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159
Meningiomas located on the anterior clinoid process may vary in size. A comprehensive surgical extension involving the anterior, middle, posterior fossa, and intraventricular areas requires a detailed analysis of preoperative imaging for effective planning. This case example involved a lesion larger than 6 cm originating from the right anterior clinoid process with a significant suprasellar and lateral cavernous sinus extension into the bilateral anterior fossa, middle fossa, and a segment of the posterior fossa, with significant compression of the optic chiasm and brainstem. A preoperative angiogram is routinely obtained for meningiomas located in this area to assess the possibility of embolizing branches from the external carotid artery. This is because branches of the internal carotid artery pose a higher risk for ischemic complications. The angiogram is obtained to define the blood supply to the tumor, regardless of whether it is possible to embolize it or not. This can provide information on the degree of displacement of the normal vasculature, collateralization, the presence of posterior communicant arteries, and cross-flow through anterior communicant arteries. All of these factors, combined with preoperative magnetic resonance imaging and computer tomography, can help define the surgical strategy. Additional tools, such as neuronavigation and neuromonitoring with techniques including somatosensory evoked potentials, brainstem auditory evoked responses, and electroencephalography, are always helpful. Given the location of the tumor, vascular proximal control measures need to be planned, either cervical carotid with prep of the cervical area, petrous carotid through the middle fossa, or clinoid carotid. Occasionally, there is the need to perform temporary clipping of some feeding tumor vessels, and neuromonitoring provides feedback on physiological stability during these episodes. The type of craniotomy, such as pterional, modified pterional, orbitocranial, or cranio-orbito-zygomatic, can be selected based on the patient’s unique anatomy. Ideally, transzygomatic or cranio-orbito-zygomatic approaches can be used for tumors with significant superior extension, as in the case example presented. In addition, techniques such as pretemporal dissection and extradural clinoidectomy are recommended to partially devascularize and remove the origin of the tumor with early optic canal decompression, which can subsequently be released intradurally after opening the falciform ligament. After meticulous extradural dissection and careful attention to hemostasis, the initial intradural approach aims to explore the anatomical distortion caused by the tumor and to identify normal anatomy. This involves searching for optic nerves, oculomotor nerves, internal carotid arteries, and anterior and middle cerebral arteries. This tumor was wrapped around the right internal carotid artery and right middle cerebral artery. The goal was to divide it into sectors, starting with the lateral component in the middle fossa and around the middle cerebral artery. Central debulking was performed using high microsurgical magnification and an ultrasonic aspirator. Releasing a tumor from vascular structures such as the middle cerebral artery and towards the carotid bifurcation can be performed using constant micro-Doppler and neuronavigation to map the vascular trajectory. Once an arterial trunk is found, it can be followed proximally to remove the majority of the tumor. In cases where a tumor is calcified around the supraclinoid carotid artery or middle cerebral artery, it may be necessary to leave a cuff of the tumor to avoid causing unnecessary injury. Through the middle fossa approach, the sector adjacent to the crural and ambiens cisterns can be carefully resected while dissecting the posterior communicant artery and perforating vessels. If a tumor extends significantly in the inferior direction to the cerebellopontine angle, an anterior petrosectomy may be necessary. However, it was not required in this case. The anterior segment of the tumor is gradually dissected, following the ipsilateral and contralateral A1 segments of the anterior cerebral artery. After performing devascularization, central and superior debulking of the mass was continued, although given the hard consistency of the tumor and its capsule, it was decided to perform a staged frontal craniotomy. This procedure was conducted through a small right frontal coronal craniotomy, with a small transcortical approach used to reach the right lateral ventricle. Central debulking was then performed, followed by medial dissection of the capsule through the arachnoid plane from the anterior cerebral artery A2 and A3 segments and lateral dissection from the superior trunk of the middle cerebral artery. Finally, the dissection was carefully performed from the superior aspects of optic nerves and chiasm.
4.277344
0.703613
sec[2]/sec[3]/p[0]
en
0.999995
PMC10296272
https://doi.org/10.3390/brainsci13060916
[ "tumor", "artery", "middle", "carotid", "this", "cerebral", "fossa", "dissection", "optic", "arteries" ]
[ { "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": "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 === [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 [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 --- [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--> [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... --EXCLUDES--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- 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... --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 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--> [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 --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system", "[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", "[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
Mrs KA was a 37 year old Gravida 6 Para 0 +5 / (G6P0 +5 / ), who presented to the University of Port Harcourt Teaching Hospital (UPTH) on the 28th October, 2015 at 28 weeks gestation with history of weakness and occasional gingival bleeding of 2 months duration. She had never had these complaints prior to pregnancy. She had no history of jaundice, haematuria, bleeding from any other orifice or spontaneous bruising. There was no familial history of similar experience. She admitted taking some local oral herbal medications for secondary infertility of 3 years duration. She took this herbal medication for about 18 months and stopped one year before pregnancy was achieved spontaneously. The symptoms of weakness and gingival bleeding started at about 20 weeks of gestation. Prior to presentation at UPTH, she had received 5 units of whole blood transfusion in a private clinic over a period of four weeks. She was married to a 39 year old unemployed graduate and most of the financial aspect of her care was handled by her siblings. She came on self referral following her elder sisters' insistence. On examination at presentation, she was markedly pale, afebrile, anicteric and had no pedal edema. Her blood pressure was 120/70mmHg and pulse rate was 90 beats per minute. Her abdomen was gravidly enlarged with a symphisio-fundal height of 29cm and a singleton active fetus. She was reviewed with the haematology team, admitted, investigations commenced and placed on double dose haematinics and antimalarials. Her investigations at presentation revealed: low Haemoglobin (Hb) of 7g/dl, normal White Blood Cell (WBC) Count and Absolute Neutrophil Count (ANC) of 5.1 X10 9 //L and 2.6 X10 9 //L respectively with low Platelet Count of 07 X10 9 //L and a low Absolute Reticulocyte Count (ARC) 21 X 10 9 //L. Significant peripheral blood film findings were a normochromic, normocytic anaemia with severe thrombocytopoenia. There were no blasts neither was there dysplasia. Her blood group was B+, Hb genotype was HbAA and direct antiglobulin test was negative. Screening for HIV, hepatitis B and C were all negative. Her urinalysis was normal. Stool analysis showed no abnormality. Obstetric ultrasonography noted an active singleton fetus at 27 weeks. For unforeseen reasons, she was only able to get a bone marrow aspiration and biopsy done 2 weeks after admission. BM aspiration revealed a hypocellular (marrow cellularity 20%), fatty marrow with depressed erythropoiesis, granulopoiesis, megakaryopoiesis and no associated dysplasia or blasts . The BM biopsy confirmed the diagnosis of aplastic anaemia. She received 7 units of fresh whole blood transfusion over a period of 2 weeks. Her post transfusion Hb was 10g/dl, ANC was 2.2 X10 9 //L and platelet count was 8 X10 9 //L. She was placed on weekly fresh whole blood transfusion as platelet concentrate was unavailable. At 33 weeks gestation, she developed hypertension and was commenced on oral antihypertensive agents. However, following serial obstetric ultrasonography that noted moderate oligohydraminous and an estimated fetal weight of 2.6kg at 37weeks gestation, she had emergency caesarean section on 31/12/15. Thirty minutes prior to the surgery and also intra-operatively, she received more fresh whole blood transfusions. She was delivered of a live male neonate of birth weight 2.9kg, with Apgar scores of 8 and 9 in the first and fifth minute respectively. Estimated blood loss was 800mls. She was observed in the intensive care unit for 24 hours and later transferred to the postnatal ward. She made good clinical improvement on broad spectrum parenteral antibiotics, analgesics, haematinics and whole blood transfusions as platelet concentrate remained unavailable. Her Hb on the second post operative day was 13g/dl, WBC 3.7 X10 9 //L, ANC was 1.5 X10 9 //L while platelet count was 02 X10 9 //L. She was also noticed to have developed fresh purpura and petechial haemorrhages on her limbs, shoulder and trunk. . Due to unavailability of platelet concentrates, she received 2 more units of fresh whole blood. She was also commenced on Cyclosporine 300mg twice daily while arrangements were being made to secure platelet concentrate from another centre, as the anaemia had been corrected. Her clinical condition improved despite the severe thrombocytopoenia; gingival bleeding reduced and the petechial haemorrhages resolved. She was discharged home on the 10 th / day postpartum following patient and relatives' complaints of financial and psychological issues with continuous admission. Her Hb was 14.7g/dl, WBC 4.0 X10 9 //L, ANC 1.9 X10 9 //L while platelet count was 8 X10 9 //L. A repeat bone marrow biopsy was not done. She was to continue with weekly outpatient appointment to the haematology clinic. She however defaulted for eight weeks. She was seen thereafter and is presently on cyclosporine and encouraged to continue follow-up.
3.888672
0.983398
sec[1]/p[0]
en
0.999995
28154632
https://doi.org/10.11604/pamj.2016.24.277.9880
[ "blood", "platelet", "count", "whole", "fresh", "gestation", "bleeding", "transfusion", "marrow", "gingival" ]
[ { "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.... --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.... --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 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... --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--> [MA12.2] Finding of hallucinogen 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 --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 --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 --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 ...", "[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 --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--> [MA12.2] Finding of hallucinogen 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 --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 63-year-old man presented at our hospital with abdominal distension and diarrhoea 1 month before hospital admission. Apart from elevated serum γ-glutamyltranspeptidase (233 U/L; normal range, 9 to 35 U/L), carcinoembryonic antigen (CEA) (89.3 ng/ml; range, 0 to 5 ng/ml), carbohydrate antigen 19-9 (CA 19-9) (2,052 U/ml; range, 0 to 37 U/ml) and hepatomegaly, all other systems and laboratory findings were normal. A colonoscopy revealed intraluminal stenosis with a reddish, irregularly shaped mass located in the ascending colon, 15.5 cm from the ileocaecal valve, so biopsy specimens were obtained. An open right hemicolectomy with ileotransverse anastomosis was performed. Intraoperatively, the interior surface of the colon demonstrated an invasive, exophytic, crater-like tumour. The clinical and pathological information about the patient is summarized in Table 1 . A microscopic examination showed an infiltrating tumour of the ascending colon, measuring 3.5 × 3.0 × 2.6 cm with extension into the pericolic fat and mesenteric lymphatics (involving 10 of 23 regional lymph nodes), with neural and vascular invasion. Histological sections revealed a connection to the intestinal mucosa with extension into the underlying muscularis propria, but without serosal affection. The tubular resection margins were without tumour involvement. The immunohistochemical stains (cytokeratin AE1/AE3 (CKAE1/AE3)–positive, chromogranin A (CgA)–positive, synaptophysin-positive, antigen Ki-67 (Ki-67) at 60%, with >20 mitoses/10 high-power fields (hpf)) supported the diagnosis of a metastatic, poorly differentiated form of high-grade colon adenocarcinoma (grade G3, pT3pN2bpM1a, Astler-Coller classification D, American Joint Committee on Cancer (AJCC) stage IVA) . Genetic testing for mutations in codons 12 or 13 of the KRAS gene was negative. Moreover, a mass in Meckel’s diverticulum, 8.7 cm proximal to the ileocaecal valve, was encountered. The histological examination revealed a firm, grey-white tumour composed of neoplastic neuroendocrine cells in the submucosa arranged in a nesting pattern measuring 3 × 2 × 2 cm. There was penetration of the muscular layer and lymphatic vessels, but without serosal, neural or vascular invasion. The resection margins were free of tumour. Immunohistochemical staging confirmed a well-differentiated, low-grade GEP-NET (low grade (grade G1), pT3pN0pM0, AJCC stage IIB, CKAE1/AE3–positive, CgA–positive, synaptophysin-positive, Ki-67 at 3%, with 2 mitoses/10 hpf, without necrosis) according to World Health Organisation and European Neuroendocrine Tumour Society guidelines. There was evidence of multiple hepatic metastases from colon carcinoma, based on abdominal ultrasonography, computed tomography (CT) and liver biopsy specimens. The postoperative indium-111-diethylenetriaminepentaacetic acid-D-phenylalanine-octreotide scintigraphy result was negative. Table 1 Clinical and pathological data of the patient a Colon adenocarcinoma Neuroendocrine tumour Tumour size 3.5 × 3.0 × 2.6 cm 3 × 2 × 2 cm Fat tissue invasion + - Lymph node invasion + (10/23) - (0/23) Perineural invasion + - Vascular invasion + - Lymphatic vessel invasion + + Muscularis propria invasion + + Serosal invasion + - Resection margins - - Tumour necrosis - - CKAE1/AE3 + + CgA + + KRAS - Not applicable Synaptophysin + + Ki-67 60% 3% Mitoses/10 hpf >20 ≤2 Grade of the cancer High grade (G3) Low grade (G1) Astler-Coller classification D Not applicable TNM stage pT3pN2bpM1a pT3pN0pM0 AJCC clinical stage IVA IIB a AJCC, American Joint Committee on Cancer; CgA, Chromogranin A; CKAE1/AE3, Cytokeratin AE1/AE3; hpf, High-power fields; Ki-67, Antigen Ki-67; KRAS , v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog; TNM, Tumour, node, metastasis classification of malignant tumours. Figure 1 Histological and immunohistochemical stains of colon adenocarcinoma. (a) Solid tumour nests and large polygonal cells (haematoxylin and eosin stain; original magnification, ×400). Immunohistochemical stains reveal positive findings for synaptophysin (b) (original magnification, ×400), cytokeratin AE1/AE3 (c) (original magnification, ×400) and chromogranin A (d) (original magnification, ×400). (e) Antigen Ki-67 immunostaging was positive in 60% of tumour cells (original magnification, ×400). Figure 2 Histological and immunohistochemical stains of Meckel’s diverticulum. (a) Moderately differentiated neuroendocrine tumour (haematoxylin and eosin stain; original magnification, ×400). Tumour cells show cytoplasmic staining for synaptophysin (b) (original magnification, ×400), cytokeratin AE1/AE3 (c) (original magnification, ×400) and chromogranin A (d) (original magnification, ×400). (e) Antigen Ki-67 immunostaging was positive in 3% of tumour cells. (original magnification, ×400). Figure 3 Radiological evaluation of liver metastases. (a) Ultrasound. (b) Unenhanced computed tomographic scan.
4.121094
0.969727
sec[1]/p[0]
en
0.999997
25427657
https://doi.org/10.1186/1477-7819-12-358
[ "tumour", "original", "magnification", "invasion", "grade", "colon", "antigen", "immunohistochemical", "synaptophysin", "cells" ]
[ { "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": "BC00", "title": "Multiple valve disease" }, { "code": "GA31.Z", "title": "Female infertility without specification whether primary or secondary" }, { "code": "GA31.01", "title": "Primary female infertility of tubal origin" }, { "code": "GA31.00", "title": "Primary female infertility of uterine origin" }, { "code": "LA8B.Y", "title": "Other specified congenital anomaly of great arteries including arterial duct" } ]
=== 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 [BC00] Multiple valve disease Also known as: Multiple valve disease | Multiple valve disease of unspecified origin | multiple valvular cardiac dysfunction | multivalvular cardiac dysfunction | Disorders of both mitral and aortic valves [GA31.Z] Female infertility without specification whether primary or secondary Also known as: Female infertility without specification whether primary or secondary | Female infertility | female infertility of unspecified origin | female sterility NOS | inability to achieve a pregnancy [GA31.01] Primary female infertility of tubal origin Definition: Female infertility caused by dysfunction of one or both fallopian tubes, usually related to pelvic adhesions or occurring after pelvic surgery, with or without hydrosalpinx Also known as: Primary female infertility of tubal origin | infertility of tubal origin NOS | Fallopian tube occlusion | blocked fallopian tube | fallopian tube obstruction [GA31.00] Primary female infertility of uterine origin Definition: Female infertility caused by uterine abnormalities on the level of the endometrium or myometrium, with more detailed description classified elsewhere, i.e. under genitourinary infections, STDs and noninflammatory benign gynaecological disease Also known as: Primary female infertility of uterine origin | infertility of uterine origin NOS | Female infertility associated with congenital anomaly of uterus | infertility associated with congenital anomaly of uterus | Nonimplantation of ovum [LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct Also known as: Other specified congenital anomaly of great arteries including arterial duct | Congenital arterial duct anomaly | Congenital ductus arteriosus anomaly | ductus arteriosus deformity | Ductus arteriosus agenesis === 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 --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- 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--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --PARENT--> [?] General symptoms --- 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--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- 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 --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....
[ "[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 --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[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 --PARENT--> [?] General symptoms", "[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--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital 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", "[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...." ]
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
The first typical case was a 23-year-old female from the Jiangsu Province who had extensive AV malformations in the left chest wall. She had previously undergone 5 rounds of superselective arterial embolization and multiple injection sclerotherapy outside the hospital; however, the effects of these treatment methods were not good. The lesion continued to grow, and the pain in the lesion area was obvious in the past year. The pain was severe at night, affecting sleep and causing palpitation, shortness of breath, and difficulty getting up the stairs. The patient was admitted to the hospital on December 1, 2014. A physical examination showed an obvious tumor protuberance on the left side of the chest and back, an obvious increase in local skin temperature, palpable lifting pulsation and tremor, and a grade IV wind-like murmur during auscultation. Diagnosis: extensive AV malformations in the left chest wall with cardiac insufficiency. Multidisciplinary consultation showed that the patient had a wide range of lesions involving major thoracic vessels and other important structures, bone destruction, and multiple ribs and thoracic vertebrae . The surgical approach was difficult, and the possibility of causing uncontrollable massive bleeding during the operation was high. The risk of this method is still great even if the tissue defect is difficult to repair after resection; thus, it was not a suitable choice for the operation. Additionally, many thick blood supply arteries of the lesion originated directly from the thoracic aorta, and the collateral vessels and AV fistulas were extremely abundant . Arterial and local interventional embolization may not be effective; however, embolization has been carried out several times in many large hospitals at a higher level. Clinical practice has proven that the lesion is still progressive and uncontrolled after treatment, and percutaneous radiofrequency ablation under ultra-real-time color monitoring can be performed. After 4 rounds (3–4 points each) of radiofrequency ablation treatment, the lesion was significantly reduced and the localized tenderness completely relieved. Moreover, the core tumor disappeared, the cardiac function gradually recovered, and shortness of breath and palpitations improved. Reexamination 3 years after treatment: the lesions of the left erector spine and intercostal muscles were further reduced and thinned; over 75% of the original enhanced lesions showed low density changes. The patient had a normal life with a grade III (good) curative effect evaluation. Fig. 1 The comparison of diseased blood vessels and collateral vessels before and after treatment. a Before treatment, the lesion of the left chest and back was obviously raised and convex. b After treatment, the lesion of the left chest and back was obviously reduced, and multiple ablation needle marks were seen on the surface skin. c The pre-treatment CTA results showed that the lesion involved the left posterior chest wall, bone destruction, and multiple ribs and thoracic vertebrae. The lesion was obviously protruded into the chest, multiple blood supply arteries were enlarged, directly from the thoracic aorta, the collateral vessels were extremely abundant, and the lesions were obviously enhanced. d After treatment, the left erector spine lesions and intercostal muscles present in the CTA were significantly reduced and thinned. Most of the original enhanced lesions showed a low density, and the blood supply and collateral vessel number decreased significantly. e The CTA case comparison before and after treatment (3-year reexamination) showed that the left erector spine lesions and intercostal muscles had been further reduced and thinned. Most of the original enhanced lesions showed a low density, and the blood supply arteries and collateral vessels decreased significantly Fig. 2 Facial lesion comparison before and after treatment. a Appearance before treatment: facial lesions have a high skin temperature, with obvious arterial pulsation, intraoral gingival thickening, tongue body thickening, and tongue body thickening. b After treatment, the facial lesions significantly reduced, the color recovered, the tongue body became smaller, and the gingival lesions disappeared. c After 2 years of treatment, the face was basically symmetrical, the skin color was close to normal, and there was no facial paralysis. d The CTA showed diffuse enhancement of right maxillofacial tongue lesions, and right neck A significantly circuitous thickening and increased. The diseased tongue filled the whole mouth. The pharyngeal cavity narrowed. e After treatment, the CTA showed low density changes in over 85% of the original tongue floor and facial enhancement lesions. Most of the abnormal blood supply arteries and collateral vessels disappeared, the diseased tongue body was significantly reduced, and the pharyngeal cavity was recovered
4.015625
0.977051
sec[2]/sec[3]/p[0]
en
0.999998
34344307
https://doi.org/10.1186/s12872-021-02169-1
[ "lesions", "lesion", "chest", "vessels", "significantly", "tongue", "blood", "collateral", "multiple", "thoracic" ]
[ { "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": "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 === [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 [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 --- [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--> [?] Inflammatory arthropathies --- 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.... --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... --- 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.... --EXCLUDES--> [?] Endocrine, nutritional or metabolic diseases Def: This chapter includes endocrine diseases, nutritional diseases as well as metabolic diseases.... --- 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... --CHILD--> [ME60.2] Ulcer of skin of uncertain nature Def: This denotes the presence of a skin ulcer but uncertainty as to its nature. No inference as to whether the ulcer might be of serious significance (e.g. suspected skin cancer) is made.... --- 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--> [?] Inflammatory 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 --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...", "[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....", "[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--> [ME60.2] Ulcer of skin of uncertain nature\n Def: This denotes the presence of a skin ulcer but uncertainty as to its nature. No inference as to whether the ulcer might be of serious significance (e.g. suspected skin cancer) is made....", "[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": "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" } ]
M00-M25
A Caucasian male patient with a history of a (follicular type) papillary thyroid carcinoma resected in toto at the age of 36 years , was scheduled for a staging CT scan after incomplete resection (R1) of a highly-differentiated verrucous (squamous cell) carcinoma (VC) of the lower lip (staged as pT1 (C4), pNx (C2), pMx (C2), G1 (squamous intraepithelial neoplasia SIN1)) at the age of 42 years. In imaging findings, suspect peritoneal lesions consistent with peritoneal metastases from colorectal carcinoma were observed and confirmed as metabolically active by ( 18 F)-FDG PET/CT, without any positive mediastinal lymph nodes. However, a colonoscopy and gastroscopy remained without pathological findings. The ensuing diagnostic laparoscopy confirmed disseminated nodular lesions spread over the small bowel, transversal colon and the liver, which were diagnosed as a differentiated epithelioid mesothelioma with papillary growth type (pan-Cytokeratin (+++) ; Vimentin (+) ; CK5/6 (+) ; BerEp4 neg. ; GLUT1 neg ; MIB-1 + ~ 5%) . Subsequently, the patient was scheduled for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC; with Cisplatin (75 mg/m 2 body surface area)/ Doxorubicin (15 mg/m 2 body surface area) for 60 min at 42 °C target temperature). During CRS, peritonectomy, omentectomy and ileum-segment resection was performed and the disseminated tumor (PCI score: 20) was macroscopically completely resected (CC-0) . The resected MPM (staged pTx, pNx, cM0) was additionally found to be positive for nuclear WT1 (+) , membrane-bound podoplanin (D2–40) (+) and calretinin (+++) in immuno-histochemistry . Since an established staging system for peritoneal mesothelioma is lacking, the findings may be classified as a T2 tumor according to a clinicopathological staging system proposed in 2011 . Repeated abdominal and thoracic CT scans remained without signs of recurrence during a two-year follow-up period after CRS and HIPEC . The patient’s medical history includes a history of smoking (until the age of 42 years), such as occupational exposure to asbestos and an axial hiatal hernia with gastroesophageal reflux disease (GERD). The patient, a carpenter by profession reported frequent occupational exposure to fibre cement roofing, containing mainly chrysotile asbestos for a period of about seven years, starting 25 years previous to being diagnosed with MPM. He was additionally exposed to asbestos containing industrial flooring in the course of building renovations, during a subsequent 5 years period. A thoracic CT scan confirmed diffuse bipulmonal thickening, appearing as milky spots and nodules remaining of constant size over time, as well as emphysematous alterations of parenchymatous lung tissue, without any lesions suspicious of malignancy. Of note, no gastrointestinal or B symptoms were apparent before diagnosis of MPM. Further, no known history of familial cancer in the parents and the father’s seven siblings was reported, but there was a history of colon cancer and bladder cancer in two of the three brothers of the mother . On examination, the patient presented with macrocephaly (head circumference 64 cm) as well as oro-laryngeal and cutaneous papillomatosis. Macrocephaly was also reported in the patient’s father. The patient fathered three children, one of whom was reported to be macrocephalic and a second was diagnosed with papilloma of the skin. Further segregation analysis was recommended. The oro-laryngeal papillomas of the aerodigestive tract showed degeneration into a highly-differentiated verrucous squamous neoplasia and had to be resected on multiple occasions , but apart from an extensive acanthosis and papillomatosis of the lesions, these were characterized by missing HPV and fungal infection, such as a low proliferation rate (MIB-1; p16 neg. ) and showed only a discrete lymphocytic infiltrate. Fig. 1 ( a ) Timeline. Relevant events, depicted in the clinical course of the patient (respective age is given in years) with focus on diagnosis and interventions, are represented in a chronological order (time line is not true to scale, colors on both sides correspond to each other). ( b ) Pedigree chart. The index patient presented with macrocephaly, typical mucocutaneous lesions and a history of different tumor diseases. He was diagnosed with thyroid cancer at the age of 36 years and with a verrucous carcinoma (VC) and malignant peritoneal mesothelioma (MPM) at the age of 42 years. The combination of the clinical symptoms subsequently led to the clinical diagnosis of PTEN-hamartoma tumor syndrome (PHTS). The patient stated that one of his sons and his father were also macrocephalic (III:2, I:1). Another son was reported to have cutaneous papillomatosis (III:1). The arrow marks the index patient, squares males and circles females. Filled symbols indicate clinical symptoms that support the diagnosis of PHTS
4.128906
0.967285
sec[1]/p[0]
en
0.999995
30111295
https://doi.org/10.1186/s12881-018-0651-4
[ "lesions", "carcinoma", "resected", "peritoneal", "without", "diagnosed", "tumor", "cancer", "staging", "differentiated" ]
[ { "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": "2D41", "title": "Unspecified carcinoma of unspecified site" }, { "code": "2C3Y", "title": "Other specified malignant neoplasms of skin" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2C25.5", "title": "Unspecified malignant epithelial neoplasm of bronchus or lung" }, { "code": "2C90.Y", "title": "Other specified malignant neoplasms of kidney, except renal pelvis" } ]
=== 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 [2D41] Unspecified carcinoma of unspecified site Also known as: Unspecified carcinoma of unspecified site | carcinoma of unspecified primary site | carcinoma NOS | Carcinoma in polyp of unspecified site | Carcinoma with apocrine metaplasia of unspecified site [2C3Y] Other specified malignant neoplasms of skin Also known as: Other specified malignant neoplasms of skin | Malignant neoplasm of eyelid NOS | Malignant pilonidal cyst | Radiotherapy-induced skin malignancy | Cutaneous carcinoma [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 [2C25.5] Unspecified malignant epithelial neoplasm of bronchus or lung Also known as: Unspecified malignant epithelial neoplasm of bronchus or lung | unspecified carcinoma of bronchus or lung | Metastatic lung carcinoma [primary lung carcinoma spreading elsewhere] | Metastatic carcinoma of lung [primary carcinoma of lung spreading elsewhere] | Lung carcinoma [2C90.Y] Other specified malignant neoplasms of kidney, except renal pelvis Also known as: Other specified malignant neoplasms of kidney, except renal pelvis | Congenital mesoblastic nephroma | Nephroblastoma | Wilms tumour of kidney | Wilms tumour of unspecified site Includes: Nephroblastoma === GRAPH WALKS === --- Walk 1 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Inflammatory arthropathies --- Walk 2 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Infection related arthropathies Def: A disease of the joints, caused by an infection with a bacterial, viral, fungal, or parasitic source. Distinction is made between the following types of etiological relationship. a) direct infection ... --- 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.... --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 --- [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 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... --CHILD--> [ME60.1] Pigmented skin lesion of uncertain nature Def: This denotes the presence of a pigmented 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.... --- 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--> [?] Inflammatory arthropathies", "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Infection related arthropathies\n Def: A disease of the joints, caused by an infection with a bacterial, viral, fungal, or parasitic source.\n\nDistinction is made between the following types of etiological relationship.\na) direct infection ...", "[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--> [?] 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 ...", "[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", "[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--> [ME60.1] Pigmented skin lesion of uncertain nature\n Def: This denotes the presence of a pigmented 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....", "[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": "2E6Z", "icd10_code": "D098", "icd10_title": "Carcinoma in situ of other specified sites" }, { "from_icd11": "2E6Z", "icd10_code": "D099", "icd10_title": "Carcinoma in situ, unspecified" }, { "from_icd11": "2E6Z", "icd10_code": "D00-D09", "icd10_title": "" }, { "from_icd11": "2E6Z", "icd10_code": "D09", "icd10_title": "Carcinoma in situ of other and unspecified sites" }, { "from_icd11": "2E6Z", "icd10_code": "D097", "icd10_title": "" } ]
M00-M25
A 16-year-old female presented to the emergency department with severe anemia (Hb 5.7 g/dL, mean corpuscular volume (MCV) 40.9 fL, hematocrit 21%,) identified while she was undergoing evaluations for a year-long history of reduced food intake with associated weight loss (−20 kg in 1 year) and chronic constipation. She was under treatment for a major depressive disorder; treatment consisted of paroxetine and olanzapine. In the emergency department, blood samples confirmed severe anemia with hypoferritinemia, and she was admitted to the pediatric ward to undergo further evaluations. Physical examination and subsequent imaging revealed a large encapsulated abdominal mass of 8.8 × 8.4 cm in the pancreatic head-body region without clear invasion of adjacent structures . She was then transferred to the pediatric oncology ward; a full body CT scan excluded the presence of distant metastasis; tumoral markers (AFP, beta-HCG, and CEA) and serological screening for infectious diseases were negative. She underwent an ultrasound-guided biopsy of the lesion, which led to the diagnosis of a SPN of the pancreas. Nine days later, she underwent laparotomy (inverted-Y laparotomy) with enucleation of the pancreatic tumor. Intraoperative findings showed an encapsulated mass adherent but not macroscopically infiltrating the duodenum and mesocolon. The tumor was completely resected with clear surgical margins; the mass had a maximum diameter of 9.5 cm, and three regional lymph nodes were removed for histological analysis. The surgery was conducted by pediatric surgeons of our institution after multidisciplinary discussion with adult pancreatic surgeons. Anatomopathological examination of the lesion confirmed the diagnosis of an SPN of the pancreas with diffuse positivity and aberrant nuclear expression of beta-catenin. Chromogranin A was negative; Ki67 was 5%. There were no signs of vascular or perineural invasion; the surgical margins were clear of disease. The three lymph nodes which were removed were free of tumor cells. Postoperatively, the patient developed a pancreatic fistula confirmed by an increase of drain output from the abdominal drainage and by high levels of amylase in the abdominal drain output, which was initially managed conservatively with dietary changes (low-fat diet) and octreotide therapy. Imaging showed a small fluid collection near the major pancreatic duct with no signs of peripancreatic abscesses. Endoscopic retrograde cholangiopancreatography (ERCP) was attempted 12 days later but failed to cannulate the pancreatic duct. A subsequent ERCP 9 days later showed a minor leakage from the main pancreatic duct into the adjacent fluid collection; conservative management was confirmed, and with dietary management and slow tapering of octreotide therapy, the fistula resolved in another 4 days, almost a month from the initial surgery. During follow-up, almost 2 months later, the patient developed acute pancreatitis, which was managed conservatively with no recurrence of fluid collections near the pancreas. However, an abdominal MRI showed a small hepatic lesion of 7 mm in segment VII–VI, hyperechoic with no other distinctive features, which was suspected to be a metastatic lesion and was subjected to strict radiological and clinical follow-up. The lesion grew during follow-up with a very slow growth rate, and 20 months after the initial surgery, it exceeded 1 cm on its longer axis. Furthermore, a similar lesion of 6 mm was now visible adjacent to the known lesion with similar radiological characteristics . The patient was admitted to the pediatric surgery ward, and after multidisciplinary discussion involving pediatric oncologists, adult pancreatic surgeons, and pediatric surgeons, she underwent a percutaneous ultrasound-guided liver biopsy that confirmed the metastatic nature of the lesion with immunohistochemical findings matching the primary lesion. A new laparotomy on the previous incision was performed; intraoperative ultrasound was used to localize the two lesions, which were confirmed to be between segment VII and VI. A Pringle maneuver was performed, and a 2.5 wedge of hepatic tissue encompassing both lesions was resected with adequate surgical margins. Biliary leakage on the resection margin was sutured, and hemostasis was achieved with haemostatic agents and fibrin sealant. One enlarged retroperitoneal lymph node was resected for histopathological analysis. Two abdominal drains were placed; the postoperative course was uneventful, with the patient resuming oral intake by the fourth postoperative day. Histological analysis of the resected lesions confirmed their metastatic nature with an immunohistochemical profile identical to the primary lesion and the tissue from the subsequent liver biopsy. Currently, the patient is undergoing regular follow-up (3 and a half year from the first surgery) with no evidence of recurrence.
4.015625
0.977051
sec[2]/sec[0]/p[0]
en
0.999998
40487841
https://doi.org/10.1155/crom/8183273
[ "lesion", "pancreatic", "pediatric", "which", "abdominal", "resected", "surgeons", "ward", "clear", "adjacent" ]
[ { "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": "DC3Z", "title": "Diseases of pancreas, unspecified" }, { "code": "DC3Y", "title": "Other specified diseases of pancreas" }, { "code": "LB21.3", "title": "Agenesis-aplasia of pancreas" }, { "code": "LB21.Z", "title": "Structural developmental anomalies of pancreas, unspecified" }, { "code": "DC35.0", "title": "Atrophy of pancreas" } ]
=== 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 [DC3Z] Diseases of pancreas, unspecified Also known as: Diseases of pancreas, unspecified [DC3Y] Other specified diseases of pancreas Also known as: Other specified diseases of pancreas | Calculus of pancreas | pancreas calculi | pancreas duct calculus | pancreas duct lithiasis [LB21.3] Agenesis-aplasia of pancreas Definition: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas. Also known as: Agenesis-aplasia of pancreas | Congenital absence of pancreas | Congenital pancreas absence | Congenital pancreatic absence | Absent pancreas [LB21.Z] Structural developmental anomalies of pancreas, unspecified Also known as: Structural developmental anomalies of pancreas, unspecified | Structural developmental anomalies of pancreas | malformations of pancreas | anomalies of pancreas | congenital abnormality of pancreas [DC35.0] Atrophy of pancreas Also known as: Atrophy of pancreas | pancreatic atrophy | pancreas ductal atrophy === GRAPH WALKS === --- Walk 1 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Inflammatory arthropathies --- Walk 2 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --- 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.... --EXCLUDES--> [?] Endocrine, nutritional or metabolic diseases Def: This chapter includes endocrine diseases, nutritional diseases as well as metabolic diseases.... --- 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--> [?] Monogenic autoinflammatory syndromes Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies.... --- 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... --CHILD--> [ME60.2] Ulcer of skin of uncertain nature Def: This denotes the presence of a skin ulcer but uncertainty as to its nature. No inference as to whether the ulcer might be of serious significance (e.g. suspected skin cancer) is made.... --- 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--> [?] Inflammatory arthropathies", "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\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....", "[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....", "[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....", "[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--> [ME60.2] Ulcer of skin of uncertain nature\n Def: This denotes the presence of a skin ulcer but uncertainty as to its nature. No inference as to whether the ulcer might be of serious significance (e.g. suspected skin cancer) is made....", "[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": "DC3Z", "icd10_code": "K8681", "icd10_title": "Exocrine pancreatic insufficiency" }, { "from_icd11": "DC3Z", "icd10_code": "K8689", "icd10_title": "Other specified diseases of pancreas" }, { "from_icd11": "DC3Z", "icd10_code": "K869", "icd10_title": "Disease of pancreas, unspecified" }, { "from_icd11": "DC3Z", "icd10_code": "K868", "icd10_title": "Other specified diseases of pancreas" }, { "from_icd11": "DC3Z", "icd10_code": "K87", "icd10_title": "Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere" }, { "from_icd11": "DC3Z", "icd10_code": "K80-K87", "icd10_title": "" }, { "from_icd11": "DC3Z", "icd10_code": "K86", "icd10_title": "Other diseases of pancreas" }, { "from_icd11": "DC3Z", "icd10_code": "K871", "icd10_title": "" }, { "from_icd11": "LB21.Z", "icd10_code": "Q450", "icd10_title": "Agenesis, aplasia and hypoplasia of pancreas" }, { "from_icd11": "LB21.Z", "icd10_code": "Q38-Q45", "icd10_title": "" } ]
M00-M25
Written informed consent for the publication of this case was obtained from the patient. A 56-year-old man (height, 165 cm; weight, 70 kg) with no significant medical history presented to the emergency room complaining of right chest pain, chest congestion and shortness of breath after sustaining blunt trauma to the right chest. His vital signs were as follows: heart rate (HR), 91 beats/min; respiratory rate (RR), 34 breaths/min; blood pressure (BP), 108/71 mmHg; and initial pulse oximetry saturation (SpO 2) of 85%. Arterial blood gas: PH 7.35, PaCO 2 47 mmHg, and PaO 2 49 mmHg. Flail chest and paradoxical breathing were evident. Significant subcutaneous emphysema in neck and anterior chest area was diagnosed with marked crepitus throughout. Computed Tomography (CT) scan showed massive subcutaneous emphysema, pneumomediastinum, multiple rib fractures, bilateral hemopneumothorax and compressive pneumothorax . The sternocostal articulation displacement was seen and the sternal portion of the right first rib penetrated the posterior tracheal wall above the carina . Chest tube was inserted to decompress pneumothoraxes and hemopneumothorax, and breathing difficulties were alleviated. Unfortunately, rapid worsening of subcutaneous emphysema indicated continuous air leak from laceration after 3 h. The patient developed respiratory distress and became hemodynamically unstable. Emergent CT demonstrated that the right first rib penetrated the posterior tracheal wall up to approximately 6 cm below the glottis and 6 cm above the carina . The first rib divided the trachea into two parts, 5.3 mm in diameter on the left and 6.6 mm on the right . The patient was quickly transferred to the operation room. He was agitated, in respiratory distress and his vital signs were: HR 108 beats/min; RR 30 breaths/min; BP 90/58 mmHg and SpO 2 80%. We maintained the hemodynamic stability with intravenous phenylephrine. A fiberoptic bronchoscope was immediately available with different sized endotracheal tubes. General anesthesia was induced with midazolam 2 mg, fentanyl 0.05 mg and 2%~ 5% sevoflurane while maintaining spontaneous ventilation. A sterile flexible fiberoptic bronchoscope loaded with a 5.5 mm endotracheal tube (outer diameter 7.3 mm) identified the laceration of the trachea and the endotracheal tube was advanced distally past the laceration site. He was spontaneously breathing with fraction of inspired oxygen 100%, tidal volume 330 ml, frequency 30, SpO 2 95% and end-tidal carbon dioxide partial pressure (PetCO 2 ) 40 mmHg. Depth of anesthesia was maintained to achieve a Bispectral Index Score of 40–60. The thoracic cavity was opened to expose the right first rib by the surgical team and the right first rib was removed approximately 30 min later . A 7.5 mm endotracheal tube was then exchanged and positioned distally to the laceration with the guidance of flexible bronchoscopy. Once confirmed location of the endotracheal tube, cisatracurium 14 mg and fentanyl 0.15 mg were administered intravenously. The patient was managed on mechanical ventilation with interval positive pressure ventilation. The respiratory parameters were: fraction of inspired oxygen 60%, tidal volume 550 ml, frequency12, airway peak pressure 22 cm H 2 O, SpO 2 98% and PetCO 2 38 mmHg. Direct surgical repair of the tracheal laceration was successful and he was transferred to the ICU intubated. In ICU, he was managed on the ventilator with synchronized intermittent mandatory ventilation and continuous positive airway pressure. In order to improve pulmonary function, elective surgical repairs of sternum fracture, multiple rib fractures and hemopneumothorax under general anesthesia were performed on day 5 after first surgery and the patient was extubated on postoperative day 7. Repeated CT demonstrated the integrity of tracheal wall . Comprehensive rehabilitation was done for 2 weeks and he was discharged home on postoperative day 41. Fig. 1 Thoracic CT scan showing massive subcutaneous emphysema, pneumomediastinum, multiple rib fractures, bilateral hemopneumothorax and compressive pneumothorax on pulmonary ( a ) and mediastinal ( b ) window Fig. 2 CT scans of multi-slice technique showing the tracheal laceration secondary to the dislocation of right first rib. a Sagittal CT image of the chest. b Axial CT image of the chest. (C) Volume rendering of thorax Fig. 3 Preoperative evaluation of Tracheobronchial lacerations by a high-resolution CT. a Sagittal CT image of the chest showing the posterior tracheal wall laceration up to 59.81 mm below the glottis and 63.76 mm above the carina. b , c Axial CT image of the chest showing the bone shadow in the trachea; the residual largest cavity of the trachea on the left was 5.33 mm in diameter and 6.66 mm on the right Fig. 4 a The right first rib was removed. b Postoperative chest CT-scan showing the integrity of posterior tracheal wall
3.859375
0.976563
sec[1]/p[0]
en
0.999998
31399024
https://doi.org/10.1186/s12871-019-0812-9
[ "chest", "tracheal", "laceration", "mmhg", "pressure", "wall", "tube", "endotracheal", "respiratory", "subcutaneous" ]
[ { "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": "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" } ]
=== 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 [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 === GRAPH WALKS === --- Walk 1 --- [CB7Z] Diseases of the respiratory system, unspecified --PARENT--> [12] Diseases of the respiratory system --CHILD--> [?] Certain lower respiratory tract diseases Def: This group refers to diseases of airways that forms the connection between the outside world and the terminal respiratory unit. Intrapulmonary airways are divided into three major groups; bronchi, mem... --- Walk 2 --- [CB7Z] Diseases of the respiratory system, unspecified --PARENT--> [12] Diseases of the respiratory system --RELATED_TO--> [?] Symptoms, signs or clinical findings of the respiratory system --- Walk 3 --- [CB27] Pleural effusion Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.... --EXCLUDES--> [?] Chylous effusion Def: A chylothorax (chylous effusion) signifies leakage of chyle from the thoracic duct. A pleural fluid triglyceride concentration of more than 110 mg per decilitre signifies a high likelihood of chylotho... --PARENT--> [?] Other pleural conditions Def: Any other condition effecting the thin serous membrane enveloping the lungs and lining the thoracic cavity... --- Walk 4 --- [CB27] Pleural effusion Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.... --EXCLUDES--> [?] Pleurisy Def: Pleurisy or Pleuritis is the medical term for inflammation of the pleura. The most common cause of pleuritis is infection, but it can also be caused by lupus, rheumatoid arthritis, and certain medicin... --CHILD--> [?] Acute pleurisy --- 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... --EXCLUDES--> [?] Primary respiratory tuberculosis without mention of bacteriological or histological confirmation Def: This is a common, and in many cases lethal, infectious disease of the respiratory caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is without mention of ba... --- 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... --EXCLUDES--> [?] Primary respiratory tuberculosis without mention of bacteriological or histological confirmation Def: This is a common, and in many cases lethal, infectious disease of the respiratory caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is without mention of ba...
[ "[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --CHILD--> [?] Certain lower respiratory tract diseases\n Def: This group refers to diseases of airways that forms the connection between the outside world and the terminal respiratory unit. Intrapulmonary airways are divided into three major groups; bronchi, mem...", "[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of the respiratory system", "[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --EXCLUDES--> [?] Chylous effusion\n Def: A chylothorax (chylous effusion) signifies leakage of chyle from the thoracic duct. A pleural fluid triglyceride concentration of more than 110 mg per decilitre signifies a high likelihood of chylotho...\n --PARENT--> [?] Other pleural conditions\n Def: Any other condition effecting the thin serous membrane enveloping the lungs and lining the thoracic cavity...", "[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --EXCLUDES--> [?] Pleurisy\n Def: Pleurisy or Pleuritis is the medical term for inflammation of the pleura. The most common cause of pleuritis is infection, but it can also be caused by lupus, rheumatoid arthritis, and certain medicin...\n --CHILD--> [?] Acute pleurisy", "[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 --EXCLUDES--> [?] Primary respiratory tuberculosis without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease of the respiratory caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is without mention of ba...", "[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 --EXCLUDES--> [?] Primary respiratory tuberculosis without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease of the respiratory caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is without mention of ba..." ]
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
Another referral pattern is where the patient visits several healthcare facilities before reaching the appropriate facility able to provide CEmONC. Women seek help at the nearest health centre and are often referred to a ‘non-functioning’ rural facility (without appropriate staff), from where they might in turn be referred to another ‘non-functioning’ rural hospital, before reaching Renk hospital. Renk hospital should be able to provide a caesarean section and blood transfusion if needed. However, Renk hospital might refer patients on again to another referral hospital (such as Kusti hospital) due to lack of blood, or inability to perform operations. Three cases illustrate this pattern of multiple referrals . Fig. 5 Multiple referral pattern 1. She was from a village 50 km north of Renk town. Her labour pains started at around 8 pm. Her family called the TBA who assured her that the delivery would be smooth, but the pregnant woman remained in severe pain for hours. By noon next day, she was in severe pain with no progress made. Her husband decided to go to the nearest health facility. They rented a pickup truck at a cost of USD10. They arrived at 1 pm at the house of the trained midwife, who was busy with another delivery. The midwife examined her and tried to deliver her. After a while she called for the doctor. The doctor referred them to Algabaleen hospital in North Sudan for an emergency caesarean section. At 6 pm they rented an ambulance, which cost them USD20 and crossed the border of North Sudan to Algabaleen town. They arrived at 7 pm and found that the theatre was closed for 72 h. They called another ambulance at 8 pm, which cost them another USD20. They arrived at Rabak city hospital at 10 pm. They were asked to pay USD20 for the caesarean section operation. There were many patients ahead of them and she was not operated until 4 am. She was transfused the next day with 4 units of blood and was given medication. She was hospitalised for 22 days. During her stay, her family stayed with her and supported her as much as they could. Her husband sold their cattle to cover the expenses. The expenses exceeded USD350. The woman lost her baby and lives now with a fistula. She goes every 14 days to the nearest health centre to her village to change her urine catheter. (13RMNM) Fig. 6 Multiple referral pattern 2. She was a very young primigravida living in a village 170 km south of Renk town. Her family called for the TBA to come to deliver her when her labour began. Day after day passed until she became restless, febrile and with no progress. They decided to seek professional healthcare on the 4th day. They arrived to the nearest health centre at 8 pm. The health centre is run by a medical assistant and a village midwife but does not have an operation room or blood bank. The medical assistant referred them to the rural hospital. On the 5th day at 1 pm the medical assistant called the doctor in charge of the rural hospital to inform him about the case and requested an ambulance for the referral. Unfortunately, the ambulance was not available. The road between the two towns is a dirt road that deteriorates during the rainy season. An hour later they managed to transfer the patient to the rural hospital that did not have an operating room or blood bank. The patient was only given antibiotics and referred to Renk hospital for an emergency caesarean section. At 11 pm the ambulance arrived at the maternity ward of Renk Hospital. The patient was given antibiotics and prepared for an emergency caesarean section. Due to delays in preparation and blood donation, the patient was only ready for the operation by 12 noon. The woman passed away during the operation. (11RMD) Fig. 7 Multiple referral pattern 3. She was in her seventh month of pregnancy. She complained of body swelling and fever and was taken by her husband to the village health centre. She was given treatment but experienced no improvement in her condition. Her husband decided to take her to Renk hospital. In the hospital, she had labour pains and after a few hours she gave birth to a stillborn boy. The woman was devastated and severely depressed. She stopped eating and drinking, and was fed by intravenous fluids and administered various pills and injections. Her health continued to deteriorate. Her abdomen became uncomfortably distended. The doctors recognised that she needed a blood transfusion. As the blood bank in Renk hospital was closed the woman had to be taken to the nearest hospital in Kusti. Her husband realised he could not afford the transport costs. Some well off relatives sent him money when they heard about her condition. They arrived at Kusti hospital, where she was admitted and transfused on the same day. Unfortunately, an hour and a half later she passed away. The husband and her brother-in-law carried her body back and buried her in their village. (4JMD)
3.3125
0.928223
sec[2]/sec[2]/sec[2]/p[0]
en
0.999998
28851308
https://doi.org/10.1186/s12884-017-1463-9
[ "they", "renk", "blood", "another", "referral", "village", "husband", "arrived", "pattern", "nearest" ]
[ { "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": "LD27.02", "title": "Hypohidrotic ectodermal dysplasia" }, { "code": "6D51", "title": "Factitious disorder imposed on another" }, { "code": "PE3Z", "title": "Assault by being cut or pierced by other or unspecified sharp object" }, { "code": "PA80.Z", "title": "Unintentionally struck by projectile from unspecified firearm" }, { "code": "QC20.Z", "title": "Person consulting on behalf of another person, 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 [LD27.02] Hypohidrotic ectodermal dysplasia Definition: Hypohidrotic ectodermal dysplasia is a genetic disorder of ectoderm development characterised by malformation of ectodermal structures such as skin, hair, teeth and sweat glands. It comprises three clinically almost indistinguishable subtypes with impaired sweating as the key symptom: Christ-Siemens-Touraine syndrome (X-linked), autosomal recessive and autosomal dominant hypohidrotic ectodermal dysplasia, as well as a fourth rare subtype with immunodeficiency as the key symptom. Also known as: Hypohidrotic ectodermal dysplasia | Anhidrotic ectodermal dysplasia | Autosomal dominant hypohidrotic ectodermal dysplasia | Autosomal recessive hypohidrotic ectodermal dysplasia | X-linked hypohidrotic ectodermal dysplasia [6D51] Factitious disorder imposed on another Definition: Factitious disorder imposed on another is characterised by feigning, falsifying, or inducing medical, psychological, or behavioural signs and symptoms or injury in another person, most commonly a child dependent, associated with identified deception. If a pre-existing disorder or disease is present in the other person, the individual intentionally aggravates existing symptoms or falsifies or induces additional symptoms. The individual seeks treatment for the other person or otherwise presents hi Also known as: Factitious disorder imposed on another | Munchhausen syndrome by proxy | Munchhausen by proxy syndrome | Factitious skin disorder imposed on another | Skin disorder resulting from Munchhausen syndrome by proxy Excludes: Malingering [PE3Z] Assault by being cut or pierced by other or unspecified sharp object Also known as: Assault by being cut or pierced by other or unspecified sharp object | assault by sharp object | assault by being stabbed NOS | stabbed NOS | stabbed by another [PA80.Z] Unintentionally struck by projectile from unspecified firearm Also known as: Unintentionally struck by projectile from unspecified firearm | Unintentionally struck by projectile from firearm | gunshot wound NOS | shooting | shot NOS [QC20.Z] Person consulting on behalf of another person, unspecified Also known as: Person consulting on behalf of another person, unspecified | Person consulting on behalf of another person | medical advice on behalf of another | counselling for non-attending third party | medical counselling on behalf of another === 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.... --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... --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... --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--> [MA12.2] Finding of hallucinogen 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--> [?] 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 --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 --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 --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--> [MA12.2] Finding of hallucinogen 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
The patient's temperature was 36.3 °C, blood pressure was 111/70 mmHg, heart rate was 75/min, respiratory rate was 18/min, and SpO 2 was 96 % on room air. Physical examination revealed skin thickening on the face, chest, upper arms, and fingers . The Rodnan score was 27: 2 for face, 2 for anterior chest, 1 for abdomen, 1 for both upper arms, 2 for both forearms, 2 for both hands, 3 for both fingers, 0 for both thighs, 1 for both legs, and 2 for both foots. There was no arthralgia or myalgia, and no neurological findings. Fine crackles ware predominantly heard in both lower back regions. Mild pitting edema of both lower legs was noted. Chest computed tomography during the inspiration phase demonstrated subpleural reticular pattern (red arrow), traction bronchiectasis (blue arrow), and consolidation (yellow arrow) . Pulmonary function tests indicated a reduced forced vital capacity of 2.13 L (63.7 % predicted) and diffusing capacity of lung for carbon monoxide (48.7 % predicted) ( Table 1 ). Electrocardiography and echocardiography showed no evidence of pulmonary hypertension or heart dysfunction ( Table 2 ). Systemic sclerosis (SSc) was strongly suspected; however, tests for anti-Scl-70 and anti-centromere antibodies were negative. Minor antibodies were also tested. Blood tests results were positive for anti-eIF2B and anti-SS-A/Ro52 antibodies, and the bronchoalveolar lavage fluid (BALF) showed an increased percentage of eosinophils ( Table 3 ). α-streptococcus was cultured in small quantities, but were determined to be commensal bacteria. Based on these findings, the patient was diagnosed with ILD and diffuse cutaneous SSc, positive for anti-eIF2B antibodies. He was administered nintedanib and followed up at our hospital. Fig. 1 Skin thickening was observed on the face, chest, upper arms and fingers (A–D). Fig. 1 Fig. 2 Chest computed tomography demonstrated subpleural reticular pattern (red arrow), traction bronchiectasis (blue arrow), and consolidation (yellow arrow) (A–C). Fig. 2 Table 1 Pulmonary function data by spirometry. Table 1 Parameter Actual data %predicted VC (L) 2.11 61.3 % ERV (L) 1.07 87.7 % TV (L) 0.74 IRV (L) 0.30 IC (L) 1.04 FVC (L) 2.13 63.7 % FEV 1.0 (L) 1.79 67.5 % FEV 1.0 % (%) 84.03 105.6 % V 50 (L/sec) 2.69 83.2 % V 25 (L/sec) 0.87 83.6 % V 50 /V 25 3.09 RV (L) 1.00 61.0 % TLC (L) 3.11 55.3 % DL CO (mL/min/mmHg) 6.81 48.7 % VC: vital capacity, ERV: expiratory reserve volume, TV: total volume, IRV: inspiratory reserve volume, IC: inspiratory capacity, FVC: forced vital capacity, FEV1.0: forced expiratory volume 1.0 second, RV: residual volume, TLC: total lung capacity, DL CO : diffusing capacity of lung for carbon monoxide. Table 2 Echocardiography. Table 2 Parameter LVEF 67 % LA dilation 40 mm TRV 2.57 m/sec Estimated RVSP 31 mmHg Estimated PADP 13 mmHg LVEF: left ventricle ejection fraction, LA: left atrium, TRV: tricuspid regurgitation velocity, RVSP: right ventricle systolic pressure, PADP: pulmonary arterial diastolic pressure. Table 3 Laboratory data. Table 3 Hematology Immunology WBC 7990 4000–8000 /μL IgG 1814 870–1700 mg/dL Neut 66 40–60 % IgA 284 110–410 mg/dL Ly 18.5 25–45 % IgM 153 33–190 mg/dL Mo 12 3–7 % ANA 40 > 40 > times Eo 2.6 1–6 % Anti-Scl-70 Ab (−) Ba 0.8 0–1 % Anti-Cent Ab (−) RBC 431 430–550 10 4 /μL Anti-ARS Ab (−) Hb 13.5 13.5–17.5 g/dL Anti-MDA-5 Ab (−) PLT 30.2 15–35 10 4 /μL Anti-Mi-2 Ab (−) Anti-TIFI1-γ Ab (−) Biochemistry Anti-RNAPIII Ab (−) TP 6.3 6.6–8.1 g/dL Anti-RNAPI Ab (−) Alb 3.2 4.1–5.1 g/dL Anti-eIF2B Ab 144.9 0–10 AST 28 13–30 U/L Anti-SS-A/Ro Ab 377.2 0–13 ALT 14 10–42 U/L Anti-SS-B Ab/La (−) LDH 283 124–222 U/L Cre 0.64 0.65–1.07 mg/dL Bronchoalveolar lavage fluid BUN 18.2 8–20 mg/dL Total cell count 149 10 3 /mL Na 138 138–145 mEq/L Neut 4.1 % K 4.1 3.6–4.8 mEq/L Ly 9.7 % Cl 105 101–108 mEq/L Mo 71.0 % CRP 0.72 0–0.14 mg/dL Eo 15.2 % KL-6 1416 0–499 U/mL Ba 0 % BNP 45.0 0–18.4 pg/mL Test laboratory data and reference values are shown. WBC: white blood cell count, Neut: neutrophil, Ly: lymphocytes, Mo: monocytes, Eo: eosinophils, Ba: basophils, RBC: red blood cell count, Hb: hemoglobin, PLT: platelet, TP: total protein, Alb: albumin, AST: aspartate aminotransferase, ALT: alanine aminotransferase, LDH: lactate dehydrogenase, Cre: creatinine, BUN: blood urea nitrogen, Na: natrium, K: kalium, Cl: chlorine, CRP: c-reactive protein, KL-6: Krebs von den Lungen 6, ANA: anti-nuclear antibody, Anti-Scl-70 Ab: anti-scleroderma 70 antibody, Anti-Cent Ab: anti centromere antibody, Anti-ARS Ab: anti-aminoacyl-tRNA synthetase antibody, Anti-MDA5 Ab: anti-melanoma differentiation-associated gene 5 antibody, Anti-TIFI1-γ Ab: anti-transcriptional intermediary factor 1-γantibody, Anti-RNAPIII Ab: anti-ribonucleic acid polymerase III antibody, Anti-RNAPI Ab: anti-ribonucleic acid polymerase I antibody, Anti-eIF2B Ab: anti-eukaryotic translation initiation factor 2B antibody.
4.109375
0.962891
sec[1]/p[2]
en
0.999995
39654607
https://doi.org/10.1016/j.rmcr.2024.102141
[ "anti", "both", "antibody", "capacity", "arrow", "blood", "chest", "mmhg", "pulmonary", "antibodies" ]
[ { "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": "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" } ]
=== 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 [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 === 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.... --CHILD--> [JA86.0] Maternal care for red cell antibodies Def: Maternal care for rhesus or other isoimmunization... --- 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.... --EXCLUDES--> [?] Placental transfusion syndromes --- 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 --PARENT--> [?] Mental or behavioural symptoms, signs or clinical findings --- 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 --CHILD--> [JA86.0] Maternal care for red cell antibodies\n Def: Maternal care for rhesus or other isoimmunization...", "[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--> [?] Placental transfusion syndromes", "[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 --PARENT--> [?] Mental or behavioural symptoms, signs or clinical findings", "[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": "LB99.6", "icd10_code": "Q7131", "icd10_title": "Congenital absence of right hand and finger" } ]
O26841
A 28-year-old man affected by dermatomyositis–polymyositis was admitted to our general intensive care unit for hypoxemic respiratory failure. He had been diagnosed with dermatomyositis–polymyositis 1 year before after muscular and cutaneous symptoms, had been treated with cyclophosphamide and was under chronic corticosteroid therapy. In intensive care unit, he was first supported with high-flow nasal cannula (HFNC) oxygen therapy. Infectious aetiology was ruled out by negative microbiological specimens (bronchoalveolar lavage for virus, bacteria and parasites, haemocultures, uroculture, serology for Chlamydia , Legionella and Mycoplasma Pneumoniae , urinary antigens for Legionella and Streptococcus Pneumoniae ). A transthoracic echocardiogram was performed but no alterations of the left ventricular systolic and diastolic function were found (ejection fraction > 55%). Patient was also negative for acute or chronic valvular diseases. Autoimmune analyses showed anti-nuclear antibody positivity (speckled pattern 1:160) and weak reactivity of anti-melanoma differentiation-associated protein 5 antibodies. Immunosuppressive therapy with high-dose intravenous immunoglobulin (2 g/kg/day for 5 days, then 0.4 g/kg/day) and methylprednisolone (1 g daily for 3 days, then 40 mg twice daily) was then started. Nevertheless, he rapidly deteriorated and required intubation for refractory hypoxemia [partial arterial oxygen pressure (PaO 2 ) 63.4 mmHg with fraction of inspired oxygen (FiO 2 ) 0.8 by HFNC, pH 7.45, PaCO 2 45.3 mmHg]. A second-line immunosuppressive treatment was introduced, with rituximab (375 mg/m 2 once a week for five cycles) and plasma exchange. Veno-venous femoro-jugular extracorporeal membrane oxygenation (ECMO) was also placed percutaneously to extubate the patient and reduce the risk of overinfection whilst immunosuppressed. Once the ECMO started and the patient extubated, non-invasive respiratory support was provided by HFNC associated to 2–3 daily cycles of mask non-invasive ventilation. Initial CT showed multiple parenchymal consolidations and diffuse ground-glass pattern affecting all lobes, bilateral architectural distortion and nodular-pattern blurred opacities with partial sparing of inferior right lobe. Lung ultrasound score was performed daily to monitor ILD response to immunosuppressive therapy, being chest X-ray poorly informative in an almost completely white lung and being transportation to CT at particularly high risk for both immunosuppression and extra-corporeal support. 12 standard thoracic regions were examined in supine position with thorax elevation around 45°, using in transversal scan a 10-MHz linear probe or a 2.5-MHz phased-array probe when a tissue-like pattern was visualized. Four steps of progressive loss of aeration were distinguished; each region was scored from 0 (normal aeration) to 3 (complete aeration loss), according to the visualized pattern, as previously described [ 5 – 9 , 14 ]. The sum of each region’s score gives the global lung ultrasound score [ 1 , 5 – 8 ], therefore ranging from 0 to 36. Lung ultrasound score, HFNC FiO 2 , ECMO settings and patient’s PaO 2 are shown in Fig. 1 . Initial lung ultrasound score was 28; a progressive reduction of the score from 28 to 17 was observed in the first 5 weeks, confirming the positive response to immunosuppressive therapy, as also supported by the CT performed after 15 days. Gas exchanges also improved with reduced ECMO and inspired FiO 2 . However, a complete lung recovery was not observed; the lung ultrasound score ranged between 17 and 22 for days and the patient failed two tests of ECMO discontinuation. A third CT was then performed, where evolution to fibrosis was described. Once overinfection was ruled out again, a third-line immunosuppressive therapy with a second cycle of intravenous immunoglobulin and intravenous cyclosporine (100 mg twice daily) was introduced. Non-invasive respiratory approach was also changed, pursuing with HFNC only. After an initial worsening, a second slower reduction in lung ultrasound score was observed, corresponding to better lung aeration at CT. The patient was finally weaned from ECMO after 93 days with a lung ultrasound score of 15 and good gas exchanges in HFNC (PaO 2 96.1 mmHg with FiO 2 0.3, pH 7.38, PaCO 2 51.2 mmHg). Fig. 1 Lung ultrasound score trend, computed tomography and clinical parameters during 93 days of extra-corporeal life support for acute exacerbation of interstitial lung disease in dermatomyositis–polymyositis ( R rituximab, Ig immunoglobuline, Cs cyclosporine, NIV non-invasive ventilation, ECMO extra-corporeal membrane oxygenation—red dot: membrane lung replacement, HFNC-FiO 2 fraction of inspired oxygen delivered by high flow nasal cannula, ML-FiO 2 fraction of inspired oxygen delivered by the membrane lung, SGF sweep gas flow, PaO 2 patient’s partial arterial oxygen pressure)
4.109375
0.964844
sec[0]/sec[0]/p[0]
en
0.999997
32409952
https://doi.org/10.1186/s13089-020-00174-7
[ "lung", "score", "ultrasound", "hfnc", "ecmo", "oxygen", "pattern", "immunosuppressive", "daily", "fraction" ]
[ { "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": "MB20.1&XC87", "title": "Glasgow Coma Scale, eyes opening, never" }, { "code": "KD30.0", "title": "Birth depression with 5 minute Apgar score 0-3" }, { "code": "KD30.1", "title": "Birth depression with 5 minute Apgar score 4-6" }, { "code": "MB20.1", "title": "Coma" }, { "code": "KB21.0", "title": "Severe birth asphyxia" } ]
=== 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 [KD30.0] Birth depression with 5 minute Apgar score 0-3 Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth. Also known as: Birth depression with 5 minute Apgar score 0-3 [KD30.1] Birth depression with 5 minute Apgar score 4-6 Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth. Also known as: Birth depression with 5 minute Apgar score 4-6 [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 [KB21.0] Severe birth asphyxia Definition: Pulse less than 100 per minute at birth and falling or steady, respiration absent or gasping, colour poor, tone absent. Also known as: Severe birth asphyxia | severe perinatal hypoxia | asphyxia pallida of newborn | Asphyxia with 5-minute Apgar score 0-3 | newborn severe asphyxia === 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 --PARENT--> [12] Diseases of the respiratory system --- 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--> [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped 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 ... --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... --- 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 --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 --PARENT--> [12] Diseases of the respiratory system", "[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--> [LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped 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 --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...", "[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
The patient was a 62-year-old postmenopausal woman, gravida 1, para 1, with no history of hypertension or diabetes mellitus and no history of surgery. On October 16, 2022, the patient visited our hospital for “conscious pelvic mass with hardness for 1 month, without abdominal pain.” She reported that she had not had a regular physical examination and had not been treated in other hospital prior to visiting us. On gynecological examination, the vulva and vagina were normal, a small amount of discharge was visible, the cervix was atrophic, with chronic inflammation on the surface, the uterus was obviously enlarged, hard, without pressure pain, reaching 2 fingers below the umbilicus, and no obvious abnormality was found in both adnexal areas. The pelvic ultrasound showed a 13.4 × 9.4 × 8.2 cm mass in the uterine region with clear borders, seemingly uterine morphology, hypoechoic inside, and a central endothelial line seemingly intermittent, about 1.2 cm thicker, with rich blood flow signal detectable on CDFI and arterial spectrum detectable, RI: 0.33 . Thinprep cytology test (TCT) showed no intraepithelial lesions or malignant lesions (NILM); HPV: negative. Normal levels of alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), glycoantigen 125 (CA-125), and glycoantigen 19-9 (CA19-9). The pelvic enhancement magnetic resonance imaging (MRI) showed that the uterine volume was significantly enlarged and the muscle wall was generally thickened, with a thicker area of 5.6 cm, with a slightly longer T1 and longer T2 signal predominating, and a heterogeneous signal in the T2WI, mixed with a few small patchy high-signal shadows, and the enhancement scan showed heterogeneous mild to moderate enhancement in the myometrial wall, which seemed to be caused by multiple nodules and masses fusion, and some of them were seen as patchy non-obvious enhancement shadows , PET-CT showed an enlarged uterus with unclear endometrium, measuring ~12.6 × 11.7 cm. There is a significant diffuse increase in FDG metabolism in the uterus with a SUVmax of 36.34 . Metastatic lesions were observed beneath the capsule of the left outer lobe of the liver, measuring ~2.2 × 2.4 cm. There were also metastatic lesions in the 6th and 11th thoracic vertebrae. Multiple lymph node metastases were detected in the bilateral pelvic sidewalls, retroperitoneal region, and left diaphragmatic angle. Because of its specific imaging presentation, we performed an ultrasound-guided transabdominal uterine mass puncture biopsy for definitive diagnosis on the patient, and the pathology showed a non-Hodgkin diffuse large B-cell lymphoma of germinal center origin . After the diagnosis of uterine lymphoma was confirmed, the patient was referred to the hematology department for further treatment. Further laboratory workup revealed the following levels: β2-MG 2.84 mg/L, LDH 421 U/L, no significant abnormalities were observed in the blood cell counts. The bone marrow cell immunophenotyping analysis revealed strong positive expression of CD20, weak positive expression of CD5, and negative expression of CD10 and Ki-67. Additionally, no abnormal monoclonal mature B lymphocytes were detected. The cerebrospinal fluid test also showed no abnormal phenotypic B lymphocytes, suggesting that the patient's lesions did not involve the nervous systems. Then she was diagnosed with Non-Hodgkin's lymphoma (Diffuse Large B-cell type), Stage IV, Group A, with an International Prognostic Index (IPI) score of 4. The treatment regimen was 6 courses of standard doses of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) every 3 weeks. During the chemotherapy process, the patient experienced side effects such as leukopenia (reduced white blood cell count) and hair loss. After six courses of treatment, the gynecological exam revealed a significant reduction in the size of the uterus. The laboratory workup revealed the following levels: β2-MG 1.73 mg/L, LDH 258 U/L. We recommended the patient to undergo a follow-up PET-CT scan, but the patient refused (owing to financial constraints) and opted only for an enhanced abdominal CT and ultrasound examinations. The abdominal enhancement CT showed a reduced uterine volume of ~6.8 × 4.3 × 3.8 cm with less uniform density . The metastatic lesion in the left lobe of the liver has also decreased in size compared to before, measuring ~1.7 × 1.8 cm. There is also a reduction in the size of the bilateral pelvic lymph nodes compared to before. The ultrasound examinations revealed no significant abnormal enlargement of lymph nodes in the bilateral axillary, supraclavicular (both above and below), neck, and inguinal regions. Three weeks after the 6th R-CHOP treatment, the patient was given 2 courses of consolidation therapy with rituximab 600 mg IV pump every 3 weeks. The patient is now in excellent general condition with no signs of recurrence.
4.066406
0.974609
sec[1]/p[0]
en
0.999995
PMC10373583
https://doi.org/10.3389/fmed.2023.1234861
[ "uterine", "pelvic", "lesions", "enhancement", "cell", "uterus", "ultrasound", "signal", "abdominal", "that" ]
[ { "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": "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" } ]
=== 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 [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 === 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... --CHILD--> [GA01.0] Acute inflammatory disease of uterus --- 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--> [GA01.0] Acute inflammatory disease of uterus --- 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).... --RELATED_TO--> [?] Leiomyoma of uterus Def: A well-circumscribed benign smooth muscle neoplasm of uterus characterised by the presence of spindle cells with cigar-shaped nuclei, interlacing fascicles, and a whorled pattern.... --- 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 --RELATED_TO--> [?] Sequelae of injury of intra-abdominal or pelvic 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 --CHILD--> [GA01.0] Acute inflammatory disease of uterus", "[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--> [GA01.0] Acute inflammatory disease of uterus", "[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 --RELATED_TO--> [?] Leiomyoma of uterus\n Def: A well-circumscribed benign smooth muscle neoplasm of uterus characterised by the presence of spindle cells with cigar-shaped nuclei, interlacing fascicles, and a whorled pattern....", "[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 --RELATED_TO--> [?] Sequelae of injury of intra-abdominal or pelvic 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": "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" } ]
N719
Inflammatory disease of uterus, unspecified
A healthy 20-year-old Japanese man was trapped beneath a 3-ton steel frame while working on a crane. He was rescued by his coworkers and exhibited constant bleeding from the right side of his lower abdomen when the ambulance arrived. He was transferred to our emergency department with the wound compressed. On arrival, his vital signs were: respiratory rate 22/minute, blood pressure 97/65 mmHg, and pulse rate 140/minute. His Glasgow Coma Scale score was E4 V5 M6. On physical examination, there was instability of his hip and constant bleeding from the wound on the right side of his lower abdomen. Endotracheal intubation and fluid resuscitation were performed. Computed tomography (CT) of his body showed: splenic injury; sacrum fracture; separation of the sacroiliac joint; and fracture of the right pubis, ischium, and acetabulum. Vancomycin and meropenem were started to prevent infection. He was immediately taken to our angiography room for transcatheter arterial embolization (TAE) for pelvic hemorrhage. Angiography showed extravasation from the bilateral internal iliac arteries, which were embolized. His bilateral external iliac arteries showed thrombosis. A SAM® Pelvic Sling™ (SAM Medical, Wilsonville, OR, USA) was applied to his pelvis. Since complete hemostasis was not achieved after TAE, a vascular surgeon was consulted. Based on the view from the expanded wound on the right side of his lower abdomen, his right external artery was ligated in the emergency room and hemostasis was achieved. Gauze was packed with the wound sutured. Subsequent CT showed ischemia of his right lower limb. Despite the amount of time that had passed since the accident and the possibility of increased risk, due to his young age and the strong desire of his family to save his limbs, revascularization surgery was performed in the operating room. After crossover graft of the axillary-femoral artery, another hemorrhage was confirmed in his retroperitoneum, which was thought to be due to the external iliac artery injury. An additional crossover graft of the axillary-femoral vein was performed. Cystostomy and external fixation of the pelvic fracture were performed. On day 2, additional debridement of the right side of his lower abdomen was performed. Packed gauze was removed and a drainage tube was inserted. Contrast CT showed ischemia of his left lower limb and right anterior tibial artery. On day 3, he was referred to our plastic surgery department for blisters on his bilateral thighs and scrotum, which were thought to be a complication of TAE of his bilateral internal iliac arteries. At a conference meeting with the intensive care unit team and orthopedic surgery team, we concluded that amputation of his bilateral lower limbs was inevitable, since we prioritized saving life over limb. On day 8, a right above-knee amputation was performed. The decision to amputate above the knee was made because there was a possibility that the soft tissue could be covered with the intact skin of his thigh. There was also a risk of massive hemorrhage due to the pelvic fracture if we performed hip disarticulation. On day 13, left hip disarticulation and colostomy were performed. On day 17, bilateral ureterostomy was performed. On day 21, he underwent another debridement. We confirmed necrosis in his bilateral gluteal muscles and part of his quadriceps muscle, which were debrided . Because it was difficult to control the hemorrhage, we had to stop debridement, even though necrotic muscle was still visible. We left the wound open because of the extensive soft tissue damage . Repeated debridement was necessary because of the ongoing infection; we performed debridement a total of six times . Part of his ilium and acetabulum was left and the posterior ilium was fully exposed after the extensive debridement. On day 112, left anterolateral thigh flap was rotated posteriorly and fixed with a suture anchor with successful coverage of the exposed pelvis. Negative-pressure wound therapy (NPWT) was applied for the formation of healthy granulation tissue . On day 168, a full-thickness skin graft, which was harvested from his head, back, and abdomen, was applied to the rest of the ulcer. On day 230, complete epithelialization was achieved . Rehabilitation was started along with the use of prosthetics . He has made progress to the point where he can get on and off a wheelchair and move around independently. Currently, he lives at home with his parents. The reconstructed pelvis allows for good prosthetic fitting. Fig. 1 Before the debridement Fig. 2 After the debridement Fig. 3 Left anterolateral thigh flap was preserved after several debridements Fig. 4 Negative-pressure wound therapy was applied Fig. 5 In lateral position. Epithelialization was achieved Fig. 6 In supine position. Epithelialization was achieved Fig. 7 Rehabilitation was started along with the use of prosthetics
3.783203
0.981934
sec[1]/p[0]
en
0.999996
31796112
https://doi.org/10.1186/s13256-019-2283-5
[ "debridement", "wound", "abdomen", "which", "side", "fracture", "pelvic", "hemorrhage", "iliac", "artery" ]
[ { "code": "MD11.5", "title": "Dyspnoea" }, { "code": "NB32.3Z", "title": "Injury of lung, unspecified" }, { "code": "NB91.1Z", "title": "Injury of liver, unspecified" }, { "code": "NA01.Z&XA9T94", "title": "Temporal wound" }, { "code": "ND56.1", "title": "Open wound of unspecified body region" }, { "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 === [MD11.5] Dyspnoea Definition: Dyspnoea is used to describe perceptions of difficulty or distress related to breathing and is recognised as symptomatic of disease when it occurs under inappropriate circumstances. Dyspnoea is a presenting complaint of patients with a wide variety of medical diseases by multiple mechanisms. Dyspnoea is considered acute when it lasts from hours up to 3 weeks, subacute from 3 weeks up to 8 weeks, and chronic dyspnoea lasts more than 8 weeks. Also known as: Dyspnoea | difficulty breathing | respiration difficult | short of breath | winded Includes: Orthopnoea Excludes: Transient tachypnoea of newborn [NB32.3Z] Injury of lung, unspecified Also known as: Injury of lung, unspecified | Certain injuries of lung | injury of lung NOS | acute lung injury NOS | lung wound NOS [NB91.1Z] Injury of liver, unspecified Also known as: Injury of liver, unspecified | Injury of liver | liver wound NOS | liver fracture NOS | hepatocellular injury [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 [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 --- [MD11.5] Dyspnoea Def: Dyspnoea is used to describe perceptions of difficulty or distress related to breathing and is recognised as symptomatic of disease when it occurs under inappropriate circumstances. Dyspnoea is a pres... --EXCLUDES--> [?] Transient tachypnoea of newborn Def: Transient tachypnoea of newborn is usually a benign self-limiting illness of term and near-term infants demonstrating increased respiratory rate and requiring supplementary oxygen after birth.... --PARENT--> [?] Respiratory distress of newborn Def: A condition characterised by developmental insufficiency of surfactant associated proteins or surfactant production and structural immaturity in the lungs.... --- Walk 2 --- [MD11.5] Dyspnoea Def: Dyspnoea is used to describe perceptions of difficulty or distress related to breathing and is recognised as symptomatic of disease when it occurs under inappropriate circumstances. Dyspnoea is a pres... --EXCLUDES--> [?] Transient tachypnoea of newborn Def: Transient tachypnoea of newborn is usually a benign self-limiting illness of term and near-term infants demonstrating increased respiratory rate and requiring supplementary oxygen after birth.... --PARENT--> [?] Respiratory distress of newborn Def: A condition characterised by developmental insufficiency of surfactant associated proteins or surfactant production and structural immaturity in the lungs.... --- Walk 3 --- [NB32.3Z] Injury of lung, unspecified --PARENT--> [NB32.3] Certain injuries of lung --PARENT--> [NB32] Injury of other or unspecified intrathoracic organs --- Walk 4 --- [NB32.3Z] Injury of lung, unspecified --PARENT--> [NB32.3] Certain injuries of lung --CHILD--> [NB32.30] Contusion of lung --- Walk 5 --- [NB91.1Z] Injury of liver, unspecified --PARENT--> [NB91.1] Injury of liver Def: Damage inflicted on the liver as the direct or indirect result of an external force, with or without disruption of structural continuity.... --RELATED_TO--> [?] Birth injury to liver Def: Rupture or subcapsular haemorrhage into the liver parenchyma as a result of birth trauma usually seen in large for gestational age infants, those with hepatomegaly, those born by breech delivery; may ... --- Walk 6 --- [NB91.1Z] Injury of liver, unspecified --PARENT--> [NB91.1] Injury of liver Def: Damage inflicted on the liver as the direct or indirect result of an external force, with or without disruption of structural continuity.... --CHILD--> [NB91.12] Laceration of liver, moderate
[ "[MD11.5] Dyspnoea\n Def: Dyspnoea is used to describe perceptions of difficulty or distress related to breathing and is recognised as symptomatic of disease when it occurs under inappropriate circumstances. Dyspnoea is a pres...\n --EXCLUDES--> [?] Transient tachypnoea of newborn\n Def: Transient tachypnoea of newborn is usually a benign self-limiting illness of term and near-term infants demonstrating increased respiratory rate and requiring supplementary oxygen after birth....\n --PARENT--> [?] Respiratory distress of newborn\n Def: A condition characterised by developmental insufficiency of surfactant associated proteins or surfactant production and structural immaturity in the lungs....", "[MD11.5] Dyspnoea\n Def: Dyspnoea is used to describe perceptions of difficulty or distress related to breathing and is recognised as symptomatic of disease when it occurs under inappropriate circumstances. Dyspnoea is a pres...\n --EXCLUDES--> [?] Transient tachypnoea of newborn\n Def: Transient tachypnoea of newborn is usually a benign self-limiting illness of term and near-term infants demonstrating increased respiratory rate and requiring supplementary oxygen after birth....\n --PARENT--> [?] Respiratory distress of newborn\n Def: A condition characterised by developmental insufficiency of surfactant associated proteins or surfactant production and structural immaturity in the lungs....", "[NB32.3Z] Injury of lung, unspecified\n --PARENT--> [NB32.3] Certain injuries of lung\n --PARENT--> [NB32] Injury of other or unspecified intrathoracic organs", "[NB32.3Z] Injury of lung, unspecified\n --PARENT--> [NB32.3] Certain injuries of lung\n --CHILD--> [NB32.30] Contusion of lung", "[NB91.1Z] Injury of liver, unspecified\n --PARENT--> [NB91.1] Injury of liver\n Def: Damage inflicted on the liver as the direct or indirect result of an external force, with or without disruption of structural continuity....\n --RELATED_TO--> [?] Birth injury to liver\n Def: Rupture or subcapsular haemorrhage into the liver parenchyma as a result of birth trauma usually seen in large for gestational age infants, those with hepatomegaly, those born by breech delivery; may ...", "[NB91.1Z] Injury of liver, unspecified\n --PARENT--> [NB91.1] Injury of liver\n Def: Damage inflicted on the liver as the direct or indirect result of an external force, with or without disruption of structural continuity....\n --CHILD--> [NB91.12] Laceration of liver, moderate" ]
MD11.5
Dyspnoea
[ { "from_icd11": "MD11.5", "icd10_code": "R0603", "icd10_title": "Acute respiratory distress" }, { "from_icd11": "MD11.5", "icd10_code": "R0601", "icd10_title": "Orthopnea" }, { "from_icd11": "MD11.5", "icd10_code": "R0602", "icd10_title": "Shortness of breath" }, { "from_icd11": "MD11.5", "icd10_code": "R0600", "icd10_title": "Dyspnea, unspecified" }, { "from_icd11": "MD11.5", "icd10_code": "R0609", "icd10_title": "Other forms of dyspnea" }, { "from_icd11": "MD11.5", "icd10_code": "R060", "icd10_title": "Dyspnea" }, { "from_icd11": "NB32.3Z", "icd10_code": "S27321A", "icd10_title": "Contusion of lung, unilateral, initial encounter" }, { "from_icd11": "NB32.3Z", "icd10_code": "S27322A", "icd10_title": "Contusion of lung, bilateral, initial encounter" }, { "from_icd11": "NB32.3Z", "icd10_code": "S27331S", "icd10_title": "Laceration of lung, unilateral, sequela" }, { "from_icd11": "NB32.3Z", "icd10_code": "S27331A", "icd10_title": "Laceration of lung, unilateral, initial encounter" }, { "from_icd11": "NB32.3Z", "icd10_code": "S27329A", "icd10_title": "Contusion of lung, unspecified, initial encounter" }, { "from_icd11": "NB32.3Z", "icd10_code": "S27339A", "icd10_title": "Laceration of lung, unspecified, initial encounter" }, { "from_icd11": "NB32.3Z", "icd10_code": "S27391A", "icd10_title": "Other injuries of lung, unilateral, initial encounter" }, { "from_icd11": "NB32.3Z", "icd10_code": "S27391S", "icd10_title": "Other injuries of lung, unilateral, sequela" }, { "from_icd11": "NB32.3Z", "icd10_code": "S27321D", "icd10_title": "Contusion of lung, unilateral, subsequent encounter" } ]
R0603
Acute respiratory distress
Ultrasonography revealed a suprasellar tumor in a fetus at 33 weeks of gestation. The suprasellar mass was confirmed by prenatal MRI at 34 weeks of gestation . The male newborn, delivered after 41 weeks of gestation, was operated at the age of 23 days, and an adamantinomatous CP was partially resected ( Table 1 ). Postoperatively, pituitary deficiency and a transient syndrome of inappropriate antidiuretic hormone secretion (SIADH) were present ( Table 2 ). At an age of 17 months, due to progression of residual tumor, a second partial resection was performed. A second progression has been documented at an age of 3.1 years. Therefore, a percutaneous proton beam therapy (total target volume dose of 54.9 Gy, fractions of 1.8 Gy) at an age of 3.4 years was applied. At a current age of 4.3 years, the patient showed a normal physical, mental, statomotor, and linguistic development with a body height of 111.1 cm (99 percentile) and a body weight of 20.5 kg (96 percentile) at last follow-up ( Table 2 ). Since his first tumor resection, the patient continuously receives substitution with hydrocortisone, thyroxine and growth hormone. At a follow-up evaluation 4 years after cCP diagnosis, the total difficulties (SDQ) score was 31 for this child, which indicates an abnormal level of difficulties. For conduct problems and peer problems, the parents gave 9 and 6 out of 10 points, respectively. Regarding the emotional and hyperactivity/inattention domain, this child received 7 and 9 out of 10 points. In prosociality, the child received 4 points, indicating low levels of prosocial behavior ( Table 2 ). The parents rated the FMH at percentile 10, indicating an impaired functional capacity for the child’s age. Figure 1 Magnetic resonance imaging (MRI) of a patient with perinatally diagnosed congenital craniopharyngioma (case 1). MRI at the fourth day of life demonstrating a cCP of intermediate size having more solid than cystic parts. The main part is in suprasellar location (A: black asterisk), only a small part is reaching intrasellarly (A: white asterisk). The optic chiasm and optic nerves are elevated and compressed (B and C: white arrows) and the posterior part is compressing the region of the mammillary bodies (A: black arrow) indicating an involvement of the posterior hypothalamus (A: sagittal T2 WI, sagittal and high resolution 3D-T2 WI with B: axial and C: coronal reconstruction). Table 1 Characteristics of three patients perinatally diagnosed with congenital adamantinomatous craniopharyngioma (cCP) and recruited between 2007 and 2019 in the craniopharyngioma studies . Case 1 Case 2 Case 3 Sex Male Male Female Gestational complications – – – Gestational age at birth, weeks 41 37 + 2 37 + 2 Mode of delivery Spontaneous Cesarean section Cesarean section Birth weight, g (P) (28) 3625 (50) 3500 (75) 3330 (75) Birth height, cm (P) (28) 54 (50) 50 (50) 48 (25) Head circumference at birth, cm (P) (28) 36.0 (50) 35.0 (75) 39.5 (97) Diagnostic method for primary diagnosis Prenatal sonography Postnatal sonography Prenatal sonography Age/GA at diagnosis 33 weeks of GA Second day of life 16 weeks of GA Tumor volume on MRI at diagnosis, cm³ 5.29 1.06 74.84 Signs of hydrocephalus on MRI No No Yes Tumor location Intra- and suprasellar Intra- and suprasellar Intra- and suprasellar Age at first surgery (histological diagnosis), day of life 23 51 11 Surgical complications – – – Degree of surgical resection Incomplete Complete Incomplete Surgical approach Right frontotemporal Right subfrontal Right frontal GA , gestational age; P, percentile. Table 2 Outcome of three patients perinatally diagnosed with congenital adamantinomatous craniopharyngioma (cCP) and recruited between 2007 and 2019 in the craniopharyngioma studies . Case 1 Case 2 Case 3 Follow-up interval, years 3.6 2.2 1.9 Age at last visit, years 3.6 2.1 2.0 Head circumference at last visit, cm (P) (30) 36 (age: 3 years; <3 P) 39 (age: 2 months; 25 P) 54.5 (age: 26 months; >99 P) Height at last visit, cm (P) (1) 111.1 (99) 87.9 (25) 75 (0.1) Weight at last visit, kg (P) (1) 20.5 (96) 12.8 (52) 9.6 (1) Body mass index ( s.d.s ) (2) at last visit +0.73 –0.03 +0.95 Presurgical grade of HI (3) II I II Grade of surgical HL (3) I I 0 Irradiation Proton beam therapy No No Arginine–vasopressin deficiency No Yes No TSH deficiency Yes Yes No ACTH deficiency Yes Yes No Gonadotropin deficiency No Yes No Growth hormone deficiency Yes Yes Yes Neurological sequelae Normal psychomotor development Normal psychomotor development Psychomotor retardation, left hemiparesis FMH, percentile (4) 10 25 3 SDQ, score (5) 31 17 9 ACTH, adrenocorticotropic hormone; FMH, Functional capacity scale Fertigkeitenskala Münster-Heidelberg; HI, hypothalamic involvement; HL, surgical hypothalamic lesion; n.a., not available; P, percentile; SDQ, The Strengths and Difficulties Questionnaire; TSH, thyroid-stimulating hormone.
4.160156
0.925293
sec[3]/sec[0]/p[0]
en
0.999998
37878777
https://doi.org/10.1530/EC-23-0294
[ "suprasellar", "deficiency", "percentile", "tumor", "hormone", "craniopharyngioma", "visit", "birth", "gestation", "prenatal" ]
[ { "code": "5A61.0", "title": "Hypopituitarism" }, { "code": "BE2Z", "title": "Diseases of the circulatory system, unspecified" }, { "code": "5B3Z", "title": "Endocrine diseases, unspecified" }, { "code": "5B7Z", "title": "Unspecified undernutrition" }, { "code": "5C72", "title": "Hypo-osmolality or hyponatraemia" }, { "code": "5B5K.1Z", "title": "Calcium deficiency, unspecified" }, { "code": "5B81.00", "title": "Obesity in children or adolescents" }, { "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" } ]
=== ICD-11 CODES FOUND === [5A61.0] Hypopituitarism Definition: 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/infarction. Also known as: Hypopituitarism | subpituitarism | hypophyseal dystrophy | hypohypophysism | anterior pituitary insufficiency (in part) Includes: pituitary cachexia | pituitary short stature [BE2Z] Diseases of the circulatory system, unspecified Also known as: Diseases of the circulatory system, unspecified | circulatory disease NOS | cardiovascular disease NOS | cardiovascular system disease NOS | CVS - [cardiovascular system] disease [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 [5B7Z] Unspecified undernutrition Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS [5C72] Hypo-osmolality or hyponatraemia Definition: Serum sodium concentrations of less than 135 mEq/L; decreased serum concentration of osmotically active particles Also known as: Hypo-osmolality or hyponatraemia | hypo-osmolality | hyponatraemia | hyponatremia syndrome | hyponatremic Includes: sodium [na] deficiency Excludes: Syndrome of inappropriate secretion of antidiuretic hormone [5B5K.1Z] Calcium deficiency, unspecified Also known as: Calcium deficiency, unspecified | Calcium deficiency | hypocalcaemia NOS | disturbance of calcium absorption | disorder of calcium absorption [5B81.00] Obesity in children or adolescents Definition: In infants, children and adolescents, BMI categories for defining obesity vary by age and gender based on WHO growth charts. Children 0 to 5 years have obesity if weight-for-length/height or BMI-for-age is above 3 standard deviations of the median of the WHO Child Growth Standards. Children aged 5 to 19 years have obesity if BMI-for-age is above 2 standard deviations of the median of WHO Growth Reference for School-aged Children and Adolescents. Also known as: Obesity in children or adolescents | morbid obesity in children or adolescents | BMI-for age -[body mass index-for-age] percentile greater than 95 percent | Obesity in infants or children up to 5 years of age | Obesity in school-aged children or adolescents from 5 to 19 years [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 === GRAPH WALKS === --- Walk 1 --- [5A61.0] 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... --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... --CHILD--> [5A61.1] Adrenocorticotropic hormone deficiency Def: Deficiency of adrenocorticotropic hormone (ACTH) resulting in functional hypocortisolism. Includes deficiency of corticotropin releasing hormone (CRH, CRF).... --- Walk 2 --- [5A61.0] 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... --RELATED_TO--> [?] Argonz-del Castillo Syndrome --PARENT--> [?] 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... --- Walk 3 --- [BE2Z] Diseases of the circulatory system, unspecified --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... --RELATED_TO--> [?] 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... --- Walk 4 --- [BE2Z] Diseases of the circulatory system, unspecified --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... --RELATED_TO--> [?] 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... --- Walk 5 --- [5B3Z] Endocrine diseases, unspecified --PARENT--> [?] Endocrine diseases --CHILD--> [?] Other disorders of glucose regulation or pancreatic internal secretion --- Walk 6 --- [5B3Z] Endocrine diseases, unspecified --PARENT--> [?] Endocrine diseases --PARENT--> [05] Endocrine, nutritional or metabolic diseases Def: This chapter includes endocrine diseases, nutritional diseases as well as metabolic diseases....
[ "[5A61.0] 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 --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 --CHILD--> [5A61.1] Adrenocorticotropic hormone deficiency\n Def: Deficiency of adrenocorticotropic hormone (ACTH) resulting in functional hypocortisolism. Includes deficiency of corticotropin releasing hormone (CRH, CRF)....", "[5A61.0] 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 --RELATED_TO--> [?] Argonz-del Castillo Syndrome\n --PARENT--> [?] 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...", "[BE2Z] Diseases of the circulatory system, unspecified\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 --RELATED_TO--> [?] 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...", "[BE2Z] Diseases of the circulatory system, unspecified\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 --RELATED_TO--> [?] 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...", "[5B3Z] Endocrine diseases, unspecified\n --PARENT--> [?] Endocrine diseases\n --CHILD--> [?] Other disorders of glucose regulation or pancreatic internal secretion", "[5B3Z] Endocrine diseases, unspecified\n --PARENT--> [?] Endocrine diseases\n --PARENT--> [05] Endocrine, nutritional or metabolic diseases\n Def: This chapter includes endocrine diseases, nutritional diseases as well as metabolic diseases...." ]
5A61.0
Hypopituitarism
[ { "from_icd11": "5A61.0", "icd10_code": "E230", "icd10_title": "Hypopituitarism" }, { "from_icd11": "5A61.0", "icd10_code": "Q044", "icd10_title": "Septo-optic dysplasia of brain" }, { "from_icd11": "5A61.0", "icd10_code": "E231", "icd10_title": "Drug-induced hypopituitarism" }, { "from_icd11": "BE2Z", "icd10_code": "I998", "icd10_title": "Other disorder of circulatory system" }, { "from_icd11": "BE2Z", "icd10_code": "I999", "icd10_title": "Unspecified disorder of circulatory system" }, { "from_icd11": "BE2Z", "icd10_code": "I4949", "icd10_title": "Other premature depolarization" }, { "from_icd11": "BE2Z", "icd10_code": "I4940", "icd10_title": "Unspecified premature depolarization" }, { "from_icd11": "BE2Z", "icd10_code": "I499", "icd10_title": "Cardiac arrhythmia, unspecified" }, { "from_icd11": "BE2Z", "icd10_code": "I498", "icd10_title": "Other specified cardiac arrhythmias" }, { "from_icd11": "BE2Z", "icd10_code": "I271", "icd10_title": "Kyphoscoliotic heart disease" }, { "from_icd11": "BE2Z", "icd10_code": "IX", "icd10_title": "" }, { "from_icd11": "BE2Z", "icd10_code": "I27", "icd10_title": "Other pulmonary heart diseases" }, { "from_icd11": "BE2Z", "icd10_code": "I30-I52", "icd10_title": "" }, { "from_icd11": "BE2Z", "icd10_code": "I494", "icd10_title": "Other and unspecified premature depolarization" }, { "from_icd11": "BE2Z", "icd10_code": "I52", "icd10_title": "Other heart disorders in diseases classified elsewhere" } ]
E230
Hypopituitarism
A 77-year-old male patient from Yunnan, China had recently traveled to Guangxi Province one week before the onset of the disease. On October 27th, 2022, the patient began to develop symptoms such as fever, chills and sweating. He was treated with oral ibuprofen suspension and intravenous infusion of piperacillin tazobactam. However, these measures have not led to significant improvements. Due to a sudden high fever, blurred consciousness, lethargy, and slurred speech on November 4th, the patient was admitted to the hospital for treatment. Upon physical examination, the heart rate was 96 beats per minute. The respiratory rate was 25 breaths per minute, blood pressure was 93/70 mmHg, transcutaneous oxygen saturation was 78%, and body temperature fluctuated between 37.5–40°C. There were no rash or subcutaneous hemorrhages on the skin and mucosa throught the body, and no swelling or tenderness in the superficial lymph nodes. Auscultation revealed diminished breath sounds over both lung fields. Positive Babinski's and Gordon's signs were observed in the right lower extremity, along with neck stiffness and positive Kernig's and Brudzinski's signs, which raised suspicion. Furthermore, the levels of alanine aminotransferase were at 250 U/l, aspartate aminotransferase at 467 U/l, direct bilirubin at 7.5 μmo1/l, lactate dehydrogenase at 991 U/l, α-hydroxybutyrate dehydrogenase at 666 U/l, and CRP at 125.40 mg/l. The serum Weil-Felix test revealed a Proteus OXK antibody level of 1:80. A chest CT on November 7th showed thickening of interlobular septa, thickening of bronchial vascular bundles, multifocal ground glass shadow, partial atelectasis, and bilateral pleural effusion . Consequently, upon the initial diagnosis of septic shock and type I respiratory failure, empirical anti-infective therapy was administered with moxifloxacin and meropenem. Additionally, antipyretic therapy was administered with ibuprofen. However, due to the unknown cause of the infection, there has been limited improvement in symptoms. At the same time, various tests were conducted to diagnose infectious pulmonary diseases, including Mycobacterium tuberculosis , Legionella, Mycoplasma, Chlamydia, Adenovirus, and so on. However, all the test results came back negative. Results of autoimmune antibodies tests in all patients were negative, which did not support the diagnosis of autoimmune diseases. Blood and sputum cultures also showed no bacterial growth. On November 6th, with the consent of the patient and his family, a lumbar puncture was performed to examine the cerebrospinal fluid. The cerebrospinal fluid was light yellow and transparent, with chloride 120 mmol/l, glucose 3.26 mmol/l, IgG 0.470, ink staining negative, positive Pandy's test, lactate dehydrogenase 67 umol/l, adenosine deaminase 2.8 umol/l, and cerebrospinal fluid protein 807.4 mmol/l. The count of nucleated cells in the cerebrospinal fluid was 6 × 10 6 cells/l, and no bacterial growth was observed even after five days of incubation. Moreover, the quantitative detection of mycobacterium tuberculosis nucleic acid was negative, so viral meningitis was initially suspected, and ganciclovir antiviral therapy was administered. However, chest ultrasound and CT on November 11st revealed an increase in pleural effusion, and the cranial CT scan revealed a symmetric reduction in white matter density surrounding the bilateral lateral ventricles, whereas no significant abnormalities were observed in other brain parenchymal structures. Additionally, the patient exhibited high fever, disturbed consciousness, and a white blood cell count below 4 * 10 9 /l, indicating further progression to systemic inflammatory response syndrome (SIRS). After a multidisciplinary consultation, considering the severe infection of the central nervous system (CNS), metagenomic second generation sequencing (mNGS) was performed on the cerebrospinal fluid, revealing the presence of oriental tsutsugamushi. Detailed pathogen detection results are shown in Fig. 2D . Combined with a history of travel prior to the fever, the patient was prescribed doxycycline 100 mg twice a day on November 9th. After 14 days of treatment, the patient regained consciousness and all vital signs, including body temperature, transcutaneous oxygen saturation, and heart rate, returned to normal. Additionally, there were no negative signs observed during brain stimulation. Laboratory results showed elevated platelets, decreased erythrocyte sedimentation and C-reactive protein (CRP), elevated albumin, decreased liver enzymes, suggesting that the treatment was effective. The chest CT on November 21st showed a decrease in fluid volume compared to the previous one , partial lobe reexpansion. The patient was discharged in stable condition on November 26th. Detailed laboratory test results and the process of patient admission are shown in Table 1 and Fig. 1 .
