Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left... --- Walk 5 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --CHILD--> [CA40.2] Fungal pneumonia --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Severe acute respiratory syndrome Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Alpha-1-antitrypsin deficiency\n Def: Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterised by low serum leve...", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --CHILD--> [CA40.2] Fungal pneumonia", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to..." ]
CB40.Y
Other specified diseases of the respiratory system
[ { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "CA40.Z", "icd10_code": "J189", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J181", "icd10_title": "Lobar pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J188", "icd10_title": "Other pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J168", "icd10_title": "Pneumonia due to other specified infectious organisms" }, { "from_icd11": "CA40.Z", "icd10_code": "J180", "icd10_title": "Bronchopneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J17", "icd10_title": "Pneumonia in diseases classified elsewhere" }, { "from_icd11": "CA40.Z", "icd10_code": "J182", "icd10_title": "Hypostatic pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J16", "icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified" }, { "from_icd11": "CA40.Z", "icd10_code": "J171", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J173", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J178", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J18", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" } ]
Q333
Agenesis of lung
We present the case of a 40-year-old female patient with an intellectual disability, who was admitted to the ED due to nausea, fatigue, fever and abdominal pain. Abdominal pain began 7 days earlier, followed by repeated episodes of headache and vomiting. She complained of loss of appetite, constipation and polyuria. The patient had no comorbidities apart from intellectual disability which has been observed since childhood, but the diagnostic work-up and close follow-up was never made. On admission, she was febrile (up to 38 Celsius) with heart rate of 112 beats per minute, blood pressure 150/70 mmHg, respiratory rate of 18 breaths per minute, and oxygen saturation 98% on room air. Results of blood testing at admission, which should be highlighted, are shown in Table 1 . Urinalysis showed sub-nephrotic proteinuria with initial signs of urinary tract infection (leukocyte esterase 1+, nitrite negative). Native X-ray of the abdomen ruled out acute abdomen but showed significant intestinal flatulence with coprostasis and dilatation of the transverse colon up to 6.5 cm in diameter. A chest X-ray showed no signs of inflammation. Abdominal and pelvic multi-slice computed tomography (MSCT) showed dilatation of ascending and transverse colon up to 6.5 cm with no signs of ileus or acute abdomen. Chest MSCT showed lung infiltrate and pleural effusion with a diffuse ground-glass opacities with thickening of the interlobular septa and mediastinal lymphadenopathy suggesting potential interstitial lung disease. After the initial diagnostic work-up was done, the patient was admitted to the intensive care unit (ICU) due to severe symptomatic hypercalcaemia and ARF combined with hyponatremia and hypokalaemia. In the ICU, correction of electrolyte imbalance and ARF was achieved with the use of zolendronic acid [4 mg intravenously (i.v.)] corticosteroids (prednisone in a dose of 20 mg/day) and crystalloid solutions (at an initial rate of 200–300 mL/h, then adjusted to maintain the urine output at 100–150 mL/h). Due to lung infiltrate and elevated inflammatory parameters, she was treated with intravenous administration of antibiotics (meropenem, ceftriaxone). Control laboratory findings showed the normalization of the electrolyte imbalance and a decrease in the values of inflammatory parameters ( Table 1 ). After 7 days, the patient was discharged from the ICU and was transferred to the Endocrinology Department. Consequently, during and after hospitalization, detailed diagnostic work-up was performed to determine the aetiology of hypercalcemia. Parathormone (PTH) values were within the normal range (< 0.6 pmol/L), with ultrasound findings of the thyroid and parathyroid glands also normal, ruling out parathyroid pathology. A control chest MSCT (which was done at the time of discharge from the hospital) showed the complete regression of all the described changes, without signs of interstitial lung disease. QuantiFERON test was negative. No pathological accumulation of radiopharmaceuticals was observed by scintigraphy of the skeleton. The rheumatologist ruled out the systemic rheumatic diseases based on the control chest MSCT and laboratory findings. Sarcoidosis was ruled out by an ophthalmologist’s and pulmonologist’s examination [based on angiotensin-converting enzyme (ACE) serum activity, normal chitotriosidase values, bronchoscopy, chest MSCT and no ocular manifestation of sarcoidosis]. Esophagogastroduodenoscopy, breast ultrasound and gynaecologist examination combined with normal values of tumour markers ruled out a potential (para)neoplastic condition. A more detailed anamnesis (medical history), physical examination and endocrinological findings ruled out milk-alkali syndrome and the possibility of intoxication with vitamin D and ethylene glycol. Complete haematological diagnostic work-up (including bone marrow biopsy, cytological analysis and serum and urine protein electrophoresis) excluded multiple myeloma and other haematological diseases. Regarding to intellectual disability and single episode of hypercalcaemia, genetic testing was performed to rule out hereditary syndromes (i.e., tubulopathies) that can cause hypercalcemia, however the results did not reveal any genetic syndrome. As part of the treatment, the patient was examined by a psychiatrist who revealed the patient’s recurrent vomiting habits, most likely as part of bulimia after which psychotherapy was recommended. Our patient underwent psychotherapy and nutritional rehabilitation. Cognitive-behavioural therapy is the first-line treatment, however due to patient’s intellectual disability, the application of therapy was demanding, but feasible, with a more strict observation of her daily routine provided by her family. Considering that PET-CT and PTH-related protein, which were subsequently done later, definitively ruled out a (para)neoplastic condition, and all other findings were normal, the only explanation is that hypercalcaemia and consequent ARF were caused by repeated and excessive vomiting .
3.964844
0.979492
sec[1]/p[0]
en
0.999995
PMC11239332
https://doi.org/10.3389/fmed.2024.1394601
[ "ruled", "which", "chest", "msct", "intellectual", "disability", "work", "lung", "abdominal", "vomiting" ]
[ { "code": "QA02", "title": "Medical observation or evaluation for suspected diseases or conditions, ruled out" }, { "code": "QA02.3", "title": "Observation for suspected mental or behavioural disorders, ruled out" }, { "code": "QA02.0", "title": "Observation for suspected tuberculosis, ruled out" }, { "code": "QA02.Y", "title": "Medical observation or evaluation for other suspected diseases or conditions, ruled out" }, { "code": "QA02.4", "title": "Observation for suspected nervous system disorder, ruled out" }, { "code": "BD50.41", "title": "Abdominal aortic aneurysm with rupture" }, { "code": "EK91", "title": "Dermatoses which may presage cutaneous lymphoma" }, { "code": "MH12.1", "title": "Death occurring less than 24 hours from onset of symptoms, not otherwise explained" }, { "code": "8A44.3", "title": "Certain specified leukodystrophies" }, { "code": "CB7Z", "title": "Diseases of the respiratory system, unspecified" } ]
=== ICD-11 CODES FOUND === [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out Definition: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or medical care because suspected condition has been ruled out. Also known as: Medical observation or evaluation for suspected diseases or conditions, ruled out | under observation | ruled out condition | observation for disease | evaluation for suspected condition Excludes: Person with feared complaint in whom no diagnosis is made [QA02.3] Observation for suspected mental or behavioural disorders, ruled out Also known as: Observation for suspected mental or behavioural disorders, ruled out | observation for suspected mental disorder | observation for suspected behavioural disorder | observation for suspected mental disorder without need for further medical care | Observation for dissocial behaviour without manifest mental disorder [QA02.0] Observation for suspected tuberculosis, ruled out Definition: Cases presenting with signs susceptible to be due to Tuberculosis, but where after observation and examination it was confirmed that this was not Tuberculosis - and no other disease had been identified that could explain the symptoms. Also known as: Observation for suspected tuberculosis, ruled out | examination for suspected tuberculosis | chest x-ray for suspected tuberculosis [QA02.Y] Medical observation or evaluation for other suspected diseases or conditions, ruled out Also known as: Medical observation or evaluation for other suspected diseases or conditions, ruled out | Observation for suspected myocardial infarction, ruled out | observation for myocardial infarction | observation for suspected cardiovascular myocardial infarction | Observation for suspected cardiovascular diseases other than suspected myocardial infarction, ruled out [QA02.4] Observation for suspected nervous system disorder, ruled out Also known as: Observation for suspected nervous system disorder, ruled out | observation for disease or disorder of nervous system | Observation for suspected cerebrovascular accident, ruled out [BD50.41] Abdominal aortic aneurysm with rupture Also known as: Abdominal aortic aneurysm with rupture | abdominal aorta aneurysm rupture | abdominal aorta aneurysm ruptured | abdominal aortic aneurysm which has ruptured | ruptured AAA [EK91] Dermatoses which may presage cutaneous lymphoma Definition: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature. Also known as: Dermatoses which may presage cutaneous lymphoma [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained Also known as: Death occurring less than 24 hours from onset of symptoms, not otherwise explained | died without sign of disease | Death known not to be violent or instantaneous for which no cause can be discovered | death known not to be violent or instantaneous, cause unknown | Death without sign of disease Includes: Death known not to be violent or instantaneous for which no cause can be discovered | Death without sign of disease [8A44.3] Certain specified leukodystrophies Also known as: Certain specified leukodystrophies | CACH syndrome | Vanishing white matter disease | Childhood ataxia with central nervous system hypomyelination | Congenital or early infantile CACH syndrome [CB7Z] Diseases of the respiratory system, unspecified Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS === GRAPH WALKS === --- Walk 1 --- [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ... --CHILD--> [QA02.1] Observation for suspected Dengue, ruled out --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ... --- Walk 2 --- [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ... --CHILD--> [QA02.2] Observation for suspected malignant neoplasm, ruled out --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ... --- Walk 3 --- [QA02.3] Observation for suspected mental or behavioural disorders, ruled out --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ... --CHILD--> [QA02.0] Observation for suspected tuberculosis, ruled out Def: Cases presenting with signs susceptible to be due to Tuberculosis, but where after observation and examination it was confirmed that this was not Tuberculosis - and no other disease had been identifie... --- Walk 4 --- [QA02.3] Observation for suspected mental or behavioural disorders, ruled out --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ... --EXCLUDES--> [?] Person with feared complaint in whom no diagnosis is made --- Walk 5 --- [QA02.0] Observation for suspected tuberculosis, ruled out Def: Cases presenting with signs susceptible to be due to Tuberculosis, but where after observation and examination it was confirmed that this was not Tuberculosis - and no other disease had been identifie... --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ... --CHILD--> [QA02.2] Observation for suspected malignant neoplasm, ruled out --- Walk 6 --- [QA02.0] Observation for suspected tuberculosis, ruled out Def: Cases presenting with signs susceptible to be due to Tuberculosis, but where after observation and examination it was confirmed that this was not Tuberculosis - and no other disease had been identifie... --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ... --CHILD--> [QA02.0] Observation for suspected tuberculosis, ruled out Def: Cases presenting with signs susceptible to be due to Tuberculosis, but where after observation and examination it was confirmed that this was not Tuberculosis - and no other disease had been identifie...
[ "[QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out\n Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ...\n --CHILD--> [QA02.1] Observation for suspected Dengue, ruled out\n --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out\n Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ...", "[QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out\n Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ...\n --CHILD--> [QA02.2] Observation for suspected malignant neoplasm, ruled out\n --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out\n Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ...", "[QA02.3] Observation for suspected mental or behavioural disorders, ruled out\n --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out\n Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ...\n --CHILD--> [QA02.0] Observation for suspected tuberculosis, ruled out\n Def: Cases presenting with signs susceptible to be due to Tuberculosis, but where after observation and examination it was confirmed that this was not Tuberculosis - and no other disease had been identifie...", "[QA02.3] Observation for suspected mental or behavioural disorders, ruled out\n --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out\n Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ...\n --EXCLUDES--> [?] Person with feared complaint in whom no diagnosis is made", "[QA02.0] Observation for suspected tuberculosis, ruled out\n Def: Cases presenting with signs susceptible to be due to Tuberculosis, but where after observation and examination it was confirmed that this was not Tuberculosis - and no other disease had been identifie...\n --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out\n Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ...\n --CHILD--> [QA02.2] Observation for suspected malignant neoplasm, ruled out", "[QA02.0] Observation for suspected tuberculosis, ruled out\n Def: Cases presenting with signs susceptible to be due to Tuberculosis, but where after observation and examination it was confirmed that this was not Tuberculosis - and no other disease had been identifie...\n --PARENT--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out\n Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ...\n --CHILD--> [QA02.0] Observation for suspected tuberculosis, ruled out\n Def: Cases presenting with signs susceptible to be due to Tuberculosis, but where after observation and examination it was confirmed that this was not Tuberculosis - and no other disease had been identifie..." ]
QA02
Medical observation or evaluation for suspected diseases or conditions, ruled out
[ { "from_icd11": "QA02", "icd10_code": "Z0379", "icd10_title": "Encounter for other suspected maternal and fetal conditions ruled out" }, { "from_icd11": "QA02", "icd10_code": "Z0374", "icd10_title": "Encounter for suspected problem with fetal growth ruled out" }, { "from_icd11": "QA02", "icd10_code": "Z0371", "icd10_title": "Encounter for suspected problem with amniotic cavity and membrane ruled out" }, { "from_icd11": "QA02", "icd10_code": "Z0389", "icd10_title": "Encounter for observation for other suspected diseases and conditions ruled out" }, { "from_icd11": "QA02", "icd10_code": "Z03", "icd10_title": "Encounter for medical observation for suspected diseases and conditions ruled out" }, { "from_icd11": "QA02", "icd10_code": "Z034", "icd10_title": "" }, { "from_icd11": "QA02", "icd10_code": "Z035", "icd10_title": "" }, { "from_icd11": "QA02", "icd10_code": "Z038", "icd10_title": "Encounter for observation for other suspected diseases and conditions ruled out" }, { "from_icd11": "QA02", "icd10_code": "Z039", "icd10_title": "" }, { "from_icd11": "QA02.3", "icd10_code": "Z032", "icd10_title": "" }, { "from_icd11": "QA02.0", "icd10_code": "Z030", "icd10_title": "" }, { "from_icd11": "QA02.4", "icd10_code": "Z033", "icd10_title": "" }, { "from_icd11": "BD50.41", "icd10_code": "I713", "icd10_title": "Abdominal aortic aneurysm, ruptured" }, { "from_icd11": "EK91", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "MH12.1", "icd10_code": "R961", "icd10_title": "" } ]
Z0379
Encounter for other suspected maternal and fetal conditions ruled out
The patient was a 51-year-old male who presented with an abdominal mass for 2 years and right upper abdominal pain for 1 month. Two years prior to this study, the abdominal ultrasonography of the patient showed an upper abdominal hypoechoic nodule, suggesting an enlarged lymph node. One and a half years prior to this study, the contrast-enhanced CT suggested that the liver and stomach space contained an irregular mass, suggesting lymphoma. One month prior to this study, the patient had pain in the right hypochondrial region with no obvious causes; the pain was intermittent and radiated to the umbilicus, with self-remission. The mass appeared in the right upper quadrant, and increased in size rapidly. After physical examination, one-7 cm mass could be felt in the right upper quadrant, and the texture was medium. In laboratory tests, there was elevated blood glucose antigen 125, 316.9 U/mL (reference value, 0.0 – 35.0 U/mL). The routine abdominal CT and contrast-enhanced CT showed that a lobulated soft tissue mass was in the liver and stomach space with a size of approximately 7.7 × 14.2 cm 2 ; the internal density was slightly heterogeneous, and the boundary was still clear. In CT arterial phase, the peripheral part of the mass had slight reinforcement. Gross vascular features were seen in the center of the lesion. During the portal phase and delay phase, there was progressive enhancement of lesions and reinforcement came from the center to the surrounding progress, showing a centrifugal reinforcement . Other manifestations included chronic liver disease, splenomegaly, ascites, a cavernous transformation of the portal vein, and a collateral circulation opening. CTA showed that the vascular features were in the center of the lesion, which had blood supplied by the anterior superior pancreaticoduodenal artery and the left gastric artery . An abdominal MRI scan showed a huge lobulated mass in the liver and stomach space compared to the muscle signal; the T1-weighted imaging (T1WI) signal was isointense, T2-weighted imaging (T2WI) was slightly hyperintense, and there were clear boundaries. A diffusion-weighted imaging (DWI) sequence of the mass showed slight hyperintensity. In a contrast-enhanced MRI, as time passed, the lesion was enhanced from the center to the periphery, and the degree of enhancement was enhanced, showing centrifugal enhancement . After completing the necessary examinations and discussing operation options with the patient, excision of the abdominal mass was carried out. During the operation, there was a small amount of ascites, and there were no obvious tumor nodules in the peritoneum, mesenteric and intestinal wall. The tumor was located between the liver and stomach; it was lobulated, hard, and closely adhered to small curved side of the stomach. Gross observation showed a mass with a size of 5.5x9.5x15 cm 3 , and the cutting section was gray. Pathological magnification showed the tumor cells were spindle. Cytoplasmic eosinophilic red showed there was substantial differentiation, but nuclear division was rare. The interstitial vascular, spindle cells and interstitial blood vessels were mixed in different proportions, and the regional blood vessels formed a dense vascular-network-like structure with some spindle cells around blood vessels protruding into the lumen of blood vessel arrangement. The spindle cells were abundant in some areas, showing bundled or braided arrangements. The immunohistochemical results were, smooth muscle actin (+) desmin (+), Ki-67 (+, few), S-100 protein (−), CD34 (−), CK (−), progesterone receptor (−), estrogen receptor (−), MelanA (−), HMB45 (−), CD117 (−), and DOG-1 (−) . The final pathological diagnosis was myopericytoma. The patient was followed up with for 5 months, and there was no recurrence or metastasis during that period. Fig. 1 Abdominal conventional and contrast-enhanced CT scan showed a lobulated mass with uneven density ( a ). Arterial phase ( b ) showed partial enhancement of the lesion center, and the venous phase ( c ) and delayed phase ( d ) expanded the enhanced scope, and showed centrifugal enhancement Fig. 2 A computed tomography angiography scan showed the anterior superior pancreaticoduodenal artery ( the thin arrow ) and the left gastric artery ( thick arrow ) branches extended to the tumor center Fig. 3 Abdominal conventional and contrast-enhanced MRI scans displayed a soft tissue mass and T1WI was isointense, compared to the muscle signal ( a ). Transverse T2WI showed slight hyperintensity ( b ). The DWI sequence showed slightly hyperintensity ( c ). Transverse artery phase showed the central region enhanced ( d ). In the venous phase ( e ) and delayed phase ( f ), the enhanced range increased, showing centrifugal enhancement Fig. 4 Histopathological examination (H&E, 100×) showed spindle cells arranged in bundles or woven around the vessels ( a ). Immunohistochemistry, SMA ( b ) and Desmin ( c ) staining were positive, and Ki-67 ( d ) had a small amount of positive staining
4.066406
0.972656
sec[1]/p[0]
en
0.999998
28219370
https://doi.org/10.1186/s12885-017-3146-3
[ "enhanced", "abdominal", "phase", "blood", "center", "enhancement", "contrast", "liver", "stomach", "artery" ]
[ { "code": "8A04.0", "title": "Enhanced physiological tremor" }, { "code": "8E4A.0", "title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord" }, { "code": "MD81.3", "title": "Acute abdomen" }, { "code": "JA01.0", "title": "Abdominal pregnancy" }, { "code": "ME04.Z", "title": "Ascites, unspecified" }, { "code": "NB51.0&XA3KX0", "title": "Laceration without foreign body of abdominal wall" }, { "code": "NB9Y", "title": "Other specified injuries to the abdomen, lower back, lumbar spine or pelvis" }, { "code": "JB02.0", "title": "Primary uterine inertia" }, { "code": "2B30.10&XH51K7", "title": "Classical Hodgkin lymphoma, nodular sclerosis, cellular phase" }, { "code": "7A60", "title": "Delayed sleep-wake phase disorder" } ]
=== ICD-11 CODES FOUND === [8A04.0] Enhanced physiological tremor Definition: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc. Also known as: Enhanced physiological tremor [8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Definition: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephalopathy, ataxia, myelopathy, myelitis) nervous system. In the paraneoplastic context, this attack is a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived from a systemic cancer. In the non-paraneoplastic context termed ‘autoimmune’ the etiology rem Also known as: Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord | Paraneoplastic encephalitis | Paraneoplastic encephalitis, neural autoantibody positive | Paraneoplastic encephalitis, neural autoantibody negative | Autoimmune encephalitis [MD81.3] Acute abdomen Definition: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases Also known as: Acute abdomen | acute abdominal pain syndrome | surgical abdomen | abdominal acute syndrome | severe abdomen pain [JA01.0] Abdominal pregnancy Definition: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy. Also known as: Abdominal pregnancy | abdomen pregnancy | intraperitoneal pregnancy Excludes: Maternal care for viable fetus in abdominal pregnancy | Delivery of viable fetus in abdominal pregnancy [ME04.Z] Ascites, unspecified Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS [NB9Y] Other specified injuries to the abdomen, lower back, lumbar spine or pelvis Also known as: Other specified injuries to the abdomen, lower back, lumbar spine or pelvis | Abdominal wall trauma | Injury of pelvic floor | pelvic floor blunt injury | pelvic floor blunt trauma [JB02.0] Primary uterine inertia Definition: A condition affecting pregnant females characterised by insufficiently strong or inappropriately coordinated rhythmic activity of the myometrium during labour to efface and dilate the cervix. Also known as: Primary uterine inertia | Primary hypotonic uterine dysfunction | hypotonic uterine dysfunction | hypotonic uterine inertia | primary hypotonic uterine inertia Includes: Primary hypotonic uterine dysfunction | Uterine inertia during latent phase of labour | Primary inadequate contractions [7A60] Delayed sleep-wake phase disorder Definition: Delayed sleep-wake phase disorder is a recurrent pattern of disturbance of the sleep-wake schedule characterised by persistent delay in the major sleep period compared to conventional or desired sleep times. The disorder results in difficulty falling asleep and difficulty awakening at desired or required times. When sleep is allowed to occur on the delayed schedule, it is essentially normal in quality and duration. The symptoms should have persisted for at least several months and result in sign Also known as: Delayed sleep-wake phase disorder | circadian rhythm sleep-wake disorder, delayed type | delayed sleep phase syndrome Includes: delayed sleep phase syndrome === GRAPH WALKS === --- Walk 1 --- [8A04.0] Enhanced physiological tremor Def: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc.... --PARENT--> [8A04] Disorders associated with tremor Def: Tremor is an involuntary oscillation of a body part and is commonly classified according to the behavioural circumstances in which it occurs. Tremor may occur during attempted relaxation (rest tremor)... --CHILD--> [8A04.2] Rest tremor Def: Resting tremors happen while the patient is sitting or lying down and relaxed. People who have a resting tremor can usually stop the tremor by deliberately moving the affected body part. It usually oc... --- Walk 2 --- [8A04.0] Enhanced physiological tremor Def: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc.... --PARENT--> [8A04] Disorders associated with tremor Def: Tremor is an involuntary oscillation of a body part and is commonly classified according to the behavioural circumstances in which it occurs. Tremor may occur during attempted relaxation (rest tremor)... --CHILD--> [8A04.2] Rest tremor Def: Resting tremors happen while the patient is sitting or lying down and relaxed. People who have a resting tremor can usually stop the tremor by deliberately moving the affected body part. It usually oc... --- Walk 3 --- [8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal... --RELATED_TO--> [?] Opsoclonus-myoclonus Def: Opsoclonus-myoclonus (OM) is an autoimmune disorder of eye movements characterised by opsoclonus (involuntary unpredictable rapid eye movements [saccades] without inter-saccadic intervals), myoclonus ... --PARENT--> [?] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal... --- Walk 4 --- [8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal... --RELATED_TO--> [?] Autoimmune retinopathy Def: Autoimmune retinopathies are immune-mediated inflammatory disorders of the retina that differ from paraneoplastic retinopathies in the lack of association with cancer. Patients present with progressiv... --PARENT--> [?] Retinopathy --- Walk 5 --- [MD81.3] Acute abdomen Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases... --PARENT--> [MD81] Abdominal or pelvic pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region.... --EXCLUDES--> [?] Renal colic Def: A severe paroxysmal pain in the flank radiating to the groin, scrotum or labia, caused by blockage of the renal pelvis or ureter most commonly by a renal stone. May be associated with nausea and vomit... --- Walk 6 --- [MD81.3] Acute abdomen Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases... --PARENT--> [MD81] Abdominal or pelvic pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region.... --CHILD--> [MD81.1] Localised abdominal pain
[ "[8A04.0] Enhanced physiological tremor\n Def: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc....\n --PARENT--> [8A04] Disorders associated with tremor\n Def: Tremor is an involuntary oscillation of a body part and is commonly classified according to the behavioural circumstances in which it occurs. Tremor may occur during attempted relaxation (rest tremor)...\n --CHILD--> [8A04.2] Rest tremor\n Def: Resting tremors happen while the patient is sitting or lying down and relaxed. People who have a resting tremor can usually stop the tremor by deliberately moving the affected body part. It usually oc...", "[8A04.0] Enhanced physiological tremor\n Def: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc....\n --PARENT--> [8A04] Disorders associated with tremor\n Def: Tremor is an involuntary oscillation of a body part and is commonly classified according to the behavioural circumstances in which it occurs. Tremor may occur during attempted relaxation (rest tremor)...\n --CHILD--> [8A04.2] Rest tremor\n Def: Resting tremors happen while the patient is sitting or lying down and relaxed. People who have a resting tremor can usually stop the tremor by deliberately moving the affected body part. It usually oc...", "[8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord\n Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal...\n --RELATED_TO--> [?] Opsoclonus-myoclonus\n Def: Opsoclonus-myoclonus (OM) is an autoimmune disorder of eye movements characterised by opsoclonus (involuntary unpredictable rapid eye movements [saccades] without inter-saccadic intervals), myoclonus ...\n --PARENT--> [?] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord\n Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal...", "[8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord\n Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal...\n --RELATED_TO--> [?] Autoimmune retinopathy\n Def: Autoimmune retinopathies are immune-mediated inflammatory disorders of the retina that differ from paraneoplastic retinopathies in the lack of association with cancer. Patients present with progressiv...\n --PARENT--> [?] Retinopathy", "[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --EXCLUDES--> [?] Renal colic\n Def: A severe paroxysmal pain in the flank radiating to the groin, scrotum or labia, caused by blockage of the renal pelvis or ureter most commonly by a renal stone. May be associated with nausea and vomit...", "[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --CHILD--> [MD81.1] Localised abdominal pain" ]
8A04.0
Enhanced physiological tremor
[ { "from_icd11": "8A04.0", "icd10_code": "G252", "icd10_title": "Other specified forms of tremor" }, { "from_icd11": "8E4A.0", "icd10_code": "G3183", "icd10_title": "Dementia with Lewy bodies" }, { "from_icd11": "8E4A.0", "icd10_code": "G2581", "icd10_title": "Restless legs syndrome" }, { "from_icd11": "8E4A.0", "icd10_code": "G3184", "icd10_title": "Mild cognitive impairment, so stated" }, { "from_icd11": "8E4A.0", "icd10_code": "G9349", "icd10_title": "Other encephalopathy" }, { "from_icd11": "8E4A.0", "icd10_code": "G0481", "icd10_title": "Other encephalitis and encephalomyelitis" }, { "from_icd11": "8E4A.0", "icd10_code": "G9589", "icd10_title": "Other specified diseases of spinal cord" }, { "from_icd11": "8E4A.0", "icd10_code": "G2589", "icd10_title": "Other specified extrapyramidal and movement disorders" }, { "from_icd11": "8E4A.0", "icd10_code": "G3189", "icd10_title": "Other specified degenerative diseases of nervous system" }, { "from_icd11": "8E4A.0", "icd10_code": "G2582", "icd10_title": "Stiff-man syndrome" }, { "from_icd11": "8E4A.0", "icd10_code": "G0489", "icd10_title": "Other myelitis" }, { "from_icd11": "8E4A.0", "icd10_code": "G9581", "icd10_title": "Conus medullaris syndrome" }, { "from_icd11": "8E4A.0", "icd10_code": "G3185", "icd10_title": "Corticobasal degeneration" }, { "from_icd11": "8E4A.0", "icd10_code": "G3181", "icd10_title": "Alpers disease" }, { "from_icd11": "8E4A.0", "icd10_code": "G3182", "icd10_title": "Leigh's disease" } ]
G252
Other specified forms of tremor
The case report describes a 53-year-old male patient who presented with paroxysmal palpitation in January 2018, leading to a diagnosis of paroxysmal AF. The patient had a history of hypertension but no other significant comorbidities. Coronary angiography showed mild stenosis of the anterior descending artery and right coronary artery, but no significant stenosis of the circumflex artery. Cardiac echocolor Doppler showed no abnormalities in cardiac function and pulmonary artery pressure. Despite occasional episodes of AF, the patient responded well to oral metoprolol succinate. Following a recurrence of AF in June 2021, the patient underwent RFA. No PV CT examination was performed before RFA. During the ablation of the PV vestibule, the power control mode was utilized at 40 watts, 43°C, and a flow rate of 30 ml/min. After achieving complete isolation of the pulmonary veins, voltage matrix mapping ablation was conducted using the power control mode at 35 watts, 43°C, and a flow rate of 25 ml/min. The patient subsequently received post-operative treatment with rivaroxaban and amiodarone. Subsequently, in January 2022, the patient experienced chest pain, coughing, chest tightness, and shortness of breath, with chest CT revealing inflammation in the lower lobe of the left lung and pleural effusion . The patient was diagnosed with pneumonia and pleurisy, leading to admission to the Department of Respiratory Medicine where anti-infective treatment was administered. Following improvement, the patient was discharged. However, 1 month later, the patient experienced a recurrence of symptoms including cough, white sputum, occasional bright red sputum, persistent left chest and back pain, chest tightness, and shortness of breath after physical activity. Despite ruling out tuberculosis and connective tissue diseases through various examinations, sputum bacterial culture did not reveal any abnormalities. Cytological examination post bronchoscopy and alveolar lavage indicated the presence of red blood cells, respiratory epithelial cells, neutrophils, and lymphocytes, with no cancer cells detected . A percutaneous lung puncture biopsy on April 21, 2022 revealed chronic non-specific interstitial inflammatory changes, edema, and scattered infiltration of lymphocytes, histiocytes, and neutrophils, with no granulomatous lesions or atypical cells observed. Tissue changes in the left lower lobe aspirate were consistent with pulmonary hemorrhage and infarction . A pulmonary artery CT scan on April 22, 2022 confirmed left lower PV occlusion, reduced perfusion, and volume reduction in the left lower lobe of the lung . The etiology of the patient's recurrent pneumonia was identified as PV occlusion following RFA for AF. Symptoms including cough, sputum production, shortness of breath, chest pain, and hemoptysis gradually manifested. Despite initial treatment with anti-infectious and anticoagulant therapies during the first hospitalization, persistent symptoms of cough and sputum production prompted a PV enhanced CT scan on July 26, 2022. The scan revealed occlusion between the left lower PV and the left atrium, with absence of contrast agent filling and presence of multiple patchy high-density shadows in the corresponding lung fields . Subsequent interventions included arterial embolization to address recurrent hemoptysis resulting from pulmonary infarction . Following this, the patient underwent the implantation of a stent in the left lower PV, measuring 9 mm in diameter and 20 mm in length. Postoperative management involved a combination of aspirin and clopidogrel for 3 months, followed by maintenance therapy with daily oral aspirin at 100 mg. The patient showed gradual improvement in symptoms such as cough, sputum production, and shortness of breath. A follow-up chest CT on March 30, 2023 revealed a dense shadow of the stent in the left lower PV and decreased density of embolic lesions in the left lung, with no mediastinal lymphadenopathy or pleural effusion detected. The patient experienced gradual relief of symptoms and a chest CT scan confirmed a significant reduction in the size of lesions in the lower lobe of the left lung . Following the placement of a left lower PV stent, the patient's clinical symptoms improved markedly. The patient underwent a review of chest CT on March 1, 2024 . From the CT images, his condition improved significantly. Cardiac echocolor Doppler examination showed pulmonary artery pressures within normal limits. The patient's current condition remains stable, with no significant restenosis observed within the PV stent. It is important to note that the initial symptoms of PVS/O can be non-specific respiratory symptoms, leading patients to seek treatment in respiratory medicine departments. However, there may be a lack of awareness among respiratory medicine physicians regarding this complication, potentially resulting in misdiagnosis and delayed treatment. The timeline of the patient's journey through clinical care can be found in Table 1 .
3.998047
0.978516
sec[0]/p[0]
en
0.999997
39917606
https://doi.org/10.3389/fcvm.2024.1509227
[ "chest", "artery", "pulmonary", "lung", "sputum", "respiratory", "shortness", "breath", "lobe", "cough" ]
[ { "code": "CB7Z", "title": "Diseases of the respiratory system, unspecified" }, { "code": "CB27", "title": "Pleural effusion" }, { "code": "CA44", "title": "Pyothorax" }, { "code": "MD30.Z", "title": "Chest pain, unspecified" }, { "code": "NA80.Y&XJ1C6", "title": "Thoracic haematoma" }, { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "BD52", "title": "Certain specified disorders of arteries or arterioles" }, { "code": "BD52.3", "title": "Rupture of artery" }, { "code": "BD52.2", "title": "Stricture of artery" }, { "code": "BD40.Z", "title": "Atherosclerotic chronic arterial occlusive disease, unspecified" } ]
=== ICD-11 CODES FOUND === [CB7Z] Diseases of the respiratory system, unspecified Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS [CB27] Pleural effusion Definition: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. Also known as: Pleural effusion | PE - [pleural effusion] | Pleurisy with effusion | pleurisy with effusion NOS | pleural effusion with transudate Includes: Pleurisy with effusion Excludes: Tuberculosis of the respiratory system | Chylous effusion | Pleurisy [CA44] Pyothorax Definition: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or penetrating trauma with a secondary infection. Also known as: Pyothorax | empyema | pyopneumothorax | Pyothorax with fistula | empyema with fistula Includes: empyema | pyopneumothorax Excludes: due to tuberculosis [MD30.Z] Chest pain, unspecified Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure [BD5Z] Diseases of arteries or arterioles, unspecified Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS [BD52] Certain specified disorders of arteries or arterioles Also known as: Certain specified disorders of arteries or arterioles | Aortic dilatation - joint hypermobility - arterial tortuosity | Generalised arterial calcification of infancy | Median arcuate ligament syndrome | Aortic root abscess Excludes: collagen (vascular) diseases | Hypersensitivity angiitis | Acute arterial occlusion [BD52.3] Rupture of artery Also known as: Rupture of artery | ruptured artery | artery fistula | Aortic duodenal fistula | Aortic colon fistula Excludes: traumatic rupture of artery - see injury of blood vessel by body region [BD52.2] Stricture of artery Also known as: Stricture of artery | arterial stenosis | arterial stricture | artery stricture | stenosis of artery [BD40.Z] Atherosclerotic chronic arterial occlusive disease, unspecified Also known as: Atherosclerotic chronic arterial occlusive disease, unspecified | Atherosclerotic chronic arterial occlusive disease | arteriosclerosis, NOS | generalised atherosclerosis | atherosclerosis NOS === GRAPH WALKS === --- Walk 1 --- [CB7Z] Diseases of the respiratory system, unspecified --PARENT--> [12] Diseases of the respiratory system --CHILD--> [?] Lung infections Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source.... --- Walk 2 --- [CB7Z] Diseases of the respiratory system, unspecified --PARENT--> [12] Diseases of the respiratory system --CHILD--> [?] Upper respiratory tract disorders Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ... --- Walk 3 --- [CB27] Pleural effusion Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.... --EXCLUDES--> [?] Tuberculosis of the respiratory system Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M.... --CHILD--> [?] Respiratory tuberculosis, confirmed Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough,... --- Walk 4 --- [CB27] Pleural effusion Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.... --EXCLUDES--> [?] Tuberculosis of the respiratory system Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M.... --CHILD--> [?] Respiratory tuberculosis, not confirmed Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has not been confirmed. This disease is characterised by a chronic cough, and sputum prod... --- Walk 5 --- [CA44] Pyothorax Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ... --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with... --CHILD--> [?] Tuberculous empyema, without mention of bacteriological or histological confirmation --- Walk 6 --- [CA44] Pyothorax Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ... --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with... --CHILD--> [?] Bronchopleural tuberculosis
[ "[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --CHILD--> [?] Lung infections\n Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source....", "[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --CHILD--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...", "[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --EXCLUDES--> [?] Tuberculosis of the respiratory system\n Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M....\n --CHILD--> [?] Respiratory tuberculosis, confirmed\n Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough,...", "[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --EXCLUDES--> [?] Tuberculosis of the respiratory system\n Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M....\n --CHILD--> [?] Respiratory tuberculosis, not confirmed\n Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has not been confirmed. This disease is characterised by a chronic cough, and sputum prod...", "[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with...\n --CHILD--> [?] Tuberculous empyema, without mention of bacteriological or histological confirmation", "[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with...\n --CHILD--> [?] Bronchopleural tuberculosis" ]
CB7Z
Diseases of the respiratory system, unspecified
[ { "from_icd11": "CB7Z", "icd10_code": "J989", "icd10_title": "Respiratory disorder, unspecified" }, { "from_icd11": "CB7Z", "icd10_code": "X", "icd10_title": "" }, { "from_icd11": "CB7Z", "icd10_code": "J09-J18", "icd10_title": "" }, { "from_icd11": "CB27", "icd10_code": "J910", "icd10_title": "Malignant pleural effusion" }, { "from_icd11": "CB27", "icd10_code": "J918", "icd10_title": "Pleural effusion in other conditions classified elsewhere" }, { "from_icd11": "CB27", "icd10_code": "J90", "icd10_title": "Pleural effusion, not elsewhere classified" }, { "from_icd11": "CB27", "icd10_code": "J90-J94", "icd10_title": "" }, { "from_icd11": "CB27", "icd10_code": "J91", "icd10_title": "Pleural effusion in conditions classified elsewhere" }, { "from_icd11": "CA44", "icd10_code": "J869", "icd10_title": "Pyothorax without fistula" }, { "from_icd11": "CA44", "icd10_code": "J860", "icd10_title": "Pyothorax with fistula" }, { "from_icd11": "CA44", "icd10_code": "J85-J86", "icd10_title": "" }, { "from_icd11": "CA44", "icd10_code": "J86", "icd10_title": "Pyothorax" }, { "from_icd11": "MD30.Z", "icd10_code": "R0781", "icd10_title": "Pleurodynia" }, { "from_icd11": "MD30.Z", "icd10_code": "R0782", "icd10_title": "Intercostal pain" }, { "from_icd11": "MD30.Z", "icd10_code": "R079", "icd10_title": "Chest pain, unspecified" } ]
J989
Respiratory disorder, unspecified
Laboratory testing showed impaired glucose tolerance (IGT) with fasting blood glucose: 5.7 mmol/L and 2 h blood glucose8.0 mmol/L, negative ketonuria. Islet-specific auto antibodies including GAD -Ab, IA2-Ab, and islet cell antibodies (ICA) were negative. Meanwhile, biochemical results exhibited hypokalemia, but no obvious dysfunctions in patient’s kidney or liver (Table 1 ). Thyroid function was normal. Initial hormonal measurements showed abnormally elevated levels of cortisol (Cortisol 8 a.m. =887.5 nmol/L, normal range 147.3 ~ 609.3 nmol/L, Cortisol 12 p.m. = 978.6 nmol/L) and morning ACTH concentration (138.1 ng/L, normal range 5.0 ~ 78 ng/L),and the result of 1 mg overnight dexamethasone suppression test indicated Cushing syndrome (Table 2 ). Then, ACTH measurement, high-dose dexamethasone suppression test were conducted to determine the hidden causes. It showed significant elevation in ACTH level, but failure of PTC suppression, suggesting possible ectopic Cushing syndrome (Table 2 ). What’s more, pituitary enhanced magnetic resonance imaging (MRI) was negative. However, the profiles of BIPSS summarized in Table 2 contradicted the former results. The blood sampling test of the inferior petroglyphic sinus vein showed that the basic ratio of ACTH in the right inferior petroglyphic sinus to peripheral blood was over 2.0, and the maximum ratio of ACTH in the right inferior petroglyphic sinus to peripheral blood was over 3.0 after the injection of 10μg DDAVP. Moreover, prolactin-normalized ACTH IPS/P ratios and post-DDAVP prolactin-normalized ACTH IPS/P ratios were above 1.3, indicating a pituitary origin. Paradoxical functional tests challenged the diagnosis. Image studies were performed to assist the diagnosis. Chest multi-slice computed tomography (MSCT) was normal. Abdominal CT showed nothing but hyperplastic adrenal glands. Sellar region enhanced magnetic resonance image (MRI) though suggested a normal pituitary, accidentally found an enhancement in the lateral rectus muscle of the patient’s left eye . Therefore, orbital enhanced MRI were performed and enhanced orbital mass was found encompassing the lateral rectus muscle of left eye . Since the venous communications between ophthalmic vein and inferior petrosal sinus has been reported in several studies , we inferred that BIPSS could be false-positive and the orbital mass could be an ectopic ACTH secreting adenoma. Table 1 The abnormal results of biochemical profiles Items Results Normal Ranges Units ALT 55 < 40 IU/L Uric 484 160–380 Umol/L LDH 397 110–220 IU/L serum potassium 2.82 3.5–5.5 mmol/L serum phosphorus 1.64 0.81–1.45 mmol/L Table 2 The hormonal results and functional measurements of the patient with EAS A. Hormone tests Items Results Normal Ranges Units 2016 2017 Pre-operation Post-operation ACTH 138.1 < 1 19.64 50–78 ng/L PTC-8:00 887.5 51.61 304.7 147.3–609.3 Umol/L 24 h-UFC (1) 3084.5 55.6 – 110–220 IU/L (2) 3256.0 – – GH 0.23 – – 0.126–9.88 ng/mL PRL 25.75 34.77 ND 6.0–29.9 ng/mL TSH 0.139 0.747 0.507 0.27–4.2 mU/l FT3 2.82 6.01 4.19 3.6–7.5 pmol/L FT4 13.35 14.56 15.67 12.0–22.0 pmol/L Testosterone 0.44 – – Fillicular phase 2.4–12.6 Luteal phase 1.0–11.4 IU/L DHEA-S 5.33 – – Fillicular phase 2.4–12.6 Luteal phase 3.5–12.5 IU/L LH 6.3 1.6 – Fillicular phase 1.7–7.7 Luteal phase IU/L FSH 6.3 2.0 – Fillicular phase 12.4–233 Luteal phase 22.3–341 IU/L E2 438.9 – Fillicular phase 0.2–1.5 Luteal phase 1.7–27 IU/L P 0.1 – IU/L B. 1 mg Overnight Dexamethasone Suppression Test Items Results Results Units PTC-8:00 am 985.6 304.7 nmol/L PTC-(secondary 8:00 am) 959.1 19.77 nmol/L Suppression Rate < 50 > 50 % C. High-dose Dexamethasone Suppression Test Items Results Units PTC-8:00 am 978.9 nmol/L PTC-(secondary 8:00 am) 820.3 nmol/L Suppression Rate < 50 % D. Inferior Petrosal Sinus Sampling and Desmopressin Stimulating Test ACTH IPS PV IPS/PV Ratio L (ng/L) R (ng/L) L R 0 min 233.2 1120.2 134.5 1.73 8.33 3 min 347.1 > 2000 198.7 1.75 > 10.07 5 min 307.8 1377.0 234.2 1.31 5.88 10 min 262.8 1275.0 236.7 1.11 5.39 PRL IPS PV IPS/PV Ratio L (ng/L) R (ng/L) L R 0 min 26.35 136.3 23.44 1.12 5.83 3 min 24.25 114.3 24.48 0.99 4.67 5 min 24.62 99.53 24.92 0.99 3.99 10 min 23.95 94.64 22.9 1.05 4.13 ACTH: Adrenocorticotropic Hormone, PTC: Plasma total cortisol, IPS: Inferior Petrosal Sinus, L: left, R: right, PV: peripheral vein, PRL: prolactin, IPS/PV Ratio: The ratio of the ACTH concentration inthe inferior petrosal sinus and that in simultaneously drawn peripheral venous blood IPS / PV ≥ 2 (≥ 3 post CRH) –Pituitary Cushing Syndrome(Cushing’s disease, CD) IPS / PV < 2 – Ectopic Cushing’s Synd R-PS / L-PS ≥ 1,4 – Lateralization Fig. 1 The image profiles of the EAS patient. a Pre - operational sellar region MRI shows normal pituitary but orbital mass around lateral rectus muscle of the patient’s left eye. b Pre - operational orbital MRI displays a tumorous lesion around lateral rectus muscle of the patient’s left eye. c Post - operational orbital MRI shows normal lateral rectus muscle of eye
4.292969
0.644531
sec[1]/p[2]
en
0.999997
32736557
https://doi.org/10.1186/s12902-020-00590-9
[ "acth", "phase", "nmol", "suppression", "sinus", "blood", "orbital", "cushing", "pituitary", "rectus" ]
[ { "code": "5A74.Y", "title": "Other specified adrenocortical insufficiency" }, { "code": "5A70.1", "title": "Ectopic ACTH syndrome" }, { "code": "5A70.Z", "title": "Cushing syndrome, unspecified" }, { "code": "5A70.Y", "title": "Other specified Cushing syndrome" }, { "code": "5A70.0", "title": "Pituitary-dependent Cushing disease" }, { "code": "JB02.0", "title": "Primary uterine inertia" }, { "code": "2B30.10&XH51K7", "title": "Classical Hodgkin lymphoma, nodular sclerosis, cellular phase" }, { "code": "7A60", "title": "Delayed sleep-wake phase disorder" }, { "code": "MD93", "title": "Dysphagia" }, { "code": "JB02.1", "title": "Secondary uterine inertia" } ]
=== ICD-11 CODES FOUND === [5A74.Y] Other specified adrenocortical insufficiency Also known as: Other specified adrenocortical insufficiency | Congenital adrenocortical insufficiency | Congenital isolated ACTH deficiency | Familial adrenal hypoplasia | Familial hypoadrenocorticism [5A70.1] Ectopic ACTH syndrome Also known as: Ectopic ACTH syndrome | Cushing syndrome secondary to ectopic ACTH-secretion | Ectopic Cushing syndrome | hypercortisolism due to nonpituitary tumour | ectopic ACTH - [adrenocorticotropic hormone] secretion [5A70.Z] Cushing syndrome, unspecified Also known as: Cushing syndrome, unspecified | Cushing syndrome | Hyperadrenocorticism | Hypercortisolism | Cushing syndrome NOS [5A70.Y] Other specified Cushing syndrome Also known as: Other specified Cushing syndrome | ACTH-dependent Cushing syndrome | ACTH-independent Cushing syndrome | ACTH-independent Cushing syndrome due to bilateral adrenocortical hyperplasia | ACTH-independent macronodular adrenal hyperplasia [5A70.0] Pituitary-dependent Cushing disease Definition: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hypercortisolism. The condition is associated with increased morbidity and mortality that can be mitigated by treatments that result in sustained endocrine remission. Transsphenoidal pituitary surgery (TSS) remains the mainstay of treatment for this disease but requires considerable neurosurgical exper Also known as: Pituitary-dependent Cushing disease | Overproduction of pituitary ACTH | Pituitary-dependent hyperadrenocorticism | Corticotroph pituitary adenoma | ACTH- [adrenocorticotropic hormone] secreting pituitary adenoma [JB02.0] Primary uterine inertia Definition: A condition affecting pregnant females characterised by insufficiently strong or inappropriately coordinated rhythmic activity of the myometrium during labour to efface and dilate the cervix. Also known as: Primary uterine inertia | Primary hypotonic uterine dysfunction | hypotonic uterine dysfunction | hypotonic uterine inertia | primary hypotonic uterine inertia Includes: Primary hypotonic uterine dysfunction | Uterine inertia during latent phase of labour | Primary inadequate contractions [7A60] Delayed sleep-wake phase disorder Definition: Delayed sleep-wake phase disorder is a recurrent pattern of disturbance of the sleep-wake schedule characterised by persistent delay in the major sleep period compared to conventional or desired sleep times. The disorder results in difficulty falling asleep and difficulty awakening at desired or required times. When sleep is allowed to occur on the delayed schedule, it is essentially normal in quality and duration. The symptoms should have persisted for at least several months and result in sign Also known as: Delayed sleep-wake phase disorder | circadian rhythm sleep-wake disorder, delayed type | delayed sleep phase syndrome Includes: delayed sleep phase syndrome [MD93] Dysphagia Definition: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the pharynx and upper oesophageal sphincter; and oesophageal dysphagia due to malfunction of the oesophagus. Also known as: Dysphagia | Difficulty in swallowing | difficulty swallowing | difficulty in swallowing NOS | swallowing problem Includes: Difficulty in swallowing Excludes: Functional swallowing disorder [JB02.1] Secondary uterine inertia Definition: A condition affecting pregnant females that is idiopathic. This condition is characterised by vigorous contractions that decrease in vigour due to exhaustion or dehydration of the individual. This condition leads to lack of labour progress. Also known as: Secondary uterine inertia | Secondary hypotonic uterine dysfunction | secondary uterine inertia during labour | secondary hypotonic dysfunction of uterus complicating delivery | secondary hypotonic labour Includes: Secondary hypotonic uterine dysfunction | Arrested active phase of labour === GRAPH WALKS === --- Walk 1 --- [5A74.Y] Other specified adrenocortical insufficiency --PARENT--> [5A74] Adrenocortical insufficiency Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg... --CHILD--> [5A74.1] Adrenal crisis Def: Adrenal crisis is a life-threatening condition that indicates severe adrenal insufficiency caused by insufficient levels of cortisol.... --- Walk 2 --- [5A74.Y] Other specified adrenocortical insufficiency --PARENT--> [5A74] Adrenocortical insufficiency Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg... --RELATED_TO--> [?] X-linked adrenoleukodystrophy Def: X-linked adrenoleukodystrophy (X-ALD) is a peroxisomal disease characterised by progressive demyelinisation of the central nervous system (CNS) (brain and/or spinal cord) and peripheral adrenal insuff... --- Walk 3 --- [5A70.1] Ectopic ACTH syndrome --PARENT--> [5A70] Cushing syndrome Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi... --PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system --- Walk 4 --- [5A70.1] Ectopic ACTH syndrome --PARENT--> [5A70] Cushing syndrome Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi... --CHILD--> [5A70.1] Ectopic ACTH syndrome --- Walk 5 --- [5A70.Z] Cushing syndrome, unspecified --PARENT--> [5A70] Cushing syndrome Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi... --CHILD--> [5A70.0] Pituitary-dependent Cushing disease Def: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hyp... --- Walk 6 --- [5A70.Z] Cushing syndrome, unspecified --PARENT--> [5A70] Cushing syndrome Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi... --CHILD--> [5A70.0] Pituitary-dependent Cushing disease Def: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hyp...
[ "[5A74.Y] Other specified adrenocortical insufficiency\n --PARENT--> [5A74] Adrenocortical insufficiency\n Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...\n --CHILD--> [5A74.1] Adrenal crisis\n Def: Adrenal crisis is a life-threatening condition that indicates severe adrenal insufficiency caused by insufficient levels of cortisol....", "[5A74.Y] Other specified adrenocortical insufficiency\n --PARENT--> [5A74] Adrenocortical insufficiency\n Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...\n --RELATED_TO--> [?] X-linked adrenoleukodystrophy\n Def: X-linked adrenoleukodystrophy (X-ALD) is a peroxisomal disease characterised by progressive demyelinisation of the central nervous system (CNS) (brain and/or spinal cord) and peripheral adrenal insuff...", "[5A70.1] Ectopic ACTH syndrome\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system", "[5A70.1] Ectopic ACTH syndrome\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --CHILD--> [5A70.1] Ectopic ACTH syndrome", "[5A70.Z] Cushing syndrome, unspecified\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --CHILD--> [5A70.0] Pituitary-dependent Cushing disease\n Def: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hyp...", "[5A70.Z] Cushing syndrome, unspecified\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --CHILD--> [5A70.0] Pituitary-dependent Cushing disease\n Def: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hyp..." ]
5A74.Y
Other specified adrenocortical insufficiency
[ { "from_icd11": "5A70.1", "icd10_code": "E243", "icd10_title": "Ectopic ACTH syndrome" }, { "from_icd11": "5A70.Z", "icd10_code": "E242", "icd10_title": "Drug-induced Cushing's syndrome" }, { "from_icd11": "5A70.Z", "icd10_code": "E249", "icd10_title": "Cushing's syndrome, unspecified" }, { "from_icd11": "5A70.Z", "icd10_code": "E248", "icd10_title": "Other Cushing's syndrome" }, { "from_icd11": "5A70.Z", "icd10_code": "E24", "icd10_title": "Cushing's syndrome" }, { "from_icd11": "5A70.0", "icd10_code": "E240", "icd10_title": "Pituitary-dependent Cushing's disease" }, { "from_icd11": "JB02.0", "icd10_code": "O620", "icd10_title": "Primary inadequate contractions" }, { "from_icd11": "MD93", "icd10_code": "R1312", "icd10_title": "Dysphagia, oropharyngeal phase" }, { "from_icd11": "MD93", "icd10_code": "R1319", "icd10_title": "Other dysphagia" }, { "from_icd11": "MD93", "icd10_code": "R1313", "icd10_title": "Dysphagia, pharyngeal phase" }, { "from_icd11": "MD93", "icd10_code": "R1314", "icd10_title": "Dysphagia, pharyngoesophageal phase" }, { "from_icd11": "MD93", "icd10_code": "R1311", "icd10_title": "Dysphagia, oral phase" }, { "from_icd11": "MD93", "icd10_code": "R130", "icd10_title": "Aphagia" }, { "from_icd11": "MD93", "icd10_code": "R1310", "icd10_title": "Dysphagia, unspecified" }, { "from_icd11": "MD93", "icd10_code": "R13", "icd10_title": "Aphagia and dysphagia" } ]
E243
Ectopic ACTH syndrome
A 77-year-old female patient was admitted to our hospital on 19 March 2024 with chief complaints of dysphoria and unfavorable speech that had been present for more than 1 month. Although the symptoms were intermittent, they were persistently worsening and accompanied by occasional headaches. The patient had a history of a cerebral infarction. A cranial MRI conducted in 2021 did not reveal any obvious signs of an intracranial tumor. On admission, a physical examination revealed Glasgow Coma Scale (GCS) score of 11, incomplete motor aphasia, bilateral ocular collapse, unresisted neck, voluntary movement of the left limbs, and decreased muscle tone in the right limbs, with a muscle strength of grade 0. Laboratory tests, including electrocardiogram and routine blood and urine tests, yielded results within the normal ranges. A cranial MRI revealed a large occupying lesion (12.9×9.1×6.1 cm3) in the left cerebral hemisphere, invading the superior sagittal sinus in the right intracranial area. Multiple tortuous and increased vascular shadows were also observed in the vicinity of the lesion. A diffusion tensor imaging examination revealed that the projecting nerve bundles in the left frontal-parietal lobe and corpus callosum area showed partial atrophy compared with those on the contralateral side, with local irregularities suggestive of damage caused by tumor infiltration. The preoperative examination revealed a robust blood supply to the tumor, accompanied by diminished visualization of the left internal carotid artery system. Cerebral angiography was planned to identify any cerebral vascular lesions and the blood supply to the tumor. This was scheduled to be followed by a craniotomy at a later stage. The patient underwent the cerebral angiography under general anesthesia with embolization of the artery supplying blood to the tumor. Postoperative medications were administered to prevent complications, such as reduced intracranial pressure, and provide neuroprotection and symptomatic support. On postoperative day 6, the patient underwent fluorescein sodium labeling microscopy under general anesthesia to evaluate the extent of the resection in the left frontoparietal lobe. During this procedure, the tumor was visualized by sodium fluorescein via the frontotemporal-parietal approach over the midline . A tumor measuring approximately 13×11×6 cm3 was successfully resected , with the bilateral anterior cerebral arteries being well-protected and uninjured. Intraoperative dynamic monitoring of blood gas analysis revealed transfusion requirements for 11 units, 500 mL of plasma, and 10 units of cold precipitation. The patient’s intraoperative blood pressure and heart rate remained stable, the anesthesia was effective, and the patient was transferred back to the neurosurgical intensive care unit under anesthesia. The postoperative pathological examination revealed a giant atypical meningioma (WHO grade 2). A review of the postoperative cranial MRI revealed complete resection of the tumor . On postoperative day 3, the patient had a GCS score of 9 and was able to perform simple verbal communication, with intermittent handshake movements in the left upper limb, grade III muscle strength in the left lower limb, and stimulation of the right lower limb with slight flexion. On postoperative day 7, the patient developed a fever that reached 39°C. A lumbar puncture was performed, and the cerebrospinal fluid culture revealed staphylococcus capitatus, indicating an intracranial infection. Meanwhile, the lung infection showed signs of worsening, and the patient was initiated on an escalating antibiotic regimen, comprising intravenous vancomycin 1 g every 12 hours and meropenem 0.5 g every 8 hours. Subsequently, the patient exhibited a rash, prompting the cessation of vancomycin and initiation of oral linezolid therapy. On postoperative day 12, the patient’s condition was characterized by severe intermittent fever, lethargy, and grade IV muscle strength in the left limbs. The left upper limb exhibited partial compliance with movement. The muscle strength of the right upper limb was classified as grade I, while that of the right lower limb was classified as grade III. After receiving the family’s consent, lumbar large-pool tube drainage was initiated. By postoperative day 20, the patient’s condition had stabilized, with no further fever and a smooth course of lumbar large-pool drainage. By postoperative day 48, the patient had made a full recovery. Her mental status was clear, her spirits were high, and her GCS score was 15. The muscle strength of the left limbs was classified as grade V-, the muscle strength of the right upper limb was classified as grade III (her muscle strength after the previous cerebral infarction was classified as grade III), and the muscle strength of the right lower limb was classified as grade IV. The patient had a right Babinski sign of (±). The patient was discharged with instructions to continue rehabilitation, supplemented by radiation therapy.