4.003906
0.979004
sec[1]/p[0]
en
0.999996
40124696
https://doi.org/10.1093/omcr/omae198
[ "november", "fluid", "cerebrospinal", "fever", "however", "consciousness", "blood", "body", "dehydrogenase", "chest" ]
[ { "code": "FA36.Z", "title": "Effusion of joint, unspecified" }, { "code": "5C70.0", "title": "Dehydration" }, { "code": "5C78", "title": "Fluid overload" }, { "code": "MG29.Z", "title": "Oedema, unspecified" }, { "code": "ME04.Z", "title": "Ascites, unspecified" }, { "code": "1D01.Z", "title": "Infectious meningitis, unspecified" }, { "code": "8A40.Z", "title": "Multiple sclerosis, unspecified" }, { "code": "MB70.Z", "title": "Clinical findings in cerebrospinal fluid, unspecified" }, { "code": "8D43.0Z", "title": "Encephalopathy due to toxicity, unspecified" }, { "code": "8D65", "title": "Cerebrospinal fluid fistula" } ]
=== ICD-11 CODES FOUND === [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 [5C70.0] Dehydration Definition: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water intake. Also known as: Dehydration | fluid depletion | anhydration | anhydremia | fluid volume deficit [5C78] Fluid overload Definition: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compartment occurs due to an increase in total body sodium content and a consequent increase in extracellular body water. The mechanism usually stems from compromised regulatory mechanisms for sodium handling as seen in congestive heart failure (CHF), kidney failure, and liver failure. It may also be cause Also known as: Fluid overload | fluid excess | fluid volume excess | hypervolemia | volume excess [MG29.Z] Oedema, unspecified Also known as: Oedema, unspecified | Oedema | dropsy | hydrops | Fluid retention NOS [ME04.Z] Ascites, unspecified Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS [1D01.Z] Infectious meningitis, unspecified Also known as: Infectious meningitis, unspecified | Infectious meningitis, not elsewhere classified | acute meningomyelitis | septic meningitis NOS | infectious meningitis NEC [8A40.Z] Multiple sclerosis, unspecified Also known as: Multiple sclerosis, unspecified | Multiple sclerosis | cerebrospinal sclerosis | disseminated sclerosis | generalised multiple sclerosis [MB70.Z] Clinical findings in cerebrospinal fluid, unspecified Also known as: Clinical findings in cerebrospinal fluid, unspecified | Clinical findings in cerebrospinal fluid | cerebrospinal fluid abnormality | nonspecific abnormal findings in cerebrospinal fluid [8D43.0Z] Encephalopathy due to toxicity, unspecified Also known as: Encephalopathy due to toxicity, unspecified | Encephalopathy due to toxicity | toxic encephalopathy | toxic brain fever | toxic brain inflammation [8D65] Cerebrospinal fluid fistula Definition: Cerebrospinal fluid fistula is a condition in which the cerebrospinal fluid (CSF) held in and around the human brain and spinal cord leaks out of the surrounding protective sac, the dura, for no apparent reason or due to several pathological processes. Also known as: Cerebrospinal fluid fistula | Cranial cerebrospinal fluid fistula | Cranial cerebrospinal fluid fistula due to injuries to the head | Cranial cerebrospinal fluid fistula due to surgery or lumbar puncture | Cranial cerebrospinal fluid fistula due to tumour invasion === GRAPH WALKS === --- Walk 1 --- [FA36.Z] Effusion of joint, unspecified --PARENT--> [FA36] Effusion of joint Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes.... --CHILD--> [FA36.0] Effusion of joint containing blood --- Walk 2 --- [FA36.Z] Effusion of joint, unspecified --PARENT--> [FA36] Effusion of joint Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes.... --CHILD--> [FA36.Y] Other specified effusion of joint --- Walk 3 --- [5C70.0] Dehydration Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water... --PARENT--> [5C70] Volume depletion --EXCLUDES--> [?] Hypovolaemic shock --- Walk 4 --- [5C70.0] Dehydration Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water... --RELATED_TO--> [?] Dehydration of newborn Def: A paediatric condition characterised by excessive loss of body water in a newborn.... --PARENT--> [?] Dehydration Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water... --- Walk 5 --- [5C78] Fluid overload Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart... --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance --CHILD--> [5C70] Volume depletion --- Walk 6 --- [5C78] Fluid overload Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart... --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance --PARENT--> [?] Metabolic disorders
[ "[FA36.Z] Effusion of joint, unspecified\n --PARENT--> [FA36] Effusion of joint\n Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes....\n --CHILD--> [FA36.0] Effusion of joint containing blood", "[FA36.Z] Effusion of joint, unspecified\n --PARENT--> [FA36] Effusion of joint\n Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes....\n --CHILD--> [FA36.Y] Other specified effusion of joint", "[5C70.0] Dehydration\n Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water...\n --PARENT--> [5C70] Volume depletion\n --EXCLUDES--> [?] Hypovolaemic shock", "[5C70.0] Dehydration\n Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water...\n --RELATED_TO--> [?] Dehydration of newborn\n Def: A paediatric condition characterised by excessive loss of body water in a newborn....\n --PARENT--> [?] Dehydration\n Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water...", "[5C78] Fluid overload\n Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart...\n --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance\n --CHILD--> [5C70] Volume depletion", "[5C78] Fluid overload\n Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart...\n --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance\n --PARENT--> [?] Metabolic disorders" ]
FA36.Z
Effusion of joint, unspecified
[ { "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" }, { "from_icd11": "FA36.Z", "icd10_code": "M25441", "icd10_title": "Effusion, right hand" }, { "from_icd11": "FA36.Z", "icd10_code": "M25452", "icd10_title": "Effusion, left hip" }, { "from_icd11": "FA36.Z", "icd10_code": "M25421", "icd10_title": "Effusion, right elbow" }, { "from_icd11": "FA36.Z", "icd10_code": "M25432", "icd10_title": "Effusion, left wrist" }, { "from_icd11": "FA36.Z", "icd10_code": "M25473", "icd10_title": "Effusion, unspecified ankle" }, { "from_icd11": "FA36.Z", "icd10_code": "M25412", "icd10_title": "Effusion, left shoulder" }, { "from_icd11": "FA36.Z", "icd10_code": "M25422", "icd10_title": "Effusion, left elbow" } ]
M25471
Effusion, right ankle
A 38-year-old woman developed numbness in the right limb and weakness and limited movement in the left limb following a fall from hitting her head on a door beam. She was unconscious on the spot. After treatment, her whole body was numb and limb activity was limited. Half an hour later, she felt numb and weak in the right limb and weak in the left limb. She had no previous hypertension, diabetes, or coronary heart disease. 13 years ago, she developed numbness in her right hand after pregnancy and was diagnosed with congenital fusion of cervical C2-5, which was not treated at that time . Her symptoms had improved and had not interfered with her normal life. There was no diplopia, slurred speech, hiccups, nausea and vomiting, dysphagia, urinary incontinence, and no corresponding symptoms such as facial sensory abnormalities. Physical examination revealed a short neck, limited cervical mobility, and low occipital hairline. Below the C3 level of spinal cord, bounded by the anterior median line, there were different sensory and motor abnormalities from left to right. The patient had decreased pinprick and temperature sensation on the right side and normal pinprick sensation on the left side. Her sense of spatial position was normal. There was increased muscle tone in the right upper and lower limbs and decreased muscle tone in the left upper and lower limbs. The muscle strength of the left upper and lower limbs was 0 out of 5 and the strength of the right upper and lower limbs was 4 out of 5. After conservative treatment, her muscle strength gradually recovered. 10 days later, some of the muscle strength showed changes, and the muscle strength of the key muscle groups was as follows: shrugging shoulder muscle strength (left 2, right4), elbow flexion muscle strength (left 2, right 4), elbow extension muscle strength (left 2, right 4), wrist flexion muscle strength (left 1, right 4). finger flexion muscle strength (left 1, right 4), finger extension muscle strength (left 1, right 3), hip flexion (left 2, right 4), knee extension (left 2, right 4), dorsalis pedis (left 3, right 4), plantarflexion (left 3, right 4), and hyperreflexia of the biceps and triceps tendons bilaterally. Abdominal wall reflexes were present, knee and Achilles tendon reflexes were hyperactive, patellar clonus was positive on the right, patellar clonus was positive on the left, ankle clonus was positive on the right and ankle clonus was positive on the left. The dorsalis pedis artery was palpable bilaterally. The bilateral Hoffman's sign was positive. Babinski's sign was positive and Kernig's sign was positive. The findings of Magnetic resonance imaging (MRI) in the neck revealed that small C2-5 vertebral body with partial fusion of the vertebral body; increased anterior atlantoaxial space, posterior superior displacement of the cardinal vertebrae, the narrowing of the spinal canal at the corresponding level and marked compression and thinning of the spinal cord (C1-2 joint instability, discontinuity of the odontoid process, congenital fusion of cervical C2-5). posterior protrusion of the C7-T1 intervertebral disc, with compression of the corresponding dural sac. No significant abnormal signs were seen in the cervical medulla. We considered that the woman sustained BBS because she had previously suffered from KFS, which according to ASIA(American Spinal Injury Association) Impairment Scale was a grade B: incomplete injury. After admission, the woman was given methylcobalamin for neurotropism and tizanidine to reduce muscle tone and received acupuncture and hyperbaric oxygen therapy. After conservative treatment, her spinal cord oedema decreased and the numbness on the right side gradually subsided, but the results were still unsatisfactory so the doctor recommended surgery. She then underwent posterior decompression of the spinal canal, and lateral mass fixation between atlas and axis with screw-plate system . After surgery, her numbness subsided and she continued to receive adenosine cobalamin for neurotropic treatment. She came to our hospital for a check 5 months later after the operation. The numbness of the right limb significantly decreased and the dysfunction of the limbs was slightly better than before. She could sit independently and stand with assistance, but she was still unable to take care of himself. She then underwent regular rehabilitation treatment in our hospital. 18 months later, the numbness of her limbs had disappeared and she was able to take care of herself with assistance, and her condition improved from grade B to grade D according to the ASIA classification. Fig. 1 DR of Patient's pre-operative cervical spine ( A neutral position, B posterior extension, C anterior flexion) Fig. 2 Patient's pre-operative sagittal MRI ( A T1W1, B T2W1, C T2W1 STIR) Fig. 3 Patient's post-operative DR ( A Sagittal position, B Coronal position)
4.03125
0.979492
sec[1]/p[0]
en
0.999997
37697343
https://doi.org/10.1186/s12891-023-06760-9
[ "muscle", "strength", "numbness", "limb", "spinal", "limbs", "cervical", "flexion", "position", "extension" ]
[ { "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": "PL13.0", "title": "Overdose of substance, as mode of injury or harm" }, { "code": "PL13.1", "title": "Underdosing, as mode of injury or harm" }, { "code": "QA70", "title": "Overdose of substance without injury or harm" }, { "code": "QA71", "title": "Underdosing without injury or harm" }, { "code": "MB40.3", "title": "Anaesthesia of skin" } ]
=== 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 [PL13.0] Overdose of substance, as mode of injury or harm Definition: Incorrect dose - too high Also known as: Overdose of substance, as mode of injury or harm | wrong dose of substance as mode of injury | wrong strength of substance as mode of injury | dose of substance administered or taken too early or too quickly as a mode of injury | extra dose of substance administered as mode of injury Includes: overdose of prescribed drug | medication error leading to excess level or effect of prescribed drug Excludes: Overdose of substance without injury or harm | Unintentional exposure to or harmful effects of drugs, medicaments or biological substances | Intentional self-harm by exposure to or harmful effects of drugs, medicaments or biological substances [PL13.1] Underdosing, as mode of injury or harm Also known as: Underdosing, as mode of injury or harm | underdosing of substance leading to inadequate level or effect of medication or substance as mode of injury | inadequate or insufficient dosage of substance, as mode of injury | missed or omitted dose of substance as mode of injury | dose of substance administered or taken too late or too slowly as mode of injury [QA70] Overdose of substance without injury or harm Definition: 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. No injury or harm occurred as a result. Also known as: Overdose of substance without injury or harm | overdose of prescribed drug without mention of injury or harm | wrong dose leading to excess level or effect of medication or substance without injury or harm | incorrect dose leading to excess level or effect of medication or substance without injury or harm | wrong strength of drug leading to excess level or effect of medication or substance without injury or harm Excludes: Overdose of substance, as mode of injury or harm [QA71] Underdosing without injury or harm Definition: Under-dosing occurs when a patient takes less of a medication than is prescribed by the provider or the manufacturer's instructions without documented injury or harm. This can be the result of inaccurate measurement of a drug, including oral administration. No injury or harm occurred as a result. Also known as: Underdosing without injury or harm | wrong dose leading to inadequate or insufficient level or effect of medication or substance without documented injury or harm | incorrect dose leading to inadequate or insufficient level or effect of medication or substance without documented injury or harm | wrong strength leading to inadequate or insufficient level or effect of medication or substance without documented injury or harm | incorrect strength of drug leading to inadequate or insufficient level or effect of medication or substance without documented injury or harm Excludes: Underdosing, as mode of injury or harm [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 === GRAPH WALKS === --- Walk 1 --- [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 2 --- [FB3Z] Disorders of muscles, unspecified --PARENT--> [?] Disorders of muscles --CHILD--> [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.... --- 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--> [?] Cramp or spasm --- 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.... --RELATED_TO--> [?] Sarcoid myositis Def: This is inflammation of skeletal muscle secondary to sarcoidosis.... --- 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... --CHILD--> [8C70.2] Emery-Dreifuss muscular dystrophy Def: Emery-Dreifuss muscular dystrophy (EDMD) is a muscle disease characterised by muscular weakness and atrophy, with early contractures of the tendons and cardiac involvement (arrhythmias, cardiomyopathy... --- 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--> [?] 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....
[ "[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...", "[FB3Z] Disorders of muscles, unspecified\n --PARENT--> [?] Disorders of muscles\n --CHILD--> [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....", "[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--> [?] Cramp or spasm", "[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 --RELATED_TO--> [?] Sarcoid myositis\n Def: This is inflammation of skeletal muscle secondary to sarcoidosis....", "[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 --CHILD--> [8C70.2] Emery-Dreifuss muscular dystrophy\n Def: Emery-Dreifuss muscular dystrophy (EDMD) is a muscle disease characterised by muscular weakness and atrophy, with early contractures of the tendons and cardiac involvement (arrhythmias, cardiomyopathy...", "[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--> [?] 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...." ]
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
A 72-year-old man presented with blurred vision in both eyes beginning 1 week earlier as a dark, partially transparent area in the center of both visual fields. The dark area gradually expanded and changed to a pericentral dark ring in both eyes. He had suffered from aplastic anemia for 4 years and received one blood transfusion per week for 8 months when he presented. He had also received five infusions of 301 mg antithymocyte globulin 1 month before the onset of visual loss and oral deferasirox beginning 4 months earlier. Deferasirox was discontinued after 1 month due to renal impairment and changed to deferoxamine infusion 1 month prior to visual loss. Past medical history included appendectomy (21 y), encephalitis (42 y), bilateral cataract surgery with pseudophakia (51 y) and curative treatment of prostate cancer (69 y). Best-corrected Snellen visual acuity (BCVA) was 0.6 in the right eye and 0.9 in the left eye, a serous detachment of the macula was found in both eyes and applanation tonometry was normal. Visual acuity deteriorated to 0.3 in both eyes 3 months later. A presumptive diagnosis of deferoxamine retinopathy prompted a switch to oral deferiprone, but visual acuity decreased to worse than 0.1 in both eyes over the following year. From half a year before presentation to half a year after presentation, plasma ferritin – a surrogate measure of iron stores – had ranged from 2000 to 7230 ng/mL , reference range 15–320 ng/mL, with prominent peaks immediately before and after the onset of visual loss . Patchy visual field sensitivity loss was seen corresponding to hyper- and hypofluorescent degeneration of the outer retina in both maculae and severely reduced cone photoreceptor density out 14 degrees from the foveola . There were no other signs of hemosiderosis. Fig. 1 Timeline chart for patient 1 and 2 with relevant blood tests and drug exposure. Legend: Patient 1, timeline from 4 years after presentation with chronic anemia through half a year leading up to the onset of visual loss and 4 months thereafter, showing the exposure to cyclosporin, antithymocyte globulin, iron chelators (deferasirox, deferoxamine and deferiprone), thrombopoietin analog (eltrombopag), onset and persistence of visual loss, onset of fever and pulmonary edema, and plasma concentrations of ferritin, creatinine, c-reactive protein and hemoglobin. Additionally, the patient received blood transfusions throughout the period of observation. Patient 2, timeline from 3 years after the diagnosis of blood dyscrasia through 37 months of follow-up. Deferiprone was exchanges for deferoxamine due to deviating renal function and inefficiency. Additionally, the patient received blood transfusions throughout the period of observation. SI conversion factor: Ferritin, ng/mL ➔ μg/L, multiply by 1; creatinine, mg/dL ➔ μmol/L, multiply by 88.42; c-reactive protein, mg/dL ➔ mg/L, multiply by 10; and hemoglobin, g/dL ➔ mmol/L, multiply by 0.62 Fig. 2 Automated perimetry examination of patient 1 and 2. Legend: Automated perimetry, 30-2, (Octopus 900, Haag-Streit, Switzerland) in two patients, patient 1 above at presentation and patient 2 below at 2 years after presentation. MS, mean sensitivity; MD, mean defect; and sLV, square root of loss variance Fig. 3 Optical coherence tomography and blue light fundus autofluorescence imaging of retinal defects. Legend: In patient 1 (A + B), a diffuse dotted blue light fundus autofluorescence of the right eye shows widespread defects in the whole macula ( A ). The corresponding horizontal transfoveal optical coherence tomography shows degeneration and irregularities in the outer retina ( B ). In patient 2 (C + D), a more localized defect is visible in the parafoveal region on blue light fundus autofluorescence ( C ). The optical coherence tomography shows the same outer retinal defects as in case 1 but temporally an intact outer retina is seen ( D ). In case 1 the images were acquired during initial visit, and in case 2 the images were acquired at follow-up 6 months after initial visit. Scans were acquired on Spectralis OCT2 (Heidelberg Engineering, Heidelberg, Germany) Fig. 4 Adaptive optics fundus photography of photoreceptor mosaic. Legend: Patient 1 ( A ), patient 2 ( B ) and a healthy age-matched volunteer ( C ), spanning from the fovea (indicated by red circles) to a position 14 degrees temporal of the foveal center. Patient 1 is remarkable for having a transitional zone (white arrows) between injured granular retina on the foveal side and more normal retina on the temporal side. Patient 2 shows patchy absence or attenuation of the photoreceptor matrix. The healthy volunteer had a normal photoreceptor distribution. The images of patient 1 and 2 were recorded 5 and 4 months, respectively, after presentation. Acquired on RTX-1 (Imagine Eyes, Orly, France) on flood-illuminated adaptive optics fundus photography
4.097656
0.964355
sec[1]/sec[0]/p[0]
en
0.999998
34256738
https://doi.org/10.1186/s12886-021-02030-1
[ "visual", "both", "loss", "eyes", "blood", "onset", "retina", "fundus", "deferoxamine", "outer" ]
[ { "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" }, { "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": "FB32.Y", "title": "Other specified disorders of muscles" } ]
=== ICD-11 CODES FOUND === [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 [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 [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 === GRAPH WALKS === --- Walk 1 --- [9E1Z] Diseases of the visual system, unspecified --PARENT--> [09] Diseases of the visual system Def: This refers to any diseases of the visual system, which includes the eyes and adnexa, the visual pathways and brain areas, which initiate and control visual perception and visually guided behaviour.... --RELATED_TO--> [?] Contusion of eyeball or orbital tissues Def: Injuries to the eyeball and surrounding tissue resulting in haemorrhage, usually manifested in the skin.... --- Walk 2 --- [9E1Z] Diseases of the visual system, unspecified --PARENT--> [09] Diseases of the visual system Def: This refers to any diseases of the visual system, which includes the eyes and adnexa, the visual pathways and brain areas, which initiate and control visual perception and visually guided behaviour.... --RELATED_TO--> [?] Contusion of eyeball or orbital tissues Def: Injuries to the eyeball and surrounding tissue resulting in haemorrhage, usually manifested in the skin.... --- Walk 3 --- [MC1Y] Other specified symptoms or signs involving the visual system --PARENT--> [?] Symptoms or signs involving the visual system --CHILD--> [MC11] Eye sensation abnormal --- Walk 4 --- [MC1Y] Other specified symptoms or signs involving the visual system --PARENT--> [?] Symptoms or signs involving the visual system --CHILD--> [MC10] Eye appearance abnormal --- Walk 5 --- [9D9Z] Vision impairment, unspecified --PARENT--> [?] Vision impairment Def: A vision impairment results when an eye condition affects the visual system and one or more of its vision functions. Typically, population-based surveys measure visual impairment using exclusively vis... --CHILD--> [9D92] Specific vision dysfunctions Def: Specific visual dysfunctions refer to functional deficits in higher cerebral centres. Such dysfunctions may exist with or without visual impairment of the eyes and the lower visual system.... --- Walk 6 --- [9D9Z] Vision impairment, unspecified --PARENT--> [?] Vision impairment Def: A vision impairment results when an eye condition affects the visual system and one or more of its vision functions. Typically, population-based surveys measure visual impairment using exclusively vis... --CHILD--> [9D93] Complex vision-related dysfunctions Def: Complex Vision-Related Dysfunctions involve interactions with other sensory and motor systems. They reflect the combined effects at all stages of processing....
[ "[9E1Z] Diseases of the visual system, unspecified\n --PARENT--> [09] Diseases of the visual system\n Def: This refers to any diseases of the visual system, which includes the eyes and adnexa, the visual pathways and brain areas, which initiate and control visual perception and visually guided behaviour....\n --RELATED_TO--> [?] Contusion of eyeball or orbital tissues\n Def: Injuries to the eyeball and surrounding tissue resulting in haemorrhage, usually manifested in the skin....", "[9E1Z] Diseases of the visual system, unspecified\n --PARENT--> [09] Diseases of the visual system\n Def: This refers to any diseases of the visual system, which includes the eyes and adnexa, the visual pathways and brain areas, which initiate and control visual perception and visually guided behaviour....\n --RELATED_TO--> [?] Contusion of eyeball or orbital tissues\n Def: Injuries to the eyeball and surrounding tissue resulting in haemorrhage, usually manifested in the skin....", "[MC1Y] Other specified symptoms or signs involving the visual system\n --PARENT--> [?] Symptoms or signs involving the visual system\n --CHILD--> [MC11] Eye sensation abnormal", "[MC1Y] Other specified symptoms or signs involving the visual system\n --PARENT--> [?] Symptoms or signs involving the visual system\n --CHILD--> [MC10] Eye appearance abnormal", "[9D9Z] Vision impairment, unspecified\n --PARENT--> [?] Vision impairment\n Def: A vision impairment results when an eye condition affects the visual system and one or more of its vision functions. Typically, population-based surveys measure visual impairment using exclusively vis...\n --CHILD--> [9D92] Specific vision dysfunctions\n Def: Specific visual dysfunctions refer to functional deficits in higher cerebral centres. Such dysfunctions may exist with or without visual impairment of the eyes and the lower visual system....", "[9D9Z] Vision impairment, unspecified\n --PARENT--> [?] Vision impairment\n Def: A vision impairment results when an eye condition affects the visual system and one or more of its vision functions. Typically, population-based surveys measure visual impairment using exclusively vis...\n --CHILD--> [9D93] Complex vision-related dysfunctions\n Def: Complex Vision-Related Dysfunctions involve interactions with other sensory and motor systems. They reflect the combined effects at all stages of processing...." ]
9E1Z
Diseases of the visual system, unspecified
[ { "from_icd11": "9E1Z", "icd10_code": "H5500", "icd10_title": "Unspecified nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5509", "icd10_title": "Other forms of nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5581", "icd10_title": "Saccadic eye movements" }, { "from_icd11": "9E1Z", "icd10_code": "H5501", "icd10_title": "Congenital nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5502", "icd10_title": "Latent nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5589", "icd10_title": "Other irregular eye movements" }, { "from_icd11": "9E1Z", "icd10_code": "H5503", "icd10_title": "Visual deprivation nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5504", "icd10_title": "Dissociated nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H44522", "icd10_title": "Atrophy of globe, left eye" }, { "from_icd11": "9E1Z", "icd10_code": "H3552", "icd10_title": "Pigmentary retinal dystrophy" }, { "from_icd11": "9E1Z", "icd10_code": "E70331", "icd10_title": "Hermansky-Pudlak syndrome" }, { "from_icd11": "9E1Z", "icd10_code": "H57812", "icd10_title": "Brow ptosis, left" }, { "from_icd11": "9E1Z", "icd10_code": "H5789", "icd10_title": "Other specified disorders of eye and adnexa" }, { "from_icd11": "9E1Z", "icd10_code": "H3550", "icd10_title": "Unspecified hereditary retinal dystrophy" }, { "from_icd11": "9E1Z", "icd10_code": "E7030", "icd10_title": "Albinism, unspecified" } ]
H5500
Unspecified nystagmus
Most studies on Hutchinson–Gilford progeria syndrome are epidemiological or oriented towards the description of the phenotypic characteristics; some others focus on the autopsy findings or the changes in laboratory tests and more recently on the genetic aspects. So far, relatively few studies have dealt with cardiac complications, and these mainly describe the results of electrocardiography and echocardiography . The causes of death in Hutchinson–Gilford progeria syndrome are mainly due to cardiovascular events, and death usually occurs in the second decade of life from myocardial infarction or cerebrovascular disease caused by premature arteriosclerosis; the average life expectancy for a child with progeria is 13–14 years . However, for many years the therapeutic aspects were little considered; a premature death was reported as an inevitable event and no treatment advices have so far been proposed, either for the chronic management or for the acute complications. Only in recent years have a few anecdotal cases been reported, in which an emergency therapy or cardiac surgery was performed . The most interesting aspect of this case consists of a PCI attempted in near emergency conditions with a high risk coronary circulation, which proved to be successful. This patient was already known due to a previous stroke and dyslipidemia; the latter, not always described in Hutchinson–Gilford progeria syndrome, may have been an additional risk factor for cardiovascular events . In the emergency room we observed a short duration of symptoms and a slight increase in the troponin level. The ECG pattern, however, showed extensive ischemic involvement of the left ventricular anterior wall, although reversible, as already described in a Hutchinson–Gilford progeria syndrome patient in the context of an echocardiographic pattern of diastolic left ventricular dysfunction, preserved contractility, and concentric hypertrophy. The image of the septum thinning was probably due to a previous ischemic event, but the small area of dyskinesia of the apical septum must be interpreted as a sign of acute ischemic distress. Therefore, the decision to first submit the patient to a CT angiography, as a safer procedure, can be shared ; in this way we could evidence the lesion of the common trunk of the left coronary artery, which appeared to be very critical. The decision to continue in the diagnostic investigation with angiography was based on the observation of extensive electrocardiographic involvement which could not be explained merely by the ostial lesion of the left coronary artery, which appeared to be chronic. On the basis of the ECG, involvement suspicion could be raised of a lesion of the right coronary one, potentially eligible for PCI. Indeed, the coronary angiography evidenced, in addition to the left coronary lesion, a severe proximal stenosis of the right coronary artery, not detected by angio-CT. We hypothesize that this might be due to motion artifacts related to high heart rate, a known limitation of coronary angio-CT in children . The critical involvement at the origin of the two main coronary arteries is a life-threatening condition and usually requires surgical treatment in adult patients . However, this was deemed too risky in this precarious patient because coronary artery bypass grafting (CABG) has rarely been described in pediatric patients, and then mainly in the treatment of coronary complications of Kawasaki disease, with only one case in a progeria patient, who died during surgery . Thus, based on risk-benefit assessment, treatment with PCI was deemed the best therapeutic option. To the best of our knowledge, only one previous case of successful PCI has been described in a 13-year-old boy with progeria in an acute myocardial infarction . Hence, this represents the first case of successful PCI procedure in a Hutchinson–Gilford progeria syndrome patient reported in the literature as an elective procedure. The particular condition of the disease creates atherosclerotic alterations similar to those of the adults in a small arterial tree, which makes its vascular access more complex, requires the use of miniaturized catheters and balloons, and increases the risk of complications such as arterial dissection . This case confirms the possibility of applying percutaneous treatment of coronary atherosclerotic lesions even in low weight pediatric patients and with a complex coronary tree. Furthermore, it proves that electrocardiography still plays a central role in the diagnosis of myocardial ischemia as the ST changes have proven to be the earliest test in guiding the therapeutic options. The use of dual antiplatelet therapy, recommended in adult patients submitted to PCI for secondary prevention of ischemic events but still not reported in children, has proven to be effective and safe in this patient in a mid-term follow-up .
4.191406
0.768555
sec[2]/p[0]
en
0.999997
PMC10047036
https://doi.org/10.3390/children10030526
[ "coronary", "this", "progeria", "which", "hutchinson", "gilford", "complications", "risk", "ischemic", "involvement" ]
[ { "code": "BA8Z", "title": "Diseases of coronary artery, unspecified" }, { "code": "BA4Z", "title": "Acute ischaemic heart disease, unspecified" }, { "code": "BA41.Z", "title": "Acute myocardial infarction, unspecified" }, { "code": "BA5Z", "title": "Chronic ischaemic heart disease, unspecified" }, { "code": "LA8C.2", "title": "Congenital coronary arterial fistula" }, { "code": "4A01.03", "title": "Transient hypogammaglobulinaemia of infancy" }, { "code": "LD2B", "title": "Syndromes with premature ageing appearance as a major feature" }, { "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" } ]
=== ICD-11 CODES FOUND === [BA8Z] Diseases of coronary artery, unspecified Also known as: Diseases of coronary artery, unspecified | coronary artery insufficiency | coronary artery heart disease | CAD - [coronary artery disease] | coronary artery disorder [BA4Z] Acute ischaemic heart disease, unspecified Also known as: Acute ischaemic heart disease, unspecified | acute coronary syndrome | ACS - [acute coronary syndrome] | Silent myocardial ischaemia | asymptomatic ischemia [BA41.Z] Acute myocardial infarction, unspecified Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction [BA5Z] Chronic ischaemic heart disease, unspecified Also known as: Chronic ischaemic heart disease, unspecified | Ischaemic heart disease (chronic) NOS | coronary ischaemia | coronary damage NOS | atheroma of heart [LA8C.2] Congenital coronary arterial fistula Definition: A congenital cardiovascular malformation in which a coronary artery communicates, through an anomalous channel, with a cardiac chamber or with any segment of the systemic or pulmonary circulation. Additional information: this communication may be simple and direct or may be tortuous and dilated. In order of frequency the involved coronary artery is the right, the left and, rarely, both coronary arteries. Occasionally multiple fistulas are present. Also known as: Congenital coronary arterial fistula | coronary fistula | congenital arteriovenous coronary fistula | congenital coronary fistula to pulmonary artery | Congenital coronary arterial fistula to right ventricle Includes: congenital coronary fistula to pulmonary artery Excludes: anomalous origin of coronary artery from pulmonary arterial tree [4A01.03] Transient hypogammaglobulinaemia of infancy Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy] [LD2B] Syndromes with premature ageing appearance as a major feature Definition: A heterogeneous group of hereditary syndromes in which affected individuals do or appear to age at an accelerated rate. Also known as: Syndromes with premature ageing appearance as a major feature | Progeroid syndromes | premature aging syndrome | progeria syndrome | Cockayne syndrome Includes: Progeroid syndromes | Cockayne syndrome | Rothmund-Thomson syndrome Excludes: Xeroderma pigmentosum | Cutis laxa [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 === GRAPH WALKS === --- Walk 1 --- [BA8Z] Diseases of coronary artery, unspecified --PARENT--> [?] Diseases of coronary artery Def: Conditions affecting the blood perfusion of the heart.... --RELATED_TO--> [?] Cardiac transplant associated coronary allograft vasculopathy Def: Coronary artery initimal proliferation following cardiac transplantation, defined based on a combination of visual angiographic vessel descriptors in concert with measures of cardiac allograft functio... --- Walk 2 --- [BA8Z] Diseases of coronary artery, unspecified --PARENT--> [?] Diseases of coronary artery Def: Conditions affecting the blood perfusion of the heart.... --CHILD--> [BA82] Coronary artery dissection Def: Coronary artery dissection results from a tear in the inner layer of the coronary artery, the tunica intima. This allows blood to penetrate and cause an intramural hematoma in the central layer, the t... --- Walk 3 --- [BA4Z] Acute ischaemic heart disease, unspecified --PARENT--> [?] Acute ischaemic heart disease --CHILD--> [BA40] Angina pectoris --- Walk 4 --- [BA4Z] Acute ischaemic heart disease, unspecified --PARENT--> [?] Acute ischaemic heart disease --CHILD--> [BA42] Subsequent myocardial infarction Def: Infarction of any myocardial site, occurring within 4 weeks (28 days) from onset of a previous infarction... --- Walk 5 --- [BA41.Z] Acute myocardial infarction, unspecified --PARENT--> [BA41] Acute myocardial infarction Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o... --CHILD--> [BA41.1] Acute non-ST elevation myocardial infarction --- Walk 6 --- [BA41.Z] Acute myocardial infarction, unspecified --PARENT--> [BA41] Acute myocardial infarction Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o... --CHILD--> [BA41.0] Acute ST elevation myocardial infarction Def: ST elevation myocardial infarction (STEMI) is an acute myocardial infarction with developing ST elevation in two contiguous leads of the electrocardiogram. The criteria of ST elevation are as follows:...
[ "[BA8Z] Diseases of coronary artery, unspecified\n --PARENT--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....\n --RELATED_TO--> [?] Cardiac transplant associated coronary allograft vasculopathy\n Def: Coronary artery initimal proliferation following cardiac transplantation, defined based on a combination of visual angiographic vessel descriptors in concert with measures of cardiac allograft functio...", "[BA8Z] Diseases of coronary artery, unspecified\n --PARENT--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....\n --CHILD--> [BA82] Coronary artery dissection\n Def: Coronary artery dissection results from a tear in the inner layer of the coronary artery, the tunica intima. This allows blood to penetrate and cause an intramural hematoma in the central layer, the t...", "[BA4Z] Acute ischaemic heart disease, unspecified\n --PARENT--> [?] Acute ischaemic heart disease\n --CHILD--> [BA40] Angina pectoris", "[BA4Z] Acute ischaemic heart disease, unspecified\n --PARENT--> [?] Acute ischaemic heart disease\n --CHILD--> [BA42] Subsequent myocardial infarction\n Def: Infarction of any myocardial site, occurring within 4 weeks (28 days) from onset of a previous infarction...", "[BA41.Z] Acute myocardial infarction, unspecified\n --PARENT--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...\n --CHILD--> [BA41.1] Acute non-ST elevation myocardial infarction", "[BA41.Z] Acute myocardial infarction, unspecified\n --PARENT--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...\n --CHILD--> [BA41.0] Acute ST elevation myocardial infarction\n Def: ST elevation myocardial infarction (STEMI) is an acute myocardial infarction with developing ST elevation in two contiguous leads of the electrocardiogram. The criteria of ST elevation are as follows:..." ]
BA8Z
Diseases of coronary artery, unspecified
[ { "from_icd11": "BA4Z", "icd10_code": "I248", "icd10_title": "Other forms of acute ischemic heart disease" }, { "from_icd11": "BA4Z", "icd10_code": "I256", "icd10_title": "Silent myocardial ischemia" }, { "from_icd11": "BA4Z", "icd10_code": "I249", "icd10_title": "Acute ischemic heart disease, unspecified" }, { "from_icd11": "BA4Z", "icd10_code": "I24", "icd10_title": "Other acute ischemic heart diseases" }, { "from_icd11": "BA41.Z", "icd10_code": "I21A1", "icd10_title": "Myocardial infarction type 2" }, { "from_icd11": "BA41.Z", "icd10_code": "I21A9", "icd10_title": "Other myocardial infarction type" }, { "from_icd11": "BA41.Z", "icd10_code": "I2109", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall" }, { "from_icd11": "BA41.Z", "icd10_code": "I2119", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall" }, { "from_icd11": "BA41.Z", "icd10_code": "I2111", "icd10_title": "ST elevation (STEMI) myocardial infarction involving right coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2102", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2129", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other sites" }, { "from_icd11": "BA41.Z", "icd10_code": "I2121", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2101", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left main coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I214", "icd10_title": "Non-ST elevation (NSTEMI) myocardial infarction" }, { "from_icd11": "BA41.Z", "icd10_code": "I213", "icd10_title": "ST elevation (STEMI) myocardial infarction of unspecified site" } ]
I248
Other forms of acute ischemic heart disease
A 38-year-old man presented to our hospital with chief complaints of fever for six days and altered sensorium for two days. He was treated elsewhere for the past four days and then shifted to our hospital. On examination he was febrile - 104 o F, haemodynamically stable, and general examination revealed no abnormality, Glasgow coma scale (GCS) was E4M5V3. He was evaluated accordingly, his reports done were: blood urea- 63.9 mg/dL, serum creatinine- 1.97 mg/dL, sodium- 141 mEq/L, potassium- 3.22 mEq/L, chloride- 103.2 mEq/L, hemoglobin- 14.6 g/dL, platelet count- 42000/cumm, tropical fever workup came negative, serology was negative, blood and urine cultures were sterile, Chest X-ray (CXR) was normal, procalcitonin (PCT) was 50 ng/ml, prothrombin time (PT) and activated partial thromboplastin time (aPTT) were normal, direct and indirect Coombs test was negative, urine routine; protein +++, glucose ++, pus cell 3-/HPF, red blood cell (RBC) 25-30/HPF, ultrasound abdomen- right kidney (RK)- 11.7 x 5.8cm, left kidney (LK)- 10.7 x 6.1 cm, raised bilateral echogenicity, cortico-medullary differentiation (CMD) maintained. Liver function test (LFT)- bilirubin (direct/Indirect) 1.17/0.9 mg/dL, aspartate transaminase (AST or SGOT) and alanine transaminase (ALT or SGPT) were normal, HbA1c was 9.2%. MRI Brain showed no significant brain parenchymal abnormality. After sending cultures, the patient was empirically started on intravenous antibiotics: injection piperacillin tazobactam + teicoplanin, injection artesunate with other supportive treatment. On day 1 evening, he became violent with the inability to control by restraint, was sedated and intubated, in view of the prolonged need of sedation and risk of respiratory depression, put on a mechanical ventilator. Lactate dehydrogenase (LDH) was 90 U/L on day 1. Repeat LDH on day 2 was 589 U/L which increased to 987 U/L on day 3. On day 3, renal function test (RFT) showed blood urea 191 mg/dl, creatinine 5.15 mg/dl and since morning his urine output had decreased, so the patient was haemodialysed. Direct and indirect Coombs tests were negative and peripheral smear for schistocytes was reported as negative. In view of fever persisting over 102 - 106 o F despite broad-spectrum antibiotics and antimalarial drugs, the elevation of LDH within three days, fall in hemoglobin, deranged RFTs, altered sensorium, and thrombocytopenia with normal coagulation parameters; a diagnosis of thrombotic thrombocytopenic purpura was made. His mean corpuscular volume (MCV) was 78.7 fl and the PLASMIC score was 6 points (high risk) denoting 72% risk of severe ADAMTS13 deficiency (defined as ADAMTS13 activity level <15%). Injection methylprednisolone 1 gm was started post hemodialysis on day 3. On day 4, LDH was 1443 U/L and the first session of plasmapheresis with an exchange of 2.5 litres followed by haemodialysis (HD) was done. The patient dramatically became afebrile after the first session of plasmapheresis, while prior to plasmapheresis he had a fever of 102 - 104 o F. A second dose of injection methylprednisolone was given post HD. Improvement in LDH level and platelet count was seen on day 5 and the second session of plasmapheresis with an exchange of 2.5 litres of plasma and the third dose of injection methylprednisolone 1 gm was given. Improvement in LDH and platelet count was seen on day 6 and day 7 and the third and fourth session of plasmapheresis with an exchange of 2.5 litres was done and oral prednisolone 1 mg/kg was started on day 6. By day 8 his sensorium had improved, and he was oriented, he was extubated, and his blood reports were urea- 137 mg/dL, creatinine- 2.08 mg/dL, sodium- 139 mEq/L, potassium- 3.41 mEq/L, chloride- 98 mEq/L, hemoglobin- 11.3 g/dL, platelet count- 208000 per cumm, LDH- 705 U/L. In view of urine output of 2550 mL, plasmapheresis was withheld even though LDH was >500 U/L as his plasmapheresis filter was not reusable and it was decided to wait and see the trend of the platelet count and LDH to decide about the further need for plasmapheresis. His blood pressure started increasing, he needed Injection nitroglycerin infusion and later started on oral antihypertensive drugs. From day 9, serial RFT and platelet count showed improvement and no further plasmapheresis or hemodialysis was needed till discharge. He was shifted to ward on day 11 and after his blood sugar level was also controlled (initial days after methylprednisolone pulses he needed insulin infusion and then shifted on to regular insulin with oral hypoglycaemic drug). After it was ascertained that his RFT, platelet count, and LDH were stable he was discharged on day 14 on antihypertensive drugs, mixture insulin and oral hypoglycaemic, and prednisolone 1 mg/kg with a plan to continue the same dose for a total of one month and then taper and omit. His daily lab reports and events are shown in Table 1 .
3.855469
0.97998
sec[1]/p[1]
en
0.999997
PMC8897657
https://doi.org/10.7759/cureus.21853
[ "plasmapheresis", "blood", "platelet", "count", "injection", "fever", "urine", "methylprednisolone", "session", "oral" ]
[ { "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.... --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.... --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--> [MF50.4Z] 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--> [MF50.41] Microscopic 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--> [MA12.2] Finding of hallucinogen 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 --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 --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 --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--> [MF50.4Z] 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--> [MF50.41] Microscopic 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--> [MA12.2] Finding of hallucinogen 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 --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 55-year-old female patient went to a local hospital for a magnetic resonance imaging (MRI) examination of her left knee 2 months ago because she felt swelling and dull pain in her left knee after daily walking. The result showed a space-occupying lesion in the left distal femur. The local doctor suggested conservative treatment and regular assessment. Conservative therapy lasted for one month, during which the symptoms did not improve, but the distension and pain of the left distal femur became more apparent, so she went to the orthopedic clinic in our hospital. She was found to have pain on the lateral side of her left distal femur by pressing, without touching the mass during the physical examination. The skin temperature of the left distal femur was normal and the skin could move freely. Anteroposterior and lateral radiographs of the left knee showed a patchy high-density shadow of the left distal femur without fracture or bone destruction . MRI of the left thigh showed an isolated patchy abnormal signal of the left distal femur, with low signal intensity on T1-weighted images , as well as a heterogeneous lesion of the left distal femur with high signal intensity on T2-weighted images , with uneven internal signal, and no clear abnormal signal in the muscle and subcutaneous soft tissue of the left thigh. We comprehensively considered it as a benign tumor initially and suspected it was endogenous chondrosarcoma. Nevertheless, there was no clear diagnostic foundation. In order to alleviate her current symptoms and ascertain the nature of the lesion, we admitted her to the hospital and began preparing her for surgery. Before the surgery, we carried out some examinations for her and found that all indicators of her hemoglobin, total white blood cell count and various specific indicators contained in white blood cell, platelets, coagulation function, calcium ions, potassium ions, antistreptolysin O, rheumatoid factor, hypersensitive c-reactive protein, fasting blood sugar, erythrocyte sedimentation rate, and renal function were normal. In addition to a slightly lower albumin index (37.3g/L, normal range: 40–55g/L) and a higher alkaline phosphatase index (174.8U/L, normal range: 50–135U/L), other indicators of hepatic function were normal. After a comprehensive analysis of preoperative examinations, no contraindications were found. We conducted surgical treatment for her on the third day in the hospital. An incision was performed on the lateral side of the left distal femur, and a long strip of the bone block with a size of 2 cm*8 cm was removed at the location of the tumor to expose the tumor. Additionally, the lesion in the medullary cavity was found to be fibrous-like and bone marrow-like in appearance. The lesion in the medullary cavity and on the bone block was thoroughly curetted until the normal bone was visible and all specimens were sent for histopathological analysis. The bleeding was thoroughly stopped, then the incision was rinsed with distilled water and normal saline. The artificial bone matrix was filled in the defect and the removed bone block is put in place. We did not perform plate fixation for her, which saved money for her, but increased the risk of postoperative fracture and the risk of thrombosis due to early failure of functional exercise. Histopathological examination of the specimens revealed that a pile of yellow broken bone tissues were visible to the naked eye, with a total volume of 4 cm*3 cm*1 cm . And in some typical microscopic images, myxoid degeneration, calcified bone tissue, fat necrosis, cystic degeneration, irregular calcification, and collagen degeneration of fibrous tissue are seen . LSMFT was confirmed after consulting with the pathology professors. We didn't give her follow-up radiation and chemotherapy because it's a benign lesion reported in the literature. The patient recovered well after the surgery. The alkaline phosphatase index decreased on the 1st day after the surgery and remained normal after the 3rd postoperative day. Anteroposterior and lateral radiographs of the left femur showed no aberrant signal at the left distal femur on the 3rd day after the surgery . On the fifth day after the operation, she was discharged from the hospital in good condition and returned home. During the routine follow-up evaluations for six months, she was found to have returned to normal daily life with no symptoms of discomfort. Six months later, anteroposterior and lateral radiographs of the left knee showed good recovery of the left distal femur, consistent with the postoperative change of the left distal femur . During the six months of follow-up, the symptoms of her affected limb showed no signs of recurrence, nor was there the indication of a recurrence of her imaging. We will continue to follow her up for a long period time and pay close attention to her life after surgery.
3.908203
0.981934
sec[1]/p[0]
en
0.999998
PMC9856175
https://doi.org/10.3389/fsurg.2022.1009975
[ "femur", "bone", "lesion", "signal", "knee", "pain", "anteroposterior", "radiographs", "tissue", "tumor" ]
[ { "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": "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": "FB86.1Z", "title": "Bone hyperplasias, unspecified" }, { "code": "FA5Z", "title": "Arthropathies, unspecified" } ]
=== ICD-11 CODES FOUND === [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 [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 [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias [FA5Z] Arthropathies, unspecified Also known as: Arthropathies, unspecified | Disorders affecting predominantly peripheral joints | Disorders affecting predominantly peripheral limb joints | arthropathy NOS | arthropathic === GRAPH WALKS === --- Walk 1 --- [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.2] Fibular hemimelia Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone.... --- Walk 2 --- [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 3 --- [FA31.8] Acquired unequal limb length --PARENT--> [FA31] Other acquired deformities of limbs --CHILD--> [FA31.1] Varus deformity, not elsewhere classified --- Walk 4 --- [FA31.8] Acquired unequal limb length --PARENT--> [FA31] Other acquired deformities of limbs --CHILD--> [FA31.0] Valgus deformity, not elsewhere classified --- Walk 5 --- [FA31.Y] Other specified acquired deformities of limbs --PARENT--> [FA31] Other acquired deformities of limbs --CHILD--> [FA31.2] Flexion deformity --- Walk 6 --- [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....
[ "[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.2] Fibular hemimelia\n Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone....", "[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--> [FA31.1] Varus deformity, not elsewhere classified", "[FA31.8] Acquired unequal limb length\n --PARENT--> [FA31] Other acquired deformities of limbs\n --CHILD--> [FA31.0] Valgus deformity, not elsewhere classified", "[FA31.Y] Other specified acquired deformities of limbs\n --PARENT--> [FA31] Other acquired deformities of limbs\n --CHILD--> [FA31.2] Flexion deformity", "[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...." ]
LB9A.8
Femoral agenesis or hypoplasia
[ { "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" }, { "from_icd11": "8C11.2", "icd10_code": "G5723", "icd10_title": "Lesion of femoral nerve, bilateral lower limbs" } ]
Q724
Longitudinal reduction defect of femur
The patient was in good health until three months before admission when he presented with fatigue, intermittent paresthesias of all limbs, cold intolerance, polyuria, weight gain, and irritability. He consulted a primary care physician that made a diagnosis of diabetes mellitus, hypertension, and dyslipidemia and began treatment with Metformin 850 mg twice daily, Glargine insulin 16 units in the morning, Enalapril 10 mg twice daily, and Atorvastatin 20 mg at night. After one month, the patient discontinued the Enalapril on his own. During the next few months the patient presented with generalized edema, abdominal striae, and depressive symptoms. Also two days before admission he presented with confusion. On arrival, the physical exam found him to be obese, with plethoric facies, severe edema of the lower limbs, bruising and red-purple abdominal striae . He was confused without any sign of focalization or lateralization. His vital signs showed a blood pressure of 210/140 mmHg, heart rate of 62 beats per minute, respiratory rate of 14 per minute, and temperature of 37.2 degree Celsius. Blood biochemistry results were as follows: hypokalemia of 1.8 mEq/L with severe metabolic alkalosis (ph 7.59, HCO3 50.7, pO2 50, Sat O2 90%), white cell count 5740/mmc, hemoglobin 13.1 g/dL, platelets 161,000/mmc, glucose 198 mg/dL, creatinine 0.74 mg/dL, sodium 141 mEq/L, chloride 99 mEq/L, lactic dehydrogenase 702 U/L, ALT 26.7 U/L, CPK 91 U/L, albumin 3.2 g/dL, PT 12 seconds (test 12.4 seconds) INR 0.95, urinary sodium 45.9 mmol/L, urinary potassium 48.2 mmol/L, urine glucose +++, urinary proteins +. The electrocardiogram showed a first degree AV block. The lungs where clear under auscultation. The chest X-ray showed an undefined nodular opacity in the hilar region of the right lung . We started intravenous administration of large amount of potassium chloride (20 mEq per hour), intravenous insulin, and an intravenous antihypertensive (sodium nitroprusside). Following the treatment he experienced complete remission of mental confusion, and improvement, however his blood pressure did not normalize (150/100 mmHg). In view of these findings a protocol for detecting endocrine hypertension was followed, including tests for Cushing’s syndrome and primary hyperaldosteronism. Forty-eight hours later basal plasma renin activity and aldosterone were measured and determined as normal. The respective values were 0.53 ng/ml/h (normal values between 0.2-2.8 ng/ml/h) and 52.5 pg/mL (normal values between 10-160 pg/mL). The abdominal CT scan showed diffuse enlargement of the adrenal glands without focal lesions, without any abnormalities of the liver or spleen . The 24 hour free cortisol urinary levels were 6600 μg (normal values 4-100 μg) using the immunoenzymatic method. The ACTH levels were 107 pg/mL (normal values are less than 46 pg/mL), by the quimioluminiscence method. High dose dexamethasone suppression test (8 mg) showed suppression of approximately 8% of the cortisol serum levels. A brain CT scan, including the sellar region was normal. These results, together with the clinical and radiological findings support the diagnostic hypothesis of ectopic ACTH-dependent Cushing’s syndrome. The patient persisted with hypokalemia and hypertension, both of which could not be controlled despite management with large dose of intravenous potassium (up to 240 mEq per day) for the hypokalemia, and Enalapril 20 mgs twice daily, Telmisartan 160 mg four times daily, Felodipine 10 mgs twice daily, and Spironolactone 200 mg four times daily (once primary hyperaldosteronism was excluded) for the hypertension. The concentration of tumor markers were as follows: alpha-fetoprotein of 3.8 ng/ml (normal values 0-15 ng/ml), carcinoembryonic antigen of 2.6 ng/ml (normal values 0-5 ng/ml), and serum glycoprotein CA 125 of 10.96 U/ml (normal values 0-35 U/ml). A chest CT scan showed a cavitated right lung mass localized in the medial lobe of the anterior medial segment and minimal pleural effusion . We also observed some degree of pleural thickening. On day 24 a CT guided fine-needle lung biopsy was performed, showing histopathological results of a small cell neoplasm . The instability of the patient did not allow for the initiation of chemotherapy, therefore treatment with Ketoconazole 400 mgs was begun before initiating chemotherapy. While waiting for the patient’s basal situation to improve before starting chemotherapy, we started ketoconazole 400 mgs twice daily with a rapid normalization of blood pressure and potassium plasma levels. Seventy two hours later the patient presented with sepsis due to a right leg cellulitis that was treated with meropenem. Despite a partial response to the medical treatment the patient worsened and developed bilateral pleural effusions, and respiratory failure that required assisted mechanical ventilation dying a few days later.
3.904297
0.979004
sec[1]/p[1]
en
0.999996
19829770
https://doi.org/10.4076/1757-1626-2-6174
[ "daily", "twice", "hypertension", "blood", "urinary", "potassium", "intravenous", "that", "enalapril", "abdominal" ]
[ { "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": "BA00.Z", "title": "Essential hypertension, unspecified" }, { "code": "9C61.01", "title": "Ocular hypertension" }, { "code": "BB01.Z", "title": "Pulmonary hypertension, unspecified" }, { "code": "JA23", "title": "Gestational hypertension" }, { "code": "BA04.Y", "title": "Other specified secondary hypertension" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" } ]
=== ICD-11 CODES FOUND === [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 [BA00.Z] Essential hypertension, unspecified Also known as: Essential hypertension, unspecified | Essential hypertension | idiopathic hypertension | primary hypertension | systemic primary arterial hypertension [9C61.01] Ocular hypertension Definition: Ocular hypertension is a condition of elevated intraocular pressure in the absence of optic nerve, nerve fibre layer or visual field abnormalities. Also known as: Ocular hypertension | intraocular pressure increase | OH - [ocular hypertension] | OHT - [ocular hypertension] | ocular HTN - [hypertension] [BB01.Z] Pulmonary hypertension, unspecified Also known as: Pulmonary hypertension, unspecified | Pulmonary hypertension | pulmonary HTN - [hypertension] | Postcapillary pulmonary hypertension | Precapillary pulmonary hypertension [JA23] Gestational hypertension Definition: A condition affecting pregnant females, characterised by systolic blood pressure greater than 140mmHg and/or a diastolic blood pressure greater or equal to 90mmHg on two occasions, 4 hours or more apart. Can be newly diagnosed after 20 weeks gestation or before 1 week postpartum. Confirmation is by measurement of blood pressure, liver and kidney functions test, and urine test. Also known as: Gestational hypertension | gestational [pregnancy-induced] hypertension without significant proteinuria | Gestational hypertension NOS | hypertension induced by pregnancy | mild proteinuric hypertension of pregnancy [BA04.Y] Other specified secondary hypertension Also known as: Other specified secondary hypertension | Secondary hypertension associated with renal parenchymal disease | Secondary hypertension associated with renovascular disease | hypertension due to renovascular disease | renal vascular hypertension [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 === GRAPH WALKS === --- Walk 1 --- [QF21] Difficulty or need for assistance with general life tasks or life management --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 2 --- [QF21] Difficulty or need for assistance with general life tasks or life management --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.... --EXCLUDES--> [?] Dependence on enabling machines or devices --- Walk 3 --- [8A83] Other primary headache disorder Def: 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 attri... --PARENT--> [?] Headache disorders --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 4 --- [8A83] Other primary headache disorder Def: 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 attri... --PARENT--> [?] Headache disorders --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 5 --- [QB42] Dependence on renal dialysis --EXCLUDES--> [?] 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 --- [QB42] Dependence on renal dialysis --EXCLUDES--> [?] 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--> [?] Care involving extracorporeal dialysis
[ "[QF21] Difficulty or need for assistance with general life tasks or life management\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", "[QF21] Difficulty or need for assistance with general life tasks or life management\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 --EXCLUDES--> [?] Dependence on enabling machines or devices", "[8A83] Other primary headache disorder\n Def: 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 attri...\n --PARENT--> [?] Headache disorders\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....", "[8A83] Other primary headache disorder\n Def: 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 attri...\n --PARENT--> [?] Headache disorders\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....", "[QB42] Dependence on renal dialysis\n --EXCLUDES--> [?] 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", "[QB42] Dependence on renal dialysis\n --EXCLUDES--> [?] 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--> [?] Care involving extracorporeal dialysis" ]
QF21
Difficulty or need for assistance with general life tasks or life management
[ { "from_icd11": "QF21", "icd10_code": "Z742", "icd10_title": "Need for assistance at home and no other household member able to render care" }, { "from_icd11": "QF21", "icd10_code": "Z600", "icd10_title": "Problems of adjustment to life-cycle transitions" }, { "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": "QB42", "icd10_code": "Z992", "icd10_title": "Dependence on renal dialysis" }, { "from_icd11": "BA00.Z", "icd10_code": "I10", "icd10_title": "Essential (primary) hypertension" }, { "from_icd11": "9C61.01", "icd10_code": "H40053", "icd10_title": "Ocular hypertension, bilateral" }, { "from_icd11": "BB01.Z", "icd10_code": "I270", "icd10_title": "Primary pulmonary hypertension" }, { "from_icd11": "BB01.Z", "icd10_code": "I27", "icd10_title": "Other pulmonary heart diseases" }, { "from_icd11": "JA23", "icd10_code": "O133", "icd10_title": "Gestational [pregnancy-induced] hypertension without significant proteinuria, third trimester" }, { "from_icd11": "JA23", "icd10_code": "O135", "icd10_title": "Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating the puerperium" } ]
Z742
Need for assistance at home and no other household member able to render care
The patient was diagnosed with invasive ductal carcinomas of the left breast (T1N3M0; ER score: 8; PgR score: 0; HER2 score 0; Ki67 score 20%) while being 28 years of age. She was exposed to four cycles of standard neoadjuvant therapy using TAC combination (paclitaxel 175 mg/m 2 , doxorubicin 50 mg/m 2 , cyclophosphamide 600 mg/m 2 every three weeks), which resulted in a partial clinical response. The analysis of tumor masses removed upon mastectomy revealed tumor down-staging to pT1N1M0 and preserved receptor status (ER+PgR-HER2-). TAC therapy was continued after the surgery for another four cycles. The patient experienced local tumor relapse right after the completion of adjuvant systemic treatment. The relapsed tumor lump was excised, and the radiological treatment was applied (36 Gy). Based on strong tumor positivity for estrogen receptors, tamoxifen was administered at a standard dose (20 mg per day). After seven months of tamoxifen treatment, the patient switched to exemestane (25 mg per day), and the ovariectomy was performed to allow the therapeutic aromatase inhibition. The treatment by exemestane appeared to be efficient for a period of two years, however, multiple bone, lymph node, and soft tissue metastases were subsequently revealed at a regular control examination. The biopsy of the tumor lump located within the soft tissues of anterior thoracic wall followed by morphological and immunohistochemical examination confirmed the relapse of breast cancer disease. Given that the prolonged effect of the aromatase inhibition and the features of metastatic spread corresponded well to the characteristics of hormone-sensitive BC, the continuing exemestane treatment was supplemented by mTOR inhibition (everolimus 10 mg per day) and bisphosphonate administration . This therapy lasted for five months when the appearance of multiple new lesions in lungs, liver, and bones was observed. The patient was offered comprehensive BRCA1/2 germ-line testing, and the deletion of exons 1-18 of BRCA2 gene was revealed. The discussion on possible therapy options led to the choice of metronomic cyclophosphamide and methotrexate; this decision was based on the preference of the patient to receive oral drug formulations, the existing evidence for increased sensitivity of BRCA2-driven cancers to alkylating agents and the prior history of prolonged disease control upon endocrine treatment. However, the condition of the patient deteriorated at a fulminant speed within the next 10 days. There was a significant worsening of the pain and increase of the levels of bilirubin (20.2 micromol/l), transaminases (ALT 591 units/l, AST 568 units/l) and creatinine (322 micromol/l). In addition, grade II anemia and grade III thrombocytopenia were observed. The patient, being at ECOG-3, was administered the infusion therapy aimed to improve the liver function as well as received a blood transfusion. Positron emission tomography-computed tomography (PET-CT) scan demonstrated multiple metabolically active metastatic lesions in the liver, bones, small pelvis, lungs, mediastinum, retroperitoneum, etc. Given the life-threatening condition of the patient and the contraindications to the standard chemotherapy, olaparib was administered at a dose 300 mg twice a day, starting in March, 2017; the reduced dose of the drug was chosen due to grade II liver insufficiency. Just after one week of the olaparib treatment, symptoms of hepatic and renal insufficiencies were resolved, and the results of biochemical and cellular analyses of the blood went back to the norm by the end of the second week of therapy. This was accompanied by full restoration of the performance status and the patient returned to work. PET-CT scan was performed at one month after the start of olaparib therapy and revealed the complete metabolic response . BRCA2-driven tumors are known to be highly sensitive to platinum compounds; furthermore, some instances of the cure of metastatic BRCA2-associated BC by high-dose therapy were described in the literature . Based on these data, the patient was offered a consolidation therapy and received two cycles of carboplatin in June 2017 and August 2017, respectively. Control PET-CT examination was performed in September 2017 and revealed some increase of standardized uptake value (SUV) in the sacrum (SUV = 10.2) and right acetabulum (SUV = 10.1). However, biopsy of the sacral bone revealed no tumor cells. In December 2017, the patient was diagnosed with the fracture of L3 vertebra, caused by an occasional awkward move. She was subjected to transpedicular osteosynthesis and laminectomy for the L3. Histological examination of excised lamina, which was a BC metastatic site at the time of the start of olaparib therapy, did not detect any tumor cells. While continuing PARPi treatment, the patient started to receive denosumab to maintain bone homeostasis.
4.070313
0.971191
sec[1]/p[1]
en
0.999997
29651367
https://doi.org/10.7759/cureus.2150
[ "tumor", "score", "metastatic", "liver", "olaparib", "cycles", "standard", "based", "exemestane", "inhibition" ]
[ { "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": "MB20.1&XC87", "title": "Glasgow Coma Scale, eyes opening, never" }, { "code": "KD30.0", "title": "Birth depression with 5 minute Apgar score 0-3" }, { "code": "KD30.1", "title": "Birth depression with 5 minute Apgar score 4-6" }, { "code": "MB20.1", "title": "Coma" }, { "code": "KB21.0", "title": "Severe birth asphyxia" } ]
=== 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 [KD30.0] Birth depression with 5 minute Apgar score 0-3 Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth. Also known as: Birth depression with 5 minute Apgar score 0-3 [KD30.1] Birth depression with 5 minute Apgar score 4-6 Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth. Also known as: Birth depression with 5 minute Apgar score 4-6 [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 [KB21.0] Severe birth asphyxia Definition: Pulse less than 100 per minute at birth and falling or steady, respiration absent or gasping, colour poor, tone absent. Also known as: Severe birth asphyxia | severe perinatal hypoxia | asphyxia pallida of newborn | Asphyxia with 5-minute Apgar score 0-3 | newborn severe asphyxia === 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--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic 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--> [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--> [?] 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.... --PARENT--> [?] Overweight or localised adiposity Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th... --- 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--> [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 --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic 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", "[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 --PARENT--> [?] Overweight or localised adiposity\n Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th...", "[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--> [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
Patient-1 developed a small (1 × 0.5 cm) grade 1 ulcer on the dorsum of his right foot. The patient had diabetic neuropathy but the absence of typical features of a neuropathic ulcer such as an ulcer forming on the pressure points on the limb or callus formation prompted us to search for PAD. CT angiography revealed heavy calcifications in both extremity arteries and severe stenosis in the right common iliac artery (CIA), right superficial femoral artery (SFA), and P1 segment of the right popliteal artery (PA) . Fig. 1 A. CT angiography and coventional angiography images of patient-1 [CGL1; AGPAT2 homozygous p.R68X (c.202 C > T)]. 3D computed tomography reconstruction of lower abdomen and extremity arteries showing severe stenosis in the right common iliac artery, superficial femoral artery (SFA), and P1 segment of the popliteal artery (PA) (I). High pressure 5-mm drug-eluting balloon (DEB) angioplasty was performed to the P1 segment of the PA. High pressure plain old balloon angioplasty (POBA) followed with 6-mm self-expanding nitinol stent implantation and post dilatation with 6mm POBA was performed to the SFA. A 10-mm balloon-expandable bare metal stent was deployed to the right common iliac artery beginning from the orifice (II). The ulcer healed weeks after the revascularization procedure. B. Patient-2 [CGL1; AGPAT2 homozygous IVS5-2 A > C (c.662-2 A > C)] had several episodes of diabetic foot ulcer (DFU). Here, her 6th episode is shown. Figure 1B (I) shows a deep infected predominantly neuropathic ulcer on the medial aspect of the right foot with a total infected area of 200 cm 2 , disseminated osteomyelitis, and soft tissue abscess. Plain lateral foot radiogram (II) shows rocker-bottom foot deformity, gas in soft tissues associated with gas gangrene, disseminated osteolysis, bone deformation and destruction. T1-weighted axial MR images (III) show distal metatarsal bone marrow edema, joint inflammation and soft tissue edema. Postcontrast T1-weighted fat-saturated axial (IV) and coronal (V) MR images display diffuse contrast enhancement of bone marrow, and soft tissue edema which is compatible with ostomyelitis and cellulitis. A soft tissue abscess formation is shown. Wound culture identified several pathogens over time including Enterococcus spp., ESBL-producing Escherichia coli, and Candida albicans. The DFU did not heal despite broad-spectrum antibiotics including ampicillin-sulbactam plus ciprofloxacin (81 days), meropenem (17 days) and teicoplanin (31 days), aggressive debridement, predilatation with the plain old balloon angioplasty followed by DEB angioplasty to the right SFA, and vacuum assisted closure (VAC) therapy was performed. She underwent a below the knee amputation; however, she is still being treated for wound infection at the amputation site. C. A grade 4 ulcer (8 × 4 cm) on the left big toe and first metatarsus, spreading to the neighboring forefoot areas which is complicated with osteomyelitis and necrosis [I; Patient-3: CGL1; AGPAT2 homozygous p.E229X (c.685G > T)]. Wound culture identified Streptococcus spp., and she received clindamycin and ciprofloxacin P.O. for 18 days. The vascular assessment identified left popliteal artery stenosis and above-the-knee amputation was performed. She also received VAC and hyperbaric oxygen post-amputation. She later developed a grade 1 neuropathic ulcer on the right big toe (II). She had accompanying onychomycosis. In the same period, she developed multiple bullae in her both hands located on the right third and left second and third fingers. These lesions healed with local wound care and antifungal treatment. D. A necrotic forefoot ulcer covering the entire right big toe, index toe and middle toe (I; Patient-7: APL). The ulcer is complicated with osteomyelitis and necrosis. Infected tissue necrosis to the stump extending the suture line (II). E. Bullous lesions on the plantar surfaces of toes (big, index, middle and fourth toes in the left foot; varying between 1 × 1 and 3 × 3 cm in size. [Patient-8: CGL1; AGPAT2 homozygous p.D180PfsX5 (c.538_539delGA)]. F. A large neuropathic ulcer (20 × 5 cm) predominantly affecting the dorsal aspect of the forefoot and midfoot (I) in patient-9 [FPLD2; LMNA heterozygous p.R482W (c.144 C > T)]. She received parenteral meropenem for 21 days followed by amoxicillin-clavulanic acid and ciprofloxacin P.O. for 6 months, and the ulcer healed. Later, she presented with another neuropathic ulcer that developed in her right big toe but widespread into her forefoot and even midfoot. The ulcer was further complicated with cellulitis, soft tissue abscess, osteomyelitis, and local gangrene. She was treated with parenteral piperacillin and tazobactam and linezolid (16 days) which was followed by linezolid monotherapy (P.O. for 14 days). She underwent a toe amputation but the ulcer has not healed yet despite wound care (II)
4.058594
0.957031
sec[2]/sec[0]/p[1]
en
0.999997
34593051
https://doi.org/10.1186/s40842-021-00132-9
[ "ulcer", "artery", "foot", "soft", "tissue", "neuropathic", "wound", "amputation", "homozygous", "balloon" ]
[ { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "EH90.Z", "title": "Pressure ulcer of unspecified grade" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "BD52", "title": "Certain specified disorders of arteries or arterioles" }, { "code": "9A76", "title": "Corneal ulcer" }, { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "BD52.3", "title": "Rupture of artery" }, { "code": "BD52.2", "title": "Stricture of artery" }, { "code": "BD40.Z", "title": "Atherosclerotic chronic arterial occlusive disease, unspecified" }, { "code": "ND19.Z", "title": "Traumatic amputation of ankle or foot, unspecified" } ]
=== ICD-11 CODES FOUND === [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [EH90.Z] Pressure ulcer of unspecified grade Also known as: Pressure ulcer of unspecified grade | Pressure ulceration | pressure injury | pressure ulcer | decubitus ulcer [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 [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 [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 [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 [BD52.3] 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 [ND19.Z] Traumatic amputation of ankle or foot, unspecified Also known as: Traumatic amputation of ankle or foot, unspecified | Traumatic amputation of ankle or foot | traumatic amputation of foot | avulsion of foot | severed foot === GRAPH WALKS === --- Walk 1 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --CHILD--> [FB84.2] Subacute osteomyelitis --- Walk 2 --- [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 3 --- [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--> [EH90.2] Pressure ulceration grade 3 Def: Pressure ulcer with full thickness skin loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. There may... --- Walk 4 --- [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 5 --- [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 6 --- [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...
[ "[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 --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...", "[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--> [EH90.2] Pressure ulceration grade 3\n Def: Pressure ulcer with full thickness skin loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. There may...", "[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,...", "[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", "[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..." ]
FB84.Z
Osteomyelitis or osteitis, unspecified
[ { "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" }, { "from_icd11": "FB84.Z", "icd10_code": "M8639", "icd10_title": "Chronic multifocal osteomyelitis, multiple sites" } ]
M86672
Other chronic osteomyelitis, left ankle and foot
A 58-year-old Japanese man, who underwent surgery to remove thymoma at the age of 54, was admitted to the emergency room on suspicion of stroke, because he acutely developed speech difficulties. His past medical history was unremarkable except for thymoma that was detected by chance during a health screening. After the thymoma resection, he had been well without recurrence, and received no medical treatment. His family history was also unremarkable. Vital signs were normal except a mild fever (37.8 °C). His general condition was normal (height: 160 cm, weight: 60 kg). Brain MRI demonstrated multiple lesions involving the frontal lobes . The left cingulate lesion was partly demonstrated as high-signal intensity in both DWI and ADC maps, suggesting that the lesion contains vasogenic edema. CSF examination was unremarkable, and no elevation of IgG or myelin basic protein was found. EEGs were within normal limits. Because the patient’s neurological findings could not be explained by the cerebral lesions identified in the MRI, we considered the possibility that brain dysfunction might be induced beyond the location of the lesion. Although the CSF findings were normal, acyclovir (10 mg/kg, three times a day) was empirically administered, and his fever and neurological symptoms fully recovered within a few days. However, 1 week after admission, the patient’s symptoms deteriorated again. Neurological examination revealed a reappearance of motor aphasia and mild right hemiparesis. The MRI demonstrated that the lesion involving the left cingulate gyrus increased in size, and an abnormal signal intensity lesion in the left corona radiata, which was presumably the cause of his right hemiparesis, and edematous swelling of the bilateral medial temporal regions appeared . These lesions were not significantly enhanced by Gadolinium. Although a limbic lesion was demonstrated by MRI, he exhibited no cognitive or psychiatric manifestations. The patient was physically intact without lymphadenopathy. A multi-slice CT scan showed no abnormal findings in his chest and body. CSF was normal. Laboratory studies revealed that the patient’s blood cell counts and chemistry were normal. Of note, marked hypogammaglobulinemia was present, with IgG 481 mg/dL , IgA 81 mg/dL (reference range, 110–410 mg/dL), and IgM 25 mg/dL (reference range, 33–190 mg/dL). There was a normal CD4/CD8 lymphocyte ratio of 0.70 with CD4 21.9 % and CD8 31.2 %. To take into account the possibility of encephalitis, the patient was screened with tests for infection. Antigens of fungi were negative. Tests for HIV, HBV, HCV, EBV, JC virus, SV40, HHV-6, and HHV-7 were also negative. Particularly, HSV and HZV DNA were repeatedly examined at admission, and 4 and 10 weeks later, and were found to be negative at all time points. CMV DNA in CSF, examined at 10 weeks after admission, was also negative, but CMV pp65 antigen-positive leukocytes were increased in serum (19 antigen-positive cells per 1.5 × 10 5 cells). Toxoplasma IgG, but not IgM, was elevated in serum. Before and after the thymoma resection, unfortunately, the present patient did not have any immune work-up. However, we believe that his hypogammaglobulinemia was not primary but secondary associated with thymoma, because he had been previously healthy with no susceptibility to infection. Based on his past history of thymoma, hypogammaglobulinemia, and the MRI findings characterized by multiple cerebral lesions involving both gray matter and white matter, the patient was diagnosed as having Good’s syndrome, resulting in opportunistic infections in the brain. To determine the agent responsible for the cerebral lesions, a brain biopsy was recommended; however, it was not performed, according to the patient’s wishes. Because the serum was positive for CMV antigen, antiviral therapy using ganciclovir, 5 mg/kg, twice a day for 2 weeks, was performed. In addition, immunoglobulin replacement therapy (5 g/day, for 3 days) was started and repeatedly performed with an interval of 1 month (5 g/day, every month). The patient has since been free from any neurological symptoms for 1 year, and lesions demonstrated by MRI are gradually improving. Fig. 1 The time course of changes in fluid-attenuated inversion recovery (FLAIR)-image brain MRI of the present patient at admission ( a , upper ), 7 days later ( b ), and 10 weeks later ( c ). In panel ( a ), middle and lower are diffusion-weighted imaging (DWI) and ADC maps, respectively. The left cingulate lesion initially expanded in size ( b ), and later became scattered ( c ). The left corona radiate lesion was initially undetectable ( a ), gradually appeared as a vaguely delineated area ( b ), and was later identified as a well-demarcated lesion ( c ). The limbic lesions initially appeared edematous ( a, b ), and later shrunk with a high signal intensity on the right side ( c )
4.105469
0.974121
sec[1]/p[0]
en
0.999998
26303293
https://doi.org/10.1186/s12883-015-0406-1
[ "lesion", "lesions", "thymoma", "that", "brain", "because", "neurological", "unremarkable", "involving", "cingulate" ]
[ { "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": "2C27.2", "title": "Thymoma" }, { "code": "3A61.Y", "title": "Other specified acquired pure red cell aplasia" }, { "code": "4B40.2", "title": "Good syndrome" }, { "code": "2C27.0", "title": "Carcinoma of thymus" }, { "code": "8C60.Y", "title": "Other specified myasthenia gravis" } ]
=== 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 [2C27.2] Thymoma Definition: A thymoma that has an aggressive clinical course (capsular invasion, infiltration of the surrounding tissues) and can metastasize. Although any morphologic subtype of thymoma may eventually have a malignant clinical course, this term is most often associated with thymoma types B3 and C. Also known as: Thymoma | malignant thymoma (deprecated) | benign thymoma (deprecated) | Thymoma type A of thymus | malignant type A thymoma [3A61.Y] Other specified acquired pure red cell aplasia Also known as: Other specified acquired pure red cell aplasia | Decreased erythroid precursor production | Red cell aplasia with thymoma [4B40.2] Good syndrome Definition: This is a condition that occurs in adults in whom hypogammaglobulinemia, deficient cell-mediated immunity, and benign thymoma may develop almost simultaneously. Also known as: Good syndrome | Thymoma immunodeficiency [2C27.0] Carcinoma of thymus Definition: A diverse group of carcinomas of the thymus gland, previously known as thymoma type C. It includes morphologic variants derived from purely epithelial cells, as well as from cells with neuroendocrine differentiation. Also known as: Carcinoma of thymus | Adenocarcinoma of thymus | Adenosquamous carcinoma of thymus | Malignant Type C Thymoma | Mucoepidermoid carcinoma of thymus [8C60.Y] Other specified myasthenia gravis Also known as: Other specified myasthenia gravis | Myasthenia gravis, AChR antibody positive | Myasthenia gravis, MuSK antibody positive | Myasthenia gravis, other antibodies positive | Myasthenia gravis, seronegative === GRAPH WALKS === --- Walk 1 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Infection related arthropathies Def: A disease of the joints, caused by an infection with a bacterial, viral, fungal, or parasitic source. Distinction is made between the following types of etiological relationship. a) direct infection ... --- Walk 2 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --- 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--> [?] Nonorgan specific systemic autoimmune disorders --- 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.... --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 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... --CHILD--> [ME60.1] Pigmented skin lesion of uncertain nature Def: This denotes the presence of a pigmented 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.... --- 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--> [ME60.1] Pigmented skin lesion of uncertain nature Def: This denotes the presence of a pigmented 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--> [?] Infection related arthropathies\n Def: A disease of the joints, caused by an infection with a bacterial, viral, fungal, or parasitic source.\n\nDistinction is made between the following types of etiological relationship.\na) direct infection ...", "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\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....", "[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", "[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--> [?] 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 ...", "[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--> [ME60.1] Pigmented skin lesion of uncertain nature\n Def: This denotes the presence of a pigmented 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....", "[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--> [ME60.1] Pigmented skin lesion of uncertain nature\n Def: This denotes the presence of a pigmented 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": "4B40.2", "icd10_code": "E32", "icd10_title": "Diseases of thymus" } ]
M00-M25
The patient’s home morphine dose was converted to the parenteral equivalent, which proved challenging as the precise bioavailability of sustained release oral morphine when injected is unknown. Further, because of her impaired vision, her degree of success in injecting her opioids in the days prior to admission was questionable, thus her true opioid requirements were not clear. During the initial period in the emergency department, the patient was started on intermittent subcutaneous hydromorphone as a bridge until she transferred to the medical unit and could be initiated on a CADD pump. see Table 1 for details of opioids prescribed. Table 1 Substances and dosing at presentation to hospital and during admission Location/timeline Substance and dosing Variables considered Lessons learned Community (at time of presentation to hospital) Crack cocaine 10–12 times per month SROM * 60 mg three times per day Morphine IR ** 10 mg four times per day 24-h total morphine: 220 mg oral daily equivalents (+ crack cocaine) Patient had impaired mobility from generalized weakness and had not been able to access crack cocaine in the period prior to admission. She may have been experiencing withdrawal symptoms from crack on arrival to hospital We overlooked the possibility that her community morphine dose had not stabilized her opioid needs and thus she was simultaneously using crack cocaine Emergency Department Initially Hydromorphone 1.5 mg sc q3hr 20 h later, rotated to morphine 8 mg sc q3h with no PRN dosing ordered 20 h after admission, patient was described as “irritated and upset with pain control” Palliative Care was consulted to optimize pain medication In the first 24 h, patient received a reduced morphine equivalent dose from 220 mg to 24 h in community to 128 mg to 24 h. She became increasingly agitated with no signs of overdose. Consideration of PRN dosing may have prevented withdrawal Acute care days 1–2 24 h into admission, Subcutaneous morphine 3 mg/hr continuous infusion with breakthrough dose of 2 mg every one hour PRN via CADD pump 24-h total morphine: ~ 140 mg oral daily equivalents Although prescribed SROM in the community, the patient was crushing, heating and injecting her opioids (because she was unable to swallow tablets), thus converting opioids into an immediate release formulation It was unclear to what extent she was successfully injecting due to her impaired vision The precise bioavailability of sustained release oral morphine when injected is unknown The patient was new to the team and there were questions about exact dosing in the community; however, the patient was clearly presenting with signs of withdrawal Morphine equivalent dose of 140 mg/24 h was an increase from what she received in the first 24 h in ER; however, there was still an 80 mg discrepancy from her community dose In retrospect there was an abundance of caution in watching for oversedation and insufficient attention to the discrepancy leading to withdrawal symptoms Acute Care Day 3 Subcutaneous morphine 5 mg/hr continuous infusion with breakthrough dose 5 mg every hour PRN via CADD pump) In addition to the CADD pump, Morphine 15 mg subcutaneous QID while titrating CADD pump to manage withdrawal symptoms Lorazepam 1 mg every 4 h PRN for agitation with withdrawal On Day 3 of admission, the patient was experiencing withdrawal symptoms (agitated, restless, muscle twitches and insomnia) and it was evident that her baseline opioid coverage was insufficient More rapid uptitration was warranted to address withdrawal symptoms Acute Care Day 4 ADD pump basal rate was discontinued and the bolus rate increased to 5 mg every one hour PRN. Morphine 15 mg subcutaneous QID PRN was continued. Ativan was decreased to 1 mg TID PRN Patient left AMA α overnight and returned the next morning. She presented as drowsy, coherent at times but predominantly slurring words Esophageal stricture was treated with dilation later in day The patient did not acknowledge using a substance in the community. The patient was monitored for oversedation and, however, was continued on morphine to prevent another episode of withdrawal Acute Care Day 5 until discharge on Day 21 Post-esophageal dilatation, she was transitioned to SROM 60 mg TID CADD pump remained in situ for breakthrough 8 mg morphine every hour as needed Once patient was able to tolerate oral medications, morphine was provided orally but the CADD pump remained for breakthrough dosing The patient did not display any further signs of withdrawal and remained engaged with care. She typically used the breakthrough dose available and had numerous additional attempts. The CADD pump provided the patient with autonomy and avoided the numerous requests for breakthrough dosing and decreased the nursing workload *SROM = sustained release oral morphine **IR = immediate release oral morphine α = against medical advice
3.902344
0.947266
sec[0]/sec[1]/p[1]
en
0.999997
37661267
https://doi.org/10.1186/s12954-023-00813-x
[ "morphine", "withdrawal", "pump", "cadd", "oral", "dosing", "community", "breakthrough", "release", "subcutaneous" ]
[ { "code": "6C43.2Z", "title": "Opioid dependence, unspecified" }, { "code": "6C43.3", "title": "Opioid intoxication" }, { "code": "6C43.Y", "title": "Other specified disorders due to use of opioids" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "PB20&XM69R4", "title": "Accidental morphine poisoning" }, { "code": "6C4G.4Z", "title": "Withdrawal due to unknown or unspecified psychoactive substance, unspecified" }, { "code": "MB23.Q", "title": "Social withdrawal" }, { "code": "MB26.12", "title": "Thought withdrawal" }, { "code": "6C45.4", "title": "Cocaine withdrawal" }, { "code": "6C43.4", "title": "Opioid withdrawal" } ]
=== 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.Y] Other specified disorders due to use of opioids Also known as: Other specified disorders due to use of opioids | Disorders due to use of codeine | Disorders due to abuse of codeine | Disorders due to use of heroin | Disorders due to abuse of heroin [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 [6C4G.4Z] Withdrawal due to unknown or unspecified psychoactive substance, unspecified Also known as: Withdrawal due to unknown or unspecified psychoactive substance, unspecified | Withdrawal due to unknown or unspecified psychoactive substance | Drug withdrawal NOS | Substance withdrawal NOS [MB23.Q] Social withdrawal Definition: Retreat from relationships and other social interactions Also known as: Social withdrawal [MB26.12] Thought withdrawal Definition: The experience that one's thoughts are being removed by an outside person or force. Also known as: Thought withdrawal [6C45.4] Cocaine withdrawal Definition: Cocaine 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 cocaine in individuals who have developed Cocaine dependence or have used cocaine for a prolonged period or in large amounts. Presenting features of Cocaine withdrawal may include dysphoric mood, irritability, fatigue, psychomotor retardation, vivid unpleasant dreams, insomnia or hypersomnia, in Also known as: Cocaine withdrawal [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 === 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... --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 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--> [6C43.0] 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 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--> [?] Harmful effects of opioids or related analgesics --CHILD--> [?] Harmful effects of opium --- Walk 5 --- [6C43.Y] Other specified disorders due to use of opioids --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.Y] Other specified disorders due to use of opioids --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... --EXCLUDES--> [?] Hazardous use of opioids Def: A pattern of opioid 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 profe...
[ "[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 --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...", "[6C43.3] 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--> [6C43.0] 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...", "[6C43.3] 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--> [?] Harmful effects of opioids or related analgesics\n --CHILD--> [?] Harmful effects of opium", "[6C43.Y] Other specified disorders due to use of opioids\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.Y] Other specified disorders due to use of opioids\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 --EXCLUDES--> [?] Hazardous use of opioids\n Def: A pattern of opioid 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 profe..." ]
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
The patient was admitted to the Pediatric Emergency Department-Intensive Brief Observation (OBI) area, where intravenous rehydration and antiemetic (serotonin receptor antagonist) therapy was administered. The ibuprofen was used for management of fever. On May 5, negative result was obtained on nasopharyngeal aspirate by a multiplex polymerase chain reaction system for the detection of common respiratory pathogens. A low positive result for SARS-CoV-2-RNA in a new nasopharyngeal swab was found. This finding combined to positive antibody response against SARS-CoV-2, showed by positive results for both anti-nucleocapsid (N, 10.3 BAU/mL [border line range 0–1]) and anti spike (S, 30.4 BAU/mL [border line range 0-0.80]) antibodies, suggested a recent natural infection. On May 6, the patient was admitted in the Pediatric Unit with abdominal pain after palpation to the right lower quadrant, edema localized on eyelids, left wrist and hand at the site of peripheral venous catheter insertion. A mild maculopapular rash onset on face, neck and torso was also observed. The abdominal ultrasound examination revealed an acute cholecystitis. A chest radiography showed interstitial peribronchial thickening. Inhaled budesonide and intravenously ceftazidime (500 mg every 12 h) were used to treat airway inflammation and cholecystitis, respectively. An additional nasopharyngeal swab confirmed the low positive result for SARS-CoV-2-RNA. On May 7, positive serological results were also obtained for IgM against CMV (137 U/mL [border line range 20–22]) with low levels of anti-CMV IgG (21 U/mL [border line range 12–20]). Furthermore, a borderline value was obtained for anti-measles virus (MV) IgM (1.02 index [border line range 0.9–1.1]), while anti-MV IgG resulted negative (7.94 UA/mL [negative range 0–13]). Due to the persistent fever and the worsening of rash (spread to the trunk and extremities) and peripheral edema, an infectious disease specialist was consulted. A multisystemic inflammatory syndrome in children (MIS-C) related to COVID-19 was suspected on the basis of the overall clinical conditions and the higher levels of inflammatory markers detected (CRP: 1.22 mg/dL; procalcitonin: 1.8 ng/dl, interleukin-6: 37.7 pg/mL, D-dimer: 1.69 mg/L). Therefore, intravenous immunoglobulin (IV-Ig) therapy (2 g/kg) was administered in combination with acetylsalicylic acid as antiplatelet agent (5 mg/kg/once daily); antimicrobial therapy was switched to cefotaxime (50 mg/kg every 6 h). A cardiac involvement, frequently observed in MIS-C cases, was excluded by electrocardiogram and ultrasound. On May 9, the overall clinical conditions worsened and the existing treatment was implemented with methylprednisolone (2 mg/Kg/day) and heparin administered subcutaneously (100 UI/kg). For edema, both furosemide (5 mg 3 times daily) and albumin (1 g/Kg) were used. Meanwhile, the virological examinations revealed CMV-DNA in both blood and urine samples (6,095 copies/ml and 1,357 copies/ml, respectively), proving an active CMV infection. Furthermore, MV-RNA was detected in both saliva and urine samples. A second serological analysis showed IgM and IgG anti-MV positivity (6.10 index and 300 UA/mL, respectively); the IgG anti-MV levels were related to the IV-Ig treatment. These results, together with the previous findings, allowed to diagnose MV and CMV co-infection in a patient with a recent SARS-CoV-2 infection. The initial MIS-C hypothesis was excluded and the therapy based on corticosteroids, aspirin and heparin was stopped. Symptomatic treatment was maintained. On May 11, the patient’s conditions improved with gradual resolution of fever, peripheral edema, rash and conjunctivitis. She was discharged on May 15 after 11 days of hospitalization with resolution of symptoms, decreased levels of transaminases and inflammatory markers. The molecular characterization of MV strain involved was performed by our laboratory (belonging to MoRoNet, the National Network of Reference Laboratories for measles and rubella), amplifying and sequencing the region N terminal 450 (N-450) . The results showed a MV strains belonging to B3 genotype. The result was confirmed by the National Reference Laboratory for Measles and Rubella (ISS, Rome), that submitted in the WHO database MeaNS the obtained sequence. Phylogenetic analysis was performed including international sequences from MeaNS. Results showed that the MV B3 strain involved in the infection was identical to strains identified a few weeks earlier in Pakistan, where the patient travelled approximately 4 weeks before the onset of symptoms leading to hospitalization. There were not any suspected measles cases notified among other family or Pakistani community members. Although epidemiological link was not found, the case was classified as correlated to an imported case on the basis of virological surveillance data.
4.082031
0.967773
sec[1]/p[6]
en
0.999998
PMC10354918
https://doi.org/10.1186/s12985-023-02099-8
[ "anti", "range", "border", "line", "infection", "sars", "both", "edema", "measles", "used" ]
[ { "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": "QA00.6Y", "title": "Other specified examination of eyes or vision" }, { "code": "4B00.0Z", "title": "Neutropaenia, unspecified" }, { "code": "3B63.1Z", "title": "Acquired thrombocytosis, unspecified" }, { "code": "MA14.1C", "title": "Raised antibody titre" }, { "code": "BD11.1", "title": "Left ventricular failure with mid range ejection fraction" } ]
=== 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 [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 [4B00.0Z] Neutropaenia, unspecified Also known as: Neutropaenia, unspecified | Neutropenia | Disorders with decreased neutrophil counts | neutropaenic disorder | neutrophil count below reference range [3B63.1Z] Acquired thrombocytosis, unspecified Also known as: Acquired thrombocytosis, unspecified | Acquired thrombocytosis | Idiopathic haemorrhagic thrombocythaemia | Essential thrombocythaemia | primary haemorrhagic thrombocythaemia [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 [BD11.1] Left ventricular failure with mid range ejection fraction Also known as: Left ventricular failure with mid range ejection fraction | HFmEF - [heart failure with mid range ejection fraction] | Left ventricular failure with mid range ejection fraction due to cardiomyopathy | Left ventricular failure with mid range ejection fraction due to coronary artery disease | Left ventricular failure with mid range ejection fraction due to myocarditis === 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.... --CHILD--> [JA86.2] Maternal care for signs of fetal hypoxia --- 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--> [JA86.2] Maternal care for signs of fetal hypoxia --- 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 --RELATED_TO--> [?] Speech dysfluency Def: Speech dysfluency is characterised by the frequent or pervasive disruption of the rhythmic flow of speech that arises subsequent to the developmental period (i.e., adult onset) and is outside the limi... --- 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--> [3B4Z] Coagulation defects, unspecified
[ "[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--> [JA86.2] Maternal care for signs of fetal hypoxia", "[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--> [JA86.2] Maternal care for signs of fetal hypoxia", "[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 --RELATED_TO--> [?] Speech dysfluency\n Def: Speech dysfluency is characterised by the frequent or pervasive disruption of the rhythmic flow of speech that arises subsequent to the developmental period (i.e., adult onset) and is outside the limi...", "[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--> [3B4Z] Coagulation defects, unspecified" ]
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": "3B63.1Z", "icd10_code": "D473", "icd10_title": "Essential (hemorrhagic) thrombocythemia" } ]
O26841
A 55-year-old woman complaining of bilateral symmetrical proximal muscle weakness in the extremities, low-grade fever, and dysphagia that progressed for 10 days was referred by her family physician and admitted to the Department of Rheumatology, Kyoto-Katsura Hospital. On physical examination, facial erythema was observed spreading from the root of the nose to the bilateral cheeks, while Gottron's sign or heliotrope rash was absent. Blood examination revealed elevation of CK, AST, LDH, and CRP but no leukocytosis. Antinuclear antibody was positive (×40) whereas all antibodies against Jo-1, DNA, SS-A/Ro, SS-B/La, PR3-ANCA, and MPO-ANCA were negative. T2-weighted MRI showed hyperintensities in the bilateral neck muscles including the left pharyngeal constrictor muscle , as well as the bilateral iliopsoas and femoral muscles. Biopsy from the left vastus lateralis muscle demonstrated lymphocyte infiltration in the endomysium and vacuolar degeneration of the muscle fibers, but specific findings of DM, such as perivascular mononuclear infiltration and perifascicular atrophy and inflammation, were absent. On the other hand, the facial erythema exhibited perivascular lymphocytic infiltration and mucin deposits. On the basis of the clinical symptoms, laboratory data, skin histopathology, and radiologic findings of the muscles, the diagnosis of DM was established. Four days after admission, otolaryngology was consulted regarding the dysphagia. On pharyngolaryngeal fiberscopy, elevation of the larynx was moderately impeded, and slight retention of the saliva in the pyriform sinuses was noted, but gross movement of the vocal cords and pharyngeal sensation remained intact with no organic mucosal lesions. Medical therapy with corticosteroid was commenced on the 7th day of hospitalization, with an initial dose of 55 mg/day (1 mg/kg) prednisolone, which was increased to 80 mg/day due to a poor response by the 4th week after admission. Regarding deglutition, she was able to orally take over half of a softened meal, but the dysphagia progressed rapidly despite intensive medical treatment. On the 4th week, intravenous hyperalimentation was started since she was no longer able to swallow meals or fluids. Gait disorders deteriorated as well, resulting in the patient becoming completely bedridden by the 25th day. In consideration of the rapidly progressive nature of her disease, she elected to undergo tracheostomy as a preventive measure against aspiration pneumonia on the 31st day. Thereafter, by the 8th week after admission, the corticosteroid was switched to betamethasone (12 mg/day), and immunosuppressants (tacrolimus: 2.0 mg/day p.o., 21st–30th day; cyclophosphamide: 700 mg/day, 32nd and 57th day; cyclosporine: 150 mg/day, 34th–36th day) and immunoglobulin were added subsequently (22.5 g/day, 21st–25th day and 49th–53rd day) due to the persistent lack of response and further disease progression. During this refractory disease course, on the 56th day after admission (the 25th day after tracheostomy), the patient developed massive hemoptysis from the tracheostomy tube and the mouth. Chest CT revealed a ground glass appearance in the right lower lobe of the lung and soft tissue densities in the peripheral airways suggesting aspiration of the bloody secretion. Otolaryngological examination including endoscopic observation of the tracheostoma, lower airway, and subglottic space failed to reveal any source of the bleeding. Transnasal fiberscopic inspection of the upper airway on the 59th day of hospitalization revealed retention of a mixture of coagulated and fresh blood in the left lateral wall of the oropharynx, with the caudal end reaching the hypopharynx . Suction removal of the debris demonstrated intermittent bleeding from this site. On the following day, hemostatic procedures were undertaken transorally under general anesthesia. After removal of the coagulated debris and collection of biopsy specimens from the lesion via oral specula for tonsillectomy , the bleeding was treated with bipolar and monopolar electric cautery, followed by closure with absorbable sutures and ligations. Absorbable hemostatic particles (Arista AH, Medafor, Inc., USA) and a microfibrillar collagen hemostat (Avitene, Davol Inc., USA) were also applied. The hemoptysis stopped immediately after the hemostatic procedures. Bacterial examination was negative for pathological organisms, including acid-fast bacteria. Histopathologically, inflammatory cellular infiltration was evident among the muscle fibers, but there were no signs of perivascular lymphocytes or perifascicular atrophy and inflammation . The pharyngeal wound healed well resulting in complete epithelialization, and the patient was able to proceed to deglutition rehabilitation 3 months after the surgical hemostasis. No recurrence of the bleeding was noted up to the 6th month after surgery.
4.023438
0.976563
sec[1]/p[0]
en
0.999998
25328739
https://doi.org/10.1155/2014/854841
[ "muscle", "infiltration", "bleeding", "dysphagia", "muscles", "including", "pharyngeal", "well", "perivascular", "able" ]
[ { "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": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "GB90.Y", "title": "Other specified disorders of kidney or ureter" }, { "code": "DB9Z", "title": "Diseases of liver, unspecified" }, { "code": "9A78.2Z", "title": "Corneal oedema, unspecified" }, { "code": "MG27", "title": "Haemorrhage, not elsewhere classified" } ]
=== 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 [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 [GB90.Y] Other specified disorders of kidney or ureter Also known as: Other specified disorders of kidney or ureter | Other secondary disorders of kidney or ureter | Other disorders of kidney and ureter NEC | Inflammatory diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis | Infectious diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis [DB9Z] Diseases of liver, unspecified Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy [9A78.2Z] Corneal oedema, unspecified Also known as: Corneal oedema, unspecified | Corneal oedema | infiltrate of cornea [MG27] Haemorrhage, not elsewhere classified Definition: Bleeding or escape of blood from a vessel. Also known as: Haemorrhage, not elsewhere classified | arterial haemorrhage | bleeding | extravasation of blood | Haemorrhage NOS Excludes: Obstetric haemorrhage | Haemorrhage or haematoma complicating a procedure, not elsewhere classified | Fetal blood loss === 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.... --CHILD--> [FB32.2] Ischaemic infarction of muscle --- 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--> [?] Cramp or spasm --- 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... --CHILD--> [8C70.2] Emery-Dreifuss muscular dystrophy Def: Emery-Dreifuss muscular dystrophy (EDMD) is a muscle disease characterised by muscular weakness and atrophy, with early contractures of the tendons and cardiac involvement (arrhythmias, cardiomyopathy... --- 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 --CHILD--> [FB32.2] Ischaemic infarction of muscle", "[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--> [?] Cramp or spasm", "[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 --CHILD--> [8C70.2] Emery-Dreifuss muscular dystrophy\n Def: Emery-Dreifuss muscular dystrophy (EDMD) is a muscle disease characterised by muscular weakness and atrophy, with early contractures of the tendons and cardiac involvement (arrhythmias, cardiomyopathy...", "[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
Initially, the patient was managed as a case of chronic diarrhoea with some dehydration and severe acute malnutrition. We also suspected that her reduced activity might be due to electrolyte imbalance or sepsis. Hence, the following investigations were done: complete blood count (CBC), serum electrolyte and creatinine, blood and stool for culture and sensitivity (C/S), routine microscopic examination (RME) of stool and urine, and chest x-ray. The test report for electrolytes showed hypochloraemic hypokalaemia with alkalosis ( Table 1 and 2 ) which, thereafter, became persistent. Based on these findings, our differential diagnosis now included gastric outlet obstruction, cystic fibrosis, Bartter Syndrome, and congenital chloride diarrhoea (CCD). Subsequent investigations showed normal chloride level in sweat, normal routine microscopy of stool, urinary Na + was 16 mmol/L (reference value 54-150), K + 24.52 mmol/L (reference value 20-80), and Cl - 12 mmol/L (reference value 110-250). Tissue transglutaminase immunoglobulin (TtG-IgA) and IgG antibodies were negative, with plasma total protein 86.47 g/L (reference value 64.0-82.0), albumin 48.97 g/L (reference value 34.0-50.0), globulin 37.5 g/L (reference value 23.0-35.0), albumin and globulin ratio 1.31 (reference value 1.10-1.80). Chloride level in stool was 126.6 mmol/L (normal range 6-17 mmol/L), potassium 30.9 mmol/L, and sodium 82.9 mmol/L (normal range 50-60 mmol/L). The diagnosis of CCD was made on the basis of the results of faecal chloride content of >90 mmol/L and faecal chloride more than the sum of faecal Na and K contents and exclusion of other suspected diseases. Genetic testing could not be done due to its unavailability in Bangladesh. Urine and stool culture showed no growth of pathogens. We started oral NaCl and KCl supplementation and commercially-available oral formulation of Omeprazole. Other recommended treatment (with oral butyrate) was not applied as it was not available in Bangladesh. After 15 days of hospitalization, the patient developed fever and respiratory distress. The respiration rate was 64/minute, she was tachycardic (175 beats per minute), and the chest x-ray was suggestive of pulmonary infiltrates. So, we suspected that this was most likely due to a hospital-acquired infection and, initially, the patient was treated with injection Ceftazidime and injection Amikacin. However, no improvement was seen even after 5 days of treatment and, subsequently, the antibiotic was changed to injection Imipenem instead of ongoing medication. In the meantime, the blood C/S report was available, and it showed Acinetobacter species sensitive to Polymyxin B. Therefore, we started injection Polymyxin B. At that time, the patient also developed a changing murmur in addition to fever and anaemia, which raised the possibility of infective endocarditis. We, therefore, arranged an echocardiogram that showed mild coarctation of aorta, mild mitral regurgitation Grade 1, and mild pulmonary hypertension with normal ejection fraction (EF) of 70%. We added Captopril to protect heart failure. After adding Captopril, we found, to our surprise, that the stool output significantly reduced, and serum potassium increased. In response to this observation, we reduced the dose of supplemental KCL and NaCL and continued the treatment with Captopril. This decision was expedited by the fact that the overall condition of the patient was improving. The stool output and consistency was also improving. The patient attended regular follow-up with us, and the electrolyte profile had been normal in the next 6 months. In the first and second follow-up visit, we used Captopril with KCl ( Table 2 ), and it showed that the diarrhoea was resolved and serum chloride and total carbon dioxide were also normal. The mother of the patient did not provide Captopril in the preceding one week prior to the third visit according to the advice of the local cardiologist, and the patient again developed alkalosis and hypokalaemia ( Table 2 ). The most recent echocardiogram showed trivial MR, good biventricular function: left ventricular ejection fraction (LVEF) 69%, FS 34% left ventricular internal dimension in systole (LVIDs) 15 mm, left ventricular internal dimension in diastole (LVIDd) 24 mm trivial TR were noticed, along with peak pressure gradient (PPG) 10 mmHg, intact interatrial septum (IAS), and interventricular septum (IVS). No PDA or coarctation was seen. No intra-cardiac mass or vegetation was seen. Chamber dimensions and wall motion were normal. All valves were normal. No pericardial effusion was seen; biventricular function was good and, finally, the cardiac anatomy showed normal findings. The patient was gradually gaining weight from 3.8 kg to 7.1 kg in 7 months, and control over her neck was then completely normal. Her blood pressure was normal throughout the follow-up period.
4.027344
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sec[0]/p[1]
en
0.999998
25995737
N/A
[ "mmol", "that", "stool", "reference", "chloride", "captopril", "blood", "injection", "diarrhoea", "suspected" ]
[ { "code": "GB42.1", "title": "Albuminuria, Grade A3" }, { "code": "GB42.0", "title": "Albuminuria, Grade A2" }, { "code": "MA18.0Y", "title": "Other specified elevated blood glucose level" }, { "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": "ME0Y", "title": "Other specified symptoms related to the lower gastrointestinal tract or abdomen" }, { "code": "ME24.A4", "title": "Melaena" } ]
=== ICD-11 CODES FOUND === [GB42.1] Albuminuria, Grade A3 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A3 | albuminuria >30 mg/mmol creatinine | macroalbuminuria | overt albuminuria | overt nephropathy [GB42.0] Albuminuria, Grade A2 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A2 | microalbuminuria | incipient nephropathy | mild to moderate albuminuria | albuminuria 3-30 mg/mmol creatinine [MA18.0Y] Other specified elevated blood glucose level Also known as: Other specified elevated blood glucose level | Blood glucose between 8.0 - 11.9 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L pre-meal or fasting | Blood glucose greater than or equal to 14.0 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L post-meal or not otherwise specified [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 [ME0Y] Other specified symptoms related to the lower gastrointestinal tract or abdomen Also known as: Other specified symptoms related to the lower gastrointestinal tract or abdomen | Change in faeces or bowel movements | Diminished rectal sensation | Incomplete emptying of faeces | Other faecal abnormalities [ME24.A4] Melaena Definition: It is bloody stools that indicate bleeding from vascular system in the digestive tract. It is also described as black, tarry, and foul-smelling stools or red/maroon-coloured stools that contain degraded blood. Also known as: Melaena | altered blood in stool | altered blood passed per rectum | tarry stools | black tarry stool Excludes: occult blood in faeces === GRAPH WALKS === --- Walk 1 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Gestational proteinuria without hypertension --- Walk 2 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --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 3 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Gestational proteinuria without hypertension --- Walk 4 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Orthostatic proteinuria Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position.... --- Walk 5 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --PARENT--> [MA18] Certain clinical findings of blood chemistry --- Walk 6 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --EXCLUDES--> [?] Postprocedural hypoinsulinaemia Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus....
[ "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension", "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\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...", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Orthostatic proteinuria\n Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position....", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --PARENT--> [MA18] Certain clinical findings of blood chemistry", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --EXCLUDES--> [?] Postprocedural hypoinsulinaemia\n Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus...." ]
GB42.1
Albuminuria, Grade A3
[ { "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
A 16-year-old right-handed male who was a high school handball player was referred to our department by a nearby hospital 5 months after the onset of pain of unknown etiology in the dorsal aspect of his right wrist. At the outside hospital, imaging findings led to a diagnosis of avascular necrosis of the capitate, but wrist immobilization using a brace did not improve the pain. At the initial visit to our department, the patient was noted to have mild swelling of the dorsal wrist, tenderness of the proximal capitate, and painful trigger wrist occurring with flexion and extension of the right wrist, with a range of motion in his wrist limited to 30°/60° of flexion/extension. The visual analog scale (VAS) score for pain was 71, with a grip strength of 70% relative to the unaffected side. Plain X-rays showed collapse of the proximal capitate and evidence of osteosclerosis, as well as palmar flexion of the lunate . The carpal height ratio and the radial lunate angle were 0.46 (unaffected side, 0.49) and 27° (unaffected side, 11°), respectively. The capitolunate angle was 32° (unaffected side, 24°). Computed tomography (CT) scans revealed a bone cyst of the proximal capitate and a free body from the palmar proximal capitate . On magnetic resonance imaging (MRI), the proximal capitate had a low signal intensity on T1-weighted images , and a high signal intensity on short TI inversion recovery (STIR) images . Fluoroscopic examination showed that the proximal articular surface of the capitate interfered with lunate motion during wrist flexion and extension. These findings led to a diagnosis of trigger wrist caused by capitolunate instability secondary to avascular necrosis of the capitate, for which surgery was performed. A longitudinal incision was made over the dorsal aspect of the right wrist, and the joint capsule was longitudinally incised over the capitate and lunate for exposure of the joint, revealing proliferation of inflammatory synovium in the joint. Morphological changes were noted on the proximal articular surface of the capitate, including flattening and eburnation. Intraoperative inspection revealed that limited compatibility between the capitate and lunate caused the triggering phenomenon during passive wrist flexion and extension . The proximal portion of the capitate was resected piece by piece using a bone chisel, while observing for any triggering during wrist flexion and extension. A palmaris longus muscle tendon ball was used to fill the cavity of the excised proximal capitate. The scaphoid and lunate were temporarily fixed using a Kirschner wire. A long-arm splint was applied for the first two weeks postoperatively, after which it was changed to a short-arm splint for an additional two weeks. Wrist rehabilitation was begun when the splint and the Kirschner wire used for fixation were removed at four weeks after surgery. Resumption of sports activities was permitted at 3 months postoperatively. Histopathological examination revealed a lack of osteocyte nuclei in the bone lacunae and incomplete ossification of the necrotic bone. These findings were consistent with avascular necrosis of the capitate . Two years after surgery, the patient’s clinical outcome was favorable, with no recurrence of wrist pain or triggering despite resumption of sports. He had an improved range of motion (75°/85° on flexion/extension) and increased grip strength (113% relative to the unaffected side). Plain X-rays showed no further collapse of the capitate, with a carpal height ratio of 0.49, a radial lunate angle of 10°, and a capitolunate angle of 18° . Fig. 1 AP radiograph, CT, and MRI findings. a , b The preoperative radiographs showed collapse of the proximal portion of the capitate along with osteonecrosis. c , d The preoperative CT scans showed collapse of the proximal portion of the capitate along with osteonecrosis, a bone cyst in the proximal capitate, and a free body in the palmar proximal portion of the capitate. e A preoperative coronal T1-weighted MRI image showed low signal intensity at the proximal capitate. f A preoperative coronal STIR MRI image showed high signal intensity at the proximal capitate. g , h At the 2-year follow-up after surgery, the radiographs showed no further collapse of the capitate or progression of carpal instability Fig. 2 Intraoperative photographs and microscopic findings of the excised surgical specimen. a Intraoperative photograph of the capitate (arrow) and the lunate (asterisk) during passive wrist extension. b Intraoperative photograph showed the triggering phenomenon between the proximal capitate (arrow) and the lunate (asterisk) during passive wrist flexion. c Intraoperative photograph after partial resection of the capitate (arrow). d Hematoxylin and eosin staining of the excised specimen (magnification 40×) showed lack of osteocyte nuclei in the bone lacunae (arrow)
4.03125
0.974121
sec[1]/p[0]
en
0.999998
29587785
https://doi.org/10.1186/s12891-018-2010-1
[ "capitate", "wrist", "lunate", "flexion", "extension", "bone", "unaffected", "side", "collapse", "intraoperative" ]
[ { "code": "NC53.1&XA06T2", "title": "Fracture of capitate bone" }, { "code": "FB82.2", "title": "Slipped upper femoral epiphysis" }, { "code": "FB82.1", "title": "Osteochondrosis or osteochondritis dissecans" }, { "code": "NC72.20", "title": "Fracture of neck of femur, subcapital" }, { "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" }, { "code": "FB81.0", "title": "Idiopathic aseptic osteonecrosis" } ]
=== ICD-11 CODES FOUND === [FB82.2] Slipped upper femoral epiphysis Also known as: Slipped upper femoral epiphysis | non-traumatic slipped upper femoral epiphysis | slipped femoral epiphysis | slipped upper femoral epiphysis NOS | SUFE - [slipped upper femoral epiphysis] [FB82.1] Osteochondrosis or osteochondritis dissecans Definition: Note: Osteochondroses are typically referred to by eponyms. The most common eponyms are indexed to osteochondrosis with specification identified by the site and time in life. Also known as: Osteochondrosis or osteochondritis dissecans | osteochondral lesion | Osteochondrosis not specified as adult or juvenile, of unspecified site | osteochondrosis NOS | Juvenile osteochondrosis [NC72.20] Fracture of neck of femur, subcapital Also known as: Fracture of neck of femur, subcapital | Fracture of neck of femur, subcapital, slight displacement | Fracture of neck of femur, subcapital, marked displacement | Physeal fracture of proximal femur | growth plate fracture of proximal femur [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 [FB81.0] Idiopathic aseptic osteonecrosis Also known as: Idiopathic aseptic osteonecrosis | idiopathic aseptic necrosis of bone, site unspecified | idiopathic aseptic necrosis of bone | idiopathic avascular necrosis of bone | Idiopathic aseptic osteochondritis dissecans === GRAPH WALKS === --- Walk 1 --- [FB82.2] Slipped upper femoral epiphysis --PARENT--> [FB82] Chondropathies --EXCLUDES--> [?] Postprocedural disorders of the musculoskeletal system --- Walk 2 --- [FB82.2] Slipped upper femoral epiphysis --PARENT--> [FB82] Chondropathies --RELATED_TO--> [?] Chondrodysplasia punctata --- Walk 3 --- [FB82.1] Osteochondrosis or osteochondritis dissecans Def: Note: Osteochondroses are typically referred to by eponyms. The most common eponyms are indexed to osteochondrosis with specification identified by the site and time in life.... --RELATED_TO--> [?] Idiopathic aseptic osteonecrosis of carpal lunate Def: Kienbock disease is a rare bone disorder of unknown etiology characterised clinically by osteonecrosis of the carpal lunate, eventually leading to collapse of the lunate bone impacting wrist function.... --PARENT--> [?] Osteochondrosis or osteochondritis dissecans Def: Note: Osteochondroses are typically referred to by eponyms. The most common eponyms are indexed to osteochondrosis with specification identified by the site and time in life.... --- Walk 4 --- [FB82.1] Osteochondrosis or osteochondritis dissecans Def: Note: Osteochondroses are typically referred to by eponyms. The most common eponyms are indexed to osteochondrosis with specification identified by the site and time in life.... --PARENT--> [FB82] Chondropathies --RELATED_TO--> [?] Chondrodysplasia punctata --- Walk 5 --- [NC72.20] Fracture of neck of femur, subcapital --PARENT--> [NC72.2] Fracture of neck of femur --PARENT--> [NC72] Fracture of femur Def: A break in the femur, longest and largest bone of the skeleton, situated between the hip and the knee.... --- Walk 6 --- [NC72.20] Fracture of neck of femur, subcapital --PARENT--> [NC72.2] Fracture of neck of femur --CHILD--> [NC72.22] Fracture of base of neck of femur
[ "[FB82.2] Slipped upper femoral epiphysis\n --PARENT--> [FB82] Chondropathies\n --EXCLUDES--> [?] Postprocedural disorders of the musculoskeletal system", "[FB82.2] Slipped upper femoral epiphysis\n --PARENT--> [FB82] Chondropathies\n --RELATED_TO--> [?] Chondrodysplasia punctata", "[FB82.1] Osteochondrosis or osteochondritis dissecans\n Def: Note: Osteochondroses are typically referred to by eponyms. The most common eponyms are indexed to osteochondrosis with specification identified by the site and time in life....\n --RELATED_TO--> [?] Idiopathic aseptic osteonecrosis of carpal lunate\n Def: Kienbock disease is a rare bone disorder of unknown etiology characterised clinically by osteonecrosis of the carpal lunate, eventually leading to collapse of the lunate bone impacting wrist function....\n --PARENT--> [?] Osteochondrosis or osteochondritis dissecans\n Def: Note: Osteochondroses are typically referred to by eponyms. The most common eponyms are indexed to osteochondrosis with specification identified by the site and time in life....", "[FB82.1] Osteochondrosis or osteochondritis dissecans\n Def: Note: Osteochondroses are typically referred to by eponyms. The most common eponyms are indexed to osteochondrosis with specification identified by the site and time in life....\n --PARENT--> [FB82] Chondropathies\n --RELATED_TO--> [?] Chondrodysplasia punctata", "[NC72.20] Fracture of neck of femur, subcapital\n --PARENT--> [NC72.2] Fracture of neck of femur\n --PARENT--> [NC72] Fracture of femur\n Def: A break in the femur, longest and largest bone of the skeleton, situated between the hip and the knee....", "[NC72.20] Fracture of neck of femur, subcapital\n --PARENT--> [NC72.2] Fracture of neck of femur\n --CHILD--> [NC72.22] Fracture of base of neck of femur" ]
NC53.1&XA06T2
Fracture of capitate bone
[ { "from_icd11": "FB82.2", "icd10_code": "M930", "icd10_title": "Slipped upper femoral epiphysis (nontraumatic)" }, { "from_icd11": "FB82.1", "icd10_code": "M9262", "icd10_title": "Juvenile osteochondrosis of tarsus, left ankle" }, { "from_icd11": "FB82.1", "icd10_code": "M9320", "icd10_title": "Osteochondritis dissecans of unspecified site" }, { "from_icd11": "FB82.1", "icd10_code": "M9261", "icd10_title": "Juvenile osteochondrosis of tarsus, right ankle" }, { "from_icd11": "FB82.1", "icd10_code": "M9250", "icd10_title": "Juvenile osteochondrosis of tibia and fibula, unspecified leg" }, { "from_icd11": "FB82.1", "icd10_code": "M4200", "icd10_title": "Juvenile osteochondrosis of spine, site unspecified" }, { "from_icd11": "FB82.1", "icd10_code": "M9112", "icd10_title": "Juvenile osteochondrosis of head of femur [Legg-Calve-Perthes], left leg" }, { "from_icd11": "FB82.1", "icd10_code": "M9111", "icd10_title": "Juvenile osteochondrosis of head of femur [Legg-Calve-Perthes], right leg" }, { "from_icd11": "FB82.1", "icd10_code": "M9110", "icd10_title": "Juvenile osteochondrosis of head of femur [Legg-Calve-Perthes], unspecified leg" }, { "from_icd11": "FB82.1", "icd10_code": "M9260", "icd10_title": "Juvenile osteochondrosis of tarsus, unspecified ankle" }, { "from_icd11": "FB82.1", "icd10_code": "M9398", "icd10_title": "Osteochondropathy, unspecified other" }, { "from_icd11": "FB82.1", "icd10_code": "M9252", "icd10_title": "Juvenile osteochondrosis of tibia and fibula, left leg" }, { "from_icd11": "FB82.1", "icd10_code": "M9180", "icd10_title": "Other juvenile osteochondrosis of hip and pelvis, unspecified leg" }, { "from_icd11": "FB82.1", "icd10_code": "M9270", "icd10_title": "Juvenile osteochondrosis of metatarsus, unspecified foot" }, { "from_icd11": "FB82.1", "icd10_code": "M9240", "icd10_title": "Juvenile osteochondrosis of patella, unspecified knee" } ]
M930
Slipped upper femoral epiphysis (nontraumatic)
An asymptomatic 40-year-old woman presented with gastric wall thickening detected by screening with an upper gastrointestinal series and underwent contrast-enhanced computed tomography (CT), which also revealed an anterior mediastinal mass. She had been diagnosed with asymptomatic SjS at the age of 35, which was overlooked during the initial work-up. She had no medication or smoking history. She had a family history of breast cancer in her mother’s side and rheumatoid arthritis in her father’s side. The laboratory data showed nothing but hypergammaglobulinemia , and the serum soluble interleukin-2 receptor level was also within the normal limits (362 U/mL). A chest radiograph revealed no abnormalities. An abdominal CT revealed a localized wall thickness measuring 22 mm with enhancement in the middle part of the gastric body on the greater curvature. A well-circumscribed mass with a heterogenous concentration measuring 49 × 22 mm in the anterior mediastinum without any distant metastases and multiple cysts in both lungs were also demonstrated. Magnetic resonance imaging revealed a multilocular mediastinal mass without invasion to the surrounding parenchyma . 18 Fluoro-2-deoxyglucose positron emission tomography (FDG-PET) was not performed before the surgery. Suspecting the gastric wall thickness suggested a gastrointestinal stromal tumor or MALT lymphoma, we performed an endoscopic incisional biopsy. The pathological findings showed lymphocytic infiltration without any atypical cells or a light chain restriction between the kappa and lambda chains on immunostaining, consistent with inflammatory changes. We successfully performed a total thymectomy, due to suspecting an anterior mediastinal mass as a thymoma, by a bilateral approach via video-assisted thoracoscopic surgery with carbon dioxide insufflation in a supine position. There were no adhesions around the mass, and it was removed from the surrounding organs without any surgical difficulty . We also performed a wedge resection of the right upper lobe of the lung as a surgical biopsy to rule out lymphangioleiomyomatosis (LAM). The operation time was 187 min with 2 g of total blood loss. The cut surface of the mediastinal tumor exhibited a grayish-white solid mass with multiple cysts. Histopathologically, there was an infiltration of numerous lymphoid cells with lymphoid follicles. Small- to medium-sized atypical lymphoid cells were observed, and some of them exhibited plasmacytoid differentiation . Cytokeratin immunostaining revealed a lymphoepithelial lesion, consistent with infiltration of lymphoid cells into the epithelium. These cells were positive for CD20 and negative for CD3, CD5, and CD10. A light chain restriction positive for kappa and negative for lambda chains was demonstrated. From these findings, we diagnosed the mediastinal mass as a MALT lymphoma. A lung cyst was found to be an emphysematous bulla without any specific histological findings suggesting LAM. The postoperative course was uneventful, and she was discharged home on postoperative day 2. FDG-PET revealed no abnormal FDG uptakes in any organs 1 month later, and she is currently disease-free at 9 months after surgery. Fig. 1 a Computed tomographic scan of the chest showing a well-circumscribed mass with a heterogenous concentration measuring 49 × 22 mm in the anterior mediastinum. b Out-of-phase dynamic magnetic resonance imaging of the mediastinum showing the multilocular mass without invasion to the surrounding parenchyma Fig. 2 Computed tomographic scan of the chest showing multiple cysts in both lungs Fig. 3 Histopathological findings of the stomach lesion showing lymphocytic infiltration without any atypical cells in the hematoxylin and eosin staining ( a ) or any light chain restriction between the kappa ( b ) and lambda ( c ) chains in the immunostaining, consistent with inflammatory changes. We used antibodies with the product number n1510 (company, DAKO; dilutions, 5 times for the kappa chains) and product number ncl-lam (company, Leica; dilutions, 200 times for the lambda chains). The positive cells are stained with a brown color Fig. 4 A total thymectomy was performed by a bilateral approach via a video-assisted thoracoscopic surgery. The mass is enclosed by the arrows without any adhesions to the surrounding tissue Fig. 5 Histopathological findings of the mediastinal mass showing small- to medium-sized atypical lymphoid cells, and some of them exhibit plasmacytoid differentiation in the hematoxylin and eosin staining ( a ). A light chain restriction positive for kappa ( b ) and negative for lambda ( c ) chains is demonstrated. We used antibodies with the product number N1510 (company, DAKO; dilutions, 5 times for the kappa chains) and product number NCL-LAM (company, Leica; dilutions, 200 times for the lambda chains). The positive cells are stained with a brown color
4.160156
0.96875
sec[1]/p[0]
en
0.999995
31478101
https://doi.org/10.1186/s40792-019-0696-4
[ "cells", "without", "chains", "mediastinal", "kappa", "lambda", "lymphoid", "surrounding", "infiltration", "atypical" ]
[ { "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": "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": "QA50", "title": "Embolisation without injury or harm" }, { "code": "LB12.1Z", "title": "Atresia of oesophagus, unspecified" }, { "code": "2A84.Z", "title": "Heavy chain diseases, 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 [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 [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 [2A84.Z] Heavy chain diseases, unspecified Also known as: Heavy chain diseases, unspecified | Heavy chain diseases or malignant immunoproliferative diseases | malignant immunoproliferative diseases without mention of remission === GRAPH WALKS === --- Walk 1 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --CHILD--> [MF91] Bilirubinuria Def: Bilirubinuria means the presence of any bile pigment in the urine.... --- Walk 2 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --CHILD--> [MF91] Bilirubinuria Def: Bilirubinuria means the presence of any bile pigment in the urine.... --- Walk 3 --- [5C56.20] Mucolipidosis --EXCLUDES--> [?] Sialidosis --CHILD--> [?] Sialidosis type 2 Def: Sialidosis is a lysosomal storage disease belonging to the group of oligosaccharidoses or glycoproteinoses. Two types of sialidosis have been defined, type 2 (also referred to as the infantile, dysmor... --- Walk 4 --- [5C56.20] Mucolipidosis --RELATED_TO--> [?] Wolman disease Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir... --PARENT--> [?] Liver disease due to disorders of lysosomal storage Def: This is liver disease due to a group of approximately 50 rare inherited metabolic disorders that result from defects in lysosomal function.... --- 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 ... --PARENT--> [?] Anaemias or other erythrocyte disorders --- 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 --CHILD--> [MF91] Bilirubinuria\n Def: Bilirubinuria means the presence of any bile pigment in the urine....", "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --CHILD--> [MF91] Bilirubinuria\n Def: Bilirubinuria means the presence of any bile pigment in the urine....", "[5C56.20] Mucolipidosis\n --EXCLUDES--> [?] Sialidosis\n --CHILD--> [?] Sialidosis type 2\n Def: Sialidosis is a lysosomal storage disease belonging to the group of oligosaccharidoses or glycoproteinoses. Two types of sialidosis have been defined, type 2 (also referred to as the infantile, dysmor...", "[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Wolman disease\n Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...\n --PARENT--> [?] Liver disease due to disorders of lysosomal storage\n Def: This is liver disease due to a group of approximately 50 rare inherited metabolic disorders that result from defects in lysosomal function....", "[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 --PARENT--> [?] Anaemias or other erythrocyte disorders", "[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": "MH12.1", "icd10_code": "R961", "icd10_title": "" }, { "from_icd11": "QA50", "icd10_code": "XXI", "icd10_title": "" }, { "from_icd11": "2A84.Z", "icd10_code": "C888", "icd10_title": "Other malignant immunoproliferative diseases" }, { "from_icd11": "2A84.Z", "icd10_code": "C88", "icd10_title": "Malignant immunoproliferative diseases and certain other B-cell lymphomas" }, { "from_icd11": "2A84.Z", "icd10_code": "C882", "icd10_title": "Heavy chain disease" }, { "from_icd11": "2A84.Z", "icd10_code": "C889", "icd10_title": "Malignant immunoproliferative disease, unspecified" }, { "from_icd11": "2A84.Z", "icd10_code": "C887", "icd10_title": "" } ]
D571
Sickle-cell disease without crisis
A 52-year-old African woman with primary infertility who had been postmenopausal for eight years presented with abdominal heaviness of nine months’ duration recently associated with postprandial vomiting. No change of her general state was noted. There were no signs of compression of the pelvic organs. Abdominal ultrasonography showed a huge abdominal mass and an effusion of average abundance. An abdominal computed tomography (CT) scan showed a tumor mass, tissue and a cystic component measuring 189×133×291mm displacing the bowel loops up and out, and the bladder and uterus down, associated by abundant ascites and a right pleural effusion of medium abundance. The level of carbohydrate antigen 125 (CA-125) was 133U/ml. Surgical exploration was indicated. A preoperative examination noted NYHA (New York Heart Association) class II dyspnea, and obesity with a body mass index (BMI) of 38.6kg/m 2 . An examination of her upper airway noted a Mallampati grade II. Auscultation found silence at the base of her right lung. Her abdomen was distended. Her pulse oximetry indicated 97%. Her electrocardiogram was normal. A preoperative chest X-ray showed effusion syndrome of medium amount. Echocardiography showed good cardiac function with an ejection fraction of 68%. There were no electrolytic disorders: potassium at 4.2mmol/l, fasting plasma glucose at 1.05g/l. Her renal function was not impaired, and hemostasis laboratory tests were normal. Her preoperative hemoglobin was 12.2g/dl. Our patient was premedicated with 50mg hydroxizine the day before surgery and 50mg on the morning of the operation. In the operating room, standard monitoring (noninvasive blood pressure, scope, arterial oxygen saturation) was performed. Venous access was secured by two 16G catheters and 2g cefazolin was administered. After 10 minutes of preoxygenation in a twenty-degree reverse-Trendelenburg position, and a vascular filling of 1000ml of crystalloid, the crash induction was administered using 100mg suxamethonium, 500mg thiopental and the Sellick’s maneuver. Oral tracheal intubation was successful at the first attempt by a tube 7mm in diameter and our patient was connected to the anesthesia machine and ventilated with a tidal volume of 480ml, respiratory rate of 14 cycles/minute. Just after connecting our patient to the ventilator, her saturation level decreased to 96%. To treat and prevent a secondary drop in saturation, an alveolar recruitment maneuver was decided upon. This maneuver was performed by the application of continuous positive airway pressure (40cm H2O/40s). After this maneuver, her positive end-expiratory pressure (PEEP) was maintained at 8cmH20. At the end of this recruitment procedure, her blood pressure decreased to 86/51mmHg, requiring filling with 500ml crystalloid and two boluses of ephedrine (60mg) to achieve a blood pressure of 112/65mmHg. After respiratory and hemodynamic stabilization, maintenance of anesthesia was provided by a mixture of oxygen, nitrous oxide (60%:40%) and 2% of sevoflurane. Airway pressures (Paw) remained at 35cm H2O with a saturation level of 99% under a fraction of inspired oxygen at 60% and PEEP of 8cmH20. Maintenance of the slightly proclive position and opening of the abdomen with the progressive removal of 3200ml ascitic fluid allowed a lower thoracic pressure (Paw=24cm H2O). Her hemodynamic status remained stable with a filling of 1000ml of saline serum (0.9%). Intraoperative bleeding was estimated at 600ml, her hemoglobin at the end of surgery was 10.9g/dl and no operative transfusion was administered. The surgical procedure consisted of resection of the tumor, hysterectomy, and omentectomy . Her bladder and bowel loops were compressed without evidence of invasion. The surgical intervention required 3 hours and 30 minutes. Diuresis at the end of the surgery was to 550ml. The intraoperative analgesia was provided by paracetamol (1g), nefopam (20mg) and morphine (5mg) by slow infusion. This analgesia was relayed postoperatively by paracetamol 1g/6h, nefopam 20mg/8h, and morphine patient-controlled analgesia (PCA). In the recovery room, extubation was made after warming, wakening and stabilizing of her respiratory and hemodynamic parameters. The monitor showed a blood pressure of 145/68mmHg and blood oxygen saturation (SpO2) of 98%. Our patient remained on oxygen for 2 hours under 4L/min of flow. Postoperative chest radiography showed no worsening of the effusion. Her hemoglobin and postoperative blood electrolytes were unremarkable. Prevention of thromboembolic disease was started 6 h after the end of the surgery based on enoxaparine 40mg/24h and compression stockings. The nature of the tumor histology was thecoma with a benign prognosis, confirming Demons-Meigs’ syndrome. Clinical evolution after five months was marked by a complete recovery of our patient and no recurrence of effusion.
3.898438
0.975586
sec[1]/p[0]
en
0.999997
25262179
https://doi.org/10.1186/1752-1947-8-320
[ "pressure", "blood", "effusion", "oxygen", "saturation", "abdominal", "maneuver", "this", "tumor", "preoperative" ]
[ { "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" }, { "code": "BA2Z", "title": "Hypotension, unspecified" }, { "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 === [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 [BA2Z] Hypotension, unspecified Also known as: Hypotension, unspecified | hypopiesis | low blood pressure | arterial hypotension NOS | decreased blood pressure [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 --- [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--> [EH90.2] Pressure ulceration grade 3 Def: Pressure ulcer with full thickness skin loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. There may... --- Walk 3 --- [MB23.L] Pressured speech Def: 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 t... --EXCLUDES--> [?] Schizophrenia or other primary psychotic disorders Def: Schizophrenia and other primary psychotic disorders are characterised by significant impairments in reality testing and alterations in behaviour manifest in positive symptoms such as persistent delusi... --CHILD--> [?] Schizoaffective disorder Def: Schizoaffective disorder is an episodic disorder in which the diagnostic requirements of schizophrenia and a manic, mixed, or moderate or severe depressive episode are met within the same episode of i... --- Walk 4 --- [MB23.L] Pressured speech Def: 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 t... --EXCLUDES--> [?] Schizophrenia or other primary psychotic disorders Def: Schizophrenia and other primary psychotic disorders are characterised by significant impairments in reality testing and alterations in behaviour manifest in positive symptoms such as persistent delusi... --CHILD--> [?] Schizoaffective disorder Def: Schizoaffective disorder is an episodic disorder in which the diagnostic requirements of schizophrenia and a manic, mixed, or moderate or severe depressive episode are met within the same episode of i... --- Walk 5 --- [MD30.Z] Chest pain, unspecified --PARENT--> [MD30] Pain in throat or chest Def: Pain in throat and chest means having pain sensation in throat or chest. Throat is a tube that carries food to oesophagus and air to windpipe and larynx. The technical name for throat is pharynx.... --EXCLUDES--> [?] 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 6 --- [MD30.Z] Chest pain, unspecified --PARENT--> [MD30] Pain in throat or chest Def: Pain in throat and chest means having pain sensation in throat or chest. Throat is a tube that carries food to oesophagus and air to windpipe and larynx. The technical name for throat is pharynx.... --RELATED_TO--> [?] Musculoskeletal chest pain
[ "[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--> [EH90.2] Pressure ulceration grade 3\n Def: Pressure ulcer with full thickness skin loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. There may...", "[MB23.L] Pressured speech\n Def: 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 t...\n --EXCLUDES--> [?] Schizophrenia or other primary psychotic disorders\n Def: Schizophrenia and other primary psychotic disorders are characterised by significant impairments in reality testing and alterations in behaviour manifest in positive symptoms such as persistent delusi...\n --CHILD--> [?] Schizoaffective disorder\n Def: Schizoaffective disorder is an episodic disorder in which the diagnostic requirements of schizophrenia and a manic, mixed, or moderate or severe depressive episode are met within the same episode of i...", "[MB23.L] Pressured speech\n Def: 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 t...\n --EXCLUDES--> [?] Schizophrenia or other primary psychotic disorders\n Def: Schizophrenia and other primary psychotic disorders are characterised by significant impairments in reality testing and alterations in behaviour manifest in positive symptoms such as persistent delusi...\n --CHILD--> [?] Schizoaffective disorder\n Def: Schizoaffective disorder is an episodic disorder in which the diagnostic requirements of schizophrenia and a manic, mixed, or moderate or severe depressive episode are met within the same episode of i...", "[MD30.Z] Chest pain, unspecified\n --PARENT--> [MD30] Pain in throat or chest\n Def: Pain in throat and chest means having pain sensation in throat or chest. Throat is a tube that carries food to oesophagus and air to windpipe and larynx. The technical name for throat is pharynx....\n --EXCLUDES--> [?] 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...", "[MD30.Z] Chest pain, unspecified\n --PARENT--> [MD30] Pain in throat or chest\n Def: Pain in throat and chest means having pain sensation in throat or chest. Throat is a tube that carries food to oesophagus and air to windpipe and larynx. The technical name for throat is pharynx....\n --RELATED_TO--> [?] Musculoskeletal chest pain" ]
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
The patient is placed in a lateral park-bench position, with the head in maximal flexion and the bed raised 20° above the horizontal to facilitate retraction of the cerebellum. Continuous neuro-monitoring of cranial nerves IV to XI is performed. A curvilinear retroauricular incision extending from the mastoid tip to the posterior temporal region is performed. A craniotomy allows the exposition of the lateral part of the transverse sinus. Transverse sigmoid junction and upper sigmoid sinus allow adequate access for this approach. Repair of any opened mastoid air cells is essential. A 5- to 8-mm durotomy parallel to the transverse and sigmoid sinuses is performed. Dural hitch stitches allow mobilization of the sinuses to improve vision. The lateral cerebellomedullary cistern is opened to drain CSF and relax the cerebellum. The surgical corridor is situated between the inferior surface of the tentorium and the quadrangular lobule. A more inferior and medial retraction of the quadrangular lobule of the cerebellum can expand the exposure of the cerebellomesencephalic fissure and the cerebellopontine cistern. This lateral cerebellar corridor, combined with the supracerebellar, expands the access to the infratentorial part of the middle incisural space allowing the surgeon to work in two windows, on either side of the superior petrosal vein and the trigeminal nerve. The exploration of the cerebellomesencephalic fissure reveals the foot of the fistulous venous communication attached to the DAVF along with the venous aneurysms in the infratentorial compartment producing brainstem compression . The venous ectasia is then carefully dissected and mobilized, in order to have a good exposure of the fistulous arterialized venous connection, which is also confirmed indocyanine green (ICG) video angiography. A clip is then applied and a repeat ICG injection is performed to verify its occlusion. The venous aneurysm needed to be decompressed to allow proper visualization of the infratentorial surface of the DAVF up to the porus trigeminus to ensure all venous connections to the DAVF is excluded. The retrograde flow though venous aneurysm is clipped using large curved clips . The dura is closed watertight and the bone flap replaced. The surgical wound is closed in layers. Fig. 1 A 76-year-old male presented 2 years ago to another institution with signs and symptoms of intracranial hypertension. On neurological examination, the patient presented a right-side mild hemiparesis, gait disturbance, mild fluent aphasia, and short-term memory problems. Brain imaging revealed an obstructive hydrocephalus due to aqueduct compression in the context of a giant venous ectasia associated with DAVF, Borden type II . The arterial feeders of the DAVF were from the branches of the middle meningeal and occipital artery as well as the artery of Bernasconi-Cassinari. The patient underwent an endoscopic third ventriculostomy and embolization of the arterial afferents. The symptoms of raised intracranial tension resolved but gait instability and memory problems persisted. He was then evaluated at our institute. The MRI showed persistence of the tentorial DAVF associated with multiple giant venous ectasias The MR images showed the major compressive effect on the brainstem associated with intrinsic brainstem hyperintensities on T2W images . The DAVF with the foot of the draining vein emerging at the anterior petrotentorial junction was well seen on axial Gd-enhanced T1W MRI . The coronal Gd-enhanced T1W MR images showed the tortuous trajectory of the fistulous intradural part of the DAVF in both the infra- and supratentorial compartments along with the compression of the brainstem and mesial temporal lobe Fig. 2 Early arterial phase of the preoperative DSA in the lateral left projection of the ICA injection showed the afferent branches from the artery of Bernasconi-Cassinari (arrow) and early filling of the emergent efferent vein . The left external carotid DSA showed several afferent branches from the left occipital and middle meningeal arteries . The DSA in the venous phase demonstrated the multiple giant venous ectasias Fig. 3 Postoperative angio-CT scan showed the clip (arrow) of the DAVF in position and disappearance of the fistulous connection. The brainstem and left mesial temporal lobe regained their normal positions in the middle incisural space and middle fossa, respectively (axial and contrast enhanced coronal CT images). MRI was not performed due to possible clip artifacts Fig. 4 Postoperative DSA (lateral projection) performed 1 year following surgery confirmed the disappearance of the fistulous connection and the tortuous venous ectasias ectatic . At this follow-up visit, the patient had no gait instability and the memory functions had significantly improved. There were no symptoms of hydrocephalus and raised intracranial tension
4.042969
0.927246
sec[1]/p[0]
en
0.999994
34386853
https://doi.org/10.1007/s00701-021-04945-6
[ "venous", "davf", "middle", "fistulous", "brainstem", "raised", "cerebellum", "temporal", "part", "transverse" ]
[ { "code": "BD74.Z", "title": "Chronic peripheral venous insufficiency of lower extremities, unspecified" }, { "code": "BD75.Y", "title": "Venous varicosities of other specified sites" }, { "code": "BD75.Z", "title": "Venous varicosities of unspecified site" }, { "code": "JA61.Z", "title": "Venous complications in pregnancy, unspecified" }, { "code": "BD74.0", "title": "Uncomplicated lower limb venous hypertension" }, { "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" } ]
=== ICD-11 CODES FOUND === [BD74.Z] Chronic peripheral venous insufficiency of lower extremities, unspecified Also known as: Chronic peripheral venous insufficiency of lower extremities, unspecified | Chronic peripheral venous insufficiency of lower extremities | Chronic venous insufficiency | postthrombotic syndrome | postphlebitic syndrome [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 [BD75.Z] Venous varicosities of unspecified site Also known as: Venous varicosities of unspecified site | Venous varicosities of sites other than lower extremity | Venous varix [JA61.Z] Venous complications in pregnancy, unspecified Also known as: Venous complications in pregnancy, unspecified | Venous complications in pregnancy | Gestational phlebopathy, NOS [BD74.0] Uncomplicated lower limb venous hypertension Definition: The presence of lower limb venous incompetence or hypertension as may be manifest by the presence of haemosiderin pigmentation of the skin, telangiectasia or finely dilated superficial veins. Also known as: Uncomplicated lower limb venous hypertension | Lower limb haemosiderosis due to venous insufficiency | Lower limb haemosiderosis secondary to venous insufficiency | Lower limb superficial venous ectasia | Venous flare [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 === GRAPH WALKS === --- Walk 1 --- [BD74.Z] Chronic peripheral venous insufficiency of lower extremities, unspecified --PARENT--> [BD74] Chronic peripheral venous insufficiency of lower extremities Def: The presence of increased pressure in the peripheral venous system, particularly of the lower extremities. Peripheral venous hypertension may be due to incompetence of venous valves following deep vei... --CHILD--> [BD74.2] Lipodermatosclerosis Def: Lipodermatosclerosis is a form of panniculitis of the lower legs that develops in the context of venous insufficiency, giving rise to features that include oedema, erythema, hyperpigmentation and indu... --- Walk 2 --- [BD74.Z] Chronic peripheral venous insufficiency of lower extremities, unspecified --PARENT--> [BD74] Chronic peripheral venous insufficiency of lower extremities Def: The presence of increased pressure in the peripheral venous system, particularly of the lower extremities. Peripheral venous hypertension may be due to incompetence of venous valves following deep vei... --RELATED_TO--> [?] Lymphoedema due to venous insufficiency Def: Permanent lymphoedema, usually of the lower extremities, resulting from venous hypertension and chronic gravitational oedema.... --- Walk 3 --- [BD75.Y] Venous varicosities of other specified sites --PARENT--> [BD75] Venous varicosities of sites other than lower extremity --EXCLUDES--> [?] Duodenal varices Def: Abnormally dilated veins developed as portosystemic shunts in the lining of duodenum in patients with portal hypertension. Once duodenal varices develop, they continue to grow, and bleeding from duode... --- Walk 4 --- [BD75.Y] Venous varicosities of other specified sites --PARENT--> [BD75] Venous varicosities of sites other than lower extremity --EXCLUDES--> [?] Duodenal varices Def: Abnormally dilated veins developed as portosystemic shunts in the lining of duodenum in patients with portal hypertension. Once duodenal varices develop, they continue to grow, and bleeding from duode... --- Walk 5 --- [BD75.Z] Venous varicosities of unspecified site --PARENT--> [BD75] Venous varicosities of sites other than lower extremity --RELATED_TO--> [?] Oesophageal varices Def: Abnormally dilated veins developed as portosystemic shunts in the lining of the lower oesophagus in patients with portal hypertension. Once oesophageal varices develop, they continue to grow, and blee... --- Walk 6 --- [BD75.Z] Venous varicosities of unspecified site --PARENT--> [BD75] Venous varicosities of sites other than lower extremity --EXCLUDES--> [?] Duodenal varices Def: Abnormally dilated veins developed as portosystemic shunts in the lining of duodenum in patients with portal hypertension. Once duodenal varices develop, they continue to grow, and bleeding from duode...
[ "[BD74.Z] Chronic peripheral venous insufficiency of lower extremities, unspecified\n --PARENT--> [BD74] Chronic peripheral venous insufficiency of lower extremities\n Def: The presence of increased pressure in the peripheral venous system, particularly of the lower extremities. Peripheral venous hypertension may be due to incompetence of venous valves following deep vei...\n --CHILD--> [BD74.2] Lipodermatosclerosis\n Def: Lipodermatosclerosis is a form of panniculitis of the lower legs that develops in the context of venous insufficiency, giving rise to features that include oedema, erythema, hyperpigmentation and indu...", "[BD74.Z] Chronic peripheral venous insufficiency of lower extremities, unspecified\n --PARENT--> [BD74] Chronic peripheral venous insufficiency of lower extremities\n Def: The presence of increased pressure in the peripheral venous system, particularly of the lower extremities. Peripheral venous hypertension may be due to incompetence of venous valves following deep vei...\n --RELATED_TO--> [?] Lymphoedema due to venous insufficiency\n Def: Permanent lymphoedema, usually of the lower extremities, resulting from venous hypertension and chronic gravitational oedema....", "[BD75.Y] Venous varicosities of other specified sites\n --PARENT--> [BD75] Venous varicosities of sites other than lower extremity\n --EXCLUDES--> [?] Duodenal varices\n Def: Abnormally dilated veins developed as portosystemic shunts in the lining of duodenum in patients with portal hypertension. Once duodenal varices develop, they continue to grow, and bleeding from duode...", "[BD75.Y] Venous varicosities of other specified sites\n --PARENT--> [BD75] Venous varicosities of sites other than lower extremity\n --EXCLUDES--> [?] Duodenal varices\n Def: Abnormally dilated veins developed as portosystemic shunts in the lining of duodenum in patients with portal hypertension. Once duodenal varices develop, they continue to grow, and bleeding from duode...", "[BD75.Z] Venous varicosities of unspecified site\n --PARENT--> [BD75] Venous varicosities of sites other than lower extremity\n --RELATED_TO--> [?] Oesophageal varices\n Def: Abnormally dilated veins developed as portosystemic shunts in the lining of the lower oesophagus in patients with portal hypertension. Once oesophageal varices develop, they continue to grow, and blee...", "[BD75.Z] Venous varicosities of unspecified site\n --PARENT--> [BD75] Venous varicosities of sites other than lower extremity\n --EXCLUDES--> [?] Duodenal varices\n Def: Abnormally dilated veins developed as portosystemic shunts in the lining of duodenum in patients with portal hypertension. Once duodenal varices develop, they continue to grow, and bleeding from duode..." ]
BD74.Z
Chronic peripheral venous insufficiency of lower extremities, unspecified
[ { "from_icd11": "BD74.Z", "icd10_code": "I87313", "icd10_title": "Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity" }, { "from_icd11": "BD74.Z", "icd10_code": "I87393", "icd10_title": "Chronic venous hypertension (idiopathic) with other complications of bilateral lower extremity" }, { "from_icd11": "BD74.Z", "icd10_code": "I87309", "icd10_title": "Chronic venous hypertension (idiopathic) without complications of unspecified lower extremity" }, { "from_icd11": "BD74.Z", "icd10_code": "I87302", "icd10_title": "Chronic venous hypertension (idiopathic) without complications of left lower extremity" }, { "from_icd11": "BD74.Z", "icd10_code": "I87339", "icd10_title": "Chronic venous hypertension (idiopathic) with ulcer and inflammation of unspecified lower extremity" }, { "from_icd11": "BD74.Z", "icd10_code": "I87319", "icd10_title": "Chronic venous hypertension (idiopathic) with ulcer of unspecified lower extremity" }, { "from_icd11": "BD74.Z", "icd10_code": "I87399", "icd10_title": "Chronic venous hypertension (idiopathic) with other complications of unspecified lower extremity" }, { "from_icd11": "BD74.Z", "icd10_code": "I87031", "icd10_title": "Postthrombotic syndrome with ulcer and inflammation of right lower extremity" }, { "from_icd11": "BD74.Z", "icd10_code": "I83208", "icd10_title": "Varicose veins of unspecified lower extremity with both ulcer of other part of lower extremity and inflammation" }, { "from_icd11": "BD74.Z", "icd10_code": "I87002", "icd10_title": "Postthrombotic syndrome without complications of left lower extremity" }, { "from_icd11": "BD74.Z", "icd10_code": "I83228", "icd10_title": "Varicose veins of left lower extremity with both ulcer of other part of lower extremity and inflammation" }, { "from_icd11": "BD74.Z", "icd10_code": "I87012", "icd10_title": "Postthrombotic syndrome with ulcer of left lower extremity" }, { "from_icd11": "BD74.Z", "icd10_code": "I87092", "icd10_title": "Postthrombotic syndrome with other complications of left lower extremity" }, { "from_icd11": "BD74.Z", "icd10_code": "I83223", "icd10_title": "Varicose veins of left lower extremity with both ulcer of ankle and inflammation" }, { "from_icd11": "BD74.Z", "icd10_code": "I83218", "icd10_title": "Varicose veins of right lower extremity with both ulcer of other part of lower extremity and inflammation" } ]
I87313
Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity
The patient’s family provided written informed consent to publish this case report and any accompanying images. A 6-year-old Caucasian boy fell off his bike in the spring and landed on his outstretched arm, producing a valgus thrust on the elbow that fractured the radial neck. The patient arrived at the emergency department the same day of the injury, reporting acute left elbow pain and inability to move it. The elbow was swollen and painful laterally, with no clinically evident deformities of the left upper arm and only a small abrasion on his left hand. There was no neurovascular deficit of the upper limb and no sign of elbow instability. Radiographs showing anteroposterior and lateral projections of the left elbow revealed a radial neck metaepiphyseal impacted fracture with a displacement of 4 mm and an angulation < 30%, classifiable as a Judet and Letournel type II fracture . The patient’s relatives accepted the treatment proposed after having been informed that the fracture, impacted and displaced, often results in a loss of forearm rotation if not treated. The patient was hospitalized for a routine preoperative checkup. His blood examination and anesthesia evaluation were carried out. The limb was placed in a splint at 90 degrees of flexion, and surgery was performed the following day. Once general anesthesia was performed, the manipulation of the left elbow was attempted with the elbow being flexed and the forearm supinated. Posteriorly directed pressure was applied to the radial shaft as described by Monson et al. . A fluoroscopy check showed that the displacement had not healed and that the fracture was still impacted. The operating room setup was similar to the one used for elective elbow arthroscopy in adults. The patient was placed on the operating table in the lateral decubitus position, using a tourniquet and maintaining the elbow at 90-degree flexion during surgery . A fluid pump was used at low pressure. Bony landmarks (radial head, epicondyles, and olecranon process) were marked, and the joint was distended with an intra-articular injection of 5 ml of saline solution through the posterior portal (the olecranon fossa). The anteromedial portal was used as the arthroscope entrance, and the anterolateral portal was used as the instrumental portal. Intra-articular evaluation of the joint showed the integrity of the annular ligament and a significant displacement and impaction of the radial head detectable as an increased gap between the radiohumeral joint, which was enhanced by pronation and supination movements . The proximal anteromedial portal was made 2 cm proximal and 1 cm anterior to the medial epicondyle to avoid injury to the ulnar nerve. The skin was carefully incised, and the soft tissues were bluntly dissected down to the level of the capsule. A 2.4-mm 30-degree arthroscope was inserted through this portal, and another portal was made under direct visualization with an outside-in technique. Using an anterolateral arthroscopic portal, a Kelly hemostatic forceps was introduced and used to gain the reduction of the radial head under arthroscopic assistance, but without success. Some force had to be applied to perform the reduction using a K-wire inserted percutaneously as a lever (joystick technique). The result was graded as good . A dynamic arthroscopic examination showed satisfactory stability of the osteosynthesis and normal articular congruity. A single check with an image intensifier, in anteroposterior and lateral views, was taken at the end of the procedure . The surgery lasted 35 minutes. Postoperatively, a cast was applied for 3 weeks, and then the K-wire was removed. The postoperative course was uneventful, and the fracture was united at 4 weeks. Three months after the fracture event, the patient had regained full range of motion with a Mayo Elbow Performance Score of 100 points. Fig. 1 Pre-operative anteroposterior (AP) and lateral x-ray view of the left elbow. A: the radial neck, displaced laterally; B: the capitulum humeri. Notice the abnormal gap between A and B in the AP view Fig. 2 Patient under general anaesthesia in lateral decubitus with the elbow at 90° of flexion Fig. 3 ( a , b ) Arthroscopic images before fracture reduction. Notice the abnormal distance (white arrow) between the radial head (A) and the capitulum humeri (B), which should normally be in contact. The condropick arthroscopic instrument easily passes through the articular space over the annular ligament (C) between the capitulum humeri and the radial head; this is an indirect sign of articular incongruity Fig. 4 Arthroscopic image, after reduction and fixation, showing the normal relation-contact between the proximal radio-humeral joint. Radial head (A) capitulum humeri (B) and intact annular ligament (C) Fig. 5 Oblique ( a ) and lateral ( b ) x-ray of the left elbow after reduction and fixation
3.929688
0.973633
sec[1]/p[0]
en
0.999997
32580779
https://doi.org/10.1186/s13256-020-02390-0
[ "elbow", "radial", "portal", "fracture", "head", "arthroscopic", "used", "articular", "reduction", "that" ]
[ { "code": "NC31.Y&XA9FF8", "title": "Laceration of elbow" }, { "code": "NC33.4", "title": "Strain or sprain of elbow" }, { "code": "NC30.Y&XA9FF8&XJ1C6", "title": "Haematoma of elbow" }, { "code": "NC30.0", "title": "Abrasion of elbow" }, { "code": "FA34.Y", "title": "Other joint derangements" }, { "code": "LB99.2", "title": "Radial hemimelia" }, { "code": "8C10.2", "title": "Lesion of radial nerve" }, { "code": "BD30.00&XA8RG5", "title": "Radial artery embolism" }, { "code": "BD30.01&XA8RG5", "title": "Radial artery thrombosis" }, { "code": "NC34.2", "title": "Injury of radial nerve at forearm level" } ]
=== ICD-11 CODES FOUND === [NC33.4] Strain or sprain of elbow Definition: A collective term for muscle and ligament injuries of the tissues associated with the elbow without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. Also known as: Strain or sprain of elbow | Sprain or strain of elbow, radial collateral ligament | Sprain or strain of elbow, ulnar collateral ligament | Sprain or strain radiohumeral joint | Sprain or strain ulnohumeral joint [NC30.0] Abrasion of elbow Also known as: Abrasion of elbow [FA34.Y] Other joint derangements Also known as: Other joint derangements | Other articular cartilage disorders | Other articular cartilage disorders, multiple sites | Other articular cartilage disorders, shoulder region | Other articular cartilage disorders, acromioclavicular joint [LB99.2] Radial hemimelia Definition: Radial hemimelia is a congenital longitudinal deficiency of the radius bone of the forearm characterised by partial or total absence of the radius. Also known as: Radial hemimelia | Longitudinal reduction defect of radius | agenesis of radial ray | agenesis of radius | congenital absence of radius Includes: Radial clubhand [8C10.2] Lesion of radial nerve Also known as: Lesion of radial nerve | radial nerve mononeuritis | Superficial radial nerve lesion | Radial nerve posterior interosseous syndrome | Radial nerve paralysis Excludes: Injury of radial nerve at upper arm level | Injury of radial nerve at forearm level | Injury of radial nerve at wrist or hand level [NC34.2] Injury of radial nerve at forearm level Also known as: Injury of radial nerve at forearm level | injury of radial nerve NOS | Laceration of radial nerve at forearm level === GRAPH WALKS === --- Walk 1 --- [NC33.4] Strain or sprain of elbow Def: A collective term for muscle and ligament injuries of the tissues associated with the elbow without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are rup... --PARENT--> [NC33] Dislocation or strain or sprain of joints or ligaments of elbow Def: A collective term for muscle and ligament injuries of the tissues associated with, or displacement of the bones of, the elbow.... --CHILD--> [NC33.2] Traumatic rupture of radial collateral ligament --- Walk 2 --- [NC33.4] Strain or sprain of elbow Def: A collective term for muscle and ligament injuries of the tissues associated with the elbow without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are rup... --PARENT--> [NC33] Dislocation or strain or sprain of joints or ligaments of elbow Def: A collective term for muscle and ligament injuries of the tissues associated with, or displacement of the bones of, the elbow.... --CHILD--> [NC33.2] Traumatic rupture of radial collateral ligament --- Walk 3 --- [NC30.0] Abrasion of elbow --PARENT--> [NC30] Superficial injury of forearm --CHILD--> [NC30.0] Abrasion of elbow --- Walk 4 --- [NC30.0] Abrasion of elbow --PARENT--> [NC30] Superficial injury of forearm --CHILD--> [NC30.1] Contusion of elbow --- Walk 5 --- [FA34.Y] Other joint derangements --PARENT--> [FA34] Certain specified joint derangements --PARENT--> [?] Certain specified joint disorders or deformities of limbs --- Walk 6 --- [FA34.Y] Other joint derangements --PARENT--> [FA34] Certain specified joint derangements --EXCLUDES--> [?] Temporomandibular joint disorders Def: This is an umbrella term covering acute or chronic pain, especially in the muscles of mastication and/or inflammation of the temporomandibular joint, which connects the mandible to the skull....
[ "[NC33.4] Strain or sprain of elbow\n Def: A collective term for muscle and ligament injuries of the tissues associated with the elbow without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are rup...\n --PARENT--> [NC33] Dislocation or strain or sprain of joints or ligaments of elbow\n Def: A collective term for muscle and ligament injuries of the tissues associated with, or displacement of the bones of, the elbow....\n --CHILD--> [NC33.2] Traumatic rupture of radial collateral ligament", "[NC33.4] Strain or sprain of elbow\n Def: A collective term for muscle and ligament injuries of the tissues associated with the elbow without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are rup...\n --PARENT--> [NC33] Dislocation or strain or sprain of joints or ligaments of elbow\n Def: A collective term for muscle and ligament injuries of the tissues associated with, or displacement of the bones of, the elbow....\n --CHILD--> [NC33.2] Traumatic rupture of radial collateral ligament", "[NC30.0] Abrasion of elbow\n --PARENT--> [NC30] Superficial injury of forearm\n --CHILD--> [NC30.0] Abrasion of elbow", "[NC30.0] Abrasion of elbow\n --PARENT--> [NC30] Superficial injury of forearm\n --CHILD--> [NC30.1] Contusion of elbow", "[FA34.Y] Other joint derangements\n --PARENT--> [FA34] Certain specified joint derangements\n --PARENT--> [?] Certain specified joint disorders or deformities of limbs", "[FA34.Y] Other joint derangements\n --PARENT--> [FA34] Certain specified joint derangements\n --EXCLUDES--> [?] Temporomandibular joint disorders\n Def: This is an umbrella term covering acute or chronic pain, especially in the muscles of mastication and/or inflammation of the temporomandibular joint, which connects the mandible to the skull...." ]
NC31.Y&XA9FF8
Laceration of elbow
[ { "from_icd11": "NC33.4", "icd10_code": "S53442A", "icd10_title": "Ulnar collateral ligament sprain of left elbow, initial encounter" }, { "from_icd11": "NC33.4", "icd10_code": "S53492A", "icd10_title": "Other sprain of left elbow, initial encounter" }, { "from_icd11": "NC33.4", "icd10_code": "S53401A", "icd10_title": "Unspecified sprain of right elbow, initial encounter" }, { "from_icd11": "NC33.4", "icd10_code": "S53402A", "icd10_title": "Unspecified sprain of left elbow, initial encounter" }, { "from_icd11": "NC33.4", "icd10_code": "S53491A", "icd10_title": "Other sprain of right elbow, initial encounter" }, { "from_icd11": "NC33.4", "icd10_code": "S53499A", "icd10_title": "Other sprain of unspecified elbow, initial encounter" }, { "from_icd11": "NC33.4", "icd10_code": "S53439A", "icd10_title": "Radial collateral ligament sprain of unspecified elbow, initial encounter" }, { "from_icd11": "NC33.4", "icd10_code": "S53409A", "icd10_title": "Unspecified sprain of unspecified elbow, initial encounter" }, { "from_icd11": "NC33.4", "icd10_code": "S53499S", "icd10_title": "Other sprain of unspecified elbow, sequela" }, { "from_icd11": "NC33.4", "icd10_code": "S53429A", "icd10_title": "Ulnohumeral (joint) sprain of unspecified elbow, initial encounter" }, { "from_icd11": "NC33.4", "icd10_code": "S53449A", "icd10_title": "Ulnar collateral ligament sprain of unspecified elbow, initial encounter" }, { "from_icd11": "NC33.4", "icd10_code": "S53419A", "icd10_title": "Radiohumeral (joint) sprain of unspecified elbow, initial encounter" }, { "from_icd11": "NC33.4", "icd10_code": "S534", "icd10_title": "Sprain of elbow" }, { "from_icd11": "NC30.0", "icd10_code": "S50311A", "icd10_title": "Abrasion of right elbow, initial encounter" }, { "from_icd11": "NC30.0", "icd10_code": "S50312A", "icd10_title": "Abrasion of left elbow, initial encounter" } ]
S53442A
Ulnar collateral ligament sprain of left elbow, initial encounter
A 12-year-old boy was admitted with a 2-month history of progressively worsening fatigue. He had been noted to be anemic a month prior to his hospitalization, with hemoglobin of 7.9 g/dL and was started on oral iron by his primary care pediatrician. At his outpatient follow-up visit, because of persistence of his symptoms, repeat laboratory testing was performed and showed his hemoglobin had decreased to 7.3 g/dL. His serum potassium was 7 mEq/L, serum bicarbonate was low at 15 mEq/L, and serum creatinine was elevated at 8.7 mg/dL (estimated glomerular filtration rate [eGFR] 11 mL/min/1.73 m 2 ). He was admitted to the pediatric intensive care unit via the emergency room where he received furosemide and sodium polystyrene. Studies to evaluate his renal disease included a renal ultrasound which revealed normal sized kidneys with bilateral grade 2 hydronephrosis without dilated ureters and with a distended, but thin-walled bladder; a voiding cystourethrogram showed no reflux and a normal urethra, but significant after void residual. Other studies included serum complements C3 and C4, both of which were normal, hepatitis B and hepatitis C and HIV serologies that were all negative, and an antinuclear antibody that was also negative. His urinalysis had a low specific gravity of 1.006 with no blood or protein. He was urgently started on hemodialysis because of hyperkalemia and was maintained on outpatient hemodialysis three times a week at discharge, with a presumptive diagnosis of advanced CKD likely from a urologic cause. His past medical history was uneventful with normal development and growth, and there were no documented urinary tract infections, unexplained febrile illnesses, or urinary complaints. For further evaluation of his renal disease and in preparation for a renal Tx, he underwent urodynamic studies which showed a normally compliant low-pressure bladder with complete bladder emptying. Even though he only had moderate hydronephrosis on ultrasound, due to the severity of his kidney disease, he underwent bilateral retrograde pyelograms which showed that both proximal ureters were somewhat medially deviated; the left proximal ureter had a 1 cm long narrow segment and the right proximal ureter had a 3 cm long narrowing. Double J ureteral stents were placed on both sides. Following stenting his urine output increased, and his renal function improved but only minimally, to a serum creatinine of 5 mg/dl (eGFR 19 mL/min/1.73 m 2 ). Due to a concern that the narrowing was from extrinsic ureteric compression, abdominal and pelvic CT scans were performed. On these scans, performed about 2 months after his initial renal ultrasound, both kidneys were noted to be very large and almost entirely replaced with nonenhancing nodules throughout the parenchyma. Mild bilateral hydronephrosis was again noted. Also noted were multiple mixed sclerotic-lytic lesions in the L2 to L5 vertebral bodies; his serum calcium was normal. He was readmitted to the hospital for further management and underwent a percutaneous renal biopsy which established the diagnosis of diffuse large B-cell lymphoma. The biopsy tissue showed parenchyma infiltrated by large atypical pleomorphic lymphoid cells with prominent nucleoli and that stained positively with CD79A and CD 20. FISH probe for MYC rearrangement was negative. His bone marrow was normal. A whole body PET scan showed findings consistent with multifocal, infiltrative renal lymphoma associated with multifocal hypermetabolic lymphoma deposits in the axial and appendicular skeleton and retroperitoneal lymph nodes. With a diagnosis of PRL, he was started on chemotherapy with vincristine, cyclophosphamide, prednisone, and intrathecal methotrexate. Following a lack of response to therapy, he was transitioned to a more aggressive protocol, consisting of additional doses of vincristine, prednisone, methotrexate, doxorubicin, etoposide, and intrathecal methotrexate. Over time, his renal function progressively improved such that he was able to come off hemodialysis, and at discharge from the hospital, he had a serum creatinine of 1.7 mg/dl (eGFR 58 mL/min/1.73 m 2 ). His subsequent clinical course was complicated by episodes of fever and neutropenia, typhlitis, and neurotoxicity from etoposide and vincristine needing extensive rehabilitation. At his last clinic visit, 5.5 years after diagnosis and 4 years after completing chemotherapy, his PET scan showed no hypermetabolic lesions to suggest active disease, his blood pressure was normal, and his serum creatinine was stable at 1.2 mg/dL (eGFR 94 mL/min/1.73 m 2 ). On his most recent ultrasound, he had mild left hydronephrosis with a significant reduction in renomegaly; his ureteral stents had been removed in the interim. He was in school performing well academically and using a walker for ambulation due to his residual neurologic injury.
4
0.977051
sec[1]/p[0]
en
0.999997
29098007
https://doi.org/10.1155/2017/9210648
[ "renal", "serum", "that", "which", "creatinine", "egfr", "ultrasound", "hydronephrosis", "both", "bladder" ]
[ { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "GB6Z", "title": "Kidney failure, unspecified" }, { "code": "LB30.1", "title": "Renal dysplasia" }, { "code": "NB92.0Y", "title": "Other specified injury of kidney" }, { "code": "LB30.7", "title": "Ectopic or pelvic kidney" }, { "code": "NE80.3", "title": "Other serum reactions" }, { "code": "5D0Y", "title": "Other specified metabolic disorders" }, { "code": "5B91.0", "title": "Hypercalcaemia" }, { "code": "4A84.Y", "title": "Other specified anaphylaxis" }, { "code": "5C50.F2", "title": "Homocarnosinosis" } ]
=== ICD-11 CODES FOUND === [GB6Z] Kidney failure, unspecified Also known as: Kidney failure, unspecified | nontraumatic kidney injury | renal failure NOS | kidney block | renal impairment NOS [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 [NB92.0Y] Other specified injury of kidney Also known as: Other specified injury of kidney | Injury of kidney without open wound into cavity | Injury of kidney with open wound into cavity | Haematoma of kidney | traumatic perirenal haematoma [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 [NE80.3] Other serum reactions Also known as: Other serum reactions | Allergic reaction to serum | serum allergy | Complications of vaccination, protein sickness | Protein sickness Excludes: serum hepatitis [5D0Y] Other specified metabolic disorders Also known as: Other specified metabolic disorders | Disorders of plasma-protein metabolism, not elsewhere classified | abnormal protein transport | dysproteinaemia | Absence of albumin in blood [5B91.0] Hypercalcaemia Definition: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused by dehydration secondary to urinary losses of calcium, water and other electrolytes, and to an increase in membrane potential caused by the elevation in extracellular fluid ionized calcium concentration. Patients with moderate to severe hypercalcaemia often complain of nausea and vomiting, symptoms Also known as: Hypercalcaemia | Calcium excess | elevated serum calcium | hypercalcaemic crisis | hypercalcaemic syndrome [4A84.Y] Other specified anaphylaxis Also known as: Other specified anaphylaxis | Latex-induced anaphylaxis | Anaphylaxis due to latex | Latex anaphylaxis | Anaphylactic shock due to serum [5C50.F2] Homocarnosinosis Definition: Homocarnosinosis is a metabolic defect characterised by progressive spastic diplegia, intellectual deficit and retinitis pigmentosa. This extremely rare disorder has been reported in only one family, namely a woman and three of her children. The latter showed but their mother was symptom free. It is therefore uncertain whether there is a relationship between the biochemical defect and the clinical symptoms. Inheritance in the reported family seems to be autosomal dominant. Also known as: Homocarnosinosis | Homocarnosinase deficiency | Serum carnosinase deficiency === GRAPH WALKS === --- Walk 1 --- [GB6Z] Kidney failure, unspecified --PARENT--> [?] Kidney failure Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ... --CHILD--> [GB6Z] Kidney failure, unspecified --- Walk 2 --- [GB6Z] Kidney failure, unspecified --PARENT--> [?] Kidney failure Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ... --RELATED_TO--> [?] Congenital renal failure Def: A severe irreversible decline in the ability of kidneys to remove wastes, concentrate urine, and maintain electrolyte balance; blood pressure; and calcium metabolism which existed at, or often before,... --- Walk 3 --- [LB30.1] Renal dysplasia Def: A condition characterised by abnormal development of one or both kidneys.... --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d... --CHILD--> [?] Autosomal dominant polycystic kidney disease, Type 2 Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin2 gene on chromosome 4 (PKD1 gene).... --- Walk 4 --- [LB30.1] Renal dysplasia Def: A condition characterised by abnormal development of one or both kidneys.... --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d... --CHILD--> [?] Autosomal dominant polycystic kidney disease, Type 2 Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin2 gene on chromosome 4 (PKD1 gene).... --- Walk 5 --- [NB92.0Y] Other specified injury of kidney --PARENT--> [NB92.0] Injury of kidney --PARENT--> [NB92] Injury of urinary or pelvic organs --- Walk 6 --- [NB92.0Y] Other specified injury of kidney --PARENT--> [NB92.0] Injury of kidney --PARENT--> [NB92] Injury of urinary or pelvic organs
[ "[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --CHILD--> [GB6Z] Kidney failure, unspecified", "[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --RELATED_TO--> [?] Congenital renal failure\n Def: A severe irreversible decline in the ability of kidneys to remove wastes, concentrate urine, and maintain electrolyte balance; blood pressure; and calcium metabolism which existed at, or often before,...", "[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --CHILD--> [?] Autosomal dominant polycystic kidney disease, Type 2\n Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin2 gene on chromosome 4 (PKD1 gene)....", "[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --CHILD--> [?] Autosomal dominant polycystic kidney disease, Type 2\n Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin2 gene on chromosome 4 (PKD1 gene)....", "[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --PARENT--> [NB92] Injury of urinary or pelvic organs", "[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --PARENT--> [NB92] Injury of urinary or pelvic organs" ]
GC2Z&XA6KU8
Disease of kidney, not elsewhere classified
[ { "from_icd11": "GB6Z", "icd10_code": "N19", "icd10_title": "Unspecified kidney failure" }, { "from_icd11": "GB6Z", "icd10_code": "N17-N19", "icd10_title": "" }, { "from_icd11": "GB6Z", "icd10_code": "N17", "icd10_title": "Acute kidney failure" }, { "from_icd11": "LB30.1", "icd10_code": "Q614", "icd10_title": "Renal dysplasia" }, { "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": "NE80.3", "icd10_code": "T880XXA", "icd10_title": "Infection following immunization, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8061XA", "icd10_title": "Other serum reaction due to administration of blood and blood products, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8069XA", "icd10_title": "Other serum reaction due to other serum, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8062XA", "icd10_title": "Other serum reaction due to vaccination, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T806", "icd10_title": "Other serum reactions" }, { "from_icd11": "NE80.3", "icd10_code": "T880", "icd10_title": "Infection following immunization" }, { "from_icd11": "5C50.F2", "icd10_code": "E7281", "icd10_title": "Disorders of gamma aminobutyric acid metabolism" }, { "from_icd11": "5C50.F2", "icd10_code": "E728", "icd10_title": "Other specified disorders of amino-acid metabolism" } ]
N19
Unspecified kidney failure
Family 1 is a consanguineous family with the 12-, 6- and 5-year-old brothers III.1, III.2 and III.3 referred for medical evaluation due to multiple congenital joint contractures . Pregnancy history and birth parameters were not available. Individual III.1 showed movement restriction of shoulder, knee and ankle joints as well as limitations in elbow flexion, internal hip and head rotation. Additional clinical features included microcephaly, camptodactyly, scapular winging, scoliosis, pectus excavatum, reduced palmar and plantar skin folds and translucent skin. Due to finger contractures, surgery was performed. Motor development was generally normal, but reduced fine motor skills and poor active speech were observed. Spinal MRI revealed a cleft formation in the anterior atlas arch. Facial dysmorphism included long face, downslanted palpebral fissures, bifid uvula, high narrow palate, micrognathia and webbed neck. At the last follow-up at the age of 12 years, his weight was 35.5 kg (− 1.0 SD), his length was 145 cm (− 1.1 SD) and his head circumference was 51.8 cm (− 2.1 SD). Physical examination of individual III.2 revealed limitations in shoulder, elbow extension, hip, knee and head rotation, camptodactyly and shortening of the entire dorsal leg muscles with a left club foot and an equinus position of the right foot. Club foot was operated on at the age of 5 years. Similarly to his affected brother III.1, he presented with long face, downslanted palpebral fissures, bifid uvula, high narrow palate, micrognathia, webbed neck, scapular winging, scoliosis, reduced palmar and plantar skin folds and translucent skin . Motor and speech development were mildly delayed. Growth measurements at the age of 6 years revealed a body weight of 22.0 kg (− 0.1 SD), a body length of 127 cm (1.4 SD) and a head circumference of 51.0 cm (− 1.5 SD). Individual III.3 showed a less severe phenotype than his brothers. He also presented with movement restrictions mainly in shoulder and elbow, whereas hip and knee are mildly affected. Additional clinical characteristics included scoliosis, camptodactyly, reduced palmar and plantar skin folds, translucent skin as well as congenital renal hypoplasia of the left side. Motor and speech development were mildly delayed. Craniofacial features were similar to those of his brothers with long face, downslanted palpebral fissures, mild micrognathia and webbed neck. Cardiac investigations in all affected brothers revealed no anomalies. Fig. 2 Pedigrees and genetic characteristics of individuals with congenital arthrogryposis and microcephaly carrying homozygous disease-causing variants in FILIP1 . a Pedigrees of families 1–3 with pathogenic FILIP1 variants. Affected siblings (solid symbols) in each family carry homozygous disease-causing variants in FILIP1 while non-affected parents and siblings (semi-solid symbols) are heterozygous for identified FILIP1 variants. b Chromatograms of the identified FILIP1 variants in family 1 (F1: c.463G>T; p.Glu155*) and family 2 showing homozygosity in affected patients (Mut/Mut) and heterozygous carrier state in healthy parents or siblings (WT/Mut). Localization of nonsense variants is indicated in red. c Copy number analysis by qPCR was used for segregation analysis of a ~ 86-kb homozygous deletion spanning FILIP1 exons 3–6 in family 3 (F3: deletion of Ex3–6) which was initially detected in exome sequencing data of the patient. qPCR for exons 4 and 5 confirmed homozygous deletion of this region in the patient and a heterozygous carrier state in his parents compared to exon 2, which was used as reference Table 1 Clinical features of patients with disease-causing variants in FILIP1 Family Family 1 Family 1 Family 1 Family 2 Family 3 Pedigree ID III.1 III.2 III.3 III.3 III.3 Gender Male Male Male Male Male Geographic origin Pakistan Pakistan Pakistan Oman India Consanguinity + + + + + FILIP1 variant (all in homozygous state) c.463G>T (p.Glu155*) c.463G>T (p.Glu155*) c.463G>T (p.Glu155*) c.2665C>T (p.Arg889*) Deletion of exons 3–6 Age at examination 12 years 6 years 5 years 7 years 11 months Length 145 cm (− 1.1 SD) 127 cm (1.4 SD) N/A 123 cm (− 0.6 SD) 66 cm (− 3.2 SD) Weight 35.5 kg (− 1.0 SD) 22.0 kg (− 0.1 SD) N/A 19.9 kg (− 1.7 SD) 6.7 kg (− 3.5 SD) Head circumference 51.8 cm (− 2.1 SD) 51.0 cm (− 1.5 SD) N/A 48.5 cm (− 3.2 SD) 42.5 cm (− 4.0 SD) Clinical characteristics Shoulder contractures + + + − − Elbow contractures + + + + + Wrist contractures + + + + − Camptodactyly + + + + + Overlapping fingers − − − − + Syndactyly − − − + − Hip contractures + + + − − Knee contractures + + + − + Foot deformity (club or rocker bottom foot) − + − + + Scoliosis + + + + − Reduced palmar and plantar skin folds + + + + N/A Translucent skin with prominent veins + + + − + Facial dysmorphism + + + + + Heart anomalies − − − − − N/A not available, SD standard deviations
4.109375
0.885254
sec[2]/sec[0]/p[0]
en
0.999997
36943452
https://doi.org/10.1007/s00439-023-02528-2
[ "family", "skin", "contractures", "variants", "affected", "head", "foot", "homozygous", "brothers", "shoulder" ]
[ { "code": "QE70.Z", "title": "Problems related to primary support group, including family circumstances, unspecified" }, { "code": "8C74.1Z", "title": "Periodic paralysis, unspecified" }, { "code": "2B90.Y", "title": "Other specified malignant neoplasms of colon" }, { "code": "EE61", "title": "Superficial fibromatoses" }, { "code": "9B70", "title": "Inherited retinal dystrophies" }, { "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" } ]
=== ICD-11 CODES FOUND === [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 [8C74.1Z] Periodic paralysis, unspecified Also known as: Periodic paralysis, unspecified | Periodic paralysis | Westphal disease | periodic myotonia | myoplegic dystrophy [2B90.Y] Other specified malignant neoplasms of colon Also known as: Other specified malignant neoplasms of colon | Neuroendocrine neoplasm of colon | Colon endocrine neoplasm | Neuroendocrine carcinoma of colon | NEC - [neuroendocrine carcinoma] of colon [EE61] Superficial fibromatoses Also known as: Superficial fibromatoses | Pachydermodactyly | Camptodactyly or streblodactyly | Familial camptodactyly | Sporadic camptodactyly [9B70] Inherited retinal dystrophies Also known as: Inherited retinal dystrophies | hereditary retinal dystrophies | Amaurosis - hypertrichosis | Autosomal dominant late-onset retinal degeneration | Bothnia retinal dystrophy Includes: Leber congenital amaurosis | Stargardt disease | Vitreoretinal dystrophy [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 === GRAPH WALKS === --- Walk 1 --- [QE70.Z] Problems related to primary support group, including family circumstances, unspecified --PARENT--> [QE70] Problems related to primary support group, including family circumstances --CHILD--> [QE70.1] Disruption of family by separation or divorce --- Walk 2 --- [QE70.Z] Problems related to primary support group, including family circumstances, unspecified --PARENT--> [QE70] Problems related to primary support group, including family circumstances --CHILD--> [QE70.2] Dependent relative needing care at home --- Walk 3 --- [8C74.1Z] Periodic paralysis, unspecified --PARENT--> [8C74.1] Periodic paralysis Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or... --PARENT--> [8C74] Periodic paralyses or disorders of muscle membrane excitability Def: These are a group of disorders caused by malfunctioning of the ion channels in skeletal muscle membranes causing the cells to depolarize leading to weakness or paralysis. The common triggers include c... --- Walk 4 --- [8C74.1Z] Periodic paralysis, unspecified --PARENT--> [8C74.1] Periodic paralysis Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or... --CHILD--> [8C74.11] Hyperkalaemic periodic paralysis Def: Hyperkalaemic periodic paralysis (HyperPP) is a muscle disorder characterised by episodic attacks of muscle weakness associated with an increase in serum potassium concentration.... --- Walk 5 --- [2B90.Y] Other specified malignant neoplasms of colon --PARENT--> [2B90] Malignant neoplasms of colon Def: Primary malignant neoplasms arising in the colon.... --RELATED_TO--> [?] Gardner syndrome Def: Gardner syndrome develops adenomatous polyps throughout the gastrointestinal tract, accompanied by extracolonic manifestations, including periampullary adenomas, papillary carcinoma of the thyroid, he... --- Walk 6 --- [2B90.Y] Other specified malignant neoplasms of colon --PARENT--> [2B90] Malignant neoplasms of colon Def: Primary malignant neoplasms arising in the colon.... --CHILD--> [2B90.1] Malignant neoplasm of descending colon and splenic flexure of colon
[ "[QE70.Z] Problems related to primary support group, including family circumstances, unspecified\n --PARENT--> [QE70] Problems related to primary support group, including family circumstances\n --CHILD--> [QE70.1] Disruption of family by separation or divorce", "[QE70.Z] Problems related to primary support group, including family circumstances, unspecified\n --PARENT--> [QE70] Problems related to primary support group, including family circumstances\n --CHILD--> [QE70.2] Dependent relative needing care at home", "[8C74.1Z] Periodic paralysis, unspecified\n --PARENT--> [8C74.1] Periodic paralysis\n Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or...\n --PARENT--> [8C74] Periodic paralyses or disorders of muscle membrane excitability\n Def: These are a group of disorders caused by malfunctioning of the ion channels in skeletal muscle membranes causing the cells to depolarize leading to weakness or paralysis. The common triggers include c...", "[8C74.1Z] Periodic paralysis, unspecified\n --PARENT--> [8C74.1] Periodic paralysis\n Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or...\n --CHILD--> [8C74.11] Hyperkalaemic periodic paralysis\n Def: Hyperkalaemic periodic paralysis (HyperPP) is a muscle disorder characterised by episodic attacks of muscle weakness associated with an increase in serum potassium concentration....", "[2B90.Y] Other specified malignant neoplasms of colon\n --PARENT--> [2B90] Malignant neoplasms of colon\n Def: Primary malignant neoplasms arising in the colon....\n --RELATED_TO--> [?] Gardner syndrome\n Def: Gardner syndrome develops adenomatous polyps throughout the gastrointestinal tract, accompanied by extracolonic manifestations, including periampullary adenomas, papillary carcinoma of the thyroid, he...", "[2B90.Y] Other specified malignant neoplasms of colon\n --PARENT--> [2B90] Malignant neoplasms of colon\n Def: Primary malignant neoplasms arising in the colon....\n --CHILD--> [2B90.1] Malignant neoplasm of descending colon and splenic flexure of colon" ]
QE70.Z
Problems related to primary support group, including family circumstances, unspecified
[ { "from_icd11": "QE70.Z", "icd10_code": "Z6379", "icd10_title": "Other stressful life events affecting family and household" }, { "from_icd11": "QE70.Z", "icd10_code": "Z6372", "icd10_title": "Alcoholism and drug addiction in family" }, { "from_icd11": "QE70.Z", "icd10_code": "Z638", "icd10_title": "Other specified problems related to primary support group" }, { "from_icd11": "QE70.Z", "icd10_code": "Z639", "icd10_title": "Problem related to primary support group, unspecified" }, { "from_icd11": "QE70.Z", "icd10_code": "Z637", "icd10_title": "Other stressful life events affecting family and household" }, { "from_icd11": "8C74.1Z", "icd10_code": "G723", "icd10_title": "Periodic paralysis" }, { "from_icd11": "EE61", "icd10_code": "F54", "icd10_title": "Psychological and behavioral factors associated with disorders or diseases classified elsewhere" }, { "from_icd11": "9B70", "icd10_code": "H3552", "icd10_title": "Pigmentary retinal dystrophy" }, { "from_icd11": "9B70", "icd10_code": "H3550", "icd10_title": "Unspecified hereditary retinal dystrophy" }, { "from_icd11": "9B70", "icd10_code": "H3553", "icd10_title": "Other dystrophies primarily involving the sensory retina" }, { "from_icd11": "9B70", "icd10_code": "H3554", "icd10_title": "Dystrophies primarily involving the retinal pigment epithelium" }, { "from_icd11": "9B70", "icd10_code": "H355", "icd10_title": "Hereditary retinal dystrophy" }, { "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" } ]
Z6379
Other stressful life events affecting family and household
Due to cerebral and splenic emboli, there was high suspicion of endocarditis. Transesophageal echocardiography showed a heavily thickened and degenerated aortic valve (AV) with concomitant vegetation and abscess formation on the left coronary cusp resulting in dehiscence, perforation, and AV insufficiency. No other valves were involved. The patient’s antibiotics were switched to trimethoprim-sulfamethoxazole (TMP-SMX) 15 mg/kg/day IV divided in four doses, amikacin 21 mg/kg IV every 24 h, and imipenem-cilastatin 500 mg IV every 6 h. This antibiotic regimen was started on day 7 of admission. Repeat blood cultures remained negative. Cardiothoracic surgery was considered and a pre-surgical work-up was recommended, including digital subtraction angiography (DSA) and left heart catheterization (LHC), due to his history of tobacco use. LHC was not performed due to the patient’s worsening renal function to avoid contrast agent exposure. He ultimately developed renal failure requiring hemodialysis on the 19th day of hospitalization [Creatinine was 3.76 mg/dL, BUN of 54 mg/dL with an estimated glomerular filtration rate (eGFR) of 17 (reference range: > 60 ml/min/1.73 M*2)]. The patient’s clinical status continued to decline, with hypotension requiring vasopressors, worsening respiratory status requiring intubation, and acute renal failure requiring continuous renal replacement therapy (CRRT). Antimicrobial susceptibility testing, performed at a Nocardia reference laboratory using broth microdilution and CLSI breakpoints, showed that the organism was susceptible to amikacin, ceftriaxone, imipenem-cilastatin, linezolid, moxifloxacin, TMP-SMX, and tobramycin (Table 1 ). He was deemed not eligible for valvular surgery due to his worsening clinical status. After family discussion, he was transitioned to outpatient hospice care, and all antibiotics were discontinued. Patient passed away a day after discharge to a hospice care facility. Table 1 Reported cases of endocarditis due to Nocardia species References Age (y)/sex Predisposing risk factor Site of involvement Nocardia species Antimicrobial treatment (Duration) Surgery Outcome Allevato et al . 53/M PAV RAA N. asteroides Streptomycin, tetracycline, vancomycin, sulfonamides N/A Died Antony et al . 74/F HTN, valvular heart disease, HLD NMV N. asteroides Imipenem, ceftriaxone (6 weeks), TMP-SMX (6 months) MVR Survived Antonovich et al . 83/F COPD, MVP, breast & endometrial cancer, systemic steroids NMV N. asteroides TMP-SMX N/A Survived Cargill et al . 85/F Ischemic heart disease, COPD, polymyalgia rheumatic, systemic steroids NMV N. cyriacigeorgica Vancomycin, pip/tazo, imipenem, doxycycline N/A Died Castelli et al . 36/M Liver transplant NMV N. species Ceftriaxone, vancomycin, TMP-SMX MVR (× 2) Survived Daikos et al . 61/F PAV PAV N. asteroides Imipenem/cilastatin, amikacin (2 months), TMP-SMX (4 months) N/A Survived Dhawan et al . 46/F N/A NMV N. species PCN, nafcillin, gentamicin, TMP-SMX, imipenem/cilastatin MVR Survived Eigel et al . 61/M PAV PAV N. asteroides Amikacin, imipenem/cilastatin, cefotiam (3 weeks) AVR Survived Eigel et al . 65/M PAV PAV N. asteroides N/A N/A Died Ertl et al . 61/M PAV PAV N. asteroides Amoxicillin, mezlocillin, tobramycin, sulphadiazine, amikacin, amoxicillin-clavulanate, imipenem (3 weeks), TMP-SMX AVR Survived Falk et al . 64/F PAV PAV N. asteroides Ampicillin, gentamicin N/A Died Gupta et al . 53/F History of breast cancer NAV N. species Meropenem, amikacin, TMP-SMX, linezolid (8 months) AVR Survived Hazim et al . 64/M Heart transplant, CKD NTV N. asteroides TMP-SMX, imipenem/cilastatin, ceftriaxone, minocycline, linezolid (7 months) N/A Survived Jackson et al . 39/M Splenectomy, tobacco use, HCV, IVDU NTV N. francinia Meropenem, vancomycin, TMP-SMX N/A Lost to follow-up Kuretski et al . 58/F History of oral cancer, COPD, PFO repair, tobacco use NMV N. farcinica Ceftriaxone, meropenem, amikacin, ciprofloxacin MVR Survived Majeed et al . 72/M Lymphoma NMV N. kroppenstedtii Meropenem, TMP-SMX, levofloxacin, linezolid, ceftriaxone, minocycline, ciprofloxacin N/A Died Vlachakis et al . 34/F PMV, rheumatic heart disease PMV N. asteroides N/A N/A Died Watson et al . 39/M IVDU NAV N. asteroides Meropenem, ceftriaxone, amikacin, cefpodoxime, TMP-SMX (6 months) AVR Survived AVR, aortic valve replacement; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; HCV, Hepatitis C virus; HLD, hyperlipidemia; HTN, hypertension; IVDU, intravenous drug use; MVP, mitral valve prolapse; MVR, mitral valve replacement; NAV, native aortic valve; NMV, native mitral valve; NTV, native tricuspid valve; PFO, patent foramen ovale; Pip/tazo, piperacillin and tazobactam; PCN, penicillin; PAV, prosthetic aortic valve; PMV, prosthetic mitral valve; PV, prosthetic valve; RAA, root of ascending aorta; TMP-SMX, trimethoprim sulfamethoxazole
4.132813
0.943848
sec[1]/p[4]
en
0.999996
34412578
https://doi.org/10.1186/s12879-021-06541-6
[ "asteroides", "survived", "valve", "imipenem", "amikacin", "ceftriaxone", "cilastatin", "died", "heart", "species" ]
[ { "code": "9B8Y", "title": "Other specified disorders of the vitreous body" }, { "code": "KD3A", "title": "Termination of pregnancy, affecting surviving fetus or newborn" }, { "code": "GB61.Z", "title": "Chronic kidney disease, stage unspecified" }, { "code": "BC00", "title": "Multiple valve disease" }, { "code": "BB9Z", "title": "Pulmonary valve disease, unspecified" }, { "code": "BB6Z", "title": "Mitral valve disease, unspecified" }, { "code": "LA8Z", "title": "Structural developmental anomaly of heart or great vessels, unspecified" }, { "code": "MG50.92", "title": "Carbapenem resistant Salmonella" }, { "code": "MG50.02", "title": "Carbapenem resistant Acinetobacter baumannii" }, { "code": "MG50.54", "title": "Carbapenem resistant Klebsiella pneumoniae" } ]
=== ICD-11 CODES FOUND === [9B8Y] Other specified disorders of the vitreous body Also known as: Other specified disorders of the vitreous body | Crystalline deposits in vitreous body | Asteroid hyalosis | asteroid hyalitis | Benson disease [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) [GB61.Z] Chronic kidney disease, stage unspecified Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease [BC00] Multiple valve disease Also known as: Multiple valve disease | Multiple valve disease of unspecified origin | multiple valvular cardiac dysfunction | multivalvular cardiac dysfunction | Disorders of both mitral and aortic valves [BB9Z] Pulmonary valve disease, unspecified Also known as: Pulmonary valve disease, unspecified | rheumatic heart disease of pulmonary valve, unspecified | chronic rheumatic pulmonary valve endocarditis | chronic rheumatic pulmonary valvular endocarditis | rheumatic disease of pulmonary valve [BB6Z] Mitral valve disease, unspecified Also known as: Mitral valve disease, unspecified | noninfective endocarditis of mitral valve | rheumatic heart disease of mitral valve, unspecified | mitral valvulopathy | mitral valve cardiopathy [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 [MG50.92] Carbapenem resistant Salmonella Also known as: Carbapenem resistant Salmonella | Doripenem resistant Salmonella | Ertapenem resistant Salmonella | Imipenem resistant Salmonella | Meropenem resistant Salmonella [MG50.02] Carbapenem resistant Acinetobacter baumannii Also known as: Carbapenem resistant Acinetobacter baumannii | Doripenem resistant Acinetobacter baumannii | Imipenem resistant Acinetobacter baumannii | Meropenem resistant Acinetobacter baumannii [MG50.54] Carbapenem resistant Klebsiella pneumoniae Also known as: Carbapenem resistant Klebsiella pneumoniae | Doripenem resistant Klebsiella pneumoniae | Ertapenem resistant Klebsiella pneumoniae | Imipenem resistant Klebsiella pneumoniae | Meropenem resistant Klebsiella pneumoniae === GRAPH WALKS === --- Walk 1 --- [9B8Y] Other specified disorders of the vitreous body --PARENT--> [?] Disorders of the vitreous body Def: Any condition of the transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina.... --RELATED_TO--> [?] Congenital anomalies of the vitreous --- Walk 2 --- [9B8Y] Other specified disorders of the vitreous body --PARENT--> [?] Disorders of the vitreous body Def: Any condition of the transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina.... --CHILD--> [9B82] Vitreous prolapse --- Walk 3 --- [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 delayed or excessive haemorrhage --- Walk 4 --- [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.... --CHILD--> [KD32] Feeding problems of newborn Def: A lack of interest in feeding or a problem receiving the proper amount of nutrition in a newborn.... --- Walk 5 --- [GB61.Z] Chronic kidney disease, stage unspecified --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--> [GB61.1] Chronic kidney disease, stage 2 Def: Kidney damage and GFR 60-89 ml/min/1.73m²... --- Walk 6 --- [GB61.Z] Chronic kidney disease, stage unspecified --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--> [GB61.2] Chronic kidney disease, stage 3a Def: GFR 45-59 ml/min/1.63m²...