3.972656
0.976563
sec[1]/p[0]
en
0.999997
PMC11659279
https://doi.org/10.3389/fonc.2024.1506297
[ "grade", "muscle", "postoperative", "tumor", "strength", "limb", "cerebral", "blood", "classified", "that" ]
[ { "code": "EH90.Z", "title": "Pressure ulcer of unspecified grade" }, { "code": "EH90.0", "title": "Pressure ulceration grade 1" }, { "code": "GA91.6", "title": "Low grade intraepithelial lesion of prostate" }, { "code": "2E67.22", "title": "High grade squamous intraepithelial lesion of vagina" }, { "code": "EH90.1", "title": "Pressure ulceration grade 2" }, { "code": "FB3Z", "title": "Disorders of muscles, unspecified" }, { "code": "FB32.Y", "title": "Other specified disorders of muscles" }, { "code": "8C70.Z", "title": "Muscular dystrophy, unspecified" }, { "code": "FB32.2Z", "title": "Ischaemic infarction of muscle, unspecified" }, { "code": "FB56.2", "title": "Myalgia" } ]
=== ICD-11 CODES FOUND === [EH90.Z] Pressure ulcer of unspecified grade Also known as: Pressure ulcer of unspecified grade | Pressure ulceration | pressure injury | pressure ulcer | decubitus ulcer [EH90.0] Pressure ulceration grade 1 Definition: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful, firm, soft, warmer or cooler as compared to adjacent tissue. It can be difficult to detect in individuals with dark skin but affected areas may differ in colour from the surrounding skin. The presence of pressure ulceration grade 1 may indicate persons at risk of progressing to frank ulceration. Also known as: Pressure ulceration grade 1 | pressure injury stage 1 | pressure injury stage 1 with nonblanchable erythema | pressure ulcer category 1 | stage I pressure injury Includes: pressure injury stage 1 with nonblanchable erythema [GA91.6] Low grade intraepithelial lesion of prostate Definition: A condition of the prostate, caused by an alteration or mutation in cell growth, or prostatic epithelial cells that are dividing more rapidly than normal epithelium. This condition is characterised by premalignant transformation and abnormal development of the prostatic epithelial tissue. Also known as: Low grade intraepithelial lesion of prostate | Low grade PIN - [prostatic intraepithelial neoplasia] | Low grade prostatic intraepithelial neoplasia | PIN - [prostatic intraepithelial neoplasia] grade 1 to 2 | Low grade dysplasia of prostate Includes: Low grade prostatic intraepithelial neoplasia Excludes: high grade dysplasia of prostate | PIN III | high grade PIN [2E67.22] High grade squamous intraepithelial lesion of vagina Also known as: High grade squamous intraepithelial lesion of vagina | vaginal intraepithelial neoplasia grade II | moderate vaginal dysplasia | vaginal intraepithelial neoplasia grade 2 | VaIN - [vaginal intraepithelial neoplasia] grade 2 [EH90.1] Pressure ulceration grade 2 Definition: Pressure injury with partial thickness loss of dermis. It presents as a shallow open ulcer with a red or pink wound bed without slough or as a serum-filled or serosanguinous blister which may rupture. This category should not be used to describe skin tears, tape burns, incontinence associated dermatitis, maceration or excoriation Also known as: Pressure ulceration grade 2 | bedsore stage II | pressure injury stage 2 | pressure ulcer category 2 | pressure injury stage 2 with partial thickness skin loss Includes: pressure injury stage 2 with partial thickness skin loss [FB3Z] Disorders of muscles, unspecified Also known as: Disorders of muscles, unspecified | disorder of muscle, unspecified | muscle disease | muscular disease | muscular disorder [FB32.Y] Other specified disorders of muscles Also known as: Other specified disorders of muscles | Muscle wasting or atrophy, not elsewhere classified | muscle wasting | muscle wasting disorder | Sarcopenia [8C70.Z] Muscular dystrophy, unspecified Also known as: Muscular dystrophy, unspecified | Muscular dystrophy | Gower's muscular dystrophy | progressive musclular dystrophy | pseudohypertrophic atrophy [FB32.2Z] Ischaemic infarction of muscle, unspecified Also known as: Ischaemic infarction of muscle, unspecified | Ischaemic infarction of muscle | muscle infarction [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain === GRAPH WALKS === --- Walk 1 --- [EH90.Z] Pressure ulcer of unspecified grade --PARENT--> [EH90] Pressure ulceration Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th... --CHILD--> [EH90.0] Pressure ulceration grade 1 Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,... --- Walk 2 --- [EH90.Z] Pressure ulcer of unspecified grade --PARENT--> [EH90] Pressure ulceration Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th... --CHILD--> [EH90.1] Pressure ulceration grade 2 Def: Pressure injury with partial thickness loss of dermis. It presents as a shallow open ulcer with a red or pink wound bed without slough or as a serum-filled or serosanguinous blister which may rupture.... --- Walk 3 --- [EH90.0] Pressure ulceration grade 1 Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,... --PARENT--> [EH90] Pressure ulceration Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th... --CHILD--> [EH90.0] Pressure ulceration grade 1 Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,... --- Walk 4 --- [EH90.0] Pressure ulceration grade 1 Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,... --PARENT--> [EH90] Pressure ulceration Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th... --EXCLUDES--> [?] Erosion or ectropion of cervix uteri Def: A condition of the cervix uteri, caused by an increase in the total estrogen level in the body. This condition is characterised by protrusion and transformation of the endocervical columnar epithelium... --- Walk 5 --- [GA91.6] Low grade intraepithelial lesion of prostate Def: A condition of the prostate, caused by an alteration or mutation in cell growth, or prostatic epithelial cells that are dividing more rapidly than normal epithelium. This condition is characterised by... --EXCLUDES--> [?] High grade intraepithelial lesion of prostate Def: High grade prostatic intraepithelial neoplasia characterised by the presence of severe architectural and cytologic abnormalities.... --PARENT--> [?] Neoplasms of the male genital organs --- Walk 6 --- [GA91.6] Low grade intraepithelial lesion of prostate Def: A condition of the prostate, caused by an alteration or mutation in cell growth, or prostatic epithelial cells that are dividing more rapidly than normal epithelium. This condition is characterised by... --EXCLUDES--> [?] High grade intraepithelial lesion of prostate Def: High grade prostatic intraepithelial neoplasia characterised by the presence of severe architectural and cytologic abnormalities.... --PARENT--> [?] Neoplasms of the male genital organs
[ "[EH90.Z] Pressure ulcer of unspecified grade\n --PARENT--> [EH90] Pressure ulceration\n Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...\n --CHILD--> [EH90.0] Pressure ulceration grade 1\n Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,...", "[EH90.Z] Pressure ulcer of unspecified grade\n --PARENT--> [EH90] Pressure ulceration\n Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...\n --CHILD--> [EH90.1] Pressure ulceration grade 2\n Def: Pressure injury with partial thickness loss of dermis. It presents as a shallow open ulcer with a red or pink wound bed without slough or as a serum-filled or serosanguinous blister which may rupture....", "[EH90.0] Pressure ulceration grade 1\n Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,...\n --PARENT--> [EH90] Pressure ulceration\n Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...\n --CHILD--> [EH90.0] Pressure ulceration grade 1\n Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,...", "[EH90.0] Pressure ulceration grade 1\n Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,...\n --PARENT--> [EH90] Pressure ulceration\n Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...\n --EXCLUDES--> [?] Erosion or ectropion of cervix uteri\n Def: A condition of the cervix uteri, caused by an increase in the total estrogen level in the body. This condition is characterised by protrusion and transformation of the endocervical columnar epithelium...", "[GA91.6] Low grade intraepithelial lesion of prostate\n Def: A condition of the prostate, caused by an alteration or mutation in cell growth, or prostatic epithelial cells that are dividing more rapidly than normal epithelium. This condition is characterised by...\n --EXCLUDES--> [?] High grade intraepithelial lesion of prostate\n Def: High grade prostatic intraepithelial neoplasia characterised by the presence of severe architectural and cytologic abnormalities....\n --PARENT--> [?] Neoplasms of the male genital organs", "[GA91.6] Low grade intraepithelial lesion of prostate\n Def: A condition of the prostate, caused by an alteration or mutation in cell growth, or prostatic epithelial cells that are dividing more rapidly than normal epithelium. This condition is characterised by...\n --EXCLUDES--> [?] High grade intraepithelial lesion of prostate\n Def: High grade prostatic intraepithelial neoplasia characterised by the presence of severe architectural and cytologic abnormalities....\n --PARENT--> [?] Neoplasms of the male genital organs" ]
EH90.Z
Pressure ulcer of unspecified grade
[ { "from_icd11": "EH90.Z", "icd10_code": "L89623", "icd10_title": "Pressure ulcer of left heel, stage 3" }, { "from_icd11": "EH90.Z", "icd10_code": "L89621", "icd10_title": "Pressure ulcer of left heel, stage 1" }, { "from_icd11": "EH90.Z", "icd10_code": "L89899", "icd10_title": "Pressure ulcer of other site, unspecified stage" }, { "from_icd11": "EH90.Z", "icd10_code": "L89620", "icd10_title": "Pressure ulcer of left heel, unstageable" }, { "from_icd11": "EH90.Z", "icd10_code": "L89622", "icd10_title": "Pressure ulcer of left heel, stage 2" }, { "from_icd11": "EH90.Z", "icd10_code": "L89892", "icd10_title": "Pressure ulcer of other site, stage 2" }, { "from_icd11": "EH90.Z", "icd10_code": "L89519", "icd10_title": "Pressure ulcer of right ankle, unspecified stage" }, { "from_icd11": "EH90.Z", "icd10_code": "L89891", "icd10_title": "Pressure ulcer of other site, stage 1" }, { "from_icd11": "EH90.Z", "icd10_code": "L89610", "icd10_title": "Pressure ulcer of right heel, unstageable" }, { "from_icd11": "EH90.Z", "icd10_code": "L89893", "icd10_title": "Pressure ulcer of other site, stage 3" }, { "from_icd11": "EH90.Z", "icd10_code": "L89890", "icd10_title": "Pressure ulcer of other site, unstageable" }, { "from_icd11": "EH90.Z", "icd10_code": "L89629", "icd10_title": "Pressure ulcer of left heel, unspecified stage" }, { "from_icd11": "EH90.Z", "icd10_code": "L89619", "icd10_title": "Pressure ulcer of right heel, unspecified stage" }, { "from_icd11": "EH90.Z", "icd10_code": "L8945", "icd10_title": "Pressure ulcer of contiguous site of back, buttock and hip, unstageable" }, { "from_icd11": "EH90.Z", "icd10_code": "L89894", "icd10_title": "Pressure ulcer of other site, stage 4" } ]
L89623
Pressure ulcer of left heel, stage 3
After 1 month of initial episodes, he developed reduced self-care, a lack of interest of work in which he was interested before the illness. He found it difficult to work as a technical officer due to low energy, lethargy, poor concentration and reduced memory. He was withdrawn at times and was less communicative. He endorsed poor sleep and had a low mood. His condition deteriorated over the next 2 weeks and developed episodic inappropriate talking, confusion, generalized rigidity of the body and urinary and fecal incontinence. He was unable to identify his family members and developed reduced level of consciousness. He was admitted to the THP 7 weeks after the initial incidence. On admission to the THP, he was haemodynamically stable with blood pressure of 140/90. On neurological examination, he was drowsy with GCS of 11/12 (E3, V3, M5). Pupils were normal in size and well reacting to light, both optic fundi were normal, and all cranial nerves were normal. He had generalized rigidity with hyperreflexia and bilateral extensor plantar response. He gradually developed masklike face, positive glabella sign and primitive reflexes (grasp reflex). Mini-Mental State Examination (MMSE) was unable to take because of his demented status. His full blood count, blood picture, ESR, CRP, serum magnesium and calcium levels, liver and renal profiles were normal (Table 1 ). He had normal electrocardiogram with normal 2D echocardiogram and troponin I was negative. His EEG showed marked generalized slowing of background with multifocal high amplitude waves and delta waves suggestive gross cerebral dysfunction without epileptiform discharges . Non contrast computer tomography (CT) of brain showed prominent cerebral white matter with obliterated sulci with preserved gray-white demarcation and normal ventricular system with no evidence of intra cerebral haemorrhage . His cerebrospinal fluid (CSF) report was normal and CSF was negative for both bacterial studies (light microscopy examination and culture) and viral studies (HSV/Entero/Flavi). The MRI brain showed diffuse high signal intensity involving subcortical white matter, globus pallidus on FLAIR and T2W images . These areas showed high signals in DWI images with no significant changes appreciated on ADC map . There was no abnormal contrast enhancement appreciated in the above areas. Rest of the cerebral hemisphere, ventricular system, brain stem and cerebellum were normal. While investigating this patient (index case) we came to know that another person (2nd case), who did a night duty with our patient and slept in the same room, also had been admitted with our patient to the same local hospital with the initial incidence. He (2nd case) too has experienced vomiting, diarrhoea, faintishness and unsteady gait, but no changing sensorium. On admission to local hospital his (2nd case) unsteady gait improved, and he had vomiting and few more episodes of diarrhoea. He was totally normal on next day and was discharged from the hospital with a diagnosis of food poisoning. Since then he was asymptomatic. Table 1 Laboratory investigations and Chest radiograph during stay in two hospitals (Local and Teaching Hospital Peradeniya) At 1st presentation to local hospital At 2nd presentation to THP Reference value Day 1 Day 2 Day 3 Day 5 Day 8 Day 12 Day 14 White blood cell 10 9.8 – 10.47 11.5 15.8 16.3 14.5 4–10 10 3 /uL Haemoglobin 15.7 15 – 15.5 15 14.3 13.2 13.1 11–16 g/dl Platelets 291 200 – 154 160 200 130 138 150–450 10 3 /uL AST 44 – 44 – – – 70 45 0–40 umol/l ALT 35 – 28 – – – 51 41 0–40 umol/l Serum creatinine 99 88 – 102 107 – 108 122 59–104 umol/l C-reactive protein 5.1 – 5.5 – 9.0 – 20 18 0–10 mg/l Erythrocyte sedimentation rate mm 1 st hr 5 – 9 – 6 – – – 3–13 mm Serum sodium 140 144 138 140 142 – 145 148 135–145 mmol/l Serum potassium 4.6 4.05 4.57 4.7 4.1 – 4.3 4.2 3.6–5 mmol/l Serum calcium 2.33 2.4 – 2.4 – – – 2.2–2.6 mmol/l Serum magnesium – – 0.89 – 1.04 – – – 0.73–1.06 mmol/l CSF analysis – Appearance-Colorless transparent; CSF protein 34 (15–45 mg/dl); WBC 1 (100%Lymp (0–5 Cu mm)); CSF glucose-3.2 mmol/l (Random blood sugar 5.1); CSF viral studies (HSV/Entero/flavi), Mycobacterium tuberculosis smear (Acid-fast stain), CSF Culture: all negative Chest X-ray – Normal – – – Right upper and middle lobe opacities AST Aspartate aminotransferase, ALT Alanine aminotransferase, CSF cerebrospinal fluid, WBC white blood cells, HSV Herpes simplex virus Fig. 1 EEG shows grossly irregular back ground rhythm with spikes, sharp waves and slow waves with paroxysmal discharge Fig. 2 Non contrast computer tomography (CT) of the brain showing prominent cerebral white matter with obliterated sulci Fig. 3 MRI brain shows diffuse high signal intensity involving subcortical white matter, globus pallidus on FLAIR images. Rest of the cerebral hemisphere and ventricular system were normal Fig. 4 MRI brain showing high signals in DWI images with no significant changes appreciated on ADC map in subcortical white matter, globus pallidus
3.933594
0.980957
sec[1]/p[1]
en
0.999997
30953563
https://doi.org/10.1186/s40360-019-0295-9
[ "white", "blood", "serum", "cerebral", "brain", "matter", "mmol", "waves", "local", "contrast" ]
[ { "code": "EF5Y", "title": "Other specified dermatoses attributable to hyperviscosity or microvascular occlusion" }, { "code": "JB41.1", "title": "Deep phlebothrombosis in the puerperium" }, { "code": "EB60.Y", "title": "Lichen sclerosus of other specified sites" }, { "code": "MC80.00", "title": "White coat hypertension" }, { "code": "1F2D.2", "title": "White piedra" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" } ]
=== ICD-11 CODES FOUND === [EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion Also known as: Other specified dermatoses attributable to hyperviscosity or microvascular occlusion | Cutaneous microvascular occlusion by platelet plugs | Cutaneous microvascular disturbances due to myeloproliferative disorder-associated platelet plugs | Cutaneous microvascular disturbances due to paroxysmal nocturnal haemoglobinuria-associated platelet plugs | Cutaneous microvascular occlusion by emboli [JB41.1] Deep phlebothrombosis in the puerperium Also known as: Deep phlebothrombosis in the puerperium | postnatal deep vein thrombosis | postpartum deep phlebothrombosis | postpartum deep-vein thrombosis | DVT - [deep venous thrombosis] postnatal [EB60.Y] Lichen sclerosus of other specified sites Also known as: Lichen sclerosus of other specified sites | Extragenital lichen sclerosus | Guttate lichen sclerosus | White spot disease | Guttate scleroderma [MC80.00] White coat hypertension Definition: Persistently elevated office blood pressure readings with persistently normal out-of-the-office readings. Also known as: White coat hypertension | white coat syndrome [1F2D.2] White piedra Definition: A disease of the hair shaft, caused by an infection with the fungi Trichosporon beigelii. This disease is characterised by irregular, soft, white, or light brown nodules which adhere to the hair follicle. Transmission is by direct contact with contaminated soil or water, or by airborne transmission. Confirmation is by identification of Trichosporon beigelii in a hair follicle sample. Also known as: White piedra | Trichosporosis nodosa Includes: Trichosporosis nodosa [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood === GRAPH WALKS === --- Walk 1 --- [EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion --PARENT--> [?] Dermatoses attributable to hyperviscosity or microvascular occlusion Def: A range of disorders characterised by vascular occlusion but attributable not to primary vascular inflammation but to intravascular occlusion.... --RELATED_TO--> [?] Thrombotic thrombocytopenic purpura Def: This condition is idiopathic. This condition is characterised by abnormality of blood coagulation causing extensive microscopic clots to form in the small blood vessels throughout the body resulting i... --- Walk 2 --- [EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion --PARENT--> [?] Dermatoses attributable to hyperviscosity or microvascular occlusion Def: A range of disorders characterised by vascular occlusion but attributable not to primary vascular inflammation but to intravascular occlusion.... --CHILD--> [EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion --- Walk 3 --- [JB41.1] Deep phlebothrombosis in the puerperium --PARENT--> [JB41] Venous complications in the puerperium --CHILD--> [JB41.1] Deep phlebothrombosis in the puerperium --- Walk 4 --- [JB41.1] Deep phlebothrombosis in the puerperium --PARENT--> [JB41] Venous complications in the puerperium --CHILD--> [JB41.2] Haemorrhoids in the puerperium --- Walk 5 --- [EB60.Y] Lichen sclerosus of other specified sites --PARENT--> [EB60] Lichen sclerosus Def: Lichen sclerosus is a chronic inflammatory dermatosis of unknown aetiology. It affects both women and men of all ages. It is characterised by the development of white, smooth, atrophic plaques on vulv... --CHILD--> [EB60.0] Lichen sclerosus of vulva Def: Lichen sclerosus of the vulva is an inflammatory disorder of unknown aetiology affecting the skin of the vulva and perianal area. Typically it affects women in the fifth and sixth decades of life thou... --- Walk 6 --- [EB60.Y] Lichen sclerosus of other specified sites --PARENT--> [EB60] Lichen sclerosus Def: Lichen sclerosus is a chronic inflammatory dermatosis of unknown aetiology. It affects both women and men of all ages. It is characterised by the development of white, smooth, atrophic plaques on vulv... --CHILD--> [EB60.0] Lichen sclerosus of vulva Def: Lichen sclerosus of the vulva is an inflammatory disorder of unknown aetiology affecting the skin of the vulva and perianal area. Typically it affects women in the fifth and sixth decades of life thou...
[ "[EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion\n --PARENT--> [?] Dermatoses attributable to hyperviscosity or microvascular occlusion\n Def: A range of disorders characterised by vascular occlusion but attributable not to primary vascular inflammation but to intravascular occlusion....\n --RELATED_TO--> [?] Thrombotic thrombocytopenic purpura\n Def: This condition is idiopathic. This condition is characterised by abnormality of blood coagulation causing extensive microscopic clots to form in the small blood vessels throughout the body resulting i...", "[EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion\n --PARENT--> [?] Dermatoses attributable to hyperviscosity or microvascular occlusion\n Def: A range of disorders characterised by vascular occlusion but attributable not to primary vascular inflammation but to intravascular occlusion....\n --CHILD--> [EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion", "[JB41.1] Deep phlebothrombosis in the puerperium\n --PARENT--> [JB41] Venous complications in the puerperium\n --CHILD--> [JB41.1] Deep phlebothrombosis in the puerperium", "[JB41.1] Deep phlebothrombosis in the puerperium\n --PARENT--> [JB41] Venous complications in the puerperium\n --CHILD--> [JB41.2] Haemorrhoids in the puerperium", "[EB60.Y] Lichen sclerosus of other specified sites\n --PARENT--> [EB60] Lichen sclerosus\n Def: Lichen sclerosus is a chronic inflammatory dermatosis of unknown aetiology. It affects both women and men of all ages. It is characterised by the development of white, smooth, atrophic plaques on vulv...\n --CHILD--> [EB60.0] Lichen sclerosus of vulva\n Def: Lichen sclerosus of the vulva is an inflammatory disorder of unknown aetiology affecting the skin of the vulva and perianal area. Typically it affects women in the fifth and sixth decades of life thou...", "[EB60.Y] Lichen sclerosus of other specified sites\n --PARENT--> [EB60] Lichen sclerosus\n Def: Lichen sclerosus is a chronic inflammatory dermatosis of unknown aetiology. It affects both women and men of all ages. It is characterised by the development of white, smooth, atrophic plaques on vulv...\n --CHILD--> [EB60.0] Lichen sclerosus of vulva\n Def: Lichen sclerosus of the vulva is an inflammatory disorder of unknown aetiology affecting the skin of the vulva and perianal area. Typically it affects women in the fifth and sixth decades of life thou..." ]
EF5Y
Other specified dermatoses attributable to hyperviscosity or microvascular occlusion
[ { "from_icd11": "JB41.1", "icd10_code": "O871", "icd10_title": "Deep phlebothrombosis in the puerperium" }, { "from_icd11": "1F2D.2", "icd10_code": "B362", "icd10_title": "White piedra" }, { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" } ]
O871
Deep phlebothrombosis in the puerperium
A 63-year-old man with a deep vein thrombosis diagnosed 5 days prior, presented with fever, tachycardia, and nausea/vomiting. The patient had a past medical history of cerebrovascular accident 9 years prior with residual left-sided weakness, epilepsy, hypertension, and hyperlipidemia. The patient denied smoking, alcohol, or drug use. The patient was transferred from an acute rehab center where a left lower extremity deep vein thrombosis had been found on ultrasound 5 days prior, and anticoagulation started. He was bridged from enoxaparin to oral warfarin. Initial laboratories were as follows: white blood cell count 12,600/mL 3 , hemoglobin 14.0 g/dL, platelet 302,000/mL 3 , total bilirubin 2.1 mg/dL, aspartate aminotransferase 68 IU/L, alanine aminotransferase 56 IU/L, prothrombin time 20.3 seconds, international normalized ratio (INR) 1.95, albumin 3.1, fibrin degradation products > 10 and < 40, blood urea nitrogen 14, and serum creatinine 0.83. Initial physical exam showed left lower lobe decreased breath sounds, and an unremarkable abdominal exam. At that time, the patient denied any pain, current nausea/vomiting, shortness of breath, constipation, or diarrhea. Chest X-ray suggested consolidation in the left lower lobe. The decision was made to admit the patient as he met the criteria for systemic inflammatory response syndrome, possibly due to a left lower lobe pneumonia versus pulmonary embolism. For further evaluation, a chest computed tomography (CT) scan was ordered. While the CT scan showed no evidence of pulmonary embolism or pneumonia, it did incidentally reveal a distended appearance to the gallbladder . Ultrasound showed distended gallbladder with a heterogeneous mixture of intermediate and low echogenic material with no evidence of stones, which was concerning for possible pus or hemorrhage. Liver was of normal size and echogenicity. Patient was started on ceftazidime, clindamycin, and vancomycin empirically for systemic inflammatory response syndrome/sepsis. The patient was initially ruled out as a surgical candidate due to his elevated INR, and given his extensive deep vein thrombosis, it was felt that the risk of stopping anticoagulation outweighed the benefits and he was recommended for interventional radiology (IR)-guided cholecystostomy. Repeat physical exam on hospital day #2 revealed a firm, tender right upper quadrant of the abdomen, with all other quadrants being soft and nontender. The patient's INR spiked to 6.28 on hospital day #2 and his hemoglobin dropped to 9.8 g/dL. This elevation of his INR was attributed to his continued anticoagulation, which was subsequently discontinued. INR on hospital day #3 was 4.53, and 4.94 on hospital day #4, at which point vitamin K and fresh frozen plasma were administered. INR improved to 1.69 on hospital day #5. IR-guided cholecystostomy was attempted on hospital day #4. The decision to proceed with an IR-guided approach had been made earlier as it was felt he was at high risk for surgery and septic. However, there was an organized clot with no drainable material and subsequently no drain left in place. An inferior vena cava filter was placed on hospital day #8. The family and patient had also up to this point refused surgery due to his history of stroke, do not resuscitate/do not intubate status, and their perceived risk of surgery. However, they eventually agreed to have surgery. On hospital day #11, laparoscopic cholecystectomy was performed, and revealed dense adhesions surrounding the gallbladder including the omentum and bowel. These adhesions were taken down to reveal a very large distended gallbladder with areas of necrosis and perforation. The contents of the gallbladder contained approximately 1,000 cubic centimeters of old clot which had perforated near the infundibulum with clot extending out into Morison's pouch and the right upper quadrant causing dense adhesions to the liver. The gallbladder was freed from these adhesions and the clot was removed. The gallbladder was dissected and freed from surrounding adhesions. The cystic duct was secured with a “PDS Endoloop” made by Ethicon. During the course of the operation, patient experienced significant bleeding and required four units of packed red blood cells. The operation was converted to an open cholecystectomy to obtain hemostasis, and a Jackson-Pratt drain was left in place. Pathology of the gallbladder specimen showed extensive hemorrhage, acute inflammation, and necrosis. Pathology of a liver specimen showed moderate fibrosis, which was suggestive of cirrhosis. However, hepatitis serology was all negative, and ultrasound of the liver showed a liver of normal size and echogenicity. No other investigation showed signs of chronic liver disease. Patient had one episode of bleeding from his drain which required transfusion, but the remainder of his hospital course was otherwise uneventful. The patient was considered too high risk for further anticoagulation and was discharged with an inferior vena cava filter in place.
3.791016
0.981445
sec[0]/p[0]
en
0.999997
29922722
https://doi.org/10.1055/s-0038-1660450
[ "gallbladder", "which", "liver", "adhesions", "anticoagulation", "risk", "clot", "vein", "thrombosis", "ultrasound" ]
[ { "code": "DC12.Z", "title": "Cholecystitis, unspecified" }, { "code": "DC10.01", "title": "Obstruction of gall bladder" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "ME24.35&XA8KL9", "title": "Perforation of gallbladder" }, { "code": "DC10.2", "title": "Fistula of gallbladder or bile duct" }, { "code": "BD50.41", "title": "Abdominal aortic aneurysm with rupture" }, { "code": "EK91", "title": "Dermatoses which may presage cutaneous lymphoma" }, { "code": "MH12.1", "title": "Death occurring less than 24 hours from onset of symptoms, not otherwise explained" }, { "code": "8A44.3", "title": "Certain specified leukodystrophies" }, { "code": "DB9Z", "title": "Diseases of liver, unspecified" } ]
=== ICD-11 CODES FOUND === [DC12.Z] Cholecystitis, unspecified Also known as: Cholecystitis, unspecified | Cholecystitis | gallbladder inflammation [DC10.01] Obstruction of gall bladder Also known as: Obstruction of gall bladder | obstruction of gallbladder | gallbladder obstruction | Constriction of gallbladder | gallbladder constriction [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [DC10.2] Fistula of gallbladder or bile duct Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs. Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula [BD50.41] Abdominal aortic aneurysm with rupture Also known as: Abdominal aortic aneurysm with rupture | abdominal aorta aneurysm rupture | abdominal aorta aneurysm ruptured | abdominal aortic aneurysm which has ruptured | ruptured AAA [EK91] Dermatoses which may presage cutaneous lymphoma Definition: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature. Also known as: Dermatoses which may presage cutaneous lymphoma [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained Also known as: Death occurring less than 24 hours from onset of symptoms, not otherwise explained | died without sign of disease | Death known not to be violent or instantaneous for which no cause can be discovered | death known not to be violent or instantaneous, cause unknown | Death without sign of disease Includes: Death known not to be violent or instantaneous for which no cause can be discovered | Death without sign of disease [8A44.3] Certain specified leukodystrophies Also known as: Certain specified leukodystrophies | CACH syndrome | Vanishing white matter disease | Childhood ataxia with central nervous system hypomyelination | Congenital or early infantile CACH syndrome [DB9Z] Diseases of liver, unspecified Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy === GRAPH WALKS === --- Walk 1 --- [DC12.Z] Cholecystitis, unspecified --PARENT--> [DC12] Cholecystitis Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders.... --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --- Walk 2 --- [DC12.Z] Cholecystitis, unspecified --PARENT--> [DC12] Cholecystitis Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders.... --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --- Walk 3 --- [DC10.01] Obstruction of gall bladder --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --CHILD--> [DC10.00] Obstruction of cystic duct --- Walk 4 --- [DC10.01] Obstruction of gall bladder --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --CHILD--> [DC10.00] Obstruction of cystic duct --- Walk 5 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --EXCLUDES--> [?] Postsurgical asplenia Def: A disease caused by underlying diseases, splenectomy or splenic rupture from trauma. This disease is characterised by absence of normal spleen function. This disease may present with increased suscept... --- Walk 6 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --CHILD--> [QF01.0] Acquired absence of breast
[ "[DC12.Z] Cholecystitis, unspecified\n --PARENT--> [DC12] Cholecystitis\n Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...", "[DC12.Z] Cholecystitis, unspecified\n --PARENT--> [DC12] Cholecystitis\n Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...", "[DC10.01] Obstruction of gall bladder\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --CHILD--> [DC10.00] Obstruction of cystic duct", "[DC10.01] Obstruction of gall bladder\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --CHILD--> [DC10.00] Obstruction of cystic duct", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --EXCLUDES--> [?] Postsurgical asplenia\n Def: A disease caused by underlying diseases, splenectomy or splenic rupture from trauma. This disease is characterised by absence of normal spleen function. This disease may present with increased suscept...", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --CHILD--> [QF01.0] Acquired absence of breast" ]
DC12.Z
Cholecystitis, unspecified
[ { "from_icd11": "DC12.Z", "icd10_code": "K812", "icd10_title": "Acute cholecystitis with chronic cholecystitis" }, { "from_icd11": "DC12.Z", "icd10_code": "K819", "icd10_title": "Cholecystitis, unspecified" }, { "from_icd11": "DC12.Z", "icd10_code": "K81", "icd10_title": "Cholecystitis" }, { "from_icd11": "DC12.Z", "icd10_code": "K818", "icd10_title": "" }, { "from_icd11": "DC10.01", "icd10_code": "K820", "icd10_title": "Obstruction of gallbladder" }, { "from_icd11": "QF01.Y", "icd10_code": "Z9049", "icd10_title": "Acquired absence of other specified parts of digestive tract" }, { "from_icd11": "DC10.2", "icd10_code": "K833", "icd10_title": "Fistula of bile duct" }, { "from_icd11": "DC10.2", "icd10_code": "K823", "icd10_title": "Fistula of gallbladder" }, { "from_icd11": "BD50.41", "icd10_code": "I713", "icd10_title": "Abdominal aortic aneurysm, ruptured" }, { "from_icd11": "EK91", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "MH12.1", "icd10_code": "R961", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K7681", "icd10_title": "Hepatopulmonary syndrome" }, { "from_icd11": "DB9Z", "icd10_code": "K7689", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K769", "icd10_title": "Liver disease, unspecified" }, { "from_icd11": "DB9Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" } ]
K812
Acute cholecystitis with chronic cholecystitis
A 24-year-old woman was referred to the gynecology clinic for a one-year history of secondary amenorrhea and symptoms of hyperandrogenism (acne and hirsutism) for two years. She had oligomenorrhea for one year prior to developing amenorrhea. She enjoyed good past health except for a referral for pediatric assessment for overweight [Body mass index (BMI) 24.9] at the age of 12 with no specific underlying cause identified. Menarche occurred at the age of 12 years. Examination revealed that she is overweight (BMI 26.0) with normal blood pressure. Acne was present but there was no obvious hirsutism (hair removal was done for cosmetic reasons). Other clinical features of Cushing's syndrome were absent. Pregnancy test was negative. Transabdominal ultrasound showed an enlarged (16.6 cm 3 ) right ovary with more than 12 small follicles (< 9 mm), which represents sonographic evidence of polycystic ovary based on the Rotterdam criteria . The left ovary was normal in appearance and size (6.8 cm 3 ). Polycystic ovary syndrome (PCOS) was suspected and combined oral contraceptive pills were prescribed with a return of menstruation. Further laboratory testing, however, demonstrated a significant elevation of serum total testosterone (10.6 nmol/L), androstenedione (28.2 nmol/L), and 17-hydroxyprogesterone (17-OHP) (52 nmol/L) all measured by liquid chromatography tandem mass spectrometry (LC-MS/MS). 1 mg overnight dexamethasone suppression test was negative for Cushing's syndrome ( Table 1 ). In view of the grossly elevated androgens and 17-OHP, PCOS was unlikely. In addition, the raised 17-OHP raised the possibility of non classical congenital adrenal hyperplasia (NCCAH). On further questioning and physical examination, the patient noticed deepening of her voice in the recent two years, and mild clitoromegaly was found. Furthermore, the patient complained of polyuria and polydipsia for 6 months and a diagnosis of diabetes mellitus was confirmed by laboratory tests (fasting glucose 7.2 mmol/L, HbA1c 6.9%). Metformin 250 mg twice daily was prescribed. 250 μ g ACTH (Synacthen) stimulation test was performed to exclude NCCAH. While the baseline and stimulated 17-OHP concentrations were both compatible with NCCAH due to 21-hydroxylase deficiency (> 30 nmol/L based on the endocrine society clinical practice guideline ), a flat response was noted ( Table 2 ), which was atypical of NCCAH. A 24-h urinary steroid profile (USP) by gas chromatography mass spectrometry (GC–MS) revealed moderate elevation of androgen metabolites , and gross elevation of two of the three metabolites of 17-OHP . 11-oxopregnanetriol, which is another metabolite of 17-OHP, was however normal (7 μ g/day, reference interval: < 44 μ g/day). Cortisol and corticosterone metabolites were not in excess. The USP findings suggested an ovarian source of 17-OHP rather than adrenal. Contrast computed tomography (CT) of the abdomen and pelvis showed a 2.6 × 2.3 × 2.5 cm ovoid enhancing soft tissue over the right adnexal region, commented to be likely the right ovary, with a small local surrounding fluid collection ( Figure 1(a) ). No adrenal mass was identified. Transabdominal pelvic ultrasound performed five months later showed an enlarged right ovary measuring 4.5 × 2.6 × 4.5 cm in size with a volume of 27.6 cm 3 . There were more than 12 tiny follicles with sizes measuring up to 8 mm present at the periphery of the right ovary, representing sonographic evidence of polycystic ovary. The left ovary measured 2.6 × 2.2 × 2.0 cm in size with a volume of 5.8 cm 3 . Similar to the CT scan obtained earlier, no obvious mass was found in either ovaries ( Figure 1(b) ). As NCCAH was less likely and severe hyperandrogenism was present, further imaging was arranged for the localization of an androgen-secreting tumor. Transvaginal ultrasound of the pelvis revealed a 2.6 × 2.4 × 2.2 cm hyperechoic solid tumor inside the right ovary with hypervascularity seen on Doppler and multiple follicles at the periphery of the right ovary ( Figure 1(c) ). The left ovary also appeared to be polycystic in appearance. Whole body [ 18 F]− fluorodeoxyglucose positron emission tomography–computed tomography (FDG PET–CT) scan with contrast showed a 2.6 × 2.3 × 2.5 cm mildly fluorodeoxyglucose–avid mass (SUV max 2.9 g/ml) in the right ovary with homogeneous solid contrast enhancement and no calcification, fat or cystic component. There were no hypermetabolic lymph nodes seen in the abdomen and pelvis ( Figure 1(d) ). A diagnosis of an androgen-secreting tumor in the right ovary was made. Laparoscopic right salpingo-oophorectomy, diagnostic hysteroscopy and curettage of the uterus were performed. Peritoneal fluid was obtained for cytology. Intraoperatively, an enlarged right ovary measuring 4.5 × 4.5 cm was found. The left ovary had a polycystic ovary-like appearance with flimsy adhesions to the ovarian fossa and adhesiolysis was performed. The resected right ovary was cut open, revealing the presence of an orange-colored tumor inside.
4.152344
0.967773
sec[1]/p[0]
en
0.999996
31772787
https://doi.org/10.1155/2019/9237459
[ "ovary", "polycystic", "nccah", "nmol", "tumor", "present", "ultrasound", "enlarged", "follicles", "which" ]
[ { "code": "GA1Z&XA1QK0", "title": "Noninflammatory disorders of ovary" }, { "code": "GA07.Z&XA1QK0", "title": "Inflammation of ovary" }, { "code": "GA30.6", "title": "Premature ovarian failure" }, { "code": "JA01.2", "title": "Ovarian pregnancy" }, { "code": "QF01.10", "title": "Acquired absence of female genital organs" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "DB99.10", "title": "Polycystic liver disease" }, { "code": "5A80.2", "title": "Polycystic ovary" }, { "code": "GB8Y", "title": "Other specified cystic or dysplastic kidney disease" }, { "code": "LA75.4", "title": "Congenital pulmonary airway malformations" } ]
=== ICD-11 CODES FOUND === [GA30.6] Premature ovarian failure Definition: Menopause occurring spontaneously before 40 years of age, generally resulting in secondary amenorrhea although some women may exhibit intermittent ovarian function and ovulation, with a minority conceiving and delivering a pregnancy. POF/POI occurs mostly without a known cause, but can be caused by the following conditions: numerical and structural chromosomal abnormalities, Fragile X (FMR1) premutations, autoimmune disorders, radiation therapy, chemotherapy, galactosemia, and other rare enzyme Also known as: Premature ovarian failure | female hypergonadotropic hypogonadism | hypergonadotrophic ovarian failure | primary female hypogonadism | POF - [premature ovarian failure] Excludes: Isolated gonadotropin deficiency | Postprocedural ovarian failure [JA01.2] Ovarian pregnancy Definition: A condition characterised by implantation of the embryo within the ovary during pregnancy. Also known as: Ovarian pregnancy [QF01.10] Acquired absence of female genital organs Also known as: Acquired absence of female genital organs | Acquired absence of cervix | amputation of cervix | Acquired absence of the uterus | acquired uterine absence [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [DB99.10] Polycystic liver disease Definition: Polycystic liver disease is a genetic disorder characterised by the appearance of numerous cysts spread throughout the liver. Also known as: Polycystic liver disease | multiple cysts of liver | PLD - [polycystic liver disease] | polycystic liver disorder | polycystic liver [5A80.2] Polycystic ovary Definition: Ovary with increased size (> 7 mL) and stromal volume, and with increased number of follicles (12 or more measuring 2-9 mm in diameter), that may be present in women with PCOS, but also in women with normal ovulatory function and normal fertility (unilaterally or bilaterally). Also known as: Polycystic ovary | polycystic ovary NOS | PCO - [polycystic ovary] Excludes: Polycystic ovary syndrome [GB8Y] Other specified cystic or dysplastic kidney disease Also known as: Other specified cystic or dysplastic kidney disease | Neonatal diabetes - congenital hypothyroidism - congenital glaucoma - hepatic fibrosis - polycystic kidneys | Senior Boichis syndrome | Hereditary cystic or dysplastic kidney disease, dominant inheritance | Glomerulocystic disease [LA75.4] Congenital pulmonary airway malformations Definition: A disease caused by failure of the bronchial structure to correctly develop during the antenatal period. This disease may present with severe respiratory distress in the newborn period, acute respiratory distress or infection later in life, or may be asymptomatic. This disease can be distinguished from other lesions and normal lung by polypoid projections of the mucosa, an increase in smooth muscle and elastic tissue within the cyst walls, an absence of cartilage in the cystic parenchyma, mucous Also known as: Congenital pulmonary airway malformations | Congenital cystic disease of lung | Congenital lung cyst | Congenital cystic lung | Congenital cystic adenomatoid malformation Includes: Congenital honeycomb lung | Congenital polycystic disease of lung Excludes: Cystic lung disease, acquired or unspecified === GRAPH WALKS === --- Walk 1 --- [GA30.6] Premature ovarian failure Def: Menopause occurring spontaneously before 40 years of age, generally resulting in secondary amenorrhea although some women may exhibit intermittent ovarian function and ovulation, with a minority conce... --EXCLUDES--> [?] Hypopituitarism Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in... --CHILD--> [?] Nonacquired hypopituitarism Def: This refers to non-acquired decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain.... --- Walk 2 --- [GA30.6] Premature ovarian failure Def: Menopause occurring spontaneously before 40 years of age, generally resulting in secondary amenorrhea although some women may exhibit intermittent ovarian function and ovulation, with a minority conce... --EXCLUDES--> [?] Hypopituitarism Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in... --CHILD--> [?] Argonz-del Castillo Syndrome --- Walk 3 --- [JA01.2] Ovarian pregnancy Def: A condition characterised by implantation of the embryo within the ovary during pregnancy.... --PARENT--> [JA01] Ectopic pregnancy Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy.... --CHILD--> [JA01.2] Ovarian pregnancy Def: A condition characterised by implantation of the embryo within the ovary during pregnancy.... --- Walk 4 --- [JA01.2] Ovarian pregnancy Def: A condition characterised by implantation of the embryo within the ovary during pregnancy.... --PARENT--> [JA01] Ectopic pregnancy Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy.... --CHILD--> [JA01.1] Tubal pregnancy Def: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy.... --- Walk 5 --- [QF01.10] Acquired absence of female genital organs --RELATED_TO--> [?] Traumatic amputation of part of vulva --PARENT--> [?] Acquired absence of female genital organs --- Walk 6 --- [QF01.10] Acquired absence of female genital organs --RELATED_TO--> [?] Traumatic amputation of entire vulva --PARENT--> [?] Acquired absence of female genital organs
[ "[GA30.6] Premature ovarian failure\n Def: Menopause occurring spontaneously before 40 years of age, generally resulting in secondary amenorrhea although some women may exhibit intermittent ovarian function and ovulation, with a minority conce...\n --EXCLUDES--> [?] Hypopituitarism\n Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in...\n --CHILD--> [?] Nonacquired hypopituitarism\n Def: This refers to non-acquired decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain....", "[GA30.6] Premature ovarian failure\n Def: Menopause occurring spontaneously before 40 years of age, generally resulting in secondary amenorrhea although some women may exhibit intermittent ovarian function and ovulation, with a minority conce...\n --EXCLUDES--> [?] Hypopituitarism\n Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in...\n --CHILD--> [?] Argonz-del Castillo Syndrome", "[JA01.2] Ovarian pregnancy\n Def: A condition characterised by implantation of the embryo within the ovary during pregnancy....\n --PARENT--> [JA01] Ectopic pregnancy\n Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy....\n --CHILD--> [JA01.2] Ovarian pregnancy\n Def: A condition characterised by implantation of the embryo within the ovary during pregnancy....", "[JA01.2] Ovarian pregnancy\n Def: A condition characterised by implantation of the embryo within the ovary during pregnancy....\n --PARENT--> [JA01] Ectopic pregnancy\n Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy....\n --CHILD--> [JA01.1] Tubal pregnancy\n Def: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy....", "[QF01.10] Acquired absence of female genital organs\n --RELATED_TO--> [?] Traumatic amputation of part of vulva\n --PARENT--> [?] Acquired absence of female genital organs", "[QF01.10] Acquired absence of female genital organs\n --RELATED_TO--> [?] Traumatic amputation of entire vulva\n --PARENT--> [?] Acquired absence of female genital organs" ]
GA1Z&XA1QK0
Noninflammatory disorders of ovary
[ { "from_icd11": "GA30.6", "icd10_code": "E2839", "icd10_title": "Other primary ovarian failure" }, { "from_icd11": "GA30.6", "icd10_code": "E28319", "icd10_title": "Asymptomatic premature menopause" }, { "from_icd11": "GA30.6", "icd10_code": "E28310", "icd10_title": "Symptomatic premature menopause" }, { "from_icd11": "GA30.6", "icd10_code": "E283", "icd10_title": "Primary ovarian failure" }, { "from_icd11": "JA01.2", "icd10_code": "O00201", "icd10_title": "Right ovarian pregnancy without intrauterine pregnancy" }, { "from_icd11": "JA01.2", "icd10_code": "O002", "icd10_title": "Ovarian pregnancy" }, { "from_icd11": "LA75.4", "icd10_code": "Q330", "icd10_title": "Congenital cystic lung" } ]
E2839
Other primary ovarian failure
Patient 1: a 14-year-old female exhibited anti-NMDAR encephalitis with seizure, consciousness disturbance, memory deficit, agitation and behavioural changes. CSF analysis showed elevated white blood cells (WBC) and protein, and the anti-NMDAR antibody was 1:1. Serum anti-NMDAR antibody was negative. Electroencephalogram (EEG) showed slow waves with epileptic discharge and brain magnetic resonance image (MRI) showed small lesions in bilateral frontal subcortical white matter. No tumor was detected. The worst mRS was 5 and worst CASE was 14. The patient showed poor response to two courses of IVIG and intravenous methylprednisolone (IVMP) treatment. Seven weeks after onset, OFA treatment was initiated. Following OFA treatment, clinical improvements were observed, including cessation of seizures, the restoration of normal consciousness, resolution of agitation, and correction of memory deficits. CSF anti-NMDAR antibody became negative after the first dose of OFA treatment. Both mRS and CASE scores decreased to 0 after the final dose of OFA, with a significant reduction in the percentage of CD19 + B cells in peripheral blood lymphocytes. The patient remained stable during a 10-month follow-up period after the final dose of OFA . Table 1 Clinical data of anti-NMDAR encephalitis patients treated with OFA. Table 1 Items Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 Age at onset (yrs) 14 12 11 11 11 Sex Female Male Female Female Female Tumor None None None None A teratoma (17mm × 14 mm x 10 mm) in right adnexal area Underwent teraomectomy CSF WBC count before OFA (x10 6 /L) 269 132 1 31 83 CSF protein before OFA (g/L) 0.75 0.37 0.14 0.40 0.37 Peripheral CD19 + B cells (%) before OFA 23.35 29.86 38.60 26.04 19.70 EEG before OFA Slow background (1.5–3.0 Hz) with epileptic discharge Slow background (8.0 Hz) with epileptic discharge Slow background (5.0–6.0 Hz) with epileptic discharge Slow background (1.5–2.0 Hz) with epileptic discharge Slow background (1.0–2.5 Hz) with epileptic discharge Brain MRI before OFA Small lesions in bilateral frontal subcortical white matter Normal Lesions in bilateral periventricular white matter Multiple demyelination lesions in the bilateral frontal lobe, temporal lobe and parietal lobe Lesions in the bilateral globus pallidus, caudate nucleus, frontal lobe, temporal lobe and insular cortex CSF anti-NMDAR antibody titer before OFA 1:1 1:10 1:10 1:30 1:320 Serum anti-NMDAR antibody titer before OFA Negative Negative Negative Negative 1:1000 mRS before OFA 5 5 5 5 5 CASE before OFA 14 17 16 22 24 Immunotherapy before OFA IVMP; IVIG IVMP; IVIG IVMP; IVIG IVMP; IVIG; IA IVMP; IVIG; PE; IA Antiepileptic drugs N/A N/A LEV; NZP; VPA LCM; CXZ LEV; CXZ Psychotropic medications Risperidone Risperidone Risperidone Risperidone Risperidone Duration from onset to OFA treatment (weeks) 7 3 6 8 9 Number of OFA infusions 3 4 3 4 5 CSF WBC count after OFA (x10 6 /L) 7 1 3 7 8 Peripheral CD19 + B cells (%) after OFA 0.21 0.24 0.17 0.13 0.56 EEG after OFA Background activity: left normal, right diffuse slowing (1.5–3 Hz); Reduced epileptic discharge Normal background with occasional slow waves; No epileptic discharge Asymmetric abnormal background activity: left posterior temporal slowing, right occasional occipital slowing; Reduced epileptic discharge Asymmetric background, poor rhythm in right occipital region; Reduced epileptic discharge Slow background (3–4 Hz) without epileptic discharge Brain MRI after OFA Lesions resolved N/A No change Lesions reduced Lesions resolved CSF anti-NMDAR antibody titer after OFA Negative Negative 1:3.2 Negative 1:32 Serum anti-NMDAR antibody titer after OFA N/A N/A N/A N/A 1:320 mRS After OFA 0 0 0 0 3 CASE after OFA 0 0 0 0 10 Side effect of OFA None Mild allergic reactions & liver enzyme increased Liver enzyme increased None None Duration of follow-up (months) 10 4 2 2 1 CSF, cerebrospinal fluid; CASE, clinical assessment scale for autoimmune encephalitis; CXZ, Clonazepam; EEG, electroencephalogram; IA, immunoadsorption; IVIG, intravenous immunoglobulin; IVMP, intravenous methylprednisolone; LCM, Lacosamide; LEV, Levetiracetam; MRI, magnetic resonance image; mRS, Modified Rankin Scale; NZP, Nitrazepam; NMDAR, N-methyl-D-aspartate receptor; N/A, not applicable; OFA, Ofatumumab; PE, plasma exchange; VPA, valproic acid; WBC, white blood cell counts. Fig. 1 Timeline depicting changes of mRS, CSF anti-NMDAR antibody, CD19 + B cell percent, treatment in five patients. The mRS scale is now indicated in points. The CD19 + B cells was measured in percentage. Blue diamond represents one course of IVIG. Red diamond represents one dose of OFA treatment. Green diamond indicates that IA treatment was used, though the number of cycles is not shown. Purple-red diamond indicates that PE treatment was used, with the number of exchanges not displayed. NMDAR, N-methyl-D-aspartate receptor; CSF, cerebrospinal fluid; mRS, Modified Rankin Scale; IVIG, intravenous immunoglobulin; PE, plasma exchange; OFA, Ofatumumab. Fig. 1
4.167969
0.951172
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en
0.999996
39660186
https://doi.org/10.1016/j.heliyon.2024.e40680
[ "nmdar", "epileptic", "anti", "background", "ivig", "antibody", "slow", "lesions", "ivmp", "none" ]
[ { "code": "8A6Z", "title": "Epilepsy or seizures, unspecified" }, { "code": "8A60.5", "title": "Epilepsy due to injuries to the head" }, { "code": "8A61.1Z", "title": "Genetic epileptic syndromes with onset in infancy, unspecified" }, { "code": "8A06.Y/8A6Z", "title": "Myoclonus due to epilepsy" }, { "code": "8A61.40", "title": "Reflex epilepsies" }, { "code": "JA86.Y", "title": "Maternal care for other specified fetal problems" }, { "code": "MB23.1", "title": "Antisocial behaviour" }, { "code": "3B4Z", "title": "Coagulation defects, unspecified" }, { "code": "4A45.Z", "title": "Antiphospholipid syndrome, unspecified" }, { "code": "4A43.Y", "title": "Other specified overlap non-organ specific systemic autoimmune disease" } ]
=== ICD-11 CODES FOUND === [8A6Z] Epilepsy or seizures, unspecified Also known as: Epilepsy or seizures, unspecified | Cerebral seizures | Seizure disorder | seizure disorder, so described | epilepsy NOS [8A60.5] Epilepsy due to injuries to the head Definition: Epilepsy occurring in relation to a traumatic brain injury. Onset is more than 1 week following the trauma, with risk increasing with the severity of brain injury. Also known as: Epilepsy due to injuries to the head | Post traumatic epilepsy | Traumatic epilepsy | traumatic epileptic [8A61.1Z] Genetic epileptic syndromes with onset in infancy, unspecified Also known as: Genetic epileptic syndromes with onset in infancy, unspecified | Genetic epileptic syndromes with onset in infancy | infantile epilepsy NOS [8A61.40] Reflex epilepsies Definition: Reflex epilepsies are rare epileptic syndromes with seizures induced by specific triggering factors (either by visual, auditory, somato-sensitive or somato-motor stimulation, or by higher cortical function activities). Photosensitive epilepsies are the most frequent form. Spontaneous seizures may also occur. "Reflex seizures'" can be classified into a simple "pure" reflex epilepsy and a complex group. The former comprises seizure triggered by simple sensory stimuli or by movements (photosensitiv Also known as: Reflex epilepsies | Photosensitive epilepsy | Reading epilepsy | Hot water epilepsy | Startle epilepsy [JA86.Y] Maternal care for other specified fetal problems Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS [MB23.1] Antisocial behaviour Definition: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated. Also known as: Antisocial behaviour | Child or adolescent antisocial behaviour [3B4Z] Coagulation defects, unspecified Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality [4A45.Z] Antiphospholipid syndrome, unspecified Also known as: Antiphospholipid syndrome, unspecified | Antiphospholipid syndrome | Hughes syndrome | Anticardiolipin syndrome [4A43.Y] Other specified overlap non-organ specific systemic autoimmune disease Also known as: Other specified overlap non-organ specific systemic autoimmune disease | Antisynthetase syndrome | Reynolds syndrome | Syndromic multisystem autoimmune disease due to ITCH deficiency | Eosinophilia myalgia syndrome === GRAPH WALKS === --- Walk 1 --- [8A6Z] Epilepsy or seizures, unspecified --PARENT--> [?] Epilepsy or seizures Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart.... --RELATED_TO--> [?] Neonatal seizures Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn.... --- Walk 2 --- [8A6Z] Epilepsy or seizures, unspecified --PARENT--> [?] Epilepsy or seizures Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart.... --RELATED_TO--> [?] Neonatal seizures Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn.... --- Walk 3 --- [8A60.5] Epilepsy due to injuries to the head Def: Epilepsy occurring in relation to a traumatic brain injury. Onset is more than 1 week following the trauma, with risk increasing with the severity of brain injury.... --PARENT--> [8A60] Epilepsy due to structural or metabolic conditions or diseases Def: Epilepsy occurring in relation to a distinct other structural or metabolic condition or disease that has been demonstrated to be associated with a substantially increased risk of developing epilepsy.... --CHILD--> [8A60.2] Epilepsy due to degenerative brain disorders Def: Epilepsy in relation to a degenerative brain disorder known to be associated with seizures, such as certain neuronal storage disorders (e.g. adult neuronal ceroid lipofuscinosis), and certain mitochon... --- Walk 4 --- [8A60.5] Epilepsy due to injuries to the head Def: Epilepsy occurring in relation to a traumatic brain injury. Onset is more than 1 week following the trauma, with risk increasing with the severity of brain injury.... --PARENT--> [8A60] Epilepsy due to structural or metabolic conditions or diseases Def: Epilepsy occurring in relation to a distinct other structural or metabolic condition or disease that has been demonstrated to be associated with a substantially increased risk of developing epilepsy.... --CHILD--> [8A60.0] Epilepsy due to prenatal or perinatal brain insults Def: Epilepsy occurring in relation to a distinct structural or metabolic condition or disease that has been demonstrated to be associated with a substantially increased risk of developing epilepsy, with t... --- Walk 5 --- [8A61.1Z] Genetic epileptic syndromes with onset in infancy, unspecified --PARENT--> [8A61.1] Genetic epileptic syndromes with onset in infancy Def: Include a vast spectrum of phenotypes having in common a genetic background and the onset in infancy. They range from benign self-remitting to severe drug resistant syndromes. Family history of epilep... --CHILD--> [8A61.11] Dravet syndrome Def: A refractory epileptic encephalopathy occurring in otherwise healthy infants during the first year of life with clonic/tonic-clonic, generalised and unilateral seizures, hemiclonic or generalised stat... --- Walk 6 --- [8A61.1Z] Genetic epileptic syndromes with onset in infancy, unspecified --PARENT--> [8A61.1] Genetic epileptic syndromes with onset in infancy Def: Include a vast spectrum of phenotypes having in common a genetic background and the onset in infancy. They range from benign self-remitting to severe drug resistant syndromes. Family history of epilep... --CHILD--> [8A61.10] Benign familial infantile epilepsy Def: Epilepsy characterised by the occurrence of repeated seizures in healthy infants with no prior medical history during the first year of life. The seizures manifest with motor arrest, impairment of con...