[ "[9B8Y] Other specified disorders of the vitreous body\n --PARENT--> [?] Disorders of the vitreous body\n Def: Any condition of the transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina....\n --RELATED_TO--> [?] Congenital anomalies of the vitreous", "[9B8Y] Other specified disorders of the vitreous body\n --PARENT--> [?] Disorders of the vitreous body\n Def: Any condition of the transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina....\n --CHILD--> [9B82] Vitreous prolapse", "[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 delayed or excessive haemorrhage", "[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 --CHILD--> [KD32] Feeding problems of newborn\n Def: A lack of interest in feeding or a problem receiving the proper amount of nutrition in a newborn....", "[GB61.Z] Chronic kidney disease, stage unspecified\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--> [GB61.1] Chronic kidney disease, stage 2\n Def: Kidney damage and GFR 60-89 ml/min/1.73m²...", "[GB61.Z] Chronic kidney disease, stage unspecified\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--> [GB61.2] Chronic kidney disease, stage 3a\n Def: GFR 45-59 ml/min/1.63m²..." ]
9B8Y
Other specified disorders of the vitreous body
[ { "from_icd11": "9B8Y", "icd10_code": "H43811", "icd10_title": "Vitreous degeneration, right eye" }, { "from_icd11": "9B8Y", "icd10_code": "H43813", "icd10_title": "Vitreous degeneration, bilateral" }, { "from_icd11": "KD3A", "icd10_code": "P964", "icd10_title": "" }, { "from_icd11": "GB61.Z", "icd10_code": "N183", "icd10_title": "Chronic kidney disease, stage 3 (moderate)" }, { "from_icd11": "GB61.Z", "icd10_code": "N189", "icd10_title": "Chronic kidney disease, unspecified" }, { "from_icd11": "GB61.Z", "icd10_code": "N250", "icd10_title": "Renal osteodystrophy" }, { "from_icd11": "GB61.Z", "icd10_code": "N18", "icd10_title": "Chronic kidney disease (CKD)" }, { "from_icd11": "BC00", "icd10_code": "I081", "icd10_title": "Rheumatic disorders of both mitral and tricuspid valves" }, { "from_icd11": "BC00", "icd10_code": "I080", "icd10_title": "Rheumatic disorders of both mitral and aortic valves" }, { "from_icd11": "BC00", "icd10_code": "I082", "icd10_title": "Rheumatic disorders of both aortic and tricuspid valves" }, { "from_icd11": "BC00", "icd10_code": "I083", "icd10_title": "Combined rheumatic disorders of mitral, aortic and tricuspid valves" }, { "from_icd11": "BC00", "icd10_code": "I088", "icd10_title": "Other rheumatic multiple valve diseases" }, { "from_icd11": "BC00", "icd10_code": "I089", "icd10_title": "Rheumatic multiple valve disease, unspecified" }, { "from_icd11": "BC00", "icd10_code": "I05-I09", "icd10_title": "" }, { "from_icd11": "BC00", "icd10_code": "I08", "icd10_title": "Multiple valve diseases" } ]
H43811
Vitreous degeneration, right eye
A 74‐year‐old man with decreased appetite, weight, and heartburn was referred to our hospital. Six months prior to the current presentation, heartburn began, and 5 months later, he lost his appetite. His weight decreased by 7 kg from his usual weight of 64 kg, without fever or diarrhea. His medical history included well‐controlled diabetes mellitus, hypertension, constipation, pruritus, and gastric ulcer. His medications were olmesartan 20 mg daily for 13 years, miglitol 100 mg daily for 8 years, dapagliflozin 5 mg daily for 6 years, sennoside 24 mg daily for 2 months, and a combination of betamethasone 0.25 mg and d‐chlorpheniramine 0.4 mg daily for 3 months. Famotidine was administered to treat suspected acid‐related diseases. One week later, esophagogastroduodenoscopy (EGD) revealed numerous small erosions in the lesser curvature of the lower corpus and antrum . The areas of inflamed mucosal islands interspersed by erosion had a cobblestone appearance . The rest of the corpus lacked erosions but appeared nodular . The gastric mucosa of the lesser curvature was friable and bled on contact with the endoscope . The esophageal and duodenal mucosa were endoscopically normal, except for a scar in the duodenal bulb. These gastric mucosal changes were not observed in the EGD performed at a clinic a year prior to the current presentation . Five gastric biopsies were performed, revealing inflammatory cell infiltration without atypical cells . The atrophy was moderate in the antrum and severe in the corpus. No subepithelial collagen deposition (Masson's trichrome stain), amyloid deposits (Congo red stain), or more than 20 eosinophils per high‐power field were identified. Laboratory studies were unrevealing, including a negative result for serum anti‐ Helicobacter pylori immunoglobulin G antibody test (Table S1 ). Computed tomography and abdominal ultrasonography findings were unremarkable. As his symptoms persisted, famotidine was changed to esomeprazole and mosapride. Six days later, he was initially presented to the emergency department for hematemesis and melena but was subsequently transferred to the gastroenterology department for further evaluation and management. An EGD revealed a gastric Dieulafoy lesion with oozing bleeding in the lesser curvature of the middle corpus , which was not the site of the biopsies. Endoscopic hemostasis was successfully achieved, and he was admitted to our hospital. Intravenous lansoprazole and oral misoprostol were administered. As gastric bleeding was well‐controlled after endoscopic hemostasis, intravenous lansoprazole was switched to oral esomeprazole. The duodenal ulcer scar and his history of gastric ulcers suggested an H. pylori infection. However, the endoscopic appearance of diffuse erosive gastritis and the negative serum anti‐ H. pylori antibody result was not typical of peptic ulcer disease. Other causes of gastritis should be considered. Autoimmune gastritis is a well‐known cause of chronic gastritis, but it typically spares the antrum. The moderate erosive gastritis in the antrum was unusual for autoimmune gastritis. Eosinophilic gastritis was unlikely in the absence of eosinophilia or mucosal eosinophil infiltration. Amyloidosis, granulomatous gastritis, and infiltrative tumors were unlikely according to the biopsy results. Additionally, an upper gastrointestinal manifestation of inflammatory bowel disease was unlikely in the absence of lower gastrointestinal symptoms. Collagenous gastritis was possible because of the nodular mucosa, which is an endoscopic feature of collagenous gastritis, but unlikely in the absence of subepithelial collagenous deposition. The working diagnosis was drug‐induced gastritis, particularly olmesartan‐induced gastritis. Because his diabetes mellitus was well controlled and his blood pressure was normal without medication, hypoglycemic and antihypertensive medications were discontinued. His appetite gradually improved during the admission. He was discharged five days after admission. Follow‐up EGD 2 months after discharge revealed that the gastric erosions healed while remaining nodular . His loss of appetite resolved. During the next 10 months, he remained in his usual state. His weight increased to 70 kg 6 months after withdrawing olmesartan. Mosapride and misoprostol were discontinued, and olmesartan was inadvertently readministered for hypertension. Two months after resuming olmesartan treatment, EGD revealed multiple short linear erosions in the antrum , although the severity was milder than at the initial examination. He had a mild loss of appetite. Therefore, the olmesartan treatment was discontinued. Healing of the gastric erosions and nodular mucosa was confirmed by EGD 1 year later . He was diagnosed with olmesartan‐induced gastritis and was instructed to avoid all ARBs. Amlodipine was used to treat his hypertension.
3.953125
0.980469
sec[1]/p[0]
en
0.999998
PMC12038180
https://doi.org/10.1002/deo2.70124
[ "gastritis", "gastric", "olmesartan", "appetite", "daily", "erosions", "antrum", "weight", "well", "corpus" ]
[ { "code": "DA42.Z", "title": "Gastritis, unspecified" }, { "code": "DA42.Y", "title": "Other specified gastritis" }, { "code": "DA42.Z&XT5R", "title": "Acute gastritis, not elsewhere classified" }, { "code": "DA42.Z&XT8W", "title": "Chronic gastritis, not elsewhere classified" }, { "code": "DA42.73", "title": "Chronic atrophic gastritis of unknown aetiology" }, { "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": "MG43.7", "title": "Anorexia" } ]
=== ICD-11 CODES FOUND === [DA42.Z] Gastritis, unspecified Also known as: Gastritis, unspecified | Gastritis | Inflammation of gastric mucosa | Gastroduodenitis | gastritis NOS [DA42.Y] Other specified gastritis Also known as: Other specified gastritis | Gastritis due to diseases classified elsewhere | Gastritis due to other diseases classified elsewhere | Gastritis due to Crohn disease | Gastritis due to sarcoidosis [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 [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 [MG43.7] Anorexia Definition: Anorexia is a pathological lack or loss of appetite. Also known as: Anorexia | anorectic | anorexic | lack of appetite | Loss of appetite Includes: Loss of appetite Excludes: loss of appetite of nonorganic origin | anorexia nervosa | Decreased appetite === GRAPH WALKS === --- Walk 1 --- [DA42.Z] Gastritis, unspecified --PARENT--> [DA42] Gastritis Def: Gastritis is an injury of gastric mucosa that involves epithelial damage, mucosal inflammation, and epithelial cell regeneration except for any epithelial defect. Gastritis is caused by various factor... --CHILD--> [DA42.0] Autoimmune gastritis Def: A type of chronic atrophic gastritis restricted to gastric body mucosa, and characterised by a severe atrophy of the acid secreting glands and achlorhydria. This is usually associated with serum antip... --- Walk 2 --- [DA42.Z] Gastritis, unspecified --PARENT--> [DA42] Gastritis Def: Gastritis is an injury of gastric mucosa that involves epithelial damage, mucosal inflammation, and epithelial cell regeneration except for any epithelial defect. Gastritis is caused by various factor... --CHILD--> [DA42.2] Eosinophilic gastritis --- Walk 3 --- [DA42.Y] Other specified gastritis --PARENT--> [DA42] Gastritis Def: Gastritis is an injury of gastric mucosa that involves epithelial damage, mucosal inflammation, and epithelial cell regeneration except for any epithelial defect. Gastritis is caused by various factor... --CHILD--> [DA42.0] Autoimmune gastritis Def: A type of chronic atrophic gastritis restricted to gastric body mucosa, and characterised by a severe atrophy of the acid secreting glands and achlorhydria. This is usually associated with serum antip... --- Walk 4 --- [DA42.Y] Other specified gastritis --PARENT--> [DA42] Gastritis Def: Gastritis is an injury of gastric mucosa that involves epithelial damage, mucosal inflammation, and epithelial cell regeneration except for any epithelial defect. Gastritis is caused by various factor... --CHILD--> [DA42.2] Eosinophilic gastritis --- Walk 5 --- [DA42.73] Chronic atrophic gastritis of unknown aetiology Def: 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... --PARENT--> [DA42.7] Gastritis of unknown aetiology with specific endoscopic or pathological features --CHILD--> [DA42.70] Acute superficial gastritis of unknown aetiology --- Walk 6 --- [DA42.73] Chronic atrophic gastritis of unknown aetiology Def: 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... --PARENT--> [DA42.7] Gastritis of unknown aetiology with specific endoscopic or pathological features --CHILD--> [DA42.72] Acute haemorrhagic gastritis of unknown aetiology Def: Rapid onset inflammation of the mucosal lining of the stomach with associated bleeding or abnormal blood flow....
[ "[DA42.Z] Gastritis, unspecified\n --PARENT--> [DA42] Gastritis\n Def: Gastritis is an injury of gastric mucosa that involves epithelial damage, mucosal inflammation, and epithelial cell regeneration except for any epithelial defect. Gastritis is caused by various factor...\n --CHILD--> [DA42.0] Autoimmune gastritis\n Def: A type of chronic atrophic gastritis restricted to gastric body mucosa, and characterised by a severe atrophy of the acid secreting glands and achlorhydria. This is usually associated with serum antip...", "[DA42.Z] Gastritis, unspecified\n --PARENT--> [DA42] Gastritis\n Def: Gastritis is an injury of gastric mucosa that involves epithelial damage, mucosal inflammation, and epithelial cell regeneration except for any epithelial defect. Gastritis is caused by various factor...\n --CHILD--> [DA42.2] Eosinophilic gastritis", "[DA42.Y] Other specified gastritis\n --PARENT--> [DA42] Gastritis\n Def: Gastritis is an injury of gastric mucosa that involves epithelial damage, mucosal inflammation, and epithelial cell regeneration except for any epithelial defect. Gastritis is caused by various factor...\n --CHILD--> [DA42.0] Autoimmune gastritis\n Def: A type of chronic atrophic gastritis restricted to gastric body mucosa, and characterised by a severe atrophy of the acid secreting glands and achlorhydria. This is usually associated with serum antip...", "[DA42.Y] Other specified gastritis\n --PARENT--> [DA42] Gastritis\n Def: Gastritis is an injury of gastric mucosa that involves epithelial damage, mucosal inflammation, and epithelial cell regeneration except for any epithelial defect. Gastritis is caused by various factor...\n --CHILD--> [DA42.2] Eosinophilic gastritis", "[DA42.73] Chronic atrophic gastritis of unknown aetiology\n Def: 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...\n --PARENT--> [DA42.7] Gastritis of unknown aetiology with specific endoscopic or pathological features\n --CHILD--> [DA42.70] Acute superficial gastritis of unknown aetiology", "[DA42.73] Chronic atrophic gastritis of unknown aetiology\n Def: 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...\n --PARENT--> [DA42.7] Gastritis of unknown aetiology with specific endoscopic or pathological features\n --CHILD--> [DA42.72] 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...." ]
DA42.Z
Gastritis, unspecified
[ { "from_icd11": "DA42.Z", "icd10_code": "K2960", "icd10_title": "Other gastritis without bleeding" }, { "from_icd11": "DA42.Z", "icd10_code": "K2971", "icd10_title": "Gastritis, unspecified, with bleeding" }, { "from_icd11": "DA42.Z", "icd10_code": "K5289", "icd10_title": "Other specified noninfective gastroenteritis and colitis" }, { "from_icd11": "DA42.Z", "icd10_code": "K52832", "icd10_title": "Lymphocytic colitis" }, { "from_icd11": "DA42.Z", "icd10_code": "K52831", "icd10_title": "Collagenous colitis" }, { "from_icd11": "DA42.Z", "icd10_code": "K52839", "icd10_title": "Microscopic colitis, unspecified" }, { "from_icd11": "DA42.Z", "icd10_code": "K5281", "icd10_title": "Eosinophilic gastritis or gastroenteritis" }, { "from_icd11": "DA42.Z", "icd10_code": "K2961", "icd10_title": "Other gastritis with bleeding" }, { "from_icd11": "DA42.Z", "icd10_code": "K2951", "icd10_title": "Unspecified chronic gastritis with bleeding" }, { "from_icd11": "DA42.Z", "icd10_code": "K52838", "icd10_title": "Other microscopic colitis" }, { "from_icd11": "DA42.Z", "icd10_code": "K5282", "icd10_title": "Eosinophilic colitis" }, { "from_icd11": "DA42.Z", "icd10_code": "K2970", "icd10_title": "Gastritis, unspecified, without bleeding" }, { "from_icd11": "DA42.Z", "icd10_code": "K529", "icd10_title": "Noninfective gastroenteritis and colitis, unspecified" }, { "from_icd11": "DA42.Z", "icd10_code": "K29", "icd10_title": "Gastritis and duodenitis" }, { "from_icd11": "DA42.Z", "icd10_code": "K291", "icd10_title": "" } ]
K2960
Other gastritis without bleeding
A laboratory investigation revealed a white blood cell count of 9900/cubic mm 3 , with 79.3% neutrophils and 10.2% lymphocytes as well as hemoglobin concentration of 11.3 g/dl and a platelet count of 476,000/cubic mm 3 . The serum biochemistry and lipid profiles were all within normal ranges. The erythrocyte sedimentation rate (ESR) was 22 mm/hr, and C-reactive protein (CRP) was 44.2 mg/dl (normal <8 mg/dl). Antibody titers of IgM to M. pneumonia measured by enzyme-linked immunosorbent assay (ELISA) were negative on admission. The chest radiograph demonstrated that there was a pneumonia patch over his right lower lung lobe and a small right-sided pleural effusion . The patient was considered to have severe pneumonia, probably due to M. pneumonia, and was given intravenous azithromycin, cefotaxime, ambroxol hydrochloride and dexamethasone. The cough began to improve, but the high body temperature persisted. A computed tomography (CT) on the third day of hospitalization showed a large high-intensity lesion in his right lower lung lobe, stenosis of the lower right bronchial lumen and right-sided pleural effusion . A chest ultrasound examination on the 4 th day of hospitalization showed a bilateral pleural effusion. On the 6 th day of hospitalization, the patient cried suddenly and shook his right upper limb after intravenous ambroxol hydrochloride for 10 min. Ambroxol hydrochloride was stopped immediately and changed to azithromycin because of the possibility of adverse reaction to a drug. The shaking of his right upper limb improved, but he was still crying and complained of blurred vision in his left eye. After stopping the intravenous azithromycin because of the possibility of allergic reaction of azithromycin and shifting to water soluble vitamins, the patient was quiet. The physical examination revealed a garden bilateral pupil with an equal 3-mm diameter, and reaction to light was normal at the initial presentation. No headache, no vomiting, no talking disorders, no disturbance of consciousness, no twitching, no convulsions and no limb movement disorders occurred. The neurological examination showed normal muscle strength and muscle tone of limbs, but no pathologic reflex and no other abnormal signs on presentation. On the following day, the patient still complained of loss of vision in the left eye. The ophthalmologic examination showed no light perception and no pupillary reaction to light, but normal anterior segment and intraocular pressure in the left eye. Visual acuity was 1.0 in the right eye. The fundus examination revealed a cherry red spot with severe retinal edema at the macular and peripapillary area, and the optic disc was pale in the left eye, but the examination was normal in the right eye, suggesting central retinal artery occlusion in the left eye. The detailed neurological examination was perforemed as follows: the nasolabial fold was symmetric, and the tongue was midline protrusion; There was no deviation of the mandible, no involuntary movement; Limb muscle strength was grade IV, and muscular tension was normal; Knee reflex and abdominal reflex was normal, and pathological reflex were negative. Initially, he was given oxygen and a low molecular dextran treatment and carteolol hydrochloride to lower the intraocular pressure 29 h after the onset of vision complaint. Electrocardiogram, echocardiography, and Doppler ultrasound of the bilateral carotid artery and vertebral artery were all normal. Magnetic resonance imaging (MRI) of the brain showed an abnormal signal of the left lentiform nucleus, caudate nucleus and within the temporal lobe, suggesting an acute infarction of the brain including the above regions . He was prescribed tienam to escalate the anti-infection treatment, and early rehabilitation therapy with neurosupplement treatment was initiated, and prepared to transfer the patient to higher level hospital. Fig. 1 a Chest X-ray showed that two lung markings were increased, the high density lower right lung patchy shadows and a small right-sided pleural effusion at the initial presentation. b Chest X-ray showed that two lung textures were increased, the right lower lung had a high patchy density, and its edge was smooth. The right rib diaphragm angle was lost. The heart shadow had no obvious increase, and the left diaphragm was normal on the second day after transfer Fig. 2 Chest CT: Large high-intensity lesions in his right lower lung lobe, the stenosis of the lower right bronchial lumen and right-sided pleural effusion at the initial presentation Fig. 3 a - b Magnetic resonance imaging (MRI) of the brain showed a T2W1-weighted high-intensity signal ( a ) and a T1W1-weighted low-intensity signal of the left lentiform nucleus, caudate nucleus and temporal lobe ( b ), suggesting an acute infarction of the brain, including the above regions the first day after transfer
3.941406
0.979004
sec[1]/p[1]
en
0.999998
27938350
https://doi.org/10.1186/s12887-016-0750-3
[ "lung", "chest", "lobe", "pleural", "effusion", "pneumonia", "sided", "azithromycin", "hydrochloride", "intensity" ]
[ { "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": "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 === [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 [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 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --CHILD--> [CB40.0] Ciliary dyskinesia Def: Defective function of the cilia lining the respiratory tract (lower and upper, sinuses, Eustachian tube, middle ear) resulting in altered mucociliary transport and manifesting as recurrent upper and l... --- Walk 2 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --CHILD--> [CB40.0] Ciliary dyskinesia Def: Defective function of the cilia lining the respiratory tract (lower and upper, sinuses, Eustachian tube, middle ear) resulting in altered mucociliary transport and manifesting as recurrent upper and l... --- 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--> [LA75.2] Congenital hypoplasia of lung --- 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 ... --CHILD--> [CA40.0] Bacterial pneumonia Def: A disease of the pulmonary system, caused by an infection with a bacterial source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhala...
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.0] Ciliary dyskinesia\n Def: Defective function of the cilia lining the respiratory tract (lower and upper, sinuses, Eustachian tube, middle ear) resulting in altered mucociliary transport and manifesting as recurrent upper and l...", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.0] Ciliary dyskinesia\n Def: Defective function of the cilia lining the respiratory tract (lower and upper, sinuses, Eustachian tube, middle ear) resulting in altered mucociliary transport and manifesting as recurrent upper and l...", "[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--> [LA75.2] Congenital hypoplasia of lung", "[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 --CHILD--> [CA40.0] Bacterial pneumonia\n Def: A disease of the pulmonary system, caused by an infection with a bacterial source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhala..." ]
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
A 36-year-old male presented to our retinal clinic with a complaint of constriction of the visual field (VF) in both eyes over the last two weeks. He reported a large alcohol intake for three consecutive days at the time visual symptoms started. Two weeks prior to onset of the symptoms, the patient suffered from a COVID-19 infection, experiencing a high fever (39 °C) for two days. His review of systems was otherwise unremarkable, with no indications of autoimmune diseases, malignancy, or other significant medical history. He also denied any family history of acquired or inherited eye diseases, particularly retinitis pigmentosa (RP). Best corrected visual acuity (BCVA) was 20/25 in the right eye (OD) and 20/32 in the left eye (OS). Intraocular pressure was normal in both eyes (OU). Slit-lamp examination showed no signs of inflammation in either the anterior segment or vitreous. Fundoscopy OU revealed slight pallor of optic discs, mild arteriolar attenuation, and retinal pigment epithelium (RPE) mottling . Spectral domain optical coherence tomography (SD-OCT) indicated severe extrafoveal outer retinal damage, including extensive loss of the ELM, EZ and interdigitation zone (IZ). Although the foveal area was comparatively preserved, there was still evidence of patchy EZ attenuation. Fundus autofluorescence (FAF) OU revealed diffuse transmitting hyper-autofluorescence in the posterior pole . Fluorescein angiography (FA) OU showed staining of the optic discs both eyes, while otherwise normal. Indocyanine green angiography (ICGA) showed extensive hyper-fluorescence in the late frames, with no leakage . Humphrey visual field (HVF) testing showed severe field constriction in both eyes, with a loss of the central island in the left eye , corresponding to the impairment of outer segments on OCT. Full-field electroretinography (ffERG) OU revealed nearly extinguished scotopic rod and photopic cone responses . Multifocal electroretinography (mf-ERG) showed a diffuse reduction in amplitude, with a greater decrease noted in the left eye . Fig. 1 Baseline images of the fundus, FA&ICGA, PPD, and ff-ERG of the patient . (A) The fundus of both eyes showed slight pallor of the optic discs, mild arteriolar attenuation, and RPE mottling. (B) FFA and ICGA demonstrated unremarkable changes except for late-phase hyper-fluorescence in the posterior pole on ICGA without leakage. (C) PPD test showed a positive result with an induration size of 13mm. (D) The ff-ERG revealed nearly extinguished scotopic rod and photopic cone responses. FA: fluorescence angiography; ICGA: indocyanine green angiography; PPD: purified protein derivative; ff-ERG: full-field electroretinography. Fig. 1 Fig. 2 Changes in the retinal structure of the patient before and after treatment. (A) At baseline, SD-OCT revealed diffuse disruption of EZ and ELM with comparatively preserved fovea. (B) Deterioration of outer retinal damage, particularly the fovea, was observed after treatment with both local and systemic use of steroid (arrow). BCVA in both eyes also decreased compared to baseline. (C) Notable restoration of the EZ and ELM in the foveal area (arrow), along with significant increase in BCVA, occurred in both eyes following one month of ATT monotherapy. (D) Both the ELM and EZ within the fovea and para-fovea were fully restored following a combined therapy of 6 months of ATT and 3 months of steroid. The BCVA improved to 20/20 in both eyes. (E) At the final follow-up at month 12 after treatment, the well-maintained BCVA and outer retinal structure in the fovea and para-fovea were observed. Note the persisting loss of EZ and ELM in the extra-foveal region throughout the entire disease course, along with progressive thinning of the ONL (D&E). (F) At baseline, FAF revealed diffuse transmitting hyper-autofluorescence in the posterior pole in both eyes. (G) Following one month of ATT monotherapy, a HAF ring around the fovea on FAF appeared (indicated by the arrows), implying control of inflammation. (H&I) At month 6 and month 12 after treatment, FAF showed a clearly defined HAF ring in both eyes. EZ: ellipsoid zone; ELM: external limiting membrane; BCVA: best-corrected visual acuity; ATT: anti-tuberculosis; ONL: outer nuclear layer; FAF: fundus autofluorescence; HAF: hyper-autofluorescence. Fig. 2 Fig. 3 Changes in visual function of the patient before and after treatment. (A&B) The baseline VF showed severe constriction in both eyes, with a loss of the central island in the left eye. Significant expansion of central VF was observed in both eyes 12 months after treatment. (C&D) The baseline mf-ERG showed a widespread reduction in amplitude, with a greater decrease in the left eye. However, at the 12-month follow-up, a notable increase in amplitude was observed, especially in the left eye. VF: visual field; mf-ERG: multifocal electroretinography. Fig. 3
4.101563
0.971191
sec[1]/p[0]
en
0.999999
40144310
https://doi.org/10.1016/j.ajoc.2025.102296
[ "both", "eyes", "visual", "fovea", "retinal", "field", "bcva", "baseline", "outer", "autofluorescence" ]
[ { "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": "9E1Z", "title": "Diseases of the visual system, unspecified" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "LA10.Y", "title": "Other specified structural developmental anomalies of ocular globes" }, { "code": "LA10.0", "title": "Microphthalmos" }, { "code": "NA06.8D", "title": "Ocular laceration without prolapse or loss of intraocular tissue, unilateral" } ]
=== 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 [9E1Z] Diseases of the visual system, unspecified Also known as: Diseases of the visual system, unspecified | eye diseases NOS | disorder of vision | visual disorder [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 [LA10.Y] Other specified structural developmental anomalies of ocular globes Also known as: Other specified structural developmental anomalies of ocular globes | Cyclopia | synophthalmia | Congenital cystic eye | Congenital malformations of the eye [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 [NA06.8D] Ocular laceration without prolapse or loss of intraocular tissue, unilateral Also known as: Ocular laceration without prolapse or loss of intraocular tissue, unilateral | Laceration of eye NOS | penetrating eyeball injury without prolapse or loss of intraocular tissue | Traumatic rupture of eye, unilateral | rupture of eye, unilateral === 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--> [LB99.2] Radial hemimelia Def: Radial hemimelia is a congenital longitudinal deficiency of the radius bone of the forearm characterised by partial or total absence of the radius.... --- 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--> [LB99.2] Radial hemimelia Def: Radial hemimelia is a congenital longitudinal deficiency of the radius bone of the forearm characterised by partial or total absence of the radius.... --- 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--> [MB51.1] Spastic diplegia of upper extremities --- 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--> [MB51.0] Flaccid diplegia of upper extremities --- 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.0] Amelia of lower 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--> [LB99.2] Radial hemimelia\n Def: Radial hemimelia is a congenital longitudinal deficiency of the radius bone of the forearm characterised by partial or total absence of the radius....", "[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--> [LB99.2] Radial hemimelia\n Def: Radial hemimelia is a congenital longitudinal deficiency of the radius bone of the forearm characterised by partial or total absence of the radius....", "[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--> [MB51.1] Spastic diplegia of upper extremities", "[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--> [MB51.0] Flaccid diplegia of upper extremities", "[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.0] Amelia of lower limb" ]
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": "9E1Z", "icd10_code": "H5500", "icd10_title": "Unspecified nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5509", "icd10_title": "Other forms of nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5581", "icd10_title": "Saccadic eye movements" }, { "from_icd11": "9E1Z", "icd10_code": "H5501", "icd10_title": "Congenital nystagmus" } ]
Q7131
Congenital absence of right hand and finger
A girl aged 1 year and 6 months initially presented with an abdominal mass with a maximum diameter of over 15 cm. The mass was located in the central diaphragm and was infiltrating the liver and pericardium with peritoneal dissemination. Ascites cytology showed class V in Papanicolaou’s classification. The patient was diagnosed as alveolar RMS IRS Stage 4, postoperative group IV, and classified in the high risk group. Chemotherapy was started, but the tumor did not shrink sufficiently: with disease progression after the first 2 courses of VAC every 3 weeks, including vincristine (VCR) + actinomycin-D (Act-D) + cyclophosphamide (CPA); and partial response (PR) after 2 courses of ICE, including ifosfamide (IFM) + carboplatin (CBDCA) + etoposide (VP-16). Surgical resection was not possible for broad tumor’s invasion of the surrounding diaphragm and radical photon radiotherapy could not be performed because the liver could not tolerate the definitive treatment dose. Palliative care was initially recommended from local pediatric oncologists, but subsequently the patient and her family visited our hospital to receive PBT, which was started in June 2009 at age 1 year and 11 months. Peritoneal dissemination disappeared after the chemotherapy, but the tumor was still located in the central diaphragm with infiltration of the liver and pericardium, and the maximum diameter was still over 8 cm at the point . One month after the last chemotherapy (ICE), a PBT dose of 54 GyE in 30 fractions was applied over a course of 58 days. The relative biological effectiveness (RBE) of the PBT was assumed to be 1.1. We used the passive scattering method for PBT . During PBT, the patient was sedated with anesthesia and immobilized in a body cast. We used a laser displacement sensor (LDS: KEYENCE LB-300) that was the prototype of AZ-733. Respiratory gating in the expiratory phase was used. A respiratory waveform is obtained using a laser range finder that monitors movement of the abdominal surface, and a gating signal is developed. The phase shifts between the respiratory waveform and the 3D tumor motion are principally in the range 0.0 to 0.3 s, regardless of the organ being measured in the system . The gating signal is applied to the accelerator, and the accelerator is triggered within 0.1 s and delivers proton beams. The CTV encompassed the gross tumor volume with a 5- to 10-mm margin in all directions. An additional 5-mm margin was included on the caudal axes to compensate for uncertainty due to respiration-induced hepatic movements. An additional margin of 10 mm was added to cover the entire CTV by enlarging the multileaf collimator and adjusting the range shifter. Proton beams from 155 to 250 MeV generated through a linear accelerator and synchrotron were spread out and shaped with ridge filters, double-scattering sheets, multicollimators, and a custom-made bolus to ensure that the beams conformed to the treatment planning data. The tumor shrunk during PBT, and the treatment field was reduced to fit the tumor size and to keep the intestinal dose within the 50Gy tolerance level . The tumor showed a good PR (−95 % of the tumor volume) after PBT and the acute toxicity was only Grade 1 radiation hepatitis and dermatitis. After PBT, high dose chemotherapy with VP-16 + CPA + pirarubicine (THP-ADR) + cisplatin (CDDP) + VCR, IFM + VP-16 + Act-D + VCR, and irinotecan (CPT-11) + VCR was continued. The tumor was well controlled for 1 year with regular follow-up MR or CT scans performed every 3 months, but then recurred at the edge of the irradiation field where the irradiation dose was reduced due to the proximity to the intestine . The chemotherapy regimen was changed to low dose VAC, but the tumor volume remained stable. Repeated radiotherapy was considered, but could not be administered due to intestinal tolerance. Therefore, tumor excision with intraoperative radiotherapy (IORT) using an electron beam of 20 Gy was conducted in May 2011, at age 3 years and 10 months. After IORT, the tumor was well controlled and a CT image showed only radiation hepatitis without a tumor . However, the patient developed secondary myelodysplastic syndrome (MDS) in December 2011, and died of hemophagocytic syndrome after umbilical cord blood transplantation in May 2012. Fig. 1 CT images after 6 courses of VAC and 2 courses of ICE, just before the start of PBT Fig. 2 The tumor shrunk during PBT and the treatment field was reduced to fit the tumor size. The white line was clinical target volume. The surrounding low dosing area (arrows) showed acute radiation hepatitis Fig. 3 These images were contrast enhanced CT image a and PET-CT image b , at 1 year after PBT. In figure a , local recurrence of the tumor is enhanced at the edge of irradiation, and FDG accumulated same place Fig. 4 The tumor was well controlled on CT images at 2 months after IORT
4.222656
0.882813
sec[1]/p[0]
en
0.999999
26573272
https://doi.org/10.1186/s13052-015-0200-0
[ "tumor", "chemotherapy", "courses", "over", "diaphragm", "liver", "radiotherapy", "used", "that", "respiratory" ]
[ { "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": "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" } ]
=== 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 [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 === 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--> [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--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --EXCLUDES--> [?] Nonspecific mesenteric lymphadenitis --- 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--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- 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--> [2E62] Carcinoma in situ of middle ear or respiratory system
[ "[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--> [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--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --EXCLUDES--> [?] Nonspecific mesenteric lymphadenitis", "[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--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital 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--> [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--> [2E62] Carcinoma in situ of middle ear or respiratory system" ]
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
Granulomatosis with polyangiitis is a multiorgan autoimmune disease with multifaceted clinical manifestations which, due to its rarity and the absence of distinctive clinical features, poses serious diagnostic challenges . Diagnostic criteria for GPA consist of clinical evidence of disease in at least two of three areas (upper airways, lung, and kidney) and biopsy results showing disease at least once . Some recent case reports introduced a possible relationship between coronaviruses and autoimmune disease. Zamani et al. reported a case that demonstrated a possible relationship between coronaviruses and systemic lupus erythematosus (SLE), and she suggested there are no published data on the association of coronaviruses with SLE, but several studies have linked coronaviruses with another autoimmune disease such as multiple sclerosis (MS) and rheumatoid arthritis (RA) . Wegener’s granulomatosis or GPA is also an autoimmune disease where the pathogenesis of it is complex but consists of inflammatory cytokines . Increased interleukin-17 (IL-17), interferon-gamma (IFN-γ), and tumor necrosis factor-alpha (TNF-α) levels lead to the formation of inflammatory granulomatous lesions in GPA . Recent studies have shown that hyperactivation of immune cells in patients with COVID-19 leads to elevated levels of various autoantibodies and inflammatory cytokines including IFN- γ and TNF- α . While there have been several reported cases of COVID-19 occurring in patients receiving immunosuppressant treatment for GPA , in this study, we report new onset of Wegener’s granulomatosis with unusual manifestations in an aged woman 2 months after COVID-19 infection. Our patient did not have any history of autoimmune disease in her own or her family. After COVID-19 symptom’s recovery, she presented sudden unilateral visual and hearing loss accompanied by peripheral facial palsy and rhinosinusitis symptoms with clinical and radiological evidence of necrosis of the nasal septum, central tympanic membrane perforation, and there was no BC in pure tone audiometry test on the right side. Based on our experiences during the COVID-19 pandemic, in the encounter of an aged woman with a history of COVID-19 and glucocorticoid usage in the treatment of these sudden and rapidly progressive signs and symptoms aforementioned, primarily, we suspected mucormycosis. Eventually, the diagnosis of GPA was established via histopathological findings. Several studies have reported an increase in mucormycosis cases during the COVID-19 pandemic. COVID-19 and glucocorticoid usage as a basic treatment can lead to immune suppression in these patients and lead to the proliferation of opportunistic infections, including mucormycosis . Mucormycosis is a rare but invasive, rapidly progressive, and life-threatening infection. A definite diagnosis of mucormycosis is only confirmed by histological findings. Early diagnosis of mucormycosis is so important given that a delay of diagnosis from 6 to 30 days can increase the mortality from 35 to 66% . The most common clinical manifestation of mucormycosis is the involvement of the paranasal sinuses (39%), followed by the lung (24%), skin (19%), brain (9%), gastrointestinal tract (7%), and a disseminated type (6%), which is similar to GPA, in variety of manifestations, whereas the onset of symptoms in GPA is often more gradual . COVID-19 and GPA share many clinical and radiological presentations. On chest CT, prominent findings in a GPA patient may be ground-glass appearance, consolidation, or even cavitation . These findings may be mutual in a patient with COVID-19-superimposed pneumonia . In our case, subpleural consolidation in the inferior lobe of the left lung was reported due to past COVID-19 pneumonia effects in radiological findings. Therefore, this evidence and normal oxygen saturation in our patient lead to the mass of the lung being an insignificant feature for the evolution of the correct identification. The diagnosis of GPA is often overlooked and delayed due to a wide range of clinical presentations. It is extremely rare to develop GPA after a COVID-19 infection. Jalalzadeh et al. reported ANCA-associated glomerulonephritis in a patient with systemic sclerosis after COVID-19 infection . Bressler et al. reported a case of new-onset GPA with many skin manifestations in the setting of active COVID-19 infection . Selvaraj et al. reported a 60-year-old woman who, 1 month after the COVID-19 infection, presented with persistent fatigue, shortness of breath, and anemia with worsening renal functions, found to have elevated C-ANCA and anti-proteinase 3 (PR3) antibodies, and was diagnosed with GPA . But there is no published data about the new onset of Wegener’s granulomatosis with similar manifestations of our case after COVID-19 infection that has led to the development of serious diagnostic challenges for us.
4.269531
0.583984
sec[2]/p[0]
en
0.999997
PMC9807977
https://doi.org/10.1186/s43163-022-00370-3
[ "covid", "infection", "mucormycosis", "autoimmune", "manifestations", "granulomatosis", "lung", "coronaviruses", "that", "lead" ]
[ { "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": "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" } ]
=== 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 [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] === GRAPH WALKS === --- Walk 1 --- [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... --PARENT--> [?] Certain zoonotic viral diseases --- Walk 2 --- [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... --PARENT--> [?] Certain zoonotic viral diseases --- 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--> [RA00] Conditions of uncertain aetiology and emergency use --- 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--> [RA01.1] COVID-19, virus not identified --EXCLUDES--> [?] Special screening examination for other viral diseases --- 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--> [?] 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...
[ "[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...\n --PARENT--> [?] Certain zoonotic viral diseases", "[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...\n --PARENT--> [?] Certain zoonotic viral diseases", "[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--> [RA00] Conditions of uncertain aetiology and emergency use", "[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--> [RA01.1] COVID-19, virus not identified\n --EXCLUDES--> [?] Special screening examination for other viral diseases", "[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..." ]
RA01.0
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": "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" }, { "from_icd11": "1H0Z", "icd10_code": "A319", "icd10_title": "Mycobacterial infection, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "B948", "icd10_title": "Sequelae of other specified infectious and parasitic diseases" }, { "from_icd11": "1H0Z", "icd10_code": "B949", "icd10_title": "Sequelae of unspecified infectious and parasitic disease" }, { "from_icd11": "1H0Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "1H0Z", "icd10_code": "N771", "icd10_title": "Vaginitis, vulvitis and vulvovaginitis in diseases classified elsewhere" } ]
Z1159
Encounter for screening for other viral diseases
Physical exam was notable for multiple thick hyperkeratotic plaques on the right plantar foot . Punch biopsy confirmed CD8+ PR, with histopathology notable for malignant cells in the papillary dermis and lower third of the epidermis ( Table I ). While a diagnosis of MF Palmaris et Plantaris was considered given dermal involvement, PR was favored due the other clinical (hyperkeratotic plaques, local spread) and immunohistochemical (CD8+, elevated Ki-67, CD30) features more classic for PR. Her persistent plaques were treated with radiation monotherapy with CR. However, after <4 months, she re-presented with 2 erythematous arcuate papules on previously uninvolved areas of the right foot instep, outside the radiation field . To rule out inflammation secondary to fungal infection, she began topical antifungal and topical steroid use. On follow-up 6 months later, she had disease progression on the right medial instep , fourth toe , and interdigital space. Repeat biopsy showed atypical epidermotropic lymphocytic infiltrate with prominent pseudoepitheliomatous change, tagging of cells along the dermal-epidermal junction, frequent microabscesses, intermediate cells, and 30% large cells , consistent with MF, PR type with increased large cells. Most lymphocytes were CD4-/CD8+, abnormal lymphocytes were CD3+ and CD5+, with aberrant loss of CD7, and 30% CD30 positivity . Ki67 proliferation index was ∼50% within atypical cells, PD-1 staining was positive in ∼10% of cells, and T-cell receptor-gamma was negative. At a multidisciplinary cutaneous T-cell lymphoma tumor board conference, she was diagnosed with recurrent PR given the CR of lesions treated with radiation and presence of new biopsy-proven lesions in a previously uninvolved area outside the prior radiation field. Given her localized area of involvement, previous allergic contact dermatitis to mechlorethamine, and prior excellent response to radiation, we recommended a second course. She received 2400 cGy in 12 fractions to both the dorsal and medial regions of the right foot, resulting in CR. Three months later, the patient began developing a new red, flaky lesion on the sole of the right foot in an area not previously involved. After 3 months of progressive worsening, she re-presented to the cutaneous oncology team with no evidence of disease in the field of recent radiation treatment and a new, large, erythematous, hyperkeratotic plaque on the right sole, with negative scrape biopsy for fungal infection, consistent with a second relapse . Fig 1 Pagetoid reticulosis of the foot before and after radiation therapy. Right plantar foot at initial presentation to cutaneous oncologist ( A ), new foot lesions on medial instep <4 m after remission from treatment with 2400 cGy radiation ( B ), progression of foot lesion on the medial instep ( C ) and new lesion on the dorsal toe ( D ) after 6 m. Table I Comparison between clinical and immunohistologic characteristics of multirelapsing pagetoid reticulosis Case report Tan et al 2 Haghighi et al 3 Age/Sex 50/F 68/M 50/M Duration (y) ∗ 1 16 3 Location Foot (several lesions) Wrist Foot (several lesions) Treatment XRT, XRT XRT ×6, topical 5-FU XRT, PUVA, XRT Outcome Relapse ×2bg Relapse ×6 Relapse ×2, then lost to F/U Follow-up (y) † 5.5 12 8 Large cells yes yes NA Dermal involvement yes yes NA CD2 +++ NA NA CD3 +++ NA +++ CD4 - 5% (epidermis), 30% (dermis) NA CD5 +++ 50% (epidermis), 80% (dermis) NA CD7 >90% reduction (epidermis), ∼60% reduction (dermis) NA NA CD8 +++ 40% (epidermis), 30% (dermis) - CD4/CD8 ratio <1:10 (epidermis) and <1:3 (dermis) 1:8 (epidermis), 1:1 (dermis) NA CD30+ Biopsy 1: 40% (epidermis), 15% (dermis)Biopsy 2: 30% NA - Beta F1 +++ NA - Ki67 Biopsy 1: +++ (epidermis), 30% (dermis) Biopsy 2: 50% NA NA PD-1 10% NA NA TOX +++ NA NA Granzyme +++ NA NA EBER - NA NA TCR-delta - NA NA TCR-gamma - NA NA - , Negative for expression; +++ , more than 50% expression; 5-FU , fluorouracil; F , female; F/U , follow-up; M , male; NA , information not available; PUVA , 8-methoxypsoralen and Ultraviolet A; TCR , T-cell receptor; XRT , radiation. ∗ Duration of symptoms prior to diagnosis. † Length of follow-up from diagnosis. Fig 2 Histologic examination of recurrent pagetoid reticulosis of the foot. H&E stain showing atypical epidermotropic lymphocytic infiltrate with prominent pseudoepitheliomatous changes at 100× ( A ) and 400× magnification ( B ). Abnormal lymphocytes with positive CD3+ ( C ) staining (40× magnification) ( C ) and 30% CD30 positivity (100× magnification) ( D ). Fig 3 Relapsed pagetoid reticulosis of the foot after radiation therapy. Right plantar foot with new erythematous hyperkeratotic plaque of the sole ( A ), Dermatoscopic images of the new right plantar plaque ( B and C ). Dorsal toe ( D ) and medial foot ( E ) and with complete remission following treatment with 2400 cGy radiation.
4.125
0.968262
sec[1]/p[1]
en
0.999998
PMC11951865
https://doi.org/10.1016/j.jdcr.2025.01.010
[ "foot", "radiation", "dermis", "epidermis", "biopsy", "cells", "lesions", "hyperkeratotic", "plantar", "instep" ]
[ { "code": "ND19.Z", "title": "Traumatic amputation of ankle or foot, unspecified" }, { "code": "QF00", "title": "Acquired absence of limb" }, { "code": "ND14.A", "title": "Strain or sprain of other or unspecified parts of foot" }, { "code": "ND11.Y", "title": "Other specified superficial injury of ankle or foot" }, { "code": "LB9A.6", "title": "Split foot" }, { "code": "NF00", "title": "Effects of radiation, not elsewhere classified" }, { "code": "QC48.Y", "title": "Other specified personal history of medical treatment" }, { "code": "EK90.Y", "title": "Other discrete epidermal dysplasias" }, { "code": "CA82.1", "title": "Chronic or other pulmonary manifestations due to radiation" }, { "code": "DA25.32", "title": "Radiation oesophageal ulcer" } ]
=== ICD-11 CODES FOUND === [ND19.Z] Traumatic amputation of ankle or foot, unspecified Also known as: Traumatic amputation of ankle or foot, unspecified | Traumatic amputation of ankle or foot | traumatic amputation of foot | avulsion of foot | severed foot [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 [ND14.A] Strain or sprain of other or unspecified parts of foot Also known as: Strain or sprain of other or unspecified parts of foot | Sprain of foot | Strain of foot | Midtarsal sprain | Midtarsal strain [ND11.Y] Other specified superficial injury of ankle or foot Also known as: Other specified superficial injury of ankle or foot | Contusion of toe with damage to nail | Haematoma of foot | feet haematoma | Nonthermal blister of toe [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 [NF00] Effects of radiation, not elsewhere classified Also known as: Effects of radiation, not elsewhere classified | radiation complications | infrared rays injury | Radiation sickness Excludes: Sunburn | Burns | specified adverse effects of radiation, such as leukaemia [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 [EK90.Y] Other discrete epidermal dysplasias Also known as: Other discrete epidermal dysplasias | Actinic cheilitis | Photochemotherapy-induced keratosis | Thermal keratosis | Chronic radiation keratosis [CA82.1] Chronic or other pulmonary manifestations due to radiation Definition: A chronic inflammatory reaction of the lung ultimately resulting in fibrosis in response to repeated or high dose radiation exposure. Also known as: Chronic or other pulmonary manifestations due to radiation | Fibrosis of lung following radiation | radiation fibrosis of lung | Chronic radiation pulmonary fibrosis [DA25.32] Radiation oesophageal ulcer Also known as: Radiation oesophageal ulcer === GRAPH WALKS === --- Walk 1 --- [ND19.Z] Traumatic amputation of ankle or foot, unspecified --PARENT--> [ND19] Traumatic amputation of ankle or foot --CHILD--> [ND19.0] Traumatic amputation of right foot at ankle level --- Walk 2 --- [ND19.Z] Traumatic amputation of ankle or foot, unspecified --PARENT--> [ND19] Traumatic amputation of ankle or foot --CHILD--> [ND19.2] Traumatic amputation of foot at ankle level, bilateral --- Walk 3 --- [QF00] Acquired absence of limb --EXCLUDES--> [?] Congenital absence of both lower leg and foot Def: Any condition caused by the failure of the lower leg and foot to develop during the antenatal period.... --PARENT--> [?] 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.... --- Walk 4 --- [QF00] Acquired absence of limb --EXCLUDES--> [?] 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 5 --- [ND14.A] Strain or sprain of other or unspecified parts of foot --PARENT--> [ND14] Dislocation or strain or sprain of joints or ligaments at ankle or foot level --CHILD--> [ND14.2] Dislocation of other toe --- Walk 6 --- [ND14.A] Strain or sprain of other or unspecified parts of foot --PARENT--> [ND14] Dislocation or strain or sprain of joints or ligaments at ankle or foot level --CHILD--> [ND14.0] Dislocation of ankle joint Def: Displacement of one or more bones of the ankle, including the tarsals...
[ "[ND19.Z] Traumatic amputation of ankle or foot, unspecified\n --PARENT--> [ND19] Traumatic amputation of ankle or foot\n --CHILD--> [ND19.0] Traumatic amputation of right foot at ankle level", "[ND19.Z] Traumatic amputation of ankle or foot, unspecified\n --PARENT--> [ND19] Traumatic amputation of ankle or foot\n --CHILD--> [ND19.2] Traumatic amputation of foot at ankle level, bilateral", "[QF00] Acquired absence of limb\n --EXCLUDES--> [?] Congenital absence of both lower leg and foot\n Def: Any condition caused by the failure of the lower leg and foot to develop during the antenatal period....\n --PARENT--> [?] 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....", "[QF00] Acquired absence of limb\n --EXCLUDES--> [?] 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....", "[ND14.A] Strain or sprain of other or unspecified parts of foot\n --PARENT--> [ND14] Dislocation or strain or sprain of joints or ligaments at ankle or foot level\n --CHILD--> [ND14.2] Dislocation of other toe", "[ND14.A] Strain or sprain of other or unspecified parts of foot\n --PARENT--> [ND14] Dislocation or strain or sprain of joints or ligaments at ankle or foot level\n --CHILD--> [ND14.0] Dislocation of ankle joint\n Def: Displacement of one or more bones of the ankle, including the tarsals..." ]
ND19.Z
Traumatic amputation of ankle or foot, unspecified
[ { "from_icd11": "ND19.Z", "icd10_code": "S98919A", "icd10_title": "Complete traumatic amputation of unspecified foot, level unspecified, initial encounter" }, { "from_icd11": "ND19.Z", "icd10_code": "S98929A", "icd10_title": "Partial traumatic amputation of unspecified foot, level unspecified, initial encounter" }, { "from_icd11": "ND19.Z", "icd10_code": "S98", "icd10_title": "Traumatic amputation of ankle and foot" }, { "from_icd11": "ND19.Z", "icd10_code": "S984", "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" }, { "from_icd11": "QF00", "icd10_code": "Z89612", "icd10_title": "Acquired absence of left leg above knee" } ]
S98919A
Complete traumatic amputation of unspecified foot, level unspecified, initial encounter
The first case refers to a morbidly obese, female patient—a feeding victim with a body mass index (BMI) of 52 kg/m 2 (height: 170 cm and weight: 180 kg)—who has been suffering from arterial hypertension, hyperthyreosis and depression. Prior to the femoral part replacement (distal two thirds of the femur) in our clinic in May 2016, the 54-year-old patient had undergone a primary total knee arthroplasty (TKA) of the left knee in April 2014. A plate osteosynthesis after distal periprosthetic femur fracture in July 2015, and a re-osteosynthesis due to a renewed diaphyseal fracture in the middle of the femur with fracture of the plate in September 2015 were performed, each procedure in a different hospital. Due to poor bone quality and corresponding loss of bone tissue through multiple fractures and revision surgeries, only a femoral part replacement was ultimately considered as an attempt to preserve the limb, when the patient was hospitalized in May 2016 after another periprosthetic fracture. A routine biopsy was taken pre-operatively for microbiological testing with a negative result. However, soon after the replacement surgery, the patient returned to our clinic in June 2016 with a fulminant periprosthetic joint infection caused by methicillin-resistant Staphylococcus aureus (MRSA). Hip-disarticulation became necessary to control the infection. Hypoalbuminaemia despite of the adipositas, postoperative bleeding anemia and repetitive lows of electrolytes in the blood samples characterized the patient’s course. The postoperative course of the patient remained difficult due to persisting and hard to control soft tissue infection and osteomyelitis, and several revision operations were required. In each surgery, microbiological samples were taken and tested for bacteria and fungi using standardized protocols. Due to the changing microbiological findings, nine different long-term antibiotics had to be used for resistogram-compliant treatment, but the infection was still progressing. In the course of time, infection with Candida albicans became evident. The long-term application of caspofungin (initial dose 70 mg, treatment dose 50 mg per day), resistogram-compliant antibiotics and the fitting of a long-term permanent drain at the amputation stump finally led to a safe wound healing (Table 2 ). The patient was discharged free of pain and self-mobile in a wheelchair after 148 days of hospital stay. Medication with one oral antimycotic (fluconazole) and two antibiotics (linezolid and ciprofloxacin) continued for another four weeks after discharge. In prolonged seroma accumulation with increased secretory output, a permanent drain was necessary to prevent complications and subsequent operations. The drain was regularly exchanged during out-patient check-ups and was eventually removed when secretion dried up in May 2017, one year after admission to the hospital. Quality of life increased once an exo-prosthesis was fitted. In a follow-up visit in February 2019, the stump presented itself as healed and without any signs of infection. The patient has been painless since discharge and is satisfied with the result. While nine different antibiotics were administered for a total of 176 days the patient’s condition only improved after an antimycotic was included in the treatment regime (caspofungin for 29 days, fluconazole for 28 days). Table 2 List of administered antibiotics and antimycotics in time course and applied days during the reported hospital stay Administered antibiotics and antimycotics in time course Applied days Case 1 Applied days Case 2 Applied days Case 3 26 26 Clindamycin 600 mg (3 × 1) i.v Levofloxacin 500 mg (2 × 1) i.v 4 Levofloxacin 500 mg (2 × 1) i.v 4 41 16 24 28 Clindamycin 600 mg (3 × 1) i.v Cotrimoxazol 960 mg (2 × 1) i.v Linezolid 600 mg (2 × 1) i.v Unacid 3 g (3 × 1) i.v Caspofungin 70 mg (loading dose)/50 mg (1 × 1) i.v 30 Vancomycin (2 × 1), level-controlled i.v 29 6 Linezolid 600 mg (2 × 1) i.v Fosfomycin 5 g (3 × 1) i.v 30 30 28 Ciprofloxacin 400 mg (3 × 1) p.o Amoxicillin 1 g (3 × 1) p.o Fluconazole 200 mg (2 × 1) p.o 30 Rifampicin 600 mg (2 × 1) i.v 19 5 14 95 Linezolid 600 mg (2 × 1) i.v Rifampicin 600 mg (2 × 1) i.v Levofloxacin 500 mg (2 × 1) i.v Caspofungin 70 mg (loading dose)/50 mg (1 × 1) i.v 17 10 Meropenem 1 g (3 × 1) i.v Unacid 3 g (3 × 1) i.v 65 Tigecyclin 100 mg (1 × 1 loading dose), DDD 50 mg (2 × 1) i.v 25 Vancomycin (2 × 1), level-controlled i.v 22 Fosfomycin 5 g (3 × 1) i.v 25 Fosfomycin 5 g (3 × 1) i.v 29 Caspofungin 70 mg (loading dose) /50 mg (1 × 1) i.v 28 28 28 Ciprofloxacin 400 mg (3 × 1) p.o Linezolid 600 mg (2 × 1) p.o Fluconazole 200 mg (2 × 1) p.o Indication of the antibiotics used, duration of application in days and type of application intravenously (i.v.) or oral (p.o.). Medication p.o. is to be regarded as discharge medication. DDD defined daily dose
3.939453
0.979004
sec[1]/sec[0]/p[0]
en
0.999995
34972536
https://doi.org/10.1186/s12941-021-00490-3
[ "antibiotics", "infection", "course", "caspofungin", "linezolid", "fracture", "fluconazole", "loading", "replacement", "femur" ]
[ { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "MG50.9Z", "title": "Salmonella resistant to unspecified antibiotic" }, { "code": "MG50.AZ", "title": "Shigella resistant to unspecified antibiotic" }, { "code": "MG50.BZ", "title": "Vibrio resistant to unspecified antibiotic" }, { "code": "QC05.Y", "title": "Other specified prophylactic measures" }, { "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" } ]
=== ICD-11 CODES FOUND === [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 [MG50.9Z] Salmonella resistant to unspecified antibiotic Also known as: Salmonella resistant to unspecified antibiotic | Antibiotic resistant Salmonella [MG50.AZ] Shigella resistant to unspecified antibiotic Also known as: Shigella resistant to unspecified antibiotic | Antibiotic resistant Shigella [MG50.BZ] Vibrio resistant to unspecified antibiotic Also known as: Vibrio resistant to unspecified antibiotic | Antibiotic resistant Vibrio [QC05.Y] Other specified prophylactic measures Also known as: Other specified prophylactic measures | Other prophylactic chemotherapy | chemoprophylaxis | prophylactic chemotherapy | Systemic prophylactic chemotherapy [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] === GRAPH WALKS === --- Walk 1 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Disorders due to substance use or addictive behaviours Def: Disorders due to substance use and addictive behaviours are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or spe... --PARENT--> [?] Mental, behavioural or neurodevelopmental disorders Def: Mental, behavioural and neurodevelopmental disorders are syndromes characterised by clinically significant disturbance in an individual's cognition, emotional regulation, or behaviour that reflects a ... --- Walk 2 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Alcohol intoxication Def: Alcohol intoxication is a clinically significant transient condition that develops during or shortly after the consumption of alcohol that is characterised by disturbances in consciousness, cognition,... --PARENT--> [?] Disorders due to use of alcohol Def: Disorders due to use of alcohol are characterised by the pattern and consequences of alcohol use. Alcohol—more specifically termed ethyl alcohol or ethanol—is an intoxicating compound produced by ferm... --- Walk 3 --- [MG50.9Z] Salmonella resistant to unspecified antibiotic --PARENT--> [MG50.9] Antibiotic resistant Salmonella --PARENT--> [MG50] Finding of gram negative bacteria resistant to antimicrobial drugs --- Walk 4 --- [MG50.9Z] Salmonella resistant to unspecified antibiotic --PARENT--> [MG50.9] Antibiotic resistant Salmonella --CHILD--> [MG50.91] Third generation cephalosporin resistant Salmonella --- Walk 5 --- [MG50.AZ] Shigella resistant to unspecified antibiotic --PARENT--> [MG50.A] Antibiotic resistant Shigella --CHILD--> [MG50.A2] Third-generation cephalosporins resistant Shigella --- Walk 6 --- [MG50.AZ] Shigella resistant to unspecified antibiotic --PARENT--> [MG50.A] Antibiotic resistant Shigella --CHILD--> [MG50.A1] Fluoroquinolone resistant Shigella
[ "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Disorders due to substance use or addictive behaviours\n Def: Disorders due to substance use and addictive behaviours are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or spe...\n --PARENT--> [?] Mental, behavioural or neurodevelopmental disorders\n Def: Mental, behavioural and neurodevelopmental disorders are syndromes characterised by clinically significant disturbance in an individual's cognition, emotional regulation, or behaviour that reflects a ...", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Alcohol intoxication\n Def: Alcohol intoxication is a clinically significant transient condition that develops during or shortly after the consumption of alcohol that is characterised by disturbances in consciousness, cognition,...\n --PARENT--> [?] Disorders due to use of alcohol\n Def: Disorders due to use of alcohol are characterised by the pattern and consequences of alcohol use. Alcohol—more specifically termed ethyl alcohol or ethanol—is an intoxicating compound produced by ferm...", "[MG50.9Z] Salmonella resistant to unspecified antibiotic\n --PARENT--> [MG50.9] Antibiotic resistant Salmonella\n --PARENT--> [MG50] Finding of gram negative bacteria resistant to antimicrobial drugs", "[MG50.9Z] Salmonella resistant to unspecified antibiotic\n --PARENT--> [MG50.9] Antibiotic resistant Salmonella\n --CHILD--> [MG50.91] Third generation cephalosporin resistant Salmonella", "[MG50.AZ] Shigella resistant to unspecified antibiotic\n --PARENT--> [MG50.A] Antibiotic resistant Shigella\n --CHILD--> [MG50.A2] Third-generation cephalosporins resistant Shigella", "[MG50.AZ] Shigella resistant to unspecified antibiotic\n --PARENT--> [MG50.A] Antibiotic resistant Shigella\n --CHILD--> [MG50.A1] Fluoroquinolone resistant Shigella" ]
NE60
Harmful effects of drugs, medicaments or biological substances, not elsewhere classified
[ { "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" }, { "from_icd11": "NE60", "icd10_code": "T50A15A", "icd10_title": "Adverse effect of pertussis vaccine, including combinations with a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50B15A", "icd10_title": "Adverse effect of smallpox vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T416X3A", "icd10_title": "" }, { "from_icd11": "NE60", "icd10_code": "T419X3A", "icd10_title": "" }, { "from_icd11": "NE60", "icd10_code": "T418X2A", "icd10_title": "" } ]
T50A95A
Adverse effect of other bacterial vaccines, initial encounter
A 14-year-old female patient reported blurry vision in the left eye for the past 8 months and had been diagnosed with uveitis at another clinic. Despite the administration of local and systemic corticosteroid, inflammation persisted; therefore, the patient was referred to our clinic. The patient presented with fine keratic precipitates and anterior chamber cell grade of 2+ in the left eye. The vitreous cell grade was 1+ in the right eye and 2+ in the left eye. FA showed diffuse fern-like capillary leakage and optic disc hyperfluorescence of the left eye. The BCVA was 1.2 in both eyes, and the IOPs of the right and left eyes were 16 and 22 mmHg, respectively. Non-ocular manifestations were oral ulcers and shoulder arthralgia. Skin or genital lesions were not observed. The differential diagnosis was as follows: Behçet’s disease, A20 haploinsufficiency, and idiopathic retinal vasculitis. Interferon-gamma release assay and tuberculin tests for tuberculosis infection, raid plasma regain assay, and Treponema pallidum antibody hemagglutination test for syphilis were negative; angiotensin-converting enzyme, antinuclear antibody, matrix metalloproteinase-3, and anti-citrullinated protein antibody levels were within the normal range. There was no family history of autoimmune diseases and colonoscopy revealed no abnormality. Behçet’s disease was suspected and the patient was referred to a paediatrician for further investigation. She tested negative for HLA-B51. Additionally, the following treatment (initiated in the previous clinic) was continued: 0.1% dexamethasone eye drops (four times/day), tropicamide/phenylephrine eye drops (once/day), and prednisolone (5 mg/day orally). In accordance with the Japanese diagnostic criteria for Behçet’s disease , the patient was diagnosed with the incomplete type of Behçet’s disease on the basis of the presence of a typical ocular symptom and recurrent oral ulcers . Retinal vasculitis recurred in both eyes; therefore, initiation of adalimumab was proposed to the patient; however, it was initially declined due to financial restrictions. Thus, prednisolone was increased to 20 mg/day, and methotrexate was initiated at 6 mg/day. A maximum of 12 mg methotrexate was administered; however, the patient experienced nausea and the inflammation relapsed. Subcutaneous adalimumab injection was then introduced, and prednisolone was slowly tapered. The patient was 15-year-old and weighed 53 kg when adalimumab was initiated, thus we administered 80 mg as a loading dose, followed by 40 mg every 2 weeks, starting 1 week after the loading dose, in accordance with the recommended dose for treatment of adult uveitis. The duration of uveoretinitis prior to starting adalimumab was 13 months. The anterior chamber cell grade improved from 3+ in both eyes to 0 and 0.5+ in the right and left eyes, respectively, within 7 weeks after beginning adalimumab administration. The peak values of laser flare photometry were 131.8 ph/ms in the right eye and 71.4 ph/ms in the left eye; these improved to 4–5 ph/ms and 10–12 ph/ms, respectively. BCVA remained ≥ 1.5 in both eyes. Oral ulcers and arthralgia were improved after adalimumab therapy. The inflammation subsided, and local and systemic corticosteroid therapies were discontinued. The follow-up period of adalimumab was 12 months at the time this report was written, and the patient had not experienced any side effects. Fig. 5 Fluorescein angiography (FA) of Case 2 before and after adalimumab treatment. a , b FA of the right and left eye at presentation, respectively, revealed fern-like diffuse vascular leakage and optic disc hyperfluorescence in the left eye. FA of the right eye at presentation did not show any vasculitis. c , d FA of the right and left eyes at 2 months after adalimumab treatment, respectively. There were no signs of vasculitis in either eye Fig. 6 Changes in anterior chamber cell grade ( a ) and prednisolone dose ( b ) in Case 2. Retinal vasculitis recurred in both eyes, and prednisolone was increased to 20 mg/day, while methotrexate was initiated at 6 mg. A maximum of 12 mg methotrexate was administered; however, the patient experienced nausea and the inflammation relapsed. After the patient was diagnosed with an incomplete type of Behçet’s disease by the paediatrician, adalimumab was introduced, and prednisolone was slowly tapered. The anterior chamber cell grade dramatically improved from 3+ in both eyes to 0 and 0.5+ in the right and left eyes, respectively, within 7 weeks after beginning administration of adalimumab. The inflammation subsided, and local and systemic corticosteroid therapies were discontinued Fig. 7 Change in laser flare photometry values in Case 2. Laser flare photometry values were recorded from day 1. Increased laser flare was observed during relapses. After adalimumab was introduced, laser flare values improved
3.939453
0.980957
sec[1]/sec[1]/p[0]
en
0.999998
31182107
https://doi.org/10.1186/s12969-019-0333-6
[ "adalimumab", "eyes", "both", "respectively", "prednisolone", "inflammation", "cell", "grade", "vasculitis", "improved" ]
[ { "code": "9E1Z", "title": "Diseases of the visual system, unspecified" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "LA10.Y", "title": "Other specified structural developmental anomalies of ocular globes" }, { "code": "LA10.0", "title": "Microphthalmos" }, { "code": "NA06.8D", "title": "Ocular laceration without prolapse or loss of intraocular tissue, unilateral" }, { "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" } ]
=== ICD-11 CODES FOUND === [9E1Z] Diseases of the visual system, unspecified Also known as: Diseases of the visual system, unspecified | eye diseases NOS | disorder of vision | visual disorder [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 [LA10.Y] Other specified structural developmental anomalies of ocular globes Also known as: Other specified structural developmental anomalies of ocular globes | Cyclopia | synophthalmia | Congenital cystic eye | Congenital malformations of the eye [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 [NA06.8D] Ocular laceration without prolapse or loss of intraocular tissue, unilateral Also known as: Ocular laceration without prolapse or loss of intraocular tissue, unilateral | Laceration of eye NOS | penetrating eyeball injury without prolapse or loss of intraocular tissue | Traumatic rupture of eye, unilateral | rupture of eye, unilateral [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 === GRAPH WALKS === --- Walk 1 --- [9E1Z] Diseases of the visual system, unspecified --PARENT--> [09] Diseases of the visual system Def: This refers to any diseases of the visual system, which includes the eyes and adnexa, the visual pathways and brain areas, which initiate and control visual perception and visually guided behaviour.... --RELATED_TO--> [?] Foreign body in multiple parts of external eye --- Walk 2 --- [9E1Z] Diseases of the visual system, unspecified --PARENT--> [09] Diseases of the visual system Def: This refers to any diseases of the visual system, which includes the eyes and adnexa, the visual pathways and brain areas, which initiate and control visual perception and visually guided behaviour.... --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics --- Walk 3 --- [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 4 --- [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 5 --- [LA10.Y] Other specified structural developmental anomalies of ocular globes --PARENT--> [LA10] Structural developmental anomalies of ocular globes Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period.... --EXCLUDES--> [?] Holoprosencephaly with cyclopia or synophthalmia --- Walk 6 --- [LA10.Y] Other specified structural developmental anomalies of ocular globes --PARENT--> [LA10] Structural developmental anomalies of ocular globes Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period.... --CHILD--> [LA10.1] Clinical anophthalmos Def: This refers to the clinical absence of one or both eyes. Both the globe (human eye) and the ocular tissue are missing from the orbit. The absence of the eye will cause a small bony orbit, a constricte...
[ "[9E1Z] Diseases of the visual system, unspecified\n --PARENT--> [09] Diseases of the visual system\n Def: This refers to any diseases of the visual system, which includes the eyes and adnexa, the visual pathways and brain areas, which initiate and control visual perception and visually guided behaviour....\n --RELATED_TO--> [?] Foreign body in multiple parts of external eye", "[9E1Z] Diseases of the visual system, unspecified\n --PARENT--> [09] Diseases of the visual system\n Def: This refers to any diseases of the visual system, which includes the eyes and adnexa, the visual pathways and brain areas, which initiate and control visual perception and visually guided behaviour....\n --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics", "[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 --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...", "[LA10.Y] Other specified structural developmental anomalies of ocular globes\n --PARENT--> [LA10] Structural developmental anomalies of ocular globes\n Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period....\n --EXCLUDES--> [?] Holoprosencephaly with cyclopia or synophthalmia", "[LA10.Y] Other specified structural developmental anomalies of ocular globes\n --PARENT--> [LA10] Structural developmental anomalies of ocular globes\n Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period....\n --CHILD--> [LA10.1] Clinical anophthalmos\n Def: This refers to the clinical absence of one or both eyes. Both the globe (human eye) and the ocular tissue are missing from the orbit. The absence of the eye will cause a small bony orbit, a constricte..." ]
9E1Z
Diseases of the visual system, unspecified
[ { "from_icd11": "9E1Z", "icd10_code": "H5500", "icd10_title": "Unspecified nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5509", "icd10_title": "Other forms of nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5581", "icd10_title": "Saccadic eye movements" }, { "from_icd11": "9E1Z", "icd10_code": "H5501", "icd10_title": "Congenital nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5502", "icd10_title": "Latent nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5589", "icd10_title": "Other irregular eye movements" }, { "from_icd11": "9E1Z", "icd10_code": "H5503", "icd10_title": "Visual deprivation nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5504", "icd10_title": "Dissociated nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H44522", "icd10_title": "Atrophy of globe, left eye" }, { "from_icd11": "9E1Z", "icd10_code": "H3552", "icd10_title": "Pigmentary retinal dystrophy" }, { "from_icd11": "9E1Z", "icd10_code": "E70331", "icd10_title": "Hermansky-Pudlak syndrome" }, { "from_icd11": "9E1Z", "icd10_code": "H57812", "icd10_title": "Brow ptosis, left" }, { "from_icd11": "9E1Z", "icd10_code": "H5789", "icd10_title": "Other specified disorders of eye and adnexa" }, { "from_icd11": "9E1Z", "icd10_code": "H3550", "icd10_title": "Unspecified hereditary retinal dystrophy" }, { "from_icd11": "9E1Z", "icd10_code": "E7030", "icd10_title": "Albinism, unspecified" } ]
H5500
Unspecified nystagmus
The patient is a 11‐year‐old boy from Jharkhand, India, who presented with pain abdomen and intermittent constipation two years back. Colonoscopy revealed polypoid stricturing lesion suggestive of sigmoid colon tumor which was further confirmed by radiological findings on CT (Computed Tomography) scan abdomen. Among nonmalignant features, dermatological feature in the form of hypopigmented macule on left shoulder was present. On reviewing the family history, there was a history of neural tube defect and early death in sibling, and a history of sudden death in paternal cousin at 14 years of age. Few incidences of consanguineous marriage were reported in their extended family. The patient underwent exploratory laparotomy and resection of polypoid segment of sigmoid colon. Histopathological examination (HPE) revealed moderately differentiated adenocarcinoma of the sigmoid colon (pT3N0). The MMR IHC done on colonic tumor block showed intact nuclear staining with MSH2, MSH6, and MLH1 while immunostain for PMS2 was attempted thrice but cannot be reported as the results were noncontributory. In view of the absence of PMS2 in both the tumor tissue and the native normal tissue, a possibility of constitutional MMR deficiency (CMMRD) was considered. The patient was planned for chemotherapy with Capecitabine. After 2 months of chemotherapy, he again presented with episodes of headache, vomiting with left‐sided facial weakness of supranuclear type and difficulty walking. CECT (Contrast‐Enhanced Computed Tomography) scan of the brain revealed right frontoparietal space‐occupying lesion (SOL) with perilesional edema and midline shift suggestive of brain tumor (glioma) for which he underwent craniotomy and surgical removal of the tumor. CNS panel on biopsy diagnosed glioblastoma multiforme (GBM) WHO grade IV. Microscopic examination revealed a proliferating glial tumor with marked nuclear pleomorphism, mitosis, necrosis, and microvascular proliferation. IHC showed tumor cells to be positive for GFAP (focal, strong), IDH1(R‐132H) was negative signifying a poorer outcome, ATRX was retained, high Ki67 index of around 70% signifying higher tumor recurrence and progression. IHC done for mismatch repair (MMR) proteins on the block of GBM showed intact nuclear staining for MLH1 and loss of nuclear expression for PMS2 in both the tumor cells and the normal brain tissue. Because of the absence of PMS2 in the tumor tissue, native normal tissue of both GBM block and prior colonic block, the diagnosis of constitutional MMR deficiency (cMMRD) was established. Mutation analysis subsequently confirmed the diagnosis. The patient had a disease‐free survival for next 3 months after which he again showed signs of progressive disease He was then further managed by salvage immunotherapy with Nivolumab, a monoclonal antibody. After 2 courses of Nivolumab given 1 month apart, the patient had episodes of vomiting, but not associated with headache or other clinical signs of raised intracranial pressure. As a part of management, Ommaya shunt was done with drainage of approximately 7.5 mL clear CSF (cerebrospinal fluid). CSF routine examination showed cell counts within normal limits and absence of any malignant cell while on biochemical evaluation CSF glucose was within normal limit but protein concentration was highly elevated to 563 mg/dL, the reference range being 12‐60 mg/dL. No metabolic abnormalities or acute infections or disease progression was evident from pathological, or microbiological work up. Contrast‐enhanced MRI (Magnetic resonance imaging) brain revealed right frontal lobe enhancing lesion and significant cerebral edema. CSF electrophoresis was done to rule out any inflammatory or noninflammatory neurological disease. In CSF electrophoresis (CSF‐PEP), an unusual faint M band near the beta region was seen, while in SPEP and CSF‐IFE, no heavy or light chain restriction pattern was noted corresponding to the M band as shown in Figure S1, S2, and S3, respectively. The patient was therefore diagnosed with immune encephalopathy post‐Nivolumab therapy. He was further treated with intravenous dexamethasone. The patient became stable and was discharged after 2 days on a dexamethasone taper. Considering the benefits of significant tumor reduction in contrast to the rare side effect malignant cerebral edema as reported by 5 , the patient was further managed by 6 courses of salvage Nivolumab therapy for next 6 months. Significant reduction of tumor lesions was evident from subsequent brain MRI without any repeat episode of nivolumab induced cerebral edema. However, despite 6 months of salvage immunotherapy, the patient suffered from progressive disease owing to the severity of glioblastoma and CMMRD disease spectrum. The patient was managed henceforth by only palliative therapy. Age at last follow‐up of the patient was 11 years.
4.15625
0.97168
sec[1]/p[0]
en
0.999998
33363830
https://doi.org/10.1002/ccr3.3249
[ "tumor", "tissue", "brain", "nivolumab", "block", "nuclear", "edema", "lesion", "sigmoid", "colon" ]
[ { "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": "FB6Z", "title": "Soft tissue disorders, unspecified" }, { "code": "MC85", "title": "Gangrene" }, { "code": "FB56.6", "title": "Other specified soft tissue disorders" }, { "code": "GB61.Z", "title": "Chronic kidney disease, stage unspecified" }, { "code": "4A43.3", "title": "Mixed connective tissue disease" } ]
=== 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 [FB6Z] Soft tissue disorders, unspecified Also known as: Soft tissue disorders, unspecified | disease of soft tissue NOS | unspecified soft tissue disorder, site unspecified | disorder of soft tissue | disorder of soft tissue NOS [MC85] Gangrene Definition: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply. Also known as: Gangrene | gangrene NOS | dry gangrene | wet gangrene | ulcerative gangrene Excludes: Pyoderma gangrenosum | Gas gangrene | Polymicrobial necrotising fasciitis [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 [GB61.Z] Chronic kidney disease, stage unspecified Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease [4A43.3] Mixed connective tissue disease Definition: Mixed connective tissue disease is an overlapping syndrome combining features of systemic lupus erythematosus, systemic sclerosis, and polymyositis with the presence of autoantibodies to U1-ribonucleoprotein. Raynaud’s phenomenon is seen in nearly all patients and pulmonary arterial hypertension is the most common cause of death in MCTD patients. Also known as: Mixed connective tissue disease | Sharp syndrome | MCTD - [mixed connective tissue disease] | Paediatric-onset mixed connective tissue disease | Paediatric-onset Sharp syndrome === 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 --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- 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--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --CHILD--> [?] Generalised lymph node enlargement --- 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--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- 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--> [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 --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[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--> [?] Generalised lymph node enlargement", "[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--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital 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", "[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
Polysomnography (PSG) with capnography revealed a normal sleep latency with a recognizable cyclic sleep structure. Patient had a continuous tachypnea of 35- 40 times per minute, with frequently a typical breathing pattern in REM sleep, starting with a deep sigh following a long exhale in combination with a moaning sound, indicative of catathrenia. She had obstructive sleep apnea, with an apnea–hypopnea index of 19.4 (normal in children < 1/h), and an oxygenation-desaturation index (≥ 3%) of 33.8 (> 10 indicative for moderate to severe obstructive sleep apnea). Lowest oxygen level was 63%. Her carbon dioxide was normal during the day, but increased upon awakening (49.4 mmHg) (Table 1 ). The melatonin test showed no increase in melatonin concentration (Table 2 ). Patient was diagnosed with obstructive sleep apnea, sleep related hypoventilation and catathrenia according to the ICSD-3 criteria. Patient was referred for nocturnal home bi-level ventilation, with a inspiratory pressure support of 18 and external pressure support of 6, after which she experienced less symptoms of insomnia, less headaches and less daytime sleepiness. Table 1 Sleep evaluation data of all four cases Subjective sleep data* Case 1 Case 2 Case 3 Case 4 TIB 10 h 17 min 9 h 47 min 11 h 49 min 8 h 39 min Bed time 8.32 p.m 9.08 p.m 9.26 p.m 9.47 p.m Rise time 6.49 a.m 6.55 a.m 9.15 a.m 6.26 a.m TST 5 h 54 min 6 h 58 min 8 h 17 min 7 h 37 min SOL 1 h 49 min 1 h 12 min 1 h 14 min 48 min WASO 2 h 17 min 20 min 41 min 1 h 53 min WASF 24 min 1 h 28 min 1 h 2 min 14 min Questionnaire ESS 12 – 11 23 MSLT – – – 2.7 min, 1 SOREMP Polysomnography** – TIB 487.0 min 573.0 min 737.0 min TST 463.5 min 500 min 547.5 min SOL 1.0 min 4.5 min 0 min, time until first REM 369 min WASO 22.5 min 68.5 min 18.5 min SE 95.2% 87.3% 74.3% Sleep stages REM 3.8% 17.0% 29.8% NREM 3 48.8% 17.4% 11.7% AHI 19.4, obstr 1.1, obs & centr 2.6, obstr & centr AI 0.0 0.1 0.3 PLMI 0.0 9.0 5.8 ODI (3%) 33.8 2.2 1.3 ODI (4%) 11.1 1.2 0.5 Mean CO2^ level: 43.0 46.0 – Highest CO2 REM: 46.2 47.5 Highest CO2 NREM: 47.2 47.5 Blood gas^^ analysis after sleep: 7 a.m.: pH 7.35, pCO2 49.3, HCO3 26.5, BE 0.9 11 a.m.: pH 7.42, PCO2 36.8, HCO3 23.2, BE − 0.5 Mean O2 level: 95% 94% 98% Lowest O2 level: 63% 86% 91% Time below 90%: 5.7 min 9.5 min 0 min TIB time in bed, TST total sleep time, SOL sleep onset latency, WASO Wake after sleep onset, WASF wake after sleep offset, ESS Epworth sleepiness scale, MSLT Multiple sleep latency test, SOREMP sleep onset REMsleep period, SE sleep efficiency, REM rapid eye movement sleep, NREM non rapid eye movement sleep, AHI apnea hypopnea index, obstr obstructive apnea, centr central apnea, AI apnea index, PLMI periodic limb movements of sleep, ODI oxygen desaturation index, CO2 carbon dioxide, HCO3 Bicarbonate, BE Base excess – = data is not available or test is not performed * Subjective sleep data consisted of data of 1 week graphical sleep wake diary, data of case 4 consisted of actigraphy data due to incorrect sleep–wake diary ** The polysomnography consisted of an all night supervised video polysomnography performed according to the AASM (American academy of sleep medicine) criteria version 2.6, including: (1) 8 EEG- channels (F4-M1, C4-M1, O2-M1, with back-up F3-M2, C3-M2 and O1-M2); (2) 2 electroculographic channels; and (3) 4 surface electromyographic channels: 2 from the mentalis, one from the right anterior tibialis and one from the left anterior tibialis in lower limbs; and (4) 7 channels to monitor respiratory function: 1 for oximetry, 1 for transcutaneous carbondioxide 2 for oro-nasal airflow using a thermistor and nasal-cannula, 2 to record thoraco-abdominal movements by inductance plethysmography, and a microphone at the suprasternal notch to detect snoring. Transcutaneous carbon dioxide measurement was calibrated with capillary blood gas samples preceding the PSG night and at awakening. Sleep stages were visually scored for 30-s epochs according to the guidelines of the American Academy of Sleep Medicine (AASM) version 2.6. Scoring was performed by an experienced sleep technologist and later reviewed by an accredited sleep specialist ^CO2 presented as mmHg ^^Blood gas presented as pH, CO2 = mm Hg, O2 = mm Hg, HCO3 = mmol/L, BE = mmol/L Table 2 Measured melatonin values of four cases Time Case 1 Case 2 Case 3 Case 4 12.00 pm 0.9 6.00 pm < 0.5 < 0.5 0.8 7.00 pm 1.7 0.9 8.00 pm 1.6 6.3 ( DLMO 7.30 ) 0.5 < 0.5 9.00 pm < 0.5 < 0.5^ 0.5 < 0.5 10.00 pm 1.0 1.1 ( DLMO 10.13 ) 11.00 pm 4.6 ( DLMO 10.50 ) 14.2 12.00 pm 6.5 28.01 1.30 am * 4.8 6.00 am 8.0 1.2 7.00 am * > 50.0^ 8.00 am 2.2 9.00 am < 0.5 Values are represented as pg/ml measured in saliva * Not enough material for detection ^Suspected measurement error due to food intake (breakfast) DLMO Dim Light Melatonin Onset (the estimated time at which salivary melatonin reaches 4 pg/ml)
4.222656
0.849121
sec[0]/sec[0]/p[2]
en
0.999998
32691357
https://doi.org/10.1007/s11102-020-01065-9
[ "sleep", "apnea", "time", "data", "index", "melatonin", "polysomnography", "obstructive", "onset", "wake" ]
[ { "code": "7B2Z", "title": "Sleep-wake disorders, unspecified" }, { "code": "MG41", "title": "Sleep disturbance, not elsewhere classified" }, { "code": "7A20.Z", "title": "Narcolepsy, unspecified" }, { "code": "7B00.1", "title": "Sleepwalking disorder" }, { "code": "7A26", "title": "Insufficient sleep syndrome" }, { "code": "MD11.0", "title": "Apnoea" }, { "code": "7A4Y", "title": "Other specified sleep-related breathing disorders" }, { "code": "KB2A.1", "title": "Obstructive neonatal apnoea" }, { "code": "KB2A.0", "title": "Central neonatal apnoea" }, { "code": "KB2A.2", "title": "Mixed neonatal apnoea" } ]
=== ICD-11 CODES FOUND === [7B2Z] Sleep-wake disorders, unspecified Also known as: Sleep-wake disorders, unspecified | sleep disorders [MG41] Sleep disturbance, not elsewhere classified Also known as: Sleep disturbance, not elsewhere classified | sleep disturbance, unspecified Excludes: Sleep-wake disorders [7A20.Z] Narcolepsy, unspecified Also known as: Narcolepsy, unspecified | Narcolepsy | narcolepsy nos | narcoleptic syndrome | paroxysmal sleep [7B00.1] Sleepwalking disorder Definition: Sleepwalking disorder is characterised by ambulation and other complex behaviours during a partial arousal from deep sleep. Also known as: Sleepwalking disorder | sleep walking | sleepwalking | somnambulism | sleep walking disorder [7A26] Insufficient sleep syndrome Definition: Insufficient sleep syndrome occurs when an individual persistently fails to obtain the amount of sleep required relative to their own physiological sleep requirements to maintain normal levels of alertness and wakefulness and is thus chronically sleep deprived. The curtailed sleep pattern is present most days for at least several months. The person’s ability to initiate and maintain sleep is unimpaired. Sleep time is often markedly extended on weekend nights or during holidays compared to weekd Also known as: Insufficient sleep syndrome | Behaviourally induced hypersomnia | nonorganic origin somnolence | primary hypersomnia | hypersomnia of nonorganic origin Includes: Behaviourally induced hypersomnia Excludes: Narcolepsy [MD11.0] Apnoea Also known as: Apnoea | apnoeic spells | central nervous system apnoea | central respiratory apnoea Excludes: Apnoea of newborn | Sleep-related breathing disorders [7A4Y] Other specified sleep-related breathing disorders Also known as: Other specified sleep-related breathing disorders | Infantile apnoea [KB2A.1] Obstructive neonatal apnoea Definition: Apnoea that occurs secondary to diminished airway airflow from an obstruction in the airway from the nose and mouth, tongue, hypopharynx, epiglottis, vocal cords or subglottic region. This is characterised by initial increased work of breathing and rapid progression to cyanosis. Also known as: Obstructive neonatal apnoea | obstructive apnoea of newborn [KB2A.0] Central neonatal apnoea Definition: Central apnoea is a cessation of airflow > 20 seconds with loss of all respiratory effort. It is due to immaturity of the brainstem to control respiration. It is found in many premature infants and generally resolves by 36 weeks of age. Also known as: Central neonatal apnoea [KB2A.2] Mixed neonatal apnoea Definition: A combination of central apnoea and obstructive apnoea. Most apnoea of prematurity is of the mixed variety, and most often resolves by 36 weeks of age. Also known as: Mixed neonatal apnoea === GRAPH WALKS === --- Walk 1 --- [7B2Z] Sleep-wake disorders, unspecified --PARENT--> [07] Sleep-wake disorders Def: Sleep-wake disorders are characterised by difficulty initiating or maintaining sleep (insomnia disorders), excessive sleepiness (hypersomnolence disorders), respiratory disturbance during sleep (sleep... --CHILD--> [?] Sleep-related breathing disorders Def: Sleep related breathing disorders are characterised by abnormalities of respiration during sleep. In some of these disorders, respiration is also abnormal during wakefulness. The disorders are grouped... --- Walk 2 --- [7B2Z] Sleep-wake disorders, unspecified --PARENT--> [07] Sleep-wake disorders Def: Sleep-wake disorders are characterised by difficulty initiating or maintaining sleep (insomnia disorders), excessive sleepiness (hypersomnolence disorders), respiratory disturbance during sleep (sleep... --CHILD--> [?] Hypersomnolence disorders Def: Hypersomnolence disorders are characterised by a complaint of daytime sleepiness that is not due to another sleep-wake disorder (e.g. disturbed nocturnal sleep, misaligned circadian rhythm, or breathi... --- Walk 3 --- [MG41] Sleep disturbance, not elsewhere classified --PARENT--> [?] General symptoms --RELATED_TO--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --- Walk 4 --- [MG41] Sleep disturbance, not elsewhere classified --PARENT--> [?] General symptoms --CHILD--> [MG20] Cachexia Def: Cachexia is a pathological generalised loss of body mass with reduction of the storage fat deposits, structural fat and musculature that can be accompanied by gradual loss of function of organs.... --- Walk 5 --- [7A20.Z] Narcolepsy, unspecified --PARENT--> [7A20] Narcolepsy Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM... --CHILD--> [7A20.0] Narcolepsy, Type 1 Def: Type 1 narcolepsy is a disorder of excessive sleepiness due to a deficiency of hypothalamic hypocretin (orexin) signaling. In addition to daily periods of irrepressible need to sleep or daytime lapses... --- Walk 6 --- [7A20.Z] Narcolepsy, unspecified --PARENT--> [7A20] Narcolepsy Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM... --CHILD--> [7A20.Z] Narcolepsy, unspecified
[ "[7B2Z] Sleep-wake disorders, unspecified\n --PARENT--> [07] Sleep-wake disorders\n Def: Sleep-wake disorders are characterised by difficulty initiating or maintaining sleep (insomnia disorders), excessive sleepiness (hypersomnolence disorders), respiratory disturbance during sleep (sleep...\n --CHILD--> [?] Sleep-related breathing disorders\n Def: Sleep related breathing disorders are characterised by abnormalities of respiration during sleep. In some of these disorders, respiration is also abnormal during wakefulness. The disorders are grouped...", "[7B2Z] Sleep-wake disorders, unspecified\n --PARENT--> [07] Sleep-wake disorders\n Def: Sleep-wake disorders are characterised by difficulty initiating or maintaining sleep (insomnia disorders), excessive sleepiness (hypersomnolence disorders), respiratory disturbance during sleep (sleep...\n --CHILD--> [?] Hypersomnolence disorders\n Def: Hypersomnolence disorders are characterised by a complaint of daytime sleepiness that is not due to another sleep-wake disorder (e.g. disturbed nocturnal sleep, misaligned circadian rhythm, or breathi...", "[MG41] Sleep disturbance, not elsewhere classified\n --PARENT--> [?] General symptoms\n --RELATED_TO--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....", "[MG41] Sleep disturbance, not elsewhere classified\n --PARENT--> [?] General symptoms\n --CHILD--> [MG20] Cachexia\n Def: Cachexia is a pathological generalised loss of body mass with reduction of the storage fat deposits, structural fat and musculature that can be accompanied by gradual loss of function of organs....", "[7A20.Z] Narcolepsy, unspecified\n --PARENT--> [7A20] Narcolepsy\n Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM...\n --CHILD--> [7A20.0] Narcolepsy, Type 1\n Def: Type 1 narcolepsy is a disorder of excessive sleepiness due to a deficiency of hypothalamic hypocretin (orexin) signaling. In addition to daily periods of irrepressible need to sleep or daytime lapses...", "[7A20.Z] Narcolepsy, unspecified\n --PARENT--> [7A20] Narcolepsy\n Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM...\n --CHILD--> [7A20.Z] Narcolepsy, unspecified" ]
7B2Z
Sleep-wake disorders, unspecified
[ { "from_icd11": "7B2Z", "icd10_code": "G4753", "icd10_title": "Recurrent isolated sleep paralysis" }, { "from_icd11": "7B2Z", "icd10_code": "G4762", "icd10_title": "Sleep related leg cramps" }, { "from_icd11": "7B2Z", "icd10_code": "G4761", "icd10_title": "Periodic limb movement disorder" }, { "from_icd11": "7B2Z", "icd10_code": "G4752", "icd10_title": "REM sleep behavior disorder" }, { "from_icd11": "7B2Z", "icd10_code": "G4750", "icd10_title": "Parasomnia, unspecified" }, { "from_icd11": "7B2Z", "icd10_code": "G4763", "icd10_title": "Sleep related bruxism" }, { "from_icd11": "7B2Z", "icd10_code": "G4754", "icd10_title": "Parasomnia in conditions classified elsewhere" }, { "from_icd11": "7B2Z", "icd10_code": "G4769", "icd10_title": "Other sleep related movement disorders" }, { "from_icd11": "7B2Z", "icd10_code": "F519", "icd10_title": "Sleep disorder not due to a substance or known physiological condition, unspecified" }, { "from_icd11": "7B2Z", "icd10_code": "G478", "icd10_title": "Other sleep disorders" }, { "from_icd11": "7B2Z", "icd10_code": "G479", "icd10_title": "Sleep disorder, unspecified" }, { "from_icd11": "7B2Z", "icd10_code": "F518", "icd10_title": "Other sleep disorders not due to a substance or known physiological condition" }, { "from_icd11": "7B2Z", "icd10_code": "F51", "icd10_title": "Sleep disorders not due to a substance or known physiological condition" }, { "from_icd11": "7B2Z", "icd10_code": "F512", "icd10_title": "" }, { "from_icd11": "7B2Z", "icd10_code": "G47", "icd10_title": "Sleep disorders" } ]
G4753
Recurrent isolated sleep paralysis
A 59-year-old male with obesity (BMI 28.6 kg/m 2 ), hypertension, and hypothyroidism was admitted with COVID-19. The hypertension was mild, and the patient was not being treated with any medications (i.e., no angiotensin-converting enzyme inhibitors, nor angiotensin-receptor blockers). Three years prior to admission, the patient had a classical Hodgkin’s lymphoma, grade IV, followed 18 months later by a follicular lymphoma (FL), grade III. Thirteen months prior to writing he received two of five cycles of G-benda, a combination of obinutuzumab, an anti-CD20 B-cell-depleting monoclonal antibody, and bendamustine, an ablative chemotherapeutic agent. Within weeks of the completion of the second G-benda cycle, the patient was admitted to an outside institution for roughly one week of fever, cough, and shortness of breath. Nasal swab qRT-PCR, abnormal imaging, and oxygen desaturation confirmed symptomatic COVID-19 infection. Throughout the month following admission, the patient required high-flow oxygen, however, the patient did not develop acute respiratory distress syndrome (ARDS) or require intubation. Anti-COVID-19 therapy consisted of hydroxychloroquine (400 mg once day one of admission, then 200 mg twice daily on days 2, 3, 7, and 8 of admission), azithromycin (500 mg once daily for the first five days of admission), lopinavir/ritonavir (200/50 mg tablets, two tablets bid days six through 15 of admission), steroids (solumedrol 80 mg iv bid, then 60 mg iv bid days 11 and 12 of admission, respectively), and two infusions of COVID-19 convalescent plasma, 30 and 50 days after diagnosis. All treatments were unsuccessful in clearing virus, as measured by unchanged nasal SARS-CoV-2 qRT-PCR and persistent symptoms. After 6 weeks, the patient was transferred to our center to receive remdesivir. Remdesivir was administered as 200 mg iv once daily for one dose, then 100 mg iv once daily for nine days. Following remdesivir, the patient exhibited slow clinical improvement. Three and a half months following diagnosis, after an overall mild clinical course and decreased oxygen dependence, patient was discharged home to quarantine for an indefinite period, given persistent detectable SARS-CoV-2 by nasal swab qRT-PCR ( Table S1 ). After 10 weeks at home, he was readmitted for severe consolidated pneumonia, in the context of lympho-neutropenia and persistently low serum IgG ( Table S2A,B ), the latter prompting treatment with IVIG. During the week following readmission, he tested negative for SARS-CoV-2 on nasal swabs taken over two consecutive days (COVID-19 IDnow (Abbott)). The pneumonia was treated with broad-spectrum antibiotic/antifungal coverage including piperacillin-tazobactam, vancomycin, voriconazole, and steroids (prednisone 60 mg po once daily). However, three weeks from readmission, since no organism could be isolated and both cough and dyspnea persisted, COVID-19-related pneumonia was suspected; a nasal swab was administered (IDnow) and tested positive. COVID-19 was reconfirmed on subsequent nasal swabs, all with a detectable genome of SARS-CoV-2 by both tests (IDnow, cobas (Roche)). In retrospect, all samples collected within a couple of days of enrollment for the research study (nasal swab, saliva, and residual broncho-alveolar lavage (BAL) fluid) had detectable SARS-CoV-2 by TaqPath/CDC qRT-PCR, ruling out a SARS-CoV-2 re-infection, and presenting more consistently with a single prolonged infection with two false-negative nasal swabs upon readmission. During his subsequent prolonged (6 month) hospitalization, the patient experienced an unchanged clinical status with no improvement but no severe worsening, and mild oxygen dependence requiring on average 4 L/min. Weekly SARS-CoV-2 qRT-PCRs either by IDnow or cobas were all positive ( Table S1 ). The patient did not develop anti-SARS-CoV-2 humoral response on serial plasma collected from days 80, 210, and 270 following initial diagnosis, using two independent ELISA platforms, both of which detect antibodies against SARS-CoV-2 nucleocapsid protein (NP) and either trimeric spike or spike receptor-binding domain (RBD) (Zalgen and in-house ELISA test) ( Table S3 ). Sequencing of the virus was possible on nasal swab, saliva, and BAL collected 6 days after re-admission, with sample SARS-CoV-2 Ct values < 14. Sequence analysis of samples collected days 74 to 296 from initial diagnosis showed the persistent accumulation of new mutations over time, resulting in six amino acid changes, some not previously described . Eight months following initial symptom onset, alerted by report of variants with increased transmissibility/severity , and having concerns regarding the possible accumulation of new mutations, we proposed to attempt to clear virus carriage using an anti-SARS-CoV-2 spike protein monoclonal antibody cocktail, casirivimab/imdevimab (REGEN-COV).