[ "[8A6Z] Epilepsy or seizures, unspecified\n --PARENT--> [?] Epilepsy or seizures\n Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart....\n --RELATED_TO--> [?] Neonatal seizures\n Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn....", "[8A6Z] Epilepsy or seizures, unspecified\n --PARENT--> [?] Epilepsy or seizures\n Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart....\n --RELATED_TO--> [?] Neonatal seizures\n Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn....", "[8A60.5] Epilepsy due to injuries to the head\n Def: Epilepsy occurring in relation to a traumatic brain injury. Onset is more than 1 week following the trauma, with risk increasing with the severity of brain injury....\n --PARENT--> [8A60] Epilepsy due to structural or metabolic conditions or diseases\n Def: Epilepsy occurring in relation to a distinct other structural or metabolic condition or disease that has been demonstrated to be associated with a substantially increased risk of developing epilepsy....\n --CHILD--> [8A60.2] Epilepsy due to degenerative brain disorders\n Def: Epilepsy in relation to a degenerative brain disorder known to be associated with seizures, such as certain neuronal storage disorders (e.g. adult neuronal ceroid lipofuscinosis), and certain mitochon...", "[8A60.5] Epilepsy due to injuries to the head\n Def: Epilepsy occurring in relation to a traumatic brain injury. Onset is more than 1 week following the trauma, with risk increasing with the severity of brain injury....\n --PARENT--> [8A60] Epilepsy due to structural or metabolic conditions or diseases\n Def: Epilepsy occurring in relation to a distinct other structural or metabolic condition or disease that has been demonstrated to be associated with a substantially increased risk of developing epilepsy....\n --CHILD--> [8A60.0] Epilepsy due to prenatal or perinatal brain insults\n Def: Epilepsy occurring in relation to a distinct structural or metabolic condition or disease that has been demonstrated to be associated with a substantially increased risk of developing epilepsy, with t...", "[8A61.1Z] Genetic epileptic syndromes with onset in infancy, unspecified\n --PARENT--> [8A61.1] Genetic epileptic syndromes with onset in infancy\n Def: Include a vast spectrum of phenotypes having in common a genetic background and the onset in infancy. They range from benign self-remitting to severe drug resistant syndromes. Family history of epilep...\n --CHILD--> [8A61.11] Dravet syndrome\n Def: A refractory epileptic encephalopathy occurring in otherwise healthy infants during the first year of life with clonic/tonic-clonic, generalised and unilateral seizures, hemiclonic or generalised stat...", "[8A61.1Z] Genetic epileptic syndromes with onset in infancy, unspecified\n --PARENT--> [8A61.1] Genetic epileptic syndromes with onset in infancy\n Def: Include a vast spectrum of phenotypes having in common a genetic background and the onset in infancy. They range from benign self-remitting to severe drug resistant syndromes. Family history of epilep...\n --CHILD--> [8A61.10] Benign familial infantile epilepsy\n Def: Epilepsy characterised by the occurrence of repeated seizures in healthy infants with no prior medical history during the first year of life. The seizures manifest with motor arrest, impairment of con..." ]
8A6Z
Epilepsy or seizures, unspecified
[ { "from_icd11": "8A6Z", "icd10_code": "G40A09", "icd10_title": "Absence epileptic syndrome, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40B09", "icd10_title": "Juvenile myoclonic epilepsy, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40B19", "icd10_title": "Juvenile myoclonic epilepsy, intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A19", "icd10_title": "Absence epileptic syndrome, intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A11", "icd10_title": "Absence epileptic syndrome, intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A01", "icd10_title": "Absence epileptic syndrome, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40409", "icd10_title": "Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40802", "icd10_title": "Other epilepsy, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40801", "icd10_title": "Other epilepsy, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40901", "icd10_title": "Epilepsy, unspecified, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G4089", "icd10_title": "Other seizures" }, { "from_icd11": "8A6Z", "icd10_code": "G40919", "icd10_title": "Epilepsy, unspecified, intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40911", "icd10_title": "Epilepsy, unspecified, intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40419", "icd10_title": "Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40109", "icd10_title": "Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus" } ]
G40A09
Absence epileptic syndrome, not intractable, without status epilepticus
A 15-year-old girl presented with a palpable mass in her right breast, which she has had for 2 months; during this time, she noticed that the lump had not increased in size. She did not have systemic symptoms or a history of weight loss. During the physical examination, two solid and painless masses were appreciated in the upper-outer and the central-low quadrants; the skin overlying the lesions was completely normal and there were no palpable lymph nodes. Blood count, liver and kidney function tests, erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), and uric acid blood levels were in the normal range. Ultrasound (US) showed a 6 cm hypervascular mass with indistinct margins in the upper-outer quadrant and other two smaller masses (diameter 1.9 cm and 2.1 cm, respectively), probably connected to the largest one, in the central-low portion; moreover, two enlarged homolateral axillary lymph nodes (maximal diameter 1.7 cm) were identified. On breast magnetic resonance imaging (MRI), a 6.5 cm single and irregular mass with intense contrast enhancement and three suspected axillary nodes (maximal diameter 1.5 cm) were described. US-guided needle biopsy of the right breast lesion was performed; analysis was carried out with a Leica microscope , Leica ICC50HD camera and Leica Acquire software for Macbook pro 16’ 2,6 GHz 6-Core Intel Core i7; histologic examination showed a diffuse large B-cell lymphoma, not otherwise specified (DLBCL, nos), CD19+, CD20+, of germinal center origin according to immunohistochemical algorithms (CD10+, BCL6+, IRF4/MUM1+, FoxP1+, LMO2+, HGAL+), with high proliferation index (MIB-1 80%). A high expression of c-MYC protein was found (70%); however, fluorescence in situ hybridization (FISH) analysis was negative for MYC translocation (Vysis break apart and IGH/MYC dual fusion translocation probes) as well as for BCL2 and BCL6 translocations (Break apart translocation probes), excluding a high-grade B-cell lymphoma with double hit. Finally, no evidence of Epstein-Barr virus (EBV) was found with in situ hybridization for the Epstein-Barr virus-encoded small RNAs (EBERs). The staging was completed with bone marrow aspirate, lumbar puncture, brain MRI, neck-thorax-abdomen computerized tomography (CT) scan, and whole-body positron emission tomography (PET)-CT scan ; a high fluorodeoxyglucose (FDG) uptake with a maximum standardized uptake value (SUVmax) of 11.5 was evidenced in the right breast. No other organ involvement was ascertained. According to St. Jude staging and the new revised International Pediatric Non-Hodgkin Lymphoma Staging System (IPNHLSS) , the stage was IIE (single extranodal tumor with regional node involvement). The girl received intensive combination chemotherapy according to the AIEOP LNH-97 trial (risk group 3) plus rituximab (Table 1 ). After the second block of chemotherapy, breast MRI and whole-body PET-CT scan showed a complete radiologic and metabolic response . These examinations were repeated at the end of the treatment, confirming the disappearance of any lesions. The total duration of chemotherapy was approximately 3 months and the girl is alive without any evidence of disease after 20 months from the end of treatment. Table 1 Therapy courses according to AIEOP LNH-97 protocol plus rituximab. According to the treatment risk group (R3), patients received the following chemotherapy cycles: prephase, AA, BB, CC, AA, BB Days Drug Dose 0 +1 +2 +3 +4 +5 Prephase Dexamethasone orally/IV a mg/sqm 5 5 10 10 10 Cyclophosphamide IV (1 h) 200 mg/sqm/day x x MTX+ARA-C+PDN IT 12 mg +30mg+10mg b x Cycle AA Rituximab IV 375 mg/sqm x f Dexamethasone orally/IV a 10 mg/sqm x x x x x Vincristine IV c 1.5 mg/sqm x Methotrexate IV d 5 g/sqm x Ifosfamide IV (1 h) 800 mg/sqm x x x x x Etoposide IV (2 h) 100 mg/sqm x x Cytarabine IV (1 h) 150 mg/sqm x -x e x - x e MTX+ARA-C+PDN IT 12 mg +30mg+10mg b x Cycle BB Rituximab IV 375 mg/sqm x Dexamethasone orally/IV a 10 mg/sqm x x x x x Vincristine IV c 1.5 mg/sqm x Methotrexate IV d 5 g/sqm x Cyclophosphamide IV (1 h) 200 mg/sqm/day x x x x x Doxorubicin IV (4 h) 25 mg/sqm x x MTX+ARA-C+PDN IT 12 mg +30mg+10mg b x Cycle CC Rituximab IV 375 mg/sqm x Dexamethasone orally/IV a 20 mg/sqm x x x x x Vindesine IV c 3 mg/sqm x Cytarabine IV (3 h) 3 g/sqm x -x e x - x e Etoposide IV (2 h) 100 mg/sqm x x Mtx+ARA-C+PDN IT 12 mg +30mg+10mg b x Abbreviations: MTX: methotrexate; ARA-C: cytarabine; PDN: prednisolone; IV: intravenously; h: hours; IT: intrathecal; CNS: central nervous system; sqm: square meters a subdivided in 3 doses b Dose of IT chemotherapy was age-adjusted for children less than 3 years. In courses AA and BB, IT therapy was administered 2 h after beginning of MTX IV c Maximum dose was 2 mg d 10% of MTX dose was given in 0.5 h, 90% of dose over 23.5 h. L-leucovorin rescue IV was 15 mg/sqm at h 42, 7.5 mg/sqm at h 48, and 54 after beginning of MTX e Doses were 12 h apart f For the first course AA, rituximab infusion on day 0 corresponded to day 5 of prephase
4.125
0.970703
sec[1]/p[0]
en
0.999994
34847896
https://doi.org/10.1186/s12887-021-03002-6
[ "rituximab", "breast", "according", "chemotherapy", "dexamethasone", "orally", "girl", "nodes", "diameter", "leica" ]
[ { "code": "GB23", "title": "Certain specified disorders of breast" }, { "code": "GB21.Z", "title": "Inflammatory disorders of breast, unspecified" }, { "code": "GB21.Y", "title": "Other specified inflammatory disorders of breast" }, { "code": "QF01.0", "title": "Acquired absence of breast" }, { "code": "GB23.3", "title": "Atrophy of breast" }, { "code": "QA47.Z", "title": "Liveborn infants according to place of birth, unspecified" }, { "code": "EE12.1", "title": "Onychomycosis" }, { "code": "QB97", "title": "Contact with health services for chemotherapy session for neoplasm" }, { "code": "QC05.Y", "title": "Other specified prophylactic measures" }, { "code": "QB9Y", "title": "Other specified contact with health services for nonsurgical interventions not involving devices" } ]
=== ICD-11 CODES FOUND === [GB23] Certain specified disorders of breast Definition: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere. Also known as: Certain specified disorders of breast | disease of breast | mastopathy [GB21.Z] Inflammatory disorders of breast, unspecified Also known as: Inflammatory disorders of breast, unspecified | Inflammatory disorders of breast | breast inflammation | inflammatory breast disease | mastitis NOS [GB21.Y] Other specified inflammatory disorders of breast Also known as: Other specified inflammatory disorders of breast | Breast antibioma | Infective mastitis | acute infective mastitis | nonpuerperal infective mastitis [QF01.0] Acquired absence of breast Also known as: Acquired absence of breast | absence of breast | mastectomy status | Acquired absence of breast, partial | Acquired absence of breast, total [GB23.3] Atrophy of breast Definition: A condition of the breast, caused by apoptosis of the cells commonly due to prolonged estrogen reduction, diminished cellular proliferation, decreased cellular volume, decreased function, ischaemia, malnutrition, disease, or mutation. This condition is characterised by a partial or complete decrease in size and function of the breast tissue. Also known as: Atrophy of breast | Hypoplasia of breast | hypoplastic breast | mammary hypoplasia [QA47.Z] Liveborn infants according to place of birth, unspecified Also known as: Liveborn infants according to place of birth, unspecified | Liveborn infants according to place of birth [EE12.1] Onychomycosis Definition: Fungal infection of fingernails and/or toenails due most commonly to dermatophytes (tinea unguium) or yeasts, especially Candida species. Also known as: Onychomycosis | Fungal infection of the nails | Onychomycosis classified according to clinical pattern | Superficial white onychomycosis | Distal and lateral subungual onychomycosis Includes: Fungal infection of the nails Excludes: Candidosis of nail or paronychium [QB97] Contact with health services for chemotherapy session for neoplasm Also known as: Contact with health services for chemotherapy session for neoplasm | antineoplastic chemotherapy regimen | cancer chemotherapy regimen | maintenance chemotherapy for neoplasm | neoplasm chemotherapy [QC05.Y] Other specified prophylactic measures Also known as: Other specified prophylactic measures | Other prophylactic chemotherapy | chemoprophylaxis | prophylactic chemotherapy | Systemic prophylactic chemotherapy [QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices Also known as: Other specified contact with health services for nonsurgical interventions not involving devices | Chemotherapy other than for neoplasm | admission for chemotherapy administration other than for neoplasm | chemotherapy regimen other than for neoplasm | drug therapy other than for neoplasm === GRAPH WALKS === --- Walk 1 --- [GB23] Certain specified disorders of breast Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.... --RELATED_TO--> [?] Other signs or symptoms in breast Def: Any sign or symptom of the breast, not classified elsewhere.... --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- Walk 2 --- [GB23] Certain specified disorders of breast Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.... --CHILD--> [GB23.0] Mammary duct ectasia Def: A condition of the breast, caused by lipid and cellular debris or secretory (such as colostrum) stasis, or a nonspecific duct widening process. This condition is characterised by obstruction and subse... --PARENT--> [GB23] Certain specified disorders of breast Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.... --- Walk 3 --- [GB21.Z] Inflammatory disorders of breast, unspecified --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --CHILD--> [GB21.0] Breast abscess Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ... --- Walk 4 --- [GB21.Z] Inflammatory disorders of breast, unspecified --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --RELATED_TO--> [?] Neonatal infectious mastitis Def: A disease of the breasts in neonates, may be caused by a maternal infection with a bacterial source. This disease is characterised by swelling, erythema, warmth, tenderness, induration of the breast, ... --- Walk 5 --- [GB21.Y] Other specified inflammatory disorders of breast --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --RELATED_TO--> [?] Nonpurulent mastitis associated with childbirth --- Walk 6 --- [GB21.Y] Other specified inflammatory disorders of breast --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --RELATED_TO--> [?] Nonpurulent mastitis associated with childbirth
[ "[GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....\n --RELATED_TO--> [?] Other signs or symptoms in breast\n Def: Any sign or symptom of the breast, not classified elsewhere....\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system", "[GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....\n --CHILD--> [GB23.0] Mammary duct ectasia\n Def: A condition of the breast, caused by lipid and cellular debris or secretory (such as colostrum) stasis, or a nonspecific duct widening process. This condition is characterised by obstruction and subse...\n --PARENT--> [GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....", "[GB21.Z] Inflammatory disorders of breast, unspecified\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --CHILD--> [GB21.0] Breast abscess\n Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ...", "[GB21.Z] Inflammatory disorders of breast, unspecified\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --RELATED_TO--> [?] Neonatal infectious mastitis\n Def: A disease of the breasts in neonates, may be caused by a maternal infection with a bacterial source. This disease is characterised by swelling, erythema, warmth, tenderness, induration of the breast, ...", "[GB21.Y] Other specified inflammatory disorders of breast\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --RELATED_TO--> [?] Nonpurulent mastitis associated with childbirth", "[GB21.Y] Other specified inflammatory disorders of breast\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --RELATED_TO--> [?] Nonpurulent mastitis associated with childbirth" ]
GB23
Certain specified disorders of breast
[ { "from_icd11": "GB23", "icd10_code": "N6459", "icd10_title": "Other signs and symptoms in breast" }, { "from_icd11": "GB23", "icd10_code": "N6489", "icd10_title": "Other specified disorders of breast" }, { "from_icd11": "GB23", "icd10_code": "N6481", "icd10_title": "Ptosis of breast" }, { "from_icd11": "GB23", "icd10_code": "N6482", "icd10_title": "Hypoplasia of breast" }, { "from_icd11": "GB23", "icd10_code": "N6452", "icd10_title": "Nipple discharge" }, { "from_icd11": "GB23", "icd10_code": "N6451", "icd10_title": "Induration of breast" }, { "from_icd11": "GB23", "icd10_code": "N6453", "icd10_title": "Retraction of nipple" }, { "from_icd11": "GB23", "icd10_code": "N64", "icd10_title": "Other disorders of breast" }, { "from_icd11": "GB23", "icd10_code": "N648", "icd10_title": "Other specified disorders of breast" }, { "from_icd11": "GB23", "icd10_code": "N645", "icd10_title": "Other signs and symptoms in breast" }, { "from_icd11": "GB21.Z", "icd10_code": "N610", "icd10_title": "Mastitis without abscess" }, { "from_icd11": "GB21.Z", "icd10_code": "N611", "icd10_title": "Abscess of the breast and nipple" }, { "from_icd11": "GB21.Z", "icd10_code": "N61", "icd10_title": "Inflammatory disorders of breast" }, { "from_icd11": "QF01.0", "icd10_code": "Z9012", "icd10_title": "Acquired absence of left breast and nipple" }, { "from_icd11": "QF01.0", "icd10_code": "Z9011", "icd10_title": "Acquired absence of right breast and nipple" } ]
N6459
Other signs and symptoms in breast
Food was withheld for 12 h before general anesthesia, whereas water was offered ad libitum. A 14-gauge × 64 mm (Surflo ® , Terumo Europe N.V., Leuven, Belgium) catheter was then placed into the right jugular vein following skin clipping, disinfection, and desensitization of the insertion site with 1 mL of Lidocaine 2% (Lidocaina 2%, ECUPHAR ITALIA S.r.l, Milano, Italy). The mare was sedated with intravenous (IV) acepromazine (Prequillan 1%, FATRO S.p.A., Bologna, Italy) at 0.03 mg/kg, and then the mouth was rinsed. Fifteen minutes following acepromazine administration, the pony was sedated with detomidine (Domosedan, Orion Pharma S.r.l., Milano, Italy) at 10 μg/kg IV. Anesthesia was induced with IV diazepam (Ziapam, Laboratoire TVM, Mougins, France) at 0.05 mg/kg and ketamine (Ketavet 100, MSD Animal Health S.r.l., Milano, Italy) at 2.5 mg/kg. Once the horse was in lateral recumbency, orotracheal intubation was performed (silicon tube, internal diameter 18 mm). Anesthesia was maintained with isofluorane delivered in a mixture of oxygen (O 2 ) and air, so as to maintain the inspired O 2 fraction (FiO 2 ) between 60 and 65%. While the mare was anesthetized, we successfully released the right stifle joint from the permanent upward fixation of the patella with the assistance of a chain-hoist. Subsequently, closed-reduction of the right coxofemoral joint luxation was attempted unsuccessfully for 30 min using the same chain-hoist to apply traction to the affected limb combined with outward rotation and adduction. At this stage, the decision to perform open surgical reduction was taken. The mare was positioned onto left lateral recumbency. The surgical area was clipped and cleaned for aseptic surgery with 2% chlorhexidine gluconate scrub (Clorexinal 2%, Nuova Farmec, Verona, Italy). A craniolateral approach to the right coxofemoral joint was performed . A 15 cm straight skin incision centered on the coxofemoral joint and parallel to the biceps femoris muscle was made. After dissection of the fascia lata, the biceps femoris was separated from the superficial gluteal muscle and the craniodorsal aspect of the greater trochanter was identified. The middle gluteal muscle was retracted dorsally while the insertion of the vastus lateralis was partially reflected caudally to allow exposure of the femoral neck. The femoral head was palpated craniodorsal to the acetabulum. Three Gelpi retractors were inserted to improve exposure of the surgical area. With the limb externally rotated, a Homhann retractor was carefully inserted beneath the luxated femoral head to improve mobilization and exposure. Severe damage of the cartilage with exposure of the subcondral bone of the femoral head was evident. The joint luxation could not be reduced because of its duration and muscle contraction. Femoral head and neck ostectomy was considered to be the best option for this pony. A first cut was performed with an oscillating bone saw (De Soutter Medical, Aston Clinton, United Kingdom) and the head of the femur with the proximal part of the neck was removed, thus improving access to the base of the neck itself. A second cut parallel to the previous one was performed with the same surgical device at the base of the femoral neck, as close as possible to the femoral shaft . Further neck debridement was achieved with a rongeur and an electric burr (De Soutter Medical, Aston Clinton, UK). The surgical site was rinsed with Lactated Ringer’s Solution (Galenica Senese, Siena, Italy) throughout the entire surgical procedure. A fat-pad graft (~5 × 5 cm) was harvested from the precrural region and placed between the femoral ostectomy site and the acetabulum as an attempt to prevent rubbing of the femur on the acetabular rim. The graft was sutured in a simple interrupted pattern (USP 2-0 polydioxanone, Ethicon ® LLC, Roma, Italy) to the deep gluteal muscle and the remnants of the joint capsule. Wound closure involved apposition of the deep gluteal and superficial gluteal muscles in a continuous chained suture (USP 2-0 polydioxanone, Ethicon ® LLC, Roma, Italy). The cut surface of the fascia lata was secured to the biceps femoris muscle in simple continuous fashion (USP 2-0 polydioxanone, Ethicon ® LLC, Roma, Italy). The skin was closed in a simple interrupted mattress suture (USP 2-0 polypropylene, Ethicon ® LLC, Roma, Italy) and a stent bandage was sutured over the wound. A desmotomy of the medial patellar ligament of the right stifle was subsequently performed through an ~2 cm skin incision centered on the distal aspect of the ligament. Skin closure was performed in a simple mattress-interrupted fashion (USP 2-0 polypropylene, Ethicon ® LLC, Roma, Italy). This procedure was carried out to prevent the recurrence of upward fixation of the patella . At the end of the surgery, the pony was kept under general anesthesia until she was transported into the box using a fork-lift. The recovery from anesthesia was uneventful and assisted by the anesthetist with head and tail manually supported.
4.121094
0.788086
sec[1]/sec[2]/p[0]
en
0.999998
PMC11851387
https://doi.org/10.3390/ani15040497
[ "italy", "femoral", "joint", "muscle", "neck", "head", "anesthesia", "skin", "gluteal", "ethicon" ]
[ { "code": "1D45", "title": "Sandfly fever" }, { "code": "LB9A.8", "title": "Femoral agenesis or hypoplasia" }, { "code": "FA31.8", "title": "Acquired unequal limb length" }, { "code": "FA31.Y", "title": "Other specified acquired deformities of limbs" }, { "code": "8C11.2", "title": "Lesion of femoral nerve" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FA5Z", "title": "Arthropathies, unspecified" }, { "code": "FA2Z", "title": "Inflammatory arthropathies, unspecified" }, { "code": "FA36.Z", "title": "Effusion of joint, unspecified" }, { "code": "FA37.Y", "title": "Other specified certain joint disorders, not elsewhere classified" } ]
=== ICD-11 CODES FOUND === [1D45] Sandfly fever Also known as: Sandfly fever | sandfly-borne phleboviral disease | pappataci fever | phlebotomus fever | three day fever Includes: pappataci fever | phlebotomus fever [LB9A.8] Femoral agenesis or hypoplasia Definition: Femoral agenesis/hypoplasia is a rare malformation of variable severity ranging from mild hypoplasia to complete absence of the femur. Also known as: Femoral agenesis or hypoplasia | absence of femur | absent femur | agenesis of femur | congenital absence of femur [FA31.8] Acquired unequal limb length Also known as: Acquired unequal limb length | unequal length of limbs | unequal limb length | Acquired unequal limb length, multiple sites | Acquired unequal limb length, shoulder region [FA31.Y] Other specified acquired deformities of limbs Also known as: Other specified acquired deformities of limbs | Acquired deformity of forearm | Deflection of radius | Bowing of the radius | Bowing of forearm [8C11.2] Lesion of femoral nerve Also known as: Lesion of femoral nerve | Femoral neuropathy | Lesion of saphenous nerve Excludes: Injury of femoral nerve at hip or thigh level [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FA5Z] Arthropathies, unspecified Also known as: Arthropathies, unspecified | Disorders affecting predominantly peripheral joints | Disorders affecting predominantly peripheral limb joints | arthropathy NOS | arthropathic [FA2Z] Inflammatory arthropathies, unspecified Also known as: Inflammatory arthropathies, unspecified | polyarthritis NOS | inflammatory joint disease NOS | nonpyogenic arthritis NOS | arthritic nodosa [FA36.Z] Effusion of joint, unspecified Also known as: Effusion of joint, unspecified | Effusion of joint | effusion into joint | effusion of joint, site unspecified | hydrarthrosis [FA37.Y] Other specified certain joint disorders, not elsewhere classified Also known as: Other specified certain joint disorders, not elsewhere classified | Calcification of joint | Periarticular calcification | Periarticular ossification | Fistula of joint === GRAPH WALKS === --- Walk 1 --- [1D45] Sandfly fever --PARENT--> [?] Certain arthropod-borne viral fevers --RELATED_TO--> [?] Dengue Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti... --- Walk 2 --- [1D45] Sandfly fever --PARENT--> [?] Certain arthropod-borne viral fevers --RELATED_TO--> [?] Central European tick-borne encephalitis --- Walk 3 --- [LB9A.8] Femoral agenesis or hypoplasia Def: Femoral agenesis/hypoplasia is a rare malformation of variable severity ranging from mild hypoplasia to complete absence of the femur.... --PARENT--> [LB9A] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB9A.1] Tibial hemimelia Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula.... --- Walk 4 --- [LB9A.8] Femoral agenesis or hypoplasia Def: Femoral agenesis/hypoplasia is a rare malformation of variable severity ranging from mild hypoplasia to complete absence of the femur.... --PARENT--> [LB9A] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB9A.1] Tibial hemimelia Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula.... --- Walk 5 --- [FA31.8] Acquired unequal limb length --PARENT--> [FA31] Other acquired deformities of limbs --CHILD--> [FA31.2] Flexion deformity --- Walk 6 --- [FA31.8] Acquired unequal limb length --PARENT--> [FA31] Other acquired deformities of limbs --CHILD--> [FA31.2] Flexion deformity
[ "[1D45] Sandfly fever\n --PARENT--> [?] Certain arthropod-borne viral fevers\n --RELATED_TO--> [?] Dengue\n Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti...", "[1D45] Sandfly fever\n --PARENT--> [?] Certain arthropod-borne viral fevers\n --RELATED_TO--> [?] Central European tick-borne encephalitis", "[LB9A.8] Femoral agenesis or hypoplasia\n Def: Femoral agenesis/hypoplasia is a rare malformation of variable severity ranging from mild hypoplasia to complete absence of the femur....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.1] Tibial hemimelia\n Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....", "[LB9A.8] Femoral agenesis or hypoplasia\n Def: Femoral agenesis/hypoplasia is a rare malformation of variable severity ranging from mild hypoplasia to complete absence of the femur....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.1] Tibial hemimelia\n Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....", "[FA31.8] Acquired unequal limb length\n --PARENT--> [FA31] Other acquired deformities of limbs\n --CHILD--> [FA31.2] Flexion deformity", "[FA31.8] Acquired unequal limb length\n --PARENT--> [FA31] Other acquired deformities of limbs\n --CHILD--> [FA31.2] Flexion deformity" ]
1D45
Sandfly fever
[ { "from_icd11": "1D45", "icd10_code": "A931", "icd10_title": "Sandfly fever" }, { "from_icd11": "LB9A.8", "icd10_code": "Q724", "icd10_title": "Longitudinal reduction defect of femur" }, { "from_icd11": "FA31.8", "icd10_code": "M21761", "icd10_title": "Unequal limb length (acquired), right tibia" }, { "from_icd11": "FA31.8", "icd10_code": "M21762", "icd10_title": "Unequal limb length (acquired), left tibia" }, { "from_icd11": "FA31.8", "icd10_code": "M21764", "icd10_title": "Unequal limb length (acquired), left fibula" }, { "from_icd11": "FA31.8", "icd10_code": "M21752", "icd10_title": "Unequal limb length (acquired), left femur" }, { "from_icd11": "FA31.8", "icd10_code": "M2170", "icd10_title": "Unequal limb length (acquired), unspecified site" }, { "from_icd11": "FA31.8", "icd10_code": "M21751", "icd10_title": "Unequal limb length (acquired), right femur" }, { "from_icd11": "FA31.8", "icd10_code": "M21733", "icd10_title": "Unequal limb length (acquired), right radius" }, { "from_icd11": "FA31.8", "icd10_code": "M21732", "icd10_title": "Unequal limb length (acquired), left ulna" }, { "from_icd11": "FA31.8", "icd10_code": "M21759", "icd10_title": "Unequal limb length (acquired), unspecified femur" }, { "from_icd11": "FA31.8", "icd10_code": "M21769", "icd10_title": "Unequal limb length (acquired), unspecified tibia and fibula" }, { "from_icd11": "FA31.8", "icd10_code": "M217", "icd10_title": "Unequal limb length (acquired)" }, { "from_icd11": "8C11.2", "icd10_code": "G5722", "icd10_title": "Lesion of femoral nerve, left lower limb" }, { "from_icd11": "8C11.2", "icd10_code": "G5720", "icd10_title": "Lesion of femoral nerve, unspecified lower limb" } ]
A931
Sandfly fever
A 49-year-old Middle Eastern man with heterozygous factor V Leyden deficiency and previous deep venous thrombosis (DVT) on Apixaban developed progressively worsening symmetric proximal upper and lower extremity muscle weakness and dysphagia. While he was scheduled for a routine cardiac stress test, he had elevated creatine phosphokinase (CPK) at 19,000 units per liter (U/L) (normal range: 49-439 U/L), aspartate transaminase (AST) of 500 iU/L (normal range: 0-40 U/L), and alanine transaminase (ALT) 171 iU/L (normal: 0-44 U/L) for which he was admitted. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were 38 mm/hour and 16.5 mg/L, respectively (normal values: 0-15 mm/hour and 0-10 mg/L, respectively). An MRI of the lower extremity showed symmetric bilateral muscle edema throughout the pelvis, suspicious for myositis per radiology report. The patient was treated supportively with intravenous (IV) hydration and IV methylprednisolone 40 mg twice a day for three days by an internal medicine team. He underwent muscle biopsy from the left thigh, which was pending on discharge. A barium swallow evaluation showed continuously regurgitated residual material. A CT of the chest, abdomen, and pelvis showed no evidence of malignancy. Prostate-specific antigen (PSA) three months prior to presentation was normal. Myositis panel was positive for Mi-2 alpha and beta antibodies (56 and 39, respectively; normal < 11), and negative for anti-signal recognition particle (SRP), transcriptional intermediary factor 1 (TIF) antibodies, and rest of the antibodies on the myositis panel (LabCorp myositis panel II). He improved clinically, and CPK trended down to 7,000 iU/L on discharge. The patient was discharged on 100 mg methylprednisolone. He was referred to our rheumatology clinic, and azathioprine was added. The muscle biopsy results showed large necrosis and phagocytosis. There was some localized necrotic fiber in other areas and no evidence of hemorrhage or vessel occlusion. Cluster of differentiation 45 (CD45) stain showed lymphocytes in the area of necrosis mainly. Major histocompatibility complex (MHC) was also upregulated in a patchy way. Nicotinamide adenine dinucleotide hydrogen (NADH) stain showed no significant diagnostic abnormalities. Periodic acid-Schiff (PAS) stain showed no glycogen accumulation in the preserved area of muscle and no lipid accumulation. No congophilic material was seen. A follow-up CPK at the time of his initial visit was 26,000 iU/L despite being on 100 mg of methylprednisolone orally daily; therefore, the patient was hospitalized again. In the hospital, the neurology and rheumatology services were consulted. Physical examination was notable for areflexia and weakness in the upper extremities (neck flexion 3/5, neck extension 4/5, deltoid abduction 1/5, biceps flexion 4/5, hip flexion 2/5, hip extension 4/5, and normal upper and lower extremity strength distally). During this admission, he developed a rash suggestive of Gottron’s papules, shawl rash, and heliotrope rash, as illustrated in Figures 1 - 3 . He was subsequently treated with one gram of methylprednisolone for three days and IVIGs 2 mg/kg for five days given dysphagia and rhabdomyolysis. His CPK peaked at 36,000 iU/L, with an ALT and AST of 413 U/L and 1,112 U/,L respectively. An electromyography (EMG) and nerve conduction study showed evidence of both sensorimotor axonal degeneration and demyelinating polyneuropathy. The EMG also showed significant spontaneous fibrillations, decreased motor unit action potential duration, and decreased amplitude in the deltoid and iliopsoas muscles, which were classic features consistent with AIDP. Skin biopsy of the left upper chest and the right dorsal hand showed interface dermatitis and features consistent with Gottron's papules, respectively. As part of the work-up for rhabdomyolysis, EBV PCR (polymerase chain reaction) was elevated at 89 IU/mL. Other extensive infectious work-up including cytomegalovirus was negative. After discharge, he followed with rheumatology and a neuromuscular specialist. Colonoscopy was recommended. Two months after discharge, his CPK normalized. Dysphagia and muscle strength also significantly improved while on methylprednisolone taper and azathioprine 150 mg (1.8 mg/kg). However, azathioprine was discontinued later due to leukopenia (neutrophil count below 500), and the patient was maintained only on IVIG and 4 mg of methylprednisolone for a total of four months. Subsequently, he had a relapse of unclear etiology, and CPK was 14,000 iU/L on routine check. The patient did not have significant weakness but complained of myalgia in the thighs. He was admitted for hydration, glucocorticoid was tapered, and mycophenolate mofetil was started. CPK peaked at 53,000 iU/L. He continues to receive monthly IVIG, mycophenolate mofetil 1,000 mg twice daily, and methylprednisolone 4 mg daily. CPK continues to trend down, which was 438 iU/L at the time of writing this case (11 weeks following discharge).
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en
0.999997
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https://doi.org/10.7759/cureus.12077
[ "methylprednisolone", "muscle", "respectively", "which", "myositis", "extremity", "weakness", "dysphagia", "three", "biopsy" ]
[ { "code": "FB3Z", "title": "Disorders of muscles, unspecified" }, { "code": "FB32.Y", "title": "Other specified disorders of muscles" }, { "code": "8C70.Z", "title": "Muscular dystrophy, unspecified" }, { "code": "FB32.2Z", "title": "Ischaemic infarction of muscle, unspecified" }, { "code": "FB56.2", "title": "Myalgia" }, { "code": "JB0D.7", "title": "Failed application of vacuum extractor or forceps, unspecified" }, { "code": "BD50.41", "title": "Abdominal aortic aneurysm with rupture" }, { "code": "EK91", "title": "Dermatoses which may presage cutaneous lymphoma" }, { "code": "MH12.1", "title": "Death occurring less than 24 hours from onset of symptoms, not otherwise explained" }, { "code": "8A44.3", "title": "Certain specified leukodystrophies" } ]
=== ICD-11 CODES FOUND === [FB3Z] Disorders of muscles, unspecified Also known as: Disorders of muscles, unspecified | disorder of muscle, unspecified | muscle disease | muscular disease | muscular disorder [FB32.Y] Other specified disorders of muscles Also known as: Other specified disorders of muscles | Muscle wasting or atrophy, not elsewhere classified | muscle wasting | muscle wasting disorder | Sarcopenia [8C70.Z] Muscular dystrophy, unspecified Also known as: Muscular dystrophy, unspecified | Muscular dystrophy | Gower's muscular dystrophy | progressive musclular dystrophy | pseudohypertrophic atrophy [FB32.2Z] Ischaemic infarction of muscle, unspecified Also known as: Ischaemic infarction of muscle, unspecified | Ischaemic infarction of muscle | muscle infarction [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain [JB0D.7] Failed application of vacuum extractor or forceps, unspecified Also known as: Failed application of vacuum extractor or forceps, unspecified | Failed application of ventouse or forceps, with subsequent delivery by forceps or caesarean section respectively Includes: Failed application of ventouse or forceps, with subsequent delivery by forceps or caesarean section respectively [BD50.41] Abdominal aortic aneurysm with rupture Also known as: Abdominal aortic aneurysm with rupture | abdominal aorta aneurysm rupture | abdominal aorta aneurysm ruptured | abdominal aortic aneurysm which has ruptured | ruptured AAA [EK91] Dermatoses which may presage cutaneous lymphoma Definition: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature. Also known as: Dermatoses which may presage cutaneous lymphoma [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained Also known as: Death occurring less than 24 hours from onset of symptoms, not otherwise explained | died without sign of disease | Death known not to be violent or instantaneous for which no cause can be discovered | death known not to be violent or instantaneous, cause unknown | Death without sign of disease Includes: Death known not to be violent or instantaneous for which no cause can be discovered | Death without sign of disease [8A44.3] Certain specified leukodystrophies Also known as: Certain specified leukodystrophies | CACH syndrome | Vanishing white matter disease | Childhood ataxia with central nervous system hypomyelination | Congenital or early infantile CACH syndrome === GRAPH WALKS === --- Walk 1 --- [FB3Z] Disorders of muscles, unspecified --PARENT--> [?] Disorders of muscles --RELATED_TO--> [?] Foreign body granuloma of soft tissue, not elsewhere classified --- Walk 2 --- [FB3Z] Disorders of muscles, unspecified --PARENT--> [?] Disorders of muscles --EXCLUDES--> [?] Muscular dystrophy Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f... --- Walk 3 --- [FB32.Y] Other specified disorders of muscles --PARENT--> [FB32] Certain specified disorders of muscle Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category.... --EXCLUDES--> [?] Alcoholic myopathy Def: Myopathy secondary to alcohol use and includes acute and chronic alcoholic myopathy. Several forms have been described: acute necrotizing myopathy, acute hypokalaemic myopathy, chronic alcoholic myopa... --- Walk 4 --- [FB32.Y] Other specified disorders of muscles --PARENT--> [FB32] Certain specified disorders of muscle Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category.... --EXCLUDES--> [?] Alcoholic myopathy Def: Myopathy secondary to alcohol use and includes acute and chronic alcoholic myopathy. Several forms have been described: acute necrotizing myopathy, acute hypokalaemic myopathy, chronic alcoholic myopa... --- Walk 5 --- [8C70.Z] Muscular dystrophy, unspecified --PARENT--> [8C70] Muscular dystrophy Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f... --PARENT--> [?] Primary disorders of muscles Def: Disorders in which the primary symptom of muscle weakness is secondary to a specific dysfunction of a muscle fiber.... --- Walk 6 --- [8C70.Z] Muscular dystrophy, unspecified --PARENT--> [8C70] Muscular dystrophy Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f... --RELATED_TO--> [?] Epidermolysis bullosa simplex with muscular dystrophy Def: Epidermolysis bullosa simplex with muscular dystrophy (EBS-MD) is an autosomal recessive basal subtype of EBS due to mutations the PLEC gene encoding plectin. It is characterised by generalised bliste...
[ "[FB3Z] Disorders of muscles, unspecified\n --PARENT--> [?] Disorders of muscles\n --RELATED_TO--> [?] Foreign body granuloma of soft tissue, not elsewhere classified", "[FB3Z] Disorders of muscles, unspecified\n --PARENT--> [?] Disorders of muscles\n --EXCLUDES--> [?] Muscular dystrophy\n Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f...", "[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --EXCLUDES--> [?] Alcoholic myopathy\n Def: Myopathy secondary to alcohol use and includes acute and chronic alcoholic myopathy. Several forms have been described: acute necrotizing myopathy, acute hypokalaemic myopathy, chronic alcoholic myopa...", "[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --EXCLUDES--> [?] Alcoholic myopathy\n Def: Myopathy secondary to alcohol use and includes acute and chronic alcoholic myopathy. Several forms have been described: acute necrotizing myopathy, acute hypokalaemic myopathy, chronic alcoholic myopa...", "[8C70.Z] Muscular dystrophy, unspecified\n --PARENT--> [8C70] Muscular dystrophy\n Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f...\n --PARENT--> [?] Primary disorders of muscles\n Def: Disorders in which the primary symptom of muscle weakness is secondary to a specific dysfunction of a muscle fiber....", "[8C70.Z] Muscular dystrophy, unspecified\n --PARENT--> [8C70] Muscular dystrophy\n Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f...\n --RELATED_TO--> [?] Epidermolysis bullosa simplex with muscular dystrophy\n Def: Epidermolysis bullosa simplex with muscular dystrophy (EBS-MD) is an autosomal recessive basal subtype of EBS due to mutations the PLEC gene encoding plectin. It is characterised by generalised bliste..." ]
FB3Z
Disorders of muscles, unspecified
[ { "from_icd11": "FB3Z", "icd10_code": "M60831", "icd10_title": "Other myositis, right forearm" }, { "from_icd11": "FB3Z", "icd10_code": "M60869", "icd10_title": "Other myositis, unspecified lower leg" }, { "from_icd11": "FB3Z", "icd10_code": "M60811", "icd10_title": "Other myositis, right shoulder" }, { "from_icd11": "FB3Z", "icd10_code": "M6080", "icd10_title": "Other myositis, unspecified site" }, { "from_icd11": "FB3Z", "icd10_code": "M60851", "icd10_title": "Other myositis, right thigh" }, { "from_icd11": "FB3Z", "icd10_code": "M6010", "icd10_title": "Interstitial myositis of unspecified site" }, { "from_icd11": "FB3Z", "icd10_code": "M6018", "icd10_title": "Interstitial myositis, other site" }, { "from_icd11": "FB3Z", "icd10_code": "M6088", "icd10_title": "Other myositis, other site" }, { "from_icd11": "FB3Z", "icd10_code": "M60862", "icd10_title": "Other myositis, left lower leg" }, { "from_icd11": "FB3Z", "icd10_code": "M60861", "icd10_title": "Other myositis, right lower leg" }, { "from_icd11": "FB3Z", "icd10_code": "M6089", "icd10_title": "Other myositis, multiple sites" }, { "from_icd11": "FB3Z", "icd10_code": "M60852", "icd10_title": "Other myositis, left thigh" }, { "from_icd11": "FB3Z", "icd10_code": "M60821", "icd10_title": "Other myositis, right upper arm" }, { "from_icd11": "FB3Z", "icd10_code": "M60871", "icd10_title": "Other myositis, right ankle and foot" }, { "from_icd11": "FB3Z", "icd10_code": "M60812", "icd10_title": "Other myositis, left shoulder" } ]
M60831
Other myositis, right forearm
The differential diagnosis was made between gelastic seizures and episodes of pathological laughter as manifestation of repeated transient ischemic attacks (TIA’s). The pseudobulbar laughter was excluded because the patient didn’t present any emotional incontinence outside the pathological laughter episodes. Brain scan showed left temporo-insular and left frontal chronic lacunar infarcts. Electroencephalography (EEG) performed during and after laughter episodes revealed no spike-wave activity . Analysis of the cerebrospinal fluid specimen revealed a protein level of 0.3 g per liter, a glucose concentration of 72.8 mg per deciliter, a white blood cells count of 5 per cubic millimeter, polymorphonuclears of 2 per cubic millimeter, monocytes of 3 per cubic millimeter, no red blood cells. Routine laboratory blood test showed elevated uric acid of 8 mg per deciliter, slightly elevated gamma-glutamyl transferase of 57 U per liter, increased glucose level of 136 mmol per liter, increased lactate dehydrogenase of 236 mmol per liter, increased triglycerides of 152.3 mg per deciliter, increase white blood cells count of 10 790 per cubic millimeter with increased neutrophils blood count of 8 150 per cubic millimeter, all the other blood tests were normal. The patient was treated initially with clopidogrel, atorvastatin, diazepam and phenytoin during acute PLC episodes and clopidogrel, atorvastatin, carbamazepine 600 mg/day and levetiracetam 1000 mg/day as maintenance treatment, but the PLC episodes continued for 3 days with a shorter duration and a longer period between them. Brain magnetic resonance imaging (MRI), performed 5 days after symptoms onset, showed lacunar infarcts localized in the left lenticular-capsular-thalamic area associated with gliotic changes; multiple round lesions in the cortical-subcortical and in the deep white matter bilateral frontal-parietal-occipital, with T2 hyperintensity, T1 isointensity and no diffusion changes . Based on symptoms, neurological examination and investigations the diagnosis of PLC as prodromal manifestation of TIA’s was made, heparin treatment was started and subsequently PLC episodes disappeared. However the gelastic seizures hypothesis could not be ruled out since EEG may not show spike-wave activity if the lesion is subcortical. Therefore the authors decided that antiepileptic treatment should be continued. The patient underwent a cognitive and psychological examination that did not reveal a cognitive dysfunction or a mood disorder. Carotid ultrasound showed non-hemodynamically significant plaque in the left carotid bulb. Transthoracic echocardiography showed moderate degenerative mitral stenosis (mitral valve area = 1.3 cm 2 , mean gradient 8 mmHg), mild mitral regurgitation, dilated left atrium, mild pulmonary hypertension and normal systolic left ventricular function and dimensions. Transesophageal echocardiography revealed, in addition to transthoracic echocardiography, left atrial spontaneous echo contrast (grade 3+), but no thrombus in left atrial appendage. Intra-cardiac defects with right-to-left shunt were also excluded. Some mobile atherosclerotic plaques on ascending aorta and initial part of the aortic arch were present, but no clear arguments for potential embolisation could be sustained. Given the degree of mitral stenosis, anticoagulation with acenocumarol was started, and clopidogrel was continued. Some concerns about this association were raised related to history of superior digestive hemorrhage of the patient, so clopidogrel 75 mg daily was preferred to low dose aspirin. The patient continued treatment with acenocumarol (INR = 2-3), clopidogrel 75 mg/day, atorvastatin 20 mg/day, carbamazepin 600 mg/day, gabapentin 900 mg/day and was discharged fully recovered. A video EEG was performed that showed no spike-waves only slow waves on the right side derivations . A month later the patient started to present multiple left carotid and vertebrobasilar TIA’s despite correct anticoagulant treatment (INR in the therapeutic range). These ongoing embolic events led to treatment with mechanical valve replacement, afterwards the patient was completely asymptomatic. Fig. 1 EEG performed during PLC episodes showed no spike wave activity only slow waves on the derivations on the right side Fig. 2 A , B Polygonal left side area intra- and supranuclear hyperintense T2, hypointense with hyperintense periphery on FLAIR images, which interface pyramidal fibers in the posterior arm of internal capsule leeding to Wallerian degeneration of them - left lateral pontine dots that apare hyperintense on T2 and FLAIR images, without restricted diffusion Fig. 3 Paraventricular left temporal poligonal area with reduced dimensions between exams - area of ischemia in the subacute stage - hyperintense on T2 and FLAIR, hypointense on T1 without restricted diffusion Fig. 4 A , B Video EEG during awake state and during sleep without spike-waves anomalies but with some slow waves especially on the right side during sleep
4.117188
0.96875
sec[1]/p[1]
en
0.999998
26459199
https://doi.org/10.1186/s12883-015-0457-3
[ "episodes", "blood", "spike", "cubic", "millimeter", "clopidogrel", "area", "waves", "laughter", "liter" ]
[ { "code": "8A68.Y", "title": "Other specified type of seizure" }, { "code": "MD11.1", "title": "Asphyxia" }, { "code": "AB31.Z", "title": "Episodic vestibular syndrome, unspecified" }, { "code": "AB31.Y", "title": "Other specified episodic vestibular syndrome" }, { "code": "6C45.0", "title": "Episode of harmful use of cocaine" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" } ]
=== ICD-11 CODES FOUND === [8A68.Y] Other specified type of seizure Also known as: Other specified type of seizure | Absence episode | Absence seizure episode | Pseudotetanus | Clonic seizure disorder [MD11.1] Asphyxia Definition: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all the conditions generating impaired or impeded breathing. Also known as: Asphyxia | pathological asphyxia | decreased oxygen supply | oxygen deficiency | positional asphyxia Excludes: asphyxia due to foreign body in respiratory tract | asphyxia due to carbon monoxide | asphyxia due to traumatic [AB31.Z] Episodic vestibular syndrome, unspecified Also known as: Episodic vestibular syndrome, unspecified | Episodic vestibular syndrome [AB31.Y] Other specified episodic vestibular syndrome Also known as: Other specified episodic vestibular syndrome | Secondary episodic vestibular syndrome | Episodic vestibular syndrome in diseases classified elsewhere | Episodic vestibular syndrome due to cerebrovascular disease | Episodic vestibular syndrome due to diseases of the circulatory system [6C45.0] Episode of harmful use of cocaine Definition: An episode of use of cocaine that has caused damage to a person’s physical or mental health or has resulted in behaviour leading to harm to the health of others. Harm to health of the individual occurs due to one or more of the following: (1) behaviour related to intoxication; (2) direct or secondary toxic effects on body organs and systems; or (3) a harmful route of administration. Harm to health of others includes any form of physical harm, including trauma, or mental disorder that is directly Also known as: Episode of harmful use of cocaine Excludes: Cocaine dependence | Harmful pattern of use of cocaine [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood === GRAPH WALKS === --- Walk 1 --- [8A68.Y] Other specified type of seizure --PARENT--> [8A68] Types of seizures --CHILD--> [8A68.1] Absence seizures, atypical Def: Absence seizures with changes in tone more pronounced than in typical absences or with non-abrupt onset and/or cessation, often associated with slow, irregular, generalised spike-wave activity.... --- Walk 2 --- [8A68.Y] Other specified type of seizure --PARENT--> [8A68] Types of seizures --EXCLUDES--> [?] Neonatal seizures Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn.... --- Walk 3 --- [MD11.1] Asphyxia Def: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all... --RELATED_TO--> [?] Birth asphyxia --EXCLUDES--> [?] Intrauterine hypoxia Def: Intrauterine hypoxia occurs when the fetus is deprived of an adequate supply of oxygen. This may occur with prolapse or occlusion of the umbilical cord, placental infarction and maternal smoking. This... --- Walk 4 --- [MD11.1] Asphyxia Def: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all... --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes Def: !markdown In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre... --EXCLUDES--> [?] Pathological fracture --- Walk 5 --- [AB31.Z] Episodic vestibular syndrome, unspecified --PARENT--> [AB31] Episodic vestibular syndrome Def: A clinical syndrome of transient vertigo, dizziness, or unsteadiness lasting seconds to hours, occasionally days, and generally including features suggestive of temporary, short-lived vestibular syste... --PARENT--> [?] Diseases of inner ear --- Walk 6 --- [AB31.Z] Episodic vestibular syndrome, unspecified --PARENT--> [AB31] Episodic vestibular syndrome Def: A clinical syndrome of transient vertigo, dizziness, or unsteadiness lasting seconds to hours, occasionally days, and generally including features suggestive of temporary, short-lived vestibular syste... --PARENT--> [?] Diseases of inner ear
[ "[8A68.Y] Other specified type of seizure\n --PARENT--> [8A68] Types of seizures\n --CHILD--> [8A68.1] Absence seizures, atypical\n Def: Absence seizures with changes in tone more pronounced than in typical absences or with non-abrupt onset and/or cessation, often associated with slow, irregular, generalised spike-wave activity....", "[8A68.Y] Other specified type of seizure\n --PARENT--> [8A68] Types of seizures\n --EXCLUDES--> [?] Neonatal seizures\n Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn....", "[MD11.1] Asphyxia\n Def: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all...\n --RELATED_TO--> [?] Birth asphyxia\n --EXCLUDES--> [?] Intrauterine hypoxia\n Def: Intrauterine hypoxia occurs when the fetus is deprived of an adequate supply of oxygen. This may occur with prolapse or occlusion of the umbilical cord, placental infarction and maternal smoking. This...", "[MD11.1] Asphyxia\n Def: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all...\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --EXCLUDES--> [?] Pathological fracture", "[AB31.Z] Episodic vestibular syndrome, unspecified\n --PARENT--> [AB31] Episodic vestibular syndrome\n Def: A clinical syndrome of transient vertigo, dizziness, or unsteadiness lasting seconds to hours, occasionally days, and generally including features suggestive of temporary, short-lived vestibular syste...\n --PARENT--> [?] Diseases of inner ear", "[AB31.Z] Episodic vestibular syndrome, unspecified\n --PARENT--> [AB31] Episodic vestibular syndrome\n Def: A clinical syndrome of transient vertigo, dizziness, or unsteadiness lasting seconds to hours, occasionally days, and generally including features suggestive of temporary, short-lived vestibular syste...\n --PARENT--> [?] Diseases of inner ear" ]
8A68.Y
Other specified type of seizure
[ { "from_icd11": "MD11.1", "icd10_code": "R0901", "icd10_title": "Asphyxia" }, { "from_icd11": "MD11.1", "icd10_code": "R0902", "icd10_title": "Hypoxemia" }, { "from_icd11": "MD11.1", "icd10_code": "R090", "icd10_title": "Asphyxia and hypoxemia" }, { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" } ]
R0901
Asphyxia
We placed a total of five ports. The lateral segment of the liver was retracted using a Nathanson's retractor. We extended the incision from the umbilicus for 45 mm ( Figure 1(a) ) and extracted the resected stomach through a small laparotomy incision. A suitable point from Treitz's ligament for Roux-en-Y anastomosis was marked beforehand, and the marked jejunum was retracted outside the body. Approximately 20 cm of the jejunum was sacrificed, with the sacrificed area determined based on the segment's jejunal arteries and veins ( Figure 1(b) ). To preserve autonomic nerves in the distal mesojejunum, the jejunum was sacrificed as close to the jejunal wall as possible. Branches from the marginal vessels were carefully sealed at the jejunal wall. The mesojejunum was usually dissected in three sections using an advanced energy device (Harmonic Ace +7; Ethicon, Cincinnati, OH, USA) to prevent both unexpected shortening of the mesojejunum and thermal nerve damage ( Figure 1(c) ). Using this approach, the jejunal limb could be lifted without tension on the elevated mesojejunum ( Figure 1(d) ), which provided better conditions for the mesenteric autonomic nerves. The stump of the lifted jejunal limb was covered by interrupted seromuscular sutures. The entry site for the endostapler was made extracorporeally at the estimated point for both an adequate length of isoperistaltic stapling and a suitable length from the end of the staple line to the jejunal stump. For subsequent procedures during intracorporeal anastomosis, two anchor sutures were preplaced at the relatively distal side of the endostapler entry site (i.e., the side opposite the direction of endostapler insertion) ( Figure 2(a) ). Next, part of the extended incision was closed before resuming pneumoperitoneum because an excellent surgical field was required for intracorporeal digestive reconstruction ( Figure 1(a) ). Under countertraction with the two anchor sutures, the endostapler (GST system (blue cartridge, 45 mm) and Powered Echelon Flex, Ethicon) was guided into the lifted jejunal limb through the entry site ( Figure 2(b) ). The endostapler was set for side-to-side use to staple the lifted jejunal limb to the gastric remnant in an isoperistaltic direction and then clamped. Clamped tissues were compressed for 2 minutes before stapling ( Figure 2(c) ) because this endostapler has an advantage for secure stapling with tissue precompression . The endostapler was fired, and hemostasis was completed using a soft-coagulation device if needed, taking care to ensure that the mucosa or stapling edge was inverted. Next, two full-thickness anchor sutures were placed for secure closure of the entry site and to bilaterally clarify termination points for subsequent sutures ( Figure 2(d) ). The entry site was closed with layer-to-layer sutures (i.e., running sutures in the mucosa and interrupted sutures in the seromuscular layer) using absorbable monofilament suture (Monocryl, 3-0, violet, 90 cm; Ethicon). At the tip of the endostapler, we easily saw an opening behind the staples, and a couple of seromuscular sutures were required to prevent postoperative leakage ( Figure 3(a) ). Longer staple lines may result in a postoperative pouch-like dilatation of the lifted jejunal limb and subsequent ileus in this dilatation. Therefore, the length of the staple line was set at 35–40 mm ( Figure 3(a) ). The entry site should be carefully closed to avoid even subtle stenosis; therefore, we used layer-to-layer sutures to close the entry site. Inverted staple lines in the gastric remnant were covered by interrupted seromuscular sutures ( Figure 3(b) ). Through a small laparotomy before closure, we were able to create a Y-limb anastomosis approximately 30 cm distal to Treitz's ligament and close gaps in the mesojejunum from Treitz's ligament and the lower side of the mesocolon along the retrocolic route. We could also close gaps in the mesojejunum of the lifted jejunal limb even along the upper side of the mesocolon. Intracorporeal sutures to close gaps in the mesojejunum of the lifted jejunal limb were required only along the upper side of the mesocolon ( Figure 3(c) and 3(d) ). It is critical to recognize that functional and surgical anastomoses are distinct for overlap anastomosis. Postoperative passage depends on patency at the functional anastomosis, not on the length of the staple line at the surgical anastomosis. Even subtle tension on the mesojejunum was avoided by sacrificing part of the jejunum, and a well-defined mesojejunum preserved the autonomic nerves in the mesojejunum of the lifted jejunal limb. Mesenteric gaps were closed with nonabsorbable sutures (Prolene, 3-0, SH-1; Ethicon) . Knot tying can be performed either intra- or extracorporeally based on surgeons' preference, and if possible, a leak test should be performed following anastomosis. Finally, the tip of a drainage tube was placed behind the anastomosis site. Actual findings during laparoscopic surgery are shown in Figures 5 and 6 .
4.148438
0.432861
sec[1]/sec[0]/p[0]
en
0.999996
30345344
https://doi.org/10.1155/2018/4938341
[ "sutures", "jejunal", "mesojejunum", "limb", "anastomosis", "lifted", "site", "endostapler", "entry", "side" ]
[ { "code": "QB85", "title": "Attention to surgical dressings, drains or sutures" }, { "code": "EH93.1", "title": "Foreign body reaction to inorganic matter in the skin" }, { "code": "JA84.3", "title": "Maternal care for cervical incompetence" }, { "code": "PK9C.31", "title": "Mechanical complication of permanent sutures" }, { "code": "LB70.0Z", "title": "Craniosynostosis, unspecified" }, { "code": "DE11", "title": "Dumping syndrome" }, { "code": "1A40.0&XA8UM1", "title": "Jejunitis" }, { "code": "DA94.0Z", "title": "Primary ulcer of small intestine, unspecified" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "LB15.1", "title": "Atresia of small intestine" } ]
=== ICD-11 CODES FOUND === [QB85] Attention to surgical dressings, drains or sutures Also known as: Attention to surgical dressings, drains or sutures | Change of dressing | Change of suture | Removal of drain | Removal of dressing [EH93.1] Foreign body reaction to inorganic matter in the skin Definition: A usually granulomatous, often sarcoidal reaction to the presence in the skin of inorganic foreign material which cannot be degraded or eliminated. Responsible agents include tattoo pigment, suture materials, silica, zirconium, aluminium, paraffin, and silicone. Also known as: Foreign body reaction to inorganic matter in the skin | Silica granuloma | Foreign body granuloma due to silica | Talc granuloma | Cutaneous suture granuloma [JA84.3] Maternal care for cervical incompetence Also known as: Maternal care for cervical incompetence | maternal care for cervical incompetence, unspecified trimester | maternal care for cervical insufficiency | cervical incompetence in pregnancy | Maternal care for cerclage with or without mention of cervical incompetence [PK9C.31] Mechanical complication of permanent sutures Also known as: Mechanical complication of permanent sutures [LB70.0Z] Craniosynostosis, unspecified Also known as: Craniosynostosis, unspecified | Craniosynostosis | congenital ossification of cranial sutures | congenital ossification of sutures of skull | craniostenosis [DE11] Dumping syndrome Definition: Dumping syndrome is a group of signs and symptoms that develops most often in people who have had surgery to remove all or part of their stomach, or in whom surgically bypassed. It may occur early (during a meal or within 15-30 minutes after a meal with nausea, vomiting, abdominal pain, cramps, diarrhoea, dizziness, and heart palpitations) or late (1 to 3 hours after eating with sweating, weakness, fatigue, dizziness, lightheadedness, heart palpitations, and fainting). Also known as: Dumping syndrome | jejunal syndrome | postgastric surgery syndrome | postgastrectomy syndrome | post cibal syndrome [DA94.0Z] Primary ulcer of small intestine, unspecified Also known as: Primary ulcer of small intestine, unspecified | Primary ulcer of small intestine | acute jejunal ulcer | jejunal peptic ulcer | acute peptic jejunal ulcer [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [LB15.1] Atresia of small intestine Definition: Jejunoileal atresias and stenoses are major causes of neonatal intestinal obstruction. Atresia refers to a congenital obstruction with complete occlusion of the intestinal lumen. It accounts for 95% of obstructions. Four types of jejunoileal atresias are described. They can range from having a small area of blockage or web to missing large sections of the intestines. Intestinal atresia is one of the most frequent causes of bowel obstruction in the newborn. The ileal atresia is more common than j Also known as: Atresia of small intestine | Congenital stenosis of small intestine | Congenital absence of small intestine | congenital small intestinal stricture NOS | Multiple-level intestinal atresia Includes: Congenital absence of small intestine | Congenital stenosis of small intestine === GRAPH WALKS === --- Walk 1 --- [QB85] Attention to surgical dressings, drains or sutures --PARENT--> [?] Contact with health services for specific surgical interventions --CHILD--> [QB81] Contact with health services for plastic surgery for unacceptable cosmetic appearance other than hair transplant --- Walk 2 --- [QB85] Attention to surgical dressings, drains or sutures --PARENT--> [?] Contact with health services for specific surgical interventions --CHILD--> [QB80] Contact with health services for prophylactic surgery --- Walk 3 --- [EH93.1] Foreign body reaction to inorganic matter in the skin Def: A usually granulomatous, often sarcoidal reaction to the presence in the skin of inorganic foreign material which cannot be degraded or eliminated. Responsible agents include tattoo pigment, suture ma... --PARENT--> [EH93] Dermatoses due to foreign bodies --CHILD--> [EH93.1] Foreign body reaction to inorganic matter in the skin Def: A usually granulomatous, often sarcoidal reaction to the presence in the skin of inorganic foreign material which cannot be degraded or eliminated. Responsible agents include tattoo pigment, suture ma... --- Walk 4 --- [EH93.1] Foreign body reaction to inorganic matter in the skin Def: A usually granulomatous, often sarcoidal reaction to the presence in the skin of inorganic foreign material which cannot be degraded or eliminated. Responsible agents include tattoo pigment, suture ma... --PARENT--> [EH93] Dermatoses due to foreign bodies --CHILD--> [EH93.0] Tattoos or tattoo reactions Def: Tattoos are the result of injection into the skin of insoluble coloured pigments as ornamentation of the body, or of inert materials such as coal dust as a result of superficial trauma or blast injury... --- Walk 5 --- [JA84.3] Maternal care for cervical incompetence --PARENT--> [JA84] Maternal care for abnormality of pelvic organs Def: A condition characterised by the provision of health interventions to the mother due to some abnormality that is either suspected or known to be present in one or more of her pelvic organs.... --EXCLUDES--> [?] Obstructed labour due to maternal pelvic abnormality Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ... --- Walk 6 --- [JA84.3] Maternal care for cervical incompetence --PARENT--> [JA84] Maternal care for abnormality of pelvic organs Def: A condition characterised by the provision of health interventions to the mother due to some abnormality that is either suspected or known to be present in one or more of her pelvic organs.... --EXCLUDES--> [?] Obstructed labour due to maternal pelvic abnormality Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ...
[ "[QB85] Attention to surgical dressings, drains or sutures\n --PARENT--> [?] Contact with health services for specific surgical interventions\n --CHILD--> [QB81] Contact with health services for plastic surgery for unacceptable cosmetic appearance other than hair transplant", "[QB85] Attention to surgical dressings, drains or sutures\n --PARENT--> [?] Contact with health services for specific surgical interventions\n --CHILD--> [QB80] Contact with health services for prophylactic surgery", "[EH93.1] Foreign body reaction to inorganic matter in the skin\n Def: A usually granulomatous, often sarcoidal reaction to the presence in the skin of inorganic foreign material which cannot be degraded or eliminated. Responsible agents include tattoo pigment, suture ma...\n --PARENT--> [EH93] Dermatoses due to foreign bodies\n --CHILD--> [EH93.1] Foreign body reaction to inorganic matter in the skin\n Def: A usually granulomatous, often sarcoidal reaction to the presence in the skin of inorganic foreign material which cannot be degraded or eliminated. Responsible agents include tattoo pigment, suture ma...", "[EH93.1] Foreign body reaction to inorganic matter in the skin\n Def: A usually granulomatous, often sarcoidal reaction to the presence in the skin of inorganic foreign material which cannot be degraded or eliminated. Responsible agents include tattoo pigment, suture ma...\n --PARENT--> [EH93] Dermatoses due to foreign bodies\n --CHILD--> [EH93.0] Tattoos or tattoo reactions\n Def: Tattoos are the result of injection into the skin of insoluble coloured pigments as ornamentation of the body, or of inert materials such as coal dust as a result of superficial trauma or blast injury...", "[JA84.3] Maternal care for cervical incompetence\n --PARENT--> [JA84] Maternal care for abnormality of pelvic organs\n Def: A condition characterised by the provision of health interventions to the mother due to some abnormality that is either suspected or known to be present in one or more of her pelvic organs....\n --EXCLUDES--> [?] Obstructed labour due to maternal pelvic abnormality\n Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ...", "[JA84.3] Maternal care for cervical incompetence\n --PARENT--> [JA84] Maternal care for abnormality of pelvic organs\n Def: A condition characterised by the provision of health interventions to the mother due to some abnormality that is either suspected or known to be present in one or more of her pelvic organs....\n --EXCLUDES--> [?] Obstructed labour due to maternal pelvic abnormality\n Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ..." ]
QB85
Attention to surgical dressings, drains or sutures
[ { "from_icd11": "QB85", "icd10_code": "Z481", "icd10_title": "Encounter for planned postprocedural wound closure" }, { "from_icd11": "QB85", "icd10_code": "Z4821", "icd10_title": "Encounter for aftercare following heart transplant" }, { "from_icd11": "QB85", "icd10_code": "Z483", "icd10_title": "Aftercare following surgery for neoplasm" }, { "from_icd11": "QB85", "icd10_code": "Z4823", "icd10_title": "Encounter for aftercare following liver transplant" }, { "from_icd11": "QB85", "icd10_code": "Z4822", "icd10_title": "Encounter for aftercare following kidney transplant" }, { "from_icd11": "QB85", "icd10_code": "Z48298", "icd10_title": "Encounter for aftercare following other organ transplant" }, { "from_icd11": "QB85", "icd10_code": "Z4802", "icd10_title": "Encounter for removal of sutures" }, { "from_icd11": "QB85", "icd10_code": "Z4803", "icd10_title": "Encounter for change or removal of drains" }, { "from_icd11": "QB85", "icd10_code": "Z4801", "icd10_title": "Encounter for change or removal of surgical wound dressing" }, { "from_icd11": "QB85", "icd10_code": "Z4800", "icd10_title": "Encounter for change or removal of nonsurgical wound dressing" }, { "from_icd11": "QB85", "icd10_code": "Z48", "icd10_title": "Encounter for other postprocedural aftercare" }, { "from_icd11": "QB85", "icd10_code": "Z480", "icd10_title": "Encounter for attention to dressings, sutures and drains" }, { "from_icd11": "EH93.1", "icd10_code": "L923", "icd10_title": "Foreign body granuloma of the skin and subcutaneous tissue" }, { "from_icd11": "JA84.3", "icd10_code": "O3432", "icd10_title": "Maternal care for cervical incompetence, second trimester" }, { "from_icd11": "JA84.3", "icd10_code": "O3433", "icd10_title": "Maternal care for cervical incompetence, third trimester" } ]
Z481
Encounter for planned postprocedural wound closure
A 50-year-old Caucasian female, with a history of arterial hypertension and no history of drug allergy, was referred to our hospital five days after a rash eruption on the neck and neckline and oral erosions, which progressively worsened. Ten days before presentation, she received tenoxicam 20 mg/day for lower back pain. After 5 days, she developed the aforementioned symptoms and received 16 mg of methylprednisolone twice a day and 5 mg/day of levocetirizine from her dermatologist and discontinued tenoxicam. However, the condition worsened, and she was admitted into the burn unit of the Emergency Clinical Hospital of Bucharest. She had a polymorphous vesicular and bullous eruption affecting almost 90% of her total body surface area (TBSA) (almost 10% skin detachment) , as well as skin erosion all over her face, hands, thighs, back, and genital region. The patient presented oral, nasal, ocular, and vaginal mucosa lesions, with mild dysphagia, severe asthenia, tachycardia (heart rate > 120 beats per minute), and a tendency for hypotension (blood pressure, 75/46 mmHg), which was fluid-responsive. The complete blood count showed leukocytosis at 11.000/uL, hyperglycemia of 165 mg/dL, hyponatremia of 130 mmol/L, hypokalemia of 3.15 mmol/L, and hypocalcemia of 0.99 mmol/L. All the other bioumoral parameters (baseline biochemistry, coagulation panel, blood urea nitrogen, creatinine, lactate, fibrinogen, albumin, total protein, alanine aminotransferase, aspartate aminotransferase, bilirubin, cholesterol, creatine kinase, and creatine kinase-MB) were within a normal range. Genetic tests could not be performed during hospitalization. The diagnosis was considered as TEN. A SCORTEN score ( Table 1 ) of 3 points was calculated. Using the algorithm for the assessment of drug causality in epidermal necrolysis (ALDEN) , we obtained a score of 6 points, indicating that the suspected drug was very likely the causative agent. Additionally, a Naranjo score of 9 points sustained the implication of the incriminated agent. Nikolsky’s sign (tenderness of the tegument, with dislodgment of the epidermis and extension of the blisters at lateral pressure application) was positive. Upon admission, systemic corticosteroids were initiated with 500 mg of methylprednisolone twice a day for 5 days, followed by tapering, along with 5 mg/day of levocetirizine, 40 mg/day of omeprazole, a replacement of fluid loss to maintain a urinary output of 0.5–1 mL/kg/hour, a correction of electrolyte imbalances, nutritional support, pain control, and general hygiene using chlorhexidine 4%. For the nasal mucosa lesions, the otorhinolaryngologist prescribed topical applications with hydrocortisone butyrate, and they prescribed topical hyaluronic acid for the oral ulcerations. The ophthalmological consultation revealed eyelid and conjunctival lesions, eye pain, and slightly blurred vision, and a topical treatment with a tobramycin/dexamethasone ophthalmic solution, along with periodic flushing with a saline solution, was initiated. The patient was evaluated by the gynecologist, who diagnosed vulvovaginitis based on an erythematous vulva and vaginal mucosa with moderate leukorrhea. A full bacterial screening was performed upon admission, identifying the presence of Staphylococcus epidermis in the ears, conjunctival secretions, and Escherichia coli in vaginal secretion. Considering that the main differential diagnosis for SJS/TEN are mainly infectious diseases, along with the increased risk of infections in face of important rapid skin detachment, the patient was evaluated by an infectious disease specialist. Due to the low SCORTEN score, along with minor leukocytosis and negative procalcitonin, there was no need for antibiotic initiation. On the second day of hospitalization, due to erosive lesions on the oral and nasal mucosa and evolving epidermal detachment (almost 30%), a skin biopsy was performed, confirming the previously established diagnosis of SJS-TEN overlap 48 h after admission to the intensive care unit. The histopathological appearance was suggestive of vesicular dermatosis with transepidermal necrolysis, which was consistent with Stevens–Johnson syndrome . Starting from the 10th day of intensive care, a regression of the lesions was observed, with the appearance of areas of tissue re-epithelialization. Urinary bacteriological examination revealed the presence of Escherichia coli and Klebsiella pneumoniae , both of which are sensitive to quinolones, and due to the association of dysuria and leukocytosis, the nephrologist decided to initiate antibiotic therapy with 500 mg/day of levofloxacin for 5 days. Systemic cortisone therapy was tapered from intravenous to oral administration until complete discontinuation. Under this complex management, after three weeks, the skin was fully re-epithelized, with areas of skin hyperpigmentation and mild anxiety. The patient was able to be discharged with the recommendation to avoid the lifelong use of all selective COX inhibitors agents.