3.949219
0.977051
sec[0]/sec[0]/p[0]
en
0.999997
34201591
https://doi.org/10.3390/v13071202
[ "sars", "nasal", "covid", "swab", "daily", "anti", "oxygen", "idnow", "collected", "three" ]
[ { "code": "1D65", "title": "Severe acute respiratory syndrome" }, { "code": "RA01.0", "title": "COVID-19, virus identified" }, { "code": "RA01.0/CA40.1Z", "title": "COVID-19 with pneumonia, SARS-CoV-2 identified" }, { "code": "RA01.1/CA40.1Z", "title": "COVID-19 with pneumonia, SARS-CoV-2 not identified" }, { "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": "RA02", "title": "Post COVID-19 condition" } ]
=== ICD-11 CODES FOUND === [1D65] Severe acute respiratory syndrome Definition: 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 pneumonia. Transmission is by direct contact, inhalation of infected respiratory secretions, or airborne transmission. Confirmation is by identification of coronavirus in a blood, stool, respiratory secretions, or body tissue sample. Also known as: Severe acute respiratory syndrome | SARS - [severe acute respiratory syndrome] Excludes: COVID-19, virus identified | COVID-19, virus not identified [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 [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 [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 === GRAPH WALKS === --- Walk 1 --- [1D65] 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... --EXCLUDES--> [?] COVID-19, virus not identified --CHILD--> [?] COVID-19 with pneumonia, SARS-CoV-2 not identified --- Walk 2 --- [1D65] 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... --EXCLUDES--> [?] COVID-19, virus not identified --EXCLUDES--> [?] COVID-19, virus identified --- Walk 3 --- [RA01.0] COVID-19, virus identified --PARENT--> [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 --- Walk 4 --- [RA01.0] COVID-19, virus identified --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... --EXCLUDES--> [?] COVID-19, virus not identified --- Walk 5 --- [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.... --PARENT--> [?] Symptoms or signs involving speech, language or voice --- Walk 6 --- [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--> [MA82.2] 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 ...
[ "[1D65] 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...\n --EXCLUDES--> [?] COVID-19, virus not identified\n --CHILD--> [?] COVID-19 with pneumonia, SARS-CoV-2 not identified", "[1D65] 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...\n --EXCLUDES--> [?] COVID-19, virus not identified\n --EXCLUDES--> [?] COVID-19, virus identified", "[RA01.0] COVID-19, virus identified\n --PARENT--> [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", "[RA01.0] COVID-19, virus identified\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...\n --EXCLUDES--> [?] COVID-19, virus not identified", "[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 --PARENT--> [?] Symptoms or signs involving speech, language or voice", "[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--> [MA82.2] 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 ..." ]
1D65
Severe acute respiratory syndrome
[ { "from_icd11": "1D65", "icd10_code": "U04", "icd10_title": "" }, { "from_icd11": "1D65", "icd10_code": "U049", "icd10_title": "" }, { "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" } ]
U04
A 14-year-old Egyptian boy was referred to our institution for evaluation of recurrent hypoglycemic attacks which occurred especially in the mornings during the preceding two months. He had been diagnosed with T1DM at the age of five years and was treated with insulin in a dose of 0.7 to 1U/kg since that time. Recently, he started to develop recurrent attacks of hypoglycemia for which his insulin dose was decreased to 0.3U/kg. He had lost 2.5kg of weight and developed a craving for salt. He suffered from fatigue and dizziness. He was born and resided in a small village in Upper Egypt to unrelated Egyptian parents. He was the sixth child in his family with no history of diabetes or other auto immune diseases among family members. He had frequent hospital admissions for control of blood sugar. He was born at term with a birth weight of 3550 grams. Apart from post circumcision bleeding that was done at the age of two years by a barber, there was nothing significant in his past medical history. On physical examination, his body temperature was 36.1C, pulse rate was 92/min, blood pressure was 80/45mmHg, his height was in the 10th percentile while his weight was in the 25th percentile. He had no pallor, jaundice, or hyperpigmentation of either the skin or mucous membranes. His thyroid gland was not enlarged either on inspection or palpation. He was prepubertal: pubic and axillary hair Tanner stage 1 and testicular volume 3ml. He had slight abdominal distension, his liver and spleen were not enlarged and there was no evidence of ascities. Skin examination revealed vitiligo in the form of multiple hypopigmented areas located over the chest and abdomen. Serum biochemistry on admission showed an average blood glucose level of 77mg/dL (normal range: 82 to 110mg / dL), hemoglobin A1c 7.5% (normal range: 3.0 to 6.1), potassium: 5.9mmol/L (normal range 3.5 to 5), sodium 121mmol/L (normal range: 130 to 145) and calcium 9.7mg/dL (normal range: 8 to 10.5). Levels of blood urea nitrogen and creatinine were within the normal range. Liver function tests revealed bilirubin 11umol/L (normal <20umol/L), alanine aminotransferase (ALT) 186IU/L (normal <50IU/L), aspartate aminotransferase (AST) 123IUL (normal <50IU/L), alkaline phosphatase 108IU/L, (normal <350IU/L), and albumin 38g/L (normal range: 35 to 45g/L). Complete blood count, serum folate and vitamin B12 levels were normal. Viral hepatitis screens (HAV IgM, HBsAg, HBsIgM and IgG, Epstein-Barr virus, cytomegalovirus and herpes simplex virus) were negative. Anti-HCV and hepatitis C virus–polymerase chain reaction (HCV–PCR) were positive, with a viral load of 88,440IU/mL. Anti-endomysial antibodies were not detected. There were no serological features of autoimmune hepatitis (anti-smooth muscle antibody, antinuclear antibody, anti-liver/kidney microsomal antibody, and anti-parietal cell antibody were negative), anti-adrenal antibodies were positive and serum immunoglobulins were normal. Hormonal assays revealed cortisol <1.0ug/dL (normal range: 6 to 24), adrenocorticotropic hormone (ACTH) > 1250pg/mL (normal range: 20 to 100), a peak cortisol level below 0.2mcg/dL after intravenous ACTH stimulation test (250mcg). Thyroid stimulating hormone (TSH) was 6.11uIU/mL (normal range: 0.4 to 5.0). Anti-thyroglobulin (Tg autoantibodies) were 217.8IU/mL (normal: <120), anti-thyroid peroxidase (TPO autoantibodies) 5176IU/mL (normal 60), and free thyroxine 1.4ng/dL (normal range: 0.7 to 2.0). The serum luteinizing hormone was 0.1mIU/ml (normal range: 2.9 to 21.7), follicle-stimulating hormone 0.2mIU/ml (normal range: 5 to 30), testosterone 0.02ng/mL (normal range: 9.0 to 40.0), prolactin 13ng/mL (normal range: 3 to 30). Insulin C-peptide was <0.50ng/mL (normal range: 1.5 to 3.5). Parathormone (PTH) was 33.4pg/mL (normal range: 2 to 72). Thyroid ultrasonography revealed heterogeneous echogenicity without any nodules, while ultrasonography of the abdomen was normal. His immunogenetic study demonstrated that human leukocyte antigen (HLA) typing was HLA-DR3. Based on combinations of 1DM, subclinical hypothyroidism due to Hashimoto’s thyroiditis, adrenal insufficiency, vililligo and HLA-DR3, a diagnosis of APS2 was made. The presence of positivity for both anti-HCV and HCV-RNA with elevated ALT and AST levels even in the absence of hepatomegaly confirmed the diagnosis of chronic hepatitis C infection. His general condition improved gradually following the administration of hydrocortisone (10mg twice daily) and fludrocortisone (0.1mg twice daily). His diabetes was controlled with intensive multiple daily insulin injections. He was referred to the regional hepatology unit for further assessment including liver biopsy and consideration of hepatitis C eradication therapy but his father preferred to delay the treatment because he was worried about the side effects of the treatment.
4.027344
0.977051
sec[1]/p[0]
en
0.999995
22839422
https://doi.org/10.1186/1752-1947-6-221
[ "range", "anti", "blood", "hepatitis", "insulin", "thyroid", "liver", "serum", "antibody", "hormone" ]
[ { "code": "QA00.6Y", "title": "Other specified examination of eyes or vision" }, { "code": "4B00.0Z", "title": "Neutropaenia, unspecified" }, { "code": "3B63.1Z", "title": "Acquired thrombocytosis, unspecified" }, { "code": "MA14.1C", "title": "Raised antibody titre" }, { "code": "BD11.1", "title": "Left ventricular failure with mid range ejection fraction" }, { "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 === [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 [4B00.0Z] Neutropaenia, unspecified Also known as: Neutropaenia, unspecified | Neutropenia | Disorders with decreased neutrophil counts | neutropaenic disorder | neutrophil count below reference range [3B63.1Z] Acquired thrombocytosis, unspecified Also known as: Acquired thrombocytosis, unspecified | Acquired thrombocytosis | Idiopathic haemorrhagic thrombocythaemia | Essential thrombocythaemia | primary haemorrhagic thrombocythaemia [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 [BD11.1] Left ventricular failure with mid range ejection fraction Also known as: Left ventricular failure with mid range ejection fraction | HFmEF - [heart failure with mid range ejection fraction] | Left ventricular failure with mid range ejection fraction due to cardiomyopathy | Left ventricular failure with mid range ejection fraction due to coronary artery disease | Left ventricular failure with mid range ejection fraction due to myocarditis [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 --- [QA00.6Y] Other specified examination of eyes or vision --PARENT--> [QA00.6] Examination of eyes or vision --EXCLUDES--> [?] Examination for driving license --- Walk 2 --- [QA00.6Y] Other specified examination of eyes or vision --PARENT--> [QA00.6] Examination of eyes or vision --EXCLUDES--> [?] Examination for driving license --- Walk 3 --- [4B00.0Z] Neutropaenia, unspecified --PARENT--> [4B00.0] Neutropenia --CHILD--> [4B00.0Z] Neutropaenia, unspecified --- Walk 4 --- [4B00.0Z] Neutropaenia, unspecified --PARENT--> [4B00.0] Neutropenia --CHILD--> [4B00.0Z] Neutropaenia, unspecified --- Walk 5 --- [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 6 --- [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--> [3B63.1Y] Other specified acquired thrombocytosis
[ "[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --EXCLUDES--> [?] Examination for driving license", "[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --EXCLUDES--> [?] Examination for driving license", "[4B00.0Z] Neutropaenia, unspecified\n --PARENT--> [4B00.0] Neutropenia\n --CHILD--> [4B00.0Z] Neutropaenia, unspecified", "[4B00.0Z] Neutropaenia, unspecified\n --PARENT--> [4B00.0] Neutropenia\n --CHILD--> [4B00.0Z] Neutropaenia, unspecified", "[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...", "[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--> [3B63.1Y] Other specified acquired thrombocytosis" ]
QA00.6Y
Other specified examination of eyes or vision
[ { "from_icd11": "3B63.1Z", "icd10_code": "D473", "icd10_title": "Essential (hemorrhagic) thrombocythemia" }, { "from_icd11": "MA14.1C", "icd10_code": "R760", "icd10_title": "Raised antibody titer" }, { "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" } ]
D473
Essential (hemorrhagic) thrombocythemia
A 39-year-old male with no relevant past medical history and family history of pulmonary Koch’s (mother was diagnosed six months back and is on anti-tubercular therapy), presented to our centre with complaints of fever of two weeks duration, malaise, and weight loss of 5 Kg over the last one month. The fever was intermittent, not associated with chills or rigors; however, it had an evening rise of temperature. It was associated with night sweats. He denied any history of vomiting, loose stools, burning micturition, travel, or exposure to pets. On general physical examination, he was febrile with an axillary temperature of 101 degrees F. His blood pressure was 138/92 mm of Hg. He did not have tachycardia or tachypnoea. He had a single right axillary lymph node measuring 1.5 cm in diameter, firm in consistency, mobile, non-tender, not adherent to underlying muscle or overlying skin. He had two macular lesions over the inner aspect of his right forearm and a macular brown-coloured lesion over the right side of the chest just below the nipple . The rest of the systemic examination was unremarkable. Clinical diagnosis of Koch’s was considered because of prolonged fever, weight loss, night sweats, and family history of Pulmonary Koch’s. The initial laboratory evaluation is presented in Table 1 . He had microcytic hypochromic anaemia with Mentzer index < 13 and raised aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH) levels. Initial fever workup revealed positive IgM typhidot and raised titre (1: 160) of the Weil Felix Test. Because of ongoing fever, transaminitis, and skin rash, the possibility of Enteric fever and rickettsial infection was considered and the patient was administered Ceftriaxone 1 gm intravenous twice a day, along with Doxycycline 100 mg orally twice a day. The patient underwent contrast-enhanced computed tomography (CECT) of the chest and abdomen, which revealed normal lung parenchyma with normal liver and spleen. There was no evidence of any enlarged hilar, mediastinal, or mesenteric lymph nodes on CECT. The patient continued to have fever with trans-aminitis and raised inflammatory markers with negative infective workup ( Table 2 ) even after two weeks of hospital admission . He underwent whole-body PET, which revealed few discrete mediastinal lymph nodes with mild FDG uptake (Maximum SUV 4.41), likely inflammatory or infective aetiology. At this stage, we considered the diagnosis of Sarcoidosis and other autoimmune connective tissue disorders. However, the patient had normal serum angiotensin converting enzyme levels. We reviewed the history and clinical examination. The patient had developed pain in both the lower limbs, and on examination he did not have muscle tenderness or weakness. He was noted to have a papular rash over the knuckles Figure 1C and a purple-coloured macular lesion over the dorsal aspect of the right elbow with roughening and cracking of the skin over the fingers and palm. He also had painless fissuring of the fingers . Because of the Gottron sign, mechanic hands, elevated muscle enzymes, and absence of clinical evidence of muscle weakness the diagnosis of dermatomyositis was considered likely clinically amyopathic dermatomyositis (CADM). The patient was subjected to magnetic resonance imaging of both thighs, which was suggestive of acute myositis . He was administered methylprednisolone 750 mg intravenous for three days followed by oral prednisolone 50 mg daily. Following the pulse glucocorticoid therapy patient became afebrile. A detailed immunological workup was done which revealed normal serum immunoglobulin profile with normal C3, C4 levels. The anti-nuclear antibody was negative by indirect immunofluorescence. He had normal levels of serum anti myeloperoxidase antibody and serum anti proteinase 3 antibody . He tested strongly positive for the Anti-MDA-5 antibody . Hence the diagnosis of Anti-MDA-5 dermatomyositis was established. The patient underwent muscle biopsy from the right thigh which had essentially unremarkable histomorphology. Skin biopsy from the volar aspect of the right forearm was also done which was suggestive of leucocytoclastic vasculitis. The patient’s AST and ALT showed a declining trend; however, he had a persistent elevation of gamma-glutamyl transferase (GGT). The trend of enzymes over the period of hospitalization is depicted in . The patient was evaluated in detail for the cause of elevated ALT and GGT. However, he tested negative for hepatitis A, hepatitis E, chronic or occult hepatitis B, and autoimmune hepatitis. He also underwent Magnetic resonance cholangiopancreatography which was normal. Finally, the patient was subjected to a Liver biopsy which showed some foci of inflammation. Hence the liver damage was attributed to the primary disease, ie, DM.
3.960938
0.979004
sec[1]/p[0]
en
0.999996
PMC9727477
https://doi.org/10.31138/mjr.33.3.361
[ "which", "fever", "over", "anti", "muscle", "however", "skin", "considered", "serum", "antibody" ]
[ { "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": "MG26", "title": "Fever of other or unknown origin" }, { "code": "1D81.Z", "title": "Infectious mononucleosis, unspecified" }, { "code": "1B99", "title": "Pasteurellosis" }, { "code": "4A60.0", "title": "Familial Mediterranean fever" }, { "code": "JB40.0", "title": "Puerperal sepsis" }, { "code": "MB22.5", "title": "Increased goal-directed activity" } ]
=== ICD-11 CODES FOUND === [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 [MG26] Fever of other or unknown origin Definition: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process. Also known as: Fever of other or unknown origin | febrile | febris | fever | feverish Excludes: fever of unknown origin in newborn | Malignant hyperthermia due to anaesthesia [1D81.Z] Infectious mononucleosis, unspecified Also known as: Infectious mononucleosis, unspecified | Infectious mononucleosis | Glandular fever | Gammaherpesviral mononucleosis | kissing disease [1B99] Pasteurellosis Definition: A disease caused by an infection with the gram-negative bacteria Pasteurella. This disease is characterised by local cellulitis and may lead to other clinical signs depending on the route of infection. Transmission is commonly by direct contact through the bite, scratch, or lick from an infected animal, inhalation of infected respiratory secretions, or ingestion of contaminated meat. Confirmation is by identification of Pasteurella from the affected individual. Also known as: Pasteurellosis | pasteurella infection | shipping fever | transport fever [4A60.0] Familial Mediterranean fever Definition: FMF is an autoinflammatory disease associated with mutations in pyrin resulting in enhanced IL1 beta production. This results in clinical attacks of inflammation in the form of fever and serositis in the form of peritoneal, pleural or synovial inflammation along with increased acute phase reactants. Also known as: Familial Mediterranean fever | Periodic disease | FMF - [familial mediterranean fever] | periodic fever | periodic polyserositis [JB40.0] Puerperal sepsis Also known as: Puerperal sepsis | puerperal fever | postpartum sepsis | generalised puerperal infection | major puerperal infection Excludes: Obstetric pyaemic or septic embolism | sepsis during labour [MB22.5] Increased goal-directed activity Definition: Increased planning of and participation in multiple activities (e.g. sexual, occupational, political, religious), compared to the individual's typical level of activity. Also known as: Increased goal-directed activity | overactivity | behaviour of overactivity === GRAPH WALKS === --- Walk 1 --- [BD50.41] Abdominal aortic aneurysm with rupture --PARENT--> [BD50.4] Abdominal aortic aneurysm --CHILD--> [BD50.40] Abdominal aortic aneurysm with perforation --- Walk 2 --- [BD50.41] Abdominal aortic aneurysm with rupture --PARENT--> [BD50.4] Abdominal aortic aneurysm --CHILD--> [BD50.41] Abdominal aortic aneurysm with rupture --- Walk 3 --- [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --CHILD--> [EK91.0] Large plaque parapsoriasis Def: Large plaque parapsoriasis is a chronic skin disorder characterised by the indolent development over years or decades of scaly patches or slightly elevated plaques which may be clinically indistinguis... --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --- Walk 4 --- [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --CHILD--> [EK91.1] Poikiloderma vasculare atrophicans Def: Poikiloderma vasculare atrophicans is a cutaneous reaction pattern characterised by mottled hyper- and hypomelanosis, telangiectasia and progressive dermal and epidermal atrophy. It may manifest as a ... --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --- Walk 5 --- [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained --PARENT--> [MH12] Other sudden death, cause unknown --EXCLUDES--> [?] Sudden infant death syndrome Def: Sudden infant death syndrome is the abrupt and unexplained death of an apparently healthy infant under one year of age, remaining unexplained after a thorough case investigation, including performance... --- Walk 6 --- [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained --PARENT--> [MH12] Other sudden death, cause unknown --CHILD--> [MH12.Y] Other specified sudden death, cause unknown
[ "[BD50.41] Abdominal aortic aneurysm with rupture\n --PARENT--> [BD50.4] Abdominal aortic aneurysm\n --CHILD--> [BD50.40] Abdominal aortic aneurysm with perforation", "[BD50.41] Abdominal aortic aneurysm with rupture\n --PARENT--> [BD50.4] Abdominal aortic aneurysm\n --CHILD--> [BD50.41] Abdominal aortic aneurysm with rupture", "[EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....\n --CHILD--> [EK91.0] Large plaque parapsoriasis\n Def: Large plaque parapsoriasis is a chronic skin disorder characterised by the indolent development over years or decades of scaly patches or slightly elevated plaques which may be clinically indistinguis...\n --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....", "[EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....\n --CHILD--> [EK91.1] Poikiloderma vasculare atrophicans\n Def: Poikiloderma vasculare atrophicans is a cutaneous reaction pattern characterised by mottled hyper- and hypomelanosis, telangiectasia and progressive dermal and epidermal atrophy. It may manifest as a ...\n --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....", "[MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained\n --PARENT--> [MH12] Other sudden death, cause unknown\n --EXCLUDES--> [?] Sudden infant death syndrome\n Def: Sudden infant death syndrome is the abrupt and unexplained death of an apparently healthy infant under one year of age, remaining unexplained after a thorough case investigation, including performance...", "[MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained\n --PARENT--> [MH12] Other sudden death, cause unknown\n --CHILD--> [MH12.Y] Other specified sudden death, cause unknown" ]
BD50.41
Abdominal aortic aneurysm with rupture
[ { "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": "MG26", "icd10_code": "R5081", "icd10_title": "Fever presenting with conditions classified elsewhere" }, { "from_icd11": "MG26", "icd10_code": "R5084", "icd10_title": "Febrile nonhemolytic transfusion reaction" }, { "from_icd11": "MG26", "icd10_code": "R5082", "icd10_title": "Postprocedural fever" }, { "from_icd11": "MG26", "icd10_code": "R5083", "icd10_title": "Postvaccination fever" }, { "from_icd11": "MG26", "icd10_code": "R509", "icd10_title": "Fever, unspecified" }, { "from_icd11": "MG26", "icd10_code": "R502", "icd10_title": "Drug induced fever" }, { "from_icd11": "MG26", "icd10_code": "R50", "icd10_title": "Fever of other and unknown origin" }, { "from_icd11": "MG26", "icd10_code": "R508", "icd10_title": "Other specified fever" }, { "from_icd11": "1D81.Z", "icd10_code": "B2700", "icd10_title": "Gammaherpesviral mononucleosis without complication" }, { "from_icd11": "1D81.Z", "icd10_code": "B2790", "icd10_title": "Infectious mononucleosis, unspecified without complication" }, { "from_icd11": "1D81.Z", "icd10_code": "B2709", "icd10_title": "Gammaherpesviral mononucleosis with other complications" }, { "from_icd11": "1D81.Z", "icd10_code": "B2780", "icd10_title": "Other infectious mononucleosis without complication" } ]
I713
Abdominal aortic aneurysm, ruptured
A 70-year-old African American female with hypertension, obesity and type 2 diabetes presented to the emergency department (ED) after a mechanical fall with severe right upper extremity pain. On exam, her right shoulder was severely tender to palpation, and range of motion was severely limited secondary to pain. An x-ray of her right shoulder demonstrated an acute fracture of the right humeral head associated with a large expansile lytic lesion , consistent with a pathologic fracture. A noncontrast CT of the right humerus was also performed, further characterizing the lytic and expansile nature of the humeral head tumor, measuring 4.3cm in greatest diameter . Given the urgent need for surgical fixation, the patient was referred to interventional radiology for preoperative embolization to minimize intraoperative blood loss. After a thorough discussion of the procedure and its risks, the patient was brought to the angiography suite, placed in the supine position and the right groin was prepped and raped in sterile fashion. Conscious sedation with continuous physiologic monitoring was provided by a IR nurse under the stewardship of the interventional radiologist. The right common femoral artery was accessed under ultrasound guidance. Fluoroscopic guidance was used for the remainder of the procedure. After placement of a 6F 90cm sheath into the thoracic aorta, a 5F angled catheter and glidewire were navigated into the aortic arch, then the brachiocephalic and right subclavian arteries, and ultimately positioned in the right axillary artery . The 6F sheath was advanced over the wire and 5F angled catheter, and positioned securely within the right subclavian artery. Subsequently, a 2.4F microcatheter system was used to subselect multiple branches of the right humeral circumflex arteries supplying the hypervascular tumor. Angiography revealed robust arterial hypertrophy, tumor blushing as well as arteriovenous fistulation characteristic of malignant neovascularity . No pseudoaneurysms were present. The tumoral vessels were each embolized using 100-300 micron particles in order to achieve distal embolization deep within the capillary bed of the tumor, and therefore minimize revascularization of the tumor from collateral vessels . Particles were infused into the tumor methodically, and frequent digital subtraction angiograms were performed to avoid nontarget embolization into the normal tissues of the extremity. The presence of robust tumoral arteriovenous fistulization (AV) precluded the use of liquid embolic agents such as n-BCA glue due to the risk of nontarget embolization into the central venous system. After adequate devascularization of the tumor was confirmed on angiography, the catheters and sheaths were removed and hemostasis was achieved at the right common femoral artery access site with manual pressure. The patient was subsequently transferred to the operating room for tumor debulking and total right shoulder arthroplasty with a long intramedullary rod component . The estimated blood loss during surgery was 100 cc. The patient had an uneventful 2-day postoperative recovery in the hospital and was subsequently discharged home. Histopathological examination of the resected specimen revealed a poorly differentiated plasma cell tumor . The patient was referred to oncology for serological and imaging work-up to guide future management. After a 2-week recovery, the patient began a 2-month course of physical therapy. At 6 months postop, the patient reports normal baseline functional status and restored right shoulder range of motion. Fig. 1 (A) Frontal x-ray and (B) coronal CT of the right shoulder show a large expansile lytic tumor in the humeral head, with an associated pathologic axial fracture of the surgical neck (arrow). (C) Intraprocedural spot fluoroscopic image demonstrates a 5F angled catheter in the right axillary artery from a femoral approach (arrow). Fig 1 Fig. 2 (A) Postprocessing digital subtraction angiography (DSA) of the right subclavian artery in the negative view demonstrates a hypervascular tumor involving the humeral head, with feeding arteries from multiple axillary and brachial artery branches (arrow). (B) DSA of a right humeral circumflex branch reveals robust arteriovenous fistulation within the tumor (arrow). (C) DSA of another humeral circumflex branch highlights the classic “tumor blush” appearance of malignancies (arrow). Fig 2 Fig. 3 (A) Postembolization right subclavian artery DSA demonstrates cessation of flow to the tumor. (B) X-ray image of right total shoulder arthroplasty using a long intramedullary rod component. Fig 3 Fig. 4 Surgical specimen from the resected tumor demonstrates immature monoclonal plasma cells with anaplastic morphology, high nuclear-to-cytoplasmic ratio, prominent nucleoli, and dispersed chromatin, consistent with plasmacytoma. Fig 4
4.042969
0.962402
sec[1]/p[0]
en
0.999996
39328946
https://doi.org/10.1016/j.radcr.2024.09.042
[ "tumor", "artery", "humeral", "shoulder", "arrow", "head", "embolization", "angiography", "subclavian", "demonstrates" ]
[ { "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": "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 === [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 [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 --- [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 --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- 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--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- Walk 5 --- [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 --- Walk 6 --- [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
[ "[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 --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[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--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital 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--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach", "[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" ]
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 77-year-old male was admitted to our hospital due to left lower limb swelling with heat sensation and redness. These symptoms had appeared 2 days prior to hospital admission. Five months before admission, he was diagnosed with polymyalgia rheumatica syndrome and started treatment with prednisolone 10 mg per day. He had no previous history of thrombosis and no family history suggestive of inherited thrombophilia. His major risk for VTE was advanced age, but he did not have any other risks, such as obesity, cancer, surgery, immobilization or recent long travel. At the time of arrival to our Emergency Department, his entire left leg was swollen and showed pitting edema with mild pain. Blood pressure was 164/78 mmHg, and pulse of 102 bpm. Respiratory rate was 12/min, and arterial oxyhemoglobin saturation was 96% at room air. Plasma D-dimer level was high (45.0 μg/mL) while serum protein level, renal function and liver function were normal. Multi-detector computed tomography (MDCT) showed massive deep vein thrombosis from the lower edge of inferior vena cava to the lower leg veins . This patient had a congenital anomaly of the iliac vein in which the left external iliac vein (EIV) and left internal iliac vein (IIV) separately branched off from the inferior vena cava without a left common iliac vein . The left EIV was compressed by the abdominal aorta and the fifth lumbar vertebra . The thrombosis extended from the calf veins to the compressed site, suggesting a variant of iliac vein compression syndrome (May-Thurner syndrome) . The left IIV also had a large thrombus . The patient did not have any symptom related with PE and his lung MDCT did not show any embolism in the pulmonary arteries. Compression venous ultrasonography also showed massive DVT from the left iliofemoral level to the lower leg level, but slight venous flow was observed by color Doppler at the level of the left common femoral vein. A diagnosis of DVT was made, and the patient was immediately started on intravenous unfractionated heparin administration. The patient subsequently provided written informed consent to participate in the J-EINSTEIN study . We screened thrombophilia including antiphospholipid syndrome, protein S/C deficiency, fibrinogen and antithrombin III abnormality, but could not find any cause of DVT except steroid administration. Then, prednisolone dose was reduced to 7.5 mg. Since the patient was assigned to begin rivaroxaban therapy on the second day of hospitalization, a 15-mg dose of rivaroxaban administration was given 4 hours after termination of heparin, according to the study protocol. His left leg swelling showed progressive reduction on a daily basis in response to rivaroxaban 15 mg twice-daily. After 2 weeks of treatment, the patient was discharged from our hospital, as his symptoms and leg swelling had markedly improved. We did not use any compression therapy because the symptom improvement was observed from initial several days. The circumference of the left femoral region had decreased from 50.6 cm to 45.8 cm over the 2 weeks of initial treatment, and plasma D-dimer level decreased to 3.9 μg/mL by the time of hospital discharge. Surprisingly, the massive DVT in his left leg had almost completely disappeared according to MDCT performed on day 22 of the treatment . Compression venous ultrasonography at day 25 only showed a small thrombus at the left popliteal vein. As per protocol, we switched the dose of rivaroxaban to 15 mg per day following 3 weeks of intensive therapy. We monitored his clinical symptom and physical examination every month and continued the study drug for 1 year. Neither bleeding nor recurrence of thrombosis occurred over the entire clinical course of the treatment. Figure 1 Multi-detector computed tomography (MDCT) on admission. A and B . Transverse plane (A) and coronal plane (B) at the ilio-cava junction level. Left external iliac vein (lt EIV) branches off directly from the inferior vena cava. The left EIA is compressed by the abdominal aorta (*) with thrombus; C to E . Transverse plane (C and E) and coronal plane (D and F) at the iliofemoral vein level. Lt EIV, right common iliac vein (rt CIV), left internal iliac vein (lt IIV) and left femoral vein (let FV) have thrombi; G . left popliteal vein thrombus (white arrow); H . thrombi of left lower leg veins/soleal veins (white arrows). Figure 2 MDCT at day 22. A and B . Transverse plane (A) and coronal plane (B) at the ilio-cava junction level. * Abdominal aorta. Iliac vein compression persists, but the contrast defect has disappeared (white arrow); C to E . Transverse plane (C and E) and coronal plane (D and F) at the iliofemoral vein level. Thrombi shown in Figure 1 have disappeared (white arrow); G . Absence of the left popliteal vein thrombus (white arrow); H . Absence of the left lower leg vein thrombus (white arrows).
4.03125
0.976074
sec[1]/p[0]
en
0.999996
25788868
https://doi.org/10.1186/s12959-015-0045-1
[ "vein", "iliac", "plane", "thrombus", "white", "mdct", "cava", "compression", "thrombosis", "veins" ]
[ { "code": "BD7Z", "title": "Diseases of veins, unspecified" }, { "code": "MC88", "title": "Prominent veins" }, { "code": "BD7Y", "title": "Other specified diseases of veins" }, { "code": "BD75.Y", "title": "Venous varicosities of other specified sites" }, { "code": "BD73.2Z", "title": "Systemic vein obstruction, unspecified" }, { "code": "BD30.10&XA83D6", "title": "Acute thromboembolic iliac artery occlusion" }, { "code": "BD30.11&XA83D6", "title": "Acute thrombotic iliac artery occlusion" }, { "code": "NB90.6Y&XA83D6", "title": "Iliac artery haematoma" }, { "code": "BD52.3", "title": "Rupture of artery" }, { "code": "NB53.6", "title": "Strain or sprain of sacroiliac joint" } ]
=== ICD-11 CODES FOUND === [BD7Z] Diseases of veins, unspecified Also known as: Diseases of veins, unspecified [MC88] Prominent veins Also known as: Prominent veins [BD7Y] Other specified diseases of veins Also known as: Other specified diseases of veins [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 [BD73.2Z] Systemic vein obstruction, unspecified Also known as: Systemic vein obstruction, unspecified | Systemic vein obstruction [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 [NB53.6] Strain or sprain of sacroiliac joint Definition: Aberrant biomechanical functions of the joints between the ilia and the sacrum, which may be as a result of local disease, systemic disease, postural strain or trauma. Also known as: Strain or sprain of sacroiliac joint | Innominate sprain of sacral junction | Innominate strain of sacral junction | Strain of sacroiliac joint | sacroiliac sprain === GRAPH WALKS === --- Walk 1 --- [BD7Z] Diseases of veins, unspecified --PARENT--> [?] Diseases of veins --RELATED_TO--> [?] Venous complications in pregnancy --- Walk 2 --- [BD7Z] Diseases of veins, unspecified --PARENT--> [?] Diseases of veins --RELATED_TO--> [?] Other venous complications following abortion, ectopic or molar pregnancy --- Walk 3 --- [MC88] Prominent veins --PARENT--> [?] Symptoms or signs involving the circulatory system --CHILD--> [MC80] Abnormal blood-pressure reading, without diagnosis Def: Abnormal blood-pressure reading, without diagnosis is a reading of blood pressure which is higher than normal blood pressure or lower than normal blood pressure, without diagnosis.... --- Walk 4 --- [MC88] Prominent veins --PARENT--> [?] Symptoms or signs involving the circulatory system --RELATED_TO--> [?] Fear of cardiovascular disease --- Walk 5 --- [BD7Y] Other specified diseases of veins --PARENT--> [?] Diseases of veins --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 6 --- [BD7Y] Other specified diseases of veins --PARENT--> [?] Diseases of veins --CHILD--> [BD72] Venous thromboembolism
[ "[BD7Z] Diseases of veins, unspecified\n --PARENT--> [?] Diseases of veins\n --RELATED_TO--> [?] Venous complications in pregnancy", "[BD7Z] Diseases of veins, unspecified\n --PARENT--> [?] Diseases of veins\n --RELATED_TO--> [?] Other venous complications following abortion, ectopic or molar pregnancy", "[MC88] Prominent veins\n --PARENT--> [?] Symptoms or signs involving the circulatory system\n --CHILD--> [MC80] Abnormal blood-pressure reading, without diagnosis\n Def: Abnormal blood-pressure reading, without diagnosis is a reading of blood pressure which is higher than normal blood pressure or lower than normal blood pressure, without diagnosis....", "[MC88] Prominent veins\n --PARENT--> [?] Symptoms or signs involving the circulatory system\n --RELATED_TO--> [?] Fear of cardiovascular disease", "[BD7Y] Other specified diseases of veins\n --PARENT--> [?] Diseases of veins\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...", "[BD7Y] Other specified diseases of veins\n --PARENT--> [?] Diseases of veins\n --CHILD--> [BD72] Venous thromboembolism" ]
BD7Z
Diseases of veins, unspecified
[ { "from_icd11": "BD7Z", "icd10_code": "I82412", "icd10_title": "Acute embolism and thrombosis of left femoral vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82621", "icd10_title": "Acute embolism and thrombosis of deep veins of right upper extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I82432", "icd10_title": "Acute embolism and thrombosis of left popliteal vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82C11", "icd10_title": "Acute embolism and thrombosis of right internal jugular vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82441", "icd10_title": "Acute embolism and thrombosis of right tibial vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82422", "icd10_title": "Acute embolism and thrombosis of left iliac vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82622", "icd10_title": "Acute embolism and thrombosis of deep veins of left upper extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I824Z1", "icd10_title": "Acute embolism and thrombosis of unspecified deep veins of right distal lower extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I82401", "icd10_title": "Acute embolism and thrombosis of unspecified deep veins of right lower extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I824Z2", "icd10_title": "Acute embolism and thrombosis of unspecified deep veins of left distal lower extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I82612", "icd10_title": "Acute embolism and thrombosis of superficial veins of left upper extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I82721", "icd10_title": "Chronic embolism and thrombosis of deep veins of right upper extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I82C12", "icd10_title": "Acute embolism and thrombosis of left internal jugular vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82B12", "icd10_title": "Acute embolism and thrombosis of left subclavian vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82421", "icd10_title": "Acute embolism and thrombosis of right iliac vein" } ]
I82412
Acute embolism and thrombosis of left femoral vein
A 35-year-old lady, not known to have systemic illnesses, presented to the emergency department (ED) at our institute complaining of pain in her left eye. The patient had a history of retinal surgery done at age of 5 years following blunt trauma with post- traumatic dislocated crystalline lens. The patient underwent a secondary intraocular lens (IOL) implantation in the affected eye as planned shortly after her retinal surgery. Fifteen years later, at the age of 20, trabeculectomy was performed at a different center and remained stable for about 9 years. Upon presentation to our hospital, the patient was using brimonidine 0.15 % twice daily, dorzolamide 2 % twice daily and timolol 0.5 % twice daily eye drops. Her vision in the affected left eye was hand motion with 38 mmHg intraocular pressure (IOP) that responded to stat medications including brimonidine 0.15 %, dorzolamide 2 % and timolol 0.5 % given in our ED and dropped to 10 mmHg. The slit lamp examination of the left eye showed a flat bleb, decompensated cornea with significant corneal edema, mid-dilated pupil, mild dislocated IOL and advanced optic nerve cup to disc ratio. The patient was discharged from the ED on full topical antiglaucoma agents in addition to oral acetazolamide and was seen after 2 weeks in the outpatient department (OPD). The patient was compliant on her drops, yet her IOP measured 40 mmHg at the time. She was booked for micro pulse- cyclophotocoagulation (MP-CPC) under local anesthesia. The procedure was conducted with MP3 micro-pulse probe (IRIDEX Inc.) where it was placed at the limbus with the notch facing the limbal side and the probe was perpendicular to the surface of the globe. The laser settings were 2000 mW power with a duty cycle of 31.33 % treating 360 degrees sparing three and nine O'clock areas. Each hemisphere is treated with 5 passes over 90 s. After the procedure, prednisolone acetate 1 % initiated every 2 h and tapered weekly over 6 weeks along with Atropine 1 % twice a day and prophylactic ofloxacin 4 times a day for one week. The IOP was controlled postoperatively with the same baseline topical medication, and she was followed up in OPD regularly. In her 1-year follow up visit the patient presented with pain and inability to close her left eyelids fully due to a protruded white corneal mass which has been increasing in size with time. The vision of the left eye was only light perception with good projection and her IOP was estimated to be 30–40 mmHg digitally. On examination, she had a large pedunculated whitish corneal mass . Ultrasound Biomicroscopy (UBM) showed a cystic mass over the cornea localized to the anterior space without invasion and the anterior segment Optical Coherence Tomography (AS- OCT) revealed a hyper-reflective lesion within the sub-epithelial space with cystic space . Initially, the provisional diagnoses were either corneal keloid or acquired corneal sub-epithelial hypertrophy. To reach definitive diagnosis, the patient was counseled to undergo surgical excision for therapeutic and diagnostic purposes. The patient was referred to a cornea specialist and after obtaining the patient's consent, the procedure was carried out in the minor treatment room under topical anesthesia. After sterilization and surgical preparation, the edge of the corneal lesion was found to be adherent to the underlying tissue. A crescent blade was used to dissect the edge to the resistance-free level. After releasing the edge, the whole lesion was successfully removed in one piece by peeling it using toothed forceps. It was found to be confined to the subepithelial space and separated from the underlying stromal bed in the center ( Video 1 ). After full excision, a bandage contact lens was applied and the patient received prophylactic topical ofloxacin 0.3 % eye drops four times a day for one week and topical ophthalmic prednisolone acetate 1 % eye drops in a tapering dose for one month. Histopathological examination of the excised tissue showed irregular thin elevated corneal epithelium with bullous changes at the periphery of the lesion . Bowman's layer was absent and the subepithelial lesion consisted of stellate-shaped and spindle cells within loose myxomatous background that is rich in glycosaminoglycans that was stained using Alcian blue . The tissue diagnosis was consistent with a corneal myxoma. The patient was seen on the first postoperative day and one week following the procedure. Visual acuity, intraocular pressure, and the corneal epithelial defect at the bed of the excised lesion were checked at follow-up. The patient showed total healing of the corneal epithelial defect after one week and did not develop recurrence over 6 months of follow-up. Later, she asked for cosmetic options and eventually underwent corneal tattooing with regular follow up visits to our OPD and a stable course.
3.855469
0.979492
sec[1]/p[0]
en
0.999998
38710120
https://doi.org/10.1016/j.ijscr.2024.109677
[ "corneal", "lesion", "topical", "twice", "drops", "mmhg", "over", "space", "epithelial", "lens" ]
[ { "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": "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" } ]
=== 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 [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 === 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... --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 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... --CHILD--> [9A72] Traumatic keratitis --- 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--> [?] Herpes simplex infection of the eye Def: A condition of the eye, caused by an infection with herpes simplex virus type 1 or 2. The condition is characterised by blepharoconjunctivitis or keratitis. Transmission is by direct contact. Confirma... --- 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--> [?] Infectious epithelial keratitis --- 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--> [9A72] Traumatic keratitis --- 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--> [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 ...
[ "[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....", "[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", "[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--> [?] Herpes simplex infection of the eye\n Def: A condition of the eye, caused by an infection with herpes simplex virus type 1 or 2. The condition is characterised by blepharoconjunctivitis or keratitis. Transmission is by direct contact. Confirma...", "[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--> [?] Infectious epithelial keratitis", "[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", "[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 ..." ]
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
The patient (II.2) is a 5-year-old girl born to non-consanguineous parents originating from and living in the USA . Both parents and her older brother are healthy. She was vaccinated against diphtheria, tetanus and pertussis (DTaP), hepatitis A and B, Haemophilus influenzae Type b (Hib), and influenza and received a conjugated polysaccharide vaccine against S taphylococcus pneumoniae (PCV13) without adverse reaction. Vaccination with live vaccines against varicella and measles, mumps, and rubella (MMR) was also uneventful. She was not vaccinated with the live Bacillus Calmette–Guérin (BCG) vaccine. From the age of 2 years, the patient suffered from recurrent upper respiratory infections and multiple cervical lymphadenitis, presenting with a large submandibular lymph node. No fever, joint symptoms, malar rash, photosensitivity, or hepatosplenomegaly was reported. Fine-needle aspiration biopsy studies of the lymph node revealed an absence of granulomas, and cotrimoxazole-susceptible Burkholderia cepacia grew in culture. The lymphadenopathy resolved on oral cotrimoxazole therapy. One month later, the patient presented with another inflamed and enlarged lymph node, in the left lower anterior cervical chain . An excisional biopsy was performed and pathology studies reported an abscess without granuloma formation. Bacterial and fungal cultures were negative. Universal microbial PCR was positive for Mycobacterium lentiflavum . The patient was treated with cotrimoxazole, isoniazid, and rifampicin. Four months after the excision biopsy, her lymph nodes had returned to a minimal size and the patient was symptom-free. Whole-blood cell counts revealed normal counts of leukocytes, including polymorphonuclear neutrophils (PMNs) and monocytes, at several time points. Lymphocyte immunophenotyping by flow cytometry confirmed that the numbers of total T, B, and NK cells but decreased relative proportions of non-class-switched (CD27 + IgD + ) and class-switched (CD27 + IgD − ) memory B cells in the patient . Her proportion of CD21 low B cells was within normal range. At presentation, the patient tested negative for ANA, anti-dsDNA, anti-ribonucleoprotein and anti-Smith antibodies, and for autoantibodies against IFN-γ. An evaluation of the patient’s circulating phagocytes with the DHR assay revealed abnormally low levels of ROS production by PMNs and monocytes in response to PMA stimulation . Based on the patient’s clinical presentation and immunological findings, a diagnosis of CGD was suspected. However, a genetic analysis of CGD-associated genes — CYBA , CYBB , NCF1 , NCF2 , NCF4 and CYBC1 — was normal, and no copy-number variants were identified. Fig. 1 Genetic and clinical features of a patient with autosomal recessive PKCδ deficiency. a Pedigree of the family, showing familial segregation of the PRKCD alleles. Generations are indicated by Roman numerals (I–II), and each individual is indicated by an Arabic numeral (1–2). The patient is represented by closed black symbol. b Images of the patient presenting left submandibular (top) and left lower anterior cervical (bottom) lymphadenitis. c Flow cytometry images of intracellular ROS production in neutrophils (top) and monocytes (bottom) from a healthy control (Ctrl) and the patient before (NS) and after PMA stimulation. d Electropherogram of exons 4 and 5 showing the variants (p.C95* and D126Y) found in the patient and their comparison with a healthy control, the patient’s parents and brother. e Minor allele frequency (MAF) and combined annotation-dependent depletion (CADD) score of the heterozygous PRKCD variants (red triangles) found in the patient, variants reported in other PKCδ-deficient patients (blue lozenges) or found in the homozygous state in gnomAD v2.1.1 (black circles). The dotted line represented the mutation significant cutoff (MSC) with its 99% confidence interval. f Schematic representation of the PRKCD gene/protein. Coding exons are numbered from 3 to 19. The PKCδ protein is presented with the C2-like domain (gray), C1 domain (light blue), ATP-binding domain (green), and the substrate-binding domain (orange). Mutations reported in PKCδ-deficient patients are indicated in black and the two heterozygous mutations found in the patient are indicated in red Table 1 Immunophenotyping in peripheral blood samples from the patient Patient Normal range T cells CD3 + T cells (percentage of lymphocytes) 52.1 56.0–75.0 CD4 + T cells (percentage of lymphocytes) 26.7 28.0–47.0 CD8 + T cells (percentage of lymphocytes) 18.2 16.0–30.0 B cells CD19 + (percentage of lymphocytes) 32.1 14–33.0 CD21 low CD38 dim (percentage of CD19 + ) 3.38 1.8–5.2 CD27 - IgD + (percentage of CD19 + ) 98.3 76·3–84.9 CD27 + IgD + (percentage of CD19 + ) 0.25 4·1–9.0 CD27 + IgD - (percentage of CD19 + ) 0.28 3·3–7.4 NK cells NK cells (percentage of lymphocytes) 14.9 4.0–17.0
4.214844
0.950195
sec[2]/sec[0]/p[0]
en
0.999997
35585372
https://doi.org/10.1007/s10875-022-01268-8
[ "cells", "lymphocytes", "against", "lymph", "variants", "domain", "parents", "healthy", "cervical", "node" ]
[ { "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": "4B0Y", "title": "Other specified immune system disorders involving white cell lineages" }, { "code": "4B0Z", "title": "Immune system disorders involving white cell lineages, unspecified" }, { "code": "DA60.5", "title": "Lymphocytic gastric ulcer" }, { "code": "DA63.Y", "title": "Other specified duodenal ulcer" }, { "code": "2B30.13", "title": "Lymphocyte depleted classical Hodgkin lymphoma" } ]
=== 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 [4B0Y] Other specified immune system disorders involving white cell lineages Also known as: Other specified immune system disorders involving white cell lineages | Abnormalities of neutrophil morphology | Acquired disorders of neutrophil morphology | Constitutional disorders of neutrophil morphology | Congenital disorders of neutrophil morphology [4B0Z] Immune system disorders involving white cell lineages, unspecified Also known as: Immune system disorders involving white cell lineages, unspecified [DA60.5] Lymphocytic gastric ulcer Definition: Gastric ulcer caused by lymphocytic gastritis. Also known as: Lymphocytic gastric ulcer [DA63.Y] Other specified duodenal ulcer Also known as: Other specified duodenal ulcer | Lymphocytic duodenal ulcer | Duodenal ulcer due to diseases classified elsewhere | Duodenal ulcer due to coeliac disease | Duodenal ulcer due to Crohn disease [2B30.13] Lymphocyte depleted classical Hodgkin lymphoma Also known as: Lymphocyte depleted classical Hodgkin lymphoma | Hodgkin disease, lymphocytic depletion | Hodgkin lymphoma, lymphocyte depletion | Hodgkin lymphocytic depletion | Classical Hodgkin lymphoma, lymphocyte depletion, diffuse fibrosis === GRAPH WALKS === --- Walk 1 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --PARENT--> [?] Symptoms, signs or clinical findings of the genitourinary system --- 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 carbohydrate metabolism --- Walk 3 --- [5C56.20] Mucolipidosis --RELATED_TO--> [?] Wolman disease Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir... --PARENT--> [?] Liver disease due to disorders of lysosomal storage Def: This is liver disease due to a group of approximately 50 rare inherited metabolic disorders that result from defects in lysosomal function.... --- Walk 4 --- [5C56.20] Mucolipidosis --EXCLUDES--> [?] Sialidosis --CHILD--> [?] Sialidosis type 1 Def: Type 1 sialidosis, also called normomorphic or 'cherry-red-spot, myoclonus' syndrome is a form of sialidosis, a lysosomal storage disease belonging to the group of oligosaccharidoses or glycoproteinos... --- 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--> [3A51.2] Sickle cell disease with crisis Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch... --- 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 ... --PARENT--> [?] Anaemias or other erythrocyte disorders
[ "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Symptoms, signs or clinical findings of the genitourinary system", "[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", "[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Wolman disease\n Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...\n --PARENT--> [?] Liver disease due to disorders of lysosomal storage\n Def: This is liver disease due to a group of approximately 50 rare inherited metabolic disorders that result from defects in lysosomal function....", "[5C56.20] Mucolipidosis\n --EXCLUDES--> [?] Sialidosis\n --CHILD--> [?] Sialidosis type 1\n Def: Type 1 sialidosis, also called normomorphic or 'cherry-red-spot, myoclonus' syndrome is a form of sialidosis, a lysosomal storage disease belonging to the group of oligosaccharidoses or glycoproteinos...", "[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--> [3A51.2] Sickle cell disease with crisis\n Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...", "[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 --PARENT--> [?] Anaemias or other erythrocyte disorders" ]
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": "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" }, { "from_icd11": "4B0Z", "icd10_code": "D7289", "icd10_title": "Other specified disorders of white blood cells" }, { "from_icd11": "4B0Z", "icd10_code": "D72820", "icd10_title": "Lymphocytosis (symptomatic)" }, { "from_icd11": "4B0Z", "icd10_code": "D72824", "icd10_title": "Basophilia" } ]
D571
Sickle-cell disease without crisis
Patient 1 (PA-1) was a 2.5-month-old boy presenting with poor appetite, soft limbs, less activity, cry, and easy to wake up for 2 months. His height was 60.0 cm (25th–50th), and his weight was 5 kg (10th). He showed underweight, low muscular tension, and enlargement of the anterior fontanelle. Biochemistry indexes revealed low serum ALP activity but high serum calcium (Ca) level (Table 2 ). Serum levels of phosphate (P), intact parathyroid hormone (i-PTH), 25 hydroxyvitamin D3 [25(OH)D3], as well as urinary calcium to creatinine ratio (Ca/Cr), were all in the normal range (Table 1 ). The X-ray of chest and lower limb long bones demonstrated the decreased bone density of the metaphysis of long bones, distal ribs, and the margin of the irregular bones, the increased distance between epiphysis and metaphysis. Abdominal ultrasound examinations showed calcium deposits in the bilateral renal medulla. He was clinically diagnosed with infantile HPP. Table 1 Clinical and biochemical features of Chinese children with HPP Disease subtype No Gender Age of onset/diagnosis Height (cm) Weight (kg) Early deciduous tooth loss Bone deformity Epilepsies Nephrocalcinosis Perinatal lethal 1 M 2 h/2 h 47.0 (3th) 3.56 (50th–75th) − + + − 2 M 12 h/12 h 45.0 (< 3th) 2.80 (10th–25th) − + − − Infantile 3 M 0.5 m/2.5 m 60.0 (25th–50th) 5 (10th) − + − + 4 F 1 m/5 m 63.0 (10th–25th) 4.3 (< 3th) − + − + 5 M 2 m/4 m 57.0 (< 3th) 5.0 (< 3th) − + − + 6 M 1 m/3 m 53.0 (< 3th) 3.6 (< 3th) − + − + 7 M 1 m/3 m 56.0 (< 3th) 4.1 (< 3th) − + − + 8 F 1 m/3 m 54.0 (< 3th) 3.7 (< 3th) − + − + 9 M 1 d/2 m < 10th NA − + + − 10 M 1 m/5 m 56.0 (< 3th) 2.59 (< 3th) − + − − 11 F NA/4 m 54.0 (< 10th) 4.23 (< 10th) − + − + 12 M 2 m/4 m 58.0 (< 3th) 5.7 (< 3th) − + − + Childhood 13 M 1 y/6 y+5 m NA 22.0 (25th–50th) − + − − 14 F 1 y/2 y + 5 m 50th NA + + − − 15 M 1 y/8 y 25th–50th NA + + − − 16 F 8 m/8 y 118 (3th) 21 (10th) + + − − 17 M 1 y/15 y 160.5 (3th–10th) NA + + − − 18 F NA/5 y 50th 50th + + − − 19 M NA/5.5 y NA NA + + − − 20 M NA/18 m NA NA + + − − 21 F 2 y/19 y 137.0 (< 3th) 35.0 (< 3th) + + − − 22 M 2 y/8 y NA NA + + − − Odonto 23 M 12 m/14 m NA NA + − − − 24 M NA/1 y + 9 m 93.0 (> 97th) 14.9 (50th–75th) + − − − 25 M 11 m/14 m 79.0 (50th–75th) 10 (25th–50th) + − − − 26 M 1.5 y/4 y 25th–50th NA + − − − 27 M 1.3 y/2.3 y 95.0 (75th–90th) 14.0 (50th–75th) + − − − 28 F 1 y/6 y 111.4 (10th–25th) 19 (25th–50th) + − − − 29 M 1 y/2 y NA NA + − − − 30 M 1 y/16 y NA NA + − − − 31 M NA/14 y NA NA + − − − 32 M NA/6 y NA NA + − − − 33 F NA/18 m NA NA + − − − Disease subtype No Gender Serum ALP (U/L) Serum Ca (mmol/L) Serum P (mmol/L) Serum 25(OH)D3 (ng/mL) Serum i-PTH (pg/mL) Urinary Ca/Cr Prognosis References Perinatal lethal 1 M < 5 ↓ Normal Normal NA NA NA Die 2 M < 5 ↓ 2.2 2.78 ↑ NA 33.4 NA Die Infantile 3 M 26 ↓ 3.46 ↑ 1.92 ↑ 19.0 12.8 0.19 NA PA-1 4 F 7 ↓ 2.80 ↑ 1.38 Normal 2.7 ↓ 1.25 ↑ Die PA-2 5 M 6 ↓ 4.22 ↑ 1.41 Normal 2.5 ↓ 2.95↑ Die PA-3 6 M 16 ↓ 3.87 ↑ 1.41 19.0 < 1 ↓ 2.35 ↑ NA PA-4 7 M 5 ↓ 3.07 ↑ 1.23 34.0 < 1 ↓ 2.26 ↑ Die PA-5 8 F 23 ↓ 4.37 ↑ 1.31 24.4 < 1 ↓ 1.51 ↑ Die PA-6 9 M 5 ↓ 3.10 ↑ 2.10 ↑ NA 2.91 ↓ NA Die 10 M 9 ↓ 3.19 ↑ Normal NA 3.5 ↓ NA NA 11 F 12 ↓ 2.90 ↑ 1.52 NA 10.36 2.70 ↑ Die 12 M 25 ↓ 3.33 ↑ 1.34 Normal < 1 ↓ NA Die Childhood 13 M 36 ↓ 2.19 2.23 ↑ NA 10 NA Live PA-7 14 F 42 ↓ 2.40 2.0 ↑ Normal 2.91 ↓ NA Live 15 M 67 ↓ 2.5 1.7 Normal 14.19 NA Live 16 F 6 ↓ 2.68 1.96 ↑ 30.7 12.6 NA Live 17 M 26 ↓ 2.48 1.89 ↑ Normal 8 ↓ NA Live 18 F 61 ↓ 2.47 1.96 ↑ 26.64 9.67 ↓ NA Live 19 M 27 ↓ NA NA NA NA NA Live 20 M 38 ↓ NA NA NA NA NA Live 21 F 6 ↓ 2.55 1.33 5.4 ↓ 17.62 NA Live 22 M 27 ↓ Normal Normal Normal NA NA Live Odonto 23 M 31 ↓ 2.25 1.79 24.1 37.7 0.33 ↑ Live PA-8 24 M 73 ↓ 2.54 2.11 ↑ NA 22.4 NA Live PA-9 25 M 11 ↓ 2.45 2.00 ↑ Normal 4.0↓ 0.84 ↑ Live PA-10 26 M 42 ↓ 2.2 1.66 Normal 3.27 ↓ NA Live 27 M 16 ↓ NA Normal ↓ 10.9 NA Live 28 F 22 ↓ 2.45 2.03 ↑ NA 8.00 ↓ NA Live 29 M 29 ↓ 2.77 ↑ 2.24 ↑ NA 16.6 NA Live 30 M 17 ↓ 2.52 1.82 ↑ Normal 54 NA Live 31 M 41.5 ↓ Normal 2.08 ↑ ↓ Normal NA Live 32 M 43.4 ↓ Normal 1.97 ↓ Normal NA Live 33 F 7 ↓ NA NA NA NA NA Live M male, F female, h hour, d day, m month, y year, ALP alkaline phosphatase, Ca calcium, P phosphate, 25(OH)D 3 25-hydroxyvitamin vitamin D 3 , i-PTH intact parathyroid hormone, Ca/Cr calcium/creatinine, Ref reference, NA not applicable, H high, L low. ↓ represents the value was below the normal range; ↑ represents the value was above the normal range Urine Ca/Cr and the blood biochemical parameters, including serum ALP, Ca, P, 25(OH)D3 and i-PTH were measured spectrophotometrically using routine assays in the central laboratory of Beijing Children’s Hospital, Capital Medical University. The normal range for serum ALP, Ca, P, 25 (OH) D3, PTH and urinary Ca/Cr were 58–400 U/L, 2.00–2.75 mmol/L, 1.10–1.80 mmol/L, 19.0–57.6 ng/mL, 10–69 pg/mL, 0.00–0.20, respectively
4.097656
0.899414
sec[1]/sec[1]/p[0]
en
0.999997
33827627
https://doi.org/10.1186/s13023-021-01798-1
[ "live", "serum", "calcium", "range", "mmol", "urinary", "bones", "infantile", "activity", "height" ]
[ { "code": "QA46.0", "title": "Single live birth" }, { "code": "QA47.2", "title": "Singleton, unspecified as to place of birth" }, { "code": "QF2Y", "title": "Difficulty or need for assistance with other specified activity" }, { "code": "QA46.2", "title": "Twins, both liveborn" }, { "code": "QA47.5", "title": "Twin, unspecified as to place of birth" }, { "code": "NE80.3", "title": "Other serum reactions" }, { "code": "5D0Y", "title": "Other specified metabolic disorders" }, { "code": "5B91.0", "title": "Hypercalcaemia" }, { "code": "4A84.Y", "title": "Other specified anaphylaxis" }, { "code": "5C50.F2", "title": "Homocarnosinosis" } ]
=== ICD-11 CODES FOUND === [QA46.0] Single live birth Definition: Live birth is the complete expulsion or extraction from a woman of a fetus, irrespective of the duration of the pregnancy, which, after such separation, shows signs of life. Also known as: Single live birth | single liveborn | outcome of delivery of single liveborn [QA47.2] Singleton, unspecified as to place of birth Also known as: Singleton, unspecified as to place of birth | liveborn infant NOS | newborn infant NOS | newborn NOS [QF2Y] Difficulty or need for assistance with other specified activity Also known as: Difficulty or need for assistance with other specified activity | Living alone with unmet need for assistance | problem with living alone [QA46.2] Twins, both liveborn Definition: Live birth is the complete expulsion or extraction from a woman of a fetus, irrespective of the duration of the pregnancy, which, after such separation, shows signs of life. Also known as: Twins, both liveborn | outcome of delivery, twins both liveborn | outcome of delivery twins NOS [QA47.5] Twin, unspecified as to place of birth Also known as: Twin, unspecified as to place of birth | liveborn twin infant NOS | newborn twin NOS [NE80.3] Other serum reactions Also known as: Other serum reactions | Allergic reaction to serum | serum allergy | Complications of vaccination, protein sickness | Protein sickness Excludes: serum hepatitis [5D0Y] Other specified metabolic disorders Also known as: Other specified metabolic disorders | Disorders of plasma-protein metabolism, not elsewhere classified | abnormal protein transport | dysproteinaemia | Absence of albumin in blood [5B91.0] Hypercalcaemia Definition: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused by dehydration secondary to urinary losses of calcium, water and other electrolytes, and to an increase in membrane potential caused by the elevation in extracellular fluid ionized calcium concentration. Patients with moderate to severe hypercalcaemia often complain of nausea and vomiting, symptoms Also known as: Hypercalcaemia | Calcium excess | elevated serum calcium | hypercalcaemic crisis | hypercalcaemic syndrome [4A84.Y] Other specified anaphylaxis Also known as: Other specified anaphylaxis | Latex-induced anaphylaxis | Anaphylaxis due to latex | Latex anaphylaxis | Anaphylactic shock due to serum [5C50.F2] Homocarnosinosis Definition: Homocarnosinosis is a metabolic defect characterised by progressive spastic diplegia, intellectual deficit and retinitis pigmentosa. This extremely rare disorder has been reported in only one family, namely a woman and three of her children. The latter showed but their mother was symptom free. It is therefore uncertain whether there is a relationship between the biochemical defect and the clinical symptoms. Inheritance in the reported family seems to be autosomal dominant. Also known as: Homocarnosinosis | Homocarnosinase deficiency | Serum carnosinase deficiency === GRAPH WALKS === --- Walk 1 --- [QA46.0] Single live birth Def: Live birth is the complete expulsion or extraction from a woman of a fetus, irrespective of the duration of the pregnancy, which, after such separation, shows signs of life.... --PARENT--> [QA46] Outcome of delivery --CHILD--> [QA46.1] Single stillbirth Def: Stillbirth is the complete expulsion or extraction from a woman of a fetus, following its death prior to the complete expulsion or extraction, at 22 or more completed weeks of gestation. Stillbirths a... --- Walk 2 --- [QA46.0] Single live birth Def: Live birth is the complete expulsion or extraction from a woman of a fetus, irrespective of the duration of the pregnancy, which, after such separation, shows signs of life.... --PARENT--> [QA46] Outcome of delivery --CHILD--> [QA46.1] Single stillbirth Def: Stillbirth is the complete expulsion or extraction from a woman of a fetus, following its death prior to the complete expulsion or extraction, at 22 or more completed weeks of gestation. Stillbirths a... --- Walk 3 --- [QA47.2] Singleton, unspecified as to place of birth --PARENT--> [QA47] Liveborn infants according to place of birth --CHILD--> [QA47.1] Singleton, born outside hospital --- Walk 4 --- [QA47.2] Singleton, unspecified as to place of birth --PARENT--> [QA47] Liveborn infants according to place of birth --CHILD--> [QA47.0] Singleton, born in hospital --- Walk 5 --- [QF2Y] Difficulty or need for assistance with other specified activity --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 6 --- [QF2Y] Difficulty or need for assistance with other specified activity --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
[ "[QA46.0] Single live birth\n Def: Live birth is the complete expulsion or extraction from a woman of a fetus, irrespective of the duration of the pregnancy, which, after such separation, shows signs of life....\n --PARENT--> [QA46] Outcome of delivery\n --CHILD--> [QA46.1] Single stillbirth\n Def: Stillbirth is the complete expulsion or extraction from a woman of a fetus, following its death prior to the complete expulsion or extraction, at 22 or more completed weeks of gestation.\nStillbirths a...", "[QA46.0] Single live birth\n Def: Live birth is the complete expulsion or extraction from a woman of a fetus, irrespective of the duration of the pregnancy, which, after such separation, shows signs of life....\n --PARENT--> [QA46] Outcome of delivery\n --CHILD--> [QA46.1] Single stillbirth\n Def: Stillbirth is the complete expulsion or extraction from a woman of a fetus, following its death prior to the complete expulsion or extraction, at 22 or more completed weeks of gestation.\nStillbirths a...", "[QA47.2] Singleton, unspecified as to place of birth\n --PARENT--> [QA47] Liveborn infants according to place of birth\n --CHILD--> [QA47.1] Singleton, born outside hospital", "[QA47.2] Singleton, unspecified as to place of birth\n --PARENT--> [QA47] Liveborn infants according to place of birth\n --CHILD--> [QA47.0] Singleton, born in hospital", "[QF2Y] Difficulty or need for assistance with other specified activity\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", "[QF2Y] Difficulty or need for assistance with other specified activity\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" ]
QA46.0
Single live birth
[ { "from_icd11": "QA46.0", "icd10_code": "Z370", "icd10_title": "Single live birth" }, { "from_icd11": "QA47.2", "icd10_code": "Z382", "icd10_title": "Single liveborn infant, unspecified as to place of birth" }, { "from_icd11": "QA46.2", "icd10_code": "Z372", "icd10_title": "Twins, both liveborn" }, { "from_icd11": "QA47.5", "icd10_code": "Z385", "icd10_title": "Twin liveborn infant, unspecified as to place of birth" }, { "from_icd11": "NE80.3", "icd10_code": "T880XXA", "icd10_title": "Infection following immunization, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8061XA", "icd10_title": "Other serum reaction due to administration of blood and blood products, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8069XA", "icd10_title": "Other serum reaction due to other serum, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8062XA", "icd10_title": "Other serum reaction due to vaccination, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T806", "icd10_title": "Other serum reactions" }, { "from_icd11": "NE80.3", "icd10_code": "T880", "icd10_title": "Infection following immunization" }, { "from_icd11": "5C50.F2", "icd10_code": "E7281", "icd10_title": "Disorders of gamma aminobutyric acid metabolism" }, { "from_icd11": "5C50.F2", "icd10_code": "E728", "icd10_title": "Other specified disorders of amino-acid metabolism" } ]
Z370
Single live birth
One day later, he experienced weakness and upper abdominal pain. On admission, clinical examination revealed a dehydrated patient with a heart rate (HR) of 130 beats/minute, a temperature of 37 °C and a systolic/diastolic blood pressure (BP) of 150/90 mmHg. He was tachypnoeic and dyspnoeic with a respiratory rate (RR) of 28 breaths/minute. He had hot and dry skin without pruritic wheals, isochoric pupils, and had no focal neurological deficit. He had normal breath sounds and a soft and non-tender abdomen. Electrocardiogram showed sinus tachycardia at a rate of 130 beats/minute. Echocardiography revealed normal chamber size and systolic function, without valvular lesions. Laboratory tests revealed high anion gap metabolic acidosis with an arterial blood pH of 6.984, bicarbonate of 2.5 mmol/litre and a serum anion gap (AG) of 26.4 mmol/litre. The arterial PO 2 and PCO 2 levels were 164.3 mmHg and 10.5 mmHg, respectively. Serum glucose was 20.79 mmol/litre, serum lactate was 1.5 mmol/litre, and urinary ketone was 11.44 mmol/litre. Serum potassium, sodium and chloride levels were 5.7 mmol/litre, 137.4 mmol/litre and 114.2 mmol/litre, respectively. Liver and renal function tests were normal, and there was a slightly elevated white blood cell count of 14.1 × 10 9 /l. He was admitted to our emergency ICU with a diagnosis of severe DKA in a patient with type 2 diabetes with an insulin allergy. Intravenous (IV) fluids, bicarbonate and potassium replacement and intermittent haemodialysis (IHD) were initiated. During the first 12 h, he received an initial 1 litre IV bolus of normal saline (0.9% NaCl) in the first hour, followed by a rate of 250 mL/hour, with 26 mmol of potassium chloride added per litre of normal saline. He also received 500 mL of sodium bicarbonate 1.4% solution over 2 h and then repeated as needed. However, his tachypnoea (35 breaths/minute) and metabolic acidosis persisted (arterial blood pH of 7.192, bicarbonate of 4.0 mmol/litre, PO 2 of 156.1 mmHg, PCO 2 of 10.3 mmHg, AG of 24.69 mmol/litre), prompting the initiation of CVVHDF using the Prismaflex® system (Gambro Lundia AB, Sweden) at the following settings: blood flow, 160 mL/minute; replacement volume, 1200 mL/hour; and dialysate, 1200 mL/hour. After 24 h of fluid resuscitation , he was haemodynamically stable and had 3500 mL of urinary output. However, he developed a decreased level of consciousness, agitation, and fatigue of his respiratory muscles. He was intubated for airway protection and was mechanically ventilated for respiratory support. Furthermore, hypotension (HR and BP were 120 beats/minute and 80/40 mmHg, respectively) occurred after intubation. A bolus of normal saline was provided, and norepinephrine was administered at a rate of 0.3 μg/kg/minute. Haemodynamic stability was recovered after 1 h, with a HR of 110 beats/minute, BP of 120/60 mmHg, and measured CVP value of 8 cmH 2 O. Arterial blood gases revealed a worsening metabolic acidosis with an arterial blood pH of 7.022, bicarbonate of 2.5 mmol/litre and a serum AG of 25.75 mmol/litre. Renal function declined with a serum creatinine level of 198 μmol/litre. Serum glucose, potassium, sodium and chloride levels were 23.32 mmol/litre, 4.35 mmol/litre, 140.5 mmol/litre and 116.6 mmol/litre, respectively. CVVHDF and IV fluids and potassium replacement were continued. Although haemodynamic and respiratory stabilities were maintained, metabolic acidosis persisted. Further skin prick testing with different types of insulin [insulin aspart (NovoRapid®), recombinant human insulin (Actrapid®, Insulatard®, Mixtard®, Humulin R®, and Humulin N®), and insulin glargine (Lantus®)] only showed positivity to two (aspart, human) of these types. However, the intradermal test with these types was positive (the time of testing as shown in Additional file 1 ). A 40 mg dose of methylprednisolone sodium succinate and 10 mg of diphenhydramine were given in the event of the possible occurrence of a severe allergic reaction, and continuous IV infusion of recombinant human insulin was initiated at a rate of 0.1 units/kg/hour. Approximately 60 min after continuous IV infusion of insulin, he developed hypotension without any signs or symptoms of allergic reactions of the skin and mucosa, and the HR was 115 beats/minute and BP was 80/40 mmHg. Infusion of insulin was temporarily stopped followed by intravenous epinephrine administration at a starting rate of 0.15 μg/kg/minute in addition to an IV bolus of 1000 mL of normal saline. He regained haemodynamic stability after 30 min, including a HR of 110 beats/minute and a BP of 120/70 mmHg, and did not require any additional administration of epinephrine after 5 h. Continuous IV infusion of recombinant human insulin at a rate of 0.1 units/kg/hour continued without any events such as signs or symptoms of allergic reactions and hypotension.
3.972656
0.970215
sec[1]/p[1]
en
0.999996
31711488
https://doi.org/10.1186/s12902-019-0451-7
[ "litre", "mmol", "minute", "mmhg", "insulin", "blood", "serum", "beats", "hour", "arterial" ]
[ { "code": "GB42.1", "title": "Albuminuria, Grade A3" }, { "code": "GB42.0", "title": "Albuminuria, Grade A2" }, { "code": "MA18.0Y", "title": "Other specified elevated blood glucose level" }, { "code": "ED5Y", "title": "Other specified disorders of epidermal keratinisation" }, { "code": "KD30.0", "title": "Birth depression with 5 minute Apgar score 0-3" }, { "code": "KD30.1", "title": "Birth depression with 5 minute Apgar score 4-6" }, { "code": "KB21.0", "title": "Severe birth asphyxia" }, { "code": "KB21.1", "title": "Mild and moderate birth asphyxia" }, { "code": "5A44", "title": "Insulin-resistance syndromes" }, { "code": "5A4Y", "title": "Other specified disorders of glucose regulation or pancreatic internal secretion" } ]
=== ICD-11 CODES FOUND === [GB42.1] Albuminuria, Grade A3 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A3 | albuminuria >30 mg/mmol creatinine | macroalbuminuria | overt albuminuria | overt nephropathy [GB42.0] Albuminuria, Grade A2 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A2 | microalbuminuria | incipient nephropathy | mild to moderate albuminuria | albuminuria 3-30 mg/mmol creatinine [MA18.0Y] Other specified elevated blood glucose level Also known as: Other specified elevated blood glucose level | Blood glucose between 8.0 - 11.9 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L pre-meal or fasting | Blood glucose greater than or equal to 14.0 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L post-meal or not otherwise specified [ED5Y] Other specified disorders of epidermal keratinisation Also known as: Other specified disorders of epidermal keratinisation | Follicular digitate keratoses | Lichen spinulosus | Keratosis spinulosa | Keratosis circumscripta [KD30.0] Birth depression with 5 minute Apgar score 0-3 Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth. Also known as: Birth depression with 5 minute Apgar score 0-3 [KD30.1] Birth depression with 5 minute Apgar score 4-6 Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth. Also known as: Birth depression with 5 minute Apgar score 4-6 [KB21.0] Severe birth asphyxia Definition: Pulse less than 100 per minute at birth and falling or steady, respiration absent or gasping, colour poor, tone absent. Also known as: Severe birth asphyxia | severe perinatal hypoxia | asphyxia pallida of newborn | Asphyxia with 5-minute Apgar score 0-3 | newborn severe asphyxia [KB21.1] Mild and moderate birth asphyxia Definition: Normal respiration not established within one minute, but heart rate 100 or above, some muscle tone present, some response to stimulation. Also known as: Mild and moderate birth asphyxia | asphyxia livida of newborn | Asphyxia with 5-minute Apgar score 4-7 | Blue asphyxia [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 [5A4Y] Other specified disorders of glucose regulation or pancreatic internal secretion Also known as: Other specified disorders of glucose regulation or pancreatic internal secretion | Other hypoglycaemia | Hyperinsulinaemia | hyperinsulinism | functional hyperinsulinaemia === GRAPH WALKS === --- Walk 1 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --PARENT--> [?] Glomerular diseases Def: Any disease characterised by pathological changes to the glomerulus.... --- Walk 2 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --CHILD--> [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --- Walk 3 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Orthostatic proteinuria Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position.... --- Walk 4 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --CHILD--> [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --- Walk 5 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --RELATED_TO--> [?] Neonatal hyperglycaemia --- Walk 6 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --RELATED_TO--> [?] Neonatal hyperglycaemia
[ "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --PARENT--> [?] Glomerular diseases\n Def: Any disease characterised by pathological changes to the glomerulus....", "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --CHILD--> [GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Orthostatic proteinuria\n Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position....", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --CHILD--> [GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --RELATED_TO--> [?] Neonatal hyperglycaemia", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --RELATED_TO--> [?] Neonatal hyperglycaemia" ]
GB42.1
Albuminuria, Grade A3
[ { "from_icd11": "KD30.0", "icd10_code": "P210", "icd10_title": "" }, { "from_icd11": "KD30.1", "icd10_code": "P211", "icd10_title": "" }, { "from_icd11": "5A44", "icd10_code": "E10-E14", "icd10_title": "" } ]
P210
A 34-year-old Chinese male visited his local tertiary hospital due to progressively worsening occipital headache for the past 4 days, without showing any other symptoms of fever, projectile vomiting and so on. His medical history showed that he had had cryptococcal meningitis and HIV infection for about 1 year, and he had been receiving (with good compliance) fluconazole and tenofovir-lamivudine-dolutegravir based antiretroviral therapy (ART) during the same time period. The levels of the inflammatory markers were normal (Leukocytes 5.61 * 10 9 cells/mL, C-reactive protein 7 mg/dL). His neurological signs showed no abnormal indications. Head Computed Tomography (CT) scan revealed no abnormalities. The lumber puncture was performed and the test result of CSF is shown in Table 1 . It shows rising levels of OP, lymphocytes and protein in CSF. The cryptococcus capsular antigen test result of CSF was positive but the results for the gram staining and culture study were negative. The patient was diagnosed with cryptococcal meningitis and was given fluconazole (400 mg, QD) continuously and TMP-SMX (0.48, QD) for 1 week by the doctor at the local hospital. However, his headache problem was not resolved. Then he came to our institution, the Infectious Disease Department of the First Affiliated Hospital, School of Medicine, Zhejiang University, and was hospitalized. Upon arrival, the patient's body temperature was 36.7 C, pulse rate was 95 beats/min, blood pressure was 138/97 mmHg, respiratory rate was 23 breaths/min, and finger pulse SpO2 was 98%. He was suffering from headache but his neurological signs were normal. The laboratory results are as follows: white blood cell count 7.0 × 10 9 /L, with a neutrophil ratio of 42%, hemoglobin 150 g/L, and platelet count 294 × 10 9 /L; C-reactive protein (CRP)1.8 mg/L; CD4 count 171 cells/μL; normal blood biochemical; negative 1,3-beta-D-glucan test (G test) and galactomannan test (GM test) results (0.1 μg/L). The IgG antibodies of Epstein-Barr virus (EBV) and Human Cytomegalovirus (CMV) were positive, while the IgM antibodies and the test of the nucleic acid of EBV and CMV were negative. The test result for mycobacterium tuberculosis (MTB) was negative based on the blood test with T-SPOT, and the result for cryptococcus capsular antigen test of the blood was positive. The chest CT scan and echocardiography results were normal. The lumber puncture was performed on day 2 and the opening pressure was 285 (cm H2O). The test result of CSF is shown in Table 1 . The cryptococcus capsular antigen test of CSF was positive. An India Ink microscopy on the CSF sample for cryptococcus was also performed and the result was negative. The results of the blood and CSF smears of bacteria and fungi were negative. The results of the acid-fast staining of CSF smear and GeneXpert were both negative for MTB. The test of the nucleic acid of CMV and EBV in CSF was negative. Based on the negative gram staining and culture study results of CSF provided by the local hospital and the above results, the CSF sample was sent to the laboratory for conventional tests and NGS test (using the Illumina Platform, IngeniGen. Ltd, Zhejiang, China) for pathogen-induced meningitis verification. Contrast-enhanced and diffusion-weighted MRI (3.0T) was performed on day 3, and the partial cerebellar surface enhancement was revealed , which matched the manifestation of cryptococcal meningitis, and no abnormal signals were detected in the cerebral parenchyma. Two days later, the NGS results showed that streptococcus suis (6 reads) and streptococcus mitis (1 reads) were found in CSF. The results of the blood and CSF culture of bacteria and fungi were still negative on day 5. So, we inquired the patient's medical history again, and he told us he had had close contact with a truck transporting pigs and had choked on water in a water park 2 weeks before his admission. Based on the test reports and his contact history, the diagnosis of streptococcus suis infection was made and intravenous Ceftriaxone (2.0, QD) was given. The patient's headache problem was resolved gradually. A second lumber puncture performed on day 12 revealed improved conditions of CSF (see Table 1 ), with negative gram staining and culture study results. Ceftriaxone was given to the patient for another 2 weeks and then oral moxifloxacin (0.4, QD) for 2 days. The third lumber puncture was performed on day 17, showing continuous conditional improvement of CSF. The patient was discharged in stable condition on day 21 after 1 week of receiving moxifloxacin. Three weeks later, we performed the fourth lumber puncture to confirm that the meningitis infection was cleared, but the patient's OP level was still abnormal, so fluconazole was given continuously until the OP level and cryptococcus capsular antigen test turned normal 6 months later.
4.035156
0.977051
sec[1]/p[0]
en
0.999997
34778300
https://doi.org/10.3389/fmed.2021.736064
[ "blood", "meningitis", "lumber", "puncture", "cryptococcus", "headache", "based", "capsular", "antigen", "staining" ]
[ { "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": "1D01.Z", "title": "Infectious meningitis, unspecified" }, { "code": "1C8E.Z", "title": "Viral meningitis, unspecified" }, { "code": "8E40.2", "title": "Inflammatory meningitis" }, { "code": "8E40.Y", "title": "Other specified disorders of the meninges excluding infection" }, { "code": "1D01.0Z", "title": "Bacterial meningitis, 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 [1D01.Z] Infectious meningitis, unspecified Also known as: Infectious meningitis, unspecified | Infectious meningitis, not elsewhere classified | acute meningomyelitis | septic meningitis NOS | infectious meningitis NEC [1C8E.Z] Viral meningitis, unspecified Also known as: Viral meningitis, unspecified | Viral meningitis, not elsewhere classified | viral meningitis NEC | viral meningitis NOS | viral meningitis, unspecified [8E40.2] Inflammatory meningitis Definition: A general term to describe a group of disorders in which there is Inflammation of the meninges due to an underlying inflammatory disorder. The syndrome is clinically characterised by headache, neck stiffness, fever and photophobia. Other central and peripheral nervous system manifestations may be present. Non-neurological features, including skin, eye and organ involvement may also be present. Diagnosis may be aided by serological testing, neuroimaging and if appropriate a tissue biopsy. Spinal Also known as: Inflammatory meningitis | Inflammatory meningitis due to certain specified cause | Meningitis due to sarcoidosis | Meningitis due to Behçet disease | Meningitis due to Wegener granulomatosis [8E40.Y] Other specified disorders of the meninges excluding infection Also known as: Other specified disorders of the meninges excluding infection | Noninfectious meningitis | noninfective serous meningitis | Meningitis due to medication | Meningitis secondary to medication [1D01.0Z] Bacterial meningitis, unspecified Also known as: Bacterial meningitis, unspecified | Bacterial meningitis | BM - [bacterial meningitis] | leptomeningitis bacterial | pachymeningitis bacterial === 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.... --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--> [MF50.41] 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--> [MA12.0] Finding of opiate drug 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--> [MA12.1] Finding of cocaine 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 --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 --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--> [MF50.41] 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--> [MA12.0] Finding of opiate drug 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--> [MA12.1] Finding of cocaine 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
In the presented case, the leading complaint which brought the patient to the emergency department was the newly emerged feeling of numbness in the area of the left lower lip and the chin. One must be aware that the most diverse of diseases can be causative for the purely syndromal and descriptive NCS. The literature describes dental disorders such as abscesses, root cysts, mental nerve trauma due to ill-fitting dentures, or also lesions of the mandible following fractures, following osteomyelitis, osteonecrosis induced by bisphosphonate treatment or odontogenic infections . Malignancies, in particular mandibular metastases of breast cancer or prostate cancer, can also lead to NCS . The prognosis for patients with NCS due to malignancies is poor, with a mean survival of 6 months or less . However, neurological diseases can also cause NCS: Peripheral-neurological lesions such as diabetic polyneuropathy or chronic inflammatory demyelinating polyneuropathy (CIDP) , Lyme’s disease, temporal arteritis , but also central-neurological lesions as in multiple sclerosis have all been described as causative. The diverse amount of possible disorders which can clinically manifest as NCS (Table 1 ), partly involved with a poor prognosis and extensive treatments for the patient, stands in contrast to the initially few deficits in NCS and harbors the danger of trivializing and overlooking it. It is important to view NCS as a “red flag” and to clarify its cause. In the current case, a lacunar ischemia of the right thalamus was found to be the cause of the NCS . The “pure sensory stroke”, in addition to the “pure motor stroke” and the “dysarthria-clumsy hand syndrome”, is a classic lacunar infarct syndrome. Moreover, the literature describes cases of a pure sensory infarct syndrome, which affects the contralateral finger and the perioral area: the Cheiro-Oral Syndrome (COS), the cause of which is mostly a thalamic lacunar infarction . As a very rare variant of this syndrome, there is an isolated sensory deficit of the face following thalamic lacunar infarction, which to our knowledge has only been published in three cases so far [ 13 – 15 ]. In these three cases, either the whole contralateral side of the face or parts of the distribution territory of the three main trigeminal branches were affected. A circumscribed unilateral numbness corresponding to the distribution area of the mental nerve in the sense of an NCS, as in the case presented here, as a consequence of a thalamic lacunar infarction, has to the best of our knowledge not been previously described in the literature. Topographically, sensory efferents from the upper extremity lie in the ventral posterolateral (VPL) nucleus of the thalamus, while the afferents from the face and the front 2/3 of the tongue lie in the neighboring ventral posteromedial (VPM) nucleus. Lesions of these two core regions lead to COS, which is associated with contralateral hypoaesthesia of the face and fingers . In one case, a lesion at the border between VPL and VPM is described (high signal intensity in T1-weigthed MR imaging), which clinically lead to deafness of the corner of the mouth and the first to third fingers (COS) . Table 1 Etiology of Numb Chin Syndrome (NCS) Nonmalignant Etiologies Malignant Etiologies Dental or iatrogenic Etiologies Systemic or other Etiologies Infectious Non-infectious Infectious Autoimmune Other Oropharyngal Other Mandibular osteomyelitis Periapical infection Periapical abscess Mandibular surgery Orthognathic surgery Benign tumor Odontogenic cysts Facial trauma Dental anesthesia Salivary gland biopsy HIV Syphilis Lyme disease Chronic inflammatory de-myelinating polyneuropathy (CIDP) Sarcoidosis Multiple sclerosis Systemic lupus erthematosus Giant cell arteritis Primary arteritis nodosa Sjögren’s syndrome Sickle cell disease Diabetic polyneuropathy Amyloidosis Aneurysms Bisphosponate therapy Mefloquine Nasopharyngeal cancer Oral cavity/oropharyngeal cancer Breast cancer Lung cancer Hematological malignancy Lhymphoma Renal tumor Malignant melanoma Gastrointestinal cancer Multiple myeloma Prostate cancer Glioblastoma Medulloblastoma Osteosarcoma Rhabdomyosarcoma Thyroid cancer Fig. 1 MR images and schematic drawing. A/B : Diffusion weighted coronal ( A ) and transversal ( B ) B1000 MRI sequences showing hyperintense signal as a correlate of restricted diffusion in the right thalamus (arrow). C : Transversal T2 FLAIR sequence with correlating hyperintense signal within the ischemic lesion of the right thalamus (arrow). Thalamus (a), pulvinar (dotted arrow), globus pallidus (b), putamen (c), caudate nucleus (d). D : Thalamus (a) schematic drawing, Ncl. ventralis anterior (VA), Ncl. ventralis lateralis (VL), pulvinar (Pu), Ncl. ventralis posterolateralis (VPL), Ncl. ventralis posteromedialis (VPM), hyperintense signal (red); modified after
4.386719
0.619629
sec[2]/p[0]
en
0.999997
31783736
https://doi.org/10.1186/s12883-019-1525-x
[ "cancer", "which", "thalamus", "lacunar", "lesions", "cause", "polyneuropathy", "sensory", "face", "signal" ]
[ { "code": "2D4Z", "title": "Unspecified malignant neoplasms of unspecified sites" }, { "code": "2C0Z", "title": "Malignant neoplasms of intestine, unspecified" }, { "code": "2B5Z", "title": "Malignant mesenchymal neoplasm of unspecified type" }, { "code": "2E2Z", "title": "Malignant neoplasm metastasis, unspecified" }, { "code": "2D42", "title": "Malignant neoplasms of ill-defined sites" }, { "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": "2A00.5", "title": "Primary neoplasm of brain of unknown or unspecified type" } ]
=== ICD-11 CODES FOUND === [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 [2C0Z] Malignant neoplasms of intestine, unspecified Also known as: Malignant neoplasms of intestine, unspecified | cancer of intestine | malignant neoplasm of intestine NOS | malignant tumour of intestine NOS | intestinal cancer NOS [2B5Z] Malignant mesenchymal neoplasm of unspecified type Also known as: Malignant mesenchymal neoplasm of unspecified type | calvarium cancer | ethmoid bone cancer | facial bone cancer | frontal bone cancer [2E2Z] Malignant neoplasm metastasis, unspecified Also known as: Malignant neoplasm metastasis, unspecified | secondary malignant neoplasm | metastasis | metastases | disseminated metastases [2D42] Malignant neoplasms of ill-defined sites Definition: Malignant neoplasms of ill defined sites is used for cases where the documentation refers to a site that includes multiple organ systems and tissue types that should be coded separately. Also known as: Malignant neoplasms of ill-defined sites | Malignant neoplasm of ill-defined site of head, face or neck | Malignant neoplasm of nose NOS | Primary malignant neoplasm of cheek | malignant neoplasm of cheek NOS [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 [2A00.5] Primary neoplasm of brain of unknown or unspecified type Also known as: Primary neoplasm of brain of unknown or unspecified type | brain tumour NOS | cerebrum neoplasia NOS | cerebral neoplasia NOS | Hypothalamic neoplasm === GRAPH WALKS === --- Walk 1 --- [2D4Z] Unspecified malignant neoplasms of unspecified sites --PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites --EXCLUDES--> [?] Malignant mesenchymal neoplasms Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn... --- Walk 2 --- [2D4Z] Unspecified malignant neoplasms of unspecified sites --PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites --CHILD--> [2D42] Malignant neoplasms of ill-defined sites Def: Malignant neoplasms of ill defined sites is used for cases where the documentation refers to a site that includes multiple organ systems and tissue types that should be coded separately.... --- Walk 3 --- [2C0Z] Malignant neoplasms of intestine, unspecified --PARENT--> [?] Malignant neoplasms of intestine --EXCLUDES--> [?] Malignant mesenchymal neoplasms Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn... --- Walk 4 --- [2C0Z] Malignant neoplasms of intestine, unspecified --PARENT--> [?] Malignant neoplasms of intestine --CHILD--> [?] Malignant neoplasms of large intestine --- Walk 5 --- [2B5Z] Malignant mesenchymal neoplasm of unspecified type --PARENT--> [?] Malignant mesenchymal neoplasms Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn... --EXCLUDES--> [?] Mesenchymal tumours of meninges --- Walk 6 --- [2B5Z] Malignant mesenchymal neoplasm of unspecified type --PARENT--> [?] Malignant mesenchymal neoplasms Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn... --CHILD--> [2B52] Ewing sarcoma, primary site Def: A small round cell tumour that lacks morphologic, immunohistochemical, and electron microscopic evidence of neuroectodermal differentiation. It represents one of the two ends of the spectrum called Ew...
[ "[2D4Z] Unspecified malignant neoplasms of unspecified sites\n --PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites\n --EXCLUDES--> [?] Malignant mesenchymal neoplasms\n Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...", "[2D4Z] Unspecified malignant neoplasms of unspecified sites\n --PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites\n --CHILD--> [2D42] Malignant neoplasms of ill-defined sites\n Def: Malignant neoplasms of ill defined sites is used for cases where the documentation refers to a site that includes multiple organ systems and tissue types that should be coded separately....", "[2C0Z] Malignant neoplasms of intestine, unspecified\n --PARENT--> [?] Malignant neoplasms of intestine\n --EXCLUDES--> [?] Malignant mesenchymal neoplasms\n Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...", "[2C0Z] Malignant neoplasms of intestine, unspecified\n --PARENT--> [?] Malignant neoplasms of intestine\n --CHILD--> [?] Malignant neoplasms of large intestine", "[2B5Z] Malignant mesenchymal neoplasm of unspecified type\n --PARENT--> [?] Malignant mesenchymal neoplasms\n Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...\n --EXCLUDES--> [?] Mesenchymal tumours of meninges", "[2B5Z] Malignant mesenchymal neoplasm of unspecified type\n --PARENT--> [?] Malignant mesenchymal neoplasms\n Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...\n --CHILD--> [2B52] Ewing sarcoma, primary site\n Def: A small round cell tumour that lacks morphologic, immunohistochemical, and electron microscopic evidence of neuroectodermal differentiation. It represents one of the two ends of the spectrum called Ew..." ]
2D4Z
Unspecified malignant neoplasms of unspecified sites
[ { "from_icd11": "2D4Z", "icd10_code": "C802", "icd10_title": "Malignant neoplasm associated with transplanted organ" }, { "from_icd11": "2D4Z", "icd10_code": "C7650", "icd10_title": "Malignant neoplasm of unspecified lower limb" }, { "from_icd11": "2D4Z", "icd10_code": "C7642", "icd10_title": "Malignant neoplasm of left upper limb" }, { "from_icd11": "2D4Z", "icd10_code": "C7640", "icd10_title": "Malignant neoplasm of unspecified upper limb" }, { "from_icd11": "2D4Z", "icd10_code": "C7652", "icd10_title": "Malignant neoplasm of left lower limb" }, { "from_icd11": "2D4Z", "icd10_code": "C7651", "icd10_title": "Malignant neoplasm of right lower limb" }, { "from_icd11": "2D4Z", "icd10_code": "C7641", "icd10_title": "Malignant neoplasm of right upper limb" }, { "from_icd11": "2D4Z", "icd10_code": "C801", "icd10_title": "Malignant (primary) neoplasm, unspecified" }, { "from_icd11": "2D4Z", "icd10_code": "C768", "icd10_title": "Malignant neoplasm of other specified ill-defined sites" }, { "from_icd11": "2D4Z", "icd10_code": "C761", "icd10_title": "Malignant neoplasm of thorax" }, { "from_icd11": "2D4Z", "icd10_code": "C762", "icd10_title": "Malignant neoplasm of abdomen" }, { "from_icd11": "2D4Z", "icd10_code": "C763", "icd10_title": "Malignant neoplasm of pelvis" }, { "from_icd11": "2D4Z", "icd10_code": "C800", "icd10_title": "Disseminated malignant neoplasm, unspecified" }, { "from_icd11": "2D4Z", "icd10_code": "C76-C80", "icd10_title": "" }, { "from_icd11": "2D4Z", "icd10_code": "C76", "icd10_title": "Malignant neoplasm of other and ill-defined sites" } ]
C802
Malignant neoplasm associated with transplanted organ
We report a rare case of nephrotic syndrome in a 33-year-old multipara that might be attributed to pregnancy-related crescentic IgA nephropathy. There has been insufficient data regarding the new onset of glomerulonephritis or aggravation of subclinical nephropathies in the course of gestation . Although the precise mechanisms remain unclear, we assume that crescentic IgA nephropathy is related to pregnancy for two reasons. First, no urinary abnormalities were observed before 36 weeks of gestation. Second, renal biopsy revealed that most crescents were cellular, with no global sclerosis. These findings suggest a relatively new-onset crescentic IgA nephropathy during pregnancy. Excessive complement activation may be involved in crescent formation, and complement inhibition with the humanized anti-C5 monoclonal antibody eculizumab may be beneficial for crescentic IgA nephropathy . In general, complement activation may play a key role in placental formation and pregnancy maintenance . It is possible that crescentic IgA nephropathy is related to pregnancy through complement activation. In this case, plasma C3, C4, and CH50 levels were normal. However, further complements, including factor H, factor B, C1q, mannose-binding lectin, C3c, C3a, C5a, and soluble C5b-9 have not been analyzed. Further studies are needed to assess whether pregnancy induces crescentic IgA nephropathy through complement activation. Crescent glomerulonephritis includes pauci-immune, immune-complex-mediated, and anti-glomerular basement membrane diseases. Macrophage inflammatory protein-1α may be involved in the development of cellular crescents in crescentic glomerulonephritis . In this case, there was no fibrinoid necrosis in the glomeruli and small arteries, and ANCA and anti-GBM antibody data were negative. Therefore, ANCA-associated vasculitis and anti-GBM diseases are less likely. IgA nephropathy is an immune-complex-mediated glomerulonephritis that is recognized as an autoimmune renal disease due to increased circulating levels of IgA1 with galactose-deficient hinge region O-glycans and antiglycan autoantibodies . There are some reports of Henoch-Schonlein purpura (HSP) during pregnancy . In this case, the possibility of HSP was low because of the absence of purpura, arthralgia, and abdominal pain. HSP and IgA nephropathy are considered related diseases resulting from the glomerular deposition of aberrantly glycosylated IgA1 . There are a number of parameters other than the complement that could be altered due to pregnancy, including the gut microbiota , which might affect levels of IgA1 glycosylation, and the galactose-deficient IgA1 immune complex. Although the effects of pregnancy on the course of HSP and IgA nephropathy remain unclear, a similar mechanism may be involved, and further research is needed. Secondary forms of IgA nephropathy have been reported and include gastrointestinal and liver disorders, infections, autoimmune disorders, and neoplasia . Although we could not differentiate all diseases, our findings indicated that secondary IgA nephropathy was less likely. Pre-eclampsia is the most frequent renal complication of pregnancy and is characterized by hypertension and proteinuria after 20 weeks of gestation. Pre-eclampsia is characterized by glomerular capillary endotheliosis , and some patients do not have hypertension . The rate of pre-existing renal disease in preeclamptic women was 71%, including IgA nephropathy (approximately 40%) . It is difficult to distinguish between preexisting IgA nephropathy and preeclampsia during late pregnancy. In this report, the patient was normotensive before, during, or after pregnancy with no glomerular capillary endotheliosis. She had no organ symptoms, such as cerebrovascular events, hepatic failure, or HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) before or after 36 weeks. In addition, the presence of hematuria is not typical of preeclampsia . Although the pathogenic role of many immunologic changes occurring during pregnancy remains unclear, we assume that pregnancy possibly triggered the new onset of crescentic IgA nephropathy or the aggravation of subclinical IgA nephropathy. In the present case, according to the International IgA nephropathy Prediction Tool , the risk of a 50% decline in estimated GFR or progression to end-stage renal disease 2 years after the landmark time post biopsy was 39.0%. Thus, it could be proposed that early diagnosis and treatment of crescentic IgA nephropathy, including pulse steroids followed by high-dose oral glucocorticoids and tonsillectomy, were crucial to achieve recovery from nephrotic syndrome and maintain renal function. In conclusion, this report describes an intriguing case in which pregnancy may trigger a new onset of crescentic IgA nephropathy or aggravation of subclinical IgA nephropathy.