4.09375
0.970703
sec[1]/p[0]
en
0.999995
PMC10418430
https://doi.org/10.3390/healthcare11152195
[ "skin", "oral", "lesions", "which", "mucosa", "score", "along", "drug", "pain", "almost" ]
[ { "code": "ME67", "title": "Skin disorder of uncertain or unspecified nature" }, { "code": "ME66.Y", "title": "Other specified skin changes" }, { "code": "EM0Y", "title": "Other specified diseases of the skin" }, { "code": "ME60.Z", "title": "Skin lesion of unspecified nature" }, { "code": "ME66.1", "title": "Changes in skin texture" }, { "code": "MD11.8Z", "title": "Mouth breathing, unspecified" }, { "code": "DA01.00", "title": "Oral leukoplakia" }, { "code": "DA01.10", "title": "Oral aphthae or aphtha-like ulceration" }, { "code": "MD80.1", "title": "Symptom or complaint of the mouth, tongue or lip" }, { "code": "DA01.1Y", "title": "Other specified noninfectious erosive or ulcerative disorders of oral mucosa" } ]
=== ICD-11 CODES FOUND === [ME67] Skin disorder of uncertain or unspecified nature Definition: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question. Also known as: Skin disorder of uncertain or unspecified nature | Skin disorder without established diagnosis | change of skin NOS | dermatological disease NOS | dermatological disorder NOS [ME66.Y] Other specified skin changes Also known as: Other specified skin changes | Cutis marmorata | Fear of skin disease | Retention hyperkeratosis | Dermatitis neglecta [EM0Y] Other specified diseases of the skin Also known as: Other specified diseases of the skin | Adverse cutaneous effects of healthcare related interventions | Cutaneous complications of surgical, laser or other interventional procedures | Postprocedural cutaneous complications of surgical, laser or other interventions | Cutaneous complications of surgical procedures [ME60.Z] Skin lesion of unspecified nature Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature [ME66.1] Changes in skin texture Definition: Alterations in skin texture of unspecified cause. Also known as: Changes in skin texture | Skin textural disturbance | Thickening of skin | induration of skin | Skin sclerosis [MD11.8Z] Mouth breathing, unspecified Also known as: Mouth breathing, unspecified | Mouth breathing | breathing orally | mouth respiration [DA01.00] Oral leukoplakia Definition: Leukoplakia is a condition where areas of keratosis appear as adherent white patches on the mucous membranes of the oral cavity. Leukoplakia may affect other gastrointestinal tract mucosal sites, or mucosal surfaces of the urinary tract and genitals. Also known as: Oral leukoplakia | Leukoplakia of gingiva | leukoplakia of oral epithelium | leucoplakia of oral mucosa | leukokeratosis of oral mucosa Includes: Leukoplakia of gingiva Excludes: Hairy leukoplakia [DA01.10] Oral aphthae or aphtha-like ulceration Definition: This is a frequent small, shallow, painful ulceration in the oral mucosa. Recurrent oral ulceration that clinically resembles recurrent aphthous stomatitis but presents atypically, including commencement after adolescence, with fever, with a strong family history, or failing to resolve with age. Also known as: Oral aphthae or aphtha-like ulceration | Recurrent aphthous stomatitis | Recurrent oral aphthae | Major recurrent aphthous stomatitis | major aphthous stomatitis [MD80.1] Symptom or complaint of the mouth, tongue or lip Also known as: Symptom or complaint of the mouth, tongue or lip | Mouth swelling | mouth oedema | swollen mouth | Lip swelling [DA01.1Y] Other specified noninfectious erosive or ulcerative disorders of oral mucosa Also known as: Other specified noninfectious erosive or ulcerative disorders of oral mucosa | Oral ulceration due to immunobullous disease | Oral mucosal involvement by immunobullous disorder classified elsewhere | Oral ulceration due to physical injury | Mechanical oral ulceration === GRAPH WALKS === --- Walk 1 --- [ME67] Skin disorder of uncertain or unspecified nature Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question.... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --CHILD--> [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --- Walk 2 --- [ME67] Skin disorder of uncertain or unspecified nature Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question.... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --PARENT--> [?] Symptoms, signs or clinical findings involving the skin --- Walk 3 --- [ME66.Y] Other specified skin changes --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs Def: Other specified skin changes which cannot be more precisely defined.... --CHILD--> [ME66.1] Changes in skin texture Def: Alterations in skin texture of unspecified cause.... --- Walk 4 --- [ME66.Y] Other specified skin changes --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs Def: Other specified skin changes which cannot be more precisely defined.... --CHILD--> [ME66.2] Excess and redundant skin Def: A condition which typically occurs in formerly grossly obese individuals following massive weight loss, as following bariatric surgery or severe calorie restriction.... --- Walk 5 --- [EM0Y] Other specified diseases of the skin --PARENT--> [14] Diseases of the skin Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and... --RELATED_TO--> [?] Haematoma of surgical wound of skin Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis... --- Walk 6 --- [EM0Y] Other specified diseases of the skin --PARENT--> [14] Diseases of the skin Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and... --CHILD--> [?] Certain skin disorders attributable to infection or infestation Def: Infections and infestations affecting the skin incorporate both direct invasion of the skin (including associated mucous membranes, hair and nails) by microorganisms or parasites and dermatoses arisin...
[ "[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...", "[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --PARENT--> [?] Symptoms, signs or clinical findings involving the skin", "[ME66.Y] Other specified skin changes\n --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs\n Def: Other specified skin changes which cannot be more precisely defined....\n --CHILD--> [ME66.1] Changes in skin texture\n Def: Alterations in skin texture of unspecified cause....", "[ME66.Y] Other specified skin changes\n --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs\n Def: Other specified skin changes which cannot be more precisely defined....\n --CHILD--> [ME66.2] Excess and redundant skin\n Def: A condition which typically occurs in formerly grossly obese individuals following massive weight loss, as following bariatric surgery or severe calorie restriction....", "[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --RELATED_TO--> [?] Haematoma of surgical wound of skin\n Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis...", "[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --CHILD--> [?] Certain skin disorders attributable to infection or infestation\n Def: Infections and infestations affecting the skin incorporate both direct invasion of the skin (including associated mucous membranes, hair and nails) by microorganisms or parasites and dermatoses arisin..." ]
ME67
Skin disorder of uncertain or unspecified nature
[ { "from_icd11": "ME67", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "ME66.Y", "icd10_code": "L578", "icd10_title": "Other skin changes due to chronic exposure to nonionizing radiation" }, { "from_icd11": "EM0Y", "icd10_code": "L918", "icd10_title": "Other hypertrophic disorders of the skin" }, { "from_icd11": "EM0Y", "icd10_code": "L988", "icd10_title": "Other specified disorders of the skin and subcutaneous tissue" }, { "from_icd11": "ME66.1", "icd10_code": "R234", "icd10_title": "Changes in skin texture" }, { "from_icd11": "MD11.8Z", "icd10_code": "R065", "icd10_title": "Mouth breathing" }, { "from_icd11": "DA01.00", "icd10_code": "K1329", "icd10_title": "Other disturbances of oral epithelium, including tongue" }, { "from_icd11": "DA01.00", "icd10_code": "K1321", "icd10_title": "Leukoplakia of oral mucosa, including tongue" }, { "from_icd11": "DA01.00", "icd10_code": "K132", "icd10_title": "Leukoplakia and other disturbances of oral epithelium, including tongue" }, { "from_icd11": "DA01.10", "icd10_code": "K120", "icd10_title": "Recurrent oral aphthae" } ]
L989
Disorder of the skin and subcutaneous tissue, unspecified
We hereby present the case of a 72-year-old woman with an extended cSCC of the leg with tibial infiltration, developed on a chronic ulcer that developed on top of NL, without diabetes mellitus . Eighteen years before, the patient had developed the same condition on the contralateral leg and a below the knee amputation had been performed. After biopsy for confirmation and staging including whole body CT scan and regional lymph node sonography, the tumor board recommended the curative resection of the localized tumor. A curative en bloc resection of the tumor together with the soft tissue and 15 cm of involved tibia was performed . A polymethyl methacrylate (PMMA) spacer was used to bridge the tibia and an external fixator stabilized the leg . The wound was temporarily closed using negative wound pressure therapy (NPWT). The histopathological findings showed macroscopically a 165 × 152-mm large tumor, microscopically with 22-mm invasion of the fatty tissue and 10-mm invasion of the tibia, with a at least 18-mm tumor-free margin on the surface and at least 5 mm deep (pT4a, pNx, L0, V0, Pn0, G2, R0) . After achieving the R0 resection, a reconstruction plan was developed. Digital subtraction angiography was performed, showing a three-vessel supply of the leg. Being the only leg in an otherwise healthy patient who was mobile with a leg prosthesis on the right side, the indication for limb preservation was established. Seven days after the first surgery, the reconstructive surgery took place. The PMMA spacer was removed and a proximal pedicled fibular bone flap was harvested. The bone length was 18 cm. The bone ends were then beveled to fit the tibial medullary cavity and the fibula was then press-fitted in the tibia, reconstructing the 15-cm bone gap with 1.5 cm of fibula lying proximally and distally in the tibia . Two centimeters of proximal fibula was resected to ensure a tension-free pedicle positioning. A plate and screw osteosynthesis was performed, bridging the fibula graft, but fixating the beveled edges to the tibia. The external fixator was now removed. The muscles of the anterior and lateral compartment remained supplied by the anterior tibial vascular pedicle. The remaining soft tissue defect of 26 × 20 cm was measured and a template was transferred to the right thigh, centered on the descending branch of the lateral circumflex femoral artery. An extended ALT fasciocutaneous flap measuring 26 × 14 cm including two perforator vessels was harvested. The vessel anastomosis at the recipient site was performed to the anterior tibial artery as a flow-through flap and to the venae commitantes using vessel couplers . The medially exposed gastrocnemius muscle was split skin grafted . The donor site was also split skin grafted from the contralateral side. Postoperatively antibiotic treatment was initiated. The distal part of the flap (8 × 4 cm) showed a demarcation due to inadequate perfusion . At revision surgery, after flap debridement, pus emptied from the plate surroundings. A thorough debridement with lavage of the site was performed. NPWT was used for one cycle to control the infection. Bacteroides fragilis could be isolated and the antibiotics were adapted to the antibiogram. At the next surgery, further debridement and lavage with the exchange of the plate and screws was performed. The remaining soft tissue defect was covered with a second ALT flap measuring 16 × 7 cm from the left thigh, including the fresh split skin donor sites, using two perforator vessels . The flap anastomosis was performed end-to-side to the posterior tibial vessels, distal to the first anastomosis. The donor site was closed primarily. Postoperatively, all wounds showed primary healing. The antibiotics were administered for a total of 6 weeks starting from the last surgery. After 4 weeks, mobilization with partial weight-bearing of the leg was initiated. Twelve weeks postoperatively, ambulation using a wheeled walker was started. Fig. 1 a Preoperative clinical photo. b Sagittal slice of preoperative CT scan (latero-lateral). c Coronal slice of preoperative MRI. d Coronal slice of preoperative MRI Fig. 2 a Intraoperative photo of the leg before en bloc tumor resection. b Leg after en bloc resection and external fixation. c Leg after implantation of the PMMA spacer. d Histopathological images with cSCC, 3 × magnification. e Histopathological images with cSCC, 8 × magnification Fig. 3 a Intraoperative planning before fibula harvest. b Pedicled fibula before transposition. c Transposed fibula as press fit into the tibial stumps. d Reconstructed tibia before plate osteosynthesis Fig. 4 a Reconstructed tibia with the plate osteosynthesis and the extended ALT flap with the two perforator vessels. b Lateral aspect of the leg after reconstruction. c Medial aspect of the leg after reconstruction Fig. 5 a Leg 4 days postoperative with reduced perfusion of the distal part, anterior view. b Leg 4 days postoperative with reduced perfusion of the distal part, medial view
4.050781
0.972168
sec[1]/p[0]
en
0.999996
PMC9901077
https://doi.org/10.1186/s12957-023-02923-z
[ "tibia", "flap", "fibula", "tibial", "tumor", "resection", "plate", "tissue", "using", "bone" ]
[ { "code": "LB9A.1", "title": "Tibial hemimelia" }, { "code": "FA31.Y", "title": "Other specified acquired deformities of limbs" }, { "code": "FB54.Y", "title": "Other specified enthesopathies of lower limb" }, { "code": "8C75", "title": "Distal myopathies" }, { "code": "8C11.4", "title": "Lesion of tibial nerve" }, { "code": "EM0Y", "title": "Other specified diseases of the skin" }, { "code": "EL51", "title": "Cutaneous flap necrosis" }, { "code": "EL52", "title": "Myocutaneous flap necrosis" }, { "code": "LB9A.2", "title": "Fibular hemimelia" }, { "code": "FB86.11", "title": "Hypertrophy of bone" } ]
=== ICD-11 CODES FOUND === [LB9A.1] Tibial hemimelia Definition: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula. Also known as: Tibial hemimelia | Longitudinal reduction defect of tibia | agenesis of tibia | congenital absence of tibia | congenital absence of tibia with or without absence of some distal elements [FA31.Y] Other specified acquired deformities of limbs Also known as: Other specified acquired deformities of limbs | Acquired deformity of forearm | Deflection of radius | Bowing of the radius | Bowing of forearm [FB54.Y] Other specified enthesopathies of lower limb Also known as: Other specified enthesopathies of lower limb | Anterior tibial syndrome | Enthesopathy of hip region | enthesopathy of hip NOS | Enthesopathy of knee region Includes: Anterior tibial syndrome [8C75] Distal myopathies Definition: Distal myopathies are heterogeneous group of myopathies characterised clinically by progressive weakness and atrophy starting in distal muscles and progressing to proximal ones, and histologically by nonspecific myopathic features on muscle biopsy. Also known as: Distal myopathies | Distal muscular dystrophy | Distal myopathy with anterior tibial onset | Markesbery-Griggs distal myopathy | Tibial muscular dystrophy [8C11.4] Lesion of tibial nerve Also known as: Lesion of tibial nerve | Lesion of medial popliteal nerve | Lesion of sural nerve Excludes: Injury of tibial nerve at lower leg level [EM0Y] Other specified diseases of the skin Also known as: Other specified diseases of the skin | Adverse cutaneous effects of healthcare related interventions | Cutaneous complications of surgical, laser or other interventional procedures | Postprocedural cutaneous complications of surgical, laser or other interventions | Cutaneous complications of surgical procedures [EL51] Cutaneous flap necrosis Definition: Necrosis of surgical skin flap Also known as: Cutaneous flap necrosis | Cutaneous flap necrosis, partial | Cutaneous flap necrosis, total [EL52] Myocutaneous flap necrosis Definition: Necrosis of a surgical flap containing both skin and muscle Also known as: Myocutaneous flap necrosis | Myocutaneous flap necrosis, partial | Myocutaneous flap necrosis, total [LB9A.2] Fibular hemimelia Definition: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone. Also known as: Fibular hemimelia | Longitudinal reduction defect of fibula | agenesis of fibula | congenital absence of fibula | congenital absence of fibula with or without absence of some distal elements [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification === GRAPH WALKS === --- Walk 1 --- [LB9A.1] Tibial hemimelia Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula.... --PARENT--> [LB9A] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --PARENT--> [?] Structural developmental anomalies of the skeleton Def: A deformation established before birth of an anatomical structure of one or more bones.... --- Walk 2 --- [LB9A.1] Tibial hemimelia Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula.... --PARENT--> [LB9A] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --PARENT--> [?] Structural developmental anomalies of the skeleton Def: A deformation established before birth of an anatomical structure of one or more bones.... --- Walk 3 --- [FA31.Y] Other specified acquired deformities of limbs --PARENT--> [FA31] Other acquired deformities of limbs --EXCLUDES--> [?] Structural developmental anomalies of the skeleton Def: A deformation established before birth of an anatomical structure of one or more bones.... --- Walk 4 --- [FA31.Y] Other specified acquired deformities of limbs --PARENT--> [FA31] Other acquired deformities of limbs --EXCLUDES--> [?] Acquired deformities of fingers or toes --- Walk 5 --- [FB54.Y] Other specified enthesopathies of lower limb --PARENT--> [FB54] Enthesopathies of lower limb Def: This is a group of disorders which refer to any abnormality of tendon and ligament insertion points of the leg. Abnormalities include inflammation and calcification.... --PARENT--> [?] Miscellaneous specified soft tissue disorders Def: This is a group of other disorders, which are not defined elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone.... --- Walk 6 --- [FB54.Y] Other specified enthesopathies of lower limb --PARENT--> [FB54] Enthesopathies of lower limb Def: This is a group of disorders which refer to any abnormality of tendon and ligament insertion points of the leg. Abnormalities include inflammation and calcification.... --CHILD--> [FB54.1] Iliotibial band syndrome Def: This is the most common running injury of the lateral side of the knee. It is a non-traumatic overuse injury caused by repeated flexion and extension of the knee that causes irritation in the structur...
[ "[LB9A.1] Tibial hemimelia\n Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --PARENT--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....", "[LB9A.1] Tibial hemimelia\n Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --PARENT--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....", "[FA31.Y] Other specified acquired deformities of limbs\n --PARENT--> [FA31] Other acquired deformities of limbs\n --EXCLUDES--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....", "[FA31.Y] Other specified acquired deformities of limbs\n --PARENT--> [FA31] Other acquired deformities of limbs\n --EXCLUDES--> [?] Acquired deformities of fingers or toes", "[FB54.Y] Other specified enthesopathies of lower limb\n --PARENT--> [FB54] Enthesopathies of lower limb\n Def: This is a group of disorders which refer to any abnormality of tendon and ligament insertion points of the leg. Abnormalities include inflammation and calcification....\n --PARENT--> [?] Miscellaneous specified soft tissue disorders\n Def: This is a group of other disorders, which are not defined elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....", "[FB54.Y] Other specified enthesopathies of lower limb\n --PARENT--> [FB54] Enthesopathies of lower limb\n Def: This is a group of disorders which refer to any abnormality of tendon and ligament insertion points of the leg. Abnormalities include inflammation and calcification....\n --CHILD--> [FB54.1] Iliotibial band syndrome\n Def: This is the most common running injury of the lateral side of the knee. It is a non-traumatic overuse injury caused by repeated flexion and extension of the knee that causes irritation in the structur..." ]
LB9A.1
Tibial hemimelia
[ { "from_icd11": "LB9A.1", "icd10_code": "Q7252", "icd10_title": "Longitudinal reduction defect of left tibia" }, { "from_icd11": "LB9A.1", "icd10_code": "Q725", "icd10_title": "Longitudinal reduction defect of tibia" }, { "from_icd11": "8C75", "icd10_code": "G718", "icd10_title": "Other primary disorders of muscles" }, { "from_icd11": "8C11.4", "icd10_code": "G574", "icd10_title": "Lesion of medial popliteal nerve" }, { "from_icd11": "EM0Y", "icd10_code": "L918", "icd10_title": "Other hypertrophic disorders of the skin" }, { "from_icd11": "EM0Y", "icd10_code": "L988", "icd10_title": "Other specified disorders of the skin and subcutaneous tissue" }, { "from_icd11": "EL51", "icd10_code": "T85898A", "icd10_title": "Other specified complication of other internal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T8586XA", "icd10_title": "" }, { "from_icd11": "EL51", "icd10_code": "T85868A", "icd10_title": "Thrombosis due to other internal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T85848A", "icd10_title": "Pain due to other internal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T85858A", "icd10_title": "Stenosis due to other internal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T85840A", "icd10_title": "Pain due to nervous system prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T85868D", "icd10_title": "Thrombosis due to other internal prosthetic devices, implants and grafts, subsequent encounter" }, { "from_icd11": "EL51", "icd10_code": "T85838A", "icd10_title": "Hemorrhage due to other internal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T85890A", "icd10_title": "Other specified complication of nervous system prosthetic devices, implants and grafts, initial encounter" } ]
Q7252
Longitudinal reduction defect of left tibia
An 8-year-old female presented to our unit with early morning headaches, vomiting, and loss of speech fluency for 1 month. Magnetic resonance imaging (MRI) demonstrated a left pontine exophytic tumour without significant pre-operative hydrocephalus . The patient subsequently underwent a midline posterior fossa craniotomy with gross total tumour resection, and histology specimens taken intra-operatively confirmed a WHO grade I low-grade glioma. A non-watertight dural closure was achieved at the end of surgery and the bone flap replaced with miniplates and screws, as per standard practice in our institution. On the fourth post-operative day, the patient developed a CSF leak requiring re-suturing and subsequent repeat MRI, obtained due to headaches and vomiting, showed new pan-ventricular hydrocephalus and a large occipital pseudomeningocele . An endoscopic third ventriculostomy (ETV) was subsequently undertaken with fenestration of both the third ventricular floor and Lillequist’s membrane, with good flow seen across the stoma intra-operatively. Despite symptomatic improvement and good CSF flow across the stoma on post-operative MRI, the pseudomeningocele continued to increase in size over the following 2 ½ months, with an unchanged ventricular configuration . The patient and her parents were counselled that insertion of ventriculoperitoneal (VP) shunt may be necessary but elected to continue with conservative management and repeat MR imaging at 3 ½ months post-surgery demonstrated reduction of both the pseudomeningocele and the associated ventriculomegaly. Palpable hardening of the pseudomeningocele was observed and subsequent CT imaging demonstrated periosteal reaction around the pseudomeingocele border with new bone formation . For cosmesis and to preserve skin integrity, surgical excision of this large ossified pseudomeningocele was performed , and histological specimens showed fibrous tissue and bony trabeculae with evidence of both active bone formation and bone remodelling in the centre . Patient was subsequently discharged from hospital and follow-up MRI taken approximately 1 month after resection of the ossified occipital pseudomeningocele, as part of the usual tumour follow-up, showed almost complete resolution of the pseudomeningocele with an associated reduction in the degree of pan-ventricular ventriculomegaly . At last clinic follow-up, the patient continues to make a good recovery from the initial surgery with no symptoms or signs of recurrent extra-cranial pseudomeningocele or hydrocephalus. Fig. 1 Pre-operative MRI imaging. Selected pre-operative MRI images demonstrating the exophytic tumour arising from the left pons. Note the presence of both solid enhancing components and non-enhancing cystic regions on the post-contrast T1-weighted imaging (T1W + C). Whilst there was some effacement of the IV th ventricle by the tumour, there was no significant pre-operative hydrocephalus observed, and there were no other intracranial or spinal lesions detected. ADC , apparent diffusion coefficient; T1W , T1-weighted; T1W + C , post-contrast T1-weighted imaging; T2W , T2-weighted Fig. 2 Post-operative MRI imaging showing development of occipital pseudomeningocele. Axial ( top ) and sagittal ( bottom ) T1-weighted images with or without contrast shown. Note at post-operative day 1 ( left panel ) the absence of any significant pseudomeningocele on the pre- or post-contrast T1-weighted imaging. In the weeks following surgery, a large occipital pseudomeningocele developed in association with pan-ventricular hydrocephalus. Despite an ETV attempt with good flow through the III rd ventricular floor stoma (as seen on the sagittal imaging), this pseudomeningocele continued to enlarge up to 2 ½ months post-surgery with persisting ventriculomegaly ( right panel ) Fig. 3 Ossified occipital meningocele. a Axial CT imaging performed at 3 ½ months post-surgery demonstrates that there has been an interval reduction in the size of the occipital pseudomeningocele associated with a new rim of ossification around its posterior wall. b 3D volume reconstruction of the CT imaging shows this ossification more clearly and its relationship to the underlying bone flap. c Intra-operative photograph (looking from cranio-caudal direction) demonstrates the large rim of ossification seen on right posterior pseudomeningocele wall (*). d Intra-operative histological specimen (H&E, × 50 magnification) showed thickened fibrous tissue with bony trabeculae. In the peripheral areas, at the interface with fibrous tissue, there was evidence of active bone formation with robust osteoblastic activity (*). Reactive woven bone is identified and towards the centre and there is evidence of remodelling of the lamellae ( +). e Axial T1-weighted MRI images taken approximately 1 month after resection of the ossified occipital pseudomeningocele membrane show almost complete resolution of the pseudomeningocele with interval reduction in the degree of pan-ventricular ventriculomegaly
3.949219
0.977539
sec[1]/p[0]
en
0.999997
36680566
https://doi.org/10.1007/s00381-023-05829-z
[ "pseudomeningocele", "imaging", "bone", "ventricular", "occipital", "weighted", "tumour", "hydrocephalus", "large", "both" ]
[ { "code": "5A74.Y", "title": "Other specified adrenocortical insufficiency" }, { "code": "MB27.3", "title": "Disturbance of body image" }, { "code": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "ME21", "title": "Clinical findings on diagnostic imaging of liver or biliary tract" }, { "code": "ME91", "title": "Clinical findings on diagnostic imaging of limbs" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" } ]
=== ICD-11 CODES FOUND === [5A74.Y] Other specified adrenocortical insufficiency Also known as: Other specified adrenocortical insufficiency | Congenital adrenocortical insufficiency | Congenital isolated ACTH deficiency | Familial adrenal hypoplasia | Familial hypoadrenocorticism [MB27.3] Disturbance of body image Definition: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it. Also known as: Disturbance of body image [MD41] Clinical findings on diagnostic imaging of lung Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging. Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass [ME21] Clinical findings on diagnostic imaging of liver or biliary tract Also known as: Clinical findings on diagnostic imaging of liver or biliary tract | Abnormal diagnostic imaging of liver | Nonvisualisation of gallbladder [ME91] Clinical findings on diagnostic imaging of limbs Also known as: Clinical findings on diagnostic imaging of limbs | abnormal diagnostic imaging of limbs [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias === GRAPH WALKS === --- Walk 1 --- [5A74.Y] Other specified adrenocortical insufficiency --PARENT--> [5A74] Adrenocortical insufficiency Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg... --CHILD--> [5A74.Y] Other specified adrenocortical insufficiency --- Walk 2 --- [5A74.Y] Other specified adrenocortical insufficiency --PARENT--> [5A74] Adrenocortical insufficiency Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg... --RELATED_TO--> [?] X-linked adrenoleukodystrophy Def: X-linked adrenoleukodystrophy (X-ALD) is a peroxisomal disease characterised by progressive demyelinisation of the central nervous system (CNS) (brain and/or spinal cord) and peripheral adrenal insuff... --- Walk 3 --- [MB27.3] Disturbance of body image Def: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it.... --PARENT--> [MB27] Symptoms or signs involving perceptual disturbance Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality.... --CHILD--> [MB27.0] Depersonalisation Def: Experiencing the self as strange or unreal, or feeling detached from, or as though one were an outside observer of, one’s thoughts, feelings, sensations, body, or actions. Depersonalization may take t... --- Walk 4 --- [MB27.3] Disturbance of body image Def: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it.... --PARENT--> [MB27] Symptoms or signs involving perceptual disturbance Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality.... --PARENT--> [?] Mental or behavioural symptoms, signs or clinical findings --- Walk 5 --- [MD41] Clinical findings on diagnostic imaging of lung Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us... --PARENT--> [?] Clinical findings in the respiratory system --CHILD--> [MD40] Clinical findings in specimens from respiratory organs and thorax --- Walk 6 --- [MD41] Clinical findings on diagnostic imaging of lung Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us... --PARENT--> [?] Clinical findings in the respiratory system --CHILD--> [MD41] Clinical findings on diagnostic imaging of lung Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...
[ "[5A74.Y] Other specified adrenocortical insufficiency\n --PARENT--> [5A74] Adrenocortical insufficiency\n Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...\n --CHILD--> [5A74.Y] Other specified adrenocortical insufficiency", "[5A74.Y] Other specified adrenocortical insufficiency\n --PARENT--> [5A74] Adrenocortical insufficiency\n Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...\n --RELATED_TO--> [?] X-linked adrenoleukodystrophy\n Def: X-linked adrenoleukodystrophy (X-ALD) is a peroxisomal disease characterised by progressive demyelinisation of the central nervous system (CNS) (brain and/or spinal cord) and peripheral adrenal insuff...", "[MB27.3] Disturbance of body image\n Def: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it....\n --PARENT--> [MB27] Symptoms or signs involving perceptual disturbance\n Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality....\n --CHILD--> [MB27.0] Depersonalisation\n Def: Experiencing the self as strange or unreal, or feeling detached from, or as though one were an outside observer of, one’s thoughts, feelings, sensations, body, or actions. Depersonalization may take t...", "[MB27.3] Disturbance of body image\n Def: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it....\n --PARENT--> [MB27] Symptoms or signs involving perceptual disturbance\n Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality....\n --PARENT--> [?] Mental or behavioural symptoms, signs or clinical findings", "[MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...\n --PARENT--> [?] Clinical findings in the respiratory system\n --CHILD--> [MD40] Clinical findings in specimens from respiratory organs and thorax", "[MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...\n --PARENT--> [?] Clinical findings in the respiratory system\n --CHILD--> [MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us..." ]
5A74.Y
Other specified adrenocortical insufficiency
[ { "from_icd11": "MD41", "icd10_code": "R911", "icd10_title": "Solitary pulmonary nodule" }, { "from_icd11": "MD41", "icd10_code": "R91", "icd10_title": "Abnormal findings on diagnostic imaging of lung" }, { "from_icd11": "ME21", "icd10_code": "R932", "icd10_title": "Abnormal findings on diagnostic imaging of liver and biliary tract" }, { "from_icd11": "ME91", "icd10_code": "R936", "icd10_title": "Abnormal findings on diagnostic imaging of limbs" }, { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X6", "icd10_title": "Other osteomyelitis, lower leg" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X9", "icd10_title": "Other osteomyelitis, unspecified sites" }, { "from_icd11": "FB84.Z", "icd10_code": "M8668", "icd10_title": "Other chronic osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M86662", "icd10_title": "Other chronic osteomyelitis, left tibia and fibula" } ]
R911
Solitary pulmonary nodule
A 48-year-old Chinese woman with no smoking history presented to the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology in October 2020 for chest tightness and chest pain. The 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) revealed a soft tissue density shadow in the right lower lobe with a size of 3.4*2.4 cm; enlarged bilateral supraclavicular and mediastinal lymph nodes, thickened bilateral pleura and increased pericardial effusion were metabolism increased; the metabolism in thoracic vertebrae T4, lumbar vertebrae L1, L5, and right ilium were also increased . Baseline lung enhanced CT images are shown in Figure 2A . Brain MRI showed no abnormalities . In October 2020, the patient underwent ultrasound-guided pericardiocentesis of pericardial effusion. Upon pathological examination of the pericardial effusion, cancer cells were detected, which was consistent with lung adenocarcinoma . Immunohistochemistry yielded the following: PCK (+), TTF-1(+), i+), CK5/6 (–), EGFR (–), C-met (–), Ros-1 (–), ALK (+). Next-generation genetic sequencing (whole-exome sequencing by company of gloriousmed) suggested the ALK EML4 ( 7 , 8 ) - ALK ( 9 , 10 ) fusion. Variant allele frequency (VAF) was 3.81%. Another driver mutation was CUX1 , and others were somatic mutations of no clinical value, such as INPP4A, MED12, CDC73, CIC, SACS, NOTCH3, ARID2, RPS2, IRS2, INHA. Therefore, the patient was initially diagnosed with lung adenocarcinoma stage cT2N3M1c IVB with EML4-ALK gene fusion (AJCC 8th Edition). She started treatment with crizotinib (p.o. 250 mg bid) in October 2020 for financial reasons. In January 2021, the patient’s lung CT showed that the lesion in the lower lobe of the right lung was 2.2*1.7 cm, and the pericardial effusion was significantly reduced ( Figure 2B . According to the criteria of resist1.1, the therapeutic effect was evaluated as partial response (PR). The patient started to have headache and dizziness in September 2021, and brain MRI showed that the pituitary gland was full in shape on September 7, 2021, approximately 1.4*1.4*1.3 cm in size, and the lung lesion was stable . Then, a lumbar puncture was performed, and no significant abnormalities were seen in the cerebrospinal fluid panel, cerebrospinal fluid biochemistry or cerebrospinal fluid cytology. ACTH (0 am): 5.83 pg/ml, ACTH (8 am): 10.20 pg/ml, ACTH (4 pm): 7.03 pg/ml (normal value: 7-64 pg/ml); cortisol (0 am):7.0μg/L, cortisol (8 am):3.0μg/L, cortisol (4 pm): 1.0μg/L (normal values: 37.0-194 μg/L); prolactin: 113.35 ng/ml (normal values: 1.2-29.9 ng/ml). No abnormalities were seen in sex hormones, thyroid hormone, growth hormone, or insulin-like growth factor. Afterward, our team conducted a multidisciplinary consultation with neurology, neurosurgery, and endocrinology and recommended a follow-up MRI after 1 month of supplemental hormone therapy. However, one month later, the patient’s symptoms of headache and dizziness worsened, and the brain MRI re-examination showed that the pituitary gland was enlarged with a size of approximately 1.8*1.4*1.6 cm. On November 15, 2021 , the patient underwent sphenoid sinus exploration and nasal endoscopic saddle area tumor excision in our neurosurgery department. During the operation, the neurosurgery team found an occupying lesion in the sellar area with high dural tension, approximately 2*1.5 cm in size, pink in color, and tightly adherent to the surrounding tissues. The postoperative pathology showed that it was consistent with metastatic adenocarcinoma with neuroendocrine marker expression in some areas of pulmonary origin. Immunohistochemistry yielded the following: PCK (+), TTF-1 (+), Napsin A (+), ACTH (–), GH (–), PRL (–), FSH (–), LH (–), TSH (–), Ki67 (Li: 5%) . The next-generation sequencing (whole-exome sequencing by company of gloriousmed) conducted on the pituitary metastasis suggested EML4 ( 6 )-ALK ( 10 ) fusion with VAF of 2.63%. Interestingly, the ALK gene then revealed a missense mutation . Four non-clinically relevant somatic gene variants (missense mutations) were also detected, namely INPP4A, MAGI2, AMER1, MED12.The patient’s postoperative headache and dizziness were significantly relieved compared to before. The patient’s hormone levels were reviewed on November 29, 2021, and most of the abnormal hormone levels returned to normal. On December 01, 2021, the pituitary gland MRI was reviewed and showed that the pituitary tumor was significantly smaller than before. Based on the patient’s gene sequencing results, we recommended that the patient replace crizotinib with ceritinib. On February 7, 2022, the patient’s lung CT showed that the lesion in the lower lobe of the right lung had shrunk further with a size of 1.8*1.4 cm, and the brain MRI re-examination showed no abnormalities . The patient was reexamined every two months by brain MRI and lung CT. The latest reexamination was on August 7, 2022, and no progression was observed .
4.066406
0.972656
sec[1]/p[0]
en
0.999996
PMC9619101
https://doi.org/10.3389/fonc.2022.1016320
[ "lung", "that", "brain", "sequencing", "pituitary", "hormone", "pericardial", "effusion", "abnormalities", "gene" ]
[ { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "CA40.Z", "title": "Pneumonia, organism unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "NB32.3Y", "title": "Other injury of lung" }, { "code": "8A80.Z", "title": "Migraine, unspecified" }, { "code": "QA76", "title": "Medication or substance that is known to be an allergen without injury or harm" }, { "code": "PL13.6", "title": "Medication or substance that is known to be an allergen, as mode of injury or harm" }, { "code": "9C40.A0", "title": "Papilloedema" }, { "code": "PA6Z", "title": "Unintentional fall from unspecified height" } ]
=== ICD-11 CODES FOUND === [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [CA40.Z] Pneumonia, organism unspecified Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [NB32.3Y] Other injury of lung Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS === GRAPH WALKS === --- Walk 1 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --CHILD--> [CB40.2] Pulmonary collapse --- Walk 2 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Alpha-1-antitrypsin deficiency Def: Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterised by low serum leve... --- Walk 3 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.0] Accessory lobe of lung Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left... --- Walk 4 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --PARENT--> [?] Structural developmental anomalies of the respiratory system --- Walk 5 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o... --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o...
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.2] Pulmonary collapse", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Alpha-1-antitrypsin deficiency\n Def: Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterised by low serum leve...", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies of the respiratory system", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii\n Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii\n Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o..." ]
CB40.Y
Other specified diseases of the respiratory system
[ { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "CA40.Z", "icd10_code": "J189", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J181", "icd10_title": "Lobar pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J188", "icd10_title": "Other pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J168", "icd10_title": "Pneumonia due to other specified infectious organisms" }, { "from_icd11": "CA40.Z", "icd10_code": "J180", "icd10_title": "Bronchopneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J17", "icd10_title": "Pneumonia in diseases classified elsewhere" }, { "from_icd11": "CA40.Z", "icd10_code": "J182", "icd10_title": "Hypostatic pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J16", "icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified" }, { "from_icd11": "CA40.Z", "icd10_code": "J171", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J173", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J178", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J18", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" } ]
Q333
Agenesis of lung
First case of gastritis dog was a male of 6 years old was reported in TVCC, Hisar with the history of urinary incontinence since 10 days. The dog was vomiting simultaneously also. In 2D ultrasonogram, the gastric wall was 0.6 cm thick and hyperechoic. There were different shadows of stomach lumen depending on the presence of gastric contents. Toward caudal and cranial side, there was anechoic content representing fluid in the stomach. Toward ventral side, the image was hypoechoic with echogenic striations due to the presence of semisolid food. The gastric fold was appreciated as hyperechoic striations. The thickening of gastric wall and prominence of gastric folds are indicative of gastritis . In 3D ultrasonogarm, the gastric fold was more distinct and clear. The prominence of the gastric fold is due to inflammatory response. The anechoic content of the fluid toward caudal side is also more distinct on 3D ultrasonogram . The gastric wall was more prominent on 3D ultrasonogram. Different layers of the gastric wall which were not clear on 2D ultrasonogram were seen separately on 3D ultrasonogram. The four layers of the stomach i.e. mucosa, submucosa, muscularis, and serosa were identified on 3D ultrasonogram. The thickening of gastric wall and appearance of separate layers along with the prominence of gastric fold was indicative of gastritis. The inflammatory changes were more distinct on 3D ultrasonogram . Second case of gastritis of a female dog of 3 years was reported in TVCC, Hisar with a history of abdominal distension, vomition, and anorexia since a month. In 2D ultrasonogram, the gastric wall was 0.7 cm thick and hyperechoic. In 2D ultrasonogram, the cavity of the stomach was full of food. Toward dorsal side, there was an anechoic shadow of the fluid. Toward ventral side, there was uniform hypoechoic shadow of the semisolid food. Thickening of gastric wall was indicative of the gastritis . These images were more distinct on 3D ultrasonogram. In 3D ultrasonogram, more distinct thickened gastric wall was seen with all four separate layers of the stomach, i.e., mucosa, submucosa, muscularis, and serosa. The anechoic and hypoechoic shadow of the stomach contents were clearer on 3D ultrasonogram. The inflammatory changes were more distinct on 3D ultrasonogram . Third case of gastritis of a male dog of 2 years was reported in TVCC, Hisar with a history of fever, vomition, inappetence, and weight loss since 1 month. In 2D ultrasonogram, gastric wall was 0.6 cm thick and hyperechoic. The hypoechoic shadow of the semisolid food particle and hyperechoic shadow of solid food particle was seen in 2D ultrasonogram. The gastric folds were not seen in 2D ultrasonogram. Toward ventral side of stomach hyperechoic reflection of the gas was present in 2D ultrasonogram. In 2D ultrasonogram, thickening of the gastric wall was indicative of the gastritis . Fourth case of a male dog of 5 years with a history of ingestion of polythene bag and not passing feces since 7 days. In 2D ultrasonogram toward cranial side of the stomach, there was appearance of anechoic fluid in lumen of the stomach. The gastric wall appeared hyperechoic and 0.55 cm thick. The hypoechoic shadow of the semisolid food particles and hyperechoic shadow of solid food particle was seen on 2D ultrasonogram. The ultrasonographic image of polythene could not be visualized. Due to ingestion of polythene there was tendency of vomiting . In 3D ultrasonogram, the hypoechoic shadow of the semisolid food particles and hyperechoic shadow of solid food particle was clearly seen . Fifth case of gastritis of a male dog of 6 months year was reported in TVCC, Hisar with history of vomition and anorexia since 10 days. In 2D ultrasonogram, gastric wall was 0.6 cm thick and hyperechoic. The anechoic shadow of fluid in the lumen of stomach was seen in 2D ultrasonogram. The semisolid gastric contents appear as hypoechoic in 2D ultrasonogram. The gastric fold was appreciated as hyperechoic striations. The thickening of gastric wall and prominence of gastric folds are indicative of gastritis . The gastric wall was more prominent on 3D ultrasonogram. Different layers of gastric wall, which were not clear on 2D ultrasonogram were seen separately on 3D ultrasonogram. The anechoic shadow of fluid toward dorsal and caudal side of the stomach was prominent in 3D ultrasonogram. The thickening of gastric wall and appearance of separate layers along with prominence of gastric fold was indicative of gastritis. The inflammatory changes were more distinct on 3D ultrasonogram . Sixth case of gastritis of a male dog of 18 months old was reported with a history of eating inanimate objects since 1 month. Ultrasonographically, the hyperechoic shadow of solid food particle and hypoechoic shadow of semisolid food particle was seen in lumen of the stomach. The gastric wall was 0.7 cm thick and hyperechoic indicative of gastritis in the dog. The anechoic shadow of fluid toward ventral side of the stomach was also visible .
3.986328
0.832031
sec[2]/p[1]
en
0.999996
27065634
https://doi.org/10.14202/vetworld.2015.707-712
[ "ultrasonogram", "gastric", "wall", "shadow", "hyperechoic", "stomach", "gastritis", "food", "toward", "side" ]
[ { "code": "DA4Z", "title": "Diseases of stomach, unspecified" }, { "code": "DA60.Z", "title": "Gastric ulcer, unspecified" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "LB13.Z", "title": "Structural developmental anomalies of stomach, unspecified" }, { "code": "DA42.73", "title": "Chronic atrophic gastritis of unknown aetiology" }, { "code": "LB0Y", "title": "Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord" }, { "code": "PA82", "title": "Unintentional striking against stationary object" }, { "code": "NB50.Y&XA3KX0&XJ1C6", "title": "Haematoma of abdominal wall" }, { "code": "DC51.1", "title": "Peritoneal adhesions" }, { "code": "LB73.1Z", "title": "Structural developmental anomalies of chest wall, unspecified" } ]
=== ICD-11 CODES FOUND === [DA4Z] Diseases of stomach, unspecified Also known as: Diseases of stomach, unspecified | disorder of stomach | gastropathy NOS | gastric disease NOS | stomach disease NOS [DA60.Z] Gastric ulcer, unspecified Also known as: Gastric ulcer, unspecified | Gastric ulcer | stomach ulcer | Cushings ulcer | cushing's ulcer of stomach [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [LB13.Z] Structural developmental anomalies of stomach, unspecified Also known as: Structural developmental anomalies of stomach, unspecified | Structural developmental anomalies of stomach | Malformations of stomach [DA42.73] Chronic atrophic gastritis of unknown aetiology Definition: Persistent or recurrent inflammation of the gastric mucosa with atrophy leading to decreased hydrochloric acid concentration in the gastric juice. Atrophic gastritis frequently progresses from chronic gastritis. Also known as: Chronic atrophic gastritis of unknown aetiology | Gastric atrophy | atrophic gastritis | AG - [atrophic gastritis] | CAG - [chronic atrophic gastritis] Includes: Gastric atrophy [LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord Also known as: Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord | Congenital deformity of abdominal wall | abdominal wall defect NOS [PA82] Unintentional striking against stationary object Also known as: Unintentional striking against stationary object | striking against stationary object | striking against or struck by other objects | Walked into wall [DC51.1] Peritoneal adhesions Definition: Disorders of peritoneum sticking by scar tissue or fibrosis Also known as: Peritoneal adhesions | abdominal adhesion | adhesive peritoneal band | peritoneal adhesion | peritoneal band Excludes: Adhesions of large intestine with obstruction | Postprocedural pelvic peritoneal adhesions | Intestinal adhesions or bands of small intestine with obstruction [LB73.1Z] Structural developmental anomalies of chest wall, unspecified Also known as: Structural developmental anomalies of chest wall, unspecified | Structural developmental anomalies of chest wall | Malformations of chest wall === GRAPH WALKS === --- Walk 1 --- [DA4Z] Diseases of stomach, unspecified --PARENT--> [?] Diseases of stomach Def: This is a group of conditions characterised as being in or associated with the stomach.... --RELATED_TO--> [?] Peptic ulcer, site unspecified Def: Peptic ulcer is defined as a distinct breach in the mucosa of the gastrointestinal tract as a result of caustic effects of acid and pepsin in the lumen. A peptic ulcer may develop in any part of the g... --- Walk 2 --- [DA4Z] Diseases of stomach, unspecified --PARENT--> [?] Diseases of stomach Def: This is a group of conditions characterised as being in or associated with the stomach.... --RELATED_TO--> [?] Peptic ulcer, site unspecified Def: Peptic ulcer is defined as a distinct breach in the mucosa of the gastrointestinal tract as a result of caustic effects of acid and pepsin in the lumen. A peptic ulcer may develop in any part of the g... --- Walk 3 --- [DA60.Z] Gastric ulcer, unspecified --PARENT--> [DA60] Gastric ulcer Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th... --EXCLUDES--> [?] Acute haemorrhagic gastritis of unknown aetiology Def: Rapid onset inflammation of the mucosal lining of the stomach with associated bleeding or abnormal blood flow.... --- Walk 4 --- [DA60.Z] Gastric ulcer, unspecified --PARENT--> [DA60] Gastric ulcer Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th... --EXCLUDES--> [?] Acute haemorrhagic gastritis of unknown aetiology Def: Rapid onset inflammation of the mucosal lining of the stomach with associated bleeding or abnormal blood flow.... --- Walk 5 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --CHILD--> [QF01.Y] Other specified acquired absence of organs --- Walk 6 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --CHILD--> [QF01.0] Acquired absence of breast
[ "[DA4Z] Diseases of stomach, unspecified\n --PARENT--> [?] Diseases of stomach\n Def: This is a group of conditions characterised as being in or associated with the stomach....\n --RELATED_TO--> [?] Peptic ulcer, site unspecified\n Def: Peptic ulcer is defined as a distinct breach in the mucosa of the gastrointestinal tract as a result of caustic effects of acid and pepsin in the lumen. A peptic ulcer may develop in any part of the g...", "[DA4Z] Diseases of stomach, unspecified\n --PARENT--> [?] Diseases of stomach\n Def: This is a group of conditions characterised as being in or associated with the stomach....\n --RELATED_TO--> [?] Peptic ulcer, site unspecified\n Def: Peptic ulcer is defined as a distinct breach in the mucosa of the gastrointestinal tract as a result of caustic effects of acid and pepsin in the lumen. A peptic ulcer may develop in any part of the g...", "[DA60.Z] Gastric ulcer, unspecified\n --PARENT--> [DA60] Gastric ulcer\n Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th...\n --EXCLUDES--> [?] Acute haemorrhagic gastritis of unknown aetiology\n Def: Rapid onset inflammation of the mucosal lining of the stomach with associated bleeding or abnormal blood flow....", "[DA60.Z] Gastric ulcer, unspecified\n --PARENT--> [DA60] Gastric ulcer\n Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th...\n --EXCLUDES--> [?] Acute haemorrhagic gastritis of unknown aetiology\n Def: Rapid onset inflammation of the mucosal lining of the stomach with associated bleeding or abnormal blood flow....", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --CHILD--> [QF01.Y] Other specified acquired absence of organs", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --CHILD--> [QF01.0] Acquired absence of breast" ]
DA4Z
Diseases of stomach, unspecified
[ { "from_icd11": "DA60.Z", "icd10_code": "K259", "icd10_title": "Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K255", "icd10_title": "Chronic or unspecified gastric ulcer with perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K254", "icd10_title": "Chronic or unspecified gastric ulcer with hemorrhage" }, { "from_icd11": "DA60.Z", "icd10_code": "K257", "icd10_title": "Chronic gastric ulcer without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K250", "icd10_title": "Acute gastric ulcer with hemorrhage" }, { "from_icd11": "DA60.Z", "icd10_code": "K256", "icd10_title": "Chronic or unspecified gastric ulcer with both hemorrhage and perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K253", "icd10_title": "Acute gastric ulcer without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K252", "icd10_title": "Acute gastric ulcer with both hemorrhage and perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K251", "icd10_title": "Acute gastric ulcer with perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K25", "icd10_title": "Gastric ulcer" }, { "from_icd11": "QF01.Y", "icd10_code": "Z9049", "icd10_title": "Acquired absence of other specified parts of digestive tract" }, { "from_icd11": "LB13.Z", "icd10_code": "Q402", "icd10_title": "Other specified congenital malformations of stomach" }, { "from_icd11": "LB13.Z", "icd10_code": "Q403", "icd10_title": "Congenital malformation of stomach, unspecified" }, { "from_icd11": "DA42.73", "icd10_code": "K2940", "icd10_title": "Chronic atrophic gastritis without bleeding" }, { "from_icd11": "DA42.73", "icd10_code": "K2941", "icd10_title": "Chronic atrophic gastritis with bleeding" } ]
K259
Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation
After starting antibiotic and anti-inflammatory therapy, the patient's complaints disappeared within 4 days. After 1 month, a follow-up laryngoscopy showed that the ectopic lingual thyroid gland had decreased in size. Examination after 2 months showed that the ectopic thyroid gland was continuing to decrease in size. The patient did not have any complaints of fullness in the throat, dysphagia or dyspnoea. Blood investigations and biochemical analysis, including thyroid-stimulating hormones, triiodothyronine and thyroxine, were within normal range. An ectopic thyroid gland is a functioning gland, which is located away from its usual position in the lower neck. An ectopic thyroid gland develops as a result of abnormal embryological migration from the foramen caecum to the usual location of the gland in the pretracheal area. An ectopic thyroid gland can develop anywhere in the path of migration of the gland from the foramen caecum to its usual location. 1 , 2 When migration of the thyroid gland stops at the base of the tongue, it results in a lingual thyroid. The incidence of ectopic thyroid gland is unknown because, in many cases, the thyroid tissue is asymptomatic and symptoms occur only if the ectopic thyroid gland becomes enlarged. Enlargement of the thyroid gland can occur at all ages, but it occurs most often during puberty, gestation or while experiencing upper respiratory tract infections. 1 , 3 If symptomatic, the clinical presentation may vary, depending on the location of the thyroid gland. A lingual thyroid gland can manifest as dysphagia, dyspnoea or dysphonia. 1 Acute infectious thyroiditis related to lingual thyroid gland is rare, 4 and in the medical literature, it has been described very sparingly. The typical clinical symptoms of acute infectious thyroiditis are febrile temperature and painful thyroid gland with local redness. Diagnosing an ectopic thyroid gland is not problematic if the clinician has considered the possibility of thyroid ectopia, because radiological examinations and nuclear medicine tests, such as scintigraphy, are sufficiently informative. 5 , 6 Ultrasound, CT scans and MRI help in visualizing the atypical anatomical structures at the root of the lingua. Thyroid gland scintigraphy with 99m Tc pertechnetate reveals radioisotope uptake by functional thyroid tissues located away from the typical position of the gland in the neck, and summing up the results of the radiological and functional nuclear medicine tests can provide a true diagnosis of an ectopic thyroid gland. Once the diagnosis is confirmed, treatment is required. A few treatment points are described later in this report. Treatment of this condition depends on results of laboratory and functional test, and radiological imaging. If the patient has no symptoms, observation is often required, especially in cases where the thyroid gland is functioning well. 7 In many cases, ectopia of the thyroid gland is associated with hypothyroidism. In approximately one-third of cases, there is decrease in functioning of the thyroid gland, 5 leading to the use of thyroid hormone. 1 If the thyroid gland is enlarged, homone suppression therapy may be necessary to minimize the size of the gland; radioiodine ablation may be used in patients with progressive and symptomatic enlargement of the thyroid gland. 2 Surgical treatment (thyroidectomy) is not necessary in most cases, but surgery can be performed if the symptoms progress despite medical management. Surgery is also required if the ectopic thyroid gland is associated with malignant thyroid disease. 1 , 5 Carcinoma arising in a lingual thyroid gland is extremely rare, with an estimated incidence of 1%, often occurring during the third decade of life. 8 In our case, the patient had symptoms typical of lingual thyroid gland, such as fullness in the throat, dysphagia and dyspnoea, but, in addition to these symptoms, she also had febrile temperature and pain during swallowing, which is not typical of an ectopic thyroid gland; therefore, the differential diagnosis of abscess was considered. In this case, the patient had an ultrasound performed, but the thyroid gland was not located in its usual position in the neck; therefore, a contrast-enhanced CT scan was required, which showed a structure at the root of the tongue with other suspected diagnoses. After 99m Tc pertechnetate scintigraphy of the thyroid gland was performed, it became clear that the lingual structure was an ectopic thyroid lesion, and according to laboratory findings and clinical investigation, it seemed to be acute infectious thyroiditis associated with lingual thyroid gland. It was assumed that the lingual thyroid gland had increased in size during the phase of acute infectious thyroiditis. This is rare; therefore, the patient was treated with antibiotics and anti-inflammatory medication, and the treatment was successful—symptoms diminished and blood tests improved. Surgical treatment was not considered as there was no suspicion of malignancy.
4.25
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en
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30363312
https://doi.org/10.1259/bjrcr.20160025
[ "thyroid", "gland", "ectopic", "lingual", "cases", "that", "usual", "infectious", "thyroiditis", "typical" ]
[ { "code": "5A03.Z", "title": "Thyroiditis, unspecified" }, { "code": "5A0Z", "title": "Disorders of the thyroid gland or thyroid hormones system, unspecified" }, { "code": "5A03.Y", "title": "Other specified thyroiditis" }, { "code": "5A00.2Z", "title": "Acquired hypothyroidism, unspecified" }, { "code": "5A03.0", "title": "Acute thyroiditis" }, { "code": "BD90.Z", "title": "Lymphadenitis, unspecified" }, { "code": "BD90.Y", "title": "Other specified lymphadenitis" }, { "code": "MA01.Z", "title": "Enlarged lymph nodes, unspecified" }, { "code": "5B3Z", "title": "Endocrine diseases, unspecified" }, { "code": "9A10.Z", "title": "Disorders of lacrimal gland, unspecified" } ]
=== ICD-11 CODES FOUND === [5A03.Z] Thyroiditis, unspecified Also known as: Thyroiditis, unspecified | Thyroiditis | inflammation of thyroid | thyroiditis NOS [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified Also known as: Disorders of the thyroid gland or thyroid hormones system, unspecified [5A03.Y] Other specified thyroiditis Also known as: Other specified thyroiditis | Riedel thyroiditis | Chronic invasive fibrous thyroiditis | Ligneous thyroiditis | Riedel struma [5A00.2Z] Acquired hypothyroidism, unspecified Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea [5A03.0] Acute thyroiditis Definition: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial. Also known as: Acute thyroiditis | infectious thyroiditis | Acute thyroiditis due to bacterial infection | Acute thyroiditis due to fungal infection | Abscess of thyroid [BD90.Z] Lymphadenitis, unspecified Also known as: Lymphadenitis, unspecified | Lymphadenitis | adenitis NOS | inflammation of gland | lymphatic gland inflammation [BD90.Y] Other specified lymphadenitis Also known as: Other specified lymphadenitis | Dermatopathic lymphadenopathy | lipomelanotic reticulosis | Infective inguinal bubo | bubo [MA01.Z] Enlarged lymph nodes, unspecified Also known as: Enlarged lymph nodes, unspecified | Enlarged lymph nodes | swollen glands | Lymphadenopathy | adenopathy [5B3Z] Endocrine diseases, unspecified Also known as: Endocrine diseases, unspecified | endocrine disorder NOS | disorder of endocrine gland | disease of endocrine gland | disorder of endocrine system [9A10.Z] Disorders of lacrimal gland, unspecified Also known as: Disorders of lacrimal gland, unspecified | Disorders of lacrimal gland === GRAPH WALKS === --- Walk 1 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --RELATED_TO--> [?] Postpartum thyroiditis Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp... --- Walk 2 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --RELATED_TO--> [?] Postpartum thyroiditis Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp... --- Walk 3 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --PARENT--> [?] Endocrine diseases --- Walk 4 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A00] Hypothyroidism --- Walk 5 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.1] Subacute thyroiditis Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection.... --- Walk 6 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.1] Subacute thyroiditis Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection....