4.320313
0.898438
sec[2]/p[0]
en
0.999997
PMC10084611
https://doi.org/10.1186/s12882-023-03152-y
[ "nephropathy", "pregnancy", "crescentic", "that", "renal", "complement", "this", "related", "onset", "glomerulonephritis" ]
[ { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "GB56.Y", "title": "Other specified obstructive or reflux nephropathy" }, { "code": "JA65.Y", "title": "Maternal care for other specified conditions predominantly related to pregnancy" }, { "code": "GB55.1", "title": "Nephropathy induced by heavy metals" }, { "code": "GB90.3", "title": "Ischaemia or infarction of kidney" }, { "code": "JA80.Z", "title": "Maternal care related to unspecified multiple gestation" }, { "code": "JA01.1", "title": "Tubal pregnancy" }, { "code": "QA40", "title": "Pregnancy examination or test" }, { "code": "JA61.Y", "title": "Other specified venous complications in pregnancy" }, { "code": "JA01.Y", "title": "Other specified ectopic pregnancy" } ]
=== ICD-11 CODES FOUND === [GB56.Y] Other specified obstructive or reflux nephropathy Also known as: Other specified obstructive or reflux nephropathy | Obstructive nephropathy | Other obstructive or reflux uropathy, acquired | Other obstructive or reflux uropathy, congenital [JA65.Y] Maternal care for other specified conditions predominantly related to pregnancy Also known as: Maternal care for other specified conditions predominantly related to pregnancy | Exhaustion complicating pregnancy | Fatigue complicating pregnancy | pregnancy-related exhaustion and fatigue | Gravidarum retinitis [GB55.1] Nephropathy induced by heavy metals Definition: A disease of the kidney, caused by exposure to heavy, nephrotoxic metals such as cadmium, lead, copper, and mercury. This disease is characterised by tubular damage, renal insufficiency, interstitial fibrosis, necrosis, or renal dysfunction. This disease may also present with hypertension, proteinuria, hyperuricaemia, aminoaciduria, or other symptoms characteristic of chronic kidney disease. Also known as: Nephropathy induced by heavy metals | heavy metal nephropathy | toxic nephropathy from heavy metals | Lead nephropathy | lead nephritis [GB90.3] Ischaemia or infarction of kidney Also known as: Ischaemia or infarction of kidney | Complete arterial ischaemia or infarction of kidney | Complete arterial ischaemia or infarction of kidney due to renal artery obstruction | obstructed renal artery | renal artery clot Excludes: Atherosclerosis of renal artery | Goldblatt kidney | Congenital renal artery stenosis [JA80.Z] Maternal care related to unspecified multiple gestation Also known as: Maternal care related to unspecified multiple gestation | Maternal care related to multiple gestation | multiple gestation, unspecified, unspecified trimester | multiple pregnancy | Multiple pregnancy NOS [JA01.1] Tubal pregnancy Definition: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy. Also known as: Tubal pregnancy | Fallopian pregnancy | fallopian tube pregnancy | Tubal abortion | Rupture of fallopian tube due to pregnancy Includes: Fallopian pregnancy | Tubal abortion [QA40] Pregnancy examination or test Also known as: Pregnancy examination or test | pregnancy examination | pregnancy test | Pregnancy examination or test, pregnancy not confirmed | pregnancy not yet confirmed [JA61.Y] Other specified venous complications in pregnancy Also known as: Other specified venous complications in pregnancy | Venous thrombosis in pregnancy | antepartum thrombosis NOS | Gestational thrombosis NOS | thrombosis in pregnancy NOS [JA01.Y] Other specified ectopic pregnancy Also known as: Other specified ectopic pregnancy | Cornual gestation or pregnancy | cornual gestation | cornual pregnancy | Cervical pregnancy === GRAPH WALKS === --- Walk 1 --- [GB56.Y] Other specified obstructive or reflux nephropathy --PARENT--> [GB56] Obstructive or reflux nephropathy Def: Distention of the pelvis and calices of the kidney with urine as a result of obstruction of the ureter or as a result of a vesicoureteral or vesicoureterorenal reflux of urine. Diffuse or focal cortic... --EXCLUDES--> [?] Urolithiasis Def: A condition of the urinary system, caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. Th... --- Walk 2 --- [GB56.Y] Other specified obstructive or reflux nephropathy --PARENT--> [GB56] Obstructive or reflux nephropathy Def: Distention of the pelvis and calices of the kidney with urine as a result of obstruction of the ureter or as a result of a vesicoureteral or vesicoureterorenal reflux of urine. Diffuse or focal cortic... --EXCLUDES--> [?] Urolithiasis Def: A condition of the urinary system, caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. Th... --- Walk 3 --- [JA65.Y] Maternal care for other specified conditions predominantly related to pregnancy --PARENT--> [JA65] 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--> [JA65.0] Liver disorders in pregnancy, childbirth or the puerperium Def: Any disorder affecting females, characterised by pathological changes to the liver that occur during pregnancy, childbirth, and the puerperium.... --- Walk 4 --- [JA65.Y] Maternal care for other specified conditions predominantly related to pregnancy --PARENT--> [JA65] 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--> [JA65.2] Excessive weight gain in pregnancy Def: Any reason for encounter to assess (or care for) a mother for excessive weight gain during pregnancy.... --- Walk 5 --- [GB55.1] Nephropathy induced by heavy metals Def: A disease of the kidney, caused by exposure to heavy, nephrotoxic metals such as cadmium, lead, copper, and mercury. This disease is characterised by tubular damage, renal insufficiency, interstitial ... --PARENT--> [GB55] Chronic tubulo-interstitial nephritis Def: A disease characterised by inflammation of and damage to tubules and/or the interstitium of the kidney, interstitial scarring, fibrosis and tubule atrophy resulting in progressive chronic renal insuff... --CHILD--> [GB55.2] Chronic urate nephropathy Def: A condition characterised by deposition of urate crystals in the tubules and interstitium, partial or complete obstruction of the collecting ducts, renal pelvis, or ureter, hyperuricaemia disproportio... --- Walk 6 --- [GB55.1] Nephropathy induced by heavy metals Def: A disease of the kidney, caused by exposure to heavy, nephrotoxic metals such as cadmium, lead, copper, and mercury. This disease is characterised by tubular damage, renal insufficiency, interstitial ... --PARENT--> [GB55] Chronic tubulo-interstitial nephritis Def: A disease characterised by inflammation of and damage to tubules and/or the interstitium of the kidney, interstitial scarring, fibrosis and tubule atrophy resulting in progressive chronic renal insuff... --EXCLUDES--> [?] Calculus of upper urinary tract Def: A condition of the urinary system, caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. Th...
[ "[GB56.Y] Other specified obstructive or reflux nephropathy\n --PARENT--> [GB56] Obstructive or reflux nephropathy\n Def: Distention of the pelvis and calices of the kidney with urine as a result of obstruction of the ureter or as a result of a vesicoureteral or vesicoureterorenal reflux of urine. Diffuse or focal cortic...\n --EXCLUDES--> [?] Urolithiasis\n Def: A condition of the urinary system, caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. Th...", "[GB56.Y] Other specified obstructive or reflux nephropathy\n --PARENT--> [GB56] Obstructive or reflux nephropathy\n Def: Distention of the pelvis and calices of the kidney with urine as a result of obstruction of the ureter or as a result of a vesicoureteral or vesicoureterorenal reflux of urine. Diffuse or focal cortic...\n --EXCLUDES--> [?] Urolithiasis\n Def: A condition of the urinary system, caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. Th...", "[JA65.Y] Maternal care for other specified conditions predominantly related to pregnancy\n --PARENT--> [JA65] 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--> [JA65.0] Liver disorders in pregnancy, childbirth or the puerperium\n Def: Any disorder affecting females, characterised by pathological changes to the liver that occur during pregnancy, childbirth, and the puerperium....", "[JA65.Y] Maternal care for other specified conditions predominantly related to pregnancy\n --PARENT--> [JA65] 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--> [JA65.2] Excessive weight gain in pregnancy\n Def: Any reason for encounter to assess (or care for) a mother for excessive weight gain during pregnancy....", "[GB55.1] Nephropathy induced by heavy metals\n Def: A disease of the kidney, caused by exposure to heavy, nephrotoxic metals such as cadmium, lead, copper, and mercury. This disease is characterised by tubular damage, renal insufficiency, interstitial ...\n --PARENT--> [GB55] Chronic tubulo-interstitial nephritis\n Def: A disease characterised by inflammation of and damage to tubules and/or the interstitium of the kidney, interstitial scarring, fibrosis and tubule atrophy resulting in progressive chronic renal insuff...\n --CHILD--> [GB55.2] Chronic urate nephropathy\n Def: A condition characterised by deposition of urate crystals in the tubules and interstitium, partial or complete obstruction of the collecting ducts, renal pelvis, or ureter, hyperuricaemia disproportio...", "[GB55.1] Nephropathy induced by heavy metals\n Def: A disease of the kidney, caused by exposure to heavy, nephrotoxic metals such as cadmium, lead, copper, and mercury. This disease is characterised by tubular damage, renal insufficiency, interstitial ...\n --PARENT--> [GB55] Chronic tubulo-interstitial nephritis\n Def: A disease characterised by inflammation of and damage to tubules and/or the interstitium of the kidney, interstitial scarring, fibrosis and tubule atrophy resulting in progressive chronic renal insuff...\n --EXCLUDES--> [?] Calculus of upper urinary tract\n Def: A condition of the urinary system, caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. Th..." ]
GC2Z&XA6KU8
Disease of kidney, not elsewhere classified
[ { "from_icd11": "JA65.Y", "icd10_code": "O26891 ", "icd10_title": "" }, { "from_icd11": "JA65.Y", "icd10_code": "O26892 ", "icd10_title": "" }, { "from_icd11": "JA65.Y", "icd10_code": "O26893 ", "icd10_title": "" }, { "from_icd11": "JA65.Y", "icd10_code": "O26899 ", "icd10_title": "" }, { "from_icd11": "JA65.Y", "icd10_code": "O99820 ", "icd10_title": "" }, { "from_icd11": "GB55.1", "icd10_code": "N143", "icd10_title": "Nephropathy induced by heavy metals" }, { "from_icd11": "GB55.1", "icd10_code": "N14", "icd10_title": "Drug- and heavy-metal-induced tubulo-interstitial and tubular conditions" }, { "from_icd11": "GB90.3", "icd10_code": "N280", "icd10_title": "Ischemia and infarction of kidney" }, { "from_icd11": "JA80.Z", "icd10_code": "O30", "icd10_title": "Multiple gestation" }, { "from_icd11": "JA80.Z", "icd10_code": "O308", "icd10_title": "Other specified multiple gestation" }, { "from_icd11": "JA80.Z", "icd10_code": "O309", "icd10_title": "Multiple gestation, unspecified" }, { "from_icd11": "JA01.1", "icd10_code": "O00102", "icd10_title": "Left tubal pregnancy without intrauterine pregnancy" }, { "from_icd11": "JA01.1", "icd10_code": "O0010", "icd10_title": "Tubal pregnancy without intrauterine pregnancy" }, { "from_icd11": "JA01.1", "icd10_code": "O00101", "icd10_title": "Right tubal pregnancy without intrauterine pregnancy" }, { "from_icd11": "JA01.1", "icd10_code": "O00111", "icd10_title": "Right tubal pregnancy with intrauterine pregnancy" } ]
O26891
On examination she was drowsy, with Glasgow Coma Scale (GCS) of 12/15, and had flapping tremors. She was pale, anicteric, and was well hydrated. No skin rashes, cutaneous bleeding, or neck stiffness was noted. Her abdomen was soft on examination and tenderness noted in right iliac fossa overlying the graft. Her respiratory system and cardiovascular system examinations were clinically normal. Optic fundi were normal except for background diabetic retinopathy. Capillary blood sugar on admission was 7.7 mmol/L. Her initial investigations revealed pancytopenia on day 3 of the illness with hemoglobin (Hb) of 78 g/L (120–160), white cell count of 3.7 × 10 9 /L (3.5–12), and platelet count of 52 × 10 9 /L (150–400). Blood picture showed normochromic normocytic red cells with reduced count, mild to moderate rouleaux formation, normal white cell count with hypersegmented and toxic-looking neutrophils. Severe thrombocytopenia was confirmed on the blood picture. We did not find any evidence of microangiopathic hemolytic anemia. Her C-reactive protein (CRP) level on admission was 108 mg/dL (< 6). Urine analysis showed 4–6 pus cells and 2–4 red cells, but no proteinuria. Serum creatinine was raised to 630 umol/L, from a background of 96 umol/L, checked 2 weeks ago on her routine clinic visit. Her serum creatinine phosphokinase level was normal. Urine and blood cultures were negative on day 3 of the illness. Non-contrast computed tomography (CT) of her brain was normal and a hip X-ray did not show evidence of any fracture. An ultrasound scan of her abdomen showed swollen kidney, with preserved corticomedullary demarcation, raising suspicions of acute renal parenchymal disease. She had no splenomegaly ultrasonically and portal vein diameter was 1.7 cm. She did not have oligo-anuria at that time. She developed metabolic acidosis, and with rising potassium levels, we decided to start renal replacement. Dengue non-structural protein 1 (NS1) antigen (day 2) was positive, but other viral studies such as cytomegalovirus and Epstein–Barr virus were negative. Subsequent blood counts revealed progressive decline in platelet and white cell counts. She developed an upper gastrointestinal (GI) bleed on day 6 (Hb, 52 g/L) and was supported with blood. From day 3 onward, of the illness, we empirically treated her with intravenously administered ceftriaxone for a suspected bacterial infection owing to her high CRP. Azathioprine and tenofovir were temporarily withheld due to possible marrow suppression and orally administered steroids doses were increased from 7.5 mg to 30 mg daily. Dengue IgM and IgG on day 6 were positive. Blood and urine cultures were sterile. Free fluid in the hepatorenal pouch was demonstrated on day 6 of the illness where she entered the critical phase. The lowest platelet count recorded was 5 × 10 9 /L. Her conscious level gradually improved and she was fully alert by day 5. She was never oligo-anuric during the period of illness. Upper GI endoscopy revealed portal gastropathy, antral gastritis, and non-bleeding small esophageal varices. We reintroduced tenofovir from day 5 onward. We had already taken her off azathioprine, but pancytopenia persisted. Intravenously administered ceftriaxone 1 g twice daily was continued up to 14 days, until CRP returned to normal. Her fluid management was monitored clinically, rather than according to the National Dengue guidelines, due to acute kidney injury (AKI). She was discharged on day 16 with creatinine normalized, but her liver enzymes and thrombocytopenia took 6 weeks to correct themselves. A review of this patient 12 weeks later revealed normal serum creatinine level and return of her blood counts to baseline. Figure 1 shows the case presentation in a timeline, while Fig. 2 describes the changes in the biochemical parameters. Table 1 describes pre-morbid, the most abnormal and convalescent values of important biochemical tests. Fig. 1 Case presentation in a timeline. GI gastrointestinal, HIV human immunodeficiency virus, NS1 non-structural protein 1 Fig. 2 Changes in biochemical parameters over the course of hospital stay. Hb hemoglobin, Plt platelets, WCC white cell count Table 1 Summary of laboratory investigations Test Units Reference Pre-illness Most abnormal Day# Discharge Follow up Potassium umol/L 3.5–5.1 4.1 6.3 2 3.3 4.0 CRP umol/L < 6 < 6 > 192* 2 6 < 6 ESR mm/hour < 20 24 128 2 60 12 Albumin mg/dL 35–50 4.0 2.8 7 3.9 4.7 ALT IU < 40 27 116 10 67 28 AST IU < 40 40 267 10 160 39 ALT alanine aminotransferase, AST aspartate aminotransferase, CRP C-reactive protein, ESR erythrocyte sedimentation rate, Day# number of days after admission to the hospital, Pre-illness the most recent value before contracting the illness, Follow up is after 84 days, *CRP was measured using dilution method, and levels more than 32 times dilution expressed as > 192
3.892578
0.979004
sec[1]/p[2]
en
0.999996
30170627
https://doi.org/10.1186/s13256-018-1790-0
[ "blood", "illness", "count", "white", "cell", "protein", "creatinine", "umol", "platelet", "cells" ]
[ { "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": "MG48", "title": "Unknown or unspecified causes of morbidity" }, { "code": "1D9Z", "title": "Unspecified viral infection of unspecified site" }, { "code": "6E8Z", "title": "Mental, behavioural or neurodevelopmental disorders, unspecified" }, { "code": "MG25", "title": "Feeling ill" }, { "code": "LA85.1", "title": "Transposition of the great arteries" } ]
=== 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 [MG48] Unknown or unspecified causes of morbidity Also known as: Unknown or unspecified causes of morbidity | undetermined cause | unknown cause of disease | illness | Illness NOS Includes: Undiagnosed disease, not specified as to the site or system involved [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 [6E8Z] Mental, behavioural or neurodevelopmental disorders, unspecified Also known as: Mental, behavioural or neurodevelopmental disorders, unspecified | Psychiatric disorder | mental disease NOS | mental disorder NOS | mental illness [MG25] Feeling ill Also known as: Feeling ill | malaise Includes: malaise [LA85.1] Transposition of the great arteries Definition: A congenital cardiovascular malformation in which the morphologically right ventricle or its remnant connects to the aorta and the morphologically left ventricle or its remnant connects to the pulmonary trunk. Also known as: Transposition of the great arteries | Discordant ventriculoarterial connection | complete transposition of great vessels | great vessels complete transposition | great vessels transposition === 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.... --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 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--> [MA12.0] Finding of opiate drug 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--> [?] 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 --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 ...", "[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--> [MA12.0] Finding of opiate drug 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
Patient One, a 22-year-old male, was admitted to the hospital for treatment of pT1bN1Mx papillary thyroid carcinoma (PTC). He had found a few lumps located beneath the jaw in midline axis. Ultrasonography (USG) confirmed enlarged lymph nodes (described as reactive lymphadenopathy), and multiply thyroid nodules. Fine needle aspiration was performed giving “ Bethesda V ” result in one lesion of right lobe. After total thyroidectomy with central and lateral lymphadenectomy patient was referred to Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine – National Research Institute for RAI treatment. During physical examination standard neck USG was performed, showing enlarged lymph node behind right sternocleidomastoid muscle . Nodule size was 13.6 × 8.5 × 13.7 mm, with increased, mixed vascular image pattern. Because of the young age, lesion features, and lack of primary ultrasound results the decision to perform DECT was made . We also performed fine needle aspiration (FNA) for cytology, and thyroglobulin (Tg) concentration which confirmed presence of PTC metastases (Table 1 Part A). In DECT only one focus (the same one found in USG) was qualified for operation. Patient underwent metastasectomy. Biochemical evaluation was made after a month (Table 1 Part B). Output Tg was 0.52 ng/ml [N: 3.5–77], thyroglobulin antibodies (aTg) was 136 IU/ml [N: 0-115 IU/ml] and stimulated Tg (0,9 mg rhTSH administration for two consecutive days) was 5.09 ng/ml. RAI treatment (120mCi) was carried out. Three days after treatment, in total body scintigraphy, two foci of increased accumulation of radioiodine in the center of the neck, and one slight trace on the right side was confirmed. In control 6 months after RAI treatment (Table 1 Part C), output Tg was 0.51 ng/ml, aTg was < 10 IU/ml, and stimulated Tg was 2.38 ng/ml. USG of the neck showed glandular-type-tissue located in postoperative bed on the right side (same side as primary cancer). Another FNA and DECT was performed. FNA was undiagnostic, but DECT confirmed high concentration of endogenous iodine. Total body scintigraphy after 3 days of administration of 3mCi 131 I showed no pathological accumulation of RAI. Due to USG and DECT results, and undiagnostic result of FNA patient was referred to the another surgery, which confirmed DTC recurrence. Fig. 1 Ultrasound of the neck after thyroidectomy. Suspicious lymph node behind sternocleidomastoid muscle, with following features: solid, hyperechogenic, mixed vascularity type and microcalcifications. ( A ) Transverse section ( B ) Sagittal section Fig. 2 DECT scans of the neck. Suspicious lymph node the same in Fig. 1 (ROI 2 - green), normal lymph node (ROI 1 - blue) and physiological muscle tissue (ROI 3 - red). Analysis with use of color maps depending on the concentration of the endogenous iodine. In pathological tissue, the concentration of accumulated iodine was the highest, it was 6.7 ± 4.17 × 100 µg / cm3, in muscle tissue it was 2.17 ± 2.36 µg / cm3, and the lowest in the normal lymph node 0.33 ± 3.81 × 100 µg / cm3 A , B . X-ray absorption analysis by pathological tissue (green), muscle (red) and normal lymph node (blue) on graphs showing ionizing radiation absorption curves depending on the photon energy in the range of 40–140 keV in the range of 5 keV based on actual values ​​ C . Graphical representation of the distribution of dense measurements in ROI 1, ROI 2 and ROI 3 in the form of percentage distributions of pixels, one of the examples of the tumor. All analyses are performed because unique capabilities of the DECT modality Fig. 3 Ultrasound of the neck after thyroidectomy and radioiodine therapy. In postoperative bed presence of previously undetectable mass of hypoechogenic glandular tissue (with increased vascularity) – suspicious of DTC recurrence. ( A ) Transverse/sagittal section ( B )Transverse section – CDI presentation Fig. 4 DECT modality analysis of thyroid cancer metastasis to the lymph node. DECT scans show pathological tissue (ROI 2 - green), normal lymph node (ROI 1 - blue) and physiological muscle tissue (ROI 3 - red). Analysis on color maps depending on the concentration of the endogenous iodine. In pathological tissue, the concentration of accumulated iodine was 12.36 ± 4.47 × 100 µg / cm3, in muscle tissue it was 1.29 ± 1.81 µg / cm3, and in the normal lymph node was 0.27 ± 1.52 × 100 µg / cm3 A , B . X-ray absorption analysis by pathological tissue (green), muscle (red) and normal lymph node (blue) on graphs showing ionizing radiation absorption curves depending on the photon energy in the range of 40–140 keV in the range of 5 keV ​​ C . Graphical representation of the distribution of dense measurements in ROI 1, ROI 2 and ROI 3 in the form of percentage distributions of pixels, one of the examples of the SPN analysis in the DECT modality
4.023438
0.975586
sec[2]/p[0]
en
0.999996
37072868
https://doi.org/10.1186/s40644-023-00555-w
[ "lymph", "tissue", "node", "dect", "muscle", "neck", "concentration", "pathological", "iodine", "section" ]
[ { "code": "BD9Z", "title": "Disorders of lymphatic vessels or lymph nodes, unspecified" }, { "code": "BD90.Z", "title": "Lymphadenitis, unspecified" }, { "code": "BD90.Y", "title": "Other specified lymphadenitis" }, { "code": "BD9Y", "title": "Other specified disorders of lymphatic vessels or lymph nodes" }, { "code": "MA01.Z", "title": "Enlarged lymph nodes, unspecified" }, { "code": "FB6Z", "title": "Soft tissue disorders, unspecified" }, { "code": "MC85", "title": "Gangrene" }, { "code": "FB56.6", "title": "Other specified soft tissue disorders" }, { "code": "GB61.Z", "title": "Chronic kidney disease, stage unspecified" }, { "code": "4A43.3", "title": "Mixed connective tissue disease" } ]
=== ICD-11 CODES FOUND === [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 [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 [BD9Y] Other specified disorders of lymphatic vessels or lymph nodes Also known as: Other specified disorders of lymphatic vessels or lymph nodes | Chylous cyst | Mesentery chylous cyst | Peritoneum chylous cyst | Lymphocele [MA01.Z] Enlarged lymph nodes, unspecified Also known as: Enlarged lymph nodes, unspecified | Enlarged lymph nodes | swollen glands | Lymphadenopathy | adenopathy [FB6Z] Soft tissue disorders, unspecified Also known as: Soft tissue disorders, unspecified | disease of soft tissue NOS | unspecified soft tissue disorder, site unspecified | disorder of soft tissue | disorder of soft tissue NOS [MC85] Gangrene Definition: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply. Also known as: Gangrene | gangrene NOS | dry gangrene | wet gangrene | ulcerative gangrene Excludes: Pyoderma gangrenosum | Gas gangrene | Polymicrobial necrotising fasciitis [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 [GB61.Z] Chronic kidney disease, stage unspecified Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease [4A43.3] Mixed connective tissue disease Definition: Mixed connective tissue disease is an overlapping syndrome combining features of systemic lupus erythematosus, systemic sclerosis, and polymyositis with the presence of autoantibodies to U1-ribonucleoprotein. Raynaud’s phenomenon is seen in nearly all patients and pulmonary arterial hypertension is the most common cause of death in MCTD patients. Also known as: Mixed connective tissue disease | Sharp syndrome | MCTD - [mixed connective tissue disease] | Paediatric-onset mixed connective tissue disease | Paediatric-onset Sharp syndrome === GRAPH WALKS === --- Walk 1 --- [BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes.... --CHILD--> [BD90] Lymphadenitis --- Walk 2 --- [BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes.... --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 3 --- [BD90.Z] Lymphadenitis, unspecified --PARENT--> [BD90] Lymphadenitis --CHILD--> [BD90.0] Acute lymphadenitis --- Walk 4 --- [BD90.Z] Lymphadenitis, unspecified --PARENT--> [BD90] Lymphadenitis --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --- Walk 5 --- [BD90.Y] Other specified lymphadenitis --PARENT--> [BD90] Lymphadenitis --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --- Walk 6 --- [BD90.Y] Other specified lymphadenitis --PARENT--> [BD90] Lymphadenitis --EXCLUDES--> [?] Human immunodeficiency virus disease Def: A case of HIV infection is defined as an individual with HIV infection irrespective of clinical stage including severe or stage 4 clinical disease (also known as AIDS) confirmed by laboratory criteria...
[ "[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified\n --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes\n Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....\n --CHILD--> [BD90] Lymphadenitis", "[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified\n --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes\n Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....\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...", "[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --CHILD--> [BD90.0] Acute lymphadenitis", "[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....", "[BD90.Y] Other specified lymphadenitis\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....", "[BD90.Y] Other specified lymphadenitis\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Human immunodeficiency virus disease\n Def: A case of HIV infection is defined as an individual with HIV infection irrespective of clinical stage including severe or stage 4 clinical disease (also known as AIDS) confirmed by laboratory criteria..." ]
BD9Z
Disorders of lymphatic vessels or lymph nodes, unspecified
[ { "from_icd11": "BD9Z", "icd10_code": "I898", "icd10_title": "Other specified noninfective disorders of lymphatic vessels and lymph nodes" }, { "from_icd11": "BD9Z", "icd10_code": "I899", "icd10_title": "Noninfective disorder of lymphatic vessels and lymph nodes, unspecified" }, { "from_icd11": "BD9Z", "icd10_code": "I89", "icd10_title": "Other noninfective disorders of lymphatic vessels and lymph nodes" }, { "from_icd11": "BD90.Z", "icd10_code": "I889", "icd10_title": "Nonspecific lymphadenitis, unspecified" }, { "from_icd11": "BD90.Z", "icd10_code": "I88", "icd10_title": "Nonspecific lymphadenitis" }, { "from_icd11": "BD90.Z", "icd10_code": "I888", "icd10_title": "Other nonspecific lymphadenitis" }, { "from_icd11": "BD90.Z", "icd10_code": "L00-L08", "icd10_title": "" }, { "from_icd11": "MA01.Z", "icd10_code": "R599", "icd10_title": "Enlarged lymph nodes, unspecified" }, { "from_icd11": "MA01.Z", "icd10_code": "R59", "icd10_title": "Enlarged lymph nodes" }, { "from_icd11": "FB6Z", "icd10_code": "M60-M79", "icd10_title": "" }, { "from_icd11": "MC85", "icd10_code": "R02", "icd10_title": "" }, { "from_icd11": "MC85", "icd10_code": "I96", "icd10_title": "Gangrene, not elsewhere classified" }, { "from_icd11": "FB56.6", "icd10_code": "M7981", "icd10_title": "Nontraumatic hematoma of soft tissue" }, { "from_icd11": "FB56.6", "icd10_code": "M7989", "icd10_title": "Other specified soft tissue disorders" }, { "from_icd11": "FB56.6", "icd10_code": "M798", "icd10_title": "Other specified soft tissue disorders" } ]
I898
Other specified noninfective disorders of lymphatic vessels and lymph nodes
Our patient was a 67-year-old woman, gravida 4, para 1. Her past medical history included epilepsy diagnosed at 56 years of age, unspecified cardiopulmonary arrest at age 57 years, peritonitis due to acute perforated gastric ulcer, venous thrombosis of the lower limb, and pulmonary arterial embolism. She was also allergic to numerous drugs and diagnostic agents (e.g., contrast media, nonsteroidal anti-inflammatory drugs, and sodium valproate). She visited the department of surgery at our hospital with chief complaints of appetite loss, nausea, and vomiting that had persisted for the prior two weeks. Because abdominal plain computed tomography (CT) revealed ileus and an abdominal incisional hernia, she was immediately admitted with a diagnosis of ileus caused by the incisional hernia. Moreover, a tumor measuring 21 cm in longest diameter was detected in the pelvis ( Figure 1(a) ). She was thus referred to our department for detailed examination and treatment. At the initial examination, the abdomen was soft without tenderness, rebound tenderness, or muscular defense. An easily movable mass extending from the right lower abdomen to the level of the umbilicus was palpated. The patient had undergone omental implantation for acute perforated gastric ulcer 10 years earlier. Preoperative abdominal plain CT had revealed a right ovarian tumor measuring 6 cm in diameter ( Figure 1(b) ), which contained a part of calcification and fatty components; however, there had been no findings suggestive of malignancy, such as a solid component or a mural nodule. The right ovarian tumor was radiologically diagnosed with a mature cystic teratoma. After surgery for the acute perforated gastric ulcer, she had not been referred to the department of gynecology. No further examination of the right ovarian tumor was performed. She had not been followed up for the ovarian tumor. When the findings of abdominal plain CT performed during the current admission were compared to those of the abdominal CT obtained 10 years earlier, the ovarian tumor was noted to have grown markedly in size and to be partially solid. The CT performed during the current admission also revealed fatty components in the ovarian cyst. On the basis of these findings, malignant transformation of the mature cystic teratoma was suspected. Furthermore, pelvic plain magnetic resonance imaging (MRI) also showed a cyst measuring 21 cm in longest diameter that was partially solid on the right side of the uterine body ( Figure 2(a) ). The solid components detected on T2-weighted images ( Figure 2(b) ) showed high signal intensity on diffusion-weighted images ( Figure 2(c) ) and low signal intensity on apparent diffusion coefficient maps, which suggested a malignant lesion. In addition, blood tests revealed tumor marker elevations: CEA, 7.1 ng/mL (<4.9 ng/mL); CA125, 58.3 U/mL (<35 U/mL); CA19-9, 405.8 U/mL (<37 U/mL); and SCC antigen, 6.2 ng/mL (<1.5 ng/mL). Based on the clinical course, imaging findings, and elevated tumor markers, malignant transformation of the previously recognized mature cystic teratoma was strongly suspected. Sixteen days after the initial examination, semiurgent surgery was performed. While neither lymphadenopathy nor distant metastasis was detected by imaging studies, the operation consisted of abdominal bilateral adnexectomy and repair of the abdominal incisional hernia in consideration of the patient's general condition. The intraoperative findings included slight accumulation of ascites with a pink tinge due to blood and swelling of the right ovary, which was larger than a newborn's head, whereas there were no signs of capsule rupture, torsion abnormality, and so on. We detected no macroscopic abnormalities in the uterus or the left adnexa. Neither disseminated lesions nor lymphadenopathy was observed in the peritoneal cavity. The tumor in the right ovary was unilocular and weighed 2960 g, containing both fatty components and hair. Moreover, protruding lesions were observed on a portion of the tumor wall . Cytology of ascites was negative. Histologically, cystic wall was lined by squamous epithelium and contained horny materials inside the cyst. Mature bone tissue and hair were also observed. Focally, granulation tissue was formed. Squamous cell carcinoma was found in the solid part protruding inside the cyst wall. There was a transition between squamous epithelium and squamous cell carcinoma . The postoperative clinical diagnosis was ovarian cancer FIGO stage IA, pT1aNxM0 due to malignant transformation of a mature cystic teratoma which had first been noted 10 years earlier. Given the history of allergy to multiple drugs, cardiopulmonary arrest, venous thrombosis of the lower limb, and pulmonary arterial embolism, postoperative chemotherapy was not planned. As of two years since surgery, no recurrence has been observed.
3.947266
0.981934
sec[1]/p[0]
en
0.999998
28607781
https://doi.org/10.1155/2017/2947927
[ "tumor", "abdominal", "ovarian", "solid", "mature", "cystic", "plain", "which", "components", "teratoma" ]
[ { "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--> [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--> [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--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --CHILD--> [?] Generalised lymph node enlargement --- 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.... --PARENT--> [?] Overweight or localised adiposity Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th... --- Walk 5 --- [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 --- Walk 6 --- [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....
[ "[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--> [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--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --CHILD--> [?] Generalised lymph node enlargement", "[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 --PARENT--> [?] Overweight or localised adiposity\n Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th...", "[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", "[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...." ]
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
The proband is a 3-year 8-month-old Japanese male who is the third child of healthy unrelated Japanese parents . Neither congenital defects nor psychomotor developmental delay was reported in his two elder brothers and relatives. He was born at 41 weeks and 2 days of gestation, with a weight of 3446 g (+0.2 SD), the height of 52 cm (+1.1 SD), head circumference of 35 cm (+1.0 SD), and Apgar scores of 8/8. At his birth, his father was 46 years old, and his mother was 36 years old. There was no particular problem with the maternal pregnancy and childbirth process. At birth, he had a cleft soft palate, distinctive facial features (flat nasal bridge, thick eyebrows, long eyelashes), right cryptorchidism, and hypertrichosis. Morphological abnormalities in the fingers and fingernails were not reported in his clinical history. MRI was performed for obstructive sleep apnea, and an arachnoid cyst was accidentally found on the dorsal side of the cerebellum. Sleep apnea disappeared immediately, and the size of the arachnoid cyst was reduced by the age of 6 months with follow-up. The karyotype was normal by G-banding. He showed psychomotor developmental delay. He had head control at 6 months, could sit without support at 10 months, could pull up on things at 17 months, could walk without support at 35 months, and does not speak a word at 42 months. The developmental quotient (DQ) was assessed using the Enjoji Scale of Infant Analytical Development at the age of 3 years 8 months; the overall DQ was 26 (physical DQ 30, social DQ 25, and language DQ 22). His clinical manifestations are summarized in Fig. 1b and Table 1 and were compared with the previous reports 2 , 6 , 12 , 13 . At the age of 3 years 6 months, a radiographic examination of his hands was performed . The lengths of the metacarpophalangeal bones were measured and evaluated compared with the Japanese standard profiles 14 to calculate Z scores (SD value above or below the expected mean) . He showed shortening of the middle phalanges (fifth) and distal phalanges (second and fifth) when we took his short stature (−1.5 SD) into account. Fig. 1 The familial pedigree, clinical features, and genetic analysis. a The pedigree of the family. b The clinical features of the proband at the age of 2 years 11 months. He showed thick eyebrows, long eyelashes, and hypertrichosis. Morphological abnormalities were not observed in his fingers. Photo usage was approved by the parents of the proband with written informed consent. c The radiographic examination of the metacarpophalangeal bones at the age of 3 years 6 months. The lengths of the bones of the left hand were measured, and the Z scores (SD value above or below the expected mean) were calculated according to age-matched Japanese standards 14 . d Genetic analysis of the proband and his parents. Sanger sequencing was performed with their genomic DNA. A heterozygous nonsense variant (NM_001374820.1:c.4282C > T, p.) was confirmed in the proband. Table 1 Clinical features of proband in this study and previously reported individuals with ARID1B variants and CSS. Clinical features Our case Gene Reviews 2 van der Sluijs, et al. 12 Mannino, et al. 13 Tsurusaki, et al. 6 CSS ARID1B -CSS ARID1B -ID ARID1B -CSS ARID1B -CSS ( n = 79) ( n = 64) ( n = 49) ( n = 20) * Developmental delay + D 98.6% 100.0% 22% 100% * Hypotonia + 75% 80.3% 82.2% 37% 90% Abnormal corpus callosum − D 29.0% 28.2% 24% 47% * Hirsutism/hypertrichosis + 95% 94.7% 75.0% 76% 95% * Sparse scalp hair − 60% 62.8% 51.0% 35% 50% * Thick eyebrows + 90% 91.0% 67.9% N.D. 100% * Long eyelashes (prominent) + 85% 75.9% 44.2% N.D. 85% Coarse appearance + 95% 90.3% 72.9% N.D. 100% * Flat nasal bridge + 50% 20.3% 22.0% N.D. 85% * Broad nasal base (wide) − 50% 43.8% 55.0% N.D. 90% Long philtrum (broad) − 70% 48.6% 35.1% N.D. 35% * Wide mouth − 80% 76.0% 58.9% N.D. 80% * Abnormal lips: − N.D. Thick lips 100% Upper vermillion, Thick N.D. 14.7% 30.8% Upper vermillion, Thin 50% 45.3% 21.2% Lower vermillion, Thick 80% 78.9% 55.1% Cleft palate + N.D. 5.7% 0.0% 20% 5% * Aplasia or hypoplasia of the 5th distal phalanx −/+** 65–80% 60.6% 9.1% 45% 80% Height (< −2 SD)/short stature − D 37.1% 21.2% N.D. 63% Feeding problems + 90% 62.9% 76.3% 12% 70% Genital findings (cryptorchidism) + D 39.30% 67.60% N.D. 10% + present, − absent, D described without frequency, N.D. not described. ARID1B -CSS: Clinically recognizable Coffin-Siris Syndrome (CSS) cases, which were confirmed by ARID1B gene variants. ARID1B -ID: Cases of intellectual disability with ARID1B variants, which were identified by large-scale exome sequencing studies. ARID1B -ID is a part of ARID1B -Related Disorders and patients with ARID1B -ID may have no or less physical symptoms of CSS. *Key features to suspect Coffin-Siris Syndrome 2 . **Radiographic analyses suggest presence of hypoplasia of phalanges.
4.148438
0.792969
sec[2]/sec[0]/p[0]
en
0.999996
35879281
https://doi.org/10.1038/s41439-022-00203-y
[ "proband", "features", "thick", "japanese", "developmental", "long", "parents", "delay", "scores", "nasal" ]
[ { "code": "MB28.Z", "title": "Symptoms and signs related to personality features, unspecified" }, { "code": "LD20.1", "title": "Syndromes with lissencephaly as a major feature" }, { "code": "EB90.1Y", "title": "Other specified forms of cutaneous mucinosis" }, { "code": "MB28.Y", "title": "Other specified symptoms and signs related to personality features" }, { "code": "LD23", "title": "Syndromes with vascular anomalies as a major feature" }, { "code": "DA01.00", "title": "Oral leukoplakia" }, { "code": "LA53", "title": "Macrocheilia" }, { "code": "9B75.1", "title": "Non-traumatic macular hole" }, { "code": "9B75.1&XS5S", "title": "Non-traumatic macular hole, stage 2, full thickness macular hole <400 microns in maximum diameter" }, { "code": "EL53", "title": "Skin graft failure" } ]
=== ICD-11 CODES FOUND === [MB28.Z] Symptoms and signs related to personality features, unspecified Also known as: Symptoms and signs related to personality features, unspecified | Symptoms or signs related to personality features [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 [EB90.1Y] Other specified forms of cutaneous mucinosis Also known as: Other specified forms of cutaneous mucinosis | Focal primary cutaneous mucinosis | Idiopathic follicular mucinosis | Alopecia mucinosa | Focal cutaneous mucinosis Includes: Idiopathic follicular mucinosis [MB28.Y] Other specified symptoms and signs related to personality features Also known as: Other specified symptoms and signs related to personality features [LD23] Syndromes with vascular anomalies as a major feature Also known as: Syndromes with vascular anomalies as a major feature | Primary intraosseous vascular malformation | Retinal cavernous haemangioma | Sturge-Weber syndrome | encephalotrigeminal angiomatosis [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 [LA53] Macrocheilia Definition: A condition characterised by above normal lip volume. This condition may present with difficulties in speaking, drinking, salivary control, or mastication. Also known as: Macrocheilia | Congenital hypertrophy of lip | Congenital macrocheilia | Thick lips [9B75.1] Non-traumatic macular hole Also known as: Non-traumatic macular hole | Hole of macula | hole degeneration of macula of retina | Non-traumatic macular hole, stage 1, impending hole | Non-traumatic macular hole, stage 2, full thickness macular hole <400 microns in maximum diameter [EL53] Skin graft failure Definition: Failure of skin graft tissue to engraft as intended Also known as: Skin graft failure | Split skin graft failure | Full thickness skin graft failure === GRAPH WALKS === --- Walk 1 --- [MB28.Z] Symptoms and signs related to personality features, unspecified --PARENT--> [MB28] Symptoms or signs related to personality features Def: Symptoms and signs involving the characteristics or qualities possessed by a person that uniquely influence his or her cognition, motivations, and behaviours in various situations.... --CHILD--> [MB28.2] Eccentricity Def: A tendency toward appearance or behaviour that is odd, unusual, peculiar, or unconventional, and is inconsistent with cultural or subcultural norms.... --- Walk 2 --- [MB28.Z] Symptoms and signs related to personality features, unspecified --PARENT--> [MB28] Symptoms or signs related to personality features Def: Symptoms and signs involving the characteristics or qualities possessed by a person that uniquely influence his or her cognition, motivations, and behaviours in various situations.... --CHILD--> [MB28.1] Callousness Def: Lack of concern for the feelings or problems of others; a lack of guilt or remorse about the negative or harmful effects of one's actions on others.... --- Walk 3 --- [LD20.1] Syndromes with lissencephaly as a major feature Def: 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) asso... --PARENT--> [LD20] Syndromes with central nervous system anomalies as a major feature --EXCLUDES--> [?] Meckel-Gruber syndrome Def: Meckel syndrome (MKS) is a monogenic disease characterised by a combination of renal cysts and variably associated features, including developmental anomalies of the central nervous system (usually oc... --- Walk 4 --- [LD20.1] Syndromes with lissencephaly as a major feature Def: 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) asso... --PARENT--> [LD20] Syndromes with central nervous system anomalies as a major feature --CHILD--> [LD20.1] Syndromes with lissencephaly as a major feature Def: 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) asso... --- Walk 5 --- [EB90.1Y] Other specified forms of cutaneous mucinosis --PARENT--> [EB90.1] Cutaneous mucinosis Def: Skin disorders characterised by accumulation of mucin in the skin... --CHILD--> [EB90.11] Lichen myxoedematosus Def: Localised lichen myxedematosus is a group of skin diseases characterised by the development of papules, nodules and/or plaques with mucin deposits and a variable degree of fibrosis in the absence of t... --- Walk 6 --- [EB90.1Y] Other specified forms of cutaneous mucinosis --PARENT--> [EB90.1] Cutaneous mucinosis Def: Skin disorders characterised by accumulation of mucin in the skin... --RELATED_TO--> [?] Mucopolysaccharidosis type 1 Def: Mucopolysaccharidosis type 1 (MPS 1) is a rare lysosomal storage disease belonging to the group of mucopolysaccharidoses. There are three variants, differing widely in their severity, with Hurler synd...
[ "[MB28.Z] Symptoms and signs related to personality features, unspecified\n --PARENT--> [MB28] Symptoms or signs related to personality features\n Def: Symptoms and signs involving the characteristics or qualities possessed by a person that uniquely influence his or her cognition, motivations, and behaviours in various situations....\n --CHILD--> [MB28.2] Eccentricity\n Def: A tendency toward appearance or behaviour that is odd, unusual, peculiar, or unconventional, and is inconsistent with cultural or subcultural norms....", "[MB28.Z] Symptoms and signs related to personality features, unspecified\n --PARENT--> [MB28] Symptoms or signs related to personality features\n Def: Symptoms and signs involving the characteristics or qualities possessed by a person that uniquely influence his or her cognition, motivations, and behaviours in various situations....\n --CHILD--> [MB28.1] Callousness\n Def: Lack of concern for the feelings or problems of others; a lack of guilt or remorse about the negative or harmful effects of one's actions on others....", "[LD20.1] Syndromes with lissencephaly as a major feature\n Def: 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) asso...\n --PARENT--> [LD20] Syndromes with central nervous system anomalies as a major feature\n --EXCLUDES--> [?] Meckel-Gruber syndrome\n Def: Meckel syndrome (MKS) is a monogenic disease characterised by a combination of renal cysts and variably associated features, including developmental anomalies of the central nervous system (usually oc...", "[LD20.1] Syndromes with lissencephaly as a major feature\n Def: 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) asso...\n --PARENT--> [LD20] Syndromes with central nervous system anomalies as a major feature\n --CHILD--> [LD20.1] Syndromes with lissencephaly as a major feature\n Def: 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) asso...", "[EB90.1Y] Other specified forms of cutaneous mucinosis\n --PARENT--> [EB90.1] Cutaneous mucinosis\n Def: Skin disorders characterised by accumulation of mucin in the skin...\n --CHILD--> [EB90.11] Lichen myxoedematosus\n Def: Localised lichen myxedematosus is a group of skin diseases characterised by the development of papules, nodules and/or plaques with mucin deposits and a variable degree of fibrosis in the absence of t...", "[EB90.1Y] Other specified forms of cutaneous mucinosis\n --PARENT--> [EB90.1] Cutaneous mucinosis\n Def: Skin disorders characterised by accumulation of mucin in the skin...\n --RELATED_TO--> [?] Mucopolysaccharidosis type 1\n Def: Mucopolysaccharidosis type 1 (MPS 1) is a rare lysosomal storage disease belonging to the group of mucopolysaccharidoses. There are three variants, differing widely in their severity, with Hurler synd..." ]
MB28.Z
Symptoms and signs related to personality features, unspecified
[ { "from_icd11": "MB28.Z", "icd10_code": "R4689", "icd10_title": "Other symptoms and signs involving appearance and behavior" }, { "from_icd11": "MB28.Z", "icd10_code": "R4681", "icd10_title": "Obsessive-compulsive behavior" }, { "from_icd11": "MB28.Z", "icd10_code": "R468", "icd10_title": "Other symptoms and signs involving appearance and behavior" }, { "from_icd11": "LD20.1", "icd10_code": "Q043", "icd10_title": "Other reduction deformities of brain" }, { "from_icd11": "LD23", "icd10_code": "Q289", "icd10_title": "Congenital malformation of circulatory system, unspecified" }, { "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": "LA53", "icd10_code": "Q186", "icd10_title": "Macrocheilia" }, { "from_icd11": "EL53", "icd10_code": "T86891", "icd10_title": "Other transplanted tissue failure" }, { "from_icd11": "EL53", "icd10_code": "T86890", "icd10_title": "Other transplanted tissue rejection" }, { "from_icd11": "EL53", "icd10_code": "T86822", "icd10_title": "Skin graft (allograft) (autograft) infection" }, { "from_icd11": "EL53", "icd10_code": "T86828", "icd10_title": "Other complications of skin graft (allograft) (autograft)" }, { "from_icd11": "EL53", "icd10_code": "T86898", "icd10_title": "Other complications of other transplanted tissue" }, { "from_icd11": "EL53", "icd10_code": "T86821", "icd10_title": "Skin graft (allograft) (autograft) failure" } ]
R4689
Other symptoms and signs involving appearance and behavior
The first case was a 34-year-old male nonsmoker with no chronic comorbidity except overweight (BMI: 26 kg/m 2 ). The patient was admitted to our center in August 2021 following respiratory distress due to a SARS-CoV-2 infection. He was intubated one day after admission because of the worsening acute respiratory distress syndrome. The right pleural drain was inserted on the same day due to the right pneumothorax. We placed him in a prone position with a positive end-expiratory pressure (PEEP) of 12 cmH 2 O, a fraction of inspired oxygen (FiO 2 ) of 100%, tidal volume (V t ) of 8 ml/kg, peak inspiratory pressure (P peak ) of 40 cmH 2 O, plateau pressure (P plat ) of 32 cmH 2 O, and static lung compliance (C stat ) of 12 ml/cmH 2 O. Upon recognition of subcutaneous emphysema during routine physical examination, a chest X-ray was ordered that confirmed 1 mcg/kg/min. We decided to perform left pleural drainage with a 28 F tube and mediastinal decompression via a suprasternal notch incision with blunt finger dissection. After the procedure, his cardiopulmonary status did not improve. The patient died 5 h after drainage (Patient 1 in Table 1 ). Table 1 Summary of 7 COVID-19 patients with tension pneumomediastinum undergoing surgical mediastinal decompression Patient Demographics (Sex, Age, BMI) Length of MV before TPM (days) Pre-procedural clinical status Surgery Post-procedural clinical status Outcome 1 Male, 39 yrs, 26 kg/m 2 8 Prone MV; Nor 1 mcg/kg/min; FiO 2 100%; PEEP 12 cmH 2 O; P peak 40 cmH 2 O; P plat 30 cmH 2 O; C stat 12 mL/cmH 2 O; P/F 60 A Prone MV; Nor 1.2 mcg/kg/min; FiO 2 100%, PEEP 12 cmH 2 O; P peak 41 cmH 2 O; P plat 31 cmH 2 O; C stat 12 mL/cmH 2 O; P/F 70 Failure to decompress TPM and the patient died in the same day 2 Male, 69 yrs, 25.5 kg/m 2 10 Prone MV; Nor 1.2 mcg/kg/min; FiO 2 100%, PEEP 12 cmH 2 O; P peak 39 cmH 2 O; P plat 34 cmH 2 O; C stat 11 mL/cmH 2 O; P/F 67 B Prone MV; vasopressor stopped; FiO 2 80%; PEEP 12 cmH 2 O; P peak 38 cmH 2 O, P plat 32 cmH 2 O, C stat 14 mL/cmH 2 O; P/F 75 TPM was initially decompressed, leading to hemodynamic amelioration but then reoccurred. The patient died of TPM and septic shock 3 Female, 69 yrs, 27 kg/m 2 9 Supine MV; Nor 0.9 mcg/kg/min; FiO 2 75%; PEEP 10 cmH 2 O; P peak 31 cmH 2 O; P plat 20 cmH 2 O; C stat 21 mL/cmH 2 O; P/F 78 C Supine MV; vasopressor stopped; FiO 2 40%, PEEP 8 cmH 2 O, P peak 29, P plat 24, C stat 25 mL/cmH 2 O; P/F 115 Drain removal on day 5 No complication. No recurrent TPM. Discharged from hospital after 34 days 4 Male, 70 yrs, 26 kg/m 2 3 Prone MV; Nor 0.75 mcg/kg/min; FiO 2 80%; PEEP 10 cmH 2 O, P peak 35 cmH 2 O, P plat 29 cmH 2 O, C stat 15 mL/cmH 2 O; P/F 90 C Prone MV; vasopressor stopped; FiO 2 45%, PEEP 5 cmH 2 O; P peak 33 cmH 2 O; P plat 26 cmH 2 O; C stat 18 mL/cmH 2 O; P/F 130 Drain removal on day 7. No complication. No recurrent TPM. The patient died of septic shock secondary to VAP 5 Female, 60yrs, 27 kg/m 2 0 Prone MV; HR 158 bpm, no vasopressor; FiO 2 100%; PEEP 10 cmH 2 O; P peak 36 cmH 2 O; P plat 30 cmH 2 O, C stat 14 mL/cmH 2 O; P/F 81 C Supine MV; HR 118 bpm; no vasopressor; FiO 2 60%; PEEP 8 cmH 2 O; P peak 30 cmH 2 O; P plat 28 cmH 2 O; C stat 20 mL/cmH 2 O; P/F 120 Drain removal on day 9. No complication. No recurrent TPM. Discharged from hospital after 36 days 6 Female, 39 yrs, 25.5 kg/m 2 0 Prone MV; HR 168 bpm; no vasopressor; FiO 2 100%; PEEP 14 cmH 2 O; P peak 41 cmH 2 O; P plat 28 cmH 2 O; C stat 17 mL/cmH 2 O; P/F 105; urgent ECMO in preparation C Supine VM; HR 120 bpm, no vasopressor; FiO 2 60%; PEEP 8 cmH 2 O; P peak 33 cmH 2 O; P plat 26 cmH 2 O, C stat 20 mL/cmH 2 O; P/F 140; ECMO cancelled Drain removal on day 20. No complication. No recurrent TPM. Transferred to a rehabilitation hospital to wean low flow nasal cannula oxygen after 33 days 7 Male, 49 yrs, 21 kg/m 2 0 Prone MV; HR 147 bpm; no vasopressor; FiO 2 100%; PEEP 10 cmH 2 O; P peak 37 cmH 2 O, P plat 26 cmH 2 O, C stat 19 mL/cmH 2 O; P/F 110 C Supine MV; HR 110 bpm; no vasopressor; FiO 2 60%; PEEP 8 cmH 2 O; P peak 29 cmH 2 O; P plat 25 cmH 2 O; C stat 23 mL/cmH 2 O; P/F 158 Drain removal on day 9. No complication. No recurrent TPM. Discharged from hospital after 62 days A: Mediastinal decompression via a suprasternal notch incision with blunt finger dissection and pleural drainage. B: Mediastinal decompression via a suprasternal notch incision with blunt finger dissection. C: Mediastinal drainage combining sternal notch and subxiphoid incisions and continuous suction. BMI body mass index, bpm beats per minute, C stat static compliance, ECMO extracorporeal membrane oxygenation, FiO 2 fraction of inspired oxygen, HR heart rate, MV mechanical ventilation, PEEP positive end-expiratory pressure, P peak peak inspiratory pressure, P plat plateau pressure, P/F PaO 2 /FiO 2 ratio, TPM tension pneumomediastinum
4.035156
0.950195
sec[1]/sec[0]/p[0]
en
0.999998
PMC9399585
https://doi.org/10.1186/s13019-022-01966-9
[ "peak", "peep", "plat", "stat", "prone", "vasopressor", "drain", "pressure", "mediastinal", "supine" ]
[ { "code": "4A00.2", "title": "Genetic susceptibility to particular pathogens" }, { "code": "MB28.A", "title": "Negative affectivity" }, { "code": "5A10", "title": "Type 1 diabetes mellitus" }, { "code": "QB85", "title": "Attention to surgical dressings, drains or sutures" }, { "code": "FB84.4", "title": "Chronic osteomyelitis with draining sinus" }, { "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" }, { "code": "BA2Z", "title": "Hypotension, unspecified" } ]
=== ICD-11 CODES FOUND === [4A00.2] Genetic susceptibility to particular pathogens Also known as: Genetic susceptibility to particular pathogens | Idiopathic CD4 lymphocytopenia | Immunodeficiency due to interleukin-1 receptor-associated kinase-4 deficiency | IRAK4 - [interleukin-1 receptor-associated kinase-4 deficiency] | Lung fibrosis - immunodeficiency - gonadal dysgenesis [MB28.A] Negative affectivity Definition: A tendency to experience a broad range of distressing emotions, e.g. anxiety, anger irritability, depression, and other negative emotional states, often in response to even relatively minor actual or perceived stressors. Also known as: Negative affectivity | negative emotionality | proneness to negative emotional states | neuroticism Includes: negative emotionality | proneness to negative emotional states [5A10] Type 1 diabetes mellitus Definition: Diabetes mellitus type 1 (type 1 diabetes, T1DM, formerly insulin dependent or juvenile diabetes) is a form of diabetes mellitus that results from destruction of insulin-producing beta cells, mostly by autoimmune mechanisms. The subsequent lack of insulin leads to increased blood and urine glucose. Also known as: Type 1 diabetes mellitus | T1DM - [type 1 diabetes mellitus] | type 1 diabetes | IDDM - [insulin dependent diabetes mellitus] | type 1 IDDM Excludes: Type 2 diabetes mellitus | Diabetes mellitus, other specified type | Diabetes mellitus in pregnancy [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 [FB84.4] Chronic osteomyelitis with draining sinus Also known as: Chronic osteomyelitis with draining sinus | chronic osteomyelitis with draining sinus, unspecified site | bone fistula with chronic osteomyelitis | Chronic osteomyelitis with draining sinus, multiple sites | Chronic osteomyelitis with draining sinus, shoulder region [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 [BA2Z] Hypotension, unspecified Also known as: Hypotension, unspecified | hypopiesis | low blood pressure | arterial hypotension NOS | decreased blood pressure === GRAPH WALKS === --- Walk 1 --- [4A00.2] Genetic susceptibility to particular pathogens --RELATED_TO--> [?] Chronic mucocutaneous candidosis Def: Chronic Mucocutaneous Candidiasis is a primary immune deficiency characterised by persistent and/or recurrent infections of skin, nails and mucous membranes, caused by organisms of the genus Candida, ... --PARENT--> [?] Candidosis of skin or mucous membranes --- Walk 2 --- [4A00.2] Genetic susceptibility to particular pathogens --RELATED_TO--> [?] Encephalitis due to herpes simplex virus Def: Herpetic encephalitis is a cerebral infection caused by herpes simplex virus type 1 (HSV1). It presents as acute necrosing temporal encephalitis. Onset is rapid (less than 48 hours) with a fever of 40... --CHILD--> [?] Herpesviral meningoencephalitis --- Walk 3 --- [MB28.A] Negative affectivity Def: A tendency to experience a broad range of distressing emotions, e.g. anxiety, anger irritability, depression, and other negative emotional states, often in response to even relatively minor actual or ... --PARENT--> [MB28] Symptoms or signs related to personality features Def: Symptoms and signs involving the characteristics or qualities possessed by a person that uniquely influence his or her cognition, motivations, and behaviours in various situations.... --CHILD--> [MB28.1] Callousness Def: Lack of concern for the feelings or problems of others; a lack of guilt or remorse about the negative or harmful effects of one's actions on others.... --- Walk 4 --- [MB28.A] Negative affectivity Def: A tendency to experience a broad range of distressing emotions, e.g. anxiety, anger irritability, depression, and other negative emotional states, often in response to even relatively minor actual or ... --PARENT--> [MB28] Symptoms or signs related to personality features Def: Symptoms and signs involving the characteristics or qualities possessed by a person that uniquely influence his or her cognition, motivations, and behaviours in various situations.... --CHILD--> [MB28.0] Attention seeking Def: A tendency to engage in behaviour designed to attract notice and to make oneself the focus of others’ attention.... --- Walk 5 --- [5A10] Type 1 diabetes mellitus Def: Diabetes mellitus type 1 (type 1 diabetes, T1DM, formerly insulin dependent or juvenile diabetes) is a form of diabetes mellitus that results from destruction of insulin-producing beta cells, mostly b... --PARENT--> [?] Diabetes mellitus Def: A metabolic disorder with heterogenous aetiologies which is characterised by chronic hyperglycaemia and disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secre... --RELATED_TO--> [?] Neonatal diabetes mellitus Def: Neonatal diabetes mellitus (NDM) is a monogenic form of diabetes that occurs in the first 6 months of life. It is a rare condition occurring in only one in 100,000 to 500,000 live births. Infants with... --- Walk 6 --- [5A10] Type 1 diabetes mellitus Def: Diabetes mellitus type 1 (type 1 diabetes, T1DM, formerly insulin dependent or juvenile diabetes) is a form of diabetes mellitus that results from destruction of insulin-producing beta cells, mostly b... --RELATED_TO--> [?] Pre-existing type 1 diabetes mellitus in pregnancy --PARENT--> [?] Diabetes mellitus in pregnancy Def: A condition caused by dysfunctional maternal insulin receptors. This condition is characterised by glucose intolerance with onset or first recognition during pregnancy, with at least one of the follow...
[ "[4A00.2] Genetic susceptibility to particular pathogens\n --RELATED_TO--> [?] Chronic mucocutaneous candidosis\n Def: Chronic Mucocutaneous Candidiasis is a primary immune deficiency characterised by persistent and/or recurrent infections of skin, nails and mucous membranes, caused by organisms of the genus Candida, ...\n --PARENT--> [?] Candidosis of skin or mucous membranes", "[4A00.2] Genetic susceptibility to particular pathogens\n --RELATED_TO--> [?] Encephalitis due to herpes simplex virus\n Def: Herpetic encephalitis is a cerebral infection caused by herpes simplex virus type 1 (HSV1). It presents as acute necrosing temporal encephalitis. Onset is rapid (less than 48 hours) with a fever of 40...\n --CHILD--> [?] Herpesviral meningoencephalitis", "[MB28.A] Negative affectivity\n Def: A tendency to experience a broad range of distressing emotions, e.g. anxiety, anger irritability, depression, and other negative emotional states, often in response to even relatively minor actual or ...\n --PARENT--> [MB28] Symptoms or signs related to personality features\n Def: Symptoms and signs involving the characteristics or qualities possessed by a person that uniquely influence his or her cognition, motivations, and behaviours in various situations....\n --CHILD--> [MB28.1] Callousness\n Def: Lack of concern for the feelings or problems of others; a lack of guilt or remorse about the negative or harmful effects of one's actions on others....", "[MB28.A] Negative affectivity\n Def: A tendency to experience a broad range of distressing emotions, e.g. anxiety, anger irritability, depression, and other negative emotional states, often in response to even relatively minor actual or ...\n --PARENT--> [MB28] Symptoms or signs related to personality features\n Def: Symptoms and signs involving the characteristics or qualities possessed by a person that uniquely influence his or her cognition, motivations, and behaviours in various situations....\n --CHILD--> [MB28.0] Attention seeking\n Def: A tendency to engage in behaviour designed to attract notice and to make oneself the focus of others’ attention....", "[5A10] Type 1 diabetes mellitus\n Def: Diabetes mellitus type 1 (type 1 diabetes, T1DM, formerly insulin dependent or juvenile diabetes) is a form of diabetes mellitus that results from destruction of insulin-producing beta cells, mostly b...\n --PARENT--> [?] Diabetes mellitus\n Def: A metabolic disorder with heterogenous aetiologies which is characterised by chronic hyperglycaemia and disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secre...\n --RELATED_TO--> [?] Neonatal diabetes mellitus\n Def: Neonatal diabetes mellitus (NDM) is a monogenic form of diabetes that occurs in the first 6 months of life. It is a rare condition occurring in only one in 100,000 to 500,000 live births. Infants with...", "[5A10] Type 1 diabetes mellitus\n Def: Diabetes mellitus type 1 (type 1 diabetes, T1DM, formerly insulin dependent or juvenile diabetes) is a form of diabetes mellitus that results from destruction of insulin-producing beta cells, mostly b...\n --RELATED_TO--> [?] Pre-existing type 1 diabetes mellitus in pregnancy\n --PARENT--> [?] Diabetes mellitus in pregnancy\n Def: A condition caused by dysfunctional maternal insulin receptors. This condition is characterised by glucose intolerance with onset or first recognition during pregnancy, with at least one of the follow..." ]
4A00.2
Genetic susceptibility to particular pathogens
[ { "from_icd11": "4A00.2", "icd10_code": "D848", "icd10_title": "Other specified immunodeficiencies" }, { "from_icd11": "5A10", "icd10_code": "E1065", "icd10_title": "Type 1 diabetes mellitus with hyperglycemia" }, { "from_icd11": "5A10", "icd10_code": "E1042", "icd10_title": "Type 1 diabetes mellitus with diabetic polyneuropathy" }, { "from_icd11": "5A10", "icd10_code": "E103592", "icd10_title": "Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye" }, { "from_icd11": "5A10", "icd10_code": "E1010", "icd10_title": "Type 1 diabetes mellitus with ketoacidosis without coma" }, { "from_icd11": "5A10", "icd10_code": "E1022", "icd10_title": "Type 1 diabetes mellitus with diabetic chronic kidney disease" }, { "from_icd11": "5A10", "icd10_code": "E1040", "icd10_title": "Type 1 diabetes mellitus with diabetic neuropathy, unspecified" }, { "from_icd11": "5A10", "icd10_code": "E10319", "icd10_title": "Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema" }, { "from_icd11": "5A10", "icd10_code": "E1043", "icd10_title": "Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy" }, { "from_icd11": "5A10", "icd10_code": "E10649", "icd10_title": "Type 1 diabetes mellitus with hypoglycemia without coma" }, { "from_icd11": "5A10", "icd10_code": "E1021", "icd10_title": "Type 1 diabetes mellitus with diabetic nephropathy" }, { "from_icd11": "5A10", "icd10_code": "E1051", "icd10_title": "Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene" }, { "from_icd11": "5A10", "icd10_code": "E103593", "icd10_title": "Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral" }, { "from_icd11": "5A10", "icd10_code": "E10610", "icd10_title": "Type 1 diabetes mellitus with diabetic neuropathic arthropathy" }, { "from_icd11": "5A10", "icd10_code": "E1069", "icd10_title": "Type 1 diabetes mellitus with other specified complication" } ]
D848
Other specified immunodeficiencies
A 67-year-old man presented with effort angina for one month. His coronary risk factors were current smoking and dyslipidemia, and his only regular medication was rosuvastatin. There was no significant past medical history. His baseline electrocardiogram (ECG) and echocardiography were normal, but coronary angiography (CAG) revealed intermediate stenosis in the left ascending artery (LAD) and left circumflex artery (LCx). We performed fractional flow reserve in the LAD and LCx; the results were 0.77 and 0.79, respectively . We planned elective PCI to the LAD for effort angina. After starting dual anti-platelet therapy (DAPT) with 100 mg/day aspirin and 75 mg/day clopidogrel, successful angioplasty of the mid-LAD was performed. An everolimus-eluting stent (3.25 mm in diameter, 33 mm in length) was deployed with high pressure balloon (3.5/10 mm) post-dilatation . The final angiogram indicated good blood flow and the intravascular ultrasound indicated that the stent was well-expanded and there was no incomplete apposition . However, the patient reported new-onset chest discomfort at rest the next morning. The symptom resolved after a few minutes with no significant ECG changes and he was discharged. However, 5 days after the PCI, he was transported to our hospital by ambulance due to crushing chest pain while drinking. On admission, his ECG revealed ST-segment elevation in the precordial leads. In the emergency room, ECG monitoring detected ventricular fibrillation, and a counter-shock was successfully delivered. He then underwent emergent CAG, which revealed thrombotic total occlusion of the proximal LAD . We diagnosed subacute ST and performed PCI. Aspiration thrombectomy and balloon angioplasty with a 3.25/15 mm balloon were performed and TIMI-3 flow was obtained . After these procedures, he was admitted to the intensive care unit, where we confirmed the resolution of his critical status. There were no major complications and his general condition was improving, but he subsequently reported frequent chest discomfort, especially during the night and in the early morning. Although no significant ECG changes were observed, we performed follow-up CAG and a spasm provocation test with ergonovine to evaluate the coronary vasomotor response 2 weeks after the initial PCI. The baseline angiography revealed no significant findings . However, intracoronary infusion of 40 μg of ergonovine into the left coronary artery provoked severe vasospasm from the left main trunk (LMT) to the LAD, except for the stented lesion, and total occlusion was detected in the LCx . He indicated the chest discomfort was the same as usual. An isosorbide dinitrate injection improved both the vasospasm and the discomfort . His condition was diagnosed as coronary vasospastic angina (VSA); treatment with calcium channel blockers and nicorandil resolved his symptoms. We evaluated his cytochrome P450 2C19 (CYP2C19) genotype and determined he had a CYP2C19 polymorphism and was therefore a poor metabolizer of clopidogrel. Thus, we replaced the 75 mg/day clopidogrel with 3.75 mg/day prasugrel. His post-discharge clinical course was uneventful. Fig. 1 Pre-intervention coronary angiography. The left coronary artery showed intermediate stenosis in the proximal left ascending artery and left circumflex artery. Fractional flow reserve was 0.77 and 0.79 in the left ascending artery and left circumflex artery, respectively. AP anterior-posterior, RAO right anterior oblique Fig. 2 Elective percutaneous coronary intervention to the left ascending artery ( a and b ) and intravascular ultrasound findings ( c - f ). a Implantation of an everolimus-eluting stent (3.25 mm in diameter, 33 mm in length). b Final angiogram after post-dilatation, indicating good blood flow. c - f Intravascular ultrasound findings of the implanted everolimus-eluting stent ( c proximal part of the stent, d part of first diagonal branch, e part of second diagonal branch, f distal part of the stent) indicating that the stent was well-expanded and without incomplete apposition Fig. 3 Emergent coronary angiography and percutaneous coronary intervention for subacute stent thrombosis. a and b Total occlusion of the proximal part of the stent with thrombus. c and d Aspiration thrombectomy and balloon angioplasty (high-pressure balloon, 3.25/15 mm) were performed. e and f Final coronary angiogram, indicating TIMI grade 3 flow. POBA plain old balloon angioplasty Fig. 4 The spasm provocation test. a and b Baseline coronary angiography. c and d Intracoronary infusion of ergonovine induced a severe spasm in the left coronary artery, except for the stented lesion; the left circumflex artery was occluded. e and f Intracoronary infusion of isosorbide dinitrate completely resolved the coronary vasospasm. EES everolimus-eluting stent, Erg ergonovine, ISDN isosorbide dinitrate
3.998047
0.973633
sec[1]/p[0]
en
0.999994
27887648
https://doi.org/10.1186/s12872-016-0410-4
[ "coronary", "artery", "stent", "flow", "balloon", "angiography", "part", "ascending", "circumflex", "angioplasty" ]
[ { "code": "BA8Z", "title": "Diseases of coronary artery, unspecified" }, { "code": "BA4Z", "title": "Acute ischaemic heart disease, unspecified" }, { "code": "BA41.Z", "title": "Acute myocardial infarction, unspecified" }, { "code": "BA5Z", "title": "Chronic ischaemic heart disease, unspecified" }, { "code": "LA8C.2", "title": "Congenital coronary arterial fistula" }, { "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 === [BA8Z] Diseases of coronary artery, unspecified Also known as: Diseases of coronary artery, unspecified | coronary artery insufficiency | coronary artery heart disease | CAD - [coronary artery disease] | coronary artery disorder [BA4Z] Acute ischaemic heart disease, unspecified Also known as: Acute ischaemic heart disease, unspecified | acute coronary syndrome | ACS - [acute coronary syndrome] | Silent myocardial ischaemia | asymptomatic ischemia [BA41.Z] Acute myocardial infarction, unspecified Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction [BA5Z] Chronic ischaemic heart disease, unspecified Also known as: Chronic ischaemic heart disease, unspecified | Ischaemic heart disease (chronic) NOS | coronary ischaemia | coronary damage NOS | atheroma of heart [LA8C.2] Congenital coronary arterial fistula Definition: A congenital cardiovascular malformation in which a coronary artery communicates, through an anomalous channel, with a cardiac chamber or with any segment of the systemic or pulmonary circulation. Additional information: this communication may be simple and direct or may be tortuous and dilated. In order of frequency the involved coronary artery is the right, the left and, rarely, both coronary arteries. Occasionally multiple fistulas are present. Also known as: Congenital coronary arterial fistula | coronary fistula | congenital arteriovenous coronary fistula | congenital coronary fistula to pulmonary artery | Congenital coronary arterial fistula to right ventricle Includes: congenital coronary fistula to pulmonary artery Excludes: anomalous origin of coronary artery from pulmonary arterial tree [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 --- [BA8Z] Diseases of coronary artery, unspecified --PARENT--> [?] Diseases of coronary artery Def: Conditions affecting the blood perfusion of the heart.... --RELATED_TO--> [?] Coronary atherosclerosis Def: Atherosclerosis is the build up inside the coronary arteries of cholesterol, fatty acids, calcium, fibrous connective tissue and cells (mostly macrophages), referred to as plaque. The effect of this i... --- Walk 2 --- [BA8Z] Diseases of coronary artery, unspecified --PARENT--> [?] Diseases of coronary artery Def: Conditions affecting the blood perfusion of the heart.... --CHILD--> [BA83] Coronary artery fistula, acquired Def: Abnormal communication between a coronary artery and a cardiac chamber or major vessels, acquired after coronary or heart surgery, coronary angioplasty, rupture or coronary artery aneurysm or injury t... --- Walk 3 --- [BA4Z] Acute ischaemic heart disease, unspecified --PARENT--> [?] Acute ischaemic heart disease --CHILD--> [BA42] Subsequent myocardial infarction Def: Infarction of any myocardial site, occurring within 4 weeks (28 days) from onset of a previous infarction... --- Walk 4 --- [BA4Z] Acute ischaemic heart disease, unspecified --PARENT--> [?] Acute ischaemic heart disease --CHILD--> [BA41] Acute myocardial infarction Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o... --- Walk 5 --- [BA41.Z] Acute myocardial infarction, unspecified --PARENT--> [BA41] Acute myocardial infarction Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o... --CHILD--> [BA41.Z] Acute myocardial infarction, unspecified --- Walk 6 --- [BA41.Z] Acute myocardial infarction, unspecified --PARENT--> [BA41] Acute myocardial infarction Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o... --EXCLUDES--> [?] Dressler syndrome Def: A condition of postmyocardial infarction (1 to 8 weeks), characterised by a set of associated symptom, including malaise, fever, pericardial discomfort, leukocytosis, an elevated sedimentation rate, a...
[ "[BA8Z] Diseases of coronary artery, unspecified\n --PARENT--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....\n --RELATED_TO--> [?] Coronary atherosclerosis\n Def: Atherosclerosis is the build up inside the coronary arteries of cholesterol, fatty acids, calcium, fibrous connective tissue and cells (mostly macrophages), referred to as plaque. The effect of this i...", "[BA8Z] Diseases of coronary artery, unspecified\n --PARENT--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....\n --CHILD--> [BA83] Coronary artery fistula, acquired\n Def: Abnormal communication between a coronary artery and a cardiac chamber or major vessels, acquired after coronary or heart surgery, coronary angioplasty, rupture or coronary artery aneurysm or injury t...", "[BA4Z] Acute ischaemic heart disease, unspecified\n --PARENT--> [?] Acute ischaemic heart disease\n --CHILD--> [BA42] Subsequent myocardial infarction\n Def: Infarction of any myocardial site, occurring within 4 weeks (28 days) from onset of a previous infarction...", "[BA4Z] Acute ischaemic heart disease, unspecified\n --PARENT--> [?] Acute ischaemic heart disease\n --CHILD--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...", "[BA41.Z] Acute myocardial infarction, unspecified\n --PARENT--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...\n --CHILD--> [BA41.Z] Acute myocardial infarction, unspecified", "[BA41.Z] Acute myocardial infarction, unspecified\n --PARENT--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...\n --EXCLUDES--> [?] Dressler syndrome\n Def: A condition of postmyocardial infarction (1 to 8 weeks), characterised by a set of associated symptom, including malaise, fever, pericardial discomfort, leukocytosis, an elevated sedimentation rate, a..." ]
BA8Z
Diseases of coronary artery, unspecified
[ { "from_icd11": "BA4Z", "icd10_code": "I248", "icd10_title": "Other forms of acute ischemic heart disease" }, { "from_icd11": "BA4Z", "icd10_code": "I256", "icd10_title": "Silent myocardial ischemia" }, { "from_icd11": "BA4Z", "icd10_code": "I249", "icd10_title": "Acute ischemic heart disease, unspecified" }, { "from_icd11": "BA4Z", "icd10_code": "I24", "icd10_title": "Other acute ischemic heart diseases" }, { "from_icd11": "BA41.Z", "icd10_code": "I21A1", "icd10_title": "Myocardial infarction type 2" }, { "from_icd11": "BA41.Z", "icd10_code": "I21A9", "icd10_title": "Other myocardial infarction type" }, { "from_icd11": "BA41.Z", "icd10_code": "I2109", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall" }, { "from_icd11": "BA41.Z", "icd10_code": "I2119", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall" }, { "from_icd11": "BA41.Z", "icd10_code": "I2111", "icd10_title": "ST elevation (STEMI) myocardial infarction involving right coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2102", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2129", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other sites" }, { "from_icd11": "BA41.Z", "icd10_code": "I2121", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2101", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left main coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I214", "icd10_title": "Non-ST elevation (NSTEMI) myocardial infarction" }, { "from_icd11": "BA41.Z", "icd10_code": "I213", "icd10_title": "ST elevation (STEMI) myocardial infarction of unspecified site" } ]
I248
Other forms of acute ischemic heart disease
A 49-year-old European, postmenopausal woman who was diagnosed with stage T1a ovarian GCT had recurrence 7 years after primary surgery and five cycles of chemotherapy: epirubicin + cisplatin. On admission, the results of her neurological examination were normal. A physical examination revealed two cystic masses above her vagina on the left and slightly to the right that varied from 6 to 10 cm in diameter. The results of the rest of her physical examination were normal. She had given birth to three children. In January 2011, magnetic resonance imaging (MRI) depicted a large pelvic mass with inhomogeneous signal intensity (87×108×70 mm), a diffuse peritoneal metastasis (68×35 mm) with ascites, a parailiacal pathological lymph node (15×10 mm), and an inguinal pathological lymph node (62×32 mm) from the left side of her pelvis . A laboratory examination did not reveal elevated levels of serum tumor markers and hormones: carcinoembryonic antigen (CEA), 1.6 ng/ml; carbohydrate antigen-125 (CA-125), 18.45 U/ml; carbohydrate antigen-15-3 (CA-15-3), 20 U/ml; carbohydrate antigen-19-9 (CA-19-9), 0.6 U/ml; alpha-fetoprotein (AFP), 2.3 μg/l; follicle-stimulating hormone (FSH), 23.1 U/l; luteinizing hormone (LH), 38.9 U/l; progesterone (P), 2 nmol/l; 17β-estradiol (E 2 ), 64 pmol/l; testosterone (T), 0.92 nmol/l; and androstenediol (A), 7.74 nmol/l. She underwent abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy 3 months later. A histologic examination revealed recurrence of GCT. Immunohistochemical staining gave positive results for alpha-inhibin. After the operation (OP), she was given three cycles of chemotherapy: bleomycin, etoposide, and cisplatin (BEP). Two months later she underwent metastasectomy through laparotomy and she was given three cycles of third line chemotherapy: cyclophosphamide and doxorubicin (CAP I). Despite surgeries and chemotherapies, in August 2014 a computed tomography (CT) scan showed significant progression of the recurrent GCT, local tumor recurrence, the presence of diffuse peritoneal carcinosis, ascites, and inguinal pathological lymph node . A laboratory examination did not reveal elevated levels of serum tumor markers: CEA, 1.3 ng/ml; CA-125, 13 U/ml. Then she was given three cycles of re-induction of epirubicin + cisplatin chemotherapy. Three months later in February 2015, CT demonstrated 25% regression of the tumor . Then, she refused further parenteral chemotherapy. From April 2016 she received oral anastrozole (Arimidex®) therapy. During the treatments, before and after the OP, 13 24-hour urinary samples were collected at different time points. Her urine samples were stored at −20 ○ C until analysis. We performed sample pre-treatment, and the extraction method we used is based on Shackleton and Whitney’s extraction method . After the sample preparation processes the concentrations (μg/24 hours) of the following urinary androgen, progesterone (P), and corticoid metabolites were determined by gas chromatography-mass spectrometry (GC-MS)/selected ion-monitoring (SIM): androsterone (An), etiocholanolone (Et), dehydroepiandrosterone (DHEA), 11β-hydroxyandrosterone (11-OH-An), 16-hydroxy-DHEA (16-OH-DHEA), pregnanediol (PD), pregnanetriol (PT), pregnenediol (Δ5-PD), androstenetriol (Δ5-AT), tetrahydro-11-deoxycortisol (THS), 11-keto-pregnanetriol (11-O-PT), tetrahydrocortisone (THE), tetrahydro-11-dehydrocorticosterone (THA), tetrahydrocorticosterone (THB), allo-tetrahydrocorticosterone (aTHB), tetrahydrocortisol (THF), allo-tetrahydrocortisol (aTHF), α-cortolone (α-CL), β-cortolone (β-CL), and α-cortol (α-C). All components were detected in all samples. The interventions and treatments of patient 1, the collection of urine samples, and the levels of the urinary steroid metabolites are shown in Fig. 3 . Fig. 1 Patient 1 – magnetic resonance images of the recurrence of ovarian granulosa cell tumor. a Axial, b sagittal, and c coronal T2-weighted images showing a local tumor recurrence (87×108×70 mm), diffuse peritoneal metastasis (68×35 mm) with ascites from the pelvis, a parailiacal pathological lymph node (15×10 mm), and an inguinal pathological lymph node (62×32 mm) from the left side of the pelvis Fig. 2 Patient 1 Computer tomography images of recurrent ovarian granulosa cell tumour. a The progression of tumour (local tumour recurrence (blue arrow), diffuse peritoneal carcinosis with ascites and inguinal pathological lymph node), and b the regression of local recurrence tumour (blue arrow) Fig. 3 Patient 1 a The interventions and treatments of patient and the collection of urine samples. b The levels of the urinary steroid metabolites at different time points. * represents a steroid level that is higher than the same age and same sex reference value. - represents a steroid level that is lower than the reference value in all samples
4.023438
0.978027
sec[1]/sec[0]/p[0]
en
0.999996
28637499
https://doi.org/10.1186/s13256-017-1324-1
[ "recurrence", "pathological", "lymph", "node", "tumor", "samples", "chemotherapy", "three", "cycles", "peritoneal" ]
[ { "code": "9A78.8", "title": "Recurrent erosion of cornea" }, { "code": "7A22", "title": "Kleine-Levin syndrome" }, { "code": "DC50.1Y", "title": "Other specified secondary peritonitis" }, { "code": "GA33", "title": "Recurrent pregnancy loss" }, { "code": "8C74.1Z", "title": "Periodic paralysis, unspecified" }, { "code": "5C64.5", "title": "Disorders of calcium metabolism" }, { "code": "JA04", "title": "Blighted ovum or nonhydatidiform mole" }, { "code": "GB06.1", "title": "Priapism" }, { "code": "6C71", "title": "Kleptomania" }, { "code": "6D10.Z", "title": "Personality disorder, severity unspecified" } ]
=== ICD-11 CODES FOUND === [9A78.8] Recurrent erosion of cornea Also known as: Recurrent erosion of cornea | corneal erosion | non-traumatic recurrent erosion of cornea | recurrent corneal erosion | recurrent erosion syndrome [7A22] Kleine-Levin syndrome Definition: Kleine-Levin syndrome is characterised by recurrent episodes of severe sleepiness in association with cognitive, psychiatric, and behavioural disturbances. A typical episode lasts a median of 10 days (range 2.5–80 days), with rare episodes lasting several weeks to months. During episodes, patients may sleep as long as 16 to 20 hours per day, waking or getting up only to eat and void. When awake during episodes, most patients are exhausted, apathetic, confused, and slow in speaking and answering. Also known as: Kleine-Levin syndrome | recurrent hypersomnolence | hypersomnia-bulimia syndrome Includes: recurrent hypersomnolence [DC50.1Y] Other specified secondary peritonitis Also known as: Other specified secondary peritonitis | Escherichia coli peritonitis | E coli peritonitis | Enterococcal peritonitis | Gram negative peritonitis, not elsewhere classified [GA33] Recurrent pregnancy loss Also known as: Recurrent pregnancy loss | recurrent aborter | recurrent miscarriage | Habitual aborter | habitual or recurrent aborter without current pregnancy Excludes: currently pregnant | with current abortion [8C74.1Z] Periodic paralysis, unspecified Also known as: Periodic paralysis, unspecified | Periodic paralysis | Westphal disease | periodic myotonia | myoplegic dystrophy [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 [JA04] Blighted ovum or nonhydatidiform mole Definition: A condition caused by genetic abnormality, abnormal cell division, or poor quality ovum or sperm. This condition is characterised by a failed pregnancy, implantation of a fertilized egg without development into an embryo, haemorrhage into the decidua, and adjacent tissue necrosis. Also known as: Blighted ovum or nonhydatidiform mole | anembryonic pregnancy | blighted ovum | blood mole | carneous mole Includes: Pathological ovum [GB06.1] Priapism Definition: A condition of the penis, caused by acute leukaemia, sickle cell anaemia, infection, a penile or central nervous system lesion, or the use of certain pharmacological agents. This condition is characterised by prolonged or persistent painful penile erection lasting over four hours without physical or psychological sexual arousal. Also known as: Priapism | mentulagra | pathologic erection | Painful erection | High-flow priapism Includes: Painful erection [6C71] Kleptomania Definition: Kleptomania is characterised by a recurrent failure to control strong impulses to steal objects in the absence of an apparent motive (e.g., objects are not acquired for personal use or monetary gain). There is an increasing sense of tension or affective arousal before instances of theft and a sense of pleasure, excitement, relief, or gratification during and immediately after the act of stealing. The behaviour is not better explained by intellectual impairment, another mental and behavioural dis Also known as: Kleptomania | pathological stealing Includes: pathological stealing Excludes: shoplifting as the reason for observation for suspected mental disorder, ruled out [6D10.Z] Personality disorder, severity unspecified Also known as: Personality disorder, severity unspecified | Personality disorder | Specific personality disorders | Enduring personality change after psychiatric illness (deprecated) | Anankastic personality disorder === GRAPH WALKS === --- Walk 1 --- [9A78.8] Recurrent erosion of cornea --PARENT--> [9A78] Certain specified disorders of cornea --RELATED_TO--> [?] Injury of conjunctiva or corneal abrasion without mention of foreign body --- Walk 2 --- [9A78.8] Recurrent erosion of cornea --PARENT--> [9A78] Certain specified disorders of cornea --CHILD--> [9A78.0] Corneal neovascularization --- Walk 3 --- [7A22] Kleine-Levin syndrome Def: Kleine-Levin syndrome is characterised by recurrent episodes of severe sleepiness in association with cognitive, psychiatric, and behavioural disturbances. A typical episode lasts a median of 10 days ... --PARENT--> [?] Hypersomnolence disorders Def: Hypersomnolence disorders are characterised by a complaint of daytime sleepiness that is not due to another sleep-wake disorder (e.g. disturbed nocturnal sleep, misaligned circadian rhythm, or breathi... --CHILD--> [7A20] Narcolepsy Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM... --- Walk 4 --- [7A22] Kleine-Levin syndrome Def: Kleine-Levin syndrome is characterised by recurrent episodes of severe sleepiness in association with cognitive, psychiatric, and behavioural disturbances. A typical episode lasts a median of 10 days ... --PARENT--> [?] Hypersomnolence disorders Def: Hypersomnolence disorders are characterised by a complaint of daytime sleepiness that is not due to another sleep-wake disorder (e.g. disturbed nocturnal sleep, misaligned circadian rhythm, or breathi... --CHILD--> [7A20] Narcolepsy Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM... --- Walk 5 --- [DC50.1Y] Other specified secondary peritonitis --PARENT--> [DC50.1] Secondary peritonitis Def: Peritonitis with evident source of an infecting agent or due to other diseases.... --EXCLUDES--> [?] Female pelvic peritonitis, unspecified Def: This is an inflammation of the peritoneum, the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs, unspecified.... --- Walk 6 --- [DC50.1Y] Other specified secondary peritonitis --PARENT--> [DC50.1] Secondary peritonitis Def: Peritonitis with evident source of an infecting agent or due to other diseases.... --CHILD--> [DC50.10] Eosinophilic peritonitis Def: 10% or more eosinophils in peritoneal effluent at presentation, and its causes are often obscure. However, cases have been reported with allergic reactions, exposure to drugs such as vancomycin, funga...