[ "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --RELATED_TO--> [?] Postpartum thyroiditis\n Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp...", "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --RELATED_TO--> [?] Postpartum thyroiditis\n Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp...", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --PARENT--> [?] Endocrine diseases", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A00] Hypothyroidism", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.1] Subacute thyroiditis\n Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection....", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.1] Subacute thyroiditis\n Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection...." ]
5A03.Z
Thyroiditis, unspecified
[ { "from_icd11": "5A03.Z", "icd10_code": "E069", "icd10_title": "Thyroiditis, unspecified" }, { "from_icd11": "5A03.Z", "icd10_code": "E064", "icd10_title": "Drug-induced thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E065", "icd10_title": "Other chronic thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E06", "icd10_title": "Thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E062", "icd10_title": "Chronic thyroiditis with transient thyrotoxicosis" }, { "from_icd11": "5A0Z", "icd10_code": "E0781", "icd10_title": "Sick-euthyroid syndrome" }, { "from_icd11": "5A0Z", "icd10_code": "E0789", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E079", "icd10_title": "Disorder of thyroid, unspecified" }, { "from_icd11": "5A0Z", "icd10_code": "E034", "icd10_title": "Atrophy of thyroid (acquired)" }, { "from_icd11": "5A0Z", "icd10_code": "E00-E07", "icd10_title": "" }, { "from_icd11": "5A0Z", "icd10_code": "E07", "icd10_title": "Other disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E078", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E35", "icd10_title": "Disorders of endocrine glands in diseases classified elsewhere" }, { "from_icd11": "5A00.2Z", "icd10_code": "E033", "icd10_title": "Postinfectious hypothyroidism" }, { "from_icd11": "5A03.0", "icd10_code": "E060", "icd10_title": "Acute thyroiditis" } ]
E069
Thyroiditis, unspecified
A thirty year-old lady presented to us with complaints of pain and watering from her right eye for the past one month. There was no history of ocular trauma. She had multiple similar episodes in the past year and a half in the same eye for which ophthalmic consultation was taken locally, where she was diagnosed with recurrent viral trabeculitis. An anterior chamber tap had revealed PCR test positivity for HSV-1. She was referred to us in view of her poor response to intraocular pressure (IOP) control with medical treatment which was further complicated by steroid responsiveness. She was on oral acyclovir 400 mg tablets twice a day, along with topical brimonidine tartrate 0.2 % and timolol maleate 0.5 % eye drops since the past 1 year. There was no significant family history. On presentation, her best corrected visual acuity (BCVA) in the right eye (RE) was 20/600 and N36, and she was 20/20 and N6 in her left eye (LE). Slit lamp biomicroscopic examination of the RE revealed large corneal epithelial bullae in the background of diffuse stromal edema, few keratic precipitates (KPs), mild anterior chamber reaction, and intraocular pressures (IOP) of 20 mmHg, and normal anterior segment findings with IOP of 14 mmHg in the left eye . We placed a large diameter bandage contact lens and started the patient on a therapeutic dose of oral acyclovir 400 mg (5 times/day) and topical and oral antiglaucoma medications (oral acetazolamide 250 mg thrice a day, topical brimonidine tartrate 0.2 % and timolol maleate 0.5 % twice daily). We also started her on topical cycloplegic (homatropine hydrobromide 5%) eye drops thrice daily. She was doing well for the initial few weeks , and the RE corneal condition improved in the subsequent visits, however, the IOP was uncontrolled even on maximum medications (upto 45 mmHg) at the one-month follow-up visit. Gonioscopic examination revealed open angles in all quadrants in both eyes with the right eye having grade 3–4 pigmented trabecular meshwork 360 degrees suggestive of secondary open-angle glaucoma (pigmentary glaucoma) with steroid response. When despite treatment with oral acyclovir 800 mg twice a day, oral acetazolamide 250 mg, topical brimonidine tartrate 0.2 %, timolol maleate 0.5 %, and dorzolamide 2 % twice daily, her IOP remained uncontrolled on maximum medical therapy, we decided to perform trabeculectomy with mitomycin-C in her right eye. Post-operatively she was doing well with visual acuity of 20/50, well-formed diffuse bleb, and IOP of 8 mmHg . However, at the one-year follow-up visit, her BCVA in the right eye had decreased to 20/100p. Her ocular examination revealed diffuse corneal stromal edema with epithelial bullae in the RE; suggestive of endothelial decompensation, hence she was planned for Descemet's stripping automated endothelial keratoplasty (DSAEK). Following DSAEK, she was prescribed oral acyclovir 400 mg five times daily for two weeks followed by maintenance of twice daily dose, and weekly tapering dose of topical prednisolone acetate 1 % from six times per day to maintenance dose of once daily for 6 months, with a combination of brimonidine tartrate 0.2 %, timolol maleate 0.5 % twice a day. Both the surgeries were performed under local anesthesia by experienced surgeons. At the final follow-up, eight months post-operatively, the DSAEK lenticule was well attached with BCVA of 20/20 in the RE. There was no evidence of recurrence of infection, and her intraocular pressures were under control. Fig. 1 (A and B). Image of the right eye at the time of presentation. A. Diffuse slit lamp image of the right eye showing multiple large paracentral epithelial bullae with. B. Anterior segment OCT image showing corneal epithelial bullae along with corneal edema. (C and D) Image of the right eye after 3 days of starting therapeutic dose of oral antiviral therapy. C. Diffuse slit lamp image of the right eye with complete resolution of epithelial bullae, compact stroma and BCL in situ. D. Anterior chamber OCT images showing the compact cornea with no corneal edema or bullae. Fig. 1 Fig. 2 Image of right eye post trabeculectomy. A. Diffuse slit lamp photo showing an elevated, diffuse conjunctival bleb in the superior bulbar conjunctiva. B. Slit-view image of the cornea of the same eye on day one post trabeculectomy. Minimal edema is noticed in the central cornea, while rest of the cornea appears clear. Fig. 2 Fig. 3 Image of right eye post endothelial keratoplasty. A. Diffuse slit lamp image with clear cornea, attached DSAEK lenticule, compact stroma, three interrupted sutures at the main section and superior low-lying, diffuse conjunctival bleb. B. Anterior segment OCT showing a well attached DSAEK lenticule with compact corneal stroma. Fig. 3 Fig. 4 Anterior segment OCT of the right eye before and after DSAEK surgery. A. Showing the corneal edema and epithelial bullae before undergoing DSAEK surgery. B. Showing the compact corneal stroma, and well attached DSAEK lenticule post-operatively. Fig. 4
3.921875
0.980469
sec[1]/p[0]
en
0.999997
35985114
https://doi.org/10.1016/j.ijscr.2022.107505
[ "corneal", "oral", "dsaek", "bullae", "twice", "topical", "slit", "epithelial", "edema", "daily" ]
[ { "code": "9A7Z", "title": "Disorders of the cornea, unspecified" }, { "code": "9A71", "title": "Infectious keratitis" }, { "code": "9A76", "title": "Corneal ulcer" }, { "code": "9A78.4", "title": "Corneal degeneration" }, { "code": "9A70.Z", "title": "Hereditary corneal dystrophies, unspecified" }, { "code": "MD11.8Z", "title": "Mouth breathing, unspecified" }, { "code": "DA01.00", "title": "Oral leukoplakia" }, { "code": "DA01.10", "title": "Oral aphthae or aphtha-like ulceration" }, { "code": "MD80.1", "title": "Symptom or complaint of the mouth, tongue or lip" }, { "code": "DA01.1Y", "title": "Other specified noninfectious erosive or ulcerative disorders of oral mucosa" } ]
=== ICD-11 CODES FOUND === [9A7Z] Disorders of the cornea, unspecified Also known as: Disorders of the cornea, unspecified | corneal disease | disease of cornea | keratopathy [9A71] Infectious keratitis Also known as: Infectious keratitis | corneal inflammation | Bacterial keratitis | Fungal keratitis | fungal infection of cornea [9A76] Corneal ulcer Definition: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue. It is often caused by bacterial, fungal, or viral infection. Also known as: Corneal ulcer | cornea ulcer | ulcerative keratitis | corneal ulcer NOS | Central corneal ulcer Includes: Central corneal ulcer | Ring corneal ulcer | Corneal ulcer with hypopyon [9A78.4] Corneal degeneration Also known as: Corneal degeneration | degenerative corneal opacity | Pellucid marginal degeneration | Arcus senilis | gerontoxon Includes: Arcus senilis Excludes: Mooren ulcer [9A70.Z] Hereditary corneal dystrophies, unspecified Also known as: Hereditary corneal dystrophies, unspecified | Hereditary corneal dystrophies | hereditary corneal dystrophy | corneal dystrophy NOS | familial hereditary corneal degeneration [MD11.8Z] Mouth breathing, unspecified Also known as: Mouth breathing, unspecified | Mouth breathing | breathing orally | mouth respiration [DA01.00] Oral leukoplakia Definition: Leukoplakia is a condition where areas of keratosis appear as adherent white patches on the mucous membranes of the oral cavity. Leukoplakia may affect other gastrointestinal tract mucosal sites, or mucosal surfaces of the urinary tract and genitals. Also known as: Oral leukoplakia | Leukoplakia of gingiva | leukoplakia of oral epithelium | leucoplakia of oral mucosa | leukokeratosis of oral mucosa Includes: Leukoplakia of gingiva Excludes: Hairy leukoplakia [DA01.10] Oral aphthae or aphtha-like ulceration Definition: This is a frequent small, shallow, painful ulceration in the oral mucosa. Recurrent oral ulceration that clinically resembles recurrent aphthous stomatitis but presents atypically, including commencement after adolescence, with fever, with a strong family history, or failing to resolve with age. Also known as: Oral aphthae or aphtha-like ulceration | Recurrent aphthous stomatitis | Recurrent oral aphthae | Major recurrent aphthous stomatitis | major aphthous stomatitis [MD80.1] Symptom or complaint of the mouth, tongue or lip Also known as: Symptom or complaint of the mouth, tongue or lip | Mouth swelling | mouth oedema | swollen mouth | Lip swelling [DA01.1Y] Other specified noninfectious erosive or ulcerative disorders of oral mucosa Also known as: Other specified noninfectious erosive or ulcerative disorders of oral mucosa | Oral ulceration due to immunobullous disease | Oral mucosal involvement by immunobullous disorder classified elsewhere | Oral ulceration due to physical injury | Mechanical oral ulceration === GRAPH WALKS === --- Walk 1 --- [9A7Z] Disorders of the cornea, unspecified --PARENT--> [?] Disorders of the cornea Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc... --CHILD--> [9A72] Traumatic keratitis --- Walk 2 --- [9A7Z] Disorders of the cornea, unspecified --PARENT--> [?] Disorders of the cornea Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc... --PARENT--> [?] Disorders of the eyeball - anterior segment Def: This refers to any disorders of the front third of the eye that includes the structures in front of the vitreous humour: the cornea, iris, ciliary body, and lens.... --- Walk 3 --- [9A71] Infectious keratitis --RELATED_TO--> [?] Herpes simplex keratitis Def: This is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct... --PARENT--> [?] Viral keratitis Def: This is a parasitic condition in which the eye's cornea, the front part of the eye, becomes inflamed. The condition is often marked by moderate to intense pain and usually involves impaired eyesight. ... --- Walk 4 --- [9A71] Infectious keratitis --RELATED_TO--> [?] Herpes simplex keratitis Def: This is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct... --CHILD--> [?] Neurotrophic keratopathy --- Walk 5 --- [9A76] Corneal ulcer Def: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue. It is often caused by bacterial, fungal, or viral infection.... --PARENT--> [?] Disorders of the cornea Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc... --CHILD--> [9A70] Hereditary corneal dystrophies Def: The term corneal dystrophy embraces a heterogeneous group of bilateral genetically determined non-inflammatory corneal diseases that are usually restricted to the cornea. The designation is imprecise ... --- Walk 6 --- [9A76] Corneal ulcer Def: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue. It is often caused by bacterial, fungal, or viral infection.... --PARENT--> [?] Disorders of the cornea Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc... --CHILD--> [9A72] Traumatic keratitis
[ "[9A7Z] Disorders of the cornea, unspecified\n --PARENT--> [?] Disorders of the cornea\n Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc...\n --CHILD--> [9A72] Traumatic keratitis", "[9A7Z] Disorders of the cornea, unspecified\n --PARENT--> [?] Disorders of the cornea\n Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc...\n --PARENT--> [?] Disorders of the eyeball - anterior segment\n Def: This refers to any disorders of the front third of the eye that includes the structures in front of the vitreous humour: the cornea, iris, ciliary body, and lens....", "[9A71] Infectious keratitis\n --RELATED_TO--> [?] Herpes simplex keratitis\n Def: This is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct...\n --PARENT--> [?] Viral keratitis\n Def: This is a parasitic condition in which the eye's cornea, the front part of the eye, becomes inflamed. The condition is often marked by moderate to intense pain and usually involves impaired eyesight. ...", "[9A71] Infectious keratitis\n --RELATED_TO--> [?] Herpes simplex keratitis\n Def: This is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct...\n --CHILD--> [?] Neurotrophic keratopathy", "[9A76] Corneal ulcer\n Def: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue. It is often caused by bacterial, fungal, or viral infection....\n --PARENT--> [?] Disorders of the cornea\n Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc...\n --CHILD--> [9A70] Hereditary corneal dystrophies\n Def: The term corneal dystrophy embraces a heterogeneous group of bilateral genetically determined non-inflammatory corneal diseases that are usually restricted to the cornea. The designation is imprecise ...", "[9A76] Corneal ulcer\n Def: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue. It is often caused by bacterial, fungal, or viral infection....\n --PARENT--> [?] Disorders of the cornea\n Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc...\n --CHILD--> [9A72] Traumatic keratitis" ]
9A7Z
Disorders of the cornea, unspecified
[ { "from_icd11": "9A7Z", "icd10_code": "H16203", "icd10_title": "Unspecified keratoconjunctivitis, bilateral" }, { "from_icd11": "9A7Z", "icd10_code": "H16229", "icd10_title": "Keratoconjunctivitis sicca, not specified as Sjogren's, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16231", "icd10_title": "Neurotrophic keratoconjunctivitis, right eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16213", "icd10_title": "Exposure keratoconjunctivitis, bilateral" }, { "from_icd11": "9A7Z", "icd10_code": "H16209", "icd10_title": "Unspecified keratoconjunctivitis, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16221", "icd10_title": "Keratoconjunctivitis sicca, not specified as Sjogren's, right eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16222", "icd10_title": "Keratoconjunctivitis sicca, not specified as Sjogren's, left eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16202", "icd10_title": "Unspecified keratoconjunctivitis, left eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16299", "icd10_title": "Other keratoconjunctivitis, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16292", "icd10_title": "Other keratoconjunctivitis, left eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16219", "icd10_title": "Exposure keratoconjunctivitis, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H169", "icd10_title": "Unspecified keratitis" }, { "from_icd11": "9A7Z", "icd10_code": "H189", "icd10_title": "Unspecified disorder of cornea" }, { "from_icd11": "9A7Z", "icd10_code": "H168", "icd10_title": "Other keratitis" }, { "from_icd11": "9A7Z", "icd10_code": "H162", "icd10_title": "Keratoconjunctivitis" } ]
H16203
Unspecified keratoconjunctivitis, bilateral
A 56-year-old man was referred to our emergency department with a 10 days history of pyrexia, productive cough and appetite loss. He reported an adverse reaction to penicillin and he had no history of intravenous drug abuse. Physical examination showed coarse crackles in lower right lung field, and patient’s laboratory workup was remarkable for elevated C-reactive protein (CRP) (16 mg/dl) and leukocytosis (16.000/mm 3 ) with neutrophilia of 88%. Chest X-ray showed right lobar consolidation. The patient was admitted to our hospital based on a diagnosis of community-acquired pneumonia. Blood samples for hemocultures were collected and empirical therapy with levofloxacin (500 mg/day) was undertaken (day 1). Considering the worsening of the patient’s general conditions, a computed tomography (CT) scan of abdomen and thorax was performed: the diagnostic imaging revealed left pleural effusion, extensive SI caused by thrombosis of the splenic artery and a hyperdense round lesion of the right hepatic lobe suspected for hepatic aneurysm (1.4 cm × 1.1 cm) . Blood cultures, taken on day 1, were positive for penicillin-sensible GBS and the patient immediately underwent a transthoracic and transesophageal echocardiography finding an infective vegetation (1.0 cm × 1.5 cm) on the mitral valve associated with mitral chordae tendineae rupture and severe regurgitation. Intravenous antibiotic therapy was consequently switched to intravenous vancomycin (2 g/day) and emergency mitral valve repair with artificial chordal replacement was performed (day 12). During post-acute cardiac rehabilitation program the patient developed jaundice and laboratory tests showed a total bilirubin of 7.4 mg/dl and elevation of alkaline phosphatase and γ-glutamyl transferase (day 20). A new emergent abdomen CT scan found an enlarging MA of the right hepatic artery of 2.4 cm × 2.0 cm of size and a 2.7 cm × 3.0 cm intrahepatic aneurysm in segment VIII, causing displacement of the portal vein and compression of the right biliary duct . Furthermore, CT images detected three smaller left hepatic artery aneurysms located in segment IV and confirmed massive SI. Thus, multiple hepatic MAs associated with GBS endocarditis was diagnosed. The patient was immediately submitted to surgical intervention, which consisted in ligation of the right hepatic artery and splenectomy. Initial postoperative course was favorable with reduction of conjugated bilirubin level. A duplex ultrasonography performed 4 days after surgery demonstrated complete thrombosis of the proximal right hepatic artery aneurysm, partial thrombosis of the aneurysm in segment VIII and no further enlargement of the small aneurysms of the left hepatic artery. However, on day 28, an episode of melena associated with low hemoglobin count emerged. The patient underwent esophagogastroduodenoscopy and colonoscopy, which did not show any gastrointestinal bleeding. On day 42, because of progressive decrease of hemoglobin level, a multislice abdomen CT angiography was performed . The radiological findings were consistent with hemobilia due to a suspected rupture of the partially thrombosed MA of segment VIII into the biliary tree. On the following day, the patient underwent a selective angiography of the coeliac axis, which revealed blood supply to the segment VIII MA from intraparenchymal branches of the left hepatic artery. The patient was then successfully treated with transcatheter coil embolization, resulting in complete obliteration of the residual segment VIII MA and of the three segment IV small aneurysms . The post-procedural course was uneventful and the patient was discharged on day 58, after 10 weeks of antibiotic therapy. A follow-up CT angiography was performed 8 weeks later, showing complete embolization of the residual MAs without any evidence of bile duct dilatation. The patient remained asymptomatic at follow-up of 12 months, with no signs of relapse of biliary obstruction or gastrointestinal bleeding . Fig. 1 Abdominal CT taken on day 3 ( a ) shows MA of the proximal right hepatic artery of 1.4 cm × 1.1 cm ( arrow ). Moreover the diagnostic imaging discloses a nonenhancing hypodense area of the spleen consistent with SI. Abdominal enhanced CT taken on day 20 ( b ) reveals an enlargement of the previously detected MA of the proximal right hepatic artery ( arrow ) and the development of a new large MA of the VIII segment ( arrow ). The radiological findings confirm SI Fig. 2 Multislice abdomen CT angiography taken on day 42 ( a ) showing ligation of the right hepatic artery ( arrow ) and three small MAs of the IV hepatic segment. The radiological images demonstrate residual blood flow in the right hepatic MAs. Selective angiography of the coeliac axis ( b ) demonstrates arterial branches from the left hepatic artery providing blood supply to the right hepatic MAs Fig. 3 Clinical timeline of the case. BT: body temperature; WBC: white blood cell count; Hb: hemoglobin; Bil: total bilirubin level; LFX: levofloxacin
3.96875
0.977539
sec[1]/p[0]
en
0.999998
29284415
https://doi.org/10.1186/s12876-017-0728-0
[ "hepatic", "artery", "segment", "blood", "viii", "angiography", "abdomen", "aneurysm", "arrow", "intravenous" ]
[ { "code": "DB9Z", "title": "Diseases of liver, unspecified" }, { "code": "DB97.Z", "title": "Inflammatory liver disease, unspecified" }, { "code": "DB99.7", "title": "Hepatic failure without mention whether acute or chronic" }, { "code": "LB20.0Y", "title": "Other specified structural developmental anomalies of liver" }, { "code": "LB20.0Z", "title": "Structural developmental anomalies of liver, unspecified" }, { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "BD52", "title": "Certain specified disorders of arteries or arterioles" }, { "code": "BD52.3", "title": "Rupture of artery" }, { "code": "BD52.2", "title": "Stricture of artery" }, { "code": "BD40.Z", "title": "Atherosclerotic chronic arterial occlusive disease, unspecified" } ]
=== ICD-11 CODES FOUND === [DB9Z] Diseases of liver, unspecified Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy [DB97.Z] Inflammatory liver disease, unspecified Also known as: Inflammatory liver disease, unspecified | Certain specified inflammatory liver diseases | Nonspecific reactive hepatitis | inflammatory liver disease | hepatitis NOS [DB99.7] Hepatic failure without mention whether acute or chronic Also known as: Hepatic failure without mention whether acute or chronic | liver decompensation | liver function failure | hepatic failure NOS | liver failure NOS [LB20.0Y] Other specified structural developmental anomalies of liver Also known as: Other specified structural developmental anomalies of liver | Alagille syndrome | Alagille-Watson syndrome | Arteriohepatic dysplasia | Syndromic bile duct paucity [LB20.0Z] Structural developmental anomalies of liver, unspecified Also known as: Structural developmental anomalies of liver, unspecified | Structural developmental anomalies of liver | Malformations of liver | congenital anomaly of liver | congenital malformation of liver [BD5Z] Diseases of arteries or arterioles, unspecified Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS [BD52] Certain specified disorders of arteries or arterioles Also known as: Certain specified disorders of arteries or arterioles | Aortic dilatation - joint hypermobility - arterial tortuosity | Generalised arterial calcification of infancy | Median arcuate ligament syndrome | Aortic root abscess Excludes: collagen (vascular) diseases | Hypersensitivity angiitis | Acute arterial occlusion [BD52.3] Rupture of artery Also known as: Rupture of artery | ruptured artery | artery fistula | Aortic duodenal fistula | Aortic colon fistula Excludes: traumatic rupture of artery - see injury of blood vessel by body region [BD52.2] Stricture of artery Also known as: Stricture of artery | arterial stenosis | arterial stricture | artery stricture | stenosis of artery [BD40.Z] Atherosclerotic chronic arterial occlusive disease, unspecified Also known as: Atherosclerotic chronic arterial occlusive disease, unspecified | Atherosclerotic chronic arterial occlusive disease | arteriosclerosis, NOS | generalised atherosclerosis | atherosclerosis NOS === GRAPH WALKS === --- Walk 1 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --CHILD--> [DB92] Non-alcoholic fatty liver disease Def: NAFLD is characterised by fatty liver related to insulin resistance in the absence of significant alcohol consumption. It embraces a pathological spectrum from simple steatosis to steatohepatitis. 10-... --- Walk 2 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --RELATED_TO--> [?] Structural developmental anomalies of liver --- Walk 3 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --EXCLUDES--> [?] Acute or subacute hepatic failure Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases.... --- Walk 4 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --EXCLUDES--> [?] Drug-induced or toxic liver disease Def: Drug-induced or toxic liver disease is hepatotoxicity as injury to the liver that is associated with impaired liver function caused by exposure to a drug or another noninfectious agent.... --- Walk 5 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --CHILD--> [DB99.2] Hepatorenal syndrome --- Walk 6 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --RELATED_TO--> [?] Cirrhotic cardiomyopathy Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation...
[ "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --CHILD--> [DB92] Non-alcoholic fatty liver disease\n Def: NAFLD is characterised by fatty liver related to insulin resistance in the absence of significant alcohol consumption. It embraces a pathological spectrum from simple steatosis to steatohepatitis. 10-...", "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Structural developmental anomalies of liver", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --EXCLUDES--> [?] Acute or subacute hepatic failure\n Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases....", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --EXCLUDES--> [?] Drug-induced or toxic liver disease\n Def: Drug-induced or toxic liver disease is hepatotoxicity as injury to the liver that is associated with impaired liver function caused by exposure to a drug or another noninfectious agent....", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --CHILD--> [DB99.2] Hepatorenal syndrome", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --RELATED_TO--> [?] Cirrhotic cardiomyopathy\n Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation..." ]
DB9Z
Diseases of liver, unspecified
[ { "from_icd11": "DB9Z", "icd10_code": "K7681", "icd10_title": "Hepatopulmonary syndrome" }, { "from_icd11": "DB9Z", "icd10_code": "K7689", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K769", "icd10_title": "Liver disease, unspecified" }, { "from_icd11": "DB9Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "DB9Z", "icd10_code": "K762", "icd10_title": "Central hemorrhagic necrosis of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K70-K77", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K778", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K72", "icd10_title": "Hepatic failure, not elsewhere classified" }, { "from_icd11": "DB9Z", "icd10_code": "K76", "icd10_title": "Other diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K768", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB97.Z", "icd10_code": "K7581", "icd10_title": "Nonalcoholic steatohepatitis (NASH)" }, { "from_icd11": "DB97.Z", "icd10_code": "K7589", "icd10_title": "Other specified inflammatory liver diseases" }, { "from_icd11": "DB97.Z", "icd10_code": "K759", "icd10_title": "Inflammatory liver disease, unspecified" }, { "from_icd11": "DB97.Z", "icd10_code": "K752", "icd10_title": "Nonspecific reactive hepatitis" }, { "from_icd11": "DB97.Z", "icd10_code": "K75", "icd10_title": "Other inflammatory liver diseases" } ]
K7681
Hepatopulmonary syndrome
We report the case of a 14-year-old boy affected by SDS that had been diagnosed in the first year of life with neutropenia, failure to thrive, and recurrent respiratory infections. In the following years, he had always been well, with moderate-to-severe neutropenia (400–600/mmc) but without severe infections. Yearly hematologic controls were performed, including regular bone marrow aspirates, with no evidence of myelodysplastic progression. When the patient was 16 years and 7 months old, he was admitted for persistent fever without other symptoms. Blood tests showed trilinear cytopenia: therefore, a bone marrow aspirate was performed, which showed a hypercellular marrow with the prevalence of erythroid precursors (50%), often with dysplastic signs, suggesting MDS. A bone marrow biopsy confirmed the presence of a hypercellular MDS with the prevalence of an immature erythroid population and an increase of megakaryocytes, which appeared dysplastic; flow cytometry analysis showed 8% of myeloid blasts . The recommendation to proceed to HSCT was formalized, and since he did not have compatible HLA siblings, a search for a matched unrelated donor (MUD) was started without starting any MDS-directed therapy. One month after the diagnosis, while waiting for the HSCT, he developed splenomegaly (2 cm below the left costal margin) and peripheral monocytosis. Repeated bone marrow aspirate showed progression to AML (bone marrow flow cytometry showed 75% blasts CD34+/CD7+/CD45+/CD33+/CD11b dim/CD117+). Cytogenetic and molecular analysis (including RNA and DNA analysis for the main translocations associated with AML) showed no abnormalities. Treatment with Fludarabine—Cytarabine (FLA) was started (fludarabine 30 mg/m 2 /day and cytarabine 2,000mg/m 2 /day for 5 days), aiming to achieve leukemic burden reduction in view of HSCT. Treatment was well tolerated overall with no major organ toxicity, yet it was followed by an Escherichia coli sepsis requiring hospital admission . Bone marrow re-evaluation showed morphologic remission (blasts 1%, confirmed by flow cytometry), with the persistence of abnormal hematopoiesis, compatible with pre-existent MDS. Maintenance therapy with low-dose i.v. cytarabine plus oral thioguanine was started, which was nevertheless discontinued due to worsening thrombocytopenia requiring platelet transfusions. Second hospital admission was required due to mucositis and febrile neutropenia, which responded to antibiotic therapy. Nevertheless, while arrangements for the MUD HSCT were being organized, AML relapsed (60% blasts in the bone marrow). Therefore a second FLA cycle was administered. This was again followed by neutropenic fever requiring hospitalization. After an initial improvement with antibiotic therapy, he developed persistent fever associated with marked hepatosplenomegaly and ascites [grade 2 according to Common Terminology Criteria for Adverse Events (CTCAE) v. 5.0]. Peripheral blood flow cytometry showed leukocytosis with 93% blasts, and bone marrow aspirates confirmed persistent massive leukemic infiltration (94% blasts). In consideration of the occurrence of severe toxicity from conventional chemotherapies, a second-line chemotherapy regimen was considered too dangerous. Therefore combination therapy with azacitidine (125 mg/day for 7 days) and venetoclax for 28 days was started, aiming to achieve disease control before proceeding to transplant. Venetoclax was started at a dose of 100 mg/day and gradually increased by 100 mg/day up to a dose of 800 mg/day. During the first 10 days of therapy, a gradual decrease of blasts in the peripheral blood was seen, with a marked decrease in hepatosplenomegaly. Therapy was overall well tolerated but was associated with diarrhea (grade 2 according to CTCAE v 5.0) and peripheral edema (grade 2 according to CTCAE v 5.0), a known side effect of venetoclax, as well as with an urticarial rash that resolved upon azacitidine discontinuation. Bone marrow examination performed at the end of the therapeutic course showed partial response on leukemic infiltration: the bone marrow appeared markedly hypocellular, thereby showing a definite response on AML burden in absolute terms (as compared to pre-treatment evaluation), even though leukemic blasts were still 52% by flow cytometry. Unfortunately, the patient developed a series of infectious complications following the end of the course, including severe Stenotrophomonas maltophilia gingivostomatitis (grade 3 according to CTCAE v 5.0), followed by two episodes of sepsis by Staphylococcus epidermidis and Escherichia coli , respectively. An increase of hepatosplenomegaly was also observed, likely due to AML progression, together with marked fluid overload only partially responding to diuretic therapy, and he was considered not eligible for HSCT or to continue therapy with a combination of azacitidine and venetoclax. Palliative therapy with azacitidine alone was started, with no response, and he eventually died from multiorgan failure.
4.082031
0.973633
sec[1]/p[0]
en
0.999998
PMC9869240
https://doi.org/10.3389/fped.2022.1059569
[ "marrow", "bone", "blasts", "flow", "cytometry", "hsct", "well", "which", "leukemic", "grade" ]
[ { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "3A70.Z", "title": "Aplastic anaemia, unspecified" }, { "code": "3C0Y", "title": "Other specified diseases of the blood or blood-forming organs" }, { "code": "3A70.12", "title": "Idiopathic aplastic anaemia" }, { "code": "NE84", "title": "Failure or rejection of transplanted organs or tissues" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" } ]
=== ICD-11 CODES FOUND === [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [3A70.Z] Aplastic anaemia, unspecified Also known as: Aplastic anaemia, unspecified | Aplastic anaemia | erythroid aplasia | AA - [aplastic anaemia] | haematopoietic aplasia [3C0Y] Other specified diseases of the blood or blood-forming organs Also known as: Other specified diseases of the blood or blood-forming organs | Congenital anomaly blood or lymph other | Blood dyscrasia | blood dyscrasia NOS | Bone marrow hyperplasia [3A70.12] Idiopathic aplastic anaemia Also known as: Idiopathic aplastic anaemia | Idiopathic bone marrow failure | idiopathic aplastic anaemia NOS [NE84] Failure or rejection of transplanted organs or tissues Also known as: Failure or rejection of transplanted organs or tissues | organ transplant rejection | transplant failure | transplant rejection | Bone-marrow transplant rejection [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c... --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics --- Walk 3 --- [3A70.Z] Aplastic anaemia, unspecified --PARENT--> [3A70] Aplastic anaemia Def: A disease caused by determinants arising after birth, in the antenatal period or genetically inherited factors leading to the inability of stem cells to generate new mature cells. This disease is char... --PARENT--> [?] Anaemias or other erythrocyte disorders --- Walk 4 --- [3A70.Z] Aplastic anaemia, unspecified --PARENT--> [3A70] Aplastic anaemia Def: A disease caused by determinants arising after birth, in the antenatal period or genetically inherited factors leading to the inability of stem cells to generate new mature cells. This disease is char... --CHILD--> [3A70.0] Congenital aplastic anaemia Def: A disease caused by determinants in the antenatal period leading to the inability of stem cells to generate new mature cells. This disease is characterised by low levels of red blood cells, white bloo... --- Walk 5 --- [3C0Y] Other specified diseases of the blood or blood-forming organs --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c... --- Walk 6 --- [3C0Y] Other specified diseases of the blood or blood-forming organs --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --CHILD--> [?] Anaemias or other erythrocyte disorders
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics", "[3A70.Z] Aplastic anaemia, unspecified\n --PARENT--> [3A70] Aplastic anaemia\n Def: A disease caused by determinants arising after birth, in the antenatal period or genetically inherited factors leading to the inability of stem cells to generate new mature cells. This disease is char...\n --PARENT--> [?] Anaemias or other erythrocyte disorders", "[3A70.Z] Aplastic anaemia, unspecified\n --PARENT--> [3A70] Aplastic anaemia\n Def: A disease caused by determinants arising after birth, in the antenatal period or genetically inherited factors leading to the inability of stem cells to generate new mature cells. This disease is char...\n --CHILD--> [3A70.0] Congenital aplastic anaemia\n Def: A disease caused by determinants in the antenatal period leading to the inability of stem cells to generate new mature cells. This disease is characterised by low levels of red blood cells, white bloo...", "[3C0Y] Other specified diseases of the blood or blood-forming organs\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...", "[3C0Y] Other specified diseases of the blood or blood-forming organs\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Anaemias or other erythrocyte disorders" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "3A70.Z", "icd10_code": "D61", "icd10_title": "Other aplastic anemias and other bone marrow failure syndromes" }, { "from_icd11": "3A70.12", "icd10_code": "D613", "icd10_title": "Idiopathic aplastic anemia" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
A 56-year-old man initially presented at our hospital complaining of having had melena for half a month. He did not have any personal or family history of bowel polyps, bowel cancer, or inflammatory bowel disease. He denied having chills, fever, nausea, vomiting, diarrhea, or abdominal pain. The flaring-up of melena was sudden and the patient was admitted, owing to tarry stools and melena. Results of a physical examination were unremarkable apart from an anemic appearance. A complete blood count test revealed anemia (hemoglobin level 4.8 g/dl) and the prothrombin time was 15.6 s (normal range, 11.5 to 14.5 s). Liver function, kidney function, and inflammatory indexes were noted to be normal. Abdominal contrast-enhanced computed tomography demonstrated a round abnormal enhancement in the lumen of the small intestine lumen in the left upper quadrant , at about the level of L3, raising suspicion of tumors or vascular lesions. Computed tomography also demonstrated a hematocele in the small intestine and colon (especially in the ileocecum). Digital subtraction angiography revealed contrast agent staining in the left upper quadrant and a microcatheter was placed in the feeding artery . Gastroscopy indicated multiple duodenal polyps. Colonoscopy was unsuccessful, owing to the presence of a hematocele. Subsequently, the patient underwent a partial resection of the small intestine. Worm-shaped polyps and small hematomas were noted; these were spread along almost the entire small intestine, and they could not be completely resected. To identify the bleeding section of the bowel, we injected methylene blue into the indwelling catheter, staining an approximately 30 cm section of jejunum. The stained section was subsequently resected. Grossly, the resected specimen revealed multiple worm-like polyps, which ranged in size from 0.2 cm to 0.5 cm; two 2-cm-diameter hematomas were also noted . The round, abnormal enhancement demonstrated on computed tomography was considered to be a hematoma. Histologically, the polyps consisted of normal mucosa characterized by nonspecific inflammatory changes . Two days after the surgery, the patient had melena again. We subsequently performed an abdominal angiographic embolization. Throughout the course of this procedure, no bleeding points were noted. There was no contrast medium extravasation when the blood pressure was 90/70 mmHg . We raised the blood pressure, and digital subtraction angiography demonstrated contrast medium extravasated to the intestinal tract . A 5 ml suspension of gelatin sponge particles was injected and successfully stopped the bleeding . The patient was informed that he had a high risk of re-bleeding owing to polyps and careful management was required. After the operation, the patient recovered smoothly, the patient’s hemoglobin level increased to 10.7 g/dl and the patient was discharged from the hospital. No recurrent melena or bleeding was reported at the last follow-up in January 2014. Figure 1 Abdominal contrast-enhanced computed tomography and digital subtraction angiography of superior mesenteric artery of the patient. (A) Abdominal contrast-enhanced computed tomography demonstrated a round abnormal enhancement (arrow) in the small intestinal lumen within the left upper quadrant. (B) Digital subtraction angiography of superior mesenteric artery demonstrated a rim-like staining (arrow) in the left upper quadrant. (C) A microcatheter was inserted into the feeding artery (arrow head); rim-like staining (arrow) was revealed after contrast medium injected in the microcatheter. (D) Digital subtraction angiography of the superior mesenteric artery demonstrated no contrast medium extravasation when the blood pressure was 90/70 mmHg. (E) Digital subtraction angiography of the superior mesenteric artery demonstrated contrast medium extravasated into the intestinal tract (arrow) when the blood pressure was raised to 120/80 mmHg. (F) Digital subtraction angiography of the superior mesenteric artery demonstrated no contrast medium extravasation after injection of 5 ml suspension of gelatin sponge particles (500 μm) and contrast medium. Figure 2 Resected small intestine and histological section of the filiform polyps. (A) Gross appearance: numerous worm-like filiform polyps (arrow head) and 2-cm-diameter hematoma (arrow) are apparent. The filiform polyps spread throughout the small intestine, ranging in size from 0.2 cm to 0.5 cm. Bleeding points could be found after the hematoma was removed. (B) Histological sections of the filiform polyps. Figure 3 Microscopic appearance of the filiform polyps of the resected small intestine. (A,B) H & E staining, ×20; (C) H & E staining, ×200. The polyps appear as slender finger-like stretching projections and are covered by histologically normal colonic mucosa. The stalks of the polyps consist of submucosal fibrovascular components. Mild chronic inflammatory cells could be seen in the lamina propria without hyperplastic or adenomatous epithelial changes.
3.882813
0.981445
sec[1]/p[0]
en
0.999997
25540051
https://doi.org/10.1186/1477-7819-12-396
[ "polyps", "contrast", "small", "intestine", "digital", "subtraction", "angiography", "artery", "medium", "arrow" ]
[ { "code": "CA0J.Y", "title": "Other specified nasal polyp" }, { "code": "DB71.Z", "title": "Anal polyp, unspecified" }, { "code": "DA09.0", "title": "Pulpitis" }, { "code": "DB71.1", "title": "Lymphoid polyp" }, { "code": "GA16.Y", "title": "Other specified acquired abnormalities of uterus, except cervix" }, { "code": "9D43", "title": "Impairment of contrast vision" }, { "code": "QA00.6Y", "title": "Other specified examination of eyes or vision" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "PB28", "title": "Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance" }, { "code": "PC98", "title": "Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance" } ]
=== ICD-11 CODES FOUND === [CA0J.Y] Other specified nasal polyp Also known as: Other specified nasal polyp | Polyp of nasal cavity | Polyp of the nasopharynx | nasopharyngeal polyp | Polyp of adenoid tissue [DB71.Z] Anal polyp, unspecified Also known as: Anal polyp, unspecified | Anal polyp [DA09.0] Pulpitis Definition: Inflammation of pulpal tissue resulting from irritating factors of diverse nature such as bacterial, hyperaemic, chemical or thermal that act directly or indirectly on the dental pulp. Also known as: Pulpitis | Pulpitis NOS | Suppurative pulpitis | Acute pulpitis | Chronic pulpitis Includes: Suppurative pulpitis [DB71.1] Lymphoid polyp Definition: Lymphoid polyp is a benign, focal or diffuse small polypoid lesion composed of well-differentiated lymphoid tissue. Also known as: Lymphoid polyp [GA16.Y] Other specified acquired abnormalities of uterus, except cervix Also known as: Other specified acquired abnormalities of uterus, except cervix | Polyp of corpus uteri | intrauterine polyp | polyp of body of uterus | polyp of uterus [9D43] Impairment of contrast vision Definition: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces. Peak Contrast sensitivity refers to the smallest differences that are discernible for large stimuli. For smaller objects, such as those involved in many Activities of Daily Living, contrast sensitivity interacts with visual acuity and visual field. Better contrast makes smaller details visible. The visual field is larger for stronger stimuli. Also known as: Impairment of contrast vision | Moderate impairment of contrast vision | Profound impairment of contrast vision [QA00.6Y] Other specified examination of eyes or vision Also known as: Other specified examination of eyes or vision | No Impairment of Contrast vision | Normal colour vision | No Impairment of Dark adaptation | No diplopia [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance Also known as: Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance | accidental overdose of other or unspecified drug, medicament or biological substance | accidental poisoning by other or unspecified drug, medicament or biological substance | other or unspecified drug, medicament or biological substance taken in error | accidental drug overdose [PC98] Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance Also known as: Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance | Intentional self-poisoning by and exposure to other or unspecified drug, medicament or biological substance | Intentional overdose of other or unspecified drug, medicament or biological substance | self-administered overdose by drugs | Intentional self-harm by exposure to or harmful effects of systemic antibiotics === GRAPH WALKS === --- Walk 1 --- [CA0J.Y] Other specified nasal polyp --PARENT--> [CA0J] Nasal polyp Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,... --CHILD--> [CA0J.0] Polypoid sinus degeneration Def: Also referred to as Woakes' syndrome or ethmoiditis. Woakes' syndrome is characterised by severe recurrent nasal polyps, often without eosinophils on histological examination and with broadening of th... --- Walk 2 --- [CA0J.Y] Other specified nasal polyp --PARENT--> [CA0J] Nasal polyp Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,... --CHILD--> [CA0J.Y] Other specified nasal polyp --- Walk 3 --- [DB71.Z] Anal polyp, unspecified --PARENT--> [DB71] Anal polyp Def: Abnormal mushroom-like growth sticking out from the epithelium rising from the lining of the anus and anal canal.... --CHILD--> [DB71.2] Hypertrophied anal papillae Def: The enlargement of existing anal papillae is a consequence of chronic inflammation and fibrotic proliferation within the anorectal zone, which is known as hypertrophied or fibrous anal polyp.... --- Walk 4 --- [DB71.Z] Anal polyp, unspecified --PARENT--> [DB71] Anal polyp Def: Abnormal mushroom-like growth sticking out from the epithelium rising from the lining of the anus and anal canal.... --CHILD--> [DB71.1] Lymphoid polyp Def: Lymphoid polyp is a benign, focal or diffuse small polypoid lesion composed of well-differentiated lymphoid tissue.... --- Walk 5 --- [DA09.0] Pulpitis Def: Inflammation of pulpal tissue resulting from irritating factors of diverse nature such as bacterial, hyperaemic, chemical or thermal that act directly or indirectly on the dental pulp.... --PARENT--> [DA09] Diseases of pulp or periapical tissues Def: Dental pulp is that part of the tooth located in the centre of the coronal portion underneath dentin and composed of connective tissue, blood vessels and nerve endings. Periapical tissues are designat... --CHILD--> [DA09.1] Necrosis of pulp Def: Necrosis of the dental pulp which clinically does not respond to thermal stimulation; the tooth may be asymptomatic or sensitive to percussion and palpation.... --- Walk 6 --- [DA09.0] Pulpitis Def: Inflammation of pulpal tissue resulting from irritating factors of diverse nature such as bacterial, hyperaemic, chemical or thermal that act directly or indirectly on the dental pulp.... --PARENT--> [DA09] Diseases of pulp or periapical tissues Def: Dental pulp is that part of the tooth located in the centre of the coronal portion underneath dentin and composed of connective tissue, blood vessels and nerve endings. Periapical tissues are designat... --CHILD--> [DA09.1] Necrosis of pulp Def: Necrosis of the dental pulp which clinically does not respond to thermal stimulation; the tooth may be asymptomatic or sensitive to percussion and palpation....
[ "[CA0J.Y] Other specified nasal polyp\n --PARENT--> [CA0J] Nasal polyp\n Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,...\n --CHILD--> [CA0J.0] Polypoid sinus degeneration\n Def: Also referred to as Woakes' syndrome or ethmoiditis. Woakes' syndrome is characterised by severe recurrent nasal polyps, often without eosinophils on histological examination and with broadening of th...", "[CA0J.Y] Other specified nasal polyp\n --PARENT--> [CA0J] Nasal polyp\n Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,...\n --CHILD--> [CA0J.Y] Other specified nasal polyp", "[DB71.Z] Anal polyp, unspecified\n --PARENT--> [DB71] Anal polyp\n Def: Abnormal mushroom-like growth sticking out from the epithelium rising from the lining of the anus and anal canal....\n --CHILD--> [DB71.2] Hypertrophied anal papillae\n Def: The enlargement of existing anal papillae is a consequence of chronic inflammation and fibrotic proliferation within the anorectal zone, which is known as hypertrophied or fibrous anal polyp....", "[DB71.Z] Anal polyp, unspecified\n --PARENT--> [DB71] Anal polyp\n Def: Abnormal mushroom-like growth sticking out from the epithelium rising from the lining of the anus and anal canal....\n --CHILD--> [DB71.1] Lymphoid polyp\n Def: Lymphoid polyp is a benign, focal or diffuse small polypoid lesion composed of well-differentiated lymphoid tissue....", "[DA09.0] Pulpitis\n Def: Inflammation of pulpal tissue resulting from irritating factors of diverse nature such as bacterial, hyperaemic, chemical or thermal that act directly or indirectly on the dental pulp....\n --PARENT--> [DA09] Diseases of pulp or periapical tissues\n Def: Dental pulp is that part of the tooth located in the centre of the coronal portion underneath dentin and composed of connective tissue, blood vessels and nerve endings.\nPeriapical tissues are designat...\n --CHILD--> [DA09.1] Necrosis of pulp\n Def: Necrosis of the dental pulp which clinically does not respond to thermal stimulation; the tooth may be asymptomatic or sensitive to percussion and palpation....", "[DA09.0] Pulpitis\n Def: Inflammation of pulpal tissue resulting from irritating factors of diverse nature such as bacterial, hyperaemic, chemical or thermal that act directly or indirectly on the dental pulp....\n --PARENT--> [DA09] Diseases of pulp or periapical tissues\n Def: Dental pulp is that part of the tooth located in the centre of the coronal portion underneath dentin and composed of connective tissue, blood vessels and nerve endings.\nPeriapical tissues are designat...\n --CHILD--> [DA09.1] Necrosis of pulp\n Def: Necrosis of the dental pulp which clinically does not respond to thermal stimulation; the tooth may be asymptomatic or sensitive to percussion and palpation...." ]
CA0J.Y
Other specified nasal polyp
[ { "from_icd11": "DB71.Z", "icd10_code": "K620", "icd10_title": "Anal polyp" }, { "from_icd11": "DA09.0", "icd10_code": "K0402", "icd10_title": "Irreversible pulpitis" }, { "from_icd11": "DA09.0", "icd10_code": "K0401", "icd10_title": "Reversible pulpitis" }, { "from_icd11": "DA09.0", "icd10_code": "K040", "icd10_title": "Pulpitis" }, { "from_icd11": "9D43", "icd10_code": "H538", "icd10_title": "Other visual disturbances" }, { "from_icd11": "NE60", "icd10_code": "T50A95A", "icd10_title": "Adverse effect of other bacterial vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z15A", "icd10_title": "Adverse effect of immunoglobulin, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z95A", "icd10_title": "Adverse effect of other vaccines and biological substances, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A95S", "icd10_title": "Adverse effect of other bacterial vaccines, sequela" }, { "from_icd11": "NE60", "icd10_code": "T50B95A", "icd10_title": "Adverse effect of other viral vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A25A", "icd10_title": "Adverse effect of mixed bacterial vaccines without a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A91A", "icd10_title": "Poisoning by other bacterial vaccines, accidental (unintentional), initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T498X5A", "icd10_title": "Adverse effect of other topical agents, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48905A", "icd10_title": "Adverse effect of unspecified agents primarily acting on the respiratory system, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48995A", "icd10_title": "Adverse effect of other agents primarily acting on the respiratory system, initial encounter" } ]
K620
Anal polyp
Case 5 is an 80-year-old man, who was admitted to our hospital due to nasal discharge and chills. His eldest son living with him, had been diagnosed with COVID-19 confirmed by PCR test, and the patient developed nasal discharge three days later. The next day, he underwent PCR test which revealed positive, and he was admitted to our hospital. He had been on hemodialysis for about a year due to ESKD with DMN. He had comorbidities such as hypertension, hyperuricemia, atrial fibrillation, and chronic heart failure. Risk factors for severe COVID-19 included high age, CKD, type 2 DM, hypertension, and ex-smoker. He completed the second vaccination 56 days earlier. On admission, his vital signs were normal, and he had no hypoxia. Physical examinations were normal, and there was no abnormality in Chest CT scan. Considering that the patient was at high risk of severe COVID-19, especially at an advanced age, REGN-COV2 was administered on the day of admission. After treatment, all symptoms disappeared on the second day of hospitalization, and he was afebrile and had never developed hypoxia throughout his hospitalization period. He was discharged home on the eighth hospitalization day (ten days after the onset of illness) (Table 1 ) . Table 1 xxxx Age, sex Duration of HD treatment Primary disease Findings and results on admission Tx Admission day from onset (days) Duration of hospitalization (days) Maximum O 2 inhalation during hospitalization Outcome Comorbidities Smoking Vaccination (times) (years, month) Severity a BT (℃) SpO 2 (%) CRP (mg/dl) HRCT 55, M 8y, 10 m DMN Moderate I 39.2 98 4.24 GGO ( +) REGN-COV2, CTRX 4 15 Nasal canula 1 L/min IMP DM, HT ( +) (−) 50, M 7y, 11 m DMN Moderate I 39 99 2.74 GGO ( +) REGN-COV2 7 8 (−) IMP DM, HT, glaucoma ( +) × 1 78, M 1y, 5 m DMN Moderate I 39.3 96 14.17 GGO ( +) REGN-COV2 3 8 Nasal canula 1 L/min IMP DM ex × 2 HT, glaucoma, BPH 71, M 11y,10 m DMN Moderate I 39.2 98 7.6 GGO ( +) REGN-COV2 3 12 Nasal canula 2 L/min IMP DM (−) × 2 HT, glaucoma ,pAf 80, M 1y, 2 m DMN Mild 36.4 98 0.11 (−) REGN-COV2 3 8 (−) IMP DM, HT, pAf ex × 2 Hyperuricemia, CHF 38, F 2 m ADPKD Moderate II 38.3 100 b 2.1 GGO ( +) DEX 2 13 Nasal canula 1 L/min IMP HT (−) (−) 71, M 4y, 9 m CGN Moderate I 39.3 95 13.75 GGO ( +) DEX 2 36 Mechanical ventilation (FiO 2 0.6) IMP pAf, HT ( +) (−) OMI CHF 76, M 14y,0 m DMN Moderate I 37.5 98 21.6 GGO ( +) VCM,CFPM 1 15 (−) Transfer DM, HT ex (−) 98, F 6y, 4 m NSC Moderate I 37.1 93 11.75 GGO ( +) (−) 2 12 (−) IMP HT, OA (−) (−) 56, M 25y, 7 m CGN Moderate I 37 97 3.69 GGO ( +) DEX 2 18 Nasal 1 L/min IMP HT, OMI (−) (−) 75, F 9y, 0 m ADPKD Moderate I 38.5 99 8.83 GGO ( +) DEX 5 18 NHF (FiO 2 80% 40 L) Dead HT, DVT (−) (−) 86, F 1y, 2 m DMN Moderate I 37.5 95 16.42 GGO ( +) SBT/ABPC 4 19 (−) Transfer DM, HT, RA, (−) (−) ASO, dementia 82, F 8 m AAV Moderate I 36.6 96 2.91 GGO ( +) (−) 7 26 Nasal 1 L/min IMP AAV, DM (−) (−) pAf, BA 78, M 6y, 1 m NSC Moderate I 37.5 96 4.07 GGO ( +) DEX 7 21 Nasal 3 L/min IMP HT ex (−) Nephrectomy 45, M 6y, 9 m DMN Moderate I 37.7 97 3.83 GGO ( +) DEX 9 22 Nasal 1 L/min IMP DM, HL, HT ex (−) 54, M 7y, 4 m DMN Moderate I 37.7 95 10.84 GGO ( +) DEX 6 14 Mask 4 L/min IMP DM, HT, (−) (−) 74, F 8y, 6 m DMN Mild 36.8 98 0.09 (−) (−) 9 9 Nasal 1 L/min IMP DM, HT, HL (−) (−) 63, F 2y, 0 m DMN Mild 36.4 98 0.15 (−) (−) 1 11 (−) IMP DM, HT ex (−) 71, M 5y, 4 m IgAN Moderate II 39.4 96 b 16.24 GGO ( +) DEX,CTRX 4 13 Nasal 3 L/min IMP HT, HL, hyperuricemia (−) × 2 90, F 7 m, 0 m DMN Moderate I 37.8 97 2.24 GGO ( +) DEX,CTRX 5 23 Nasal 1 L/min Transfer DM, OMI, HT, Af (−) × 2 57, M 0 m ADPKD Moderate I 37.9 96 0.62 GGO ( +) DEX, TOC 1 30 NHF(FiO 2 75% 40 L) Transfer HT (−) × 1 64, M 8y, 3 m TIN Moderate I 38.2 100 8.53 GGO ( +) DEX, CTRX, MEPM, CAZ 5 76 Intubation(FiO 2 60) Dead HT, BPH (−) (−) DMN diabetic nephropathy; ADPKD autosomal dominant polycystic kidney disease; CGN chronic glomerulonephritis; NSC nephrosclerosis; AAV ANCA-associated vasculitis; IgAN IgA nephritis; HRCT high-resolution computed tomography; TX treatment; CTRX ceftriaxone sodium; DEX dexamethasone; VCM vancomycin; CFPM cefepime; SBT/ABPC sulbactam/ampicillin; TOC tocilizumab; MEPM meropenem; CAZ ceftazidime; DM diabetes mellitus; HT hypertension; BPH benign prostatic hypertrophy; pAf periodic atrial fibrillation; CHF chronic heart failure; OMI old myocardial infarction; OA osteoarthritis; DVT deep vein thrombosis; RA rheumatoid arthritis; ASO atherosclerosis obliterans; AAV ANCA-associated angiitis; OMI old myocardial infarction; BA bronchial asthma; HL hyperlipemia a The notation of disease severity followed the Japanese diagnostic guide; “mild disease” refers to cases without complications of pneumonia, “Moderate I” refers to cases with pneumonia but no need for oxygen inhalation, “Moderate II” refers to cases with pneumonia and need for oxygen inhalation, “Severe” refers to cases that require a ventilator or nasal high flow (NHF) b This patient was receiving nasal oxygen inhalation at 1 L/min
4.058594
0.96875
sec[2]/sec[0]/p[4]
en
0.999996
35182277
https://doi.org/10.1007/s10157-021-02151-3
[ "nasal", "regn", "hospitalization", "ctrx", "inhalation", "canula", "adpkd", "transfer", "refers", "cases" ]
[ { "code": "MA82.2", "title": "Nasality" }, { "code": "CA0Z", "title": "Upper respiratory tract disorders, unspecified" }, { "code": "CA0Y", "title": "Other specified upper respiratory tract disorders" }, { "code": "LA70.2", "title": "Choanal atresia" }, { "code": "NA00.3&XJ1C6", "title": "Haematoma of nose" }, { "code": "6C4B.3", "title": "Volatile inhalant intoxication" }, { "code": "6C4B.Z", "title": "Disorders due to use of volatile inhalants, unspecified" }, { "code": "KB26.0", "title": "Neonatal aspiration of meconium" }, { "code": "ND72.Y", "title": "Foreign body in other parts of respiratory tract" }, { "code": "NE01", "title": "Burn of respiratory tract" } ]
=== ICD-11 CODES FOUND === [MA82.2] Nasality Definition: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur when there is obstruction in one of the cavities, causing hyponasality, or when there is velopharyngeal dysfunction, causing hypernasality. This category should only be assigned when hyponasality or hypernasality is outside the limits of normal variation and results in reduced intelligibility and si Also known as: Nasality | Hypernasality | Hyponasality [CA0Z] Upper respiratory tract disorders, unspecified Also known as: Upper respiratory tract disorders, unspecified | Disorder of the nose, unspecified | Disease of nose, unspecified | nasal disease | Lesion of nose, unspecified [CA0Y] Other specified upper respiratory tract disorders Also known as: Other specified upper respiratory tract disorders | Acute adenoiditis | adenoid infection | Pharyngotonsillitis | tonsillopharyngitis [LA70.2] Choanal atresia Definition: Any condition in neonates, caused by failure of the nose to correctly develop during the antenatal period. This condition is characterised by narrowing or blockage of the nasal airway by tissue. This condition may also present with chest retraction unless child is breathing through mouth or crying, difficulty breathing, cyanosis, and inability to nurse and breathe at same time. Also known as: Choanal atresia | choanal fusion | atresia of nares | congenital stenosis of nares | congenital stenosis of choanae [6C4B.3] Volatile inhalant intoxication Definition: Volatile inhalant intoxication is a clinically significant transient condition that develops during or shortly after the consumption of a volatile inhalant that is characterised by disturbances in consciousness, cognition, perception, affect, behaviour, or coordination. These disturbances are caused by the known pharmacological effects of volatile inhalants and their intensity is closely related to the amount of volatile inhalant consumed. They are time-limited and abate as the volatile inhalant Also known as: Volatile inhalant intoxication | bad trip due to volatile inhalants | inhalant intoxication | intoxication due to volatile solvents Excludes: Possession trance disorder [6C4B.Z] Disorders due to use of volatile inhalants, unspecified Also known as: Disorders due to use of volatile inhalants, unspecified | Disorders due to use of volatile inhalants | Disorders due to petrol sniffing | Disorders due to abuse of volatile inhalants | inhalant use disorder [KB26.0] Neonatal aspiration of meconium Definition: Meconium Aspiration Syndrome (MAS) is defined as respiratory distress in an infant born through meconium-stained amniotic fluid with roentgenographic findings consistent with MAS and whose symptoms could not be otherwise explained. Also known as: Neonatal aspiration of meconium | meconium aspiration syndrome | meconium aspiration syndrome of newborn | meconium inhalation | MAS - [meconium aspiration syndrome] Excludes: Meconium passage during delivery | Meconium staining [ND72.Y] Foreign body in other parts of respiratory tract Also known as: Foreign body in other parts of respiratory tract | Asphyxia due to foreign body | suffocation due to airway foreign body | Asphyxia on mucus in respiratory tract | mucous asphyxia [NE01] Burn of respiratory tract Definition: Injury to the tissues of the respiratory tract caused by contact with, for example, heat, steam, chemicals, or electricity. Also known as: Burn of respiratory tract | burn and corrosion of respiratory tract | corrosion of respiratory tract, part unspecified | corrosion of respiratory tract | inhalation burn === GRAPH WALKS === --- Walk 1 --- [MA82.2] Nasality Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ... --PARENT--> [MA82] Voice disturbances Def: Voice disturbances include dysphonia, aphonia, hypernasality and hyponasality, and other voice disturbances.... --CHILD--> [MA82.0] Aphonia Def: Aphonia is the inability to produce voice. It is considered more severe than dysphonia. Like dysphonia, aphonia can be caused by voice strain or overuse, injury, by structural laryngeal anomalies or b... --- Walk 2 --- [MA82.2] Nasality Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ... --PARENT--> [MA82] Voice disturbances Def: Voice disturbances include dysphonia, aphonia, hypernasality and hyponasality, and other voice disturbances.... --CHILD--> [MA82.0] Aphonia Def: Aphonia is the inability to produce voice. It is considered more severe than dysphonia. Like dysphonia, aphonia can be caused by voice strain or overuse, injury, by structural laryngeal anomalies or b... --- Walk 3 --- [CA0Z] Upper respiratory tract disorders, unspecified --PARENT--> [?] Upper respiratory tract disorders Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ... --PARENT--> [12] Diseases of the respiratory system --- Walk 4 --- [CA0Z] Upper respiratory tract disorders, unspecified --PARENT--> [?] Upper respiratory tract disorders Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ... --CHILD--> [CA02] Acute pharyngitis Def: Acute pharyngitis is defined as an infection or irritation of the pharynx and/or tonsils and is a part of the common cold symptoms. The etiology is usually infectious, with most cases being of viral o... --- Walk 5 --- [CA0Y] Other specified upper respiratory tract disorders --PARENT--> [?] Upper respiratory tract disorders Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ... --PARENT--> [12] Diseases of the respiratory system --- Walk 6 --- [CA0Y] Other specified upper respiratory tract disorders --PARENT--> [?] Upper respiratory tract disorders Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ... --CHILD--> [CA02] Acute pharyngitis Def: Acute pharyngitis is defined as an infection or irritation of the pharynx and/or tonsils and is a part of the common cold symptoms. The etiology is usually infectious, with most cases being of viral o...
[ "[MA82.2] Nasality\n Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ...\n --PARENT--> [MA82] Voice disturbances\n Def: Voice disturbances include dysphonia, aphonia, hypernasality and hyponasality, and other voice disturbances....\n --CHILD--> [MA82.0] Aphonia\n Def: Aphonia is the inability to produce voice. It is considered more severe than dysphonia. Like dysphonia, aphonia can be caused by voice strain or overuse, injury, by structural laryngeal anomalies or b...", "[MA82.2] Nasality\n Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ...\n --PARENT--> [MA82] Voice disturbances\n Def: Voice disturbances include dysphonia, aphonia, hypernasality and hyponasality, and other voice disturbances....\n --CHILD--> [MA82.0] Aphonia\n Def: Aphonia is the inability to produce voice. It is considered more severe than dysphonia. Like dysphonia, aphonia can be caused by voice strain or overuse, injury, by structural laryngeal anomalies or b...", "[CA0Z] Upper respiratory tract disorders, unspecified\n --PARENT--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...\n --PARENT--> [12] Diseases of the respiratory system", "[CA0Z] Upper respiratory tract disorders, unspecified\n --PARENT--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...\n --CHILD--> [CA02] Acute pharyngitis\n Def: Acute pharyngitis is defined as an infection or irritation of the pharynx and/or tonsils and is a part of the common cold symptoms. The etiology is usually infectious, with most cases being of viral o...", "[CA0Y] Other specified upper respiratory tract disorders\n --PARENT--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...\n --PARENT--> [12] Diseases of the respiratory system", "[CA0Y] Other specified upper respiratory tract disorders\n --PARENT--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...\n --CHILD--> [CA02] Acute pharyngitis\n Def: Acute pharyngitis is defined as an infection or irritation of the pharynx and/or tonsils and is a part of the common cold symptoms. The etiology is usually infectious, with most cases being of viral o..." ]
MA82.2
Nasality
[ { "from_icd11": "MA82.2", "icd10_code": "R4921", "icd10_title": "Hypernasality" }, { "from_icd11": "MA82.2", "icd10_code": "R4922", "icd10_title": "Hyponasality" }, { "from_icd11": "MA82.2", "icd10_code": "R492", "icd10_title": "Hypernasality and hyponasality" }, { "from_icd11": "CA0Z", "icd10_code": "J349", "icd10_title": "Unspecified disorder of nose and nasal sinuses" }, { "from_icd11": "CA0Z", "icd10_code": "J3489", "icd10_title": "Other specified disorders of nose and nasal sinuses" }, { "from_icd11": "CA0Z", "icd10_code": "J3481", "icd10_title": "Nasal mucositis (ulcerative)" }, { "from_icd11": "CA0Z", "icd10_code": "J398", "icd10_title": "Other specified diseases of upper respiratory tract" }, { "from_icd11": "CA0Z", "icd10_code": "J392", "icd10_title": "Other diseases of pharynx" }, { "from_icd11": "CA0Z", "icd10_code": "J399", "icd10_title": "Disease of upper respiratory tract, unspecified" }, { "from_icd11": "CA0Z", "icd10_code": "J00-J06", "icd10_title": "" }, { "from_icd11": "CA0Z", "icd10_code": "J30-J39", "icd10_title": "" }, { "from_icd11": "CA0Z", "icd10_code": "J34", "icd10_title": "Other and unspecified disorders of nose and nasal sinuses" }, { "from_icd11": "CA0Z", "icd10_code": "J348", "icd10_title": "Other specified disorders of nose and nasal sinuses" }, { "from_icd11": "CA0Z", "icd10_code": "J39", "icd10_title": "Other diseases of upper respiratory tract" }, { "from_icd11": "LA70.2", "icd10_code": "Q300", "icd10_title": "Choanal atresia" } ]
R4921
Hypernasality
Our patient's clinical presentation was consistent with diabetic uremic syndrome, as proposed by Wang et al. , because of her background of receiving maintenance dialysis for diabetic nephropathy and having subacute onset of parkinsonism and bilateral basal ganglia lesions. In addition, our patient met the diagnostic criteria proposed by Manickavasagar et al. , so we diagnosed her as having EPS-CKDD. An effective treatment for this syndrome has not yet been clarified, as some cases resolved spontaneously with continued maintenance dialysis, while others presented with sequelae. Our case showed rapid improvement of her symptoms and MRI findings despite only discontinuation of metformin with continued maintenance dialysis. There have been scattered reports of the syndrome since it was first proposed by Wang et al. . Meanwhile, cases of metformin-induced encephalopathy have been reported. There have been eight reported cases of metformin-induced encephalopathy with bilateral basal ganglia lesions [ , , , , , , ], all of which involved diabetes mellitus and end-stage renal disease with bilateral basal ganglia lesions including the lentiform fork sign, and thus the clinical pictures are almost identical to those of diabetic uremic syndrome ( Table 1 ). However, in these cases, the symptoms appeared during metformin use and promptly improved after its discontinuation, suggesting that metformin was strongly involved. There are no established diagnostic criteria for metformin-induced encephalopathy, which is diagnosed on the basis of MRI findings and improvement after discontinuation of metformin, and those findings also seem to apply to the present case. In the first report on diabetic uremic syndrome by Wang et al. , most cases were accompanied by metabolic acidosis. Furthermore, in the report by Kumar et al. , almost all cases of certain diseases, including methanol intoxication and mitochondrial diseases, presenting with the lentiform fork sign were accompanied by metabolic acidosis, suggesting that metabolic acidosis may be the main cause of this condition. Both diabetic uremic syndrome and metformin-induced encephalopathy were accompanied by metabolic acidosis in some cases, and thus the two diseases may have a common underlying pathology. The reason for our case showing no acidosis on admission is speculated as follows. Our patient may have developed acidosis after taking metformin that was corrected by maintenance dialysis, and the maintenance dialysis may also have partially eliminated the metformin . However, maintenance dialysis only was insufficient, because the blood levels of metformin remained high and metformin tends to accumulate in several tissues including the brain , and thus metformin should be discontinued. Another possible mechanism is a direct effect of metformin on the central nervous system . Our case supports the proposed diagnostic criteria for EPS-CKDD, which includes diabetic uremic syndrome and metformin encephalopathy, and confirms that metformin use is a risk factor. Table 1 Background characteristics, coexisting medical problems, and clinical outcomes of patients reported to have metformin-induced encephalopathy with basal ganglia lesions. Table 1 Case Reference Age and sex Past history Duration of dialysis Duration of metformin use Duration from symptom onset Neurological symptoms Acidosis Prognosis 1 Berrada et al. 49 F DM, ESRD ND 5 days Rapid Parkinsonism, DOC Absent A clinical and radiological outcome was favorable 1 month later. 2 Simon ＆ Thomas 63 M DM, ESRD, old cerebrovascular accident 2 years Long-term 1 month Parkinsonism, DOC, mild weakness, asterixis Present Improvement in sensorium after a few days. Brain MRI showed resolution of changes after 2 months. 3 McGarvey et al. 44 F DM, ESRD, HT, obesity, hypothyroidism 3 months Several months (increased dose 7 weeks before) 4 weeks Parkinsonism ND Recovered over the next few days without neurological sequelae. 4 Fernandes et al. 63 F DM, ESRD ND 1 week Subacute Parkinsonism ND ND 5 Kang et al. 62 M DM, ESRD, HT 5 years 5 weeks 10 days DOC, dysarthria, gait disturbance, myoclonus ND Neurological abnormalities had almost completely resolved after three regular hemodialysis sessions. MRI revealed complete resolution. 6 Kang et al. 55 F DM, ESRD 4 years 4 weeks 3 days Dysarthria, myoclonus, involuntary movement of legs ND Neurological abnormalities had almost completely resolved after three hemodialysis sessions. MRI after 2 weeks revealed complete resolution. 7 Jung et al. 51 M DM, ESRD 2 years 3 months 1 month Dysarthria, mild hemiparesis, myoclonus, asterixis, trismus ND Symptoms and signs had completely disappeared at 7 days after admission. MRI after 3 weeks showed a marked improvement. 8 Mewborne et al. 55 M DM, ESRD, HT ND 18 months 2 days DOC, slurred speech, generalized weakness Present Full recovery was observed. DOC, disturbance of consciousness; DM, diabetes mellitus; ESRD, end-stage renal disease; HT, hypertension; ND, not documented.