[ "[9A78.8] Recurrent erosion of cornea\n --PARENT--> [9A78] Certain specified disorders of cornea\n --RELATED_TO--> [?] Injury of conjunctiva or corneal abrasion without mention of foreign body", "[9A78.8] Recurrent erosion of cornea\n --PARENT--> [9A78] Certain specified disorders of cornea\n --CHILD--> [9A78.0] Corneal neovascularization", "[7A22] Kleine-Levin syndrome\n Def: Kleine-Levin syndrome is characterised by recurrent episodes of severe sleepiness in association with cognitive, psychiatric, and behavioural disturbances. A typical episode lasts a median of 10 days ...\n --PARENT--> [?] Hypersomnolence disorders\n Def: Hypersomnolence disorders are characterised by a complaint of daytime sleepiness that is not due to another sleep-wake disorder (e.g. disturbed nocturnal sleep, misaligned circadian rhythm, or breathi...\n --CHILD--> [7A20] Narcolepsy\n Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM...", "[7A22] Kleine-Levin syndrome\n Def: Kleine-Levin syndrome is characterised by recurrent episodes of severe sleepiness in association with cognitive, psychiatric, and behavioural disturbances. A typical episode lasts a median of 10 days ...\n --PARENT--> [?] Hypersomnolence disorders\n Def: Hypersomnolence disorders are characterised by a complaint of daytime sleepiness that is not due to another sleep-wake disorder (e.g. disturbed nocturnal sleep, misaligned circadian rhythm, or breathi...\n --CHILD--> [7A20] Narcolepsy\n Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM...", "[DC50.1Y] Other specified secondary peritonitis\n --PARENT--> [DC50.1] Secondary peritonitis\n Def: Peritonitis with evident source of an infecting agent or due to other diseases....\n --EXCLUDES--> [?] Female pelvic peritonitis, unspecified\n Def: This is an inflammation of the peritoneum, the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs, unspecified....", "[DC50.1Y] Other specified secondary peritonitis\n --PARENT--> [DC50.1] Secondary peritonitis\n Def: Peritonitis with evident source of an infecting agent or due to other diseases....\n --CHILD--> [DC50.10] Eosinophilic peritonitis\n Def: 10% or more eosinophils in peritoneal effluent at presentation, and its causes are often obscure. However, cases have been reported with allergic reactions, exposure to drugs such as vancomycin, funga..." ]
9A78.8
Recurrent erosion of cornea
[ { "from_icd11": "7A22", "icd10_code": "G478", "icd10_title": "Other sleep disorders" }, { "from_icd11": "GA33", "icd10_code": "N96", "icd10_title": "Recurrent pregnancy loss" }, { "from_icd11": "8C74.1Z", "icd10_code": "G723", "icd10_title": "Periodic paralysis" }, { "from_icd11": "5C64.5", "icd10_code": "E8352", "icd10_title": "Hypercalcemia" }, { "from_icd11": "5C64.5", "icd10_code": "E8351", "icd10_title": "Hypocalcemia" }, { "from_icd11": "5C64.5", "icd10_code": "E8359", "icd10_title": "Other disorders of calcium metabolism" }, { "from_icd11": "5C64.5", "icd10_code": "E8350", "icd10_title": "Unspecified disorder of calcium metabolism" }, { "from_icd11": "5C64.5", "icd10_code": "E835", "icd10_title": "Disorders of calcium metabolism" }, { "from_icd11": "JA04", "icd10_code": "O020", "icd10_title": "Blighted ovum and nonhydatidiform mole" }, { "from_icd11": "JA04", "icd10_code": "O02", "icd10_title": "Other abnormal products of conception" }, { "from_icd11": "GB06.1", "icd10_code": "N4833", "icd10_title": "Priapism, drug-induced" }, { "from_icd11": "GB06.1", "icd10_code": "N4839", "icd10_title": "Other priapism" }, { "from_icd11": "GB06.1", "icd10_code": "N4830", "icd10_title": "Priapism, unspecified" }, { "from_icd11": "GB06.1", "icd10_code": "N4831", "icd10_title": "Priapism due to trauma" }, { "from_icd11": "GB06.1", "icd10_code": "N4832", "icd10_title": "Priapism due to disease classified elsewhere" } ]
G478
Other sleep disorders
The 59-year-old male patient was initially diagnosed with stage IIIA follicular lymphoma in January 2018, which transformed to germinal center B-cell like DLBCL in October of the same year. Refractory to multiple cycles of Rituximab-based immunochemotherapy , the patient underwent leukapheresis for CAR T-cell therapy in April 2019. The patient experienced significant lymphoma progression during the manufacturing process of Axicabtagene ciloleucel (Axi-cel), manifesting itself in the form of malignant pleural effusions and progressive lymphadenopathy . In the six-week period between leukapheresis and lymphodepletion, the patient remained severely neutropenic after R-CHOP and developed possible invasive fungal disease (IFD) as well as E. coli septicemia secondary to a urinary tract infection. These infections were treated successfully with liposomal amphotericin B and piperacillin/tazobactam. Prior to lymphodepletion (D-5), the patient presented with an ECOG performance status of 1, intact renal and liver function, while observing residually depressed blood counts . BM histopathology showed a hypocellular marrow with no evidence of lymphoma infiltration. Analysis of lymphocyte subpopulations demonstrated severe B-cell aplasia and decreased absolute CD4+ (84/μl) and CD8+ (271/μl) counts. His anti-infective prophylaxis consisted of a combination of acyclovir, sulfamethoxazole/trimethoprim (TMP/SMZ), and posaconazole. The fludarabine/cyclophosphamide lympho-preparative regimen was applied on days − 5 to − 3 according to the provider’s protocol, followed by CAR T-cell transfusion on day 0. Fig. 1 Overview of CAR T-cell mediated hematotoxicity and infectious complications. a Treatment course prior to CAR T-cell therapy. b Timeline of infectious complications during CAR T-cell treatment course. Positive microbiologic culture results are underlined. Bottom: Overview of utilized anti-infectives with the respective bars displaying the length of treatment. P/T = piperacillin/tazobactam, Ami = amikacin, Mero = meropenem, Vanco = vancomycin, Line = linezolid, Posa = posaconazole (p.o.), Mica = micafungin (i.v.), Amb = liposomal amphotericin B. The patient also received prophylactic acyclovir and sulfamethoxazole/trimethoprim (TMP/SMZ) during treatment. c Complete Blood Count (CBC) timeline. ANC (blue), platelet count (green), Hemoglobin (red). Transfusion events (green: platelet transfusion, red: pRBC transfusion) and G-CSF support (blue bar) are integrated in the curve. d Dynamics of Serum Inflammatory Markers. Infectious complications are superimposed above the graph. e Histopathologic analysis of BM biopsies demonstrating severe BM aplasia 1 month after CAR T-cell transfusion (Day 32, upper panel) and evidence of recovering hematopoiesis following autologous stem cell transfer (Autopsy, lower panel). Immunohistochemical staining for myeloperoxidase (= MPO) highlighting strong activation of myelopoiesis (right panel) Fig. 2 Radiographic evidence of partial response to Axi-cel after 36 days. Contrast-enhanced CT abdomen (axial view) displaying pleural manifestations before ( a ) and after ( b ) CAR T-cell treatment. Involved paraaortic lymph nodes (red arrows) demonstrate an interval decrease in size ( c-d , e-f ). The inset of panel F depicts splenic hypodensities consistent with necrosis of tumor tissue secondary to immune therapy and a reduction of splenomegaly. G Graphical depiction of response over time. Tumor extent was quantified as the sum of the product of perpendicular diameters according to Lugano criteria over 3 time points and is graphed on the y-axis. H Timeline of LDH levels (U/l). The increase in LDH levels at day 25 correlated with the gastrointestinal toxicity and liver dysfunction Fig. 3 Multi-organ toxicity secondary to CD19-directed CAR T-cell therapy. a Contrast-enhanced CT abdomen demonstrating a non-inflamed baseline state of GI mucosal tissue prior to CAR T therapy. b Panmural swelling of the sigma (left panel), ascending colon (middle panel), and stomach. c Non-pathologic CT of the brain. d Axial FLAIR-weighted (left), T1-weighted contrast-enhanced (middle), and diffusion-weighted (right) MRI displaying no evidence of cerebral edema, white matter lesions, diffusion restriction, microbleeds, meningeal enhancement or contrast enhancing lesions. e High-resolution CT thorax with bilateral fungal infiltrates observing the typical halo configuration 6 weeks prior to CAR T-cell transfusion. f On day − 3 the right-sided infiltrates have decreased in size. The left lung is collapsed due to malignant pleural effusion. g Lung parenchyma exhibiting an infiltration of non-dimorphic blastoconidial morphology consistent with Candida glabrata . h PAS staining of a lung specimen highlights septated hiphae and acute-angle branching, features consistent of with aspergillus infection
4.140625
0.933105
sec[1]/p[0]
en
0.999996
33509115
https://doi.org/10.1186/s12879-020-05755-4
[ "cell", "transfusion", "panel", "evidence", "contrast", "lymphoma", "pleural", "infectious", "complications", "timeline" ]
[ { "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": "NE80.Z", "title": "Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified, unspecified" }, { "code": "JA8A.0", "title": "Placental transfusion syndromes" }, { "code": "KA02.4", "title": "Fetus or newborn affected by placental transfusion syndromes" }, { "code": "PL14.4", "title": "Other problem associated with transfusion" }, { "code": "QB63.7", "title": "Presence of transfused blood" } ]
=== 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 [NE80.Z] Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified, unspecified Also known as: Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified, unspecified | Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified | transfusion reaction NOS | Blood transfusion reaction not elsewhere classified | blood transfusion reaction NOS [JA8A.0] Placental transfusion syndromes Also known as: Placental transfusion syndromes | placental transfusion | placenta transfusion syndrome | Twin to twin transfusion syndrome | Feto-fetal transfusion syndrome [KA02.4] Fetus or newborn affected by placental transfusion syndromes Definition: Twin-to-twin transfusion syndrome (TTTS) occurs in monozygotic twins while they are in the uterus. It occurs when blood travels from one twin to the other, and the twin that loses blood is the donor twin, while the twin that receives blood is the recipient twin. Depending on the severity of the transfusion, both infants may experience problems, such as anaemia, paleness, and dehydration in the donor twin, and redness and an increased blood pressure in the recipient twin. Also known as: Fetus or newborn affected by placental transfusion syndromes | Placental and cord abnormalities resulting in twin-to-twin or other transplacental transfusion | fetal transfusion syndrome | placental transfusion in fetus or newborn | placental transfusion syndrome in fetus or newborn Includes: Placental and cord abnormalities resulting in twin-to-twin or other transplacental transfusion [PL14.4] Other problem associated with transfusion Also known as: Other problem associated with transfusion [QB63.7] Presence of transfused blood Also known as: Presence of transfused blood | blood transplant status | blood transfusion status | presence of transplanted blood === GRAPH WALKS === --- Walk 1 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --CHILD--> [MF91] Bilirubinuria Def: Bilirubinuria means the presence of any bile pigment in the urine.... --- 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--> [?] Wolman disease Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir... --PARENT--> [?] Lysosomal acid lipase deficiency Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater... --- 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 ... --RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy --- 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 ... --RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy
[ "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --CHILD--> [MF91] Bilirubinuria\n Def: Bilirubinuria means the presence of any bile pigment in the urine....", "[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--> [?] Wolman disease\n Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...\n --PARENT--> [?] Lysosomal acid lipase deficiency\n Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater...", "[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 --RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy", "[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 --RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy" ]
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": "NE80.Z", "icd10_code": "T80A11A", "icd10_title": "Non-ABO incompatibility with delayed hemolytic transfusion reaction, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80219A", "icd10_title": "Unspecified infection due to central venous catheter, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T8089XA", "icd10_title": "Other complications following infusion, transfusion and therapeutic injection, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T8029XA", "icd10_title": "Infection following other infusion, transfusion and therapeutic injection, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80818A", "icd10_title": "Extravasation of other vesicant agent, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T801XXA", "icd10_title": "Vascular complications following infusion, transfusion and therapeutic injection, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80212A", "icd10_title": "Local infection due to central venous catheter, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T8092XA", "icd10_title": "Unspecified transfusion reaction, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80218A", "icd10_title": "Other infection due to central venous catheter, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80211D", "icd10_title": "Bloodstream infection due to central venous catheter, subsequent encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80910A", "icd10_title": "Acute hemolytic transfusion reaction, unspecified incompatibility, initial encounter" } ]
D571
Sickle-cell disease without crisis
A 64-year-old Japanese man noticed a mass in the right breast and sought medical attention. The patient’s medical records showed that he was currently undergoing treatment for alcoholic hepatitis. Physical findings confirmed gynecomastia in both breasts. An elastic and soft neoplastic 3-cm lesion was palpated in the right papilla . There were no skin lesions, and swollen lymph nodes were not palpated. Blood tests showed that tumor marker levels were normal (carcinoembryonic antigen [CEA] level of 1.6 ng/ml [normal, < 5.0 ng/ml], cancer antigen 15-3 [CA15-3] level of 7.5 IU/ml [normal, < 25.0 IU/ml], and National Cancer Center-Stomach-439 (NCC-ST-439) level of 1.0 U/ml [normal, < 4.5 U/ml]). On mammary ultrasonography, a cystic lesion of 3.9 × 2.6 cm was confirmed immediately below the right papilla (mixed pattern). As a 1-cm solid tumor with a gradual rise from the cyst wall was confirmed within the cyst, vacuum-assisted biopsy (VAB) was performed on that site . Pathological examination of the biopsy revealed heterotypic cells with an enlarged oval nucleus forming dense papillary structures mainly of vascular connective tissue components . There was a nucleolus in the nucleus, and some mitotic images were noted. No invasion of tumor cells into the interstitium was noted. Upon immunohistochemical staining, estrogen receptor (ER) and progesterone receptor (PgR) were diffusely positive, human epidermal growth factor receptor 2 (HER2) was negative, and the Ki 67 index was 62.5%. Contrast-enhanced computed tomography (CT) confirmed thickening of the wall that protruded outside the cyst . A systemic examination demonstrated that there were no metastases to the lungs, liver, or lymph nodes. Furthermore, there were no bone metastases as determined via bone scintigraphy. The preoperative diagnosis was right breast cancer (male IPC) TisN0M0 stage 0 luminal B-like. Total mastectomy and sentinel lymph node biopsy were performed. Intraoperative pathological diagnosis confirmed a lack of metastasis to the sentinel lymph node; hence, axillary lymph node dissection was omitted. In the excised specimen, a 4.0-cm unilocular cyst was found, along with a 1-cm solid tumor with a gradual rise from the cyst wall . Pathological diagnosis of the resected specimen shared similar characteristics with the solid tumor in the cyst: notably, an oval nucleus with histologically clear nucleolus and fine granular chromatin, cylindrically shaped heterotypic cells, and the presence of basophilic cells in the papillary growth with a thin stem of fibrovasculature as the axis. Some invasion of tumor cells into the interstitium was confirmed. In the papillary structure, p63-positive myoepithelial cells were absent and it was not biphasic (nuclear grade grade 2, nuclear atypia score 3, mitotic counts score 1) (surgical margin free) . ER and PgR staining were diffusely positive, HER2 staining was negative, and the Ki 67 index was 6.6%. In immunostaining, cytokeratin (CK) 20 was negative, and androgen receptor (AR) was positive. As such, the final diagnosis was right breast cancer (male IPC) T2N0M0 stage IIA luminal B-like. The expression of hormone receptor (ER and PgR) was high, and endocrine therapy was initiated postoperatively (20 mg/day tamoxifen). At the present time (3 months postoperation), there has not been any evidence of metastasis. Fig. 1 Physical and ultrasonography findings: An elastic and soft neoplastic 3-cm lesion was palpated in the right papilla ( a ). On mammary ultrasonography, a cystic lesion of 3.9 × 2.6 cm was confirmed immediately below the right papilla (mixed pattern). As a 1-cm solid tumor with a gradual rise from the cyst wall was confirmed within the cyst ( b ) Fig. 2 Pathological findings of vacuum-assisted biopsy: Pathological examination of the biopsy revealed heterotypic cells with an enlarged oval nucleus forming dense papillary structures mainly of vascular connective tissue components ( a × 100) ( b × 400) Fig. 3 CT image findings: Contrast-enhanced computed tomography confirmed thickening of the wall that protruded outside the cyst ( a , b ) Fig. 4 Macroscopic diagnosis of the resected specimen: In the excised specimen, a 4.0-cm unilocular cyst was found, along with a 1-cm solid tumor with a gradual rise from the cyst wall (arrow) ( a anterior image) ( b split face of posterior image) Fig. 5 Pathological diagnosis of the resected specimen: Pathological diagnosis of the resected specimen shared similar characteristics with the solid tumor in the cyst: notably, an oval nucleus with histologically clear nucleolus and fine granular chromatin, cylindrically shaped heterotypic cells, and the presence of basophilic cells in the papillary growth with a thin stem of fibrovasculature as the axis ( a × 100) ( b × 400). Some invasion of tumor cells into the interstitium was confirmed (arrow)
4.070313
0.966309
sec[1]/p[0]
en
0.999998
29361955
https://doi.org/10.1186/s12957-018-1318-5
[ "cyst", "tumor", "cells", "pathological", "that", "solid", "wall", "specimen", "lymph", "biopsy" ]
[ { "code": "FB80.5", "title": "Solitary bone cyst" }, { "code": "EK70.Z", "title": "Cutaneous cysts, unspecified" }, { "code": "FB4Y", "title": "Other specified disorders of synovium or tendon" }, { "code": "CA0C", "title": "Cyst or mucocele of nose or nasal sinus" }, { "code": "9A7Y", "title": "Other specified disorders of the cornea" }, { "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 === [FB80.5] Solitary bone cyst Definition: A solitary bone cyst is a benign non-epithelial bone cavity that is asymptomatic and that is found most commonly in the second decade of life by chance. The long bones are most often affected, but cases involving the jaw bone have been reported. Also known as: Solitary bone cyst | cyst of bone | local cyst of bone | simple bone cyst | solitary bone cyst, unspecified site Excludes: solitary cyst of jaw [EK70.Z] Cutaneous cysts, unspecified Also known as: Cutaneous cysts, unspecified | Cutaneous cysts | Follicular cysts of skin and subcutaneous tissue [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 [CA0C] Cyst or mucocele of nose or nasal sinus Definition: A condition which refers to diseases of the nose and nasal sinus that cause a cyst or mucocele. A mucocele is any dilatation (typically pathologic) with accumulation of mucus. Mucoceles are benign, epithelium-lined cysts filled with mucus, which can form in the paranasal sinuses. These structures may cause symptoms if sufficiently large or if exerting pressure on surrounding anatomic structures. Symptomatic mucoceles typically require surgical intervention. Mucoceles should be differentiated fro Also known as: Cyst or mucocele of nose or nasal sinus | cyst of sinus | mucocele of sinus | Cyst of maxillary sinus | cyst of maxillary antrum [9A7Y] Other specified disorders of the cornea Also known as: Other specified disorders of the cornea | Secondary disorders of sclera or cornea | Disorders of sclera and cornea in diseases classified elsewhere | Secondary keratitis or keratoconjunctivitis | Keratitis and keratoconjunctivitis in other diseases classified elsewhere [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 --- [FB80.5] Solitary bone cyst Def: A solitary bone cyst is a benign non-epithelial bone cavity that is asymptomatic and that is found most commonly in the second decade of life by chance. The long bones are most often affected, but cas... --EXCLUDES--> [?] Other cysts of jaw Def: This is mostly odontogenic cysts but may be also of non-odontogenic source. The mandible and maxilla are the bones with the highest prevalent of cysts in the human body owing to odontogenic and develo... --CHILD--> [?] Aneurysmal cyst of jaw --- Walk 2 --- [FB80.5] Solitary bone cyst Def: A solitary bone cyst is a benign non-epithelial bone cavity that is asymptomatic and that is found most commonly in the second decade of life by chance. The long bones are most often affected, but cas... --EXCLUDES--> [?] Other cysts of jaw Def: This is mostly odontogenic cysts but may be also of non-odontogenic source. The mandible and maxilla are the bones with the highest prevalent of cysts in the human body owing to odontogenic and develo... --CHILD--> [?] Haemorrhagic cyst of jaw --- Walk 3 --- [EK70.Z] Cutaneous cysts, unspecified --PARENT--> [EK70] Cutaneous cysts --RELATED_TO--> [?] Neonatal milia --- Walk 4 --- [EK70.Z] Cutaneous cysts, unspecified --PARENT--> [EK70] Cutaneous cysts --PARENT--> [?] Benign proliferations, neoplasms and cysts of the skin --- 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.... --CHILD--> [FB42] Certain specified disorders of synovium or tendon --- 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--> [FB40] Tenosynovitis
[ "[FB80.5] Solitary bone cyst\n Def: A solitary bone cyst is a benign non-epithelial bone cavity that is asymptomatic and that is found most commonly in the second decade of life by chance. The long bones are most often affected, but cas...\n --EXCLUDES--> [?] Other cysts of jaw\n Def: This is mostly odontogenic cysts but may be also of non-odontogenic source. The mandible and maxilla are the bones with the highest prevalent of cysts in the human body owing to odontogenic and develo...\n --CHILD--> [?] Aneurysmal cyst of jaw", "[FB80.5] Solitary bone cyst\n Def: A solitary bone cyst is a benign non-epithelial bone cavity that is asymptomatic and that is found most commonly in the second decade of life by chance. The long bones are most often affected, but cas...\n --EXCLUDES--> [?] Other cysts of jaw\n Def: This is mostly odontogenic cysts but may be also of non-odontogenic source. The mandible and maxilla are the bones with the highest prevalent of cysts in the human body owing to odontogenic and develo...\n --CHILD--> [?] Haemorrhagic cyst of jaw", "[EK70.Z] Cutaneous cysts, unspecified\n --PARENT--> [EK70] Cutaneous cysts\n --RELATED_TO--> [?] Neonatal milia", "[EK70.Z] Cutaneous cysts, unspecified\n --PARENT--> [EK70] Cutaneous cysts\n --PARENT--> [?] Benign proliferations, neoplasms and cysts of the skin", "[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--> [FB42] Certain specified disorders of synovium or tendon", "[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--> [FB40] Tenosynovitis" ]
FB80.5
Solitary bone cyst
[ { "from_icd11": "FB80.5", "icd10_code": "M85412", "icd10_title": "Solitary bone cyst, left shoulder" }, { "from_icd11": "FB80.5", "icd10_code": "M85441", "icd10_title": "Solitary bone cyst, right hand" }, { "from_icd11": "FB80.5", "icd10_code": "M8548", "icd10_title": "Solitary bone cyst, other site" }, { "from_icd11": "FB80.5", "icd10_code": "M8540", "icd10_title": "Solitary bone cyst, unspecified site" }, { "from_icd11": "FB80.5", "icd10_code": "M854", "icd10_title": "Solitary bone cyst" }, { "from_icd11": "EK70.Z", "icd10_code": "L729", "icd10_title": "Follicular cyst of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "EK70.Z", "icd10_code": "L728", "icd10_title": "Other follicular cysts of the skin and subcutaneous tissue" }, { "from_icd11": "EK70.Z", "icd10_code": "L60-L75", "icd10_title": "" }, { "from_icd11": "EK70.Z", "icd10_code": "L72", "icd10_title": "Follicular cysts of skin and subcutaneous tissue" }, { "from_icd11": "CA0C", "icd10_code": "J341", "icd10_title": "Cyst and mucocele of nose and nasal sinus" }, { "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" } ]
M85412
Solitary bone cyst, left shoulder
A two and a half years old male with fever was admitted to our hospital on August 2019. He had been diagnosed as pineoblastoma 7 months ago and underwent surgical resection and chemotherapy. He received a ventriculo-peritoneal shunt for obstructive hydrocephalus 4 months ago. He presented with fever (up to 40.4 °C), chills and nausea 2 days before hospital admission. Physical examination did not reveal any significant findings except pharyngeal hyperemia and swollen tonsils. His breath and heart sounds were normal. No redness or swelling occurred at the peripherally inserted central catheter (PICC) site, which had been in indwelled for 6 months, and the catheter was flushed. Computed tomography, urine examination and cerebrospinal fluid were normal. His white blood cell count and C-reaction protein concentration were 17.6 × 10 9 /L (96.3% neutrophils) and 130.5 mg/L . Three sets of blood cultures were collected from peripheral venipuncture at the beginning of the febrile period, then he was treated with cefoperazone/sulbactam. Two of the blood cultures were positive and the pathogens were identified as Stenotrophomonas maltophilia by MALDI-TOF MS (bioMérieux, Marcy-l’Étoile, France). Susceptibility testing showed the organism was susceptible to sulfamethoxazole-trimethoprim, minocycline, ceftazidime, levofloxacin, chloramphenicol, and ticarcillin/clavulanate. The antibiotic treatment was changed to the combination of cefoperazone/sulbactam and sulfamethoxazole–trimethoprim. Then the boy remitted and the body temperature dropped to normal range within 3 days since the treatment was adjusted. The white blood cell counts also returned to normal level and repeated blood cultures (collected from peripheral vein) were negative. However, on the 13th day, his temperature increased again with the highest point of 39.1 °C, and blood specimens were collected from two peripheral veinpuncture sites (left hand and right foot). After 12 h of incubation, gram-negative bacilli were detected from one blood culture, which was collected from right foot. Two types of colonies grew in the blood agar after cultivation, which were identified as S. maltophilia and O. intermedium by MALDI-TOF MS with 99.9% confidence; however, the Vitek II automated system (bioMérieux) failed to identify strain 045999. Genomic DNA of strain 045999 was prepared using the QIAamp DNA mini kit (Qiagen; Hilden, Germany) and were subjected to whole genome sequencing using the HiSeq X10 Sequencer (Illumina; San Diego, CA, USA). For the whole genome sequence of strain 045999, 5,619,077 reads and 1.69 GB bases were generated (coverage, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\times$$\end{document} × 400), which were assembled into a 4.9 Mb draft genome contains 82 contigs ≥ 200 bp in length (N 50 , 454,256 bp) with a 57.71 mol% GC content. ANI between strain 045999 and the type strain LMG 3301 T of O. intermedium was determined using the JSpecies . The ANI value was 97.57%, which was above the cutoff (≥ 95–96% ANI) defining the boundaries of bacterial species , confirming that the identification was precise. The same organisms were isolated from the other blood culture collected from left hand after 4 days incubation. Antimicrobial susceptibility testing was performed using broth microdilution with the Vitek II automated system (bioMérieux) and interpreted according to the guidelines for other non-Enterobacterales in CLSI M100 . The strain 045999 was susceptible to sulfamethoxazole–trimethoprim, minocycline, tigecycline, cefepime, levofloxacin, meropenem, imipenem (Table 1 ). The strain 045999 formed beige, translucent, shiny and mucoid colonies on blood agar within 24 h of incubation at 35 °C and gram-staining indicated gram-negative, rod-shaped bacteria without spores. The antimicrobial susceptibility of the S. maltophilia was consistent with previous results. According to the results of susceptibility test, the S. maltophilia was susceptible to levofloxacin and ceftazidime, and strain 045999 was also susceptible to sulfamethoxazole–trimethoprim and levofloxacin. Therefore, cefoperazone/sulbactam was replaced with levofloxacin and ceftazidime, and sulfamethoxazole–trimethoprim was continued as before. One week after the treatment, blood cultures were obtained from both peripheral venipuncture and PICC. The blood culture obtained from PICC was positive with the growth of S. maltophilia and O. intermedium whereas the blood obtained from peripheral venipuncture was negative. Meanwhile, the PICC was removed and the culture was negative. Therefore, the therapy mentioned above was continued for 10 days, and the patient discharged after recovery.
4.164063
0.939941
sec[1]/p[0]
en
0.999997
34906070
https://doi.org/10.1186/s12879-021-06938-3
[ "blood", "strain", "usepackage", "which", "collected", "maltophilia", "sulfamethoxazole", "trimethoprim", "levofloxacin", "picc" ]
[ { "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": "ND33", "title": "Dislocations, strains or sprains involving multiple body regions" }, { "code": "ND56.3", "title": "Dislocation or strain or sprain of unspecified body region" }, { "code": "NB53.5", "title": "Strain or sprain of lumbar spine" }, { "code": "ND51.0", "title": "Dislocation or strain or sprain of unspecified joint or ligament of trunk" }, { "code": "9D50", "title": "Visual discomfort" } ]
=== 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 [ND33] Dislocations, strains or sprains involving multiple body regions Also known as: Dislocations, strains or sprains involving multiple body regions | Dislocations, strains or sprains involving head with neck | Dislocations, sprains and strains of sites classifiable as head or neck level | Multiple dislocations of head and neck | Multiple sprains of head and neck [ND56.3] Dislocation or strain or sprain of unspecified body region Also known as: Dislocation or strain or sprain of unspecified body region | subluxation NOS | Dislocation or subluxation | dislocation NOS | Traumatic subluxation of joint Excludes: multiple dislocations, sprains and strains NOS [NB53.5] Strain or sprain of lumbar spine Definition: A collective term for muscle and ligament injuries of the tissues associated with the lumbar spine without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. Also known as: Strain or sprain of lumbar spine | Lumbar sprain | Lumbar strain | Lumbosacral sprain | Lumbosacral strain [ND51.0] Dislocation or strain or sprain of unspecified joint or ligament of trunk Also known as: Dislocation or strain or sprain of unspecified joint or ligament of trunk | Back dislocation | Back sprain | Back strain | Dislocation of vertebra, not elsewhere classified [9D50] Visual discomfort Also known as: Visual discomfort | Asthenopia | eye strain | simple eye strain | Scintillating scotoma Includes: Asthenopia === 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--> [?] 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 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--> [?] 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 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--> [MF50.41] Microscopic 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--> [MA12.0] Finding of opiate drug 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--> [?] 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...", "[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....", "[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--> [MF50.41] Microscopic 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--> [MA12.0] Finding of opiate drug 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 60-year-old male patient, due to routinely health examination, ulcerated lesions 30 cm away from the incisors were found by gastroscopy, pathology showed ESCC, then performed radical surgery for esophageal cancer on June 28, 2015. Postoperative pathology showed that: moderately differentiated squamous cell carcinoma, invading the submucosa (tumor size: 1.8 × 1.5 × 0.4 cm), interstitial fibrosis of the cancer tissue, scattered focal lymphocytes, no involvement of vasculature and nerves, no lymph node metastasis (0/15). Among them, cardia lymph nodes (0/2), esophageal lymph nodes (0/13); immunohistochemistry (IHC): EGFR (+), P53 (80%+), Ki67 (70%+); Tumor Node Metastasis (TNM) staging was pT1bN0M0, stage I. Twenty months later, he unconsciously found mass on the left neck. Only left cervical lymph nodes (size: 4.7 × 3.7 cm) showed hypermetabolism by whole body Positron Emission Computed Tomography (PET-CT) , squamous cell carcinoma was verified by needle biopsy, so it was diagnosed as solitary left cervical lymph node metastasis, at this time, the TNM stage of the patient was cT0N0M1, stage IV. Metastatic lymph nodes were resected on March 5, 2017, and confirmed as squamous cell carcinoma by pathology; IHC: CK5/6 (local+), p40 (local+), CK7 (local+), CK20 (local+), P53 (70%+), Ki67 (50%+), EGFR (local+), CD56 (small focus+), CgA (–), Syn (–), EBER (–). Twenty days later, enlarged lymph nodes in the IV region of the left neck were found. According to the National Comprehensive Cancer Network (NCCN) guidelines, paclitaxel combined with platinum or docetaxel combined with platinum can be selected for locally advanced esophageal cancer. Therefore, we chose docetaxel combined with platinum. From March 28, 2017 to June 5, 2017, the patient received docetaxel (75 mg/m 2 ) plus lobaplatin (25 mg/m 2 ) for 4 courses of chemotherapy, simultaneously the patient received radiation therapy (50 Gy/25 f) from March 28, 2017 to May 3, 2017, the target area include the lymph node drainage area of the II to V region of the double neck and the esophageal anastomosis. After 2 courses of chemotherapy and 4 courses of chemotherapy, the efficacy was evaluated as stable disease (SD). After 40 days from the end of chemotherapy, the left cervical lymph nodes enlarged, and PET-CT showed no other metastasis. Squamous cell carcinoma was verified again by needle biopsy, and metastatic lymph node radioactive particle implantation was performed on August 18, 2017. After 1 month, the size of lymph nodes in the implanted area shrank, but the surrounding lymph nodes enlarged by comparison of PET-CT. After that, the patient took apatinib (500 mg qd) for only 1 week but could not tolerate due to hand-foot syndrome (CTCAE4.0 Grade III), which manifested as skin loss, ulcers, blisters in the palms and soles of the feet, and pain in the soles of the feet. We recommended that the patient took half the dosage, and the patient rejected the recommendation. Then the patient received PD-1 inhibitor (Pembrolizumab) treatment (200 mg, once every treatment, 21 days for a course of treatment) since October 27, 2017, the therapeutic effect was evaluated as PR after 6 courses of treatment and CR after 15 courses of treatment, as shown in Fig. 2 . Only mild subclinical hypothyroidism was observed during the application, and the rest had no obvious side effects. There was also no dosage adjustment during the application. Before Pembrolizumab treatment, IHC indicated that PD-L1 (20%), MLH1 (+80%), MSH2 (+80%), MSH6 (+80%), from both the patient's postoperative specimens of esophageal primary lesion and metastatic lymph nodes. Results of esophageal primary lesion postoperative specimen detection by clinical whole exon sequencing (CWES): tumor mutational burden (TMB) value is 226. The number of insertion mutations and deletion mutations (Indels) is 58, and the ratio of Indels/TMB is 25.66%. Results of metastatic lymph nodes postoperative specimen detection by CWES: TMB is 203. The number of Indels is 29, and the ratio of Indels/TMB is 14.29%. In addition, lymphocyte infiltration in metastatic lymph nodes postoperative specimen is showed by HE staining . Besides, the copy number of EGFR/CCND1/CKD4/CKD6/FGF3/FGF4/FGF19/MDM2/MDM4 in both postoperative specimens of esophageal primary lesion and metastatic lymph nodes by CWES are normal. The patient's peripheral blood circulating tumor DNA (ctDNA) abundance was monitored for the first time on August 26, 2017, which was 0.61%. After 7 courses PD-1 inhibitor treatment, the peripheral blood ctDNA abundance decreased to 0.20%, and further decreased to 0.15% after 20 courses of PD-1 inhibitor treatment, as shown in Fig. 4 . To sum up, the patient benefited from PD-1 inhibitor treatment. Currently, the tumor has been controlled, the efficacy is CR, and the duration of response is 13.2 months.
4.128906
0.956543
sec[1]/p[0]
en
0.999998
32150096
https://doi.org/10.1097/MD.0000000000019440
[ "lymph", "nodes", "esophageal", "courses", "postoperative", "metastatic", "tumor", "node", "local", "cancer" ]
[ { "code": "BD9Z", "title": "Disorders of lymphatic vessels or lymph nodes, unspecified" }, { "code": "BD90.Z", "title": "Lymphadenitis, unspecified" }, { "code": "BD90.Y", "title": "Other specified lymphadenitis" }, { "code": "BD9Y", "title": "Other specified disorders of lymphatic vessels or lymph nodes" }, { "code": "MA01.Z", "title": "Enlarged lymph nodes, unspecified" }, { "code": "FA20.0", "title": "Seropositive rheumatoid arthritis" }, { "code": "MF30", "title": "Breast lump or mass female" }, { "code": "BB40", "title": "Acute or subacute infectious endocarditis" }, { "code": "FA0Z", "title": "Osteoarthritis, unspecified" }, { "code": "FA85.10", "title": "Localised central endplate defect" } ]
=== ICD-11 CODES FOUND === [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 [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 [BD9Y] Other specified disorders of lymphatic vessels or lymph nodes Also known as: Other specified disorders of lymphatic vessels or lymph nodes | Chylous cyst | Mesentery chylous cyst | Peritoneum chylous cyst | Lymphocele [MA01.Z] Enlarged lymph nodes, unspecified Also known as: Enlarged lymph nodes, unspecified | Enlarged lymph nodes | swollen glands | Lymphadenopathy | adenopathy [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 [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 [BB40] Acute or subacute infectious endocarditis Also known as: Acute or subacute infectious endocarditis | subacute infective endocarditis NOS | infective endocarditis NOS | acute infective endocarditis NOS | infectious endocarditis Excludes: Infectious myocarditis [FA0Z] Osteoarthritis, unspecified Also known as: Osteoarthritis, unspecified | osteoarthritis NOS | arthrosis NOS | OA - [osteoarthritis] | Osteoarthritis with determinants [FA85.10] Localised central endplate defect Also known as: Localised central endplate defect | Schmorl nodes | schmorl's nodes | schmorl's nodules === GRAPH WALKS === --- Walk 1 --- [BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes.... --CHILD--> [BD91] Lymphangitis Def: Lymphangitis is an inflammation of lymphatic vessels. It is most often caused by infection from bacteria, virus or fungus or infiltration by cancer cells.... --- Walk 2 --- [BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes.... --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --- Walk 3 --- [BD90.Z] Lymphadenitis, unspecified --PARENT--> [BD90] Lymphadenitis --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --- Walk 4 --- [BD90.Z] Lymphadenitis, unspecified --PARENT--> [BD90] Lymphadenitis --EXCLUDES--> [?] Human immunodeficiency virus disease Def: A case of HIV infection is defined as an individual with HIV infection irrespective of clinical stage including severe or stage 4 clinical disease (also known as AIDS) confirmed by laboratory criteria... --- Walk 5 --- [BD90.Y] Other specified lymphadenitis --PARENT--> [BD90] Lymphadenitis --EXCLUDES--> [?] Human immunodeficiency virus disease Def: A case of HIV infection is defined as an individual with HIV infection irrespective of clinical stage including severe or stage 4 clinical disease (also known as AIDS) confirmed by laboratory criteria... --- Walk 6 --- [BD90.Y] Other specified lymphadenitis --PARENT--> [BD90] Lymphadenitis --CHILD--> [BD90.0] Acute lymphadenitis
[ "[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified\n --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes\n Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....\n --CHILD--> [BD91] Lymphangitis\n Def: Lymphangitis is an inflammation of lymphatic vessels. It is most often caused by infection from bacteria, virus or fungus or infiltration by cancer cells....", "[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified\n --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes\n Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....", "[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....", "[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Human immunodeficiency virus disease\n Def: A case of HIV infection is defined as an individual with HIV infection irrespective of clinical stage including severe or stage 4 clinical disease (also known as AIDS) confirmed by laboratory criteria...", "[BD90.Y] Other specified lymphadenitis\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Human immunodeficiency virus disease\n Def: A case of HIV infection is defined as an individual with HIV infection irrespective of clinical stage including severe or stage 4 clinical disease (also known as AIDS) confirmed by laboratory criteria...", "[BD90.Y] Other specified lymphadenitis\n --PARENT--> [BD90] Lymphadenitis\n --CHILD--> [BD90.0] Acute lymphadenitis" ]
BD9Z
Disorders of lymphatic vessels or lymph nodes, unspecified
[ { "from_icd11": "BD9Z", "icd10_code": "I898", "icd10_title": "Other specified noninfective disorders of lymphatic vessels and lymph nodes" }, { "from_icd11": "BD9Z", "icd10_code": "I899", "icd10_title": "Noninfective disorder of lymphatic vessels and lymph nodes, unspecified" }, { "from_icd11": "BD9Z", "icd10_code": "I89", "icd10_title": "Other noninfective disorders of lymphatic vessels and lymph nodes" }, { "from_icd11": "BD90.Z", "icd10_code": "I889", "icd10_title": "Nonspecific lymphadenitis, unspecified" }, { "from_icd11": "BD90.Z", "icd10_code": "I88", "icd10_title": "Nonspecific lymphadenitis" }, { "from_icd11": "BD90.Z", "icd10_code": "I888", "icd10_title": "Other nonspecific lymphadenitis" }, { "from_icd11": "BD90.Z", "icd10_code": "L00-L08", "icd10_title": "" }, { "from_icd11": "MA01.Z", "icd10_code": "R599", "icd10_title": "Enlarged lymph nodes, unspecified" }, { "from_icd11": "MA01.Z", "icd10_code": "R59", "icd10_title": "Enlarged lymph nodes" }, { "from_icd11": "FA20.0", "icd10_code": "M0569", "icd10_title": "Rheumatoid arthritis of multiple sites with involvement of other organs and systems" }, { "from_icd11": "FA20.0", "icd10_code": "M0579", "icd10_title": "Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement" }, { "from_icd11": "FA20.0", "icd10_code": "M05612", "icd10_title": "Rheumatoid arthritis of left shoulder with involvement of other organs and systems" }, { "from_icd11": "FA20.0", "icd10_code": "M0570", "icd10_title": "Rheumatoid arthritis with rheumatoid factor of unspecified site without organ or systems involvement" }, { "from_icd11": "FA20.0", "icd10_code": "M0560", "icd10_title": "Rheumatoid arthritis of unspecified site with involvement of other organs and systems" }, { "from_icd11": "FA20.0", "icd10_code": "M0500", "icd10_title": "Felty's syndrome, unspecified site" } ]
I898
Other specified noninfective disorders of lymphatic vessels and lymph nodes
A 40 year old man underwent dual chamber right infraclavicular pacemaker implantation for malignant vasovagal syndrome in 1988. This was complicated by two further reexplorations, one for a slipped atrial lead, and the second for primary wound dehiscence which required a pulse generator change. This was followed, in 1993, by infection of the pacemaker pocket by Staphylococcus epidermidis requiring pacemaker removal. However, only the pulse generator could be removed, and the percutaneous removal of the leads by traction had to be abandoned on account of cardiac arrest, in all probability, and with the benefit of hindsight, due to perforation of right atrium by the atrial lead during attempted percutaneous removal which consequently had to be abandoned. The patient was resuscitated successfully without taking recourse to median sternotomy, the leads were cut short and buried under pectoralis major and the wound closed. A fresh dual chamber pacemaker was implanted in left infraclavicular pocket, followed by an elective pulse generator change in 2001. Patient next presented in December 2006 with history of fever, rigors, night sweats and weight loss. Examination revealed bilateral pacemaker pocket infection and discharge and unremarkable cardiovascular examination. Chest X ray confirmed four pacing leads in the SVC, with two in right atrium and two in right ventricle, a pulse generator in the left infraclavicular pocket only . Routine blood examination revealed white cell count of 20.3, neutrophils 17.3 and CRP 59. Bacterial culture of the wound discharge grew coagulase negative staphylococcus. Intravenous vancomycin and gentamycin was started. Vancomycin was changed to intravenous flucloxacillin after two days and oral rifampicin added subsequently. Transthoracic echocardiogram demonstrated large vegetations associated with the pacing leads at the atrial level, part of which prolapsed through the tricuspid valve during diastole . Transesophageal echocardiogram revealed extensive and complex vegetation surrounding all leads in SVC, RA, RV and also involving tricuspid valve and right atrial and right ventricular endocardium . At median sternotomy, one of the atrial leads was densely adherent to the under surface of the right half of the sternum just below the manubriosternal joint. It was surrounded by a large fibrous granuloma from the point it exited from the atrium till the point of its adherence to the under surface of the sternum . Presumably, the lead perforated the right atrium during the attempted percutaneous removal of the right sided pacing leads in 1993 which had to be abandoned when patient had had an asystolic arrest. Pericardial cavity was obliterated by adhesions. Cardiopulmonary bypass was established with ascending aortic and direct SVC and IVC cannulations. Caval tapes were snugged, temperature was allowed to only gently drift and right atriotomy was made on the beating heart. Both infraclavicular pacemaker pockets were exposed and the pulse generator on the left side removed after disconnecting the leads. The perforated atrial lead lying under the sternum, encased in the pericardial granuloma, was dissected out within the granuloma, excised at the level of the appendage and removed . The remaining portion of the lead, along with the other atrial lead, were removed after dissecting them out from the atrial endocardium along with the adherent thrombotic vegetations. There were large vegetations on the posterior and septal leaflets tricuspid valve leaflets and the chordae of the two leaflets had twined themselves around the ventricular pacing leads . The endocardium of the inlet of the right ventricle was infiltrated by vegetations as well. The ventricular pacing leads were dissected off from the ventricular muscle and the tricuspid valve leaflets and chordae and removed. The tricuspid valve leaflets were excised completely, the adjoining atrial and ventricular infiltrated endocardium debrided and a 31 mm St Jude mechanical prosthesis stitched in place using 14 pledgetted interrupted 2 O ticron sutures. Atriotomy closed in a single layer. An epicardial pacemaker (Medtronic) was sutured in place and the pulse generator kept in a preperitoneal and retrorectus position in left hypochondrium and set at a rate of 90/min. Post procedure TOE revealed satisfactory prosthetic valve function and no residual vegetations in SVC, RA or RV. Patient received intravenous Flucloxacillin and oral rifampicin for a total duration of 6 weeks. Post operative period was uncomplicated apart from the requirement for large doses of warfarin to maintain INR in the required range, possibly as a result of antibiotic interactions. The postoperative transthoracic echocardiogram showed satisfactory tricuspid prosthetic valve function and patient was discharged home, 5 weeks after his operation.
3.970703
0.975586
sec[0]/p[0]
en
0.999997
19239701
https://doi.org/10.1186/1749-8090-4-12
[ "leads", "atrial", "pacemaker", "valve", "lead", "pulse", "generator", "tricuspid", "pacing", "vegetations" ]
[ { "code": "NE61", "title": "Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified" }, { "code": "CA60.Y/PB36&XB17", "title": "Lead miner lung" }, { "code": "MA13.00", "title": "Abnormal level of lead in blood" }, { "code": "8D43.1", "title": "Cognitive impairment due to toxicity" }, { "code": "8D43.0Y&XM0ZH6", "title": "Encephalopathy due to lead" }, { "code": "BC46&XA91S4", "title": "Atrial thrombosis" }, { "code": "LA8Z", "title": "Structural developmental anomaly of heart or great vessels, unspecified" }, { "code": "BC40.Z", "title": "Acquired atrial abnormality, unspecified" }, { "code": "BC81.2Z", "title": "Macro reentrant atrial tachycardia, unspecified" }, { "code": "LA8Y", "title": "Other specified structural developmental anomaly of heart or great vessels" } ]
=== ICD-11 CODES FOUND === [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 [MA13.00] Abnormal level of lead in blood Definition: Abnormal level of lead in blood in those who have been exposed to lead and who require management. Also known as: Abnormal level of lead in blood Excludes: Harmful effects of or exposure to noxious substances, Substances chiefly nonmedicinal as to source, Metals [8D43.1] Cognitive impairment due to toxicity Definition: These are conditions of impaired cognition due to the toxicity of substances. Also known as: Cognitive impairment due to toxicity | Cognitive impairment due to lead toxicity [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 [BC40.Z] Acquired atrial abnormality, unspecified Also known as: Acquired atrial abnormality, unspecified | Acquired atrial abnormality [BC81.2Z] Macro reentrant atrial tachycardia, unspecified Also known as: Macro reentrant atrial tachycardia, unspecified | Macro reentrant atrial tachycardia | MRAT - [macro re-entrant atrial tachycardia] | intra-atrial re-entry tachycardia | Atrial flutter NOS [LA8Y] Other specified structural developmental anomaly of heart or great vessels Also known as: Other specified structural developmental anomaly of heart or great vessels | Congenital anomaly of position or spatial relationships of thoraco-abdominal organs | Usual atrial arrangement | atrial situs solitus | Abnormal atrial arrangement === GRAPH WALKS === --- Walk 1 --- [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 2 --- [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified --EXCLUDES--> [?] Burns Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute... --EXCLUDES--> [?] Adverse effects of phototherapy --- Walk 3 --- [MA13.00] Abnormal level of lead in blood Def: Abnormal level of lead in blood in those who have been exposed to lead and who require management.... --EXCLUDES--> [?] Harmful effects of or exposure to noxious substances, Substances chiefly nonmedicinal as to source, Metals --CHILD--> [?] Harmful effects of or exposure to noxious substances, Substances chiefly nonmedicinal as to source, Metals, Lead or its compounds Def: Inhalation and dermal exposure to lead and its compounds result in neurotoxicity, nephrotoxicity, gastrointestinal toxicity, altered sperm count, hypertension, arthralgias, myalgias, and irritation of... --- Walk 4 --- [MA13.00] Abnormal level of lead in blood Def: Abnormal level of lead in blood in those who have been exposed to lead and who require management.... --EXCLUDES--> [?] Harmful effects of or exposure to noxious substances, Substances chiefly nonmedicinal as to source, Metals --CHILD--> [?] Harmful effects of or exposure to noxious substances, Substances chiefly nonmedicinal as to source, Metals, Chromium or its compounds Def: Inhalation and dermal exposure to chromium and its compounds result in pneumotoxicity, lung cancer and irritation and ulcers of the eyes, skin, mucous membranes and respiratory tract.... --- Walk 5 --- [8D43.1] Cognitive impairment due to toxicity Def: These are conditions of impaired cognition due to the toxicity of substances.... --RELATED_TO--> [?] Dementia due to carbon monoxide poisoning Def: Carbon monoxide (CO) intoxication is known to sometimes cause delayed anoxic encephalopathy (DAE), which manifests neuropsychiatric symptoms including cognitive decline, dementia, hypokinesia, akineti... --PARENT--> [?] Cognitive impairment due to toxicity Def: These are conditions of impaired cognition due to the toxicity of substances.... --- Walk 6 --- [8D43.1] Cognitive impairment due to toxicity Def: These are conditions of impaired cognition due to the toxicity of substances.... --RELATED_TO--> [?] Dementia due to carbon monoxide poisoning Def: Carbon monoxide (CO) intoxication is known to sometimes cause delayed anoxic encephalopathy (DAE), which manifests neuropsychiatric symptoms including cognitive decline, dementia, hypokinesia, akineti... --PARENT--> [?] Cognitive impairment due to toxicity Def: These are conditions of impaired cognition due to the toxicity of substances....
[ "[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--> [?] Burns\n Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute...\n --EXCLUDES--> [?] Adverse effects of phototherapy", "[MA13.00] Abnormal level of lead in blood\n Def: Abnormal level of lead in blood in those who have been exposed to lead and who require management....\n --EXCLUDES--> [?] Harmful effects of or exposure to noxious substances, Substances chiefly nonmedicinal as to source, Metals\n --CHILD--> [?] Harmful effects of or exposure to noxious substances, Substances chiefly nonmedicinal as to source, Metals, Lead or its compounds\n Def: Inhalation and dermal exposure to lead and its compounds result in neurotoxicity, nephrotoxicity, gastrointestinal toxicity, altered sperm count, hypertension, arthralgias, myalgias, and irritation of...", "[MA13.00] Abnormal level of lead in blood\n Def: Abnormal level of lead in blood in those who have been exposed to lead and who require management....\n --EXCLUDES--> [?] Harmful effects of or exposure to noxious substances, Substances chiefly nonmedicinal as to source, Metals\n --CHILD--> [?] Harmful effects of or exposure to noxious substances, Substances chiefly nonmedicinal as to source, Metals, Chromium or its compounds\n Def: Inhalation and dermal exposure to chromium and its compounds result in pneumotoxicity, lung cancer and irritation and ulcers of the eyes, skin, mucous membranes and respiratory tract....", "[8D43.1] Cognitive impairment due to toxicity\n Def: These are conditions of impaired cognition due to the toxicity of substances....\n --RELATED_TO--> [?] Dementia due to carbon monoxide poisoning\n Def: Carbon monoxide (CO) intoxication is known to sometimes cause delayed anoxic encephalopathy (DAE), which manifests neuropsychiatric symptoms including cognitive decline, dementia, hypokinesia, akineti...\n --PARENT--> [?] Cognitive impairment due to toxicity\n Def: These are conditions of impaired cognition due to the toxicity of substances....", "[8D43.1] Cognitive impairment due to toxicity\n Def: These are conditions of impaired cognition due to the toxicity of substances....\n --RELATED_TO--> [?] Dementia due to carbon monoxide poisoning\n Def: Carbon monoxide (CO) intoxication is known to sometimes cause delayed anoxic encephalopathy (DAE), which manifests neuropsychiatric symptoms including cognitive decline, dementia, hypokinesia, akineti...\n --PARENT--> [?] Cognitive impairment due to toxicity\n Def: These are conditions of impaired cognition due to the toxicity of substances...." ]
NE61
Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified
[ { "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" }, { "from_icd11": "NE61", "icd10_code": "T63713A", "icd10_title": "Toxic effect of contact with venomous marine plant, assault, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63714A", "icd10_title": "Toxic effect of contact with venomous marine plant, undetermined, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63791A", "icd10_title": "Toxic effect of contact with other venomous plant, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63792A", "icd10_title": "Toxic effect of contact with other venomous plant, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63793A", "icd10_title": "Toxic effect of contact with other venomous plant, assault, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63794A", "icd10_title": "Toxic effect of contact with other venomous plant, undetermined, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T61771A", "icd10_title": "Other fish poisoning, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T61772A", "icd10_title": "Other fish poisoning, intentional self-harm, initial encounter" } ]
T5802XA
Toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, initial encounter
LBRF patients originated from Eritrea and Somalia, respectively, with a final common travel route via Sudan, Libya and Italy before arriving in Switzerland in June to December 2015. All patients were referred to the emergency department of our three institutions with fever and other non-specific complaints shortly (one to seven days) after arrival. Interestingly, all patients reported a previous febrile episode in Italy or Libya. Important clinical characteristics of the patients are shown in the Table 1 . All patients denied a significant past medical history or past/current medical treatment. With the exception of enlarged cervical and axillary lymph nodes in patient 3, physical examination was essentially non-specific and consistent with sepsis of unknown origin in the context of fever, tachycardia and hypotension. Routine blood tests were significant for mild to moderate thrombocytopenia, mild anaemia and markedly elevated inflammatory markers in all cases (Table 1 ). In addition, one patient showed evidence of haemolysis with an increased LDH and bilirubin. Differential diagnosis entertained by the treating clinicians included bacterial sepsis of unknown origin, typhoid fever and malaria in all patients, and primary EBV infection in patient 3. Two sets of blood cultures, stained blood smears and a malaria rapid diagnostic test were ordered in all patients. Diagnosis of Borrelia -associated relapsing fever was established by demonstration of abundant extracellular spirochetes in stained blood films . Additional work-up including blood cultures and malaria tests was negative in patients 1 and 3, and positive for Mycobacterium tuberculosis lymphadenitis (lymph node biopsy demonstrating acid fast bacilli on auramine staining and isolation of M. tuberculosis from culture) and Plasmodium falciparum malaria ( P. falciparum parasites were observed concomitantly with spirochetes in stained blood films) in patients 2 and 4, respectively. The first two patients were admitted to the intensive-care unit for supportive treatment of sepsis-related hypotension and were started on intravenous ceftriaxone, whereas the last two patients received doxycycline (in addition to standard first-line anti-tuberculous treatment in patient 2 and artemether/lumefantrine in patient 4 for concurrent Plasmodium falciparum malaria) and were admitted to the general medical ward after fluid resuscitation. All patients rapidly recovered after antibiotic treatment. Treatment duration was longer than necessary for LBRF to cover for potential tick-borne relapsing fever, as confirmation of LBRF by PCR was not available immediately. A Jarisch-Herxheimer reaction including aggravated hypotension, tachycardia and high-grade fever was only observed in patient 2. Table 1 Characteristics of four patients suffering from louse-borne relapsing fever ( Borrelia recurrentis ) diagnosed in Switzerland from June to December 2015 Case Sex, age Origin Travel route Location of first febrile episode Symptoms Platelet count (on admission, nadir; × 10 9 ) CRP (on admission, peak; mg/L) Other laboratory features Treatment 1 M, 25 y Eritrea ER, SU, LB, IT, CH Libya Fever, abdominal pain, epistaxis 56, 30 312, 312 Mild anemia, hyponatremia and hypokalemia Ceftriaxone for 2 days followed by doxycycline for 7 days 2 M, 29 y Somalia SO, KE, SU, LB, IT, CH Italy (infestation with body lice in Libya) Fever, abdominal pain, headache, muscle aches 141, 54 245, 245 Mild anemia, leukocytosis and hyponatremia Ceftriaxone for 1 day followed by doxycycline for 7 days plus HRZE b 3 F, 21 y Somalia SO, KE, UG, SU, LB, IT, CH Italy Fever, pollakisuria, swollen/painful cervical/axillary lymphadenopathy 45, 27 367, 367 Mild anemia, leukocytosis and hyponatremia, elevated creatinine (mild), bilirubin and LDH (both moderate) Doxycycline for 5 days 4 M, 17y Somalia SO, ET, SU, LB, IT, CH Libya Fever, chills, cough, urinary incontinence 167, 62 127, 235 Moderate anemia, mild hyponatremia, hypokalemia, elevated creatinine and LDH (both mild) Doxycycline for 3 days plus Artemether/lumefantrine a Abbreviations : F female, M male, Y year, CRP C-reactive protein, HRZE antimycobacterial treatment with isoniazid (H), rifampicin (R), pyrazinamide (Z) and ethambutol (E) Travel route: CH Switzerland, ER Eritrea, ET Ethiopia, IT Italy, LB Libya, SU Sudan, SO Somalia, UG Uganda Platelet count, norm: 150–450 × 10 9 /L; C-reactive protein, norm: <10 mg/L a Artemether/lumefantrine treatment was administered for concurrent Plasmodium falciparum malaria infection b Antimycobacterial treatment consisting of HRZE for two months followed by HR for four months was administered for concurrent M. tuberculosis lymphadenitis Fig. 1 Microscopic detection of spirochetes (black arrows) in blood from patient 2. May-Grünwald Giemsa (MGG)-stained blood smear, 1000-fold magnification
4.238281
0.524902
sec[1]/p[0]
en
0.999998
27188655
https://doi.org/10.1186/s12879-016-1541-z
[ "patients", "fever", "blood", "libya", "malaria", "somalia", "italy", "doxycycline", "stained", "falciparum" ]
[ { "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" }, { "code": "MG26", "title": "Fever of other or unknown origin" }, { "code": "1D81.Z", "title": "Infectious mononucleosis, unspecified" }, { "code": "1B99", "title": "Pasteurellosis" }, { "code": "4A60.0", "title": "Familial Mediterranean fever" }, { "code": "JB40.0", "title": "Puerperal sepsis" } ]
=== ICD-11 CODES FOUND === [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 [MG26] Fever of other or unknown origin Definition: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process. Also known as: Fever of other or unknown origin | febrile | febris | fever | feverish Excludes: fever of unknown origin in newborn | Malignant hyperthermia due to anaesthesia [1D81.Z] Infectious mononucleosis, unspecified Also known as: Infectious mononucleosis, unspecified | Infectious mononucleosis | Glandular fever | Gammaherpesviral mononucleosis | kissing disease [1B99] Pasteurellosis Definition: A disease caused by an infection with the gram-negative bacteria Pasteurella. This disease is characterised by local cellulitis and may lead to other clinical signs depending on the route of infection. Transmission is commonly by direct contact through the bite, scratch, or lick from an infected animal, inhalation of infected respiratory secretions, or ingestion of contaminated meat. Confirmation is by identification of Pasteurella from the affected individual. Also known as: Pasteurellosis | pasteurella infection | shipping fever | transport fever [4A60.0] Familial Mediterranean fever Definition: FMF is an autoinflammatory disease associated with mutations in pyrin resulting in enhanced IL1 beta production. This results in clinical attacks of inflammation in the form of fever and serositis in the form of peritoneal, pleural or synovial inflammation along with increased acute phase reactants. Also known as: Familial Mediterranean fever | Periodic disease | FMF - [familial mediterranean fever] | periodic fever | periodic polyserositis [JB40.0] Puerperal sepsis Also known as: Puerperal sepsis | puerperal fever | postpartum sepsis | generalised puerperal infection | major puerperal infection Excludes: Obstetric pyaemic or septic embolism | sepsis during labour === GRAPH WALKS === --- Walk 1 --- [PL14.C] Patient received diagnostic test or treatment intended for another patient --EXCLUDES--> [?] Procedure undertaken at wrong site or wrong side, as mode of injury or harm --CHILD--> [?] Performance of inappropriate operation --- Walk 2 --- [PL14.C] Patient received diagnostic test or treatment intended for another patient --EXCLUDES--> [?] Procedure undertaken at wrong site or wrong side, as mode of injury or harm --CHILD--> [?] Performance of inappropriate operation --- Walk 3 --- [QB14] Unavailability or inaccessibility of health care facilities --EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere --CHILD--> [?] Person awaiting admission to residential aged care service --- Walk 4 --- [QB14] Unavailability or inaccessibility of health care facilities --EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere --PARENT--> [?] Factors related to medical facilities or other health care --- Walk 5 --- [PL14.2] Problem associated with physical transfer of patient --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft --- Walk 6 --- [PL14.2] Problem associated with physical transfer of patient --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft
[ "[PL14.C] Patient received diagnostic test or treatment intended for another patient\n --EXCLUDES--> [?] Procedure undertaken at wrong site or wrong side, as mode of injury or harm\n --CHILD--> [?] Performance of inappropriate operation", "[PL14.C] Patient received diagnostic test or treatment intended for another patient\n --EXCLUDES--> [?] Procedure undertaken at wrong site or wrong side, as mode of injury or harm\n --CHILD--> [?] Performance of inappropriate operation", "[QB14] Unavailability or inaccessibility of health care facilities\n --EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere\n --CHILD--> [?] Person awaiting admission to residential aged care service", "[QB14] Unavailability or inaccessibility of health care facilities\n --EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere\n --PARENT--> [?] Factors related to medical facilities or other health care", "[PL14.2] Problem associated with physical transfer of patient\n --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft", "[PL14.2] Problem associated with physical transfer of patient\n --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft" ]
PL14.C
Patient received diagnostic test or treatment intended for another patient
[ { "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" }, { "from_icd11": "MG26", "icd10_code": "R5081", "icd10_title": "Fever presenting with conditions classified elsewhere" }, { "from_icd11": "MG26", "icd10_code": "R5084", "icd10_title": "Febrile nonhemolytic transfusion reaction" }, { "from_icd11": "MG26", "icd10_code": "R5082", "icd10_title": "Postprocedural fever" }, { "from_icd11": "MG26", "icd10_code": "R5083", "icd10_title": "Postvaccination fever" }, { "from_icd11": "MG26", "icd10_code": "R509", "icd10_title": "Fever, unspecified" }, { "from_icd11": "MG26", "icd10_code": "R502", "icd10_title": "Drug induced fever" }, { "from_icd11": "MG26", "icd10_code": "R50", "icd10_title": "Fever of other and unknown origin" } ]
Z753
Unavailability and inaccessibility of health-care facilities
A 29-year-old primigravida woman had no history of gestational diabetes mellitus, preeclampsia, or coagulation disorders, and no anti-coagulation therapy with heparin. Prenatal laboratory testing showed normal results: platelet count, 157 × 10 9 /L; hemoglobin (Hb), 132 g/L; prothrombin (PT), 10 s; activated partial thromboplastin time (APTT), 27 s; international normalized ratio (INR), 0.81; alanine aminotransferase (ALT), 31 U/L; aspartate aminotransferase (AST), 36U/L; total bile acid (TBA), 9.1 μmol/L. She was scheduled for transvaginal delivery after pregnancy for 41 + 2 weeks on June 3, 2021. She received epidural labor analgesia when the cervix dilated to 2 cm with numerical rating scale (NRS) for pain was 9 (0 represents “no pain” and 10 represents “worst pain imaginable”) : A selective epidural puncture was performed at the L2-3 level, and a 4 cm catheter was inserted and securely fixed. Following the administration of a 4 mL test dose of 2 % lidocaine, a 5 mL epidural solution (comprising ropivacaine 0.125 % and sufentanil 3 μg) was delivered through the catheter. Subsequently, the patient-controlled epidural analgesia (PCEA) pump was connected to the catheter, infusing a mixture of 0.75 % ropivacaine (10 mL) and sufentanil (20 μg) in saline, resulting in a 60 mL solution. The continuous background infusion rate was set at 8 mL per hour, with a patient-controlled dose of 3 mL and a locking interval of 15 minutes.The NRS for pain decreased to 4 following analgesia, with no motor blockade or breakthrough pain observed. Subsequently, 3 h later, the patient underwent an emergency cesarean section due to grade 2 amniotic fluid turbidity. Anesthesia for the cesarean section was administered via the pre-implanted epidural catheter, utilizing 12 mL of 3 % chloroprocaine. The intraoperative blood loss amounted to 400 mL. Post-surgery, patient-controlled intravenous analgesia (PCIA) was initiated. This involved a solution composed of 800 mg tramadol, 0.2 mg fentanyl, and 10 mg dexamethasone dissolved in saline, resulting in a 100 mL mixture. The PCIA regimen featured a background dose of 2 mL per hour, a patient-controlled dose of 0.5 mL, and a 15-min locking interval. The sensation and muscle strength in the right lower limb fully recovered within 15 hours following the puncture. Conversely, mild soreness and swelling were noted in the left lower limb, accompanied by a manual muscle testing (MMT) grade of 2 . Hypesthesia, manifesting below the chest level, abruptly manifested 45.5 hours following the puncture. Subsequently, there was a reduction in the muscle strength of both lower limbs, rapidly progressing to flaccid paralysis. A spinal MRI examination revealed a space-occupying lesion at the left epidural site of T2-3, measuring approximately 12 × 10 × 30 mm. The axial view showed spinal compression with a rightward shift . The T1WI and T2FS sequences exhibited high signals , while the T2WI displayed mixed high/low signals . Notably, no abnormalities were detected at the lumbar puncture site . Following consultations with anesthetists and neurosurgeons, a diagnosis of SSEH was suspected. The patient subsequently underwent laminectomy 14.5 hours after paralysis onset. Intraoperative observations revealed a blood clot on the left side posterior to the T2-T3 vertebral bodies, pushing the spinal dura to the right . Additionally, it was noted that the posterior veins of the T3 vertebrae and the venous plexus of the intervertebral foramen displayed a cirsoid and circuitous pattern, with thinner venous walls than usual. Pathological examination confirmed the presence of a vascular malformation. Post-laminectomy, the patient received a treatment regimen consisting of methylprednisolone, mannitol, hyperbaric oxygen therapy and aggressive rehabilitation programs, aimed at facilitating the recovery of neurological function. During the last follow-up visit, conducted 17 months post-operation, sensory function in both lower limbs and muscle strength in the right lower limb had been fully restored to normal levels, while the left lower limb achieved a MMT grade of 4. The patient provided written informed consent for the publication of this case report and any accompanying images. Fig. 1 Thoracic MRI of the patient. Axial T3 sequence shows abnormally enhanced epidural signals (arrow), which pushed the spine to the right. Fig. 1 Fig. 2 MRI of cervical, thoracic and lumbar vertebrae. Sagittal T2-3 sequence shows epidural abnormality, T1WI and T2FS show high signals , and T2WI shows mixed high/low signals . These findings are in agreement with the manifestations of acute epidural hemorrhage. No abnormality was found at the site of lumbar puncture . Fig. 2 Fig. 3 Intraoperative findings show the blood clots (arrow) at the T2 and T3 levels, which pushed the spinal dura to the right. Fig. 3
4.003906
0.96875
sec[1]/p[0]
en
0.999997
38125522
https://doi.org/10.1016/j.heliyon.2023.e22855
[ "epidural", "pain", "puncture", "signals", "analgesia", "catheter", "subsequently", "controlled", "muscle", "limb" ]
[ { "code": "NA07.5", "title": "Traumatic epidural haemorrhage" }, { "code": "1D04.5", "title": "Intraspinal epidural granuloma" }, { "code": "1D03.4", "title": "Intraspinal epidural abscess" }, { "code": "2A02.Z", "title": "Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system, unspecified" }, { "code": "8B03", "title": "Nontraumatic epidural haemorrhage" }, { "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 === [NA07.5] Traumatic epidural haemorrhage Also known as: Traumatic epidural haemorrhage | extradural haemorrhage | traumatic epidural haematoma | traumatic extradural haemorrhage | extradural brain haematoma [1D04.5] Intraspinal epidural granuloma Definition: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the epidural space. This condition may present with neurological deficits. Also known as: Intraspinal epidural granuloma | Bacterial epidural granuloma | Mycobacterial epidural granuloma | Fungal epidural granuloma | Parasitic epidural granuloma [1D03.4] Intraspinal epidural abscess Definition: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by a focal accumulation of purulent material within the epidural space. This condition presents with symptoms depending on the location of the abscess. Transmission is through haematogenous spread of the infectious agent commonly from a cutaneous or mucosal source. Also known as: Intraspinal epidural abscess | epidural abscess | epidural abscess of spinal cord | spinal epidural abscess | epidural embolic abscess of spinal cord, any part [2A02.Z] Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system, unspecified Also known as: Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system, unspecified | Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system | Neoplasm of uncertain or unknown behaviour of spinal cord | Epidural cancer NOS [8B03] Nontraumatic epidural haemorrhage Also known as: Nontraumatic epidural haemorrhage | nontraumatic extradural brain haematoma | nontraumatic epidural brain haematoma | nontraumatic extradural haemorrhage [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 --- [NA07.5] Traumatic epidural haemorrhage --RELATED_TO--> [?] Extradural or epidural haemorrhage due to birth injury Def: Haemorrhage in the plane between the skull bone and the periosteum on the inner surface of the skull from injury to the middle meningeal artery from birth trauma... --CHILD--> [?] Extradural haemorrhage due to birth injury --- Walk 2 --- [NA07.5] Traumatic epidural haemorrhage --RELATED_TO--> [?] Extradural or epidural haemorrhage due to birth injury Def: Haemorrhage in the plane between the skull bone and the periosteum on the inner surface of the skull from injury to the middle meningeal artery from birth trauma... --CHILD--> [?] Extradural haemorrhage due to birth injury --- Walk 3 --- [1D04.5] Intraspinal epidural granuloma Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the epi... --PARENT--> [1D04] Infectious granulomas of the central nervous system --RELATED_TO--> [?] Meningeal tuberculoma Def: Meningeal tuberculomas are conglomerate caseous foci within the meninges of the brain, caused by dissemination of tuberculosis to the central nervous system.... --- Walk 4 --- [1D04.5] Intraspinal epidural granuloma Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the epi... --PARENT--> [1D04] Infectious granulomas of the central nervous system --CHILD--> [1D04.1] Intracranial granuloma Def: A condition of the cranial cavity, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the cra... --- Walk 5 --- [1D03.4] Intraspinal epidural abscess Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by a focal accumulation of purulent material within the ... --PARENT--> [1D03] Infectious abscess of the central nervous system Def: A focal suppurative process of the brain parenchyma, the intracranial or spinal epidural or subdural space, and less commonly the spinal cord parenchyma. The suppurative process is most commonly assoc... --CHILD--> [1D03.2] Intraspinal extradural abscess --- Walk 6 --- [1D03.4] Intraspinal epidural abscess Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by a focal accumulation of purulent material within the ... --PARENT--> [1D03] Infectious abscess of the central nervous system Def: A focal suppurative process of the brain parenchyma, the intracranial or spinal epidural or subdural space, and less commonly the spinal cord parenchyma. The suppurative process is most commonly assoc... --CHILD--> [1D03.0] Intraspinal intramedullary abscess
[ "[NA07.5] Traumatic epidural haemorrhage\n --RELATED_TO--> [?] Extradural or epidural haemorrhage due to birth injury\n Def: Haemorrhage in the plane between the skull bone and the periosteum on the inner surface of the skull from injury to the middle meningeal artery from birth trauma...\n --CHILD--> [?] Extradural haemorrhage due to birth injury", "[NA07.5] Traumatic epidural haemorrhage\n --RELATED_TO--> [?] Extradural or epidural haemorrhage due to birth injury\n Def: Haemorrhage in the plane between the skull bone and the periosteum on the inner surface of the skull from injury to the middle meningeal artery from birth trauma...\n --CHILD--> [?] Extradural haemorrhage due to birth injury", "[1D04.5] Intraspinal epidural granuloma\n Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the epi...\n --PARENT--> [1D04] Infectious granulomas of the central nervous system\n --RELATED_TO--> [?] Meningeal tuberculoma\n Def: Meningeal tuberculomas are conglomerate caseous foci within the meninges of the brain, caused by dissemination of tuberculosis to the central nervous system....", "[1D04.5] Intraspinal epidural granuloma\n Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the epi...\n --PARENT--> [1D04] Infectious granulomas of the central nervous system\n --CHILD--> [1D04.1] Intracranial granuloma\n Def: A condition of the cranial cavity, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the cra...", "[1D03.4] Intraspinal epidural abscess\n Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by a focal accumulation of purulent material within the ...\n --PARENT--> [1D03] Infectious abscess of the central nervous system\n Def: A focal suppurative process of the brain parenchyma, the intracranial or spinal epidural or subdural space, and less commonly the spinal cord parenchyma. The suppurative process is most commonly assoc...\n --CHILD--> [1D03.2] Intraspinal extradural abscess", "[1D03.4] Intraspinal epidural abscess\n Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by a focal accumulation of purulent material within the ...\n --PARENT--> [1D03] Infectious abscess of the central nervous system\n Def: A focal suppurative process of the brain parenchyma, the intracranial or spinal epidural or subdural space, and less commonly the spinal cord parenchyma. The suppurative process is most commonly assoc...\n --CHILD--> [1D03.0] Intraspinal intramedullary abscess" ]
NA07.5
Traumatic epidural haemorrhage
[ { "from_icd11": "NA07.5", "icd10_code": "S064X9A", "icd10_title": "Epidural hemorrhage with loss of consciousness of unspecified duration, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X0A", "icd10_title": "Epidural hemorrhage without loss of consciousness, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X2A", "icd10_title": "Epidural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X6A", "icd10_title": "Epidural hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X1A", "icd10_title": "Epidural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X7A", "icd10_title": "Epidural hemorrhage with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X9S", "icd10_title": "Epidural hemorrhage with loss of consciousness of unspecified duration, sequela" }, { "from_icd11": "NA07.5", "icd10_code": "S064X0S", "icd10_title": "Epidural hemorrhage without loss of consciousness, sequela" }, { "from_icd11": "NA07.5", "icd10_code": "S064X9D", "icd10_title": "Epidural hemorrhage with loss of consciousness of unspecified duration, subsequent encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X5A", "icd10_title": "Epidural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X8A", "icd10_title": "Epidural hemorrhage with loss of consciousness of any duration with death due to other causes prior to regaining consciousness, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X3A", "icd10_title": "Epidural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X4A", "icd10_title": "Epidural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064", "icd10_title": "Epidural hemorrhage" }, { "from_icd11": "8B03", "icd10_code": "I621", "icd10_title": "Nontraumatic extradural hemorrhage" } ]
S064X9A
Epidural hemorrhage with loss of consciousness of unspecified duration, initial encounter
In April 2021, a 55-year-old woman was admitted to our Diabetes Unit because of hyperosmolar hyperglycemic state (HHS) and sepsis. Prior medical history included HIV infection, insulin-treated diabetes mellitus (both diagnosed at age 42), hypercholesterolemia, non-proliferative diabetic retinopathy, and chronic kidney disease. Home therapy included a three-drug combination ART (dolutegravir 50 mg, abacavir 600 mg, lamivudine 300 mg), arbitrarily stopped due to intolerance, atorvastatin (10 mg) and insulin therapy with poor adherence to treatment due to fear of hypoglycemia. On clinical examination, patient appeared dehydrated with dry buccal mucosa, tachycardia (120 beats per minute), altered mental status, fever (38.3°C), and ulcerated vulvar lichen sclerosus with signs of genital infection and purulent secretions. Her body weight was 48.5 kg (BMI 20.2 kg/m 2 ). The Malnutrition Universal Screening Tool (MUST) excluded malnutrition, undernutrition, or weight loss ≥5% in past 3-6 months. No drug addiction was apparent. Systolic blood pressure was 155 mmHg and diastolic blood pressure 90 mmHg. On admission, plasma glucose level was 54.5 mmol/L, HbA1c 155 mmol/mol, osmolarity 389.4 mOsm/kg, bicarbonate 24.6 mmol/L, and there were no detectable serum ketones ( Table 1 ). Lipid levels were: total cholesterol 2.09 mmol/L; LDLc 0.57 mmol/L; HDLc 0.65 mmol/L, and triglycerides 1.51 mmol/L. Real time PCR confirmed the HIV-1 genoma with high HIV viral load (68.900 copies/ml). CD4 cell count was 362.6/μL . Blood cultures were positive for methicillin-susceptible Staphylococcus aureus (MMSA). The patient was treated with i.v. fluid and insulin infusion and started on an empirical antibiotic therapy (piperacillin/tazobactam) that was subsequently switched to target MMSA (daptomycin and oxacillin). A transesophageal echocardiography excluded infective endocarditis. Upon HHS and sepsis resolution, basal-bolus insulin therapy was initiated yielding significant improvement of daily glucose profiles and progressive reduction of insulin requirement. Three weeks after initiation of insulin therapy, total daily insulin requirement was 0.3 unit per kg of body weight (approximately 15 U/day) with fasting capillary glucose levels ranging between 5.55-6.44 mmol/L and postprandial ones between 8.32-9.44 mmol/L with no hypoglycemic events. Pancreatic beta cell reserve was preserved as indicated by a fasting plasma C-peptide level of 0.5761 nmol/L. The search for anti-GAD and anti-IA2 autoantibodies was negative supporting a diagnosis of type 2 diabetes. Table 1 shows changes in laboratory parameters at hospital admission and 21 days later when insulin therapy was stopped and low dose of metformin (500 mg twice daily) plus linagliptin (5 mg once daily) were started. On a vascular screening, bilateral carotid artery stenosis (50% in the left bulbar internal carotid artery) and bilateral hemodynamically significant renal artery stenosis (> 80% in the para-ostial district of the left renal artery and > 60% on the right) were identified. Magnetic resonance imaging of the brain showed chronic ischemic vasculopathy of the semi-oval centers and radiate crowns. An abdominal ultrasound (US) examination showed liver enlargement with rounded margins and inhomogeneous distribution of steatosis. In view of the patient’s high cardiovascular risk linagliptin was discontinued and GLP-1 receptor agonist therapy in combination with metformin was initiated in agreement with current guidelines ( 9 , 10 ). At discharge, the complete treatment plan for the patient included dulaglutide (at starting dose of 0.75 mg once weekly), metformin (adjusted to 500 mg once daily to prevent pharmacological interaction with antiretroviral therapy), atorvastatin (10 mg once daily), aspirin (100 mg once daily), bisoprolol (1.25 mg once daily), amlodipine (5 mg once daily), and bictegravir/emtricitabine/tenofovir alafenamide (50 mg/200 mg/25 mg daily), as prescribed by the local infectious disease specialist, given the patient intolerance to previous antiretroviral therapy. Three months after starting dulaglutide, HbA1c was 51 mmol/mol, fasting glucose 7.3 mmol/L and self-monitoring of blood glucose showed a good glycemic control. The patient reported no hypoglycemia nor gastro-intestinal side effects ensuring a high level of adherence to therapy; body weight dropped from 48.5 kg to 45.5 kg with a final BMI of 18.9 Kg/m 2 . At follow-up, an abdominal US no longer detected liver steatosis, although within the limit of inter-operator variability. Urinary albumin-to-creatinine ratio (from 346.7 to 92.1 mg/g) and creatinine value (from 129.9 to 96.4 μmol/L) improved as well and the HIV viral load was markedly reduced (29 copies/ml). Figure 1 summarizes the effects of antihyperglycemic therapy on fasting plasma glucose, HbA1c and body weight.
4.089844
0.967773
sec[1]/p[0]
en
0.999997
PMC8918572
https://doi.org/10.3389/fendo.2022.847778
[ "mmol", "daily", "insulin", "glucose", "weight", "body", "blood", "fasting", "artery", "diabetes" ]
[ { "code": "GB42.1", "title": "Albuminuria, Grade A3" }, { "code": "GB42.0", "title": "Albuminuria, Grade A2" }, { "code": "MA18.0Y", "title": "Other specified elevated blood glucose level" }, { "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": "5A44", "title": "Insulin-resistance syndromes" }, { "code": "5A4Y", "title": "Other specified disorders of glucose regulation or pancreatic internal secretion" }, { "code": "QB51.5", "title": "Presence of endocrine implants" }, { "code": "EF02.0", "title": "Fat hypertrophy" } ]
=== ICD-11 CODES FOUND === [GB42.1] Albuminuria, Grade A3 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A3 | albuminuria >30 mg/mmol creatinine | macroalbuminuria | overt albuminuria | overt nephropathy [GB42.0] Albuminuria, Grade A2 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A2 | microalbuminuria | incipient nephropathy | mild to moderate albuminuria | albuminuria 3-30 mg/mmol creatinine [MA18.0Y] Other specified elevated blood glucose level Also known as: Other specified elevated blood glucose level | Blood glucose between 8.0 - 11.9 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L pre-meal or fasting | Blood glucose greater than or equal to 14.0 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L post-meal or not otherwise specified [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 [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 [5A4Y] Other specified disorders of glucose regulation or pancreatic internal secretion Also known as: Other specified disorders of glucose regulation or pancreatic internal secretion | Other hypoglycaemia | Hyperinsulinaemia | hyperinsulinism | functional hyperinsulinaemia [QB51.5] Presence of endocrine implants Also known as: Presence of endocrine implants | presence of insulin pump Includes: presence of insulin pump [EF02.0] Fat hypertrophy Definition: Focal hypertrophy of subcutaneous adipose tissue. It is a common sequela of long-term insulin injection into the skin. Also known as: Fat hypertrophy | Insulin-induced localised fat hypertrophy | Insulin-induced lipohypertrophy === GRAPH WALKS === --- Walk 1 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Orthostatic proteinuria Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position.... --- Walk 2 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Gestational proteinuria without hypertension --- Walk 3 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Gestational proteinuria without hypertension --- Walk 4 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Orthostatic proteinuria Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position.... --- Walk 5 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --RELATED_TO--> [?] Neonatal hyperglycaemia --- Walk 6 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --EXCLUDES--> [?] Postprocedural hypoinsulinaemia Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus....
[ "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Orthostatic proteinuria\n Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position....", "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Orthostatic proteinuria\n Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position....", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --RELATED_TO--> [?] Neonatal hyperglycaemia", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --EXCLUDES--> [?] Postprocedural hypoinsulinaemia\n Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus...." ]
GB42.1
Albuminuria, Grade A3
[ { "from_icd11": "QF21", "icd10_code": "Z742", "icd10_title": "Need for assistance at home and no other household member able to render care" }, { "from_icd11": "QF21", "icd10_code": "Z600", "icd10_title": "Problems of adjustment to life-cycle transitions" }, { "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": "QB42", "icd10_code": "Z992", "icd10_title": "Dependence on renal dialysis" }, { "from_icd11": "5A44", "icd10_code": "E10-E14", "icd10_title": "" }, { "from_icd11": "QB51.5", "icd10_code": "Z9641", "icd10_title": "Presence of insulin pump (external) (internal)" }, { "from_icd11": "QB51.5", "icd10_code": "Z964", "icd10_title": "Presence of endocrine implants" }, { "from_icd11": "EF02.0", "icd10_code": "L988", "icd10_title": "Other specified disorders of the skin and subcutaneous tissue" }, { "from_icd11": "EF02.0", "icd10_code": "E881", "icd10_title": "Lipodystrophy, not elsewhere classified" } ]
Z742
Need for assistance at home and no other household member able to render care
This case lasted for one decade. The patient was diagnosed with a ureteral calculus when he first admitted in 2013, which was accompanied by hydroureter and hydronephrosis. The laboratory assay showed that the renal function was normal in 2013, which was due to the compensatory effect of the contralateral kidney. Subsequent CT scans confirmed compensatory hypertrophy of the normal side of the kidney. If the kidney in a nonureteral calculus side had developed lesions before, it may lead to renal dysfunction . It can develop into severe urinary tract infections when ureteral obstruction is caused by a ureteral calculus . The recurrent low fever that the patient experienced in 2014 indicated the occurrence of infection caused by the ureteral obstruction. He had not received treatment in time when the infection occurred due to the lack of follow-up. The recurrent fever and abdominal pain the patient experienced in 2014 and 2015 were the evidence of the existence of infections, which might be in the abdominal cavity or in the pelvic cavity because pain in the abdomen or pelvic accompanied by fever is a characteristic symptom of peritoneal or pelvic cavity infections. The images the patient had been examined did not show a left ureteral calculus, hydroureter, and hydronephrosis when he was admitted in 2015, so we speculate that complete obstruction of the ureter caused by a ureteral calculus led to hydroureter and hydronephrosis, which was followed by purulent nephropathy, and ultimately leading to necrosis of the ureteral wall. The images showed renal atrophy, which was caused by high pressure in the renal pelvis. There are many reports in literature that high pressure in the renal pelvis can lead to nephron atrophy . The necrosis of the ureteral wall might lead to the ureter rupture, and pus and the ureteral calculus entered the abdominal cavity, which was manifested by abdominal pain and high fever of the patient in late 2014. After pus had entered the abdominal cavity, it first caused intra-abdominal infection and then formed an intra-abdominal abscess . The pus might be confined because his immune system resisted the infection. The formation of an intra-abdominal abscess is the result of the confinement of pus. The antimicrobial agents applied to him by the local general practitioner also had a therapeutic efficacy on intra-abdominal infection, as his abdominal pain and fever symptoms could be alleviated. The patient benefited from the application of antimicrobial agents and did not develop diffuse peritonitis, which might occur due to the diffusion of intra-abdominal infection. A ureteral calculus can be a cause of an intra-abdominal abscess, which has been reported in literature . The intra-abdominal abscess and stone of the patient might migrate to the pelvic cavity due to gravity, forming a pelvic abscess and a pelvic stone. This was confirmed by images conducted after the patient's admission in 2015. The metabolic products produced by bacteria in the abscess can penetrate into the blood , leading to fever because there are no endothelial cells on the wall of an abscess cavity. The patient was diagnosed with a pelvic abscess after he had admitted in 2015 and subsequently completed aspiration treatment. The follow-up MRI and B-mode sonograph were examined 3 days later after the abscess was aspirated, but CT scan was not conducted. MR images showed mixed signals existing at the original location of the abscess, and B-mode sonograph images showed high echoic shadows. The hyperechoic shadows at the original location of the abscess could not rule out the influence of some fluid drug mixture, which was injected into the pus cavity after aspiration. It was not possible to diagnose a pelvic stone at that time since it could not be denied whether the hyperechoic shadows were caused by the fluid of drug mixture. MR images also failed to diagnose the pelvic stone because it is not the modality of choice in the detection of stones, whereas the diagnosis of lithiasis usually relies on CT scan . The fluid in the abscess cavity might have disappeared gradually after inflammation subsides by taking antibiotics, leaving one stone in the abscess cavity. This is consistent with the images that showed a pelvic stone at the original location of the pelvic abscess on CT images in October 2023. We followed up with the patient for 6 months and found no symptoms related to his abscess after he had stopped using antibiotics in 2015. We have been unable to contact him for over 7 years, which has led to our lack of understanding of the patient's condition in recent years. Fortunately, we saw the patient recently, and he underwent a CT scan, which led to the diagnosis of a pelvic stone and confirmed that a pelvic abscess is related to the ureteral calculus. That is also why we report this case now.
4.101563
0.969727
sec[2]/p[0]
en
0.999998
39263255
https://doi.org/10.1155/2024/2382520
[ "abscess", "abdominal", "pelvic", "ureteral", "which", "cavity", "calculus", "that", "stone", "caused" ]
[ { "code": "1B75.3", "title": "Pyogenic abscess of the skin" }, { "code": "FB30", "title": "Infectious myositis" }, { "code": "FA10.Z", "title": "Direct infections of joint, unspecified" }, { "code": "FB84.Y", "title": "Other specified osteomyelitis or osteitis" }, { "code": "FB40.0", "title": "Infectious tenosynovitis" }, { "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 === [1B75.3] Pyogenic abscess of the skin Definition: A pus-producing abscess of the skin most commonly due to bacterial infection by Staphylococcus aureus. It is prone to develop where the normal anatomy is disturbed as in pilonidal disease, an epidermoid cyst or around foreign bodies such as surgical sutures. Also known as: Pyogenic abscess of the skin | abscess NOS [FB30] Infectious myositis Definition: Infective myositis is an acute, subacute, or chronic infection of skeletal muscle and may be caused by a wide range of infecting organisms. Immunosuppression, particularly as the result of HIV infection, is an important predisposing factor. Also known as: Infectious myositis | Bacterial myositis | Bacterial pyomyositis | Tropical muscle abscess | Tropical pyomyositis [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 [FB84.Y] Other specified osteomyelitis or osteitis Also known as: Other specified osteomyelitis or osteitis | Other chronic osteomyelitis | Garre's disease | chronic or old osteomyelitis with or without mention of periostitis | chronic bone abscess [FB40.0] Infectious tenosynovitis Also known as: Infectious tenosynovitis | Bacterial infection of tendon sheath | Fungal infection of tendon sheath | Mycobacterial infection of tendon sheath | Parasitic infection of tendon sheath [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 --- [1B75.3] Pyogenic abscess of the skin Def: A pus-producing abscess of the skin most commonly due to bacterial infection by Staphylococcus aureus. It is prone to develop where the normal anatomy is disturbed as in pilonidal disease, an epidermo... --RELATED_TO--> [?] Infected epidermoid cyst Def: An epidermoid cyst which has become secondarily infected by, most commonly, Staphylococcus aureus. It manifests as pain, swelling and erythema of a preexisting cyst and is predisposed to rupture.... --PARENT--> [?] Epidermoid cyst Def: A cutaneous cyst with an epidermoid wall filled with keratin and its breakdown products. It most commonly forms as the result of squamous metaplasia in a damaged sebaceous gland but may result from tr... --- Walk 2 --- [1B75.3] Pyogenic abscess of the skin Def: A pus-producing abscess of the skin most commonly due to bacterial infection by Staphylococcus aureus. It is prone to develop where the normal anatomy is disturbed as in pilonidal disease, an epidermo... --RELATED_TO--> [?] Infected epidermoid cyst Def: An epidermoid cyst which has become secondarily infected by, most commonly, Staphylococcus aureus. It manifests as pain, swelling and erythema of a preexisting cyst and is predisposed to rupture.... --PARENT--> [?] Pyogenic abscess of the skin Def: A pus-producing abscess of the skin most commonly due to bacterial infection by Staphylococcus aureus. It is prone to develop where the normal anatomy is disturbed as in pilonidal disease, an epidermo... --- Walk 3 --- [FB30] Infectious myositis Def: Infective myositis is an acute, subacute, or chronic infection of skeletal muscle and may be caused by a wide range of infecting organisms. Immunosuppression, particularly as the result of HIV infecti... --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 4 --- [FB30] Infectious myositis Def: Infective myositis is an acute, subacute, or chronic infection of skeletal muscle and may be caused by a wide range of infecting organisms. Immunosuppression, particularly as the result of HIV infecti... --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 5 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --CHILD--> [FA10.1] Viral infection of joint --- Walk 6 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --CHILD--> [FA10.2] Fungal infection of joint
[ "[1B75.3] Pyogenic abscess of the skin\n Def: A pus-producing abscess of the skin most commonly due to bacterial infection by Staphylococcus aureus. It is prone to develop where the normal anatomy is disturbed as in pilonidal disease, an epidermo...\n --RELATED_TO--> [?] Infected epidermoid cyst\n Def: An epidermoid cyst which has become secondarily infected by, most commonly, Staphylococcus aureus. It manifests as pain, swelling and erythema of a preexisting cyst and is predisposed to rupture....\n --PARENT--> [?] Epidermoid cyst\n Def: A cutaneous cyst with an epidermoid wall filled with keratin and its breakdown products. It most commonly forms as the result of squamous metaplasia in a damaged sebaceous gland but may result from tr...", "[1B75.3] Pyogenic abscess of the skin\n Def: A pus-producing abscess of the skin most commonly due to bacterial infection by Staphylococcus aureus. It is prone to develop where the normal anatomy is disturbed as in pilonidal disease, an epidermo...\n --RELATED_TO--> [?] Infected epidermoid cyst\n Def: An epidermoid cyst which has become secondarily infected by, most commonly, Staphylococcus aureus. It manifests as pain, swelling and erythema of a preexisting cyst and is predisposed to rupture....\n --PARENT--> [?] Pyogenic abscess of the skin\n Def: A pus-producing abscess of the skin most commonly due to bacterial infection by Staphylococcus aureus. It is prone to develop where the normal anatomy is disturbed as in pilonidal disease, an epidermo...", "[FB30] Infectious myositis\n Def: Infective myositis is an acute, subacute, or chronic infection of skeletal muscle and may be caused by a wide range of infecting organisms. Immunosuppression, particularly as the result of HIV infecti...\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...", "[FB30] Infectious myositis\n Def: Infective myositis is an acute, subacute, or chronic infection of skeletal muscle and may be caused by a wide range of infecting organisms. Immunosuppression, particularly as the result of HIV infecti...\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...", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --CHILD--> [FA10.1] Viral infection of joint", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --CHILD--> [FA10.2] Fungal infection of joint" ]
1B75.3
Pyogenic abscess of the skin
[ { "from_icd11": "1B75.3", "icd10_code": "L02612", "icd10_title": "Cutaneous abscess of left foot" }, { "from_icd11": "1B75.3", "icd10_code": "L02611", "icd10_title": "Cutaneous abscess of right foot" }, { "from_icd11": "1B75.3", "icd10_code": "L02511", "icd10_title": "Cutaneous abscess of right hand" }, { "from_icd11": "1B75.3", "icd10_code": "L02512", "icd10_title": "Cutaneous abscess of left hand" }, { "from_icd11": "1B75.3", "icd10_code": "L02619", "icd10_title": "Cutaneous abscess of unspecified foot" }, { "from_icd11": "1B75.3", "icd10_code": "L02519", "icd10_title": "Cutaneous abscess of unspecified hand" }, { "from_icd11": "1B75.3", "icd10_code": "L02529", "icd10_title": "Furuncle unspecified hand" }, { "from_icd11": "1B75.3", "icd10_code": "L02539", "icd10_title": "Carbuncle of unspecified hand" }, { "from_icd11": "1B75.3", "icd10_code": "L02629", "icd10_title": "Furuncle of unspecified foot" }, { "from_icd11": "1B75.3", "icd10_code": "L02639", "icd10_title": "Carbuncle of unspecified foot" }, { "from_icd11": "1B75.3", "icd10_code": "L02214", "icd10_title": "Cutaneous abscess of groin" }, { "from_icd11": "1B75.3", "icd10_code": "L02414", "icd10_title": "Cutaneous abscess of left upper limb" }, { "from_icd11": "1B75.3", "icd10_code": "L0231", "icd10_title": "Cutaneous abscess of buttock" }, { "from_icd11": "1B75.3", "icd10_code": "L02413", "icd10_title": "Cutaneous abscess of right upper limb" }, { "from_icd11": "1B75.3", "icd10_code": "L02212", "icd10_title": "Cutaneous abscess of back [any part, except buttock]" } ]
L02612
Cutaneous abscess of left foot
A 67-year-old woman from Romania presented to our Emergency Department for confusion and subacute ideomotor decline in the previous 5 days. Insomnia, nocturnal awakenings, urinary incontinence, and amnesia for recent events were reported in the last month. The patient had a past medical history of paroxysmal atrial fibrillation, previously treated with amiodarone and apixaban, which were self-suspended 1 year ago, obesity, hypertension, and rectal carcinoma which was surgically treated with an enterostomy. The patient had no known history of seizures or other neurological diseases, recent illness, brain trauma, or recent surgical procedures. The chronic therapy encompassed olmesartan, bisoprolol, indapamide, furosemide, amlodipine, acetylsalicylic acid, and ranitidine. The vital parameters were normal, and the Glasgow Coma Scale (GCS) score was 15. The general physical examination did not show pathological items, nor signs of trauma. The chest X-ray was normal, while the electrocardiogram was suggestive of atrial fibrillation. From a neurological point of view, the patient was disoriented in space and time and unable to denominate objects of common use. The pupils were isochoric and reactive to light. The posture was normal and there were no signs of meningism. The cranial nerve examination was normal, except for dubious absence of the menace reflex on the left, not confirmed by a subsequent evaluation. The global strength of the limbs was preserved, as well as tactile sensitivity and coordination. The osteotendinous reflexes were valid, symmetrical in the upper limbs, with a mild prevalence on the right, and weak and symmetrical in the lower limbs. Cutaneous plantar response was mute bilaterally. A stroke was initially suspected, and a neuroimaging study was performed with brain computed tomography (CT), CT angiography, and CT perfusion, which were unremarkable. Because of the persistence of the altered mental state, electroencephalography (EEG) was performed. EEG showed a broadly slowed trace, with a background theta rhythm, which was more expressed on the right. Fast paroxysmal bilateral activity of the type sharp wave was superimposed and more represented on the right and mainly frontotemporal areas. Herein, NCSE was suspected and 10 mg of diazepam was administered intravenously, with regression of the paroxysmal activity on the synchronous recording of the EEG. Furthermore, antiepileptic therapy with 4,000 mg of intravenous levetiracetam was started, and the mental state progressively improved. The next day, the EEG was repeated, and epileptiform activity did not reappear ; levetiracetam was switched to an oral dosage of 2,000 mg daily. The patient was admitted to our Neurology Department with the presumptive diagnosis of NCSE, and a 3 Tesla brain MRI with gadolinium was performed. Bilateral hyperintensity of the lenticular nucleus was detected on T1W sequences , while bilateral hyperintensity of the corticospinal tract signal was displayed on FLAIR . Neuroimaging ruled out an ischemic event and an expansive lesion, with findings suggestive of chronic HE. As a completion, a lumbar puncture with examination of cerebral spinal fluid was performed. It did not show any noteworthy findings, including the real-time polymerase chain reaction for an infectious agent or dosage of autoantibodies associated with autoimmune and paraneoplastic encephalitis. The patient was obese (body mass index = 38.3 kg/m 2 ) but had no past history of alcoholic abuse. There were no signs of ascites and declining edema. She presented no signs of asterixis. Blood tests performed a few days later revealed: chronic coinfection of Hepatitis B (HBV) and D (HDV) virus, negative Hepatitis C virus (HCV) infection, ammonium 141 umol/L (11.2–48.2 umol/L), albumin 2.7 mg/dl (3.4–4.8), total bilirubin 1.33 (0.12–1.1 mg/dl), INR 1.25 (0.8–1.2), proteins 5.6 g/dl (6.4–8 g/dl), cobalamin 1,121 pg/ml (191–663 pg/ml), and normal levels of folate, transferrin, sideremia, and ferritin. Hepatic elastography recorded values compatible with cirrhosis. Hepatic cirrhosis from mixed etiology, chronic HBV-HDV co-infection, and metabolic syndrome was diagnosed. The clinical picture was considered to be an episode of HE, presenting as NCSE. Anti-HBV therapy with entecavir (0.5 mg daily orally) was started, as well as secondary prevention of HE with lactulose (10 g two times daily orally) and rifaximin (400 mg three times daily orally). On the day of discharge, her mental state was normal, and the patient noted improvement in her general health condition . Afterwards, she continued to receive levetiracetam for epilepsy, besides lactulose and rifaximine for secondary prevention of HE; relatives reported no other episodes of mental confusion. Three months later, a brain MRI was repeated, and radiological findings were stable.
3.988281
0.979004
sec[1]/p[0]
en
0.999998
PMC9133409
https://doi.org/10.3389/fneur.2022.880068
[ "which", "brain", "mental", "daily", "paroxysmal", "limbs", "state", "activity", "ncse", "levetiracetam" ]
[ { "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": "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": "6E8Z", "title": "Mental, behavioural or neurodevelopmental disorders, unspecified" } ]
=== ICD-11 CODES FOUND === [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 [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 [6E8Z] Mental, behavioural or neurodevelopmental disorders, unspecified Also known as: Mental, behavioural or neurodevelopmental disorders, unspecified | Psychiatric disorder | mental disease NOS | mental disorder NOS | mental illness === GRAPH WALKS === --- Walk 1 --- [BD50.41] Abdominal aortic aneurysm with rupture --PARENT--> [BD50.4] Abdominal aortic aneurysm --CHILD--> [BD50.41] Abdominal aortic aneurysm with rupture --- Walk 2 --- [BD50.41] Abdominal aortic aneurysm with rupture --PARENT--> [BD50.4] Abdominal aortic aneurysm --CHILD--> [BD50.40] Abdominal aortic aneurysm with perforation --- Walk 3 --- [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --CHILD--> [EK91.0] Large plaque parapsoriasis Def: Large plaque parapsoriasis is a chronic skin disorder characterised by the indolent development over years or decades of scaly patches or slightly elevated plaques which may be clinically indistinguis... --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --- Walk 4 --- [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --PARENT--> [?] Disorders of the skin of uncertain or unpredictable malignant potential --CHILD--> [EK92] Histiocytoses of uncertain malignant potential Def: Disorders characterised by abnormal proliferation of dendritic cells and macrophages. The proliferation may or may not be clonal and the prognosis is unpredictable.... --- Walk 5 --- [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained --PARENT--> [MH12] Other sudden death, cause unknown --CHILD--> [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained --- Walk 6 --- [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained --PARENT--> [MH12] Other sudden death, cause unknown --EXCLUDES--> [?] Sudden infant death syndrome Def: Sudden infant death syndrome is the abrupt and unexplained death of an apparently healthy infant under one year of age, remaining unexplained after a thorough case investigation, including performance...