4.265625
0.887695
sec[2]/p[0]
en
0.999997
PMC10009720
https://doi.org/10.1016/j.heliyon.2023.e14255
[ "metformin", "esrd", "dialysis", "cases", "acidosis", "diabetic", "maintenance", "encephalopathy", "uremic", "parkinsonism" ]
[ { "code": "GB61.5", "title": "Chronic kidney disease, stage 5" }, { "code": "QB94.Z", "title": "Care involving dialysis, unspecified" }, { "code": "QB94.1", "title": "Care involving extracorporeal dialysis" }, { "code": "9B73.0", "title": "Retinal detachment with retinal break" }, { "code": "QB94.2", "title": "Care involving peritoneal dialysis" }, { "code": "QB94.Y", "title": "Care involving other specified dialysis" }, { "code": "JB20.Z", "title": "Single spontaneous delivery, unspecified" }, { "code": "QA48.0", "title": "Care or examination immediately after delivery" }, { "code": "5C73.Z", "title": "Acidosis, unspecified" }, { "code": "5C73.Y", "title": "Other specified acidosis" } ]
=== ICD-11 CODES FOUND === [GB61.5] Chronic kidney disease, stage 5 Definition: Kidney failure, GFR < 15 ml/min/1.73m² Also known as: Chronic kidney disease, stage 5 | chronic renal failure, stage 5 | CKD - [chronic kidney disease] stage 5 | end stage kidney failure | end stage renal failure Includes: chronic renal failure, stage 5 [QB94.Z] Care involving dialysis, unspecified Also known as: Care involving dialysis, unspecified | Care involving dialysis | dialysis preparation and treatment | dialysis NOS [QB94.1] Care involving extracorporeal dialysis Also known as: Care involving extracorporeal dialysis | encounter for extracorporeal dialysis | encounter for dialysis NOS | encounter for renal dialysis NOS | aftercare involving extracorporeal dialysis [9B73.0] Retinal detachment with retinal break Also known as: Retinal detachment with retinal break | Rhegmatogenous retinal detachment | ruptured retina with detachment | retinal hole with detachment | Retinal detachment with giant retinal tear Includes: Rhegmatogenous retinal detachment [QB94.2] Care involving peritoneal dialysis Also known as: Care involving peritoneal dialysis | aftercare involving peritoneal dialysis | intermittent peritoneal dialysis | peritoneum dialysis [QB94.Y] Care involving other specified dialysis Also known as: Care involving other specified dialysis [JB20.Z] Single spontaneous delivery, unspecified Also known as: Single spontaneous delivery, unspecified | Single spontaneous delivery | spontaneous delivery NOS | normal delivery NOS | uncomplicated delivery [QA48.0] Care or examination immediately after delivery Also known as: Care or examination immediately after delivery | care and observation in uncomplicated delivery cases | postpartum care immediately after delivery | postpartum examination immediately after delivery | Postpartum care after hospital delivery Excludes: Complications predominantly related to the puerperium [5C73.Z] Acidosis, unspecified Also known as: Acidosis, unspecified | Acidosis | acidosis NOS | metabolic acidaemia | lactic acidosis [5C73.Y] Other specified acidosis Also known as: Other specified acidosis | Non-anion gap metabolic acidosis === GRAPH WALKS === --- Walk 1 --- [GB61.5] Chronic kidney disease, stage 5 Def: Kidney failure, GFR < 15 ml/min/1.73m²... --RELATED_TO--> [?] Albuminurica retinopathy --PARENT--> [?] Retinopathy --- Walk 2 --- [GB61.5] Chronic kidney disease, stage 5 Def: Kidney failure, GFR < 15 ml/min/1.73m²... --PARENT--> [GB61] Chronic kidney disease Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist... --CHILD--> [GB61.0] Chronic kidney disease, stage 1 Def: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²)... --- Walk 3 --- [QB94.Z] Care involving dialysis, unspecified --PARENT--> [QB94] Care involving dialysis Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education... --CHILD--> [QB94.2] Care involving peritoneal dialysis --- Walk 4 --- [QB94.Z] Care involving dialysis, unspecified --PARENT--> [QB94] Care involving dialysis Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education... --EXCLUDES--> [?] Dependence on renal dialysis --- Walk 5 --- [QB94.1] Care involving extracorporeal dialysis --PARENT--> [QB94] Care involving dialysis Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education... --EXCLUDES--> [?] Dependence on renal dialysis --- Walk 6 --- [QB94.1] Care involving extracorporeal dialysis --PARENT--> [QB94] Care involving dialysis Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education... --CHILD--> [QB94.2] Care involving peritoneal dialysis
[ "[GB61.5] Chronic kidney disease, stage 5\n Def: Kidney failure, GFR < 15 ml/min/1.73m²...\n --RELATED_TO--> [?] Albuminurica retinopathy\n --PARENT--> [?] Retinopathy", "[GB61.5] Chronic kidney disease, stage 5\n Def: Kidney failure, GFR < 15 ml/min/1.73m²...\n --PARENT--> [GB61] Chronic kidney disease\n Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist...\n --CHILD--> [GB61.0] Chronic kidney disease, stage 1\n Def: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²)...", "[QB94.Z] Care involving dialysis, unspecified\n --PARENT--> [QB94] Care involving dialysis\n Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education...\n --CHILD--> [QB94.2] Care involving peritoneal dialysis", "[QB94.Z] Care involving dialysis, unspecified\n --PARENT--> [QB94] Care involving dialysis\n Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education...\n --EXCLUDES--> [?] Dependence on renal dialysis", "[QB94.1] Care involving extracorporeal dialysis\n --PARENT--> [QB94] Care involving dialysis\n Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education...\n --EXCLUDES--> [?] Dependence on renal dialysis", "[QB94.1] Care involving extracorporeal dialysis\n --PARENT--> [QB94] Care involving dialysis\n Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education...\n --CHILD--> [QB94.2] Care involving peritoneal dialysis" ]
GB61.5
Chronic kidney disease, stage 5
[ { "from_icd11": "GB61.5", "icd10_code": "N186", "icd10_title": "End stage renal disease" }, { "from_icd11": "GB61.5", "icd10_code": "N185", "icd10_title": "Chronic kidney disease, stage 5" }, { "from_icd11": "QB94.Z", "icd10_code": "Z4931", "icd10_title": "Encounter for adequacy testing for hemodialysis" }, { "from_icd11": "QB94.Z", "icd10_code": "Z4932", "icd10_title": "Encounter for adequacy testing for peritoneal dialysis" }, { "from_icd11": "QB94.Z", "icd10_code": "Z49", "icd10_title": "Encounter for care involving renal dialysis" }, { "from_icd11": "QB94.1", "icd10_code": "Z491", "icd10_title": "" }, { "from_icd11": "9B73.0", "icd10_code": "H33051", "icd10_title": "Total retinal detachment, right eye" }, { "from_icd11": "9B73.0", "icd10_code": "H33012", "icd10_title": "Retinal detachment with single break, left eye" }, { "from_icd11": "9B73.0", "icd10_code": "H33052", "icd10_title": "Total retinal detachment, left eye" }, { "from_icd11": "9B73.0", "icd10_code": "H33001", "icd10_title": "Unspecified retinal detachment with retinal break, right eye" }, { "from_icd11": "9B73.0", "icd10_code": "H33009", "icd10_title": "Unspecified retinal detachment with retinal break, unspecified eye" }, { "from_icd11": "9B73.0", "icd10_code": "H33059", "icd10_title": "Total retinal detachment, unspecified eye" }, { "from_icd11": "9B73.0", "icd10_code": "H33029", "icd10_title": "Retinal detachment with multiple breaks, unspecified eye" }, { "from_icd11": "9B73.0", "icd10_code": "H33039", "icd10_title": "Retinal detachment with giant retinal tear, unspecified eye" }, { "from_icd11": "9B73.0", "icd10_code": "H330", "icd10_title": "Retinal detachment with retinal break" } ]
N186
End stage renal disease
A 19-year-old female had presented to our Emergency Department, complaining of sudden severe chest and epigastric pain since 1 day, which was associated with sweating. The pain was radiating to neck and left arm. The pain did not relieve on rest but subsided on medications. Similar episodes were also reported in the past few days, however, with less severity. The patient confirmed to not having shortness of breath, palpitation, syncope, dizziness, nausea, emesis, fever, or cough. There was no history of any previous cardiac ailment/surgery/other identifiable cardiovascular risk factors or any other history of infection. There is no evidence to suggest chest wall trauma. There is no history of comorbidities or any history of smoking. There is no significant family history or any similar past history. Upon admission, patient was conscious, alert with heart rate of 86 bpm, blood pressure measuring 110/60 mm Hg, 97% oxygen saturation at room air, temperature of 36.4 °C, and respiration rate of 15 breaths/min. The cardiac biomarker troponin T levels were extremely raised, measuring 50,000 pg/ml, and CK-MB was raised, measuring 111U/Lt. Laboratory findings showed that inflammation markers were normal, C-reactive protein (5.8.0 mg/L) and D-dimer (94 ng/mL). Other laboratory findings such as lipid profile, complete blood count, electrolytes, fasting blood glucose, HBA1c, and renal and liver function tests were normal. Cardiac auscultation showed normal S1, S2 without murmurs or pericardial rub and any sign of heart failure. Initial ECG revealed ST segment elevation in the leads I, aVL, V4, V5, and V6 leads, normal sinus rhythm (60 beats per min) without any other abnormalities , which was resolved by day 3. Arrhythmias were not found during continuous cardiac monitoring. Echocardiogram showcased an ejection fraction of the left ventricle to be 60%, whereas the echocardiographic metrics were not very significant. Patient was then treated as ACS with a salicylate-based nonsteroidal anti-inflammatory drug (NSAID), anticoagulants, and anti-thrombolytics. CMR was done on 3 T MRI machine with acquisition including T2/STIR Dark blood four-chamber long axis; CINE images in short axis, long axis, RVOT, and LVOT; and early dynamic gadolinium enhancement images and delayed gadolinium enhancement in PSIR images. T2/STIR Dark blood sequences showed T2 hyperintensity in the subepicardial region along left lateral wall . There was associated mild global hypokinesia with mildly reduced ejection fraction/systolic function . Patchy delayed gadolinium enhancement of intramural, subepicardial as all tans-mural enhancement with non-involvement of the subendocardium (suggesting a non-ischemic pattern) in multiple segments of cardiac basal , mid cavity , and apical cavity—with predominant involvement of lateral and inferior wall segments in the basal cavity. There were no signs of infarction of myocardium; therefore, the patient was diagnosed with acute myocarditis (based on Lake Louise Criteria for Acute Myocarditis). Further, viral and autoimmune workups results were found to be negative. It included hepatitis (B, C), human immunodeficiency virus, Coxsackie virus, COVID-19, cytomegalovirus, Epstein–Barr virus (EBV), and Parvovirus B-19. On further analysis and detailed relevant history workup, the patient admitted to using cannabis for the past 1 year with last exposure being 3 days before admission. On the basis of detailed clinical history, findings on CMR with other negative viral markers, and possible etiological factors, a final diagnosis of myocarditis presumed secondary to marijuana/cannabis toxin abuse was made. Patient was released from the hospital on the seventh day with advised conservative treatment. The patient was counseled to abstain completely from cannabis or related drugs. Patient was advised to repeat a CMR control, three months later. A 3–4-month restriction on high-intensity activity was also given to the patient following discharge. Fig. 1 ECG at initial presentation—showing ST segment elevation in the leads I, aVL, V4, V5, and V6 leads Fig. 2 Long-axis 4 chambers A T2 STIR Dark blood; B T2 Dark blood—showing patchy T2 hyperintensity in subepicardial region along left lateral wall Fig. 3 Snapshot from CINE Image T2 A Long-axis 4 chambers; B short-axis 2 chambers—showing mild global hypokinesia and left ventricle dilatation Fig. 4 Short-axis 2-chamber PSIR sequence (basal cavity) A MAG; B PHASE images—showing patchy delayed gadolinium enhancement of intramural, subepicardial, tans-mural enhancement in inferior and lateral wall segments of cardiac basal cavity Fig. 5 Short-axis 2-chamber PSIR sequence (Mid Cavity)- A MAG; B PHASE images—showing patchy delayed gadolinium enhancement of subepicardial in multiple segments of cardiac mid cavity Fig. 6 Long-axis 4-chamber PSIR sequence— A MAG; B PHASE images—showing patchy delayed gadolinium enhancement of intramural, subepicardial as all tans-mural enhancement along the left lateral wall
4.058594
0.974121
sec[1]/p[0]
en
0.999996
PMC9672602
https://doi.org/10.1186/s43055-022-00923-9
[ "axis", "enhancement", "cardiac", "blood", "cavity", "wall", "gadolinium", "subepicardial", "long", "patchy" ]
[ { "code": "BD52.5", "title": "Coeliac artery compression syndrome" }, { "code": "NA22.13", "title": "Other fracture of second cervical vertebra" }, { "code": "NA23.11", "title": "Atlanto-axial dislocation" }, { "code": "NA22.1Z", "title": "Fracture of second cervical vertebra, unspecified" }, { "code": "LB73.23", "title": "Aplasia or hypoplasia of the odontoid process of axis" }, { "code": "8A04.0", "title": "Enhanced physiological tremor" }, { "code": "8E4A.0", "title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord" }, { "code": "BE2Y", "title": "Other specified diseases of the circulatory system" }, { "code": "BC4Z", "title": "Diseases of the myocardium or cardiac chambers, unspecified" }, { "code": "BD1Z", "title": "Heart failure, unspecified" } ]
=== ICD-11 CODES FOUND === [BD52.5] Coeliac artery compression syndrome Also known as: Coeliac artery compression syndrome | celiac artery compression syndrome | celiac axis compression syndrome | celiac axis syndrome | coeliac axis compression syndrome [NA22.13] Other fracture of second cervical vertebra Also known as: Other fracture of second cervical vertebra | other fracture of axis [NA23.11] Atlanto-axial dislocation Also known as: Atlanto-axial dislocation | dislocation C1/C2 | atlas dislocation | axis dislocation | dislocation of occiput from atlas [NA22.1Z] Fracture of second cervical vertebra, unspecified Also known as: Fracture of second cervical vertebra, unspecified | Fracture of second cervical vertebra | fracture of axis of spine | C2 fracture | axial fracture dislocation [LB73.23] Aplasia or hypoplasia of the odontoid process of axis Also known as: Aplasia or hypoplasia of the odontoid process of axis [8A04.0] Enhanced physiological tremor Definition: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc. Also known as: Enhanced physiological tremor [8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Definition: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephalopathy, ataxia, myelopathy, myelitis) nervous system. In the paraneoplastic context, this attack is a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived from a systemic cancer. In the non-paraneoplastic context termed ‘autoimmune’ the etiology rem Also known as: Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord | Paraneoplastic encephalitis | Paraneoplastic encephalitis, neural autoantibody positive | Paraneoplastic encephalitis, neural autoantibody negative | Autoimmune encephalitis [BE2Y] Other specified diseases of the circulatory system Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart [BC4Z] Diseases of the myocardium or cardiac chambers, unspecified Also known as: Diseases of the myocardium or cardiac chambers, unspecified | Heart disease NOS | cardiac disease NOS [BD1Z] Heart failure, unspecified Also known as: Heart failure, unspecified | myocardial failure | cardiac decompensation | cardiac failure | cardiac failure NOS === GRAPH WALKS === --- Walk 1 --- [BD52.5] Coeliac artery compression syndrome --PARENT--> [BD52] Certain specified disorders of arteries or arterioles --EXCLUDES--> [?] Acute arterial occlusion --- Walk 2 --- [BD52.5] Coeliac artery compression syndrome --PARENT--> [BD52] Certain specified disorders of arteries or arterioles --PARENT--> [?] Diseases of arteries or arterioles --- Walk 3 --- [NA22.13] Other fracture of second cervical vertebra --PARENT--> [NA22.1] Fracture of second cervical vertebra --CHILD--> [NA22.12] Fracture of odontoid process --- Walk 4 --- [NA22.13] Other fracture of second cervical vertebra --PARENT--> [NA22.1] Fracture of second cervical vertebra --CHILD--> [NA22.11] Other traumatic spondylolisthesis of second cervical vertebra --- Walk 5 --- [NA23.11] Atlanto-axial dislocation --PARENT--> [NA23.1] Dislocation of cervical vertebra Def: Displacement of one or more bones of the cervical spine... --CHILD--> [NA23.12] Dislocation of other specified cervical vertebra --- Walk 6 --- [NA23.11] Atlanto-axial dislocation --PARENT--> [NA23.1] Dislocation of cervical vertebra Def: Displacement of one or more bones of the cervical spine... --PARENT--> [NA23] Dislocation or strain or sprain of joints or ligaments at neck level
[ "[BD52.5] Coeliac artery compression syndrome\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles\n --EXCLUDES--> [?] Acute arterial occlusion", "[BD52.5] Coeliac artery compression syndrome\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles\n --PARENT--> [?] Diseases of arteries or arterioles", "[NA22.13] Other fracture of second cervical vertebra\n --PARENT--> [NA22.1] Fracture of second cervical vertebra\n --CHILD--> [NA22.12] Fracture of odontoid process", "[NA22.13] Other fracture of second cervical vertebra\n --PARENT--> [NA22.1] Fracture of second cervical vertebra\n --CHILD--> [NA22.11] Other traumatic spondylolisthesis of second cervical vertebra", "[NA23.11] Atlanto-axial dislocation\n --PARENT--> [NA23.1] Dislocation of cervical vertebra\n Def: Displacement of one or more bones of the cervical spine...\n --CHILD--> [NA23.12] Dislocation of other specified cervical vertebra", "[NA23.11] Atlanto-axial dislocation\n --PARENT--> [NA23.1] Dislocation of cervical vertebra\n Def: Displacement of one or more bones of the cervical spine...\n --PARENT--> [NA23] Dislocation or strain or sprain of joints or ligaments at neck level" ]
BD52.5
Coeliac artery compression syndrome
[ { "from_icd11": "BD52.5", "icd10_code": "I774", "icd10_title": "Celiac artery compression syndrome" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12100A", "icd10_title": "Unspecified displaced fracture of second cervical vertebra, initial encounter for closed fracture" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12101A", "icd10_title": "Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12120A", "icd10_title": "Other displaced dens fracture, initial encounter for closed fracture" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12110A", "icd10_title": "Anterior displaced Type II dens fracture, initial encounter for closed fracture" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12112A", "icd10_title": "Nondisplaced Type II dens fracture, initial encounter for closed fracture" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12190A", "icd10_title": "Other displaced fracture of second cervical vertebra, initial encounter for closed fracture" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12130A", "icd10_title": "Unspecified traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12112S", "icd10_title": "Nondisplaced Type II dens fracture, sequela" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12110D", "icd10_title": "Anterior displaced Type II dens fracture, subsequent encounter for fracture with routine healing" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12111A", "icd10_title": "Posterior displaced Type II dens fracture, initial encounter for closed fracture" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12100D", "icd10_title": "Unspecified displaced fracture of second cervical vertebra, subsequent encounter for fracture with routine healing" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12111D", "icd10_title": "Posterior displaced Type II dens fracture, subsequent encounter for fracture with routine healing" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12121A", "icd10_title": "Other nondisplaced dens fracture, initial encounter for closed fracture" }, { "from_icd11": "NA22.1Z", "icd10_code": "S12110S", "icd10_title": "Anterior displaced Type II dens fracture, sequela" } ]
I774
Celiac artery compression syndrome
A 33-year-old man with a diagnosis of familial hypercholesterolemia treated by simvastatin presented to the outpatient clinic in the otolaryngology department of a tertiary hospital with a two-year history of right-sided pulsatile tinnitus, hearing loss, and vertigo. The patient had no history of ear pain or discharge in the right ear and reported no complaints in the left ear. The patient denied any previous surgery or trauma to either ear. His family history was positive for familial hypercholesterolemia, with three first-degree relatives affected. Physical examination revealed multiple xanthomas around the joints in both hands and feet, and there are bilateral eyelid xnthelasma . Cranial nerves and otoscopic examinations were normal bilaterally. The Rinne test was positive bilaterally and the Weber test was lateralized to the left side. Pure tone audiometry confirmed moderate sensorineural hearing loss with a pure tone average of 40 dB on the right side and hearing thresholds in the normal range on the left side. The speech recognition threshold levels were 40 dB in the right ear and 15 dB in the left ear. A tympanogram showed a type A graph bilaterally. The patient’s laboratory results included a fasting plasma cholesterol level of 17.65 mmol/L (reference range 3.63–5.15) and a low-density lipoprotein cholesterol level of 17.60 mmol/L (reference range 0.00–3.40). A computed tomography (CT) scan of the temporal bone revealed an incidental finding of a large, destructive, heterogenous mass lesion measuring 5.5 cm × 4 cm × 4.2 cm that was centered in the left tympanomastoid region. The mass was bulging into the external auditory canal and middle ear cavity, with a mass effect in the cerebellum causing tonsillar herniation. There was also a smaller lesion of the same appearance and density on the right mastoid measuring 1 cm × 0.75 cm . Magnetic resonance imaging (MRI) of the temporal bone identified a large, heterogenous mass in the left tympanomastoid region with involvement of the mastoid air cells, occipital bone, and a mass effect on the cerebellum and left posterior temporal and occipital lobes that was causing crowding of the posterior fossa structures and tonsillar herniation. The mass showed very tiny foci of enhancement and had intrinsic high-signal intensity on T1 and T2-weighted imaging . A similarly limited but smaller mass was found on the right mastoid. There was no intracranial invasion on the right side. A treatment plan was devised that included exploration and biopsy of the left mastoid lesion. However, management of the right ear consisted of observation only because the mass was small and asymptomatic. When sent to preoperative anesthesia clinic, the patient was found to have severe narrowing in several major vessels; therefore, interventions for cholesterol granuloma were delayed because of the high risk of cardiac events during non-cardiac surgery. The patient was referred to cardiology. One year later, he underwent successful coronary artery bypass graft surgery. Eight months later, the patient was admitted to hospital for resection of left ear mass. Intraoperatively, the patient underwent subtotal petrosectomy and the intracranial part of the mass was approached through retrolabyrinthine, retrosegmoid approach. Dissection was carried out in extradural plane. The yellowish to brownish semisolid mass which was destroying the squamous, mastoid and occipital bones, and it was found to be adherent to the middle and posterior fossa dura and extending to the retrofacial air cells and jugular foramen. The mass was resected completely. The external auditory canal was closed using blind sac procedure, the cavity was filled with abdominal fat, and the bone defect was reconstructed using titanium mesh with insertion of an external ventricular drain that was removed after two days. The patient’s postoperative course was uneventful, and he was discharged home on the fifth postoperative day. Fig. 1 Xanthelasma around both eyelids and multiple xanthomas around joints of both hands and feet. Fig. 1 Fig. 2 Computed tomography (CT) scan of the temporal bone showing a large, expansile, heterogenous mass, centered in the left tympanomastoid region. The mass was bulging into the external auditory canal, middle ear cavity, and extending posteriorly to temporal and occipital region. Smaller lesion is seen on the right side within the mastoid cavity. Fig. 2 Fig. 3 a. T1 without IV contrast. b. T2 weight image. c. Coronal T1 weighted image with IV contrast. Magnetic resonance imaging (MRI) of the temporal bone identified a large, expansile, heterogenous mass in the left tympanomastoid region with involvement of the mastoid air cells, and occipital bone and a mass effect on the cerebellum and left posterior temporal and occipital lobes. The mass showed very tiny foci of enhancement (c) and had intrinsic high-signal intensity on T1 and T2-weighted imaging. A similarly limited but smaller mass was found on the right side. Fig. 3
4.070313
0.976563
sec[1]/p[0]
en
0.999998
31499414
https://doi.org/10.1016/j.ijscr.2019.07.018
[ "temporal", "bone", "mastoid", "side", "occipital", "region", "large", "heterogenous", "lesion", "that" ]
[ { "code": "4A44.2", "title": "Giant cell arteritis" }, { "code": "8B82.Z", "title": "Disorders of trigeminal nerve, unspecified" }, { "code": "4A44.Y", "title": "Other specified vasculitis" }, { "code": "NA0Z&XA9T94", "title": "Temporal region injury" }, { "code": "NA01.Z&XA9T94", "title": "Temporal wound" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" } ]
=== ICD-11 CODES FOUND === [4A44.2] Giant cell arteritis Definition: Arteritis, often granulomatous, usually affecting the aorta and/or its major branches, with a predilection for the branches of the carotid artery. Often involves the temporal artery. Onset usually in patients older than 50 and often associated with polymyalgia rheumatica. Also known as: Giant cell arteritis | GCA - [giant cell arteritis] | temporal arteritis | cranial arteritis | Horton disease [8B82.Z] Disorders of trigeminal nerve, unspecified Also known as: Disorders of trigeminal nerve, unspecified | Disorders of trigeminal nerve | Disorders of 5th cranial nerve | disorders of the fifth cranial nerve | Gasserian ganglion lesion [4A44.Y] Other specified vasculitis Also known as: Other specified vasculitis | Large vessel vasculitis | Juvenile temporal arteritis | Medium-sized vessel vasculitis | Polyangiitis overlap syndrome [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias === GRAPH WALKS === --- Walk 1 --- [4A44.2] Giant cell arteritis Def: Arteritis, often granulomatous, usually affecting the aorta and/or its major branches, with a predilection for the branches of the carotid artery. Often involves the temporal artery. Onset usually in ... --PARENT--> [4A44] Vasculitis Def: Vasculitides represent a heterogenous group of diseases of multifactorial aetiology characterised by inflammatory lesions of vessels. These lesions consist of fibrinoid necrosis (necrotizing arteritis... --RELATED_TO--> [?] Behçet disease Def: Behçet disease is a disease of incompletely understood aetiopathogenesis characterised by recurrent oral and/or genital aphthous ulcers accompanied by cutaneous, ocular, articular, gastrointestinal, a... --- Walk 2 --- [4A44.2] Giant cell arteritis Def: Arteritis, often granulomatous, usually affecting the aorta and/or its major branches, with a predilection for the branches of the carotid artery. Often involves the temporal artery. Onset usually in ... --PARENT--> [4A44] Vasculitis Def: Vasculitides represent a heterogenous group of diseases of multifactorial aetiology characterised by inflammatory lesions of vessels. These lesions consist of fibrinoid necrosis (necrotizing arteritis... --PARENT--> [?] Nonorgan specific systemic autoimmune disorders --- Walk 3 --- [8B82.Z] Disorders of trigeminal nerve, unspecified --PARENT--> [8B82] Disorders of trigeminal nerve Def: The trigeminal nerve is a mixed nerve with three divisions, ophthalmic, maxillary and mandibular divisions, that provides sensory innervation to the face and mucous membrane of the oral and nasal cavi... --RELATED_TO--> [?] Atypical facial pain Def: This is a chronic pain of the face, which does not meet other diagnostic criteria.... --- Walk 4 --- [8B82.Z] Disorders of trigeminal nerve, unspecified --PARENT--> [8B82] Disorders of trigeminal nerve Def: The trigeminal nerve is a mixed nerve with three divisions, ophthalmic, maxillary and mandibular divisions, that provides sensory innervation to the face and mucous membrane of the oral and nasal cavi... --RELATED_TO--> [?] Atypical facial pain Def: This is a chronic pain of the face, which does not meet other diagnostic criteria.... --- Walk 5 --- [4A44.Y] Other specified vasculitis --PARENT--> [4A44] Vasculitis Def: Vasculitides represent a heterogenous group of diseases of multifactorial aetiology characterised by inflammatory lesions of vessels. These lesions consist of fibrinoid necrosis (necrotizing arteritis... --CHILD--> [4A44.1] Aortic arch syndrome Def: Arteritis, often granulomatous, predominantly affecting the aorta and/or its major branches. Onset usually in patients younger than 50.... --- Walk 6 --- [4A44.Y] Other specified vasculitis --PARENT--> [4A44] Vasculitis Def: Vasculitides represent a heterogenous group of diseases of multifactorial aetiology characterised by inflammatory lesions of vessels. These lesions consist of fibrinoid necrosis (necrotizing arteritis... --CHILD--> [4A44.0] Rhizomelic pseudopolyarthritis
[ "[4A44.2] Giant cell arteritis\n Def: Arteritis, often granulomatous, usually affecting the aorta and/or its major branches, with a predilection for the branches of the carotid artery. Often involves the temporal artery. Onset usually in ...\n --PARENT--> [4A44] Vasculitis\n Def: Vasculitides represent a heterogenous group of diseases of multifactorial aetiology characterised by inflammatory lesions of vessels. These lesions consist of fibrinoid necrosis (necrotizing arteritis...\n --RELATED_TO--> [?] Behçet disease\n Def: Behçet disease is a disease of incompletely understood aetiopathogenesis characterised by recurrent oral and/or genital aphthous ulcers accompanied by cutaneous, ocular, articular, gastrointestinal, a...", "[4A44.2] Giant cell arteritis\n Def: Arteritis, often granulomatous, usually affecting the aorta and/or its major branches, with a predilection for the branches of the carotid artery. Often involves the temporal artery. Onset usually in ...\n --PARENT--> [4A44] Vasculitis\n Def: Vasculitides represent a heterogenous group of diseases of multifactorial aetiology characterised by inflammatory lesions of vessels. These lesions consist of fibrinoid necrosis (necrotizing arteritis...\n --PARENT--> [?] Nonorgan specific systemic autoimmune disorders", "[8B82.Z] Disorders of trigeminal nerve, unspecified\n --PARENT--> [8B82] Disorders of trigeminal nerve\n Def: The trigeminal nerve is a mixed nerve with three divisions, ophthalmic, maxillary and mandibular divisions, that provides sensory innervation to the face and mucous membrane of the oral and nasal cavi...\n --RELATED_TO--> [?] Atypical facial pain\n Def: This is a chronic pain of the face, which does not meet other diagnostic criteria....", "[8B82.Z] Disorders of trigeminal nerve, unspecified\n --PARENT--> [8B82] Disorders of trigeminal nerve\n Def: The trigeminal nerve is a mixed nerve with three divisions, ophthalmic, maxillary and mandibular divisions, that provides sensory innervation to the face and mucous membrane of the oral and nasal cavi...\n --RELATED_TO--> [?] Atypical facial pain\n Def: This is a chronic pain of the face, which does not meet other diagnostic criteria....", "[4A44.Y] Other specified vasculitis\n --PARENT--> [4A44] Vasculitis\n Def: Vasculitides represent a heterogenous group of diseases of multifactorial aetiology characterised by inflammatory lesions of vessels. These lesions consist of fibrinoid necrosis (necrotizing arteritis...\n --CHILD--> [4A44.1] Aortic arch syndrome\n Def: Arteritis, often granulomatous, predominantly affecting the aorta and/or its major branches. Onset usually in patients younger than 50....", "[4A44.Y] Other specified vasculitis\n --PARENT--> [4A44] Vasculitis\n Def: Vasculitides represent a heterogenous group of diseases of multifactorial aetiology characterised by inflammatory lesions of vessels. These lesions consist of fibrinoid necrosis (necrotizing arteritis...\n --CHILD--> [4A44.0] Rhizomelic pseudopolyarthritis" ]
4A44.2
Giant cell arteritis
[ { "from_icd11": "4A44.2", "icd10_code": "M316", "icd10_title": "Other giant cell arteritis" }, { "from_icd11": "8B82.Z", "icd10_code": "G508", "icd10_title": "Other disorders of trigeminal nerve" }, { "from_icd11": "8B82.Z", "icd10_code": "G509", "icd10_title": "Disorder of trigeminal nerve, unspecified" }, { "from_icd11": "8B82.Z", "icd10_code": "G50", "icd10_title": "Disorders of trigeminal nerve" }, { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X6", "icd10_title": "Other osteomyelitis, lower leg" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X9", "icd10_title": "Other osteomyelitis, unspecified sites" }, { "from_icd11": "FB84.Z", "icd10_code": "M8668", "icd10_title": "Other chronic osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M86662", "icd10_title": "Other chronic osteomyelitis, left tibia and fibula" } ]
M316
Other giant cell arteritis
We reported a patient with COVID-19 suffering from MG that developed CIP during the ICU stay. To the best of our knowledge, this is the first case of a subject who had ICUAW that was associated with MG. After rehabilitation, the patient gained back his motor ability, although he required the application of AFO to the left limb and reached full recovery 6 months after discharge. COVID-19 might favor MG. AchR antibody-associated MG ( 5 ), MUSK antibody-associated MG ( 11 , 12 ), and new-onset ocular MG ( 6 ) have been reported, but our patient suffered from MG before the pandemic. Viral and bacterial infections, including COVID-19, are established triggers for a myasthenic crisis in patients with preexisting MG ( 7 ). Thus, it is conceivable that, in our patient, COVID-19 itself or an exacerbation of myasthenic crisis induced by COVID-19 might have caused respiratory failure, which required ICU admission. The clinical course of patients with MG and COVID-19 can be variable, although the infection does not dramatically influence the course of MG ( 13 ). In this respect, long-term chronic corticosteroid treatment, older age, and previously unsatisfactory control of MG symptoms are risk factors for worsening of outcome and high mortality rate in these patients ( 8 , 14 ). Furthermore, comorbidities are relevant, affecting the clinical course and favoring myasthenic exacerbation, particularly in elder patients with MG ( 15 , 16 ). In those with MG and COVID-19, comorbidities could be responsible for poor outcomes ( 17 – 19 ). Although our patient developed CIP, he did not have any of the factors, and this condition might explain the favorable outcome of the myasthenic disorder. A recent study has detected a favorable outcome in people with MG vaccinated against COVID-19 and has reported 44% of mortality due to COVID-19 in unvaccinated patients ( 20 ). Our patient did not receive any dose of vaccination at the time of COVID-19 contraction because vaccines were not available; nevertheless, he reached full recovery. The impact and effects of anti-COVID vaccination on people with MG are important, but several questions are still unclear. There are no specific guidelines concerning vaccinations of patients with MG, and several doubts remain unsolved, including efficacy, timing and type of vaccine, and risk of exacerbation of MG after COVID-19 ( 21 ). Regarding the occurrence of ICUAW in this subject, several hypotheses can be made. ICUAW is a common neurological complication in ICU patients, and a median prevalence of 43% has been reported ( 22 ). Therefore, ICUAW could occur regardless of clinical conditions that require ICU admission. In this respect, ICUAW has been frequently detected in critically ill subjects with COVID-19 who experience a severe inflammatory condition ( 23 ). The same risk factors and the severity of the systemic disease itself might favor the occurrence of ICUAW in subjects with COVID-19. Therefore, unsurprisingly, our patient with MG developed ICUAW. This disorder can produce severe impairment and persistent disability with poor quality of life. Concerning that point, although several questions remain unsolved about the rehabilitative strategies to carry out on these subjects, a recent systematic review has detected that 70.3% of ICU survivors with ICUAW could achieve a good recovery ( 24 ). However, the outcome in patients with COVID-19 who developed ICUAW remains uncertain. We have recently described the clinical course and functional outcome of four patients with COVID-19 and ICUAW, and, at the same time, we performed a review of the literature on this issue. Regarding the functional outcome, the percentage of subjects with COVID-19 and ICUAW who gained good recovery was lower than that of general patients with ICUAW. On the other hand, we observed that the functional outcome in our subjects with COVID-19 and ICUAW was in line with the findings reported in the literature. Indeed, three out of four subjects (75%) reached full recovery. Several reasons may explain this contrasting finding: one could be the measurements used for the functional evaluation and another one could be that ICU specialists may have preferred to describe this neurological complication in patients with COVID-19 during the ICU stay or at discharge and overlooked to report the recovery. However, in particular, the main reason could be that the rehabilitative treatment may have had a role in producing the reported benefits and in improving the outcome. The COVID pandemic has significantly influenced the outcome in patients affected by neuromuscular disease, including patients with MG with relevant consequences on the quality of life, leading to an increase in sedentary behavior and a related decrease in the practice of physical activity ( 25 ). In this respect, the patient described in this report underwent a tailored rehabilitation program, and the rehabilitative interventions might be the reason for the observed benefit during recovery.
4.292969
0.861816
sec[2]/p[0]
en
0.999997
PMC9253533
https://doi.org/10.3389/fneur.2022.906402
[ "covid", "icuaw", "patients", "this", "that", "outcome", "recovery", "subjects", "several", "although" ]
[ { "code": "RA01.0", "title": "COVID-19, virus identified" }, { "code": "RA02", "title": "Post COVID-19 condition" }, { "code": "RA01", "title": "COVID-19" }, { "code": "RA01.1", "title": "COVID-19, virus not identified" }, { "code": "QA08.5", "title": "Special screening examination for other viral diseases" }, { "code": "PL14.C", "title": "Patient received diagnostic test or treatment intended for another patient" }, { "code": "QB14", "title": "Unavailability or inaccessibility of health care facilities" }, { "code": "PL14.2", "title": "Problem associated with physical transfer of patient" }, { "code": "QB12.0", "title": "Organ transplant candidate" }, { "code": "QA15.1", "title": "Counselling related to sexual behaviour and orientation or sexual relationships of the person" } ]
=== ICD-11 CODES FOUND === [RA01.0] COVID-19, virus identified Also known as: COVID-19, virus identified | 2019-new Coronavirus acute respiratory disease (deprecated) | 2019-nCoV acute respiratory disease [temporary name] (deprecated) | Coronavirus disease 2019 | SARS-CoV-2 disease Includes: Coronavirus disease 2019 | COVID-19 NOS Excludes: Coronavirus infection, unspecified site | Middle East respiratory syndrome | Severe acute respiratory syndrome [RA02] Post COVID-19 condition Definition: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others, and generally have an impact on everyday functioning. Symptoms may be new onset following initial recovery from an acute COVID-19 episode or persist fr Also known as: Post COVID-19 condition | postCOVID condition | post-COVID-19 condition | long COVID [RA01] COVID-19 Definition: As definition may evolve, the URL for the Global surveillance document will be added as the short description Also known as: COVID-19 [RA01.1] COVID-19, virus not identified Also known as: COVID-19, virus not identified | clinically diagnosed COVID-19 | suspected COVID-19 | probable COVID-19 | clinical COVID-19 Excludes: COVID-19, virus identified | Coronavirus infection, unspecified site | Special screening examination for other viral diseases [QA08.5] Special screening examination for other viral diseases Also known as: Special screening examination for other viral diseases | Measles screening | Poliomyelitis screening | Rubella screening | Screening for Dengue fever Includes: Screening for COVID-19 Excludes: Viral intestinal infections | Special screening examination for infections with a predominantly sexual mode of transmission | Special screening examination for human immunodeficiency virus [PL14.C] Patient received diagnostic test or treatment intended for another patient Also known as: Patient received diagnostic test or treatment intended for another patient | wrong patient | incorrect patient Excludes: Procedure undertaken at wrong site or wrong side, as mode of injury or harm [QB14] Unavailability or inaccessibility of health care facilities Also known as: Unavailability or inaccessibility of health care facilities | unavailability of medical facilities | Unavailability of outpatient clinic | Unavailability or inaccessibility of residential aged care service Excludes: bed unavailable [PL14.2] Problem associated with physical transfer of patient Also known as: Problem associated with physical transfer of patient [QB12.0] Organ transplant candidate Also known as: Organ transplant candidate | patient waiting for organ availability | health services provided because of need for organ transplant | organ transplant candidate awaiting organ availability | person on organ transplant waiting list [QA15.1] Counselling related to sexual behaviour and orientation or sexual relationships of the person Also known as: Counselling related to sexual behaviour and orientation or sexual relationships of the person | advice on sexual behaviour or orientation | counselling on sexual behaviour or orientation | promiscuity counselling | patient concerned regarding sexual orientation === GRAPH WALKS === --- Walk 1 --- [RA01.0] COVID-19, virus identified --EXCLUDES--> [?] Coronavirus infection, unspecified site --EXCLUDES--> [?] Severe acute respiratory syndrome Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to... --- Walk 2 --- [RA01.0] COVID-19, virus identified --EXCLUDES--> [?] Coronavirus infection, unspecified site --EXCLUDES--> [?] Severe acute respiratory syndrome Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to... --- Walk 3 --- [RA02] Post COVID-19 condition Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont... --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use --CHILD--> [RA02] Post COVID-19 condition Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont... --- Walk 4 --- [RA02] Post COVID-19 condition Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont... --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use --CHILD--> [RA01] COVID-19 Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description... --- Walk 5 --- [RA01] COVID-19 Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description... --CHILD--> [RA01.0] COVID-19, virus identified --EXCLUDES--> [?] Middle East respiratory syndrome Def: A disease caused by an infection with Middle East Respiratory Syndrome coronavirus (MERS-CoA). This disease is characterised by severe acute respiratory illness with fever, cough, and shortness of bre... --- Walk 6 --- [RA01] COVID-19 Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description... --CHILD--> [RA01.0] COVID-19, virus identified --EXCLUDES--> [?] Coronavirus infection, unspecified site
[ "[RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Coronavirus infection, unspecified site\n --EXCLUDES--> [?] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...", "[RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Coronavirus infection, unspecified site\n --EXCLUDES--> [?] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...", "[RA02] Post COVID-19 condition\n Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...\n --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use\n --CHILD--> [RA02] Post COVID-19 condition\n Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...", "[RA02] Post COVID-19 condition\n Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...\n --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use\n --CHILD--> [RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...", "[RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...\n --CHILD--> [RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Middle East respiratory syndrome\n Def: A disease caused by an infection with Middle East Respiratory Syndrome coronavirus (MERS-CoA). This disease is characterised by severe acute respiratory illness with fever, cough, and shortness of bre...", "[RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...\n --CHILD--> [RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Coronavirus infection, unspecified site" ]
RA01.0
COVID-19, virus identified
[ { "from_icd11": "QA08.5", "icd10_code": "Z1159", "icd10_title": "Encounter for screening for other viral diseases" }, { "from_icd11": "QA08.5", "icd10_code": "Z1151", "icd10_title": "Encounter for screening for human papillomavirus (HPV)" }, { "from_icd11": "QA08.5", "icd10_code": "Z115", "icd10_title": "Encounter for screening for other viral diseases" }, { "from_icd11": "QB14", "icd10_code": "Z753", "icd10_title": "Unavailability and inaccessibility of health-care facilities" }, { "from_icd11": "QA15.1", "icd10_code": "F66", "icd10_title": "Other sexual disorders" }, { "from_icd11": "QA15.1", "icd10_code": "F660", "icd10_title": "" }, { "from_icd11": "QA15.1", "icd10_code": "F661", "icd10_title": "" }, { "from_icd11": "QA15.1", "icd10_code": "F662", "icd10_title": "" }, { "from_icd11": "QA15.1", "icd10_code": "F668", "icd10_title": "" }, { "from_icd11": "QA15.1", "icd10_code": "F669", "icd10_title": "" }, { "from_icd11": "QA15.1", "icd10_code": "Z701", "icd10_title": "Counseling related to patient's sexual behavior and orientation" } ]
Z1159
Encounter for screening for other viral diseases
An 18-year-old female was admitted to the hospital with abdominal pain on January 31, 2016. Routine blood test revealed white blood cell count of 102.52×10 9 /L, hemoglobin levels of 6.9 g/dL, and platelet count of 57×10 9 /L. Bone marrow smear and flow cytometry identified 90% of blast cells expressing CD34, HLA-DR, CD19, CD10, and CD22. Cytogenetic analysis showed a normal 46, XX karyotype. RT-PCR analysis did not detect any gene rearrangements, such as ETV6, KMT2A, ABL1, ABL2, JAK2, IKZF1, CRLF2, PDGFR B , TCF3, ZNF384, and CSFF1R. Therefore, the patient was diagnosed with B-ALL (common-B, poor-risk group). On February 9, she received induction chemotherapy with VIP regimen (vincristine, idarubicin, and dexamethasone) and successfully achieved CR. Next, consolidation chemotherapy including VILP (VIP+ asparaginase) and hyper-CVAD regimen was performed. The patient refused allo-HSCT at the time of the first CR. In November 2016, bone marrow examination showed 41% lymphoblastic cells, indicating leukemia relapse. After re-induction therapy with VILP regimen, the patient attained her second CR. She subsequently underwent an umbilical cord blood transplantation (UCBT) in May 2017. Allografts were from a 4/6 HLA-matched unrelated umbilical cord blood according to low-resolution. The doses of total nucleated cells and CD34+ cells infused were 3.9×107/kg and 3.0×105/kg, respectively. The conditioning regimen included intravenous busulfan at 3.2 mg/kg/d for 4 days, cyclophosphamide at 60 mg/kg daily for 2 days, and fludarabine at 30 mg/m2 daily for 4 days. Cyclosporine and mycophenolate mofetil were used for GVHD prophylaxis. Neutrophil and platelet engraftment was observed on day 22 and day 37 after umbilical cord blood infusion, respectively. The patient maintained CR for 19 months with complete donor chimerism and without graft-versus-host disease. However, in January 2019, 21% of lymphoblasts were detected in the bone marrow by morphological analysis and flow cytometry . The patient relapsed again after UCBT. Intriguingly, chimerism testing using short tandem repeats still showed complete donor chimerism at this time point. This was termed “donor cell-derived leukemia”(DCL). Chemotherapy with VIP regimen failed to induce remission (32% lymphoblasts in bone marrow). The patient had no opportunity for second transplantation due to lack of available donors. CAR-T cell therapy was recommended for the patient. She was enrolled in our clinical trial of anti-CD19 CAR-T cell therapy . After informed consent, peripheral blood lymphocytes were collected from the patient to prepare anti-CD19 CAR-T cells, which were engineered by Gracell Biotechnologies of Shanghai, China. The patient received lymphodepletion pretreatment with FC regimen (fludarabine 30 mg/m2 daily for 3 days, cyclophosphamide 300 mg/m2 daily for 3 days) from March 13, 2019 to March 15, 2019. After the lymphodepletion pretreatment, anti-CD19 CAR-T cells were infused at a total dose of 2.0×10 6 /kg for 3 consecutive days (0.2×10 6 /kg at day 0, 0.6×10 6 /kg at day 1, 1.2×10 6 /kg at day 2). Body temperature, cytokine levels, and c-reactive protein (CRP) were monitored . The patient developed a fever with a maximum body temperature of 38°C on day 6. The temperature rose to 39°C and the blood pressure dropped to 83/58 mmHg on day 7. According to the standard of the American Society for Transplantation and Cellular Therapy (ASTCT), the patient was diagnosed with grade 2 cytokine release syndrome (CRS) ( 13 ). Non-steroidal anti-inflammatory drugs (NSAIDs) and tocilizumab (8 mg/kg) were used for CRS. Afterward, the temperature dropped gradually and returned to normal after a week. The highest serum level of interleukin 6 (IL-6) was 363 pg/mL on day 7. The copy number of anti-CD19 CAR in peripheral blood reached its peak on day 10, which was 1.08×10 5 copies/μg.DNA . On April 4, 2019 (day 17), the bone marrow smear found no lymphoblast, and FCM revealed MRD negative (MRD<0.01% by 8-color flow cytometry). On day 118 after CAR-T cells infusion, the copy number of CAR was not detected. The patient remained in MRD-negative status for 5 months. On August 20, 2019, flow cytometry examination showed MRD levels of 0.05% for 2 consecutive bone marrow samples within a 1-month interval. The immunophenotype of MRD was CD34+CD10+CD19+CD22+ CD58dim CD20-CD123-. Given the increased MRD levels, the patient was given 3 million IU of interferon-α-2b, three times a week. She achieved MRD negative again after 42 days of interferon-alpha treatment. Interferon-α-2b was used for 2 years. Notably, analysis of immune cell subsets from peripheral blood showed a significant increase in the proportion of CD16 + CD56 + NK cells. To date, the patient has maintained CR for 41 months after CAR-T cells followed by interferon-α therapy. No adverse reactions were observed during interferon-α treatment. The patient is still under follow-up now. The main clinical process of the patient is summarized in Figure 3 .
4.15625
0.965332
sec[1]/p[0]
en
0.999997
PMC9731404
https://doi.org/10.3389/fonc.2022.1021786
[ "blood", "cells", "bone", "marrow", "regimen", "cell", "anti", "interferon", "flow", "cytometry" ]
[ { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "MF9Y", "title": "Other specified clinical findings on examination of urine, without diagnosis" }, { "code": "5C56.20", "title": "Mucolipidosis" }, { "code": "3A51.1", "title": "Sickle cell disease without crisis" }, { "code": "9A96.3", "title": "Primary anterior uveitis" }, { "code": "3A61.Z", "title": "Acquired pure red cell aplasia, unspecified" } ]
=== ICD-11 CODES FOUND === [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood [MF9Y] Other specified clinical findings on examination of urine, without diagnosis Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine [5C56.20] Mucolipidosis Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2 Excludes: Sialidosis (mucolipidosis type 1) [3A51.1] Sickle cell disease without crisis Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing. Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease] [9A96.3] Primary anterior uveitis Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid. Also known as: Primary anterior uveitis | anterior chamber cell [3A61.Z] Acquired pure red cell aplasia, unspecified Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Diseases of the immune system --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --CHILD--> [?] Coagulation defects, purpura or other haemorrhagic or related conditions Def: A condition caused by determinants arising during the antenatal period, after birth or by genetically inherited factors, leading to coagulation defects. This condition is characterised by increased br... --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC... --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.1] Finding of cocaine in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.2] Finding of hallucinogen in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Diseases of the immune system", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Coagulation defects, purpura or other haemorrhagic or related conditions\n Def: A condition caused by determinants arising during the antenatal period, after birth or by genetically inherited factors, leading to coagulation defects. This condition is characterised by increased br...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.2] Finding of hallucinogen in blood" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
A 48-year-old man was referred to the Eye Clinic of the University of Florence with bilateral decreased vision and hemeralopia in 2012. Best-Corrected Visual Acuity (BCVA) was 3.2/10 (0.50 LogMAR) in the Right Eye (RE) and 8/10 (0.10 LogMAR) in the Left Eye (LE). Spherical equivalent was − 6.0 and − 5.0 diopters in right and left eyes respectively. Slit lamp examination of the anterior segment showed mild posterior subcapsular lens opacities in the RE and clear lens in the LE. Intraocular pressure was normal. Fundoscopic examinations revealed a pale optic disc with widespread chorioretinal atrophy with a residual island of preserved retina at the macula of both eyes . Genetic examination performed at the Genetic Department of Careggi Teaching Hospital in Florence (Italy) identified the pathogenic deletion on the CHM gene. During follow-up, the patient showed progressive worsening of vision in the RE. From January 2015 to May 2017, BCVA was stable (1/20; 1.30 LogMAR), while at the last visit , BCVA was hand motion and 6.3/10 (0.20 LogMAR) in the right and left eyes respectively. OCT examination revealed the presence of a MH (which was not present at previous follow-ups). More specifically, avascular homogeneous material of medium reflectivity adherent to the inner retina at the margins of the macular hole resembling Lamellar Hole-associated Epiretinal Proliferation (LHEP) was detected . No hypo-reflective spaces were detectable between LHEP and the inner retina. The foveal edge appeared elevated. Schitic cavities, involving the residual atrophic neurosensory retina were characterized by hyper-reflective bridges of tissue crossing wider hypo-reflective spaces (typical of LMH) . Outer retinal tubulations were also present. Surgery was considered due to the decrease in visual acuity and the development of macular hole in the right eye. The patient underwent a standard 25-Gauge pars plana vitrectomy, complete removal of LHEP and peeling of the Internal Limiting Membrane (ILM) using Membrane Blue-Dual and fluid-air exchange. Simultaneous phacoemulsification was performed at the time of surgery. No complications were observed during surgery and one month later. At the 4-week postoperative follow-up the macular hole was closed ; the visual acuity remained stable: hand motion in right eye. Pre- and post-operative microperimetry (MP-3, Nidek, Japan) examinations did not change and no improvement of the retinal sensitivity and fixation stability was observed post-surgery. The macular hole remained closed and visual acuity stable at the last follow-up . The epiretinal cell proliferation specimen was prepared and processed with standard fixation (Karnowski’s fluid and OsO4), embedding epoxy-resin, and sectioned for electron microscopy. Using transmission electron microscopy, the LHEP had a wavy retinal side and smooth vitreal side, and was made up of dense amorphous material mainly composed of abundant clusters of fibrous collagens, closely resembling compact fibrous long spacing collagen (FLSC) embedded in native vitreous collagen (NVC) and type IV collagen. NVC and collagen type IV were the 2 main types of collagen strands observed in the extracellular matrix . In all the specimens collected neither fibroblasts, hyalocytes or myofibroblasts were identified. Written informed consent was obtained to report this clinical case. Fig. 1 ( A , B ) Color fundus photographs (CFP) of the RE and LE respectively showing extensive chorioretinal atrophy at the referral in April 2012 ( A ) and in May 2017 ( B ). ( C ) Fundus autofluorescence (Blue-FAF) imaging showing an island of preserved RPE in the macula of both eyes. ( D , E ) OCT examination of the RE in 2012 ( D ) and in May 2017 ( E ) showing very thin neuroepithelium. ( F ) In October 2018, Epiretinal Proliferation (LHEP) is clearly visible attached to the inner surface of the retina. The red rectangle shows the magnified area in ( G ); the LHEP is outlined by yellow arrowheads. Two intraretinal cysts (blue asterisks) are visible at the inner nuclear layer and fine hyper-reflective bridges of tissue (blue arrows) across the neurosensory retina. Outer retinal tubulations (red circle) are detectable. ( H ) Post-surgical OCT scan shows closed macular hole . ( I ) CFP of the RE and LE in July 2020; ( J ) OCT examination of the RE in July 2020. ( K ) Infrared-reflectance and OCT imaging of the left eye Fig. 2 A – D Transmission electron microscopy images of epiretinal tissue. Image A showing dense extracellular matrix constituted of amorphous material of collagen strands (native vitreous collagen NVC and type IV collagen). The red square shows the magnified area in B . In Image B abundant clusters of fibrous collagen closely resembling compact FLSC (red arrowheads) embedded in native vitreous collagen (NVC) and type IV collagen are detectable. C The vitreal side of the epiretinal tissue appear smoother than the retinal side. D FLSC (detail in yellow square) embedded in vitreous collagen fibrils
4.023438
0.978027
sec[1]/p[0]
en
0.999997
34666838
https://doi.org/10.1186/s40942-021-00333-5
[ "collagen", "retina", "hole", "lhep", "macular", "epiretinal", "retinal", "visual", "acuity", "logmar" ]
[ { "code": "4A4Z", "title": "Nonorgan specific systemic autoimmune disorders, unspecified" }, { "code": "DA93.Y", "title": "Other specified motility disorders of small intestine" }, { "code": "8C70.6", "title": "Congenital muscular dystrophy" }, { "code": "DA25.2", "title": "Oesophageal ulcer due to allergic or immunologic disorder" }, { "code": "DB33.10", "title": "Collagenous colitis" }, { "code": "9B7Z", "title": "Disorders of the retina, unspecified" }, { "code": "9B74.Z", "title": "Retinal vascular occlusions, unspecified" }, { "code": "9B73.4", "title": "Retinal breaks without detachment" }, { "code": "9B78.9", "title": "Retinal atrophy" }, { "code": "9B7Y", "title": "Other specified disorders of the retina" } ]
=== ICD-11 CODES FOUND === [4A4Z] Nonorgan specific systemic autoimmune disorders, unspecified Also known as: Nonorgan specific systemic autoimmune disorders, unspecified | systemic autoimmune disease | systemic collagen vascular disease | systemic vascular disease | autoimmune disease NOS [DA93.Y] Other specified motility disorders of small intestine Also known as: Other specified motility disorders of small intestine | Secondary chronic idiopathic intestinal pseudo-obstruction | Dysmotility due to drugs | Secondary dysmotility | Dysmotility due to systemic diseases classified elsewhere [8C70.6] Congenital muscular dystrophy Definition: Congenital muscular dystrophies with central nervous system abnormalities are a heterogeneous group of autosomal recessively inherited degenerative muscle disorders associated with cerebral and cerebellar dysplasia, white matter abnormalities and ocular abnormalities in some subtypes. Also known as: Congenital muscular dystrophy | hereditary muscular dystrophy | congenital hereditary muscular dystrophy | congenital progressive muscular dystrophy | hereditary progressive muscular dystrophy [DA25.2] Oesophageal ulcer due to allergic or immunologic disorder Definition: Oesophageal ulcer or erosion due to allergic disorders or systemic immunologic disorders. Also known as: Oesophageal ulcer due to allergic or immunologic disorder | Oesophageal ulcer due to collagen diseases | Oesophageal ulcer due to eosinophilic disorder [DB33.10] Collagenous colitis Definition: Collagenous colitis is characterised by chronic watery diarrhoea, normal radiological and endoscopic appearance of the colon, and a specific histopathological feature consisting in the presence of a subepithelial collagen band (10 mm or more) adjacent to the basal membrane, together with epithelial lymphocyte infiltration and chronic inflammation of the lamina propria. Also known as: Collagenous colitis [9B7Z] Disorders of the retina, unspecified Also known as: Disorders of the retina, unspecified | retinal disease | retinal lesion NOS [9B74.Z] Retinal vascular occlusions, unspecified Also known as: Retinal vascular occlusions, unspecified | Retinal vascular occlusions | occlusion of retinal vessels | retinal obstruction [9B73.4] Retinal breaks without detachment Also known as: Retinal breaks without detachment | Retinal break NOS | ruptured retina | Horseshoe tear of retina without detachment | Round hole of retina without detachment Includes: Horseshoe tear of retina without detachment | Round hole of retina without detachment Excludes: Chorioretinal scars after surgery for detachment | peripheral retinal degeneration without break [9B78.9] Retinal atrophy Definition: This is a group of genetic diseases and is characterised by the bilateral degeneration of the retina, causing progressive vision loss culminating in blindness. Also known as: Retinal atrophy | atrophic retina [9B7Y] Other specified disorders of the retina Also known as: Other specified disorders of the retina | Åland Island eye disease | Cone dystrophy with supernormal rod response | Familial retinal arterial macroaneurysm | IRVAN syndrome === GRAPH WALKS === --- Walk 1 --- [4A4Z] Nonorgan specific systemic autoimmune disorders, unspecified --PARENT--> [?] Nonorgan specific systemic autoimmune disorders --CHILD--> [4A41] Idiopathic inflammatory myopathy Def: These comprise a diverse group of syndromes that have in common persistent muscle inflammation of unknown pathophysiology, resulting in damage that affects muscle function. The inflammatory muscle dis... --- Walk 2 --- [4A4Z] Nonorgan specific systemic autoimmune disorders, unspecified --PARENT--> [?] Nonorgan specific systemic autoimmune disorders --PARENT--> [04] Diseases of the immune system --- Walk 3 --- [DA93.Y] Other specified motility disorders of small intestine --PARENT--> [DA93] Motility disorders of small intestine Def: Disorders of small intestinal motility due to abnormal contractions, such as weak contractions and disorganised (unsynchronized) contractions. The loss of ability to coordinate motor activity may caus... --CHILD--> [DA93.0] Paralytic ileus Def: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need... --- Walk 4 --- [DA93.Y] Other specified motility disorders of small intestine --PARENT--> [DA93] Motility disorders of small intestine Def: Disorders of small intestinal motility due to abnormal contractions, such as weak contractions and disorganised (unsynchronized) contractions. The loss of ability to coordinate motor activity may caus... --CHILD--> [DA93.Y] Other specified motility disorders of small intestine --- Walk 5 --- [8C70.6] Congenital muscular dystrophy Def: Congenital muscular dystrophies with central nervous system abnormalities are a heterogeneous group of autosomal recessively inherited degenerative muscle disorders associated with cerebral and cerebe... --PARENT--> [8C70] Muscular dystrophy Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f... --RELATED_TO--> [?] Barth syndrome Def: Barth syndrome is an inborn error of phospholipid metabolism characterised by dilated cardiomyopathy (DCM), skeletal myopathy, neutropaenia, growth delay and organic aciduria.... --- Walk 6 --- [8C70.6] Congenital muscular dystrophy Def: Congenital muscular dystrophies with central nervous system abnormalities are a heterogeneous group of autosomal recessively inherited degenerative muscle disorders associated with cerebral and cerebe... --PARENT--> [8C70] Muscular dystrophy Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f... --RELATED_TO--> [?] Epidermolysis bullosa simplex with muscular dystrophy Def: Epidermolysis bullosa simplex with muscular dystrophy (EBS-MD) is an autosomal recessive basal subtype of EBS due to mutations the PLEC gene encoding plectin. It is characterised by generalised bliste...
[ "[4A4Z] Nonorgan specific systemic autoimmune disorders, unspecified\n --PARENT--> [?] Nonorgan specific systemic autoimmune disorders\n --CHILD--> [4A41] Idiopathic inflammatory myopathy\n Def: These comprise a diverse group of syndromes that have in common persistent muscle inflammation of unknown pathophysiology, resulting in damage that affects muscle function. The inflammatory muscle dis...", "[4A4Z] Nonorgan specific systemic autoimmune disorders, unspecified\n --PARENT--> [?] Nonorgan specific systemic autoimmune disorders\n --PARENT--> [04] Diseases of the immune system", "[DA93.Y] Other specified motility disorders of small intestine\n --PARENT--> [DA93] Motility disorders of small intestine\n Def: Disorders of small intestinal motility due to abnormal contractions, such as weak contractions and disorganised (unsynchronized) contractions. The loss of ability to coordinate motor activity may caus...\n --CHILD--> [DA93.0] Paralytic ileus\n Def: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need...", "[DA93.Y] Other specified motility disorders of small intestine\n --PARENT--> [DA93] Motility disorders of small intestine\n Def: Disorders of small intestinal motility due to abnormal contractions, such as weak contractions and disorganised (unsynchronized) contractions. The loss of ability to coordinate motor activity may caus...\n --CHILD--> [DA93.Y] Other specified motility disorders of small intestine", "[8C70.6] Congenital muscular dystrophy\n Def: Congenital muscular dystrophies with central nervous system abnormalities are a heterogeneous group of autosomal recessively inherited degenerative muscle disorders associated with cerebral and cerebe...\n --PARENT--> [8C70] Muscular dystrophy\n Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f...\n --RELATED_TO--> [?] Barth syndrome\n Def: Barth syndrome is an inborn error of phospholipid metabolism characterised by dilated cardiomyopathy (DCM), skeletal myopathy, neutropaenia, growth delay and organic aciduria....", "[8C70.6] Congenital muscular dystrophy\n Def: Congenital muscular dystrophies with central nervous system abnormalities are a heterogeneous group of autosomal recessively inherited degenerative muscle disorders associated with cerebral and cerebe...\n --PARENT--> [8C70] Muscular dystrophy\n Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f...\n --RELATED_TO--> [?] Epidermolysis bullosa simplex with muscular dystrophy\n Def: Epidermolysis bullosa simplex with muscular dystrophy (EBS-MD) is an autosomal recessive basal subtype of EBS due to mutations the PLEC gene encoding plectin. It is characterised by generalised bliste..." ]
4A4Z
Nonorgan specific systemic autoimmune disorders, unspecified
[ { "from_icd11": "4A4Z", "icd10_code": "M358", "icd10_title": "Other specified systemic involvement of connective tissue" }, { "from_icd11": "4A4Z", "icd10_code": "M359", "icd10_title": "Systemic involvement of connective tissue, unspecified" }, { "from_icd11": "4A4Z", "icd10_code": "M368", "icd10_title": "Systemic disorders of connective tissue in other diseases classified elsewhere" }, { "from_icd11": "4A4Z", "icd10_code": "M30-M36", "icd10_title": "" }, { "from_icd11": "4A4Z", "icd10_code": "M35", "icd10_title": "Other systemic involvement of connective tissue" }, { "from_icd11": "4A4Z", "icd10_code": "M36", "icd10_title": "Systemic disorders of connective tissue in diseases classified elsewhere" }, { "from_icd11": "9B7Z", "icd10_code": "H30-H36", "icd10_title": "" }, { "from_icd11": "9B7Z", "icd10_code": "H32", "icd10_title": "Chorioretinal disorders in diseases classified elsewhere" }, { "from_icd11": "9B7Z", "icd10_code": "H320", "icd10_title": "" }, { "from_icd11": "9B7Z", "icd10_code": "H328", "icd10_title": "" }, { "from_icd11": "9B74.Z", "icd10_code": "H348192", "icd10_title": "Central retinal vein occlusion, unspecified eye, stable" }, { "from_icd11": "9B74.Z", "icd10_code": "H348310", "icd10_title": "Tributary (branch) retinal vein occlusion, right eye, with macular edema" }, { "from_icd11": "9B74.Z", "icd10_code": "H348112", "icd10_title": "Central retinal vein occlusion, right eye, stable" }, { "from_icd11": "9B74.Z", "icd10_code": "H348122", "icd10_title": "Central retinal vein occlusion, left eye, stable" }, { "from_icd11": "9B74.Z", "icd10_code": "H34819", "icd10_title": "Central retinal vein occlusion, unspecified eye" } ]
M358
Other specified systemic involvement of connective tissue
Following the appearance of a rapidly evolving jaundice, a 62-year-old Caucasian male was diagnosed with moderately differentiated cholangiocarcinoma localized at the level of the common biliary duct. This tumor was classified as cT3N0M0, or subtype I, according to the Bismuth classification. A surgical resection was performed with Whipple’s duodenocephalic pancreatectomy. Two years later, he presented with postprandial pain, and he had lost approximately 20 kg in 1 year. These symptoms were found to be associated with recurrence in the liver and lung. The patient began chemotherapy with cisplatin and gemcitabine (cisplatin at a dose of 30 mg/m 2 and gemcitabine at 1,000 mg/m 2 on days 1 and 8, respectively, every 3 weeks). Given the excellent therapeutic response after nine courses, the patient continued monotherapy with gemcitabine alone. Despite the stability of persistent lesions in the liver and lymph nodes, this medication was discontinued, due to the appearance of a discrete pulmonary infiltrate, which suggested gemcitabine toxicity. At the 5-month follow-up examination, the patient reported pain around his left shoulder without any other symptoms. A computed tomography (CT) scan showed an increase in the size of a lung nodule. F18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT confirmed recurrence of the cholangiocarcinoma. Moreover, there were two other suspicious lesions: one was in the anterior portion of the vertebral body of L2 and the other was located intramedullary at the C4 level . When the patient returned to learn the results, he reported that, within the last 36 h, he had developed a motor deficit in his left arm. The pain in the upper part of the left shoulder had also persisted. Therefore, magnetic resonance imaging (MRI) was performed, and the results confirmed an intramedullary metastasis at the C4 level with spinal cord compression . The MRI results also revealed numerous parenchymal brain metastases . The high number of brain metastases disqualified the patient for neurosurgery. In addition, the risk of operating on the spinal lesion was considered too high for either a complete resection of the lesion or a decompressive cranial laminectomy. The next day, radiotherapy of the whole brain and cervical spine to C5 was started, combined with corticosteroid therapy (64 mg methylprednisolone/day). A total dose of 30 Gy was administered in daily fractions of 3 Gy, dispensed with two lateral photon beams shaped with a multi-leaf collimator. After completion of the radiotherapy, systemic treatment with cisplatin and gemcitabine was reinitiated, due to the patient’s previous excellent response to this chemotherapy regimen. The clinical evolution of the symptoms rapidly became favorable in terms of managing pain and neurological deficit. By the middle of the radiotherapy treatment, the patient had completely recovered from the paresis in the left upper extremity. At the time of publication of the present study, he remained on chemotherapy without any signs of neurological or systemic progression. Figure 1 F18 fluorodeoxyglucose positron emission tomography/computed tomography shows spinal cord intramedullary metastasis of cholangiocarcinoma at the C4 level. Metabolic activity (standardized uptake values of 6.7 g/ml) was observed in the left paramedian intraductal region (arrow). Figure 2 Magnetic resonance imaging of intramedullary spinal cord metastasis of cholangiocarcinoma. (a) Magnetic resonance imaging of the cervical spine with T2 short-tau inversion recovery sequences show intramedullary metastases of cholangiocarcinoma at the C4 level. The hyperintensity extended in the spinal cord cranially and caudally relative to the lesion, corresponding to perilesional edema (arrow). (b) Magnetic resonance imaging T1 sequences of the cervical spinal cord acquired at the same level as in (a) . Images show contrast enhancement around the medullary lesion, which was moderately intense in the central region and at the periphery (arrow). (c) Three months after radiotherapy, magnetic resonance imaging T1 sequences show that the intramedullary spinal metastasis had regressed markedly. Figure 3 Magnetic resonance imaging of brain metastases of cholangiocarcinoma. (a) Multiple metastases of the cholangiocarcinoma were observed before radiotherapy in a T1 multiplanar reconstruction of magnetic resonance imaging sequences after intravenous injection of a gadolinium chelated contrast agent. Rounded lesions are present in the left frontal lobe and right cerebellum. The lesions show peripheral enhancement and are moderately thick and irregular. The lesion center is hypointense or nonenhancing (thick arrows). A perilesional hyposignal corresponding to perilesional edema (thin arrow) is also present. (b) Evolution of brain metastases 2 months after the end of radiotherapy, followed by chemotherapy. The lesion volume is reduced, but no changes are apparent in the enhancement features or in the perilesional edema.
4.003906
0.973145
sec[1]/p[0]
en
0.999997
25889352
https://doi.org/10.1186/s13104-015-0998-y
[ "cholangiocarcinoma", "magnetic", "resonance", "imaging", "spinal", "intramedullary", "metastases", "lesion", "radiotherapy", "gemcitabine" ]
[ { "code": "2C12.10", "title": "Intrahepatic cholangiocarcinoma" }, { "code": "2C18.0", "title": "Hilar cholangiocarcinoma" }, { "code": "2C12.00", "title": "Combined hepatocellular-cholangiocarcinoma" }, { "code": "DB96.20", "title": "Primary sclerosing cholangitis with cirrhosis" }, { "code": "DB96.2Y", "title": "Other specified primary sclerosing cholangitis" }, { "code": "NA06.80", "title": "Retained intraocular magnetic foreign body, unilateral" }, { "code": "NA06.80&XA03X9", "title": "Retained magnetic foreign body in ciliary body, unilateral" }, { "code": "NA06.80&XA4HU2", "title": "Retained magnetic foreign body in vitreous, unilateral" }, { "code": "NA06.80&XA3GW7", "title": "Retained magnetic foreign body in iris, unilateral" }, { "code": "NA06.80&XA13U9", "title": "Retained magnetic foreign body in lens, unilateral" } ]
=== ICD-11 CODES FOUND === [2C12.10] Intrahepatic cholangiocarcinoma Definition: A carcinoma that arises from the intrahepatic bile duct epithelium in any site of the intrahepatic biliary tree. Grossly, the malignant lesions are solid, nodular, and grayish. Morphologically, the vast majority of cases are adenocarcinomas. Early detection is difficult and the prognosis is generally poor. Also known as: Intrahepatic cholangiocarcinoma | Adenocarcinoma of intra-hepatic bile ducts | Cholangiocarcinoma, unspecified site | Cholangiocarcinoma of liver | Bile duct carcinoma of liver [2C18.0] Hilar cholangiocarcinoma Definition: Klatskin tumour is an extra-hepatic cholangiocarcinoma arising in the junction of the main right or left hepatic ducts to form the common hepatic duct. Also known as: Hilar cholangiocarcinoma | Adenocarcinoma of hepatic duct | Klatskin tumour of biliary tree [2C12.00] Combined hepatocellular-cholangiocarcinoma Definition: Combined hepatocellular-cholangiocarcinoma is a tumour containing unequivocal, intimately mixed elements of both hepatocellular carcinoma and cholangiocarcinoma. Also known as: Combined hepatocellular-cholangiocarcinoma | combined hepatocellular carcinoma and cholangiocarcinoma | hepatocellular carcinoma with cholangiocarcinoma | Hepatocholangiocarcinoma | mixed hepatocellular and bile duct carcinoma Includes: Hepatocholangiocarcinoma [DB96.20] Primary sclerosing cholangitis with cirrhosis Definition: Primary sclerosing cholangitis with cirrhosis is primary sclerosing cholangitis complicated with liver cirrhosis. Also known as: Primary sclerosing cholangitis with cirrhosis | Primary sclerosing cholangitis with cirrhosis, with cholangiocarcinoma | Primary sclerosing cholangitis with cirrhosis, without cholangiocarcinoma [DB96.2Y] Other specified primary sclerosing cholangitis Also known as: Other specified primary sclerosing cholangitis | Primary sclerosing cholangitis without cirrhosis | Primary sclerosing cholangitis NEC | Primary sclerosing cholangitis, without cirrhosis, with cholangiocarcinoma | Primary sclerosing cholangitis without cirrhosis, without cholangiocarcinoma [NA06.80] Retained intraocular magnetic foreign body, unilateral Also known as: Retained intraocular magnetic foreign body, unilateral | old intraocular magnetic foreign body | retained magnetic intraocular foreign body | old magnetic foreign body in eyeball | Retained magnetic foreign body in anterior chamber, unilateral Includes: old magnetic foreign body in eyeball === GRAPH WALKS === --- Walk 1 --- [2C12.10] Intrahepatic cholangiocarcinoma Def: A carcinoma that arises from the intrahepatic bile duct epithelium in any site of the intrahepatic biliary tree. Grossly, the malignant lesions are solid, nodular, and grayish. Morphologically, the va... --PARENT--> [2C12.1] Malignant neoplasm of intrahepatic bile ducts --PARENT--> [2C12] Malignant neoplasms of liver or intrahepatic bile ducts Def: The most frequent and important hepatic neoplasm is the primary hepatocellular carcinoma (HCC). In many parts of the world, in particular Africa and Asia, it poses a significant disease burden. In the... --- Walk 2 --- [2C12.10] Intrahepatic cholangiocarcinoma Def: A carcinoma that arises from the intrahepatic bile duct epithelium in any site of the intrahepatic biliary tree. Grossly, the malignant lesions are solid, nodular, and grayish. Morphologically, the va... --PARENT--> [2C12.1] Malignant neoplasm of intrahepatic bile ducts --CHILD--> [2C12.1Y] Other specified malignant neoplasms of intrahepatic bile ducts --- Walk 3 --- [2C18.0] Hilar cholangiocarcinoma Def: Klatskin tumour is an extra-hepatic cholangiocarcinoma arising in the junction of the main right or left hepatic ducts to form the common hepatic duct.... --PARENT--> [2C18] Malignant neoplasms of perihilar bile duct Def: “Includes left, right and common hepatic ducts to the origin of the cystic duct”... --CHILD--> [2C18.2] Neuroendocrine neoplasm of perihilar bile duct --- Walk 4 --- [2C18.0] Hilar cholangiocarcinoma Def: Klatskin tumour is an extra-hepatic cholangiocarcinoma arising in the junction of the main right or left hepatic ducts to form the common hepatic duct.... --PARENT--> [2C18] Malignant neoplasms of perihilar bile duct Def: “Includes left, right and common hepatic ducts to the origin of the cystic duct”... --CHILD--> [2C18.0] Hilar cholangiocarcinoma Def: Klatskin tumour is an extra-hepatic cholangiocarcinoma arising in the junction of the main right or left hepatic ducts to form the common hepatic duct.... --- Walk 5 --- [2C12.00] Combined hepatocellular-cholangiocarcinoma Def: Combined hepatocellular-cholangiocarcinoma is a tumour containing unequivocal, intimately mixed elements of both hepatocellular carcinoma and cholangiocarcinoma.... --PARENT--> [2C12.0] Malignant neoplasm of liver --CHILD--> [2C12.01] Hepatoblastoma Def: A malignant liver neoplasm that occurs almost exclusively in infants, although isolated cases in older children and adults have been reported. Grossly, hepatoblastoma is solid, well circumscribed, and... --- Walk 6 --- [2C12.00] Combined hepatocellular-cholangiocarcinoma Def: Combined hepatocellular-cholangiocarcinoma is a tumour containing unequivocal, intimately mixed elements of both hepatocellular carcinoma and cholangiocarcinoma.... --PARENT--> [2C12.0] Malignant neoplasm of liver --CHILD--> [2C12.02] Hepatocellular carcinoma of liver Def: A carcinoma that arises from the hepatocytes....
[ "[2C12.10] Intrahepatic cholangiocarcinoma\n Def: A carcinoma that arises from the intrahepatic bile duct epithelium in any site of the intrahepatic biliary tree. Grossly, the malignant lesions are solid, nodular, and grayish. Morphologically, the va...\n --PARENT--> [2C12.1] Malignant neoplasm of intrahepatic bile ducts\n --PARENT--> [2C12] Malignant neoplasms of liver or intrahepatic bile ducts\n Def: The most frequent and important hepatic neoplasm is the primary hepatocellular carcinoma (HCC). In many parts of the world, in particular Africa and Asia, it poses a significant disease burden. In the...", "[2C12.10] Intrahepatic cholangiocarcinoma\n Def: A carcinoma that arises from the intrahepatic bile duct epithelium in any site of the intrahepatic biliary tree. Grossly, the malignant lesions are solid, nodular, and grayish. Morphologically, the va...\n --PARENT--> [2C12.1] Malignant neoplasm of intrahepatic bile ducts\n --CHILD--> [2C12.1Y] Other specified malignant neoplasms of intrahepatic bile ducts", "[2C18.0] Hilar cholangiocarcinoma\n Def: Klatskin tumour is an extra-hepatic cholangiocarcinoma arising in the junction of the main right or left hepatic ducts to form the common hepatic duct....\n --PARENT--> [2C18] Malignant neoplasms of perihilar bile duct\n Def: “Includes left, right and common hepatic ducts to the origin of the cystic duct”...\n --CHILD--> [2C18.2] Neuroendocrine neoplasm of perihilar bile duct", "[2C18.0] Hilar cholangiocarcinoma\n Def: Klatskin tumour is an extra-hepatic cholangiocarcinoma arising in the junction of the main right or left hepatic ducts to form the common hepatic duct....\n --PARENT--> [2C18] Malignant neoplasms of perihilar bile duct\n Def: “Includes left, right and common hepatic ducts to the origin of the cystic duct”...\n --CHILD--> [2C18.0] Hilar cholangiocarcinoma\n Def: Klatskin tumour is an extra-hepatic cholangiocarcinoma arising in the junction of the main right or left hepatic ducts to form the common hepatic duct....", "[2C12.00] Combined hepatocellular-cholangiocarcinoma\n Def: Combined hepatocellular-cholangiocarcinoma is a tumour containing unequivocal, intimately mixed elements of both hepatocellular carcinoma and cholangiocarcinoma....\n --PARENT--> [2C12.0] Malignant neoplasm of liver\n --CHILD--> [2C12.01] Hepatoblastoma\n Def: A malignant liver neoplasm that occurs almost exclusively in infants, although isolated cases in older children and adults have been reported. Grossly, hepatoblastoma is solid, well circumscribed, and...", "[2C12.00] Combined hepatocellular-cholangiocarcinoma\n Def: Combined hepatocellular-cholangiocarcinoma is a tumour containing unequivocal, intimately mixed elements of both hepatocellular carcinoma and cholangiocarcinoma....\n --PARENT--> [2C12.0] Malignant neoplasm of liver\n --CHILD--> [2C12.02] Hepatocellular carcinoma of liver\n Def: A carcinoma that arises from the hepatocytes...." ]
2C12.10
Intrahepatic cholangiocarcinoma
[ { "from_icd11": "2C12.10", "icd10_code": "C221", "icd10_title": "Intrahepatic bile duct carcinoma" }, { "from_icd11": "NA06.80", "icd10_code": "H44609", "icd10_title": "Unspecified retained (old) intraocular foreign body, magnetic, unspecified eye" }, { "from_icd11": "NA06.80", "icd10_code": "H446", "icd10_title": "Retained (old) intraocular foreign body, magnetic" } ]
C221
Intrahepatic bile duct carcinoma
A 12-year-old girl was hospitalized due to acute lymphoblastic leukemia . Routine imaging examinations before treatment introduction (brain magnetic resonance imaging, abdominal ultrasound scan as well as neck and thyroid ultrasound scan) showed no abnormalities. Agranulocytosis with neutrophils count below 200 per μL was observed since the introduction of antineoplastic therapy (prednisone 60 mg/m 2 , vincristine, daunorubicin, L-asparaginase). On the 21st day of therapy, the general condition of the patient deteriorated and inspiratory–expiratory dyspnoea was observed. Computed tomography of the chest showed diffuse inflammatory infiltration in the majority of the right lung and free fluid in the right pleural cavity. The child required mechanical ventilation for 7 days. Since the etiological factor of the pulmonary infiltration remained unknown and because there was no clinical improvement in spite of the introduced antibacterial (cefepime 100 mg/kg daily replaced with meropenem 60 mg/kg daily and vancomycin 40 mg/kg daily) and antifungal treatment (voriconazole 12 mg/kg daily), we decided to perform an exploratory pleural puncture. Direct microscopy of the pleural fluid was negative. Pleural fluid was incubated at 37 °C the first 24 h and then at room temperature. The outgrowing colonies on Sabouraud agar and Columbia agar with 5 % blood were fast growing, floccose and white in color (becoming darker after several days). Microscopic examination in lactophenol blue stain revealed wide non-septate hyphae and sporangiophores with short branches bearing spherical sporangia with columellae. Collars were evident after rupture of the sporangia and apophysis was absent. The strain was mesophilic. The described characters identified the strain as Mucor sp. The strain was susceptible to amphotericin B (MIC 0.5) and resistance to caspofungin (MIC 32) and voriconazole (MIC 32). Posaconazole tests were not available in that period in our laboratory. Combined antifungal treatment was introduced—amphotericin B lipid complex (10 mg/kg daily) and posaconazole (600 mg daily). After extubation attempt, we observed a change in the voice timbre, which was related to intratracheal intubation and mechanical ventilation. Three weeks after the combined antifungal treatment, the patient demonstrated alarming clinical symptoms such as increasing anxiety, psychomotor agitation, psychotic symptoms and sleeplessness. The psychiatrist who consulted the child diagnosed psychotic syndrome and prescribed a phenothiazine antipsychotic. Four days later, we observed septic fever which did not respond to antipyretics. There were numerous loose stools and the girl reported spasmodic abdominal pains. All microbiologic examinations of the blood, urine and stool as well as viral examination of the stool turned out to be negative. On examination, we observed tachycardia (heart rate >180 per min) and arterial hypertension with a high systolic and diastolic amplitude. The thyroid gland was enlarged and tender on examination, with no flare or increased temperature of the skin over the gland. Hormonal evaluation confirmed the tentative diagnosis of hyperthyroidism (TSH—0.088 μU/mL, fT4—26.56 pmol/L, fT3—3.95 pmol/L). The level of antithyroid antibodies was unremarkable, including the level of TSH receptor antibodies. Hyperthyroidism was diagnosed. An ultrasound scan of the thyroid gland was also performed, and it revealed signs of an intense inflammatory process with an increased flow . An uneventful ultrasound-guided fine-needle aspiration biopsy of the thyroid gland was carried out under general anesthesia. The histopathological examination showed signs of an intense inflammatory process. The direct Gomori methenamine silver-stained preparation revealed broad irregular, rarely septated fungal hyphae typical for Mucorales ; the hyphae were rarely branching with wide angle and bulbous dilatations . Intravenous infusions with thiamazole derivative and propranolol were introduced in the treatment and gave a rapid regression of hyperthyroidism, including the psychotic symptoms. Control hormonal evaluation proved to be normal 18 days after the introduction of antithyroid treatment (TSH—4.59 μU/mL, fT4—12.96 pmol/L, fT3—2.28 pmol/L). Despite the complex antifungal therapy, further progression of mucormycosis was observed. Even though a pulmonectomy was carried out, further spread of the infection to the right kidney and the contralateral lung was seen. The child died because of multiorgan failure due to general fungal infection 49 days after the invasive fungal infection was diagnosed. No autopsy examination was performed. Fig. 1 Right thyroid lobe: a longitudinal scan—diffused hypoechoic area with hyperechoic linear fibrous septa and focal isoechoic areas; b transverse scan—decreased echo of thyroid gland with isoechoic areas in the central part of right lobe and isthmus Fig. 2 Fungal hyphae with wide angle branching in thyroid tissue. Gomori methenamine silver stain
4.105469
0.974121
sec[1]/p[0]
en
0.999998
23007613
https://doi.org/10.1007/s11046-012-9584-1
[ "thyroid", "daily", "scan", "gland", "ultrasound", "pleural", "antifungal", "hyphae", "pmol", "fungal" ]
[ { "code": "5A03.Z", "title": "Thyroiditis, unspecified" }, { "code": "5A0Z", "title": "Disorders of the thyroid gland or thyroid hormones system, unspecified" }, { "code": "5A03.Y", "title": "Other specified thyroiditis" }, { "code": "5A00.2Z", "title": "Acquired hypothyroidism, unspecified" }, { "code": "5A03.0", "title": "Acute thyroiditis" }, { "code": "QF21", "title": "Difficulty or need for assistance with general life tasks or life management" }, { "code": "8A83", "title": "Other primary headache disorder" }, { "code": "QB42", "title": "Dependence on renal dialysis" }, { "code": "MB71.Y", "title": "Other specified clinical findings on diagnostic imaging of central nervous system" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" } ]
=== ICD-11 CODES FOUND === [5A03.Z] Thyroiditis, unspecified Also known as: Thyroiditis, unspecified | Thyroiditis | inflammation of thyroid | thyroiditis NOS [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified Also known as: Disorders of the thyroid gland or thyroid hormones system, unspecified [5A03.Y] Other specified thyroiditis Also known as: Other specified thyroiditis | Riedel thyroiditis | Chronic invasive fibrous thyroiditis | Ligneous thyroiditis | Riedel struma [5A00.2Z] Acquired hypothyroidism, unspecified Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea [5A03.0] Acute thyroiditis Definition: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial. Also known as: Acute thyroiditis | infectious thyroiditis | Acute thyroiditis due to bacterial infection | Acute thyroiditis due to fungal infection | Abscess of thyroid [QF21] Difficulty or need for assistance with general life tasks or life management Also known as: Difficulty or need for assistance with general life tasks or life management | difficulty with carrying out tasks and daily routine | life management problem | difficulty with life management tasks | Difficulty with dealing with change such as relocation Includes: difficulty with carrying out tasks and daily routine [8A83] Other primary headache disorder Definition: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attributed to direct physical but innocuous stimuli; epicranial headaches; and other miscellaneous primary headache disorders. Also known as: Other primary headache disorder | Primary cough headache | Primary exercise headache | Primary headache associated with sexual activity | Preorgasmic headache [QB42] Dependence on renal dialysis Also known as: Dependence on renal dialysis | renal dialysis status | presence of arteriovenous shunt for dialysis | dependence on haemodialysis | Dependence on renal dialysis, acute haemodialysis Includes: renal dialysis status Excludes: dialysis preparation, treatment or session [MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system Also known as: Other specified clinical findings on diagnostic imaging of central nervous system | Epidural haemorrhage, localised, no generalised mass effect or midline shift | Epidural haemorrhage, confined to a small region in relation to a fracture | Epidural haemorrhage, size less than 1 x 1 x 1 cm, not in relation to a fracture | Epidural haemorrhage, mass effect or midline shift less than 0.5 cm [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug === GRAPH WALKS === --- Walk 1 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --RELATED_TO--> [?] Postpartum thyroiditis Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp... --- Walk 2 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --- Walk 3 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A00] Hypothyroidism --- Walk 4 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A02] Thyrotoxicosis Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone... --- Walk 5 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.1] Subacute thyroiditis Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection.... --- Walk 6 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --EXCLUDES--> [?] Acquired hypothyroidism Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....
[ "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --RELATED_TO--> [?] Postpartum thyroiditis\n Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp...", "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A00] Hypothyroidism", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A02] Thyrotoxicosis\n Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone...", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.1] Subacute thyroiditis\n Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection....", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Acquired hypothyroidism\n Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth...." ]
5A03.Z
Thyroiditis, unspecified
[ { "from_icd11": "5A03.Z", "icd10_code": "E069", "icd10_title": "Thyroiditis, unspecified" }, { "from_icd11": "5A03.Z", "icd10_code": "E064", "icd10_title": "Drug-induced thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E065", "icd10_title": "Other chronic thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E06", "icd10_title": "Thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E062", "icd10_title": "Chronic thyroiditis with transient thyrotoxicosis" }, { "from_icd11": "5A0Z", "icd10_code": "E0781", "icd10_title": "Sick-euthyroid syndrome" }, { "from_icd11": "5A0Z", "icd10_code": "E0789", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E079", "icd10_title": "Disorder of thyroid, unspecified" }, { "from_icd11": "5A0Z", "icd10_code": "E034", "icd10_title": "Atrophy of thyroid (acquired)" }, { "from_icd11": "5A0Z", "icd10_code": "E00-E07", "icd10_title": "" }, { "from_icd11": "5A0Z", "icd10_code": "E07", "icd10_title": "Other disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E078", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E35", "icd10_title": "Disorders of endocrine glands in diseases classified elsewhere" }, { "from_icd11": "5A00.2Z", "icd10_code": "E033", "icd10_title": "Postinfectious hypothyroidism" }, { "from_icd11": "5A03.0", "icd10_code": "E060", "icd10_title": "Acute thyroiditis" } ]
E069
Thyroiditis, unspecified
Animal bite injuries occur in the United States in more than a million cases per year, a number that probably only represents 25% to 50% of all incidents . Herman et al report even more cases with an estimate of 3.5 million cases per year . Twenty percent of dog bites and cat scratches or bites involve the head and neck area. Of all cat injuries to the head and neck, 60% involve the globe or ocular adnexa and 40% of the patients sustain corneal abrasions. This leads to the estimate of approximately 300,000 globe and ocular adnexa injuries due to animal bites in the United States every year making it an important socioeconomic and health care problem. The case reported in this article shows the potential complexity of such cases. The fact that the patient was attacked by a wild animal arouses suspicion that the animal may have a rabies infection. Rabies is a viral infection transmitted in the saliva of infected mammals. The virus enters the central nervous system of the host, causing an encephalomyelitis that is almost always fatal. As reported by the CDC, rabies among wildlife occurs throughout the continental United States and the animals most often infected include raccoons, skunks and bats; only Hawaii seems to remain consistently rabies-free . The attacking animal in this case report was a bobcat, which is also known as a wildcat or bay lynx and its distribution is all over the continental United States and the Eastern border of Canada. In the case of human attacks an immediate consultation with a doctor is recommended in order to start appropriate post exposure rabies prophylaxis. The latest recommendation by the CDC for cases of not previously vaccinated people states that firstly the wound should be thoroughly cleansed with soap, water and, if available, povidone-iodine, followed by passive immunization which should be started immediately afterwards with 20 IU of rabies immune globulin per kg of body weight. This should be infiltrated around the wound and any remaining volume should be administered intramuscularly at an anatomic site distant from the wound. In the reported case the wound was not infiltrated with passive immunoglobulin due to the unknown toxicity to intraocular tissue. Infiltration of lid lacerations on the other hand seems to be quite reasonable for rabies prophylaxis. The vaccine to induce an active immune response with neutralizing antibodies should be injected into the deltoid muscle at a dosage of 1.0 ml on day 0 (first day of vaccination), then on days 3, 7, 14, and 28. The vaccine is available as human diploid cell vaccine (HDCV), purified chick embryo cell (PCEC) vaccine and rabies vaccine adsorbed (RVA). If a person has previously been vaccinated, wound cleansing should be performed as described above and the vaccine for active immune response should be administered into the deltoid muscle in the dosage of 1.0 ml, however, only on day 0 and day 3. Rabies immune globulin (RIG) for passive immunization should not be administered . There is no cure for rabies once symptoms begin and the disease is always fatal; the postexposure prophylaxis can only prevent the disease if given before symptoms start. Therefore, immediate prophylaxis in suspicious cases is essential. However, even postexposure prophylaxis in rare cases cannot prevent the disease. Tabbara and Al-Omar reported on two patients with eyelid lacerations after an attack by a rabid desert fox and one of the patients died despite prophylactic treatment . They attributed the death to the size of the inoculum and the proximity of the laceration to the cranial nerves. Haltia et al described the ocular pathology of rabies when they reported the first European case of human bat-borne rabies . They found granules with rabies virus antigen in the cytoplasm of retinal ganglion cells as well as in the patient's brain. Additionally, they detected glial fibrillary acidic protein (GFAP) in Müller cells at the ora serata. They postulate that this occurred as a response to retinitis and retinal vasculitis as observed in their case. Other possible ocular manifestations of rabies in humans include the cornea. Schneider reported in 1969 the cornea test to intra-vitally diagnose rabies . He found that viral antigen could be detected via fluorescent antibody testing of corneal epithelial cell impressions. Normally the virological diagnosis of rabies is made in man or animals only at an autopsy by examining the brain . The most common ways of rabies transmission in the United States are bat bites, which accounted for 21 out of 36 human cases of rabies diagnosed in the United States since 1980 . Four cases of transmission through corneal transplants have been reported so far worldwide since 1980 with one case in the United States . Other potential ways of transmission, besides animal bites, include breast feeding, transplacental, aerosol inhalation and the rabies virus can also be detected in tracheal and nasal secretions, tears, urinary sediment and more .
4.265625
0.57666
sec[2]/p[0]
en
0.999997
20184710
https://doi.org/10.4076/1757-1626-2-9192
[ "rabies", "cases", "states", "united", "that", "animal", "vaccine", "bites", "this", "prophylaxis" ]
[ { "code": "1C82", "title": "Rabies" }, { "code": "QC90.3", "title": "Contact with or exposure to rabies" }, { "code": "QC01.2", "title": "Need for immunization against rabies" }, { "code": "JB20.Z", "title": "Single spontaneous delivery, unspecified" }, { "code": "QA48.0", "title": "Care or examination immediately after delivery" }, { "code": "QE84", "title": "Acute stress reaction" }, { "code": "QA41", "title": "Pregnant state" }, { "code": "MB20.2", "title": "Clouding of consciousness" }, { "code": "MF55", "title": "Polyuria" }, { "code": "8E20", "title": "Persistent vegetative state" } ]
=== ICD-11 CODES FOUND === [1C82] Rabies Definition: A disease caused by infection with the rabies virus. This disease is characterised by fever, and headache, followed by neurological symptoms dominated by a furious or paralytic form. Also known as: Rabies | hydrophobia | lyssa | St Hubert disease | Suspected rabies [QC90.3] Contact with or exposure to rabies Also known as: Contact with or exposure to rabies | rabies contact | exposure to rabies | suspected contact with or exposure to rabies [QC01.2] Need for immunization against rabies Also known as: Need for immunization against rabies | prophylactic vaccination against rabies [JB20.Z] Single spontaneous delivery, unspecified Also known as: Single spontaneous delivery, unspecified | Single spontaneous delivery | spontaneous delivery NOS | normal delivery NOS | uncomplicated delivery [QA48.0] Care or examination immediately after delivery Also known as: Care or examination immediately after delivery | care and observation in uncomplicated delivery cases | postpartum care immediately after delivery | postpartum examination immediately after delivery | Postpartum care after hospital delivery Excludes: Complications predominantly related to the puerperium [QE84] Acute stress reaction Definition: Acute stress reaction refers to the development of transient emotional, somatic, cognitive, or behavioural symptoms as a result of exposure to an event or situation (either short- or long-lasting) of an extremely threatening or horrific nature (e.g., natural or human-made disasters, combat, serious accidents, sexual violence, assault). Symptoms may include autonomic signs of anxiety (e.g., tachycardia, sweating, flushing), being in a daze, confusion, sadness, anxiety, anger, despair, overactivit Also known as: Acute stress reaction | acute stress disorder | acute crisis reaction | acute reaction to stress | psychic shock Includes: acute crisis reaction | acute reaction to stress Excludes: Post traumatic stress disorder [QA41] Pregnant state Also known as: Pregnant state | pregnant state, incidental | pregnant state NOS [MB20.2] Clouding of consciousness Definition: An impairment in the clarity of consciousness characterised by impaired ability to comprehend aspects of the environment or the self in relation to the environment, inattention, and abnormalities in thought processes, comprehension. It is typically accompanied by subjective experience of mental clouding described as feeling ‘foggy’. Clouding of consciousness is a common form of cognitive disturbance in Delirium, but it is not synonymous with Delirium because Delirium includes additional diagnost Also known as: Clouding of consciousness | Clouded state | brain fog | mental fog | Subsyndromal delirium Excludes: Delirium [MF55] Polyuria Definition: Polyuria is a condition defined as excessive or abnormally large production or passage of urine. Also known as: Polyuria | passes too much urine | polyuric state | urine output high | excessive urine discharge [8E20] Persistent vegetative state Definition: Subacute or chronic state of severe disturbance of consciousness lasting at least a month, characterised by the recovery of cyclic arousal states mimicking sleep/wake cycles after a severe brain injury. Patients with this condition are unresponsive and show no evidence of awareness of themselves or their environment. Cardiopulmonary and visceral autonomic regulation is maintained by the brainstem. Also known as: Persistent vegetative state | Unresponsive wakefulness syndrome | Apallic syndrome === GRAPH WALKS === --- Walk 1 --- [1C82] Rabies Def: A disease caused by infection with the rabies virus. This disease is characterised by fever, and headache, followed by neurological symptoms dominated by a furious or paralytic form.... --PARENT--> [?] Viral infections of the central nervous system Def: Any disease of the central nervous system, caused by an infection with a viral source.... --RELATED_TO--> [?] Enteroviral exanthematous fever Def: An acute febrile, characteristically morbilliform exanthem due to infection by one of many different enteroviruses, especially Coxsackievirus and Echovirus.... --- Walk 2 --- [1C82] Rabies Def: A disease caused by infection with the rabies virus. This disease is characterised by fever, and headache, followed by neurological symptoms dominated by a furious or paralytic form.... --PARENT--> [?] Viral infections of the central nervous system Def: Any disease of the central nervous system, caused by an infection with a viral source.... --EXCLUDES--> [?] Cytomegaloviral disease Def: Any condition caused by an infection with cytomegalovirus (CMV). These conditions are commonly asymptomatic. Transmission is by direct contact with infected body fluids.... --- Walk 3 --- [QC90.3] Contact with or exposure to rabies --PARENT--> [QC90] Contact with or exposure to communicable diseases --CHILD--> [QC90.0] Contact with or exposure to intestinal infectious diseases --- Walk 4 --- [QC90.3] Contact with or exposure to rabies --PARENT--> [QC90] Contact with or exposure to communicable diseases --CHILD--> [QC90.2] Contact with or exposure to infections with a predominantly sexual mode of transmission --- Walk 5 --- [QC01.2] Need for immunization against rabies --PARENT--> [QC01] Need for immunization against certain single viral diseases --EXCLUDES--> [?] Need for immunization against combinations of infectious diseases --- Walk 6 --- [QC01.2] Need for immunization against rabies --PARENT--> [QC01] Need for immunization against certain single viral diseases --CHILD--> [QC01.2] Need for immunization against rabies
[ "[1C82] Rabies\n Def: A disease caused by infection with the rabies virus. This disease is characterised by fever, and headache, followed by neurological symptoms dominated by a furious or paralytic form....\n --PARENT--> [?] Viral infections of the central nervous system\n Def: Any disease of the central nervous system, caused by an infection with a viral source....\n --RELATED_TO--> [?] Enteroviral exanthematous fever\n Def: An acute febrile, characteristically morbilliform exanthem due to infection by one of many different enteroviruses, especially Coxsackievirus and Echovirus....", "[1C82] Rabies\n Def: A disease caused by infection with the rabies virus. This disease is characterised by fever, and headache, followed by neurological symptoms dominated by a furious or paralytic form....\n --PARENT--> [?] Viral infections of the central nervous system\n Def: Any disease of the central nervous system, caused by an infection with a viral source....\n --EXCLUDES--> [?] Cytomegaloviral disease\n Def: Any condition caused by an infection with cytomegalovirus (CMV). These conditions are commonly asymptomatic. Transmission is by direct contact with infected body fluids....", "[QC90.3] Contact with or exposure to rabies\n --PARENT--> [QC90] Contact with or exposure to communicable diseases\n --CHILD--> [QC90.0] Contact with or exposure to intestinal infectious diseases", "[QC90.3] Contact with or exposure to rabies\n --PARENT--> [QC90] Contact with or exposure to communicable diseases\n --CHILD--> [QC90.2] Contact with or exposure to infections with a predominantly sexual mode of transmission", "[QC01.2] Need for immunization against rabies\n --PARENT--> [QC01] Need for immunization against certain single viral diseases\n --EXCLUDES--> [?] Need for immunization against combinations of infectious diseases", "[QC01.2] Need for immunization against rabies\n --PARENT--> [QC01] Need for immunization against certain single viral diseases\n --CHILD--> [QC01.2] Need for immunization against rabies" ]
1C82
Rabies
[ { "from_icd11": "1C82", "icd10_code": "A82", "icd10_title": "Rabies" }, { "from_icd11": "1C82", "icd10_code": "A820", "icd10_title": "Sylvatic rabies" }, { "from_icd11": "1C82", "icd10_code": "A821", "icd10_title": "Urban rabies" }, { "from_icd11": "1C82", "icd10_code": "A829", "icd10_title": "Rabies, unspecified" }, { "from_icd11": "QC90.3", "icd10_code": "Z203", "icd10_title": "Contact with and (suspected) exposure to rabies" }, { "from_icd11": "QC01.2", "icd10_code": "Z242", "icd10_title": "" }, { "from_icd11": "JB20.Z", "icd10_code": "O80", "icd10_title": "Encounter for full-term uncomplicated delivery" }, { "from_icd11": "JB20.Z", "icd10_code": "O808", "icd10_title": "" }, { "from_icd11": "JB20.Z", "icd10_code": "O809", "icd10_title": "" }, { "from_icd11": "QA48.0", "icd10_code": "Z390", "icd10_title": "Encounter for care and examination of mother immediately after delivery" }, { "from_icd11": "QE84", "icd10_code": "F430", "icd10_title": "Acute stress reaction" }, { "from_icd11": "QA41", "icd10_code": "Z332", "icd10_title": "Encounter for elective termination of pregnancy" }, { "from_icd11": "QA41", "icd10_code": "Z331", "icd10_title": "Pregnant state, incidental" }, { "from_icd11": "QA41", "icd10_code": "Z333", "icd10_title": "Pregnant state, gestational carrier" }, { "from_icd11": "QA41", "icd10_code": "Z33", "icd10_title": "Pregnant state" } ]
A82
Rabies
Patient 1 is a 62-year-old woman who presented with intermittent vaginal bleeding for 2 weeks. Her past medical history was unremarkable. Initial findings were a heterogenous longitudinal uterine mass of length 4.6 cm on ultrasonography and a hard, whitish, 2.0-cm sized mass arising from anterior vagina. A punch biopsy of vaginal mass was performed. Histologic and immunohistochemical findings (positive for SMA, but negative for HMB45) were malignant tumor, suggestive of leiomyosarcoma . Pelvic magnetic resonance imaging (MRI) revealed a 4.6 × 5.5 cm sized heterogeneous enhancing mass in the uterine myometrium . Additionally, a 2.1 × 1.1 cm sized indistinct, heterogeneous, enhancing mass was observed in the lower vagina . Subsequent chest computerized tomography (CT) revealed multiple pulmonary metastatic nodules. Consequently, the patient underwent explorative laparotomy and surgical staging operation (Table 1 ). Histologic examination revealed that the tumor cells were predominantly composed of epithelioid cells with eosinophilic cytoplasm and showed cytologic atypia, high mitotic activity (4/10 HPFs), an infiltrative growth pattern, and necrosis. Immunohistochemistry showed patchy expressions of HMB45 and SMA. Tumor cells were negative for PAN-CK, desmin, S-100, melan-A, EMA, and CD10 . In combination of these pathological features and the Immunohistochemistry results, the final pathologic diagnosis was of malignant perivascular epithelioid cell tumor (PEComa). The mass from vagina displayed the same histologic findings. The patient was started on the mTOR inhibitor everolimus at 25 mg i.v. weekly. She is undergoing surveillance at 9 months of follow-up. Fig. 1 Microscopic findings of malignant uterine PEComa (case 1, a – d ). Punch biopsy from vagina ( a , b ); section showing atypical epithelioid tumor cells with marked necrosis ( a , original magnification ×100). Immunostaining was negative for HMB45 ( b , ×100). Tumor mass obtained by hysterectomy ( c , d ); section revealing epithelioid tumor cells with cytologic atypia and high mitotic activity (arrow) ( c , ×200). The tumor cells showed patchy HMB45 expression by immunostaining ( d , ×200). Microscopic findings of uterine mass (case 2, e , f ). The tumor showed local infiltration into adjacent uterine smooth muscle ( e , original magnification ×40) and predominantly benign-looking epithelioid tumor cells ( f , ×400) Fig. 2 Preoperative pelvic MRI findings of malignant uterine PEComa (case 1, a – d ). Sagittal T2-weighted ( a ) and axial T2-weighted ( b ) images showed two masses with heterogeneous hyperintensity in the uterine myometrium ( arrow in a ) and the lower vagina ( arrow in b ). Axial fat-suppressed contrast-enhanced T1-weighted images ( c , d ) showed the enhancement of the masses ( arrows in c , d ). Preoperative pelvic MRI findings of benign uterine PEComa (case 2, e , f ). Axial T2-weighted ( e ) and fat-suppressed contrast-enhanced T1-weighted ( f ) images showed a well-defined, homogeneous submucosal uterine mass ( arrows ), showing signal intensity or enhancement similar to that of the myometrium. Note bilateral ovarian complex cystic masses with solid enhancing portions ( arrowheads ) Table 1 Summary of clinicopathologic characteristics of the two cases of uterine PEComa Characteristics Case 1 (uterine PEComa, malignant) Case 2 (uterine PEComa, benign) Age (year) 62 38 Association of TSC No Yes Synchronous cancer No Yes (epithelial ovarian cancer) Initial presentation Abnormal uterine bleeding No Tumor site/size (cm) Myometrial mass in uterus/4.6 cm; anterior mass in vaginal wall/1.2 cm Submucosal mass in uterus/4.6 cm Extent of disease Involvement of both lung as well as anterior vagina Involvement of peri-aortic lymph nodes Radiologic findings (MRI) Degenerative fibroid or leiomyosarcoma Leiomyoma Histologic findings Epithelioid; infiltrative; tumor necrosis present; cytologic atypia present; high mitotic activity (4/10HPFs) Epithelioid; focal Infiltrative; major cytological or nuclear pleomorphism absent; low mitotic rate; Positive IHC profile HMB-45, SMA HMB-45, SMA Negative IHC profile PAN-CK, desmin, S-100, melan-A, EMA, CD10 PAN-CK, desmin, S-100, melan-A, EMA, CD10, c-kit Treatment Surgical Hysterectomy; BSO; partial omentectomy; appendectomy; mass resection in the anterior vagina Hysterectomy; BSO; infracolic omentectomy; pelvic LN dissection; para-aortic LN dissection; appendectomy Adjuvant mTOR inhibitor—everolimus (weekly, ongoing) Paclitaxel and carboplatin CTX (6 cycles of tri-weekly) Follow-up Lung and bone metastases, AWD at 18 months ANED at 6 months PEComas perivascular epithelioid tumors, TSC tuberous sclerosis complex, MRI magnetic resonance imaging, HPF high power field, IHC immunohistochemical, HMB-45 human melanoma black 45, SMA smooth muscle actin, PAN-CK pan-cytokeratin, EMA epithelial membrane antigen, BSO bilateral salpingo-oophorectomy, CTX chemotherapy, AWD alive with disease, ANED alive with no evidence of disease
4.105469
0.965332
sec[1]/sec[0]/p[0]
en
0.999997
28270196
https://doi.org/10.1186/s40001-017-0248-y
[ "uterine", "tumor", "epithelioid", "vagina", "cells", "pecoma", "malignant", "weighted", "histologic", "pelvic" ]
[ { "code": "GA1Z&XA99N3", "title": "Noninflammatory disorders of uterus, except cervix" }, { "code": "GA01.Z", "title": "Inflammatory disorders of the uterus, except cervix, unspecified" }, { "code": "GA16.Y", "title": "Other specified acquired abnormalities of uterus, except cervix" }, { "code": "NB92.6", "title": "Injury of uterus" }, { "code": "GC04.1Y", "title": "Other specified fistulae involving female genital tract" }, { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" } ]
=== ICD-11 CODES FOUND === [GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified Also known as: Inflammatory disorders of the uterus, except cervix, unspecified | Inflammatory disorders of the uterus, except cervix | inflammatory disease of the uterus | uterine inflammatory disease | uterus inflammation [GA16.Y] Other specified acquired abnormalities of uterus, except cervix Also known as: Other specified acquired abnormalities of uterus, except cervix | Polyp of corpus uteri | intrauterine polyp | polyp of body of uterus | polyp of uterus [NB92.6] Injury of uterus Also known as: Injury of uterus | uterine injury | intrauterine injury NOS | Injury of uterus without open wound into cavity | Injury of uterus with open wound into cavity [GC04.1Y] Other specified fistulae involving female genital tract Also known as: Other specified fistulae involving female genital tract | Other female intestinal-genital tract fistulae | Intestinouterine fistula | enterouterine fistula | Cervicosigmoidal fistula [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS === GRAPH WALKS === --- Walk 1 --- [GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i... --PARENT--> [?] Inflammatory disorders of the female genital tract --- Walk 2 --- [GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i... --CHILD--> [GA01.Y] Other specified inflammatory disorders of the uterus, except cervix --- Walk 3 --- [GA16.Y] Other specified acquired abnormalities of uterus, except cervix --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix).... --CHILD--> [GA16.2] Intrauterine synechiae Def: Intrauterine adhesions caused by pelvic inflammatory disease, uterine surgery, or complications related to spontaneous, incomplete or induced abortion. May be asymptomatic or associated with amenorrhe... --- Walk 4 --- [GA16.Y] Other specified acquired abnormalities of uterus, except cervix --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix).... --PARENT--> [?] Noninflammatory disorders of female genital tract Def: Any disorder of the female genital tract, characterised by pathological changes, leading to noninflammatory effects.... --- Walk 5 --- [NB92.6] Injury of uterus --PARENT--> [NB92] Injury of urinary or pelvic organs --EXCLUDES--> [?] Injury of intra-abdominal organs --- Walk 6 --- [NB92.6] Injury of uterus --PARENT--> [NB92] Injury of urinary or pelvic organs --RELATED_TO--> [?] Female Genital Mutilation Def: A condition caused by procedures or other interventions for non-medical purposes. This condition is characterised by the partial or total removal of the external female genitalia or other injury to th...
[ "[GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified\n --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix\n Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i...\n --PARENT--> [?] Inflammatory disorders of the female genital tract", "[GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified\n --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix\n Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i...\n --CHILD--> [GA01.Y] Other specified inflammatory disorders of the uterus, except cervix", "[GA16.Y] Other specified acquired abnormalities of uterus, except cervix\n --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix\n Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix)....\n --CHILD--> [GA16.2] Intrauterine synechiae\n Def: Intrauterine adhesions caused by pelvic inflammatory disease, uterine surgery, or complications related to spontaneous, incomplete or induced abortion. May be asymptomatic or associated with amenorrhe...", "[GA16.Y] Other specified acquired abnormalities of uterus, except cervix\n --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix\n Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix)....\n --PARENT--> [?] Noninflammatory disorders of female genital tract\n Def: Any disorder of the female genital tract, characterised by pathological changes, leading to noninflammatory effects....", "[NB92.6] Injury of uterus\n --PARENT--> [NB92] Injury of urinary or pelvic organs\n --EXCLUDES--> [?] Injury of intra-abdominal organs", "[NB92.6] Injury of uterus\n --PARENT--> [NB92] Injury of urinary or pelvic organs\n --RELATED_TO--> [?] Female Genital Mutilation\n Def: A condition caused by procedures or other interventions for non-medical purposes. This condition is characterised by the partial or total removal of the external female genitalia or other injury to th..." ]
GA1Z&XA99N3
Noninflammatory disorders of uterus, except cervix
[ { "from_icd11": "GA01.Z", "icd10_code": "N719", "icd10_title": "Inflammatory disease of uterus, unspecified" }, { "from_icd11": "GA01.Z", "icd10_code": "N71", "icd10_title": "Inflammatory disease of uterus, except cervix" }, { "from_icd11": "NB92.6", "icd10_code": "S3763XA", "icd10_title": "Laceration of uterus, initial encounter" }, { "from_icd11": "NB92.6", "icd10_code": "S3769XA", "icd10_title": "Other injury of uterus, initial encounter" }, { "from_icd11": "NB92.6", "icd10_code": "S3760XA", "icd10_title": "Unspecified injury of uterus, initial encounter" }, { "from_icd11": "NB92.6", "icd10_code": "S376", "icd10_title": "Injury of uterus" }, { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" } ]
N719
Inflammatory disease of uterus, unspecified
A 38-year-old man (height, 172 cm; body weight, 120 kg; body mass index, 37) experienced chest discomfort 3 weeks ago, which improved within few days. However, after that episode, he was admitted with rapidly deteriorating severe breathlessness in a preshock state with acute heart failure. The patient had a smoking habit and hyperlipidemia. Electrocardiography revealed abnormal Q waves and slight ST elevation in the aVl, V1, V2, and V3 leads. However, laboratory findings demonstrated creatine kinase (CK) and CK-MB levels within the normal range. Echocardiography revealed aneurysmal enlargement in the anterior wall and moderate-to-massive pericardial effusion, and severely reduced wall motion of LV. Emergency coronary angiography demonstrated an occluded left anterior descending artery . Circulatory support with an intra-aortic balloon pumping (IABP) catheter was started because of unstable hemodynamics. Enhanced computed tomography showed extensive aneurysm formation on the anterior LV wall and contrast from the inner cavity to the LV myocardium, with moderately accumulated pericardial effusion . Emergency surgery was performed, and his blood pressure ranged 80 to 90 / 50 to 60 mmHg, with 40 mmHg for PA and 20 mmHg for CVP. After the median sternotomy, bloody pericardial effusion (400 ml) was drained, and cardiac tamponade was relieved. A large aneurysmal formation was noted on the anterior LV wall, slightly attached to the pericardium . Cardiopulmonary bypass (CPB) was established with an ascending aorta and bicaval cannulation. After dissecting the pericardium, a 5-mm, slit-like LV rupture site was found in the aneurysm, which caused cardiac tamponade . Following cardiac arrest by antegrade cardioplegia, the middle aneurysm portion was dissected parallel to the LAD. The anterior myocardium comprised intramyocardial heavy and flesh hematoma and necrotic myocardium . Of note, the anterior and posterior papillary muscles were not involved. After removing the hematoma and debriding the necrotic tissue, the anterior wall defect measured 10 × 7 cm. Traction sutures were placed at each anticipated closing line. Then, two sheets of bovine pericardial patch were tailored to the anterior wall defect shape, which was 5 cm × 10 cm. The LV defect was closed using the patch with transmural interrupted mattress sutures to avoid excessive reduction in the ventricular volume . Subsequently, the ventricular edge was closed with interrupted sutures using two Teflon felt strips to reinforce the suture from the outside . A second running suture was used to ensure a secure left ventriculotomy closure, and another Teflon felt strip was placed in the middle of the edge . Cardiopulmonary bypass was easily weaned. He was extubated the following day, and the IABP was smoothly removed. Postoperative echocardiography revealed an improvement in LV function (LVEF:40%), without mitral regurgitation. Postoperative cardiac magnetic resonance image revealed a well-reconstructed LV. He was discharged without any complication 3 weeks postoperatively. The LV aneurysmal rupture site specimen was sent for pathological study . Pathological findings showed myocardial necrotic tissue with cellular infiltration within the aneurysmal wall, consistent with a pseudo-false aneurysm, which was contained by the elements of the ventricular wall . Fig. 1 Preoperative coronary angiography. Occluded LAD artery is in the middle portion Fig. 2 Preoperative computed tomography. ( a – c ) Extensive aneurysm formation on the anterior LV wall, with pericardial effusion accumulation. ( b ) The aneurysm showing leakage of contrast from the inner cavity to the LV myocardium. ( c ) Intra-LV wall aneurysm with the dissected myocardium Fig. 3 Intraoperative findings. ( a ) A large aneurysmal formation on the anterior LV wall, slightly attached to the pericardium is noted. ( b ) After dissecting the pericardium, a 5-mm, slit-like LV rupture site is found in the aneurysm, which caused cardiac tamponade. ( c ) The anterior myocardium of the aneurysm containing intramyocardial heavy and flesh hematoma Fig. 4 Surgical procedure for reconstruction of LV wall ( a ) The LV defect was closed using the patch with transmural interrupted mattress sutures to avoid excessive reduction in the ventricular volume. ( b ) The ventricular edge was closed by interrupted sutures using two Teflon felt strips to reinforce the suture from the outside. ( c ) A second running suture was used to ensure a secure left ventriculotomy closure placing another Teflon felt strip in the middle of the edge Fig. 5 Pathological findings of the LV aneurysmal rupture site ( a ) The resected LV aneurysmal rupture site specimen. ( b ) Pathological finding in the ruptured myocardium (low power field, × 4). The myocardium of the left ventricular wall shows myocardial necrosis ( arrows ), and the surrounding tissue shows cell infiltration. In particular, there is granulation tissue formation at the epicardium side ( arrowhead )
4.039063
0.973633
sec[1]/p[0]
en
0.999997
31101055
https://doi.org/10.1186/s13019-019-0915-x
[ "wall", "aneurysm", "myocardium", "aneurysmal", "ventricular", "which", "pericardial", "formation", "cardiac", "rupture" ]
[ { "code": "LB0Y", "title": "Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord" }, { "code": "PA82", "title": "Unintentional striking against stationary object" }, { "code": "NB50.Y&XA3KX0&XJ1C6", "title": "Haematoma of abdominal wall" }, { "code": "DC51.1", "title": "Peritoneal adhesions" }, { "code": "LB73.1Z", "title": "Structural developmental anomalies of chest wall, unspecified" }, { "code": "BD51.Z", "title": "Aneurysm and dissection of unspecified artery" }, { "code": "BD75.Y", "title": "Venous varicosities of other specified sites" }, { "code": "BA81", "title": "Coronary artery aneurysm" }, { "code": "BB02.1Z", "title": "Aneurysm of pulmonary artery, unspecified" }, { "code": "BD51.4", "title": "Aneurysm or dissection of renal artery" } ]
=== ICD-11 CODES FOUND === [LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord Also known as: Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord | Congenital deformity of abdominal wall | abdominal wall defect NOS [PA82] Unintentional striking against stationary object Also known as: Unintentional striking against stationary object | striking against stationary object | striking against or struck by other objects | Walked into wall [DC51.1] Peritoneal adhesions Definition: Disorders of peritoneum sticking by scar tissue or fibrosis Also known as: Peritoneal adhesions | abdominal adhesion | adhesive peritoneal band | peritoneal adhesion | peritoneal band Excludes: Adhesions of large intestine with obstruction | Postprocedural pelvic peritoneal adhesions | Intestinal adhesions or bands of small intestine with obstruction [LB73.1Z] Structural developmental anomalies of chest wall, unspecified Also known as: Structural developmental anomalies of chest wall, unspecified | Structural developmental anomalies of chest wall | Malformations of chest wall [BD51.Z] Aneurysm and dissection of unspecified artery Also known as: Aneurysm and dissection of unspecified artery | Arterial aneurysm or dissection, excluding aorta | cirsoid aneurysm NOS | false aneurysm NOS | ruptured aneurysm NOS [BD75.Y] Venous varicosities of other specified sites Also known as: Venous varicosities of other specified sites | Caput medusae | Jugular venous aneurysm | jugular vein aneurysm | Orbital varices [BA81] Coronary artery aneurysm Definition: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times. Also known as: Coronary artery aneurysm | aneurysm of coronary vessels | aneurysmal lesion of coronary artery | arteriovenous aneurysm of coronary vessels | coronary aneurysm Excludes: Congenital coronary arterial aneurysm | Mucocutaneous lymph node syndrome [BB02.1Z] Aneurysm of pulmonary artery, unspecified Also known as: Aneurysm of pulmonary artery, unspecified | Aneurysm of pulmonary artery | pulmonary artery aneurysm | PA - [pulmonary artery aneurysm] | pulmonary aneurysm [BD51.4] Aneurysm or dissection of renal artery Also known as: Aneurysm or dissection of renal artery | aneurysm of renal artery | renal artery aneurysm | renal aneurysm === GRAPH WALKS === --- Walk 1 --- [LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord --PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period.... --CHILD--> [LB01] Omphalocele Def: Omphalocele is an embryopathy classified in the group of abdominal celosomias and is characterised by a large hernia of the abdominal wall, centred on the umbilical cord, in which the protruding visce... --- Walk 2 --- [LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord --PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period.... --CHILD--> [LB01] Omphalocele Def: Omphalocele is an embryopathy classified in the group of abdominal celosomias and is characterised by a large hernia of the abdominal wall, centred on the umbilical cord, in which the protruding visce... --- Walk 3 --- [PA82] Unintentional striking against stationary object --PARENT--> [?] Unintentional exposure to object, not elsewhere classified --CHILD--> [PA80] Unintentionally struck by projectile from firearm --- Walk 4 --- [PA82] Unintentional striking against stationary object --PARENT--> [?] Unintentional exposure to object, not elsewhere classified --CHILD--> [PA82] Unintentional striking against stationary object --- Walk 5 --- [DC51.1] Peritoneal adhesions Def: Disorders of peritoneum sticking by scar tissue or fibrosis... --EXCLUDES--> [?] Postprocedural pelvic peritoneal adhesions Def: A condition caused by or subsequent to any pelvic intervention leading to damage and inflammation of the peritoneum. This condition is characterised by fibrous bands of scar tissue and abnormal connec... --PARENT--> [?] Postprocedural disorders of genitourinary system Def: Any disorder caused by or subsequent to any intervention of the genitourinary system.... --- Walk 6 --- [DC51.1] Peritoneal adhesions Def: Disorders of peritoneum sticking by scar tissue or fibrosis... --EXCLUDES--> [?] Intestinal adhesions or bands of small intestine with obstruction Def: Small bowel obstruction resulting from intraabdominal adhesion due to laparotomy, trauma, and intraabdominal inflammation such as endometriosis.... --CHILD--> [?] Postoperative obstruction of the small intestine
[ "[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n --PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period....\n --CHILD--> [LB01] Omphalocele\n Def: Omphalocele is an embryopathy classified in the group of abdominal celosomias and is characterised by a large hernia of the abdominal wall, centred on the umbilical cord, in which the protruding visce...", "[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n --PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period....\n --CHILD--> [LB01] Omphalocele\n Def: Omphalocele is an embryopathy classified in the group of abdominal celosomias and is characterised by a large hernia of the abdominal wall, centred on the umbilical cord, in which the protruding visce...", "[PA82] Unintentional striking against stationary object\n --PARENT--> [?] Unintentional exposure to object, not elsewhere classified\n --CHILD--> [PA80] Unintentionally struck by projectile from firearm", "[PA82] Unintentional striking against stationary object\n --PARENT--> [?] Unintentional exposure to object, not elsewhere classified\n --CHILD--> [PA82] Unintentional striking against stationary object", "[DC51.1] Peritoneal adhesions\n Def: Disorders of peritoneum sticking by scar tissue or fibrosis...\n --EXCLUDES--> [?] Postprocedural pelvic peritoneal adhesions\n Def: A condition caused by or subsequent to any pelvic intervention leading to damage and inflammation of the peritoneum. This condition is characterised by fibrous bands of scar tissue and abnormal connec...\n --PARENT--> [?] Postprocedural disorders of genitourinary system\n Def: Any disorder caused by or subsequent to any intervention of the genitourinary system....", "[DC51.1] Peritoneal adhesions\n Def: Disorders of peritoneum sticking by scar tissue or fibrosis...\n --EXCLUDES--> [?] Intestinal adhesions or bands of small intestine with obstruction\n Def: Small bowel obstruction resulting from intraabdominal adhesion due to laparotomy, trauma, and intraabdominal inflammation such as endometriosis....\n --CHILD--> [?] Postoperative obstruction of the small intestine" ]
LB0Y
Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
[ { "from_icd11": "PA82", "icd10_code": "W2209XA", "icd10_title": "Striking against other stationary object, initial encounter" }, { "from_icd11": "PA82", "icd10_code": "W2201XA", "icd10_title": "Walked into wall, initial encounter" }, { "from_icd11": "PA82", "icd10_code": "W2211XA", "icd10_title": "Striking against or struck by driver side automobile airbag, initial encounter" }, { "from_icd11": "PA82", "icd10_code": "W228XXS", "icd10_title": "Striking against or struck by other objects, sequela" }, { "from_icd11": "PA82", "icd10_code": "W2203XD", "icd10_title": "Walked into furniture, subsequent encounter" }, { "from_icd11": "PA82", "icd10_code": "W2203XA", "icd10_title": "Walked into furniture, initial encounter" }, { "from_icd11": "PA82", "icd10_code": "W228XXD", "icd10_title": "Striking against or struck by other objects, subsequent encounter" }, { "from_icd11": "PA82", "icd10_code": "W2212XA", "icd10_title": "Striking against or struck by front passenger side automobile airbag, initial encounter" }, { "from_icd11": "PA82", "icd10_code": "W2209XS", "icd10_title": "Striking against other stationary object, sequela" }, { "from_icd11": "PA82", "icd10_code": "W228XXA", "icd10_title": "Striking against or struck by other objects, initial encounter" }, { "from_icd11": "PA82", "icd10_code": "W22", "icd10_title": "Striking against or struck by other objects" }, { "from_icd11": "DC51.1", "icd10_code": "K660", "icd10_title": "Peritoneal adhesions (postprocedural) (postinfection)" }, { "from_icd11": "LB73.1Z", "icd10_code": "Q766", "icd10_title": "Other congenital malformations of ribs" }, { "from_icd11": "BD51.Z", "icd10_code": "I728", "icd10_title": "Aneurysm of other specified arteries" }, { "from_icd11": "BD51.Z", "icd10_code": "I729", "icd10_title": "Aneurysm of unspecified site" } ]
W2209XA
Striking against other stationary object, initial encounter
Patient female, 48 years old, married and childless, history of schizophrenia for 20 years, currently on oral olanzapine treatment, In 2018, she underwent laparoscopic debulking of right ovarian cyst in our hospital due to chocolate cyst of ovary. She was admitted to our department in December 2022 due to “sudden abdominal distension for 2 days, abnormal vaginal bleeding for 1 day, and discovery of pelvic mass for 6 hours”. Gynecological ultrasound showed: hypoechoic uterus in the upper right side of the uterus, about 83*65*55mm in size, with irregular morphology, and hypoechoic pelvis in the left side of the pelvic cavity, about 80*43*46mm in size, with unclear boundaries. Computed tomography (CT) scan of the whole abdomen: multiple occupations in the right subperitoneum and pelvis, the large one was about 71*56mm, and there was a large amount of fluid in the abdominal cavity and pelvis . Further, he performed puncture drainage of the abdominal cavity and puncture biopsy of the pelvic mass, and the paraffin-embedded pathology of ascites sediment suggested that more lymphocyte-like cells and a small number of mesothelial cells could be seen, which was suspicious for lymphoma. Pelvic mass puncture biopsy suggested: low differentiated neuroendocrine carcinoma (small cell carcinoma) possible. Immunohistochemical results: tumor cells AE1/AE3 (sporadic +), CAM5.2 (sporadic +), CgA (sporadic +), Syn (weak +), NSE (a few +), CD56 (a few +), PAX-8 (a few +), p53 (80% +), WT1 (Golgi +), Ki -67 (90% +) . Gynecological examination: vulva was normal, vagina was smooth, uterus was usually large, no pressure pain, pelvis could be touched on the right side of the mass, the size of about 8*7*6cm, the border was not clear, poor mobility. Triple diagnosis: left posterior uterus can reach the lower pole of the mass, about 7.0*6.0*5.0cm, hard, poor mobility. Adjunctive examination: tumor markers: NSE (neuron-specific enolase) 80.11 ng/ml and CA125 (glycan antigen 125) 318.60 U/ml were significantly higher than the reference value, HE4 (epithelial secretion protein) did not show any abnormality. Lung CT suggested: cords and stripes in the lower lobes of both lungs; a small amount of pleural effusion on the right side, mild thickening of the pleura bilaterally; a small amount of pericardial effusion; calcium ions: 2.04 mmol/L, which was not elevated; gastroenteroscopy did not show any obvious abnormality. PET-CT conclusions: abnormal elevation of glucose metabolism of the right anterior and left pelvic cavity (periungerocele), and the multiple pelvic cavity (left posterocele to presacral) masses, considered malignant; the multiple lymph nodes in the diaphragm on the bilateral sides, the right side of the wall peritoneum, intrahepatic right parietal effusion, splenic peritoneum, multiple masses on the right side of the pelvis (anterior to the psoas major muscle), increased flocculent density of the greater omentum and lesser omentum sheets, and increased glycaemic metabolism of the right hemicolon mesentery were considered to be metastatic. A large amount of fluid in the abdominopelvic cavity with increased glucose metabolism was considered, and the presence of tumor cells in the fluid was considered. . According to FIGO (Federation International of Gynecology and Obstetrics) , the diagnosis: stage IVB small cell neuroendocrine carcinoma of the ovary, a multidisciplinary MDT consultation was performed, and it was suggested that either surgery or chemotherapy could be considered; the patient refused to undergo surgery due to personal reasons, and was adamant in requesting chemotherapy. Since December 2022, 8 times of paclitaxel+carboplatin regimen chemotherapy (d1 paclitaxel 270mg IV, d1 carboplatin 550mg IV) were conducted, of which the first 2 times were combined with targeted anti-angiogenic drugs (d3 bevacizumab 300mg IV), and the last 2 times were combined with immunosuppressant drugs (d2 tirilizumab 200mg IV) with an interval of 21 days each time. On the 3rd times of chemotherapy, the patient stopped bevacizumab for economic reasons. Repeat CT of the whole abdomen at the end of chemotherapy showed that the lesion was significantly smaller than before. Maintenance therapy with tirilizumab monotherapy once every 3 weeks was started in June 2023 for a total of 12 times (d1 tirilizumab 200 mg IV). The whole abdomen enhanced CT results showed the lesion continued to shrink and achieved partial remission (PR) . The patient’s symptoms of abdominal distension had completely disappeared, and the pelvic mass was significantly smaller than before, and pelvic and abdominal fluid had disappeared. Tumor markers, CA125 and NSE, were reduced to normal , and there were no obvious side effects after chemotherapy, targeted and immunotherapy. Tirilizumab monotherapy maintenance therapy was stopped in June 2024, by which time the patient’s PFS had exceeded 19 months. Subsequent reviews were performed every 3 months, and we will follow this patient closely.
3.849609
0.983398
sec[1]/p[0]
en
0.999997
40475766
https://doi.org/10.3389/fimmu.2025.1569011
[ "pelvic", "side", "cavity", "chemotherapy", "abdominal", "about", "pelvis", "small", "considered", "times" ]
[ { "code": "FC00.3", "title": "Acquired deformity of pelvis" }, { "code": "GA34.Y", "title": "Other specified female pelvic pain associated with genital organs or menstrual cycle" }, { "code": "LB30.7", "title": "Ectopic or pelvic kidney" }, { "code": "MD82", "title": "Intra-abdominal or pelvic swelling, mass or lump" }, { "code": "GA05.Z", "title": "Female pelvic inflammatory diseases, unspecified" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "LA8B.2Y", "title": "Other specified congenital anomaly of aorta or its branches" }, { "code": "LB9A.6", "title": "Split foot" }, { "code": "LA80.0", "title": "Laevocardia" }, { "code": "LA80.1", "title": "Dextrocardia" } ]
=== ICD-11 CODES FOUND === [FC00.3] Acquired deformity of pelvis Also known as: Acquired deformity of pelvis | deformity of pelvis | pelvic deformity | ischium deformity | ilium deformity Excludes: Maternal care for disproportion | Obstructed labour due to maternal pelvic abnormality | Obstructed labour due to deformed pelvis [GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle Also known as: Other specified female pelvic pain associated with genital organs or menstrual cycle | Pelvic congestion syndrome | Pelvic varicosities | Female frozen pelvis | Female intrapelvic haemorrhage [LB30.7] Ectopic or pelvic kidney Definition: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones Also known as: Ectopic or pelvic kidney | Congenital displaced kidney | congenital misplaced kidney | congenital malposition of kidney | congenital prolapsed kidney Includes: Congenital displaced kidney | Malrotation of kidney [MD82] Intra-abdominal or pelvic swelling, mass or lump Definition: This refers to the presence of abdominal or pelvic wall swelling, mass or tumour in the abdominal and pelvic regions. These mass or tumours can be recognised by visual examination and/or palpation. Also known as: Intra-abdominal or pelvic swelling, mass or lump | Abdominal mass without further specification | mass in abdomen | intra-abdominal lump | intra-abdominal mass Excludes: Abdominal distension | Ascites [GA05.Z] Female pelvic inflammatory diseases, unspecified Also known as: Female pelvic inflammatory diseases, unspecified | Female pelvic inflammatory diseases | PID - [pelvic inflammatory disease] | pelvic inflammatory disease NOS | Parametritis [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [LA8B.2Y] Other specified congenital anomaly of aorta or its branches Also known as: Other specified congenital anomaly of aorta or its branches | Congenital anomaly of ascending aorta | Hypoplasia of ascending aorta | Congenital ascending aorta aneurysm or dilation | congenital ascending aortic aneurysm or dilation [LB9A.6] Split foot Definition: A condition caused by malformation of the foot during the antenatal period. This condition is characterised by a deep median cleft of the foot due to the absence of the central rays. Also known as: Split foot | lobster claw foot | split foot, unspecified side | cleft of foot | Split foot, unilateral [LA80.0] Laevocardia Definition: A congenital cardiovascular finding in which the heart is predominantly to the left of the thoracic midline. Also known as: Laevocardia | Left-sided heart | Levocardia [LA80.1] Dextrocardia Definition: A congenital cardiovascular malformation in which the heart is predominantly to the right of the thoracic midline. This is independent of the orientation of the cardiac apex. Also known as: Dextrocardia | heart in right chest | right-sided heart | congenital dextrocardia of heart | transposition of heart Excludes: Isomerism of left atrial appendages | Isomerism of right atrial appendages | Total mirror imagery === GRAPH WALKS === --- Walk 1 --- [FC00.3] Acquired deformity of pelvis --EXCLUDES--> [?] Obstructed labour due to deformed pelvis --PARENT--> [?] Obstructed labour due to maternal pelvic abnormality Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ... --- Walk 2 --- [FC00.3] Acquired deformity of pelvis --EXCLUDES--> [?] Maternal care for disproportion Def: A condition characterised by the provision of health interventions to the mother due to the situation in which the head or body of the fetus is too large to fit through the pelvis of the mother.... --CHILD--> [?] Maternal care for disproportion due to deformity of maternal pelvic bones --- Walk 3 --- [GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle --PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle.... --EXCLUDES--> [?] Chronic secondary visceral pain Def: Chronic visceral pain is persistent or recurrent pain originating from internal organs of the head/neck region and of the thoracic, abdominal and pelvic cavities. The visceral etiology of the pain sho... --- Walk 4 --- [GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle --PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle.... --PARENT--> [?] Diseases of the female genital system --- Walk 5 --- [LB30.7] Ectopic or pelvic kidney Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones... --PARENT--> [LB30] Structural developmental anomalies of kidneys Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period.... --CHILD--> [LB30.1] Renal dysplasia Def: A condition characterised by abnormal development of one or both kidneys.... --- Walk 6 --- [LB30.7] Ectopic or pelvic kidney Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones... --PARENT--> [LB30] Structural developmental anomalies of kidneys Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period.... --CHILD--> [LB30.2] Congenital single renal cyst Def: A single cyst in a kidney, noted in utero or from birth. No other structural abnormality of the kidney or urinary tract noted....
[ "[FC00.3] Acquired deformity of pelvis\n --EXCLUDES--> [?] Obstructed labour due to deformed pelvis\n --PARENT--> [?] Obstructed labour due to maternal pelvic abnormality\n Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ...", "[FC00.3] Acquired deformity of pelvis\n --EXCLUDES--> [?] Maternal care for disproportion\n Def: A condition characterised by the provision of health interventions to the mother due to the situation in which the head or body of the fetus is too large to fit through the pelvis of the mother....\n --CHILD--> [?] Maternal care for disproportion due to deformity of maternal pelvic bones", "[GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle\n --PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle\n Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle....\n --EXCLUDES--> [?] Chronic secondary visceral pain\n Def: Chronic visceral pain is persistent or recurrent pain originating from internal organs of the head/neck region and of the thoracic, abdominal and pelvic cavities. The visceral etiology of the pain sho...", "[GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle\n --PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle\n Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle....\n --PARENT--> [?] Diseases of the female genital system", "[LB30.7] Ectopic or pelvic kidney\n Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones...\n --PARENT--> [LB30] Structural developmental anomalies of kidneys\n Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period....\n --CHILD--> [LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....", "[LB30.7] Ectopic or pelvic kidney\n Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones...\n --PARENT--> [LB30] Structural developmental anomalies of kidneys\n Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period....\n --CHILD--> [LB30.2] Congenital single renal cyst\n Def: A single cyst in a kidney, noted in utero or from birth. No other structural abnormality of the kidney or urinary tract noted...." ]
FC00.3
Acquired deformity of pelvis
[ { "from_icd11": "FC00.3", "icd10_code": "M955", "icd10_title": "Acquired deformity of pelvis" }, { "from_icd11": "LB30.7", "icd10_code": "Q632", "icd10_title": "Ectopic kidney" }, { "from_icd11": "LB30.7", "icd10_code": "Q63", "icd10_title": "Other congenital malformations of kidney" }, { "from_icd11": "MD82", "icd10_code": "R1900", "icd10_title": "Intra-abdominal and pelvic swelling, mass and lump, unspecified site" }, { "from_icd11": "MD82", "icd10_code": "R1909", "icd10_title": "Other intra-abdominal and pelvic swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1902", "icd10_title": "Left upper quadrant abdominal swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1904", "icd10_title": "Left lower quadrant abdominal swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1903", "icd10_title": "Right lower quadrant abdominal swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1901", "icd10_title": "Right upper quadrant abdominal swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1907", "icd10_title": "Generalized intra-abdominal and pelvic swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1906", "icd10_title": "Epigastric swelling, mass or lump" }, { "from_icd11": "MD82", "icd10_code": "R190", "icd10_title": "Intra-abdominal and pelvic swelling, mass and lump" }, { "from_icd11": "GA05.Z", "icd10_code": "N739", "icd10_title": "Female pelvic inflammatory disease, unspecified" }, { "from_icd11": "GA05.Z", "icd10_code": "N738", "icd10_title": "Other specified female pelvic inflammatory diseases" }, { "from_icd11": "GA05.Z", "icd10_code": "N74", "icd10_title": "Female pelvic inflammatory disorders in diseases classified elsewhere" } ]
M955
Acquired deformity of pelvis
A 17-year-old healthy white Caucasian primigravida underwent a vaginal delivery with mediolateral episiotomy in a secondary care hospital. Her past medical history was unremarkable and the pregnancy was uncomplicated. According to the report of the referring hospital, the patient complained of local pain at that time, which was considered as normal after birth. The white blood cells were high in the first postpartum day (23.81/nL) and were decreasing in the second (13.69/nL), third (8.42/nL), and fifth (2.98/nL) postpartum day showing a beginning of leukocytopenia. In the fourth postpartum day, the patient developed a severe pain and edema in the episiotomy site as well as the lower extremities. Further on, the patient exhibited a progressive purpuric discoloration on the right leg radiating from the episiotomy site, which was accompanied by general deterioration. In the early hours of the fifth postpartum day, the patient was admitted to the intensive care unit (ICU) under antibiotic therapy (Piperacillin/Combactam, Metronidazole, and Clindamycin). Ultrasound showed perifascial fluids in the suprapubic region and in both groins to the iliac vessels, which extends downwards to the medial aspect of both thighs. Chest X-ray demonstrated a cardiomegaly with pulmonary congestion with no evidence of pleural effusion. Duplex ultrasound ruled out thrombophlebitis of both lower extremities. In the late morning hours of that day, the patient was referred to our tertiary care medical center. Due to the instable status, the patient had to be intubated and under high dose of catecholamine. Vital signs at the time of admission were as follows: blood pressure 140/90 mmHg, respiratory rate 20/min, pulse 90/min, and temperature 35.5°C. Both upper extremities presented with massive swelling and signs of compartment syndrome. Both lower extremities were massively swollen with discoloration (purple to red) of the skin more on the right side. Computer tomography (CT) scan was performed to the trunk and extremities. The scan showed bilateral pleural effusion and atelectasis, splenomegaly and partial splenic infarction (2 cm) , free intra-abdominal fluid , anasarca, and edematous lower limbs especially the muscles (right > left) as well as thrombosis of the great saphenous vein on the right side. After the emergent initial investigations, NF was diagnosed clinically and the antibiotic therapy was adjusted to Clindamycin and Penicillin G. The patient was driven to the operating theater with low lactic acid and pH in the arterial blood gasses with value of 3.7 mg/dL and 7.26, respectively. These values have been normalized in the following 2 hours. An interdisciplinary team from the departments of general surgery, plastic surgery, and gynecological surgery initiated a radical debridement of the necrotic tissues of the perineum and pelvic floor as well as fasciotomy of the four extremities. Multiple biopsies of the fascia were sent to the department of pathology as well as department of microbiology for immediate examination. All cultures of the samples showed Streptococcus pyogenes . Some of the samples showed Bacteroides fragilis and Escherichia coli as well. Interestingly, the patient remained with good renal and liver functions together with adequate urine output. Thus, a suspicion of an increase in intra-abdominal pressure as well as abdominal compartment syndrome was ruled out and a decompressive laparotomy was not indicated. However, the myoglobin in urine exceeded the maximum measurable value in our laboratory . Intraoperatively the patient developed light fixed pupils. An emergent cranial CT, after the initial emergent surgery, ruled out any hypoxia or intracranial bleeding. The blood work-up test at this time revealed signs of disseminated intravascular coagulopathy (DIC): platelet count = 10 g/L, TPZ (Quick) = 43%, partial thromboplastin time (PTT) = 57 sec., fibrinogen = 1.2 μ g/L, and D-dimers = 6778 μ g/L. Therefore, the patient required sixteen units of packed red blood cells (250 mL each), twelve units of fresh frozen plasma, and four units of concentrated platelets (250 mL each) while being in our hospital. After the surgery and as a supportive therapy, the patient was referred to hyperbaric oxygen therapy (HBO). The vital signs were at that time as follows: blood pressure 110/70 mmHg, respiratory rate 14/min, pulse 100/min, and temperature 37°C under high dose of catecholamine. After three hours in the HBO chamber the patient dropped with blood pressure and consequently catecholamine therapy was escalated. After being transferred back to our ICU, a transthoracic echocardiogram has been carried out and showed massively dilated ventricles on both sides and reduced cardiac output with global cardiac hypo- to akinesia. Short after, the patient had to be resuscitated according to European Resuscitation Council (ERC). Resuscitation attempts failed and the patient died due to septic shock after 16 hours since hospital transfer.
3.939453
0.97998
sec[1]/p[0]
en
0.999998
26064762
https://doi.org/10.1155/2015/562810
[ "blood", "well", "extremities", "both", "time", "hours", "postpartum", "pressure", "episiotomy", "that" ]
[ { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "EB30", "title": "Eosinophilic cellulitis" }, { "code": "QC2Y", "title": "Other specified contact with health services associated with the health of others" }, { "code": "4A60.1", "title": "Cryopyrin-associated periodic syndromes" }, { "code": "2D10.0", "title": "Follicular carcinoma of thyroid gland" }, { "code": "2B5H", "title": "Well differentiated lipomatous tumour, primary site" } ]
=== ICD-11 CODES FOUND === [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood [EB30] Eosinophilic cellulitis Definition: Eosinophilic cellulitis (Wells syndrome) is characterised by a distinctive clinical picture resembling cellulitis, and a typical histology with tissue eosinophilia, oedema and ‘flame’ figures (clusters of eosinophils and histiocytes around a core of collagen and eosinophilic debris). It can affect either sex, usually in adult life. Any site may be involved, with single or multiple lesions, and recurrences are common. Initially, the lesions are itchy erythematous plaques with features resembling Also known as: Eosinophilic cellulitis | Wells' syndrome [QC2Y] Other specified contact with health services associated with the health of others Also known as: Other specified contact with health services associated with the health of others | Boarder in health-care facility other than healthy person accompanying sick person | Health supervision or care of other healthy infant or child | child in care | healthy infant receiving care [4A60.1] Cryopyrin-associated periodic syndromes Definition: CAPS is an autoinflammatory disease associated with gain of function changes in the cryopyrin protein, resulting in inflammasome activation and enhanced IL1 beta production. This results in clinical signs and symptoms of inflammation in the form of rash, fever, joint and eye symptoms with increased acute phase reactants. Also known as: Cryopyrin-associated periodic syndromes | CAPS - [Cryopyrin-associated periodic syndromes] | Cryopyrinopathies | Chronic infantile neurological, cutaneous and articular syndrome | Infantile-onset multisystem inflammatory disease Includes: Cryopyrinopathies [2D10.0] Follicular carcinoma of thyroid gland Definition: A differentiated adenocarcinoma arising from the follicular cells of the thyroid gland. The nuclear features which characterise the thyroid gland papillary carcinoma are absent. Radiation exposure is a risk factor and it comprises approximately 10% to 15% of thyroid cancers. Clinically, it usually presents as a solitary mass in the thyroid gland. It is generally unifocal and thickly encapsulated and shows invasion of the capsule or the vessels. Diagnostic procedures include: thyroid ultrasound a Also known as: Follicular carcinoma of thyroid gland | follicular carcinoma of unspecified site | follicular thyroid carcinoma | moderately differentiated follicular carcinoma of thyroid gland | pure follicle carcinoma of thyroid gland [2B5H] Well differentiated lipomatous tumour, primary site Also known as: Well differentiated lipomatous tumour, primary site | Atypical liposarcoma === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ... --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.41] Microscopic haematuria --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC... --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.1] Finding of cocaine in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.0] Finding of opiate drug in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.41] Microscopic haematuria", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
This case report highlights an unusual presentation of a patient with symptoms consistent with those seen in patients with an aortic dissection, where further diagnostics however revealed an initial manifestation of TPP which was induced by intravenous pulse prednisolone therapy. TPP is a well-known complication of thyrotoxicosis in Asian populations. The overall incidence of TPP among patients with hyperthyroidism in China and Japan is 1.8 and 1.9% respectively , whereas it is 0.1-0.2% among North American population with thyrotoxicosis . Recently Cesur et al. analyzed 40 cases of TPP within the Turkish population, where most of the population are Caucasoid, with the main subgroup belonging to the Mediterranid extraction . This report and other reports from the Mediterranean regions indicate the tendency to find TPP in the Mediterranid ethnicity other than the remaining Caucasoid subspecies. Despite the woman predominance of hyperthyroidism, TPP occurs more commonly in men at a ratio of 20 ;: ;1. The majority of thyrotoxic patients associated with TPP is due to Graves’ disease, while other conditions have been reported . TPP is characterized by recurrent, transient episodes of muscle weakness to complete flaccid paralysis in the setting of a low serum potassium level and biochemical evidence of thyrotoxicosis, low TSH along with elevated fT4 or fT3, as observed in our patient. Deep tendon reflexes are reduced or absent. Findings of thyrotoxicosis may be subtle or even clinical silent . The pathogenesis of TPP remains still unclear. Hypokalemia is the consequence of a rapid and massive shift of potassium from the extracellular into the intracellular compartment, related to increased sodium-potassium-adenosine triphosphate (Na/K-ATPase) pump-activity . Patients with TPP have significantly higher Na/K-ATPase pump number and activity than thyrotoxic patients without TPP and the activity returns to normal when their thyroid function is controlled. Correction of the underlying thyrotoxic state aborts the attacks, but they can recur with the return of thyrotoxicosis . It has been shown that thyroid hormones increase via transcriptional and posttranscriptional mechanisms Na/K-ATPase activity in skeletal muscles. Apart from direct stimulation by thyroid hormones, catecholamine and the enhanced β-adrenergic response in thyrotoxicosis further increases the activity of the Na/K-ATPase in skeletal muscle . Furthermore there are indications that insulin plays an important role in the development of TPP and it could be demonstrated that serum insulin levels are elevated prior to the attack. Insulin-response sequences are present in the upstream region of Na/K-ATPase genes in skeletal muscle and insulin has been shown to stimulate Na/K-ATPase activity which may explain the association of TPP attacks with carbohydrate-rich meals. Other precipitating factors for an attack are ingestion of alcohol or strenuous exercise . Overall it appears that patients with TPP have an underlying predisposition for activation of Na/K-ATPase activity, either directly by thyroid hormone or indirectly via adrenergic stimulation, insulin or exercise. To determine whether this predisposition is genetically associated rigorous attempts have been devoted to the search of the gene mutation of ion channels in TPP. The pathogenesis of FHPP (Familial Hypokalemic Periodic Paralysis), another entity of the primary periodic paralyses which is frequently experienced in Caucasian countries , has been elucidated and in most cases the abnormal gene is the alpha-1 subunit of the dihydropyridine-sensitive calcium channel in skeletal muscle (CACN1AS). In others it appears to be due to mutations in the skeletal muscle sodium channel (SCN4A) or the potassium channel (KCNE3) . In TPP however, to date only certain single-nucleotide polymorphisms (SNiPs) of CACN1AS were associated with TPP in southern Chinese. Those SNiPs may provide a risk to the attack of TPP . Glucocorticoids may induce hypokalemia from a transcellular potassium shift caused by an increased Na/K-ATPase pool in skeletal muscles and steroid-induced hyperinsulinemia and hyperglycemia which we also observed in our patient . Current treatment recommendations involve treating the underlying hyperthyroid state and supplementation with potassium chloride (KCL) to prevent major cardiopulmonary complications. The dose of KCL required varies between 40 and 200 mmol. However excessive potassium replacement may result in rebound hyperkalemia during recovery of the paralysis when potassium is released from cells as the paralysis subsides, posing another risk of cardiac arrhythmia . Furthermore a therapy with nonselective β-blockers has been reported, based on the implication of hyperadrenergic activity in the pathogenesis of TPP . Whether the combination of low dose KCL and nonselective β-blockers is the treatment of choice in facilitating the recovery and reducing rebound hyperkalemia awaits further study in future.
4.414063
0.820801
sec[2]/p[0]
en
0.999997
19918467
https://doi.org/10.4076/1757-1626-2-7501
[ "potassium", "atpase", "activity", "patients", "thyrotoxicosis", "skeletal", "muscle", "insulin", "which", "paralysis" ]
[ { "code": "5C77", "title": "Hypokalaemia" }, { "code": "5C76", "title": "Hyperkalaemia" }, { "code": "BC65.0", "title": "Long QT syndrome" }, { "code": "GB90.46", "title": "Tubular disorders of sodium or potassium transport" }, { "code": "KB63.3Z", "title": "Disturbances of potassium balance of newborn, unspecified" }, { "code": "5C54.2", "title": "Disorders of multiple glycosylation or other pathways" }, { "code": "5C53.2Y", "title": "Other specified disorders of mitochondrial oxidative phosphorylation" }, { "code": "QF2Z", "title": "Difficulty or need for assistance with unspecified activity" }, { "code": "6A05.Z", "title": "Attention deficit hyperactivity disorder, presentation unspecified" }, { "code": "QF23", "title": "Difficulty or need for assistance with mobility" } ]
=== ICD-11 CODES FOUND === [5C77] Hypokalaemia Also known as: Hypokalaemia | Potassium [K] deficiency | Potassium deficiency | hypokalaemic syndrome | hypopotassaemia [5C76] Hyperkalaemia Also known as: Hyperkalaemia | Potassium [K] excess | Potassium [K] overload | hyperaemic syndrome | hyperpotassaemia Includes: Potassium [K] excess | Potassium [K] overload [BC65.0] Long QT syndrome Definition: A congenital disorder of ventricular myocardial repolarization characterised by a prolonged QT interval on the electrocardiogram (ECG) that can lead to symptomatic ventricular arrhythmias and an increased risk of sudden cardiac death. Also known as: Long QT syndrome | Congenital long QT syndrome | Familial long QT syndrome | Long QT syndrome type 1 | Long QT syndrome type 2 [GB90.46] Tubular disorders of sodium or potassium transport Definition: Abnormalities of the renal tubules resorptive or secretory functions, inherited or acquired. Also known as: Tubular disorders of sodium or potassium transport | Inherited tubular disorders of potassium or sodium transport | Acquired tubular disorders of potassium or sodium transport associated with causes classified elsewhere Excludes: Fanconi syndrome [KB63.3Z] Disturbances of potassium balance of newborn, unspecified Also known as: Disturbances of potassium balance of newborn, unspecified | Disturbances of potassium balance of newborn | transitory disorder of potassium in newborn | transitory disorder of potassium balance in newborn [5C54.2] Disorders of multiple glycosylation or other pathways Also known as: Disorders of multiple glycosylation or other pathways | Dolichol-phosphate-mannose synthase 1 deficiency | GDP-Man: Dol-P-mannosyltransferase deficiency | Carbohydrate deficient glycoprotein syndrome type 1E | Congenital disorder of glycosylation type 1E [5C53.2Y] Other specified disorders of mitochondrial oxidative phosphorylation Also known as: Other specified disorders of mitochondrial oxidative phosphorylation | Mitochondrial oxidative phosphorylation disorders due to mitochondrial DNA anomalies | Respiratory chain disorders caused by mutations of mtDNA | OXPHOS - [oxidative phosphorylation] diseases due to mtDNA anomalies | Proximal tubulopathy - diabetes mellitus - cerebellar ataxia [QF2Z] Difficulty or need for assistance with unspecified activity Also known as: Difficulty or need for assistance with unspecified activity | need for assistance with activities | dependence on care provider | difficulty with activities [6A05.Z] Attention deficit hyperactivity disorder, presentation unspecified Also known as: Attention deficit hyperactivity disorder, presentation unspecified | Attention deficit hyperactivity disorder | disturbance of activity and attention | disorder of activity and attention | ADHD - [attention deficit hyperactivity disorder] [QF23] Difficulty or need for assistance with mobility Also known as: Difficulty or need for assistance with mobility | difficulty with mobility | need for assistance due to reduced mobility | need for assistance with mobility | problem with impaired mobility Excludes: Abnormalities of gait or mobility === GRAPH WALKS === --- Walk 1 --- [5C77] Hypokalaemia --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance --CHILD--> [5C71] Hyperosmolality or hypernatraemia Def: Serum sodium concentrations in excess of 145 mmol/L; increased serum concentration of osmotically active particles... --- Walk 2 --- [5C77] Hypokalaemia --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance --CHILD--> [5C72] Hypo-osmolality or hyponatraemia Def: Serum sodium concentrations of less than 135 mEq/L; decreased serum concentration of osmotically active particles... --- Walk 3 --- [5C76] Hyperkalaemia --RELATED_TO--> [?] Hyperkalaemia of newborn Def: Hyperkalaemia is defined as serum potassium greater than 5.5 mmol/L.... --PARENT--> [?] Disturbances of potassium balance of newborn Def: A paediatric condition characterised by abnormally high or low levels of potassium in the blood in a newborn, when the normal range is defined as 3.5 to 5.5 mmol/L.... --- Walk 4 --- [5C76] Hyperkalaemia --RELATED_TO--> [?] Hyperkalaemia of newborn Def: Hyperkalaemia is defined as serum potassium greater than 5.5 mmol/L.... --PARENT--> [?] Hyperkalaemia --- Walk 5 --- [BC65.0] Long QT syndrome Def: A congenital disorder of ventricular myocardial repolarization characterised by a prolonged QT interval on the electrocardiogram (ECG) that can lead to symptomatic ventricular arrhythmias and an incre... --PARENT--> [BC65] Cardiac arrhythmia associated with genetic disorder --CHILD--> [BC65.2] Short QT syndrome Def: Familial short QT syndrome is a rare cardiac rhythm disorder that associates a short QT interval (QT and QTc 300 ms) on the surface electrocardiogram (ECG) with a high risk of syncope or sudden death ... --- Walk 6 --- [BC65.0] Long QT syndrome Def: A congenital disorder of ventricular myocardial repolarization characterised by a prolonged QT interval on the electrocardiogram (ECG) that can lead to symptomatic ventricular arrhythmias and an incre... --PARENT--> [BC65] Cardiac arrhythmia associated with genetic disorder --PARENT--> [?] Cardiac arrhythmia Def: This is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heartbeat may be too fast or too slow, and may be regular or irregular....
[ "[5C77] Hypokalaemia\n --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance\n --CHILD--> [5C71] Hyperosmolality or hypernatraemia\n Def: Serum sodium concentrations in excess of 145 mmol/L; increased serum concentration of osmotically active particles...", "[5C77] Hypokalaemia\n --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance\n --CHILD--> [5C72] Hypo-osmolality or hyponatraemia\n Def: Serum sodium concentrations of less than 135 mEq/L; decreased serum concentration of osmotically active particles...", "[5C76] Hyperkalaemia\n --RELATED_TO--> [?] Hyperkalaemia of newborn\n Def: Hyperkalaemia is defined as serum potassium greater than 5.5 mmol/L....\n --PARENT--> [?] Disturbances of potassium balance of newborn\n Def: A paediatric condition characterised by abnormally high or low levels of potassium in the blood in a newborn, when the normal range is defined as 3.5 to 5.5 mmol/L....", "[5C76] Hyperkalaemia\n --RELATED_TO--> [?] Hyperkalaemia of newborn\n Def: Hyperkalaemia is defined as serum potassium greater than 5.5 mmol/L....\n --PARENT--> [?] Hyperkalaemia", "[BC65.0] Long QT syndrome\n Def: A congenital disorder of ventricular myocardial repolarization characterised by a prolonged QT interval on the electrocardiogram (ECG) that can lead to symptomatic ventricular arrhythmias and an incre...\n --PARENT--> [BC65] Cardiac arrhythmia associated with genetic disorder\n --CHILD--> [BC65.2] Short QT syndrome\n Def: Familial short QT syndrome is a rare cardiac rhythm disorder that associates a short QT interval (QT and QTc 300 ms) on the surface electrocardiogram (ECG) with a high risk of syncope or sudden death ...", "[BC65.0] Long QT syndrome\n Def: A congenital disorder of ventricular myocardial repolarization characterised by a prolonged QT interval on the electrocardiogram (ECG) that can lead to symptomatic ventricular arrhythmias and an incre...\n --PARENT--> [BC65] Cardiac arrhythmia associated with genetic disorder\n --PARENT--> [?] Cardiac arrhythmia\n Def: This is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heartbeat may be too fast or too slow, and may be regular or irregular...." ]
5C77
Hypokalaemia
[ { "from_icd11": "5C77", "icd10_code": "E876", "icd10_title": "Hypokalemia" }, { "from_icd11": "5C76", "icd10_code": "E875", "icd10_title": "Hyperkalemia" }, { "from_icd11": "BC65.0", "icd10_code": "I498", "icd10_title": "Other specified cardiac arrhythmias" }, { "from_icd11": "BC65.0", "icd10_code": "I49", "icd10_title": "Other cardiac arrhythmias" }, { "from_icd11": "GB90.46", "icd10_code": "N2589", "icd10_title": "Other disorders resulting from impaired renal tubular function" }, { "from_icd11": "GB90.46", "icd10_code": "N258", "icd10_title": "Other disorders resulting from impaired renal tubular function" }, { "from_icd11": "KB63.3Z", "icd10_code": "P743", "icd10_title": "Disturbances of potassium balance of newborn" }, { "from_icd11": "5C54.2", "icd10_code": "E778", "icd10_title": "Other disorders of glycoprotein metabolism" }, { "from_icd11": "QF2Z", "icd10_code": "Z7389", "icd10_title": "Other problems related to life management difficulty" }, { "from_icd11": "QF2Z", "icd10_code": "Z7382", "icd10_title": "Dual sensory impairment" }, { "from_icd11": "QF2Z", "icd10_code": "Z742", "icd10_title": "Need for assistance at home and no other household member able to render care" }, { "from_icd11": "QF2Z", "icd10_code": "Z602", "icd10_title": "Problems related to living alone" }, { "from_icd11": "QF2Z", "icd10_code": "Z748", "icd10_title": "Other problems related to care provider dependency" }, { "from_icd11": "QF2Z", "icd10_code": "Z73", "icd10_title": "Problems related to life management difficulty" }, { "from_icd11": "QF2Z", "icd10_code": "Z738", "icd10_title": "Other problems related to life management difficulty" } ]
E876
Hypokalemia
A 19-year-old nulliparous virgo, with unremarkable past medical history, initially presented to our department with a feeling of abdominal fullness. Pelvic examination revealed a painless right adnexal mass that was occupying the whole abdominal cavity. The mass was firm, solid, of low mobility, and with hard-to-define boundaries. Transabdominal and transvaginal ultrasonography revealed a predominantly solid and vascularized, bilateral adnexal formation with an area of 80 mm. The level of the serum carbohydrate antigen-125 was elevated to 271 U/ml (normal, < 35 U/ml), while other serum tumor markers (β-HCG, AFP) were not elevated. The patient underwent an exploratory laparotomy. Approximately 1,000 ml of amber-colored cytologically negative ascites were withdrawn intraoperatively. Two large, irregular, and predominantly solid, bilateral ovarian masses (both ∼ 20 cm) were found with small tumor implants on the sigmoid colon, omentum, and cul-de-sac. The interiliac lymph nodes measured 4 cm, bilaterally. Using intraoperative frozen section diagnosis, the tumor tissue of right ovary was interpreted as a malignant tumor, probably dysgerminoma. A bilateral salpingo-oophorectomy, bilateral pelvic lymphadenectomy, total abdominal hysterectomy, complete omentectomy, and resection of the disseminated tumors with interiliac lymph node excision were performed. The patient was optimally debulked with no residual tumor seen. Macroscopically, the right and the left ovarian masses were pearly white, predominantly solid with partially pseudocystic areas and necrosis. Conventional hematoxylin and eosin stained sections demonstrated small and round tumor cell nests separated by a prominent desmoplastic stroma. The mitotic count of the tumor cells was high , suggesting a poorly-differentiated carcinoma. Immunohistochemical staining was performed using the antigen retrieval technique. The tumor cells were diffuse positive for broad-spectrum cytokeratins (CK AE1/AE3), epithelial membrane antigen (EMA), and vimentin. Polymerase chain reaction (PCR) analysis showed positive results for Ewing sarcoma (EWS)—Wilms tumor 1 (WT1) fusion gene, while additional confirmation of the DSRCT diagnosis was made via detection of the tumor-specific chromosomal translocation t(11;22)(p13;q12). Based on the morphology and immunohistochemistry findings, a final diagnosis of intraabdominal DSRCT with ovarian involvement was made. Bone marrow biopsy was performed after a final pathologic diagnosis and within three weeks after surgery, revealing normocellular pattern. Furthermore, a PET/CT scan demonstrated enlarged paraaortic lymph node in projection of third lumbar vertebrae with cluster of hyperdense nodes beside it, without metabolic activity. According to the CWS 2009 protocol scheme, she has received intensive chemotherapy treatment for metastatic disease: 3 cycles of ifosfamide 9,000 mg/m 2 , vincristine 1,5 mg/m 2 , actinomycin 1,5 mg/m 2 (IVA), 3 cycles of carboplatin 500 mg/m 2 , epirubicin 150 mg/m 2 , Vincristine 1.5 mg/m 2 (CEV), and 3 cycles of ifosfamide 9,000 mg/m 2 , vincristine 1,5 mg/m 2 , etopozide 450 mg/m 2 (IVE) with informed consent of the patient and her family. Only in first cycle of IVA and in the first cycle of CEV she has received vincristine 3 × 1.5 mg/m 2 . Because of suspect malignancy propagation on positron emission tomography/computed tomography (PET/CT) scan, we conducted a second debulking surgery (SDS), about 4 months after initial surgical treatment. Intraoperative finding was a solid tumor (9 × 5 cm), barely fixed with external iliac vessels. We performed successful tumor resection with no residual tumor seen in the abdominal cavity. Cytological and immunohistochemistry findings confirmed diagnosis of DSRCT. The patient received nine cycles of CWS protocol overall. After the ninth cycle of CWS protocol, a disease remission was accomplished, and the patient underwent high-dose chemotherapy (busulfan 600 mg/m 2 , melphalan 140 mg/m 2 ) followed by autologous stem cell support. After the autologous stem cell support, she received a couple of cycles of maintenance therapy (etoposide 2 × 25 mg/m 2 /day, idarubicin 4 × 5 mg/m 2 and trofosfamide 2 × 75 mg/m 2 /day) but, due to drug induced high transaminase levels, we stopped it. The transaminase levels have normalised soon after. Twelve months after the patient's admission, a control PET/CT scan, pelvic and abdominal MRI were without evidence of eventual disease reccurence. In accordance with the above mentioned clinical findings, our approach was to provide a radiotherapy to the site of initial bulk disease (dose of 30.6 Gy divided in 17 fractions). The only noticeable adverse effect during the course of therapy was thrombocytopenia, which was extensive at one point, so it required treatment with intravenous immunoglobulins and platelet transfusion. Up to date, she is in good general condition without evidence of disease reccurence, 40 months after her initial diagnosis.
4.167969
0.966797
sec[1]/p[0]
en
0.999996
32483810
https://doi.org/10.1055/s-0040-1710350
[ "tumor", "abdominal", "solid", "cycles", "vincristine", "pelvic", "predominantly", "antigen", "ovarian", "lymph" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "MD81.3", "title": "Acute abdomen" }, { "code": "JA01.0", "title": "Abdominal pregnancy" }, { "code": "ME04.Z", "title": "Ascites, unspecified" }, { "code": "NB51.0&XA3KX0", "title": "Laceration without foreign body of abdominal wall" }, { "code": "NB9Y", "title": "Other specified injuries to the abdomen, lower back, lumbar spine or pelvis" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [MD81.3] Acute abdomen Definition: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases Also known as: Acute abdomen | acute abdominal pain syndrome | surgical abdomen | abdominal acute syndrome | severe abdomen pain [JA01.0] Abdominal pregnancy Definition: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy. Also known as: Abdominal pregnancy | abdomen pregnancy | intraperitoneal pregnancy Excludes: Maternal care for viable fetus in abdominal pregnancy | Delivery of viable fetus in abdominal pregnancy [ME04.Z] Ascites, unspecified Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS [NB9Y] Other specified injuries to the abdomen, lower back, lumbar spine or pelvis Also known as: Other specified injuries to the abdomen, lower back, lumbar spine or pelvis | Abdominal wall trauma | Injury of pelvic floor | pelvic floor blunt injury | pelvic floor blunt trauma === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --PARENT--> [?] Symptoms, signs or clinical findings involving the skin --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --CHILD--> [?] Localised lymph node enlargement --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --PARENT--> [?] Symptoms, signs or clinical findings involving the skin", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --CHILD--> [?] Localised lymph node enlargement", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
A 15 year-old Caucasian male was referenced to our institution in November 2005 for investigation of severe episodes of flushing, hypotension and vascular collapse since his late-early childhood; at that time, he referred a past history of several admissions at the emergency room for similar episodes. He had no history of urticaria, angioedema, and allergy or identified MCA triggers. In particular, the life-threatening episodes were not caused by food, medications, insect bites, temperature changes, exercise, or other recognized factors. Of note, the patient had been diagnosed with cutaneous mastocytosis at the age of 3-year, based on histopathological analysis of maculopapular skin lesions which disappeared soon thereafter. At the time of referral, he didn’t have skin lesions, hepatomegaly, splenomegaly, or lymphadenopathy, and he was under H1 anti-histamines therapy, without the relief of the crises. Laboratory investigation showed markedly increased baseline serum tryptase levels (175 μg/l; normal range: 2–13 µg/l). Transient increase in serum tryptase above the baseline values during the MC-mediators related events were not documented, because blood samples for determination of serum tryptase levels were not taken at the episodes flushing, hypotension and vascular collapse. The BM aspirate was normocellular with increased numbers of MC (1.7%), most of which had an atypical (type I) morphology (spindle-shaped MC with irregular distribution and focal accumulation of the cytoplasmic granules, and elongated cytoplasmic extensions); the myeloid/erythroid ratio was normal and there was no myelodysplasia . The BM trephine (stained with hematoxylin-eosin and Giemsa), showed a normocellular BM without dysplastic features or increased blast cells, but a few scattered morphologically abnormal MCs, difficult to recognize . Dense BM mast cell aggregates (>15 cells/aggregate) were not observed. Flow cytometry confirmed the presence of BM mast cells with abnormally high light scatter values (SSC and FSC), and a mature (CD117+high, FcεRI+high), but aberrant (CD2+, CD25+) and activated (CD63+high, CD69+high) phenotype . Molecular analysis showed the absence of the KIT Asp-816(r)Val mutation; in contrast, the KIT Val-560(r)Gly activating mutation was detected in FACS-purified BM mast cells , but not in other BM myeloid and lymphoid cells, including BM precursors. Serum IgE levels were within normal values (7 KU/l; normal levels <100 KU/l), and the screening for IgE antibodies specific for common food and inhalant allergens and Hymenoptera venom was negative. The remaining work-up, which included a full blood cell count, biochemical tests, bone densitometry and abdominal ultrasound, was unremarkable. Thus, although the patient had no skin lesions since his late childhood, the case fulfilled the WHO criteria for the diagnosis of ISM. Based on these findings and on the clinical manifestations, the patient was diagnosed with the ISMs(−) variant . H1 anti-histamines were maintained and oral DSCG (200 mg capsules, administered 5-times/day) was added. Since the start of DSCG therapy, systemic MC-associated symptoms have remained under control and serum tryptase levels progressively decreased over time, from 175 µg/l in November 2005 (first observation) to 61 µg/l in 2008, 49 µg/l in 2011, 45 µg/l in 2013, 31 µg/l in August 2015 and 35 µg/l in September 2016 (last observation). The patient is currently 26 years-old and he remains completely asymptomatic under DSCG therapy. Fig. 1 Bone marrow cytological and histopathological features at diagnosis. a Leishman’s ( A1 ), toluidine blue ( A2 ) and chloroacetate esterase ( A3 ) staining of bone marrow (BM) smears from the patient at diagnosis, revealing atypical mast cells (MCs) with elongated cytoplasmic extensions and abnormal granulation (*). A normal MC is shown for comparison ( A1 , **). b Hematoxilin-eosin ( B1 , 40×; B2 , 400×), Giemsa staining ( B3 , 400×) and CD117 immunostaining ( B4 , 400×) of a BM trephine biopsy from the patient at diagnosis, showing normocellular marrow with osteosclerosis ( B1 , *) and scattered elongated and degranulated abnormal ( B2 and B3 , *), CD117 positive (B4) MCs Fig. 2 Immunophenotypic and genetic features of bone marrow (BM) mast cells (MCs). a Illustrating bivariate dot-plots of the BM cells from the patient ( panel A1 ), and after selecting specifically for BM mast cells ( panels A2 – A4 ); as illustrated, bone marrow MCs showed a mature (CD117+high, FcεRI+high) ( panel A2 ), aberrant (CD2+, CD25+) ( panel A3 ) immunophenotype, with expression of activation-associated markers (CD63, CD69) in a large fraction of the cells ( panel A4 ). Corresponding dot plots from normal bone marrow MCs ( blue dots ) are show for comparison. b Sequences of polymerase chain reaction (PCR) products illustrating the presence of the KIT V560G mutation in bone marrow MCs from the patient, at diagnosis ( panel B2 ); the wild-type (WT) sequence is shown for comparison
4.285156
0.852051
sec[1]/p[0]
en
0.999998
28439288
https://doi.org/10.1186/s13223-017-0193-x
[ "cells", "bone", "marrow", "mast", "serum", "panel", "episodes", "tryptase", "since", "time" ]
[ { "code": "MF9Y", "title": "Other specified clinical findings on examination of urine, without diagnosis" }, { "code": "5C56.20", "title": "Mucolipidosis" }, { "code": "3A51.1", "title": "Sickle cell disease without crisis" }, { "code": "9A96.3", "title": "Primary anterior uveitis" }, { "code": "3A61.Z", "title": "Acquired pure red cell aplasia, unspecified" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" } ]
=== ICD-11 CODES FOUND === [MF9Y] Other specified clinical findings on examination of urine, without diagnosis Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine [5C56.20] Mucolipidosis Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2 Excludes: Sialidosis (mucolipidosis type 1) [3A51.1] Sickle cell disease without crisis Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing. Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease] [9A96.3] Primary anterior uveitis Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid. Also known as: Primary anterior uveitis | anterior chamber cell [3A61.Z] Acquired pure red cell aplasia, unspecified Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias === GRAPH WALKS === --- Walk 1 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --EXCLUDES--> [?] Inborn errors of carbohydrate metabolism --- Walk 2 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism --- Walk 3 --- [5C56.20] Mucolipidosis --RELATED_TO--> [?] Mucolipidosis type 4 Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu... --PARENT--> [?] Mucolipidosis --- Walk 4 --- [5C56.20] Mucolipidosis --RELATED_TO--> [?] Mucolipidosis type 4 Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu... --PARENT--> [?] Mucolipidosis --- Walk 5 --- [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ... --CHILD--> [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --- Walk 6 --- [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ... --CHILD--> [3A51.0] Sickle cell trait Def: A disease caused by genetic inheritance of one abnormal allele of the haemoglobin gene. This disease does not display the severe symptoms of sickle cell disease that occurs in homozygous individuals. ...
[ "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of carbohydrate metabolism", "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism", "[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Mucolipidosis type 4\n Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...\n --PARENT--> [?] Mucolipidosis", "[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Mucolipidosis type 4\n Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...\n --PARENT--> [?] Mucolipidosis", "[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...", "[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.0] Sickle cell trait\n Def: A disease caused by genetic inheritance of one abnormal allele of the haemoglobin gene. This disease does not display the severe symptoms of sickle cell disease that occurs in homozygous individuals. ..." ]
MF9Y
Other specified clinical findings on examination of urine, without diagnosis
[ { "from_icd11": "3A51.1", "icd10_code": "D571", "icd10_title": "Sickle-cell disease without crisis" }, { "from_icd11": "3A61.Z", "icd10_code": "D609", "icd10_title": "Acquired pure red cell aplasia, unspecified" }, { "from_icd11": "3A61.Z", "icd10_code": "D608", "icd10_title": "Other acquired pure red cell aplasias" }, { "from_icd11": "3A61.Z", "icd10_code": "D60", "icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]" }, { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X6", "icd10_title": "Other osteomyelitis, lower leg" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X9", "icd10_title": "Other osteomyelitis, unspecified sites" }, { "from_icd11": "FB84.Z", "icd10_code": "M8668", "icd10_title": "Other chronic osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M86662", "icd10_title": "Other chronic osteomyelitis, left tibia and fibula" } ]
D571
Sickle-cell disease without crisis
We report the case of C.B., a 16 years-old girl affected by PWS, who presented PP in the context of CAH by 21OHD and later developed T1DM.She was born at 37 weeks by cesarean section, her birth weight was 2500 g (-0,89 standard deviation scores [SDS]). During infancy she presented with severe hypotonia, respiratory distress, weak cry, small hands and feet, which led to the suspicion of PWS. At 12 months of age the diagnosis was confirmed by methylation-specific multiplex ligation-dependent probe amplification analysis (MS-MLPA) and chromosome 15 DNA polymorphism analysis conducted on the proband and her parents, demonstrated the presence of maternal UPD. During childhood she presented neurodevelopmental disorders comprising learning and intellectual disability, language delay and impairment. Neuropsychiatric evaluation did not report behavioral disorders, although skin picking of the four limbs was found on pre-existing injuries. Food seeking behavior was controlled through parental training, providing a strict schedule of meals and avoiding the intake of sweet and high calorie foods from infancy; this is particularly relevant since the hyperphagia phase in PWS usually occurs between 2 and 4 years of age, and is then followed by an abnormal interest towards food ( 31 ). At the age of 2.4 years she presented short stature ( Table 1 ) alongside reduced levels of insulin-like growth factor-1 (IGF-1) for age and gender (31 ng/mL, n.v. 49-289) and growth hormone (GH) stimulation tests with arginine (0.5 g/Kg iv) and clonidine (150 µg/m 2 orally) were performed, leading to the diagnosis of GHD ( Table 2 ). According to the 2006 Italian Drug Agency (AIFA) Note 39 criteria ( 32 ) rhGH therapy was started at a dose of 0.033 mg/Kg/d (0.7 mg/m²/d); thereafter the dose was titrated according to IGF-1 levels, keeping it within <2 SDS, according to guidelines for GHD treatment in PWS ( 31 , 33 ). Clinical follow up was established every six months and polysomnography were performed once a year to exclude obstructive sleep apnea syndrome (OSAS) which can worsen during rhGH therapy. A controlled diet with the support of a nutrition specialist permitted to control the patient’s body mass index (BMI) keeping it in the normal weight range . Regular growth with a height velocity (HV) of 6-7 cm/yr was registered until the age of 5.5 (75° centile; +0.74 SDS), alongside pre-pubertal Tanner stage 1 by physical examination. At 5.5 years of age pubic hair growth was noted, without thelarche, and at the age of 5.9 an endocrinological evaluation was requested ( Tables 1 , 2 ). Six months later, elevated 17OHP and DHEA-S levels were confirmed, HV attested at 10.4 cm/yr (>97° centile; +4.7 SDS) and physical examination confirmed a Tanner stage Ph2-Pb1, with no evidence of axillary hair. Stimulation test for CAH with tetracosactide 250 µg IV was conducted showing basal and stimulated level of 17OHP >10 ng/mL, both diagnostic for 21OHD ( 35 ). The patient and her parents were referred for genetic testing (MLPA confirmed by Sanger sequencing) for non-classic CAH due to 21OHD with evidence of compound heterozygosity for CYP21A2 mutation: V281L, inherited from the mother, and A(C)656G [intron 2], inherited from the father. At the age of 7.7 years the patient confirmed accelerated HV (10 cm/aa; + 5.2 SDS), physical examination revealed Tanner stage Ph3-Pb2, initial axillary hair and clitoral enlargement; bone age (BA) was advanced corresponding to 9.5 years, according to Greulich&Pyle method, and pelvic ultrasound showed infantile uterine morphometry, with maximum ovarian volume of 1.2 mL and a thin endometrium. The evidence of pubertal progression prompted the execution of a stimulation test with 100 µg IV gonadotropin-releasing hormone (GnRH test), which showed a FSH and LH peak in accordance with pubertal activation of the hypothalamic-pituitary-gonadal axis ( Table 2 ). According with the biochemical and clinical evidence of hyperandrogenism which led to the linear growth acceleration, and considering the risk of premature epiphyseal closure, therapy with hydrocortisone 20 mg/m 2 /d was started in order to promptly suppress androgen levels. Eight months after the start of therapy, Tanner stage was Ph3-Pb2, suppressed levels steroid hormones were observed, HV declined to 5 cm/yr and a left-hand X-ray documented a BA of 10.5 years ( Tables 1 , 2 ). An oral glucose tolerance test (oGTT 1.75 g/Kg) showed an impaired glucose tolerance (IGT), and therefore rhGH therapy and hydrocortisone therapy were reduced to 0.021 mg/Kg/d and 14 mg/m 2 /d, respectively). At the age of 9.0 the patient presented HV 3.9 cm/yr (3rd centile; -1.9 SDS) and Tanner stage did not change. Considering the patient having entered an appropriate age for pubertal start (>8 years-old), the HV and pubertal stage stability, hydrocortisone therapy was reduced to 11.5 mg/m 2 /d and rhGH therapy increased to 0.026 mg/Kg/d, to allow linear growth and spontaneous pubertal progression.
4.195313
0.964844
sec[1]/p[0]
en
0.999997
PMC10130376
https://doi.org/10.3389/fendo.2023.1148318
[ "growth", "pubertal", "stage", "according", "tanner", "which", "rhgh", "evidence", "stimulation", "centile" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "MG44.1Z", "title": "Lack of expected normal physiological development, unspecified" }, { "code": "5A61.3", "title": "Growth hormone deficiency" }, { "code": "8C7Y", "title": "Other specified primary disorders of muscles" }, { "code": "FB86.Z", "title": "Disorders associated with bone growth, unspecified" }, { "code": "EE40.1Y", "title": "Stretch marks of other specified aetiology" }, { "code": "GB22", "title": "Hypertrophy of breast" }, { "code": "GA2Y", "title": "Other specified abnormal uterine or vaginal bleeding" }, { "code": "BD93.0", "title": "Primary lymphoedema" }, { "code": "DA0C.1", "title": "Aggressive periodontitis" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [MG44.1Z] Lack of expected normal physiological development, unspecified Also known as: Lack of expected normal physiological development, unspecified | Lack of expected normal physiological development | delayed physiological development | unspecified delay in development | development arrest [5A61.3] Growth hormone deficiency Definition: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficiency. Includes idiopathic, inborn and acquired forms of growth hormone deficiency. Also known as: Growth hormone deficiency Excludes: Hypopituitarism [8C7Y] Other specified primary disorders of muscles Also known as: Other specified primary disorders of muscles | Certain specified primary disorders of muscles | Myopathy due to calsequestrin or SERCA1 protein overload | Delayed muscle maturation | delayed muscle growth [FB86.Z] Disorders associated with bone growth, unspecified Also known as: Disorders associated with bone growth, unspecified | Disorders associated with bone growth [EE40.1Y] Stretch marks of other specified aetiology Also known as: Stretch marks of other specified aetiology | Pubertal stretch marks | Pubertal striae distensae | Obesity-related stretch marks | Striae distensae due to obesity [GB22] Hypertrophy of breast Definition: A condition affecting the breast, characterised by unilateral or bilateral enlargement or thickening of the connective tissues that exceeds 3% of the total body weight. This condition may be associated with increased histologic sensitivity to, or abnormally high levels of, prolactin, estrogen, and progesterone in the blood. Also known as: Hypertrophy of breast | Hypertrophy of breast NOS | hypertrophic breast | excessive development of breast | macromastia [GA2Y] Other specified abnormal uterine or vaginal bleeding Also known as: Other specified abnormal uterine or vaginal bleeding | Abnormal uterine bleeding | metrostaxis | haemorrhage in uterus | uterine haemorrhage [BD93.0] Primary lymphoedema Definition: Lymphoedema as a result of lymphatic vessel hypoplasia Also known as: Primary lymphoedema | Congenital lymphoedema | Simple primary lymphoedema | Congenital primary lymphoedema | Milroy disease [DA0C.1] Aggressive periodontitis Definition: A type of periodontal disease and includes localised aggressive periodontitis (LAP), and Generalised aggressive periodontitis (GAP). Also known as: Aggressive periodontitis | Juvenile periodontitis | prepubertal periodontitis | Generalised aggressive periodontitis | Localised aggresssive periodontitis Includes: Juvenile periodontitis === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F92] Neoplasms of unknown behaviour of skin --- Walk 3 --- [MG44.1Z] Lack of expected normal physiological development, unspecified --PARENT--> [MG44.1] Lack of expected normal physiological development Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang... --EXCLUDES--> [?] Disorders of intellectual development Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ... --- Walk 4 --- [MG44.1Z] Lack of expected normal physiological development, unspecified --PARENT--> [MG44.1] Lack of expected normal physiological development Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang... --CHILD--> [MG44.11] Failure to thrive in infant or child Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender.... --- Walk 5 --- [5A61.3] Growth hormone deficiency Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc... --PARENT--> [5A61] Hypofunction or certain other specified disorders of pituitary gland Def: Clinical status with disordered function of the pituitary gland without excessive pituitary hormone production, which is caused by a variety of diseases... --RELATED_TO--> [?] Non-secreting pituitary adenoma --- Walk 6 --- [5A61.3] Growth hormone deficiency Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc... --EXCLUDES--> [?] Hypopituitarism Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in... --CHILD--> [?] Acquired hypopituitarism Def: This is the acquired decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain....
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F92] Neoplasms of unknown behaviour of skin", "[MG44.1Z] Lack of expected normal physiological development, unspecified\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --EXCLUDES--> [?] Disorders of intellectual development\n Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...", "[MG44.1Z] Lack of expected normal physiological development, unspecified\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --CHILD--> [MG44.11] Failure to thrive in infant or child\n Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender....", "[5A61.3] Growth hormone deficiency\n Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc...\n --PARENT--> [5A61] Hypofunction or certain other specified disorders of pituitary gland\n Def: Clinical status with disordered function of the pituitary gland without excessive pituitary hormone production, which is caused by a variety of diseases...\n --RELATED_TO--> [?] Non-secreting pituitary adenoma", "[5A61.3] Growth hormone deficiency\n Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc...\n --EXCLUDES--> [?] Hypopituitarism\n Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in...\n --CHILD--> [?] Acquired hypopituitarism\n Def: This is the acquired decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain...." ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "MG44.1Z", "icd10_code": "R6250", "icd10_title": "Unspecified lack of expected normal physiological development in childhood" }, { "from_icd11": "MG44.1Z", "icd10_code": "R6259", "icd10_title": "Other lack of expected normal physiological development in childhood" }, { "from_icd11": "MG44.1Z", "icd10_code": "R6251", "icd10_title": "Failure to thrive (child)" }, { "from_icd11": "MG44.1Z", "icd10_code": "R6252", "icd10_title": "Short stature (child)" }, { "from_icd11": "MG44.1Z", "icd10_code": "R62", "icd10_title": "Lack of expected normal physiological development in childhood and adults" }, { "from_icd11": "MG44.1Z", "icd10_code": "R628", "icd10_title": "" }, { "from_icd11": "MG44.1Z", "icd10_code": "R629", "icd10_title": "" }, { "from_icd11": "FB86.Z", "icd10_code": "M89761", "icd10_title": "Major osseous defect, right lower leg" }, { "from_icd11": "FB86.Z", "icd10_code": "M89772", "icd10_title": "Major osseous defect, left ankle and foot" } ]
D487
Neoplasm of uncertain behavior of other specified sites