[ "[BD50.41] Abdominal aortic aneurysm with rupture\n --PARENT--> [BD50.4] Abdominal aortic aneurysm\n --CHILD--> [BD50.41] Abdominal aortic aneurysm with rupture", "[BD50.41] Abdominal aortic aneurysm with rupture\n --PARENT--> [BD50.4] Abdominal aortic aneurysm\n --CHILD--> [BD50.40] Abdominal aortic aneurysm with perforation", "[EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....\n --CHILD--> [EK91.0] Large plaque parapsoriasis\n Def: Large plaque parapsoriasis is a chronic skin disorder characterised by the indolent development over years or decades of scaly patches or slightly elevated plaques which may be clinically indistinguis...\n --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....", "[EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....\n --PARENT--> [?] Disorders of the skin of uncertain or unpredictable malignant potential\n --CHILD--> [EK92] Histiocytoses of uncertain malignant potential\n Def: Disorders characterised by abnormal proliferation of dendritic cells and macrophages. The proliferation may or may not be clonal and the prognosis is unpredictable....", "[MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained\n --PARENT--> [MH12] Other sudden death, cause unknown\n --CHILD--> [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained", "[MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained\n --PARENT--> [MH12] Other sudden death, cause unknown\n --EXCLUDES--> [?] Sudden infant death syndrome\n Def: Sudden infant death syndrome is the abrupt and unexplained death of an apparently healthy infant under one year of age, remaining unexplained after a thorough case investigation, including performance..." ]
BD50.41
Abdominal aortic aneurysm with rupture
[ { "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": "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" } ]
I713
Abdominal aortic aneurysm, ruptured
A 35-year-old woman who underwent peritoneal dialysis for 11 months because of ESRD secondary to chronic glomerulonephritis was hospitalized for living kidney transplantation. Proteinuria and renal dysfunction were observed during her pregnancy, and her serum creatinine level was 1.4 mg/mL at that time; thereafter, she was followed up by a nephrologist at our institution. Although renal biopsy was considered, the atrophic change of her kidneys was too severe for a renal biopsy for pathological diagnosis. She underwent ABO-incompatible living kidney transplantation donated from her 62-year-old mother. Her left kidney was procured, and the allograft had a single artery that showed no evidence of arteriosclerosis or stenosis . The transplanted artery was anastomosed to the internal iliac artery, and the transplanted vein was anastomosed to the external iliac vein. After the completion of anastomosis, Doppler US revealed an increased peak systolic flow velocity at around 250 cm/sec with > 200 cm/sec peak velocity at anastomosis correlating with significant stenosis . Arterial anastomotic stenosis was suspected; however, there was no evidence for it. At the same time, a change in hue was detected in a part of the transplant renal artery; that part of the artery turned dark brown, and hematoma was strongly suspected . Furthermore, that part was exactly where vascular clamping was performed temporarily in order to drain the air and check bleeding at the anastomosis. Therefore, transplant renal artery stenosis (TRAS) might have resulted from TRAD. The part of the transplanted renal artery was resected, and cold reflux was started again. Injury of the transplant artery was detected macroscopically, and the rest of the transplanted renal artery was anastomosed to the external iliac artery. After re-anastomosis, Doppler US revealed that the blood flow of the renal artery was adequate without an increase in the systolic blood velocity, resulting in sufficient blood flow throughout the allograft. Urine output was also observed as soon as the blood flow returned. An hour after the allograft blood flow returned, the allograft biopsy was performed at the lower pole of the allograft, and no bleeding from the operative field, including the biopsy site, was observed. An immunosuppression regimen including tacrolimus, mycophenolate mofetil, prednisone, and basiliximab was prescribed. After the kidney transplantation, her serum creatinine level decreased to 0.95 mg/dL . An allograft biopsy showed no evidence of rejection or acute tubular necrosis. Furthermore, pathological diagnosis of the resected artery was tunica media dissection. Fig. 1 Representative images of the allograft obtained by presurgical unenhanced computed tomography. The donor was the recipient’s mother who was 62 years old, who was good in shape and had no complication. Her left renal artery shows no evidence of arteriosclerosis (red arrow: a axial image; b three-dimensional image) Fig. 2 Representative image of the arterial anastomotic stenosis obtained by Doppler ultrasonography. This is a representative image for illustrative purposes. Arterial anastomotic stenosis shows an increased systolic in the systolic blood velocity Fig. 3 Representative macroscopic images of the allograft and injured transplant kidney artery. Immediately after vascular anastomosis (internal iliac artery-renal artery, external iliac vein-renal vein), Doppler ultrasonography shows an increase in the systolic blood velocity; thus, arterial anastomotic stenosis was suspected and explored. As a result, a color change is observed at the transplanted renal artery (red arrow). The cause of transplant renal artery stenosis was artery dissection ( a whole image; b magnified image). Resected transplant renal artery was cut vertically, and artery dissection was observed macroscopically (blue arrow: c ) Fig. 4 Clinical course of serum creatinine level and urine output and the immunosuppression regimen. After surgery, the serum creatinine level decreased to 0.95 mg/dL, and urine output increased. The immunosuppression regimen was as follows: rituximab, tacrolimus, mycophenolate mofetil, prednisone, and basiliximab. To decrease existing antibody double filtration plasmapheresis and plasma exchange were performed in a presurgical state. At discharge, doses of each immunosuppressive agent were as follows: 7 mg/day tacrolimus, 1000 mg/day mycophenolate mofetil, and 5 mg/day prednisone. On the day of transplantation and postoperative day 4, 20 mg/day basiliximab was administered. POD = postoperative day; TAC = tacrolimus; MMF = mycophenolate mofetil; PSL = prednisone; BXM = basiliximab; RXM = rituximab; DFPP = double filtration plasmapheresis; PE = plasma exchange Written informed consent was obtained from the patient and her mother for participation in this report.
4.046875
0.975098
sec[1]/p[0]
en
0.999998
31996160
https://doi.org/10.1186/s12882-020-1699-x
[ "artery", "renal", "allograft", "stenosis", "blood", "transplant", "kidney", "that", "biopsy", "transplanted" ]
[ { "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" }, { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "GB6Z", "title": "Kidney failure, unspecified" }, { "code": "LB30.1", "title": "Renal dysplasia" }, { "code": "NB92.0Y", "title": "Other specified injury of kidney" }, { "code": "LB30.7", "title": "Ectopic or pelvic kidney" } ]
=== ICD-11 CODES FOUND === [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 [GB6Z] Kidney failure, unspecified Also known as: Kidney failure, unspecified | nontraumatic kidney injury | renal failure NOS | kidney block | renal impairment NOS [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 [NB92.0Y] Other specified injury of kidney Also known as: Other specified injury of kidney | Injury of kidney without open wound into cavity | Injury of kidney with open wound into cavity | Haematoma of kidney | traumatic perirenal haematoma [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 === GRAPH WALKS === --- Walk 1 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --EXCLUDES--> [?] Diseases of coronary artery Def: Conditions affecting the blood perfusion of the heart.... --- Walk 2 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --CHILD--> [BD30] Acute arterial occlusion --- Walk 3 --- [BD52] Certain specified disorders of arteries or arterioles --EXCLUDES--> [?] Nonorgan specific systemic autoimmune disorders --CHILD--> [?] Systemic sclerosis Def: Systemic sclerosis is a systemic disorder of the connective tissue; manifested by hardening and thickening of the skin, by abnormalities involving the microvasculature and larger vessels, and by fibro... --- Walk 4 --- [BD52] Certain specified disorders of arteries or arterioles --CHILD--> [BD52.0] Segmental arterial mediolysis Def: Segmental arterial mediolysis is a rare noninflammatory vascular disease of the abdominal splanchnic arteries, characterised by disruption of the arterial medial layer. It will induce multiple aneurys... --PARENT--> [BD52] Certain specified disorders of arteries or arterioles --- Walk 5 --- [BD52.3] Rupture of artery --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--> [?] Stress fracture, not elsewhere classified --- Walk 6 --- [BD52.3] Rupture of artery --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--> [?] Stress fracture, not elsewhere classified
[ "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --EXCLUDES--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....", "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [BD30] Acute arterial occlusion", "[BD52] Certain specified disorders of arteries or arterioles\n --EXCLUDES--> [?] Nonorgan specific systemic autoimmune disorders\n --CHILD--> [?] Systemic sclerosis\n Def: Systemic sclerosis is a systemic disorder of the connective tissue; manifested by hardening and thickening of the skin, by abnormalities involving the microvasculature and larger vessels, and by fibro...", "[BD52] Certain specified disorders of arteries or arterioles\n --CHILD--> [BD52.0] Segmental arterial mediolysis\n Def: Segmental arterial mediolysis is a rare noninflammatory vascular disease of the abdominal splanchnic arteries, characterised by disruption of the arterial medial layer. It will induce multiple aneurys...\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles", "[BD52.3] Rupture of artery\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--> [?] Stress fracture, not elsewhere classified", "[BD52.3] Rupture of artery\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--> [?] Stress fracture, not elsewhere classified" ]
BD5Z
Diseases of arteries or arterioles, unspecified
[ { "from_icd11": "BD5Z", "icd10_code": "I7389", "icd10_title": "Other specified peripheral vascular diseases" }, { "from_icd11": "BD5Z", "icd10_code": "I7419", "icd10_title": "Embolism and thrombosis of other parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7411", "icd10_title": "Embolism and thrombosis of thoracic aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7410", "icd10_title": "Embolism and thrombosis of unspecified parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7381", "icd10_title": "Erythromelalgia" }, { "from_icd11": "BD5Z", "icd10_code": "I745", "icd10_title": "Embolism and thrombosis of iliac artery" }, { "from_icd11": "BD5Z", "icd10_code": "I789", "icd10_title": "Disease of capillaries, unspecified" }, { "from_icd11": "BD5Z", "icd10_code": "I748", "icd10_title": "Embolism and thrombosis of other arteries" }, { "from_icd11": "BD5Z", "icd10_code": "I749", "icd10_title": "Embolism and thrombosis of unspecified artery" }, { "from_icd11": "BD5Z", "icd10_code": "I781", "icd10_title": "Nevus, non-neoplastic" }, { "from_icd11": "BD5Z", "icd10_code": "I788", "icd10_title": "Other diseases of capillaries" }, { "from_icd11": "BD5Z", "icd10_code": "I744", "icd10_title": "Embolism and thrombosis of arteries of extremities, unspecified" }, { "from_icd11": "BD5Z", "icd10_code": "I70-I79", "icd10_title": "" }, { "from_icd11": "BD5Z", "icd10_code": "I74", "icd10_title": "Arterial embolism and thrombosis" }, { "from_icd11": "BD5Z", "icd10_code": "I73", "icd10_title": "Other peripheral vascular diseases" } ]
I7389
Other specified peripheral vascular diseases
Although the mare indeed survived post-hospitalization, there were a number of unprecedented complications encountered throughout treatment, such as inadequate cervical relaxation, which resulted in failed attempts at transcervical removal of fetal remnants, as well as surgical complications such as inadequate exposure of the uterus and incorporation of fetal remnants into the uterine stump. This account is unique as it is the first reported case in the literature of fetal remnants being incorporated into the caudal stump of the ovariohysterectomy site as a complication in surgical management of fetal maceration and pyometra in the mare. In previous reports, successful resolution of the condition by evacuation of the remnant fetal structures was performed via less invasive transcervical endoscopic techniques and uterine lavage. However, this approach proved to be unsuccessful due to failure of cervical relaxation and incomplete compliance. Previously reported techniques for relaxation of the cervix include pharmacological treatments such as systemic prostaglandin F2α (250 µg cloprostenol) and manual application of prostaglandin E 1 (crushed 200 µg Cytotec tablet) on the cervix itself . Unfortunately, these techniques were not successful in this case. This could possibly have been due to fibrotic changes in the cervix resulting in poor elasticity and failure to dilate, being an older maiden mare. Due to the evidence of a deteriorating clinical picture in the mare, along with failed transcervical evacuation attempts, intervention in the form of surgery was considered. Ovariohysterectomy is a well-recognized procedure in the horse for unresolved cases of pyometra that are refractory to medical management, including cervical drainage and antimicrobial therapy . Despite the reported technical difficulties associated with the procedure, most clinical reports summarize that the prognosis post-surgery can be quite good . Surgical management of cases that involve fetal maceration, specifically in the horse, have only been reported in the literature twice . However, despite this, surgical management of fetal maceration in other species has been well recognized . Various approaches to access the uterus have been described including a transvaginal approach via colpotomy , standing abdominal approaches including both left and right flank incisions in the cow , and recumbent abdominal celiotomy approaches such as paramedian and ventral midline incisions in mares as well as both standing and recumbent laparoscopic approaches . A common issue encountered during this procedure in mares is achieving complete and adequate exposure to the caudal aspect of the reproductive tract . Similar difficulties were encountered during surgery for this mare, and this was perhaps attributable to both the inherent anatomy and stature of the mare as well as the size and positioning of the uterus itself. Techniques to improve surgical exposure include using stay sutures, right angled clamps, and perhaps even the use of a TA-90 Autosuture instrument (4United States Surgical Corp., Norwalk, CT, USA) as described by Rötting et al. . Other reports describe initial dissection of ovarian structures via intra-abdominal laparoscopic techniques, with subsequent removal/amputation of the uterus caudally via a colpotomy or through the left flank via a paralumbar fossa incision . Removal of the fetus via a hysterotomy without removal of the uterus has also been described in the cow and may be another alternative procedure for consideration in horses . Ovariohysterectomy over hysterotomy was chosen in this mare to prevent recurrence of pyometra in future. Unlike in cattle where pyometra is associated with a persistent corpus luteum and closed cervix, the main reason for development of pyometra in mares is due to a problem with cervical drainage because of cervical incompetence. This was an old nulliparous mare, and age-related fibrotic changes likely led to the failure of cervical dilation even after manual and medical interventions. The progesterone level in this mare was baseline (0.78 ng/mL) which ruled out any influence of cervical closure due to increased progesterone levels. Moreover, the influence of progestogens from the feto-placental unit was also ruled out due to absence of fetal membranes. There are other recognized complications associated with partial and/or complete ovariohysterectomies which include peritonitis, infection of the uterine stump, abdominal hemorrhage, and incision site infection . Additional considerations as to cost and prognosis may not be completely applicable to every manifestation of these rare cases. In this particular instance, the owners of this mare were not severely financially restricted and a decision to treat this mare was mainly due to their emotional attachment to the animal.
4.351563
0.807129
sec[2]/p[0]
en
0.999997
36356061
https://doi.org/10.3390/vetsci9110584
[ "this", "mare", "fetal", "cervical", "well", "uterus", "pyometra", "techniques", "removal", "cervix" ]
[ { "code": "4A01.03", "title": "Transient hypogammaglobulinaemia of infancy" }, { "code": "LD9Z", "title": "Developmental anomalies, unspecified" }, { "code": "KB20.Z", "title": "Intrauterine hypoxia, unspecified" }, { "code": "3A50.4", "title": "Hereditary persistence of fetal haemoglobin" }, { "code": "KB42", "title": "Persistent pulmonary hypertension of the newborn" }, { "code": "LD2Z", "title": "Multiple developmental anomalies or syndromes, unspecified" }, { "code": "GA04", "title": "Cervicitis" }, { "code": "GA1Z&XA5WW1", "title": "Noninflammatory disorders of cervix uteri" }, { "code": "FB1Y", "title": "Other specified conditions associated with the spine" }, { "code": "GA04&XT5R", "title": "Acute cervicitis" } ]
=== ICD-11 CODES FOUND === [4A01.03] Transient hypogammaglobulinaemia of infancy Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy] [LD9Z] Developmental anomalies, unspecified Also known as: Developmental anomalies, unspecified | congenital malformations, deformations and chromosomal abnormalities | congenital malformation NOS | developmental abnormality NOS | fetal abnormality NOS [KB20.Z] Intrauterine hypoxia, unspecified Also known as: Intrauterine hypoxia, unspecified | Intrauterine hypoxia | fetal distress | fetal distress syndrome | intrauterine distress [3A50.4] Hereditary persistence of fetal haemoglobin Definition: Hereditary persistence of fetal haemoglobin (HPFH) associated with beta-thalassaemia is a haemoglobinopathy characterised by high haemoglobin (Hb)F levels and an increased number of fetal-Hb-containing cells. The association of HPFH with beta-thalassaemia mitigates the clinical manifestations which vary from a normal state to beta-thalassaemia intermedia. Also known as: Hereditary persistence of fetal haemoglobin | HPFH - [Hereditary persistence of fetal haemoglobin] | fetal haemoglobin | persistence of fetal haemoglobin | persistent haemoglobin F [KB42] Persistent pulmonary hypertension of the newborn Definition: Persistent pulmonary hypertension of the newborn is a cardiopulmonary disorder characterised by systemic arterial hypoxemia secondary to pulmonary hypertension and extrapulmonary right-to-left shunting across the foramen ovale and ductus arteriosus. Also known as: Persistent pulmonary hypertension of the newborn | persistent fetal circulation syndrome | fetal circulation | PFC - [persistent fetal circulation] syndrome | PPHN - [Persistent pulmonary hypertension of the newborn] [LD2Z] Multiple developmental anomalies or syndromes, unspecified Also known as: Multiple developmental anomalies or syndromes, unspecified | multiple congenital birth defects NOS | multiple congenital birth deformities NOS | multiple fetal abnormalities NOS | severe birth deformities NOS [GA04] Cervicitis Also known as: Cervicitis | inflammation of cervix | inflammation of cervix uteri | Ulcer of cervix with cervicitis | Acute cervicitis [FB1Y] Other specified conditions associated with the spine Also known as: Other specified conditions associated with the spine | Other recurrent vertebral subluxation | Interspinous ligament syndrome | Spondylitis muscularis | Posterior longitudinal ligament calcification === GRAPH WALKS === --- Walk 1 --- [4A01.03] Transient hypogammaglobulinaemia of infancy --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... --PARENT--> [4A01] Primary immunodeficiencies due to disorders of adaptive immunity --- Walk 2 --- [4A01.03] Transient hypogammaglobulinaemia of infancy --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--> [4A01.02] Specific antibody deficiency with normal immunoglobulin concentrations or normal number of B cells --- Walk 3 --- [LD9Z] Developmental anomalies, unspecified --PARENT--> [20] 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.... --CHILD--> [?] Structural developmental anomalies primarily affecting one body system Def: A deformation established before birth of an anatomical structure.... --- Walk 4 --- [LD9Z] Developmental anomalies, unspecified --PARENT--> [20] 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.... --EXCLUDES--> [?] Inborn errors of metabolism Def: Inborn errors of metabolism comprise a large class of genetic diseases involving disorders of metabolism. The majority are due to defects of single genes that code for enzymes that facilitate conversi... --- Walk 5 --- [KB20.Z] Intrauterine hypoxia, unspecified --PARENT--> [KB20] 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... --EXCLUDES--> [?] Hypoxic ischaemic encephalopathy of newborn Def: Hypoxic ischaemic encephalopathy (HIE) is when a newborn’s brain fails to receive a sufficient amount of oxygen or blood before and during birth that may lead to brain damage or death.... --- Walk 6 --- [KB20.Z] Intrauterine hypoxia, unspecified --PARENT--> [KB20] 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... --EXCLUDES--> [?] Hypoxic ischaemic encephalopathy of newborn Def: Hypoxic ischaemic encephalopathy (HIE) is when a newborn’s brain fails to receive a sufficient amount of oxygen or blood before and during birth that may lead to brain damage or death....
[ "[4A01.03] Transient hypogammaglobulinaemia of infancy\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 --PARENT--> [4A01] Primary immunodeficiencies due to disorders of adaptive immunity", "[4A01.03] Transient hypogammaglobulinaemia of infancy\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--> [4A01.02] Specific antibody deficiency with normal immunoglobulin concentrations or normal number of B cells", "[LD9Z] Developmental anomalies, unspecified\n --PARENT--> [20] 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....\n --CHILD--> [?] Structural developmental anomalies primarily affecting one body system\n Def: A deformation established before birth of an anatomical structure....", "[LD9Z] Developmental anomalies, unspecified\n --PARENT--> [20] 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....\n --EXCLUDES--> [?] Inborn errors of metabolism\n Def: Inborn errors of metabolism comprise a large class of genetic diseases involving disorders of metabolism. The majority are due to defects of single genes that code for enzymes that facilitate conversi...", "[KB20.Z] Intrauterine hypoxia, unspecified\n --PARENT--> [KB20] 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...\n --EXCLUDES--> [?] Hypoxic ischaemic encephalopathy of newborn\n Def: Hypoxic ischaemic encephalopathy (HIE) is when a newborn’s brain fails to receive a sufficient amount of oxygen or blood before and during birth that may lead to brain damage or death....", "[KB20.Z] Intrauterine hypoxia, unspecified\n --PARENT--> [KB20] 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...\n --EXCLUDES--> [?] Hypoxic ischaemic encephalopathy of newborn\n Def: Hypoxic ischaemic encephalopathy (HIE) is when a newborn’s brain fails to receive a sufficient amount of oxygen or blood before and during birth that may lead to brain damage or death...." ]
4A01.03
Transient hypogammaglobulinaemia of infancy
[ { "from_icd11": "4A01.03", "icd10_code": "D807", "icd10_title": "Transient hypogammaglobulinemia of infancy" }, { "from_icd11": "LD9Z", "icd10_code": "Q898", "icd10_title": "Other specified congenital malformations" }, { "from_icd11": "LD9Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "LD9Z", "icd10_code": "Q89", "icd10_title": "Other congenital malformations, not elsewhere classified" }, { "from_icd11": "LD9Z", "icd10_code": "XVII", "icd10_title": "" }, { "from_icd11": "LD9Z", "icd10_code": "Q10-Q18", "icd10_title": "" }, { "from_icd11": "LD9Z", "icd10_code": "Q38-Q45", "icd10_title": "" }, { "from_icd11": "LD9Z", "icd10_code": "Q80-Q89", "icd10_title": "" }, { "from_icd11": "KB20.Z", "icd10_code": "P20", "icd10_title": "" }, { "from_icd11": "KB20.Z", "icd10_code": "P209", "icd10_title": "" }, { "from_icd11": "3A50.4", "icd10_code": "D564", "icd10_title": "Hereditary persistence of fetal hemoglobin [HPFH]" }, { "from_icd11": "KB42", "icd10_code": "P293", "icd10_title": "Persistent fetal circulation" }, { "from_icd11": "LD2Z", "icd10_code": "Q8789", "icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified" }, { "from_icd11": "LD2Z", "icd10_code": "Q8781", "icd10_title": "Alport syndrome" }, { "from_icd11": "LD2Z", "icd10_code": "Q871", "icd10_title": "Congenital malformation syndromes predominantly associated with short stature" } ]
D807
Transient hypogammaglobulinemia of infancy
A 77-year-old German male was referred to our tropical medicine department in April 2023 after oral surgery of a lingual ulcer clinically highly suspicious for malignancy . Histopathologically, however, roundish intracellular structures could be detected which were compatible with amastigote Leishmania parasites . During the past four months before presentation a single and slowly growing lesion was developing at the left distal third of his tongue causing halitosis and increasing difficulties in eating and speaking. There were no cervical, submandibular or nuchal lymph nodes palpable and no signs of hepatosplenomegaly. The patient did not report any fever, weight loss or night sweating. Erythrocytes, platelets and white blood count (WBC) were within the normal range. The WBC differential did not show an increase in eosinophils, but IgE levels were highly elevated . Serum electrophoresis did not show an increase of the gamma fraction. Erythrocyte sedimentation rate (ESR) (28 mm/h; normal < 3–15 mm/h) and c-reactive protein (CRP) (2.7 mg/dl; normal < 0.5) were moderately elevated. Serological screening for Treponema pallidum (Chemiluminescent immunoassay, CLIA) and human immunodeficiency virus (HIV) was negative. There was no medical history besides arterial hypertension, obesity and an obstructive sleeping apnea syndrome (OSAS). The patient is a former smoker with the history of 40 pack years. He is retired and travelling occasionally to the Costa brava in Spain. No travel outside of Europe and no contact to animals was reported. For confirmation of the diagnosis and species identification scratching was performed carefully from the excision´s margin. Microscopy of the tissue smear did not show any amastigotes of Leishmania spp. in Giemsa staining. Nucleic acid amplification testing (NAAT) with a routine Leishmania complex-screening polymerase chain reaction (PCR) targeting the 18 S ribosomal ribonucleic acid (rRNA) genes did not detect any Leishmania parasites. Serum antibodies against Leishmania species were detected by an in-house indirect immunofluorescence testing (IFAT) using cultured L. infantum and L. major promastigotes and fluorescence-coupled sheep anti-human IgGAM (total Ig). IFAT titer was 1:1,280 (normal < 1:20 as determined with 40 healthy blood donors), indicating a past or present infection. With a more sensitive PCR targeting the parasite’s kinetoplast deoxyribonucleic acid (DNA) , nucleic acid of Leishmania species was detected from the smear material. However, the amount of nucleic acid was too little to perform further PCRs used for sequencing and species identification from this material. Therefore, formalin-fixed paraffin-embedded (FFPE) tissue from the oral surgery was analyzed. Histology revealed amastigotes of Leishmania spp. . From this material, the Leishmania complex-screening PCR was positive for the Leishmania donovani complex and, following sequencing of the cpb gene , Leishmania infantum was identified . This finding is in line with the travel history of the patient to northern Spain, although L. infantum is not known to frequently cause mucosal leishmaniasis. A second anamnesis revealed that the patient once was suffering from a badly healing wound on his right forearm eight years ago, but already forgot about it. At that time, the lesion was biopsied, excised and covered with a flap plastic surgery at a dermatology clinic. We therefore requested the dermatologist’s report and the archived FFPE material, which revealed the diagnosis of a cutaneous leishmaniasis in histopathology . Following surgery, no species identification was performed and no sequential antiparasitic treatment was administered. The patient stayed asymptomatic until recently. On our microscopic examination from the stored slides, the diagnosis of CL was confirmed and PCR detected L. donovani complex from the archived slides. Unfortunately, the nucleic acid quality was too poor and the amount too little to perform sequencing. L. infantum belongs to the L. donovani complex and is the only species of Leishmania species endemic in Spain , hence it can be assumed that the patient suffered from a reactivation of his cutaneous leishmaniasis eight years ago rather than re-infection by lingual inoculation. Due to the long travelling distance of the patient to our department and cost effectiveness, treatment was initiated with oral fluconazole 200 mg for six weeks. In the meantime, the patient was hospitalized due to an ischemic stroke. At clinical follow-up in October 2023 a new ulcerating lesion of the tongue approximately 2 cm ventral of the resection site of the previous mucosal leishmaniasis was noticed . Again, L. infantum could be identified by PCR and sequencing . We started treatment with oral miltefosine 150 mg/d for 28 days. As of October 2024, no relapse was noticed.
4.285156
0.910645
sec[1]/p[0]
en
0.999995
39966762
https://doi.org/10.1186/s12879-025-10592-4
[ "leishmania", "species", "acid", "complex", "infantum", "oral", "nucleic", "material", "sequencing", "leishmaniasis" ]
[ { "code": "1F54.Z", "title": "Leishmaniasis, unspecified" }, { "code": "1F54.2", "title": "Mucocutaneous leishmaniasis" }, { "code": "1F54.0", "title": "Visceral leishmaniasis" }, { "code": "1F85", "title": "Paragonimiasis" }, { "code": "1F6F", "title": "Trichostrongyliasis" }, { "code": "1F86.Z", "title": "Schistosomiasis due to unspecified or unknown Schistosoma species" }, { "code": "1C1B.Y", "title": "Other specified forms of nocardiosis" }, { "code": "1B91", "title": "Leptospirosis" }, { "code": "5C73.Z", "title": "Acidosis, unspecified" }, { "code": "DA22.Z", "title": "Gastro-oesophageal reflux disease, unspecified" } ]
=== ICD-11 CODES FOUND === [1F54.Z] Leishmaniasis, unspecified Also known as: Leishmaniasis, unspecified | Leishmaniasis | leishmania | leishmania infection | leishmaniosis [1F54.2] Mucocutaneous leishmaniasis Definition: Mucocutaneous leishmaniasis is a secondary infection of nasal and oral mucosae, predominantly by Leishmania braziliensis. It usually first manifests within two years of initial cutaneous infection but often after the latter has healed. It results from lymphatic or haematogenous spread of infection and can cause severe local tissue destruction. Also known as: Mucocutaneous leishmaniasis | Espundia | American mucocutaneous leishmaniasis | Leishmania braziliensis infection | Nasopharyngeal leishmaniasis Includes: Leishmania braziliensis infection [1F54.0] Visceral leishmaniasis Definition: A disease caused by an infection with the protozoan parasite Leishmania. This disease is characterised by biphasic fever, hepatosplenomegaly, pancytopenia, wasting, darkening of the skin, or may be asymptomatic. Transmission is through the bite of an infected female phlebotomine sandfly. Confirmation is by identification of Leishmania from a tissue or blood sample, or detection of antibodies against Leishmania. Also known as: Visceral leishmaniasis | Sahib disease | Ponos | Burdwan fever | Kala-azar Includes: Kala-azar [1F85] Paragonimiasis Definition: A disease caused by an infection with the parasitic worm Paragonimus. This disease is characterised by cough or haemoptysis, or may be asymptomatic. This disease may present with other symptoms depending on the site where the parasite migrates to. Transmission is commonly by ingestion of undercooked contaminated crustaceans (crab or crayfish). Confirmation is commonly by identification of Paragonimus eggs in a sputum or faecal sample. Also known as: Paragonimiasis | Pulmonary distomiasis | Parasitic haemoptysis | Oriental lung fluke disease | Endemic haemoptysis Includes: lung fluke disease | infection due to paragonimus species | Infestation due to Paragonimus species [1F6F] Trichostrongyliasis Definition: A disease caused by an infection with the parasitic worm Trichostrongylus. This disease is characterised by abdominal pain, diarrhoea, weight loss, or may be asymptomatic. Transmission is by ingestion of contaminated food or water. Confirmation is by identification of Trichostrongylus eggs in a faecal sample. Also known as: Trichostrongyliasis | trichostrongylosis | infection by trichostrongylus | infection by trichostrongylus species | trichostrongylus infestation [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 [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 [1B91] Leptospirosis Definition: A disease caused by an infection with the gram-negative bacteria Leptospira. In the first phase, this disease is characterised by generalised illness (fever, chills, or myalgias) or individuals may be asymptomatic; in the second phase, the heart, liver, kidneys, or brain may be affected by the infection (symptoms are dependent on the site affected). Transmission is by ingestion of contaminated food or water, droplet transmission, or direct cutaneous contact. Confirmation is by identification of Also known as: Leptospirosis | Nanukayami disease | Nanukayami fever | seven-day fever | EIA - [equine infectious anaemia] [5C73.Z] Acidosis, unspecified Also known as: Acidosis, unspecified | Acidosis | acidosis NOS | metabolic acidaemia | lactic acidosis [DA22.Z] Gastro-oesophageal reflux disease, unspecified Also known as: Gastro-oesophageal reflux disease, unspecified | Gastro-oesophageal reflux disease | GORD - [gastro-oesophageal reflux disease] | gastroesophageal reflux disease | acid reflux disease === GRAPH WALKS === --- Walk 1 --- [1F54.Z] Leishmaniasis, unspecified --PARENT--> [1F54] Leishmaniasis Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos... --PARENT--> [?] Nonintestinal protozoal diseases Def: Infections with unicellular organisms of the subkingdom Protozoa.... --- Walk 2 --- [1F54.Z] Leishmaniasis, unspecified --PARENT--> [1F54] Leishmaniasis Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos... --CHILD--> [1F54.0] Visceral leishmaniasis Def: A disease caused by an infection with the protozoan parasite Leishmania. This disease is characterised by biphasic fever, hepatosplenomegaly, pancytopenia, wasting, darkening of the skin, or may be as... --- Walk 3 --- [1F54.2] Mucocutaneous leishmaniasis Def: Mucocutaneous leishmaniasis is a secondary infection of nasal and oral mucosae, predominantly by Leishmania braziliensis. It usually first manifests within two years of initial cutaneous infection but... --PARENT--> [1F54] Leishmaniasis Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos... --CHILD--> [1F54.2] Mucocutaneous leishmaniasis Def: Mucocutaneous leishmaniasis is a secondary infection of nasal and oral mucosae, predominantly by Leishmania braziliensis. It usually first manifests within two years of initial cutaneous infection but... --- Walk 4 --- [1F54.2] Mucocutaneous leishmaniasis Def: Mucocutaneous leishmaniasis is a secondary infection of nasal and oral mucosae, predominantly by Leishmania braziliensis. It usually first manifests within two years of initial cutaneous infection but... --PARENT--> [1F54] Leishmaniasis Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos... --CHILD--> [1F54.2] Mucocutaneous leishmaniasis Def: Mucocutaneous leishmaniasis is a secondary infection of nasal and oral mucosae, predominantly by Leishmania braziliensis. It usually first manifests within two years of initial cutaneous infection but... --- Walk 5 --- [1F54.0] Visceral leishmaniasis Def: A disease caused by an infection with the protozoan parasite Leishmania. This disease is characterised by biphasic fever, hepatosplenomegaly, pancytopenia, wasting, darkening of the skin, or may be as... --PARENT--> [1F54] Leishmaniasis Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos... --CHILD--> [1F54.1] Cutaneous leishmaniasis Def: Cutaneous leishmaniasis results from bites by sandflies infected by protozoan parasites of the genus Leishmania. Phlebotomus is the principal vector in the Old World (Mediterranean, North Africa, Ethi... --- Walk 6 --- [1F54.0] Visceral leishmaniasis Def: A disease caused by an infection with the protozoan parasite Leishmania. This disease is characterised by biphasic fever, hepatosplenomegaly, pancytopenia, wasting, darkening of the skin, or may be as... --PARENT--> [1F54] Leishmaniasis Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos... --CHILD--> [1F54.1] Cutaneous leishmaniasis Def: Cutaneous leishmaniasis results from bites by sandflies infected by protozoan parasites of the genus Leishmania. Phlebotomus is the principal vector in the Old World (Mediterranean, North Africa, Ethi...
[ "[1F54.Z] Leishmaniasis, unspecified\n --PARENT--> [1F54] Leishmaniasis\n Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos...\n --PARENT--> [?] Nonintestinal protozoal diseases\n Def: Infections with unicellular organisms of the subkingdom Protozoa....", "[1F54.Z] Leishmaniasis, unspecified\n --PARENT--> [1F54] Leishmaniasis\n Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos...\n --CHILD--> [1F54.0] Visceral leishmaniasis\n Def: A disease caused by an infection with the protozoan parasite Leishmania. This disease is characterised by biphasic fever, hepatosplenomegaly, pancytopenia, wasting, darkening of the skin, or may be as...", "[1F54.2] Mucocutaneous leishmaniasis\n Def: Mucocutaneous leishmaniasis is a secondary infection of nasal and oral mucosae, predominantly by Leishmania braziliensis. It usually first manifests within two years of initial cutaneous infection but...\n --PARENT--> [1F54] Leishmaniasis\n Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos...\n --CHILD--> [1F54.2] Mucocutaneous leishmaniasis\n Def: Mucocutaneous leishmaniasis is a secondary infection of nasal and oral mucosae, predominantly by Leishmania braziliensis. It usually first manifests within two years of initial cutaneous infection but...", "[1F54.2] Mucocutaneous leishmaniasis\n Def: Mucocutaneous leishmaniasis is a secondary infection of nasal and oral mucosae, predominantly by Leishmania braziliensis. It usually first manifests within two years of initial cutaneous infection but...\n --PARENT--> [1F54] Leishmaniasis\n Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos...\n --CHILD--> [1F54.2] Mucocutaneous leishmaniasis\n Def: Mucocutaneous leishmaniasis is a secondary infection of nasal and oral mucosae, predominantly by Leishmania braziliensis. It usually first manifests within two years of initial cutaneous infection but...", "[1F54.0] Visceral leishmaniasis\n Def: A disease caused by an infection with the protozoan parasite Leishmania. This disease is characterised by biphasic fever, hepatosplenomegaly, pancytopenia, wasting, darkening of the skin, or may be as...\n --PARENT--> [1F54] Leishmaniasis\n Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos...\n --CHILD--> [1F54.1] Cutaneous leishmaniasis\n Def: Cutaneous leishmaniasis results from bites by sandflies infected by protozoan parasites of the genus Leishmania. Phlebotomus is the principal vector in the Old World (Mediterranean, North Africa, Ethi...", "[1F54.0] Visceral leishmaniasis\n Def: A disease caused by an infection with the protozoan parasite Leishmania. This disease is characterised by biphasic fever, hepatosplenomegaly, pancytopenia, wasting, darkening of the skin, or may be as...\n --PARENT--> [1F54] Leishmaniasis\n Def: Leishmaniasis is due to infection by vector-borne protozoa from the genus Leishmania. These protozoa exist as obligate intracellular parasites in human and mammalian hosts and are transmitted from hos...\n --CHILD--> [1F54.1] Cutaneous leishmaniasis\n Def: Cutaneous leishmaniasis results from bites by sandflies infected by protozoan parasites of the genus Leishmania. Phlebotomus is the principal vector in the Old World (Mediterranean, North Africa, Ethi..." ]
1F54.Z
Leishmaniasis, unspecified
[ { "from_icd11": "1F54.Z", "icd10_code": "B559", "icd10_title": "Leishmaniasis, unspecified" }, { "from_icd11": "1F54.Z", "icd10_code": "B55", "icd10_title": "Leishmaniasis" }, { "from_icd11": "1F54.2", "icd10_code": "B552", "icd10_title": "Mucocutaneous leishmaniasis" }, { "from_icd11": "1F54.0", "icd10_code": "B550", "icd10_title": "Visceral leishmaniasis" }, { "from_icd11": "1F85", "icd10_code": "B664", "icd10_title": "Paragonimiasis" }, { "from_icd11": "1F6F", "icd10_code": "B812", "icd10_title": "Trichostrongyliasis" }, { "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": "1B91", "icd10_code": "A279", "icd10_title": "Leptospirosis, unspecified" }, { "from_icd11": "1B91", "icd10_code": "A27", "icd10_title": "Leptospirosis" }, { "from_icd11": "1B91", "icd10_code": "A270", "icd10_title": "Leptospirosis icterohemorrhagica" }, { "from_icd11": "1B91", "icd10_code": "A278", "icd10_title": "Other forms of leptospirosis" }, { "from_icd11": "5C73.Z", "icd10_code": "E872", "icd10_title": "Acidosis" }, { "from_icd11": "DA22.Z", "icd10_code": "K219", "icd10_title": "Gastro-esophageal reflux disease without esophagitis" } ]
B559
Leishmaniasis, unspecified
In our case, a 69-year-old nulliparous woman presented at the Department of Obstetrics and Gynecology, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy, complaining of postmenopausal abnormal uterine bleeding and pelvic pain. A few weeks before, she underwent a Pap test which showed Atypical Glandular Cells (AGC). Her medical history was consistent with arterial hypertension, well controlled by oral therapy. Her gynecological history included a revision of the uterine cavity 5 years earlier for an endometrial polyp. Gynecological examination showed normal vulva, vagina and ectocervix. The parameters were nodular, the cervix barrel-dilated, the uterus fixed. A transvaginal ultrasound revealed a vascularized endocervical lesion (color score 2) with a maximum diameter of 4 cm. Endometrial thickness was eight millimeters. Adnexa were regular according to the postmenopausal status. We performed hysteroscopy in an outpatient setting (without anesthesia or analgesia) with a 5.5 mm hysteroscope (Karl Storz endoscope). Vaginoscopic approach showed an atrophic ectocervix and a punctiform external uterine orifice with active bleeding at the entrance of the cervical canal. After synechiolysis and repeated washings, a whitish “snowflake-like” swelling occupying the right lateral wall of the caudal part of the endocervix was visualized . In the cranial part of the endocervix, there was a suspicious friable bleeding necrotic tissue, also suspicious in a heteroplasic sense. The isthmus appeared free from lesions. Inside the cavity, we were able to observe a cystic-gland endometrium, and a small endometrial polyp of about 1 cm. Multiple endocervical biopsies with micro scissors and forceps, and a complete excision of the endometrial polyp were carried out. The procedure lasted 12 min and there were no complications. Reported pain, measured with a Visual Analogue Scale (VAS) ranging from 0 to 10, was 2. The histological examination of the endometrial polyp was totally negative, while in the endocervical biopsies’ histological examination was reported the presence of multiple tissue fragments in which a neoplastic lesion with a solid growth pattern was present . Occasional focal accumulations of blackish material collected in coarse clumps referable to melanic pigment were observed. The proliferating fraction, assessed with monoclonal antibody Ki 67, was above 70% . The cellular immunophenotypic profile resulted positive for S100, antimelanoma HMB45 , tyrosinase and vimentin, suggesting a melanocytic cell origin of the lesion. Thus, the histomorphologic and immunohistochemical findings were considered consistent with a malignant melanoma. Determination of the mutational status of the BRAF gene and the N-RAS gene was negative. No mutations were detected in codon V600 of the BRAF gene and in codons 12, 13, 58, 59, 61, 117 and 146 of the N-RAS gene. The presence of primary melanoma in other more common sites at the time of diagnosis was ruled out. An extensive dermatological examination resulted completely negative. Within 15 days, the patient underwent a staging CT-PET scan total body and magnetic resonance image, which showed a voluminous expansive formation of the cervix of 75 × 76 × 66 mm, tightly adherent to the bladder without a secure plane of cleavage, initial infiltration of uterine vaginal septum and of lateral parameters, especially on the right, and intraperitoneal solid tissue tokens up to 15 mm in maximum size at the subhepatic site referable to peritoneal carcinosis. With these data, the patient was staged using the Fédération Internationale de Gynécologie et d’Obstétrique staging system for cervical cancer to FIGO stage IV B, therefore, after multidisciplinary discussion, was referred for immunotherapy with Pembrolizumab. Twelve days after the first administration of the monoclonal antibody, multiple subcutaneous nodulations appeared in the thoracic region. The right and left subclavicular lesions were biopsied (needle aspiration) with a cytologic result indicative for a melanocytic origin of the neoplasia. At the time of the second administration of Pembrolizumab, the patient reported radiating epigastric pain, and her blood analysis showed increased values of amylase and lipase. It was therefore decided to postpone immunotherapy and refer the patient to abdomen ultrasound and subsequent CT, which resulted positive for edematous pancreatitis. During hospitalization, the patient underwent therapeutic fasting, hydration and antibiotic therapy with Teicoplanin and Meropenem with gradual improvement of clinical and laboratory status. Metrorrhagia occurred during hospitalization, therefore, the patient was referred for palliative radiotherapy with hemostatic purposes. Two months after the start of palliative radiotherapy the patient deceased.
4.109375
0.973633
sec[1]/p[0]
en
0.999997
38920558
https://doi.org/10.3390/diseases12060126
[ "endometrial", "uterine", "which", "polyp", "gene", "bleeding", "pain", "endocervical", "lesion", "status" ]
[ { "code": "GA16.Y", "title": "Other specified acquired abnormalities of uterus, except cervix" }, { "code": "GA16.0", "title": "Endometrial glandular hyperplasia" }, { "code": "2E88", "title": "Benign endometrial stromal nodule" }, { "code": "GA1Z&XA99N3", "title": "Noninflammatory disorders of uterus, except cervix" }, { "code": "GA10.Z", "title": "Endometriosis of unspecified site" }, { "code": "GA01.Z", "title": "Inflammatory disorders of the uterus, except cervix, unspecified" }, { "code": "NB92.6", "title": "Injury of uterus" }, { "code": "GC04.1Y", "title": "Other specified fistulae involving female genital tract" }, { "code": "BD50.41", "title": "Abdominal aortic aneurysm with rupture" }, { "code": "EK91", "title": "Dermatoses which may presage cutaneous lymphoma" } ]
=== ICD-11 CODES FOUND === [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 [GA16.0] Endometrial glandular hyperplasia Definition: A condition of the uterus, caused by chronic, excess oestrogen stimulation due to obesity, anovulation, or oestrogen therapy. This condition is characterised by excessive proliferation of the endometrial gland cells and a greater gland-to-stroma ratio of endometrial cells. This condition may also present with abnormal uterine bleeding, particularly among postmenopausal women and premenopausal women of increasing age. Confirmation is by sampling endometrial tissue through biopsy or dilation and c Also known as: Endometrial glandular hyperplasia | endometrial hypertrophy | endometrial hyperplasia NOS | Hyperplasia of endometrium NOS | glandular hyperplasia of endometrium [2E88] Benign endometrial stromal nodule Also known as: Benign endometrial stromal nodule | benign endometrial stromal tumour | Endometrial node | Stromal nodule [GA10.Z] Endometriosis of unspecified site Also known as: Endometriosis of unspecified site | Endometriosis | endometriosis, site unspecified | endometrial ectopia [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 [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 [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 === GRAPH WALKS === --- Walk 1 --- [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).... --RELATED_TO--> [?] Adenomyosis Def: A condition of the uterus characterised by endometrial tissue growth in the myometrium, hypertrophy of the myometrium, and heavy or prolonged menstrual bleeding, dysmenorrhoea, dyspareunia, bleeding b... --- Walk 2 --- [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).... --RELATED_TO--> [?] Caesarean scar defect of uterus Def: Caesarean scar defect of uterus is the formation of a pouch or indentation at the site of a previous caesarean incision with a depth of at least 2mm. When symptoms are associated with a Caesarean scar... --- Walk 3 --- [GA16.0] Endometrial glandular hyperplasia Def: A condition of the uterus, caused by chronic, excess oestrogen stimulation due to obesity, anovulation, or oestrogen therapy. This condition is characterised by excessive proliferation of the endometr... --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--> [GA16.0] Endometrial glandular hyperplasia Def: A condition of the uterus, caused by chronic, excess oestrogen stimulation due to obesity, anovulation, or oestrogen therapy. This condition is characterised by excessive proliferation of the endometr... --- Walk 4 --- [GA16.0] Endometrial glandular hyperplasia Def: A condition of the uterus, caused by chronic, excess oestrogen stimulation due to obesity, anovulation, or oestrogen therapy. This condition is characterised by excessive proliferation of the endometr... --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 --- [2E88] Benign endometrial stromal nodule --PARENT--> [?] Benign mesenchymal neoplasms Def: Bening neoplasms of muscle, fat, fibrous tissue, bone, cartilage, and blood vessels.... --CHILD--> [2E81] Benign vascular neoplasms --- Walk 6 --- [2E88] Benign endometrial stromal nodule --PARENT--> [?] Benign mesenchymal neoplasms Def: Bening neoplasms of muscle, fat, fibrous tissue, bone, cartilage, and blood vessels.... --CHILD--> [2E81] Benign vascular neoplasms
[ "[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 --RELATED_TO--> [?] Adenomyosis\n Def: A condition of the uterus characterised by endometrial tissue growth in the myometrium, hypertrophy of the myometrium, and heavy or prolonged menstrual bleeding, dysmenorrhoea, dyspareunia, bleeding b...", "[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 --RELATED_TO--> [?] Caesarean scar defect of uterus\n Def: Caesarean scar defect of uterus is the formation of a pouch or indentation at the site of a previous caesarean incision with a depth of at least 2mm. When symptoms are associated with a Caesarean scar...", "[GA16.0] Endometrial glandular hyperplasia\n Def: A condition of the uterus, caused by chronic, excess oestrogen stimulation due to obesity, anovulation, or oestrogen therapy. This condition is characterised by excessive proliferation of the endometr...\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--> [GA16.0] Endometrial glandular hyperplasia\n Def: A condition of the uterus, caused by chronic, excess oestrogen stimulation due to obesity, anovulation, or oestrogen therapy. This condition is characterised by excessive proliferation of the endometr...", "[GA16.0] Endometrial glandular hyperplasia\n Def: A condition of the uterus, caused by chronic, excess oestrogen stimulation due to obesity, anovulation, or oestrogen therapy. This condition is characterised by excessive proliferation of the endometr...\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....", "[2E88] Benign endometrial stromal nodule\n --PARENT--> [?] Benign mesenchymal neoplasms\n Def: Bening neoplasms of muscle, fat, fibrous tissue, bone, cartilage, and blood vessels....\n --CHILD--> [2E81] Benign vascular neoplasms", "[2E88] Benign endometrial stromal nodule\n --PARENT--> [?] Benign mesenchymal neoplasms\n Def: Bening neoplasms of muscle, fat, fibrous tissue, bone, cartilage, and blood vessels....\n --CHILD--> [2E81] Benign vascular neoplasms" ]
GA16.Y
Other specified acquired abnormalities of uterus, except cervix
[ { "from_icd11": "GA16.0", "icd10_code": "N8502", "icd10_title": "Endometrial intraepithelial neoplasia [EIN]" }, { "from_icd11": "GA16.0", "icd10_code": "N8500", "icd10_title": "Endometrial hyperplasia, unspecified" }, { "from_icd11": "GA16.0", "icd10_code": "N850", "icd10_title": "Endometrial hyperplasia" }, { "from_icd11": "GA16.0", "icd10_code": "N851", "icd10_title": "" }, { "from_icd11": "GA10.Z", "icd10_code": "N809", "icd10_title": "Endometriosis, unspecified" }, { "from_icd11": "GA10.Z", "icd10_code": "N808", "icd10_title": "Other endometriosis" }, { "from_icd11": "GA10.Z", "icd10_code": "N801", "icd10_title": "Endometriosis of ovary" }, { "from_icd11": "GA10.Z", "icd10_code": "N80", "icd10_title": "Endometriosis" }, { "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": "BD50.41", "icd10_code": "I713", "icd10_title": "Abdominal aortic aneurysm, ruptured" } ]
N8502
Endometrial intraepithelial neoplasia [EIN]
A 13-year-old girl who had been experiencing spinal scoliosis and rapidly advancing hip stiffness for 2 years visited our hospital. Two years back, she was admitted due to drooping of the right corner of the mouth and ossification of the back fascia . Physical examination revealed facial asymmetry, palpable tumors in the left mandibular angle, and limited oral closure. However, pain was not observed. At the age of 8 years, the patient developed soft tissue heterotopic ossification in the back. After several days, the lesion became stiff like a stone. Halluces were characterized by hallux valgus deformity with big toe deformity. The patient did not have a previous history of trauma, surgeries, infections, allergies, other known underlying conditions, and medication use. She is the second child of a healthy non-consanguineous marriage and has a healthy 24-year-old sister. Her mother remembered that her grandmother had microdactyly of the hallux but no extraskeletal bone formation on the body and no signs of limited activity. Anteroposterior and axial radiographic evaluation showed that a large amount of radiopaque formation was mainly located in the back area and scoliosis . There was a stiff, osseous lesion originating from the left chest wall and extending to the ilium region . Computed tomography scan revealed spontaneous cervical fusion, heterotopic ossification of the left dorsal fascia causing scoliosis, and developmental deformity of the right chest wall . The Risser’s sign was grade 0. The patient was then diagnosed with FOP according to the presence of congenital great toe deformity, dorsal fascia heterotopic ossification, and cervical fascia contracture. Therefore, genetic testing was recommended to obtain a definite diagnosis. However, due to financial constraints, the examination was not performed. To prevent the progression of scoliosis caused by tethering during the peak period of spinal growth and oral closure difficulties, back fascia ossification resection and fascial release surgery, which is a minimally invasive procedure, were performed. After 6 months of follow-up, the right cervical fascial contracture, closing movement of the mouth, and facial asymmetry significantly improved. However, the patient developed soft tissue ossification in the back. After several days, the swollen area progressed to ossification. After 2 years of follow-up, the patient came to our hospital for treatment due to continuous right hip pain and rapid progress of hip stiffness, which developed within the last 2 months. Passive left hip range of motions (ROMs) were restricted to 80° flexion, 5° external rotation, and 15° abduction with abnormal gait pattern . She had a history of snoring for 3 years. Physical examination showed improved facial asymmetry and mandibular angle fascia contracture and a mass in the left iliopsoas muscle with bulging but intact overlying skin . The mass originated from the left medial side of the iliac and extended to the lesser trochanter on the left leg region . Anteroposterior radiography and computed tomography scan showed recurrent heterotopic ossification of the left back with spinal scoliosis and chest wall malformations . The patient was provided with a detailed explanation of her medical condition and treatment options. Based on history taking, clinical examination, and thorough diagnostic investigations, surgical resection of large heterotopic ossification in the left iliopsoas muscle area. However, the heterotopic ossification in the left back was left because the growth in the spine stopped. We performed careful dissection to reach the edge of the heterotopic ossified mass, thereby preventing any damage to the neurovascular supply . Resection of the iliopsoas ossification was conducted, and the ossification distal to the lesser trochanter was left to prevent vascular and nerve injury . Intraoperative blood loss 50 ml. Apply drainage tube and confirm again that there is no limitation of joint movement before suturing the wound. Immediately after operation, anteroposterior pelvis radiography showed successful resection of heterotopic ossified mass, which was in accordance with the preoperative plan . We administrated indomethacin for 4 weeks and thromboprophylaxis for 3 weeks ( 5 , 6 ). The patient was discharged 7 days after operation, the pain was tolerable, and the passive left ROM was unobstructed. She walked without crutches and was advised to avoid any intense physical activity (e.g., strenuous hip and stretching exercises) for another 2 months. During the follow-up of 6 months after operation, no signs of disability, hip pain and infection were observed, and there were no radiological indications of ossification recurrence . The passive left hip ROMs were 100° flexion, 35° external rotation, 10° internal rotation, and 30° abduction.
3.957031
0.97998
sec[1]/p[0]
en
0.999997
PMC9520337
https://doi.org/10.3389/fped.2022.981372
[ "ossification", "back", "heterotopic", "fascia", "scoliosis", "however", "pain", "deformity", "resection", "spinal" ]
[ { "code": "FB31.Y", "title": "Other specified calcification or ossification of muscle" }, { "code": "EB90.40", "title": "Dystrophic calcification of the skin of uncertain or unspecified aetiology" }, { "code": "FB4Y", "title": "Other specified disorders of synovium or tendon" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "CA0H.Y", "title": "Other specified diseases of vocal cords or larynx, not elsewhere classified" }, { "code": "ND51.0", "title": "Dislocation or strain or sprain of unspecified joint or ligament of trunk" }, { "code": "ME84.Z", "title": "Spinal pain, unspecified" }, { "code": "ND51.Y", "title": "Other specified injuries of spine or trunk, level unspecified" }, { "code": "FB10", "title": "Spinal instabilities" }, { "code": "FA70.0", "title": "Kyphosis" } ]
=== ICD-11 CODES FOUND === [FB31.Y] Other specified calcification or ossification of muscle Also known as: Other specified calcification or ossification of muscle | Calcification or ossification of muscles with known aetiology | Calcification of muscle associated with adult dermatomyositis | Myositis ossificans traumatica | Myositis ossificans traumatica, multiple sites [EB90.40] Dystrophic calcification of the skin of uncertain or unspecified aetiology Definition: Abnormal deposition of calcium in the skin and subcutaneous tissues of unknown (idiopathic) or unspecified cause. Also known as: Dystrophic calcification of the skin of uncertain or unspecified aetiology | Calcinosis cutis of uncertain or unspecified aetiology | Osteoma cutis | Cutaneous ossification | Subepidermal calcified nodule Includes: Calcinosis cutis [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 [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 [CA0H.Y] Other specified diseases of vocal cords or larynx, not elsewhere classified Also known as: Other specified diseases of vocal cords or larynx, not elsewhere classified | Other diseases of vocal cords | Vocal cord granuloma | Abscess of vocal cord | vocal cord abscess [ND51.0] Dislocation or strain or sprain of unspecified joint or ligament of trunk Also known as: Dislocation or strain or sprain of unspecified joint or ligament of trunk | Back dislocation | Back sprain | Back strain | Dislocation of vertebra, not elsewhere classified [ME84.Z] Spinal pain, unspecified Also known as: Spinal pain, unspecified | Spinal pain | joint stiffness of spine | Dorsalgia | back ache [ND51.Y] Other specified injuries of spine or trunk, level unspecified Also known as: Other specified injuries of spine or trunk, level unspecified | Superficial injury of trunk, level unspecified | multiple superficial injuries of trunk | Abrasion of trunk, level unspecified | Contusion of trunk, level unspecified [FB10] Spinal instabilities Also known as: Spinal instabilities | spinal instabilities, site unspecified | spinal instability | instability of back | relaxation of back ligaments Excludes: Spondylolysis [FA70.0] Kyphosis Definition: This is a curving of the spine that causes a bowing or rounding of the back, which leads to a hunchback or slouching posture. Also known as: Kyphosis | postural kyphosis | Kyphosis with no determinant | primary kyphosis | idiopathic kyphosis Excludes: Post radiation kyphosis === GRAPH WALKS === --- Walk 1 --- [FB31.Y] Other specified calcification or ossification of muscle --PARENT--> [FB31] Calcification or ossification of muscle --CHILD--> [FB31.Y] Other specified calcification or ossification of muscle --- Walk 2 --- [FB31.Y] Other specified calcification or ossification of muscle --PARENT--> [FB31] Calcification or ossification of muscle --CHILD--> [FB31.1] Fibrodysplasia ossificans progressiva Def: This is an extremely rare disease of the connective tissue where a mutation of the body's repair mechanism causes fibrous tissue (including muscle, tendon, and ligament) to be ossified when damaged.... --- Walk 3 --- [EB90.40] Dystrophic calcification of the skin of uncertain or unspecified aetiology Def: Abnormal deposition of calcium in the skin and subcutaneous tissues of unknown (idiopathic) or unspecified cause.... --PARENT--> [EB90.4] Calcification of skin or subcutaneous tissue Def: A heterogeneous group of disorders which result in deposition of calcium in skin and soft tissues.... --CHILD--> [EB90.42] Calcific arteriolopathy Def: Calcific arteriolopathy (calciphylaxis) is a life-threatening vasculopathic disorder characterised by painful cutaneous ischaemia and infarction due to calcification, intimal fibroplasia, and thrombos... --- Walk 4 --- [EB90.40] Dystrophic calcification of the skin of uncertain or unspecified aetiology Def: Abnormal deposition of calcium in the skin and subcutaneous tissues of unknown (idiopathic) or unspecified cause.... --PARENT--> [EB90.4] Calcification of skin or subcutaneous tissue Def: A heterogeneous group of disorders which result in deposition of calcium in skin and soft tissues.... --CHILD--> [EB90.41] Calcific panniculitis Def: Calcific panniculitis presents as discrete, firm subcutaneous masses, often affecting the thighs and hips. It is strongly associated with hyperparathyroidism, particularly in the context of chronic re... --- 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.... --CHILD--> [FB40] Tenosynovitis --- 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.... --PARENT--> [?] Soft tissue disorders
[ "[FB31.Y] Other specified calcification or ossification of muscle\n --PARENT--> [FB31] Calcification or ossification of muscle\n --CHILD--> [FB31.Y] Other specified calcification or ossification of muscle", "[FB31.Y] Other specified calcification or ossification of muscle\n --PARENT--> [FB31] Calcification or ossification of muscle\n --CHILD--> [FB31.1] Fibrodysplasia ossificans progressiva\n Def: This is an extremely rare disease of the connective tissue where a mutation of the body's repair mechanism causes fibrous tissue (including muscle, tendon, and ligament) to be ossified when damaged....", "[EB90.40] Dystrophic calcification of the skin of uncertain or unspecified aetiology\n Def: Abnormal deposition of calcium in the skin and subcutaneous tissues of unknown (idiopathic) or unspecified cause....\n --PARENT--> [EB90.4] Calcification of skin or subcutaneous tissue\n Def: A heterogeneous group of disorders which result in deposition of calcium in skin and soft tissues....\n --CHILD--> [EB90.42] Calcific arteriolopathy\n Def: Calcific arteriolopathy (calciphylaxis) is a life-threatening vasculopathic disorder characterised by painful cutaneous ischaemia and infarction due to calcification, intimal fibroplasia, and thrombos...", "[EB90.40] Dystrophic calcification of the skin of uncertain or unspecified aetiology\n Def: Abnormal deposition of calcium in the skin and subcutaneous tissues of unknown (idiopathic) or unspecified cause....\n --PARENT--> [EB90.4] Calcification of skin or subcutaneous tissue\n Def: A heterogeneous group of disorders which result in deposition of calcium in skin and soft tissues....\n --CHILD--> [EB90.41] Calcific panniculitis\n Def: Calcific panniculitis presents as discrete, firm subcutaneous masses, often affecting the thighs and hips. It is strongly associated with hyperparathyroidism, particularly in the context of chronic re...", "[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--> [FB40] Tenosynovitis", "[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" ]
FB31.Y
Other specified calcification or ossification of muscle
[ { "from_icd11": "EB90.40", "icd10_code": "L943", "icd10_title": "Sclerodactyly" }, { "from_icd11": "EB90.40", "icd10_code": "L949", "icd10_title": "Localized connective tissue disorder, unspecified" }, { "from_icd11": "EB90.40", "icd10_code": "L942", "icd10_title": "Calcinosis cutis" }, { "from_icd11": "EB90.40", "icd10_code": "L94", "icd10_title": "Other localized connective tissue disorders" }, { "from_icd11": "ND51.0", "icd10_code": "T092", "icd10_title": "" }, { "from_icd11": "ME84.Z", "icd10_code": "M5489", "icd10_title": "Other dorsalgia" }, { "from_icd11": "ME84.Z", "icd10_code": "M5481", "icd10_title": "Occipital neuralgia" }, { "from_icd11": "ME84.Z", "icd10_code": "M5408", "icd10_title": "Panniculitis affecting regions of neck and back, sacral and sacrococcygeal region" }, { "from_icd11": "ME84.Z", "icd10_code": "M549", "icd10_title": "Dorsalgia, unspecified" }, { "from_icd11": "ME84.Z", "icd10_code": "M54", "icd10_title": "Dorsalgia" }, { "from_icd11": "ME84.Z", "icd10_code": "M540", "icd10_title": "Panniculitis affecting regions of neck and back" }, { "from_icd11": "ME84.Z", "icd10_code": "M548", "icd10_title": "Other dorsalgia" }, { "from_icd11": "ND51.Y", "icd10_code": "S30860A", "icd10_title": "Insect bite (nonvenomous) of lower back and pelvis, initial encounter" }, { "from_icd11": "ND51.Y", "icd10_code": "S30861A", "icd10_title": "Insect bite (nonvenomous) of abdominal wall, initial encounter" }, { "from_icd11": "FB10", "icd10_code": "M532X2", "icd10_title": "Spinal instabilities, cervical region" } ]
L943
Sclerodactyly
The patient was a 20‐year‐old young man with an opioid use disorder (OUD) who suffered from falling down and paraplegia while serving in the military. He underwent surgery for a fractured thoracic vertebra. After multiple trauma (MT), the patient experienced fractures of T4, T5, and T6 vertebrae, along with an open wound on the back with exudate. After developing a fever, he was transferred from another center to a university general hospital in one of Iran's northern cities. Following the surgical site infection (SSI), the device was removed and the fever subsided. As well, he was intubated and connected to a respiratory ventilator after severe pulmonary empyema, and then, a bilateral chest tube was installed. The patient also received a short‐acting morphine sulfate infusion for 10 days that followed by 10 mg of intramuscular methadone 10 mg, twice a day. Because of his restlessness, the consultation‐liaison psychiatry services (CLPS) team visited the patient on two consecutive days and 4 days later in 2018. The first visit occurred 6 days after hospitalization. At this point, the patient was intubated and restless, and he removed the angiocatheter. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) criteria 11 , 12 and the Confusion Assessment Method for the ICU (CAM‐ICU) as the diagnostic algorithm, opium use disorder (OUD) and delirium were diagnosed. Later, severe SSI was suggested as the main cause of delirium. Some related investigations, including blood cultures and cultures of infection at the surgical site, were also performed, and patient was monitored regularly by a neurosurgeon, a critical care specialist and an infectious disease specialist and received the appropriate antibiotics. QTP was started at 12/5 mg, three times a day, and increased to 25 mg, three times a day on the second day after delirium due to continued agitation. Of note, the dosage was increased to 50 mg three times a day on the sixth day and then to 75 mg three times a day (225 mg daily) on the ninth day after the start of the QTP for agitation due to hyperactive delirium. On the sixth day after the QTP administration, an ultrasound sonography was performed on the patient due to scrotal swelling and afterward consultation with a urologist was ordered. The ultrasound report showed a bilateral increase in scrotal thickness along with many tracts of liquid, indicating scrotal edema. During the consultation with the urologist, the mechanism of injury was suggested as the cause the edema, and scrotal elevation was recommended. As well, 15 days after the psychiatric consultation for delirium, the patient was consulted once again due to depressed mood. Until then, he continued to receive 225 mg QTP/day for persistent delirium. At this visit, the patient was conscious and oriented and the delirium had subsided. The patient presented the giving up‐given up complex, hopelessness and helplessness, subjective incompetence (SI), a broken sense of connection between the past and the future, as well as earlier failure re‐experiencing. 13 , 14 The psychiatric assistant did not recommend a plan for QTP reduction and the discontinuation of QTP and only performed supportive psychotherapy with diagnosis of demoralization. On the 29th day after hospitalization, due to edema of the face, the upper and lower extremities, and the chest wall, a new psychiatric visit was scheduled with the possibility of QTP‐induced edema. At the time, with regard to empyema associated with Staphylococcus aureus culture, he was thus a candidate for evacuation and thoracotomy, but this was canceled due to chest wall edema. The patient was also oriented, and not agitated. Consequently, the QTP dose was reduced to 100 mg/day according to a tapering schedule and then discontinued due to edema and the resolution of persistent delirium. As a whole, edema was temporarily relieved. Over the next 2 days, the swellings of the face and the upper extremities decreased, but the chest wall and lower extremity edema continued. In the next 4 days, the QTP was completely discontinued, and the edema finally disappeared 2 days later. Laboratory tests did not confirm the patient's edema in terms of thyroid‐stimulating hormone (TSH), albumin (Alb), electrolytes, blood urea nitrogen (BUN), liver function tests, erythrocyte sedimentation rate (ESR), and serum creatinine (CRT). Echocardiography also showed no pathological findings. The patient was not taking any other medications that could explain the edema, and he had no history of methadone‐induced edema in the past. The edema disappeared sufficiently after stopping QTP, despite methadone intake. Subsequently, the patient was discharged on the 37th day after admission. When he was discharged, he was conscious and oriented, and the wound infection was gone.
3.841797
0.98291
sec[1]/p[0]
en
0.999997
PMC10354354
https://doi.org/10.1002/ccr3.7661
[ "edema", "delirium", "chest", "consultation", "three", "times", "scrotal", "infection", "well", "methadone" ]
[ { "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" }, { "code": "6D70.Z", "title": "Delirium, unspecified or unknown cause" }, { "code": "6D70.0", "title": "Delirium due to disease classified elsewhere" }, { "code": "6D70.Y", "title": "Delirium, other specified cause" }, { "code": "6C40.5", "title": "Alcohol-induced delirium" }, { "code": "6C45.5", "title": "Cocaine-induced delirium" } ]
=== ICD-11 CODES FOUND === [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 [6D70.Z] Delirium, unspecified or unknown cause Also known as: Delirium, unspecified or unknown cause | Delirium | acute confusional state NOS [6D70.0] Delirium due to disease classified elsewhere Definition: All definitional requirements for delirium are met. There is evidence from history, physical examination, or laboratory findings that Delirium is caused by the direct physiological consequences of a disorder or disease classified elsewhere. Also known as: Delirium due to disease classified elsewhere [6D70.Y] Delirium, other specified cause Also known as: Delirium, other specified cause [6C40.5] Alcohol-induced delirium Definition: Alcohol-induced delirium is characterised by an acute state of disturbed attention and awareness with specific features of delirium that develops during or soon after substance intoxication or withdrawal or during the use of alcohol. The amount and duration of alcohol use must be capable of producing delirium. Specific features of alcohol-induced delirium may include impaired consciousness with disorientation, vivid hallucinations and illusions, insomnia, delusions, agitation, disturbances of at Also known as: Alcohol-induced delirium | alcohol delirium | alcohol withdrawal induced delirium tremens | alcohol withdrawal with delirium | delirium tremens Includes: Delirium tremens (alcohol-induced) | Delirium induced by alcohol withdrawal [6C45.5] Cocaine-induced delirium Definition: Cocaine-induced delirium is characterised by an acute state of disturbed attention and awareness with specific features of delirium that develops during or soon after substance intoxication or withdrawal or during the use of cocaine. The amount and duration of cocaine use must be capable of producing delirium. The symptoms are not better explained by a primary mental disorder, by use of or withdrawal from a different substance, or by another health condition that is not classified under Mental, Also known as: Cocaine-induced delirium | Mental or behavioural disorders due to use of cocaine withdrawal state with delirium === GRAPH WALKS === --- Walk 1 --- [MG29.Z] Oedema, unspecified --PARENT--> [MG29] Oedema Def: Abnormal fluid accumulation in tissues or body cavities not coded elsewhere.... --EXCLUDES--> [?] Other diseases of pharynx --- Walk 2 --- [MG29.Z] Oedema, unspecified --PARENT--> [MG29] Oedema Def: Abnormal fluid accumulation in tissues or body cavities not coded elsewhere.... --CHILD--> [MG29.1] Generalised oedema --- Walk 3 --- [5B7Z] Unspecified undernutrition --PARENT--> [?] Undernutrition Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c... --RELATED_TO--> [?] Undernutrition-dehydration cataract Def: This is the condition that results from eating a diet in which certain nutrients are lacking, in excess (too high an intake), or in the wrong proportions. This diagnosis is with dehydration cataract.... --- Walk 4 --- [5B7Z] Unspecified undernutrition --PARENT--> [?] Undernutrition Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c... --RELATED_TO--> [?] Fetal intrauterine malnutrition without mention of small for gestational age Def: Neonate, not light or small for gestational age, showing signs of fetal malnutrition, such as dry, peeling skin or loss of subcutaneous tissue.... --- Walk 5 --- [FA36.Z] Effusion of joint, unspecified --PARENT--> [FA36] Effusion of joint Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes.... --EXCLUDES--> [?] Tertiary yaws Def: Tertiary yaws develops in <10% of untreated infected individuals after and interval of 5 years or more. The late stage skin lesions are characterised by gummatous nodules with necrotic tissue destruct... --- Walk 6 --- [FA36.Z] Effusion of joint, unspecified --PARENT--> [FA36] Effusion of joint Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes.... --CHILD--> [FA36.Z] Effusion of joint, unspecified
[ "[MG29.Z] Oedema, unspecified\n --PARENT--> [MG29] Oedema\n Def: Abnormal fluid accumulation in tissues or body cavities not coded elsewhere....\n --EXCLUDES--> [?] Other diseases of pharynx", "[MG29.Z] Oedema, unspecified\n --PARENT--> [MG29] Oedema\n Def: Abnormal fluid accumulation in tissues or body cavities not coded elsewhere....\n --CHILD--> [MG29.1] Generalised oedema", "[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --RELATED_TO--> [?] Undernutrition-dehydration cataract\n Def: This is the condition that results from eating a diet in which certain nutrients are lacking, in excess (too high an intake), or in the wrong proportions. This diagnosis is with dehydration cataract....", "[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --RELATED_TO--> [?] Fetal intrauterine malnutrition without mention of small for gestational age\n Def: Neonate, not light or small for gestational age, showing signs of fetal malnutrition, such as dry, peeling skin or loss of subcutaneous tissue....", "[FA36.Z] Effusion of joint, unspecified\n --PARENT--> [FA36] Effusion of joint\n Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes....\n --EXCLUDES--> [?] Tertiary yaws\n Def: Tertiary yaws develops in <10% of untreated infected individuals after and interval of 5 years or more. The late stage skin lesions are characterised by gummatous nodules with necrotic tissue destruct...", "[FA36.Z] Effusion of joint, unspecified\n --PARENT--> [FA36] Effusion of joint\n Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes....\n --CHILD--> [FA36.Z] Effusion of joint, unspecified" ]
MG29.Z
Oedema, unspecified
[ { "from_icd11": "MG29.Z", "icd10_code": "R609", "icd10_title": "Edema, unspecified" }, { "from_icd11": "MG29.Z", "icd10_code": "R60", "icd10_title": "Edema, not elsewhere classified" }, { "from_icd11": "5B7Z", "icd10_code": "E43", "icd10_title": "Unspecified severe protein-calorie malnutrition" }, { "from_icd11": "5B7Z", "icd10_code": "E538", "icd10_title": "Deficiency of other specified B group vitamins" }, { "from_icd11": "5B7Z", "icd10_code": "E569", "icd10_title": "Vitamin deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E638", "icd10_title": "Other specified nutritional deficiencies" }, { "from_icd11": "5B7Z", "icd10_code": "E639", "icd10_title": "Nutritional deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E41", "icd10_title": "Nutritional marasmus" }, { "from_icd11": "5B7Z", "icd10_code": "E539", "icd10_title": "Vitamin B deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E568", "icd10_title": "Deficiency of other vitamins" }, { "from_icd11": "5B7Z", "icd10_code": "E649", "icd10_title": "Sequelae of unspecified nutritional deficiency" }, { "from_icd11": "5B7Z", "icd10_code": "E618", "icd10_title": "Deficiency of other specified nutrient elements" }, { "from_icd11": "5B7Z", "icd10_code": "E40-E46", "icd10_title": "" }, { "from_icd11": "5B7Z", "icd10_code": "E50-E64", "icd10_title": "" }, { "from_icd11": "5B7Z", "icd10_code": "E53", "icd10_title": "Deficiency of other B group vitamins" } ]
R609
Edema, unspecified
A 78-year-old asymptomatic man, who was found to have multiple liver masses by magnetic resonance imaging (MRI) done as part of his routine medical examination on Apr 22,2016. These masses increased in size over six weeks , with no symptoms or abnormal findings on his physical examination. There is no treatment during this time. He was admitted in our hospital on June 13,2016. Liver function tests, hematology parameters as well as tumor markers such as α-fetoprotein (AFP), carbohydrate antigen 199 (CA199), Carcinoembryonic antigen (CEA), and chromogranin A (CgA) were all normal. Percutaneous liver biopsy was performed in two days later, pathology revealed hepatic endothelial cells predominately proliferating in the dilated sinusoid, atypical endothelial cells with marked nuclear pleomorphism. The immunochemistry showed CD34(+++), CD31(+++), FVIII(+), Ki-67(50%+), CD3(−), CD20(−), CD68(−), CD163(−), GPC3(−), HCC(−), CD5(−), CK19(−), PD-1(−), PD-L1(−), C-MET(−), ROS-1(−), VEGF(+), EGFR(−), HER2(−), ALK D5F3(−), VEGFR2(60%+), VEGFR3(−). . Final pathologic diagnosis was primary hepatic angiosarcoma. Endoscopy was normal. Positron emission tomography/computed tomography (PET/CT) showed no metastatic lesions. Next generation sequencing (NGS) using the TruSeq Amplicon-Cancer 295 gene panel (Guangzhou Burning Rock Biotechnology Inc. China) for liver biopsy tissue and peripheral blood were done, including EGFR, HER-2, KRAS, ALK, ROS1, MET, RAT, BRAF, KIT, PDGFRA and so on. Unfortunately, the result revealed no known mutations. The patient has a history of hypertension, type 2 diabetes, multiple arteriosclerosis, the right renal artery stenosis and left subclavian artery stenosis treated with stent implantation one year ago, hyperlipidemia, chronic kidney disease 3a stage and acute cerebrovascular infarction two years ago. On June 24, four major lesions were treated with radiofrequency ablation (RFA), and this treatment was repeated on July 11. The patient had mild adverse effects including fatigue, transient elevated hepatic transaminase (ALT peaked at 280 U/L and AST at 200 U/L) and hypoalbuminemia after RFA. Unfortunately, he developed new lesions seen by enhanced MRI on July 22 . Due to rapid progression of his angiosarcoma, the treatment team decided to initiate a combination of targeted therapy and immunotherapy. From July 22, the patient received pazopanib 200 mg daily for 2 days, 400 mg daily for 5 days, then 600 mg daily up to now. He experienced no adverse effects. Due to concern regarding the aggressive behavior of the cancer, on August 1st, pembrolizumab at 100 mg every three weeks was started. Patient experienced no significant adverse effects from this combination. On August 9 the patient received 3 cycles of allogeneic RAK cells therapy. Dose was 3 billion cells daily in 3 consecutive days, given every 4 weeks. The combination of these three therapeutic agents was able to decrease the size and number of the liver masses as showed by MRI on Aug18 . Subsequent abdominal enhanced MRI demonstrated stable disease till last image on Oct 26,2017 . Treatment course timeline is included as Fig. 3 . Currently the patient is in stable clinical condition, without any complaints. His Karnofsky performance status (KPS) is 90. Routine laboratory examinations including blood routine, urine routine, blood coagulation, liver and renal function, thyroid gland function, ECG, etc. were all within normal parameters. The patient tolerated pazopanib and pembrolizumab very well. Just after He experienced mild infusion reactions with RAK cell treatment, including transient fever, mild hypertension. Fig. 1 Abdomen MRI T2WI changes in liver lesions. a Apr-22-2016 MRI showing multiple hepatic lesions found. b Jun-08-2016 MRI showing hepatic lesions increase in number and size. c Jul-22-2016 MRI showing new lesions emerge after RFA. d Aug-18-2016 MRI showing tumor up to PR after first cycle of pazopanib plus PD-1 inhibitor and RAK cell. e - j From Oct-08-2016 to Oct-26-2017 MRI showing tumor stable disease. Arrows indicate the lesion. MRI, magnetic resonance imaging; PR, partial response; RAK cell. RetroNectin-activated killer cells Fig. 2 Histopathology staining of the core needle liver biopsy specimen. a H&E low-magnification view (× 40) and high-magnification view (× 400) in black frame showing sinusoids lined by atypical endothelial cells with marked nuclear pleomorphism, and vascular channels. b - f Immunohistochemistry low-magnification view (× 40–100) and high-magnification view (× 200–400) in black frame showing the cells were positive for Ki-67, CD31, CD34, FVIII and VEGF respectively. g-i Immunohistochemistry magnification view (× 100–200) showing the cells were negative for VEGFR3, PD-1 and PD-L1 respectively. H&E, hematoxylin and eosin Fig. 3 Timeline of patient’s clinical course
4.027344
0.977051
sec[1]/p[0]
en
0.999997
29466964
https://doi.org/10.1186/s12885-018-3996-3
[ "liver", "cells", "lesions", "hepatic", "magnification", "view", "routine", "including", "daily", "multiple" ]
[ { "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": "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 === [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 [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 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --RELATED_TO--> [?] Metabolic or transporter liver disease --- 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 viral hepatitis Def: A group of liver diseases characterised by liver inflammation and fibrosis, caused by less than 6 months of infection with one or more of hepatitis B virus, hepatitis C virus and hepatitis D virus, wi... --- Walk 4 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --CHILD--> [DB97.1] Hepatic berylliosis --- 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.... --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... --- 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.... --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....
[ "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Metabolic or transporter liver disease", "[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 viral hepatitis\n Def: A group of liver diseases characterised by liver inflammation and fibrosis, caused by less than 6 months of infection with one or more of hepatitis B virus, hepatitis C virus and hepatitis D virus, wi...", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.1] Hepatic berylliosis", "[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...", "[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--> [?] 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...." ]
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
A 40-year-old man suffering from dilated cardiomyopathy had been prescribed amiodarone for 2.5 years. Seven weeks before the consultation at our department, his serum-free T 4 levels increased above the upper limit and thyrotoxicosis developed. His thyroid status was as shown in Figure 1 . An attending cardiologist consulted at our thyroid clinic about the patient's thyrotoxicosis, but he had no complaints. He did not show any tachycardia or finger tremor, despite the thyrotoxicosis. His thyroid gland was not swollen and ultrasonic study revealed a slightly enlarged thyroid gland with almost monotonous echogenicity ( Figure 2(a) ). The Doppler flow rate inside the thyroid gland was not increased ( Figure 2(b) ). To differentiate the diagnosis of thyrotoxicosis, we planned to investigate thyroid iodine uptake. Ten days after the first visit, he showed symptoms of acute heart failure and was admitted to the intensive care unit of our hospital. His thyrotoxicosis had worsened by the time of admission, with increased levels of thyroglobulin, suggesting destructive thyroiditis ( Table 1 ). Amiodarone administration was stopped and inorganic iodine administration (189 mg/day) was started upon admission; however, his thyrotoxicosis was prolonged and worsened. His cardiac function also worsened, with the thyrotoxicosis being exacerbated . On admission, his heart rate was over 180 bpm and systolic blood pressure was 220 mmHg. Oxygen saturation rate was 70% under 10 L/min of oxygen administration with a venturi mask. Intra-arterial balloon pumping was performed to maintain the circulation. On the day after admission, administration of 200 mg of hydrocortisone was started, in addition to inorganic iodine. After the hydrocortisone administration, free T 3 levels were somewhat improved, but free T 4 levels remained high. To control and suppress the destruction of the thyroid, 40 mg of PSL was administered instead of hydrocortisone. Subsequently, 60 mg of PSL improved the serum-free T 4 levels, so we tapered the dose of PSL gradually. However, at a dose of 20 mg of PSL, the thyrotoxicosis relapsed. At this point, TSH receptor antibody (TRAb) became positive , so we decided to prescribe 15 mg of methimazole (MMI) together with 40 mg of PSL. Two days after these prescriptions, his free T 4 levels increased to above the normal range. Thirty milligrams of MMI, 40 mg of PSL, and inorganic iodine (189 mg/day) did not suppress the destructive thyroiditis. On the 17th day of admission, thyroid 99m Tc uptake was investigated, but none was observed ( Figure 2(c) ). At this point, we made a final diagnosis of type 2 amiodarone-induced thyrotoxicosis (AIT). On the 23rd day of admission, MMI was discontinued and the administration of 80 mg of PSL was maintained. Subsequently, we attempted to taper the dose of PSL, but under a dose of 80 mg of PSL, overt thyrotoxicosis was not controlled . Since over 2.5 months had passed since a high dose of PSL had been administered, we decided to perform total thyroidectomy. The administration of 80 mg of PSL was continued until the operation. With informed consent from the patient and his wife, total thyroidectomy was performed on the 78th day of admission. Intravenous administration of 40 mg of PSL and 200 mg of hydrocortisone was performed during the operation. The operation was safely performed and 25.6 g of thyroid was resected. After the operation, PSL was discontinued and the dose of hydrocortisone was carefully tapered. Two days after the thyroidectomy, hydrocortisone was tapered to 100 mg and administered orally. Then, hydrocortisone was again gradually tapered to 15 mg eleven days after the surgery. Twenty-five days after the operation, hydrocortisone was tapered to 5 mg, and it was discontinued on the forty-sixth day after the thyroidectomy. During the tapering of hydrocortisone and after its discontinuation, the patient demonstrated no symptoms of adrenal insufficiency. Pathological findings of the excised thyroid gland are as shown in Figure 4 . Grossly, the lobes became firm in consistency but maintained their normal shape ( Figure 4(a) ). On microscopy, several sizes of follicles were regularly lined with flattened follicular epithelium. The lumen was filled with colloid. Scattered disrupted follicles with enlarged epithelium and cytoplasmic vacuoles were observed ( Figure 4(b) ). It is of note that macrophages had infiltrated and multinucleated giant cells were also found in the follicular lumen ( Figure 4(c) ). Immunostaining with anti-KP1 (CD68) and antithyroglobulin antibodies confirmed that the infiltrated cells were macrophages but not follicular cells (Figures 4(d) and 4(e) ). These findings characterized by scattered follicle disruption, vacuoles in epithelial cells, and macrophage infiltration are compatible with amiodarone toxicity .
4.042969
0.972656
sec[1]/p[0]
en
0.999997
25664188
https://doi.org/10.1155/2015/416145
[ "thyrotoxicosis", "thyroid", "hydrocortisone", "administration", "free", "tapered", "amiodarone", "gland", "iodine", "thyroidectomy" ]
[ { "code": "5A02.Z", "title": "Thyrotoxicosis, unspecified" }, { "code": "5A02.Y", "title": "Other specified thyrotoxicosis" }, { "code": "JA65.Y", "title": "Maternal care for other specified conditions predominantly related to pregnancy" }, { "code": "5A02.0", "title": "Thyrotoxicosis with diffuse goitre" }, { "code": "KB62.0", "title": "Transitory neonatal hyperthyroidism" }, { "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 === [5A02.Z] Thyrotoxicosis, unspecified Also known as: Thyrotoxicosis, unspecified | Thyrotoxicosis | hyperthyroidism | hyperactive thyroid gland | overactive thyroid [5A02.Y] Other specified thyrotoxicosis Also known as: Other specified thyrotoxicosis | Thyrotoxicosis with certain specified conditions | Thyrotoxic heart disease | cardiothyreosis | Thyrotoxic periodic paralysis [JA65.Y] Maternal care for other specified conditions predominantly related to pregnancy Also known as: Maternal care for other specified conditions predominantly related to pregnancy | Exhaustion complicating pregnancy | Fatigue complicating pregnancy | pregnancy-related exhaustion and fatigue | Gravidarum retinitis [5A02.0] Thyrotoxicosis with diffuse goitre Definition: Thyrotoxicosis occurs by the ingestion of excessive amounts of exogenous thyroid hormone in the form of thyroid hormone supplements such as the most widely used supplement levothyroxine. Also known as: Thyrotoxicosis with diffuse goitre | Toxic diffuse goitre | toxic primary thyroid hyperplasia | Stokes disease | thyrotoxicosis with goitre Includes: Toxic diffuse goitre | Graves disease [KB62.0] Transitory neonatal hyperthyroidism Definition: A paediatric condition characterised by a temporarily abnormally increased level of thyroid hormones (triiodothyronine (T3) and thyroxine (T4)) in the blood of a newborn. Also known as: Transitory neonatal hyperthyroidism | transient neonatal hyperthyroidism | Neonatal thyrotoxicosis Includes: Neonatal thyrotoxicosis [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 --- [5A02.Z] Thyrotoxicosis, unspecified --PARENT--> [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... --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 2 --- [5A02.Z] Thyrotoxicosis, unspecified --PARENT--> [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... --CHILD--> [5A02.1] Thyrotoxicosis with toxic single thyroid nodule --- Walk 3 --- [5A02.Y] Other specified thyrotoxicosis --PARENT--> [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... --RELATED_TO--> [?] Human chorionic gonadotrophin-induced thyrotoxicosis --- Walk 4 --- [5A02.Y] Other specified thyrotoxicosis --PARENT--> [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... --CHILD--> [5A02.2] Thyrotoxicosis with toxic multinodular goitre Def: Thyrotoxicosis caused by functioning thyroid multinodules... --- Walk 5 --- [JA65.Y] Maternal care for other specified conditions predominantly related to pregnancy --PARENT--> [JA65] 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--> [JA65.1] Pregnancy dermatoses Def: A group of skin disorders which are specific to pregnancy.... --- Walk 6 --- [JA65.Y] Maternal care for other specified conditions predominantly related to pregnancy --PARENT--> [JA65] 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--> [JA65.1] Pregnancy dermatoses Def: A group of skin disorders which are specific to pregnancy....
[ "[5A02.Z] Thyrotoxicosis, unspecified\n --PARENT--> [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...\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....", "[5A02.Z] Thyrotoxicosis, unspecified\n --PARENT--> [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...\n --CHILD--> [5A02.1] Thyrotoxicosis with toxic single thyroid nodule", "[5A02.Y] Other specified thyrotoxicosis\n --PARENT--> [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...\n --RELATED_TO--> [?] Human chorionic gonadotrophin-induced thyrotoxicosis", "[5A02.Y] Other specified thyrotoxicosis\n --PARENT--> [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...\n --CHILD--> [5A02.2] Thyrotoxicosis with toxic multinodular goitre\n Def: Thyrotoxicosis caused by functioning thyroid multinodules...", "[JA65.Y] Maternal care for other specified conditions predominantly related to pregnancy\n --PARENT--> [JA65] 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--> [JA65.1] Pregnancy dermatoses\n Def: A group of skin disorders which are specific to pregnancy....", "[JA65.Y] Maternal care for other specified conditions predominantly related to pregnancy\n --PARENT--> [JA65] 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--> [JA65.1] Pregnancy dermatoses\n Def: A group of skin disorders which are specific to pregnancy...." ]
5A02.Z
Thyrotoxicosis, unspecified
[ { "from_icd11": "5A02.Z", "icd10_code": "E0580", "icd10_title": "Other thyrotoxicosis without thyrotoxic crisis or storm" }, { "from_icd11": "5A02.Z", "icd10_code": "E0590", "icd10_title": "Thyrotoxicosis, unspecified without thyrotoxic crisis or storm" }, { "from_icd11": "5A02.Z", "icd10_code": "E0581", "icd10_title": "Other thyrotoxicosis with thyrotoxic crisis or storm" }, { "from_icd11": "5A02.Z", "icd10_code": "E0591", "icd10_title": "Thyrotoxicosis, unspecified with thyrotoxic crisis or storm" }, { "from_icd11": "5A02.Z", "icd10_code": "E05", "icd10_title": "Thyrotoxicosis [hyperthyroidism]" }, { "from_icd11": "5A02.Z", "icd10_code": "E058", "icd10_title": "Other thyrotoxicosis" }, { "from_icd11": "5A02.Z", "icd10_code": "E059", "icd10_title": "Thyrotoxicosis, unspecified" }, { "from_icd11": "JA65.Y", "icd10_code": "O26891 ", "icd10_title": "" }, { "from_icd11": "JA65.Y", "icd10_code": "O26892 ", "icd10_title": "" }, { "from_icd11": "JA65.Y", "icd10_code": "O26893 ", "icd10_title": "" }, { "from_icd11": "JA65.Y", "icd10_code": "O26899 ", "icd10_title": "" }, { "from_icd11": "JA65.Y", "icd10_code": "O99820 ", "icd10_title": "" }, { "from_icd11": "5A02.0", "icd10_code": "E0500", "icd10_title": "Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm" }, { "from_icd11": "5A02.0", "icd10_code": "E0501", "icd10_title": "Thyrotoxicosis with diffuse goiter with thyrotoxic crisis or storm" }, { "from_icd11": "5A02.0", "icd10_code": "E050", "icd10_title": "Thyrotoxicosis with diffuse goiter" } ]
E0580
Other thyrotoxicosis without thyrotoxic crisis or storm
An eight-year-old male presented with a mass in the right anterior neck that had been apparent for one week. Upon physical examination, blood pressure was recorded as 100/65 mmHg, heart rate was 80 beats per min, respiratory rate was 20 breaths per min and temperature was 36.1°C. A mass measuring ~4.0 cm in size, which caused difficulty in swallowing, was identified in the right anterior neck. The laboratory test results demonstrated a normal blood count and serum biochemistry, as well as normal levels of electrolytes and carcinoembryonic antigen. In addition, the test results for Epstein-Barr virus (EBV) viral capsid antigens immunoglobulin (Ig)M and IgG, human immunodeficiency virus (HIV) and hepatitis C virus antibodies, hepatitis B antigen and syphilis were negative. Furthermore, the thyroid hormone test results were as follows: Free thyroxine (FT) 4 levels of 11.8 pmol/l (normal range, 9–25 pmol/l); FT3 levels of 4.2 pmol/l (normal range, 3–9 pmol/l); thyroid-stimulating hormone levels of 0.720 μIU/ml (normal range, 0.34–5.60 μIU/ml); anti-thyroglobulin levels of 20 IU/ml (normal range, <115 IU/ml); and anti-thyroid peroxidase levels of 25 IU/ml (normal range, <34 IU/ml). The patient had no significant past medical or family history of disease. A B-mode ultrasound examination revealed a mass measuring 4.0×3.0×2.5 cm in the right lobe of the thyroid , however, the lymph nodes surrounding the mass were normal . The patient underwent a right lobe and isthmus thyroidectomy whereby two lymph nodes were excised simultaneously. Following the surgery, positron emission tomography-computed tomography scans showed normal metabolism in the left lobe of the thyroid and other parts of the body . The patient’s bone marrow cytology was also normal, however, histological examination revealed diffuse infiltration of atypical lymphocytes and the observation of residual thyroid follicles and necrosis . In addition, under low magnification, the ‘starry sky’ histology was observed in certain areas . The atypical lymphocytes were medium-sized and consistent, with centrally located nuclei of irregular shape, displaying dispersed and deep basophilic chromatin and scanty cytoplasm. Additionally, certain neoplastic cells were visible, while varying numbers of nucleoli and apoptosis and mitosis were observed. Benign tissue cells engulfing apoptotic bodies were also observed under high magnification , however, the isthmus of the thyroid was not infiltrated by the neoplastic cells. No reactive lymphocyte infiltration or fibrosis was identified in the stroma of the thyroid, and no oxyphilic change or squamous metaplasia was observed in the epithelial cells of the background thyroid tissues . The only change in the two lymph nodes that were simultaneously excised, was the presence of reactive hyperplasia of the lymphoid follicles . Immunohistochemical staining was then performed with the primary antibodies shown in Table I (Zymed Corporation, Inc., San Francisco, CA, USA; Santa Cruz Biotechnology, Inc., Santa Cruz, CA, USA). The results showed that the neoplastic cells were diffusely positive for cluster of differentiation (CD)20 and CD10 , marginally positive for CD38, CD43 and B-cell lymphoma (Bcl)-6, but negative for Bcl-2 and terminal deoxynucleotidyl transferase (TDT). In addition, CD3 and CD5 stained the background T cells, and the Ki-67 proliferation index was >95% . Analysis using an EBV-encoded small RNA (EBER) digoxin-labeled probe (PanPath B.V., Budel, Netherlands) was performed and revealed a negative result , however, positive nuclei were observed in the nasopharyngeal carcinoma tissue, which was used as the positive control . Analysis using the C-MYC break-apart detection probe (Guangzhou LBP Medical Science Technology Co., Ltd., Guangzhou, China) was also performed and the results revealed that ~90% of the neoplastic cells exhibited red and green signal separation, which indicated that chromosome breakage and translocation of the MYC gene had occurred in the neoplastic cells . Immunoglobulin gene rearrangement assays were performed according to instructions of the Biomed-2 Polymerase Chain Reaction kit (Invivoscribe technologies, Inc., San Diego, CA, USA), followed by capillary electrophoresis, which was analyzed using Genemarker ® v1.5. software (SoftGenetics, LLC, State College, PA, USA). Positive gene arrangements of IgH and IgK were observed in the tumor tissues, however, no positive gene rearrangements were observed for IgL . Consequently, the patient was diagnosed with primary BL of the thyroid and underwent alternate R-B-NHL-BFM-90-A and R-B-NHL-BFM-90-B treatment, for four cycles each. The two regimens, including the dose and duration of chemotherapy, are described in Table II . After almost four years of follow-up, the patient appears well and remains free of disease.
4.140625
0.963867
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en
0.999998
24765169
https://doi.org/10.3892/ol.2014.1941
[ "thyroid", "cells", "that", "range", "however", "neoplastic", "which", "pmol", "gene", "addition" ]
[ { "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": "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 === [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 [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 --- [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.... --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--> [5A03.2] 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... --CHILD--> [5A03.0] Acute thyroiditis Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial....
[ "[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 --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--> [5A03.2] 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 --CHILD--> [5A03.0] Acute thyroiditis\n Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial...." ]
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
Our patient initially presented with abdominal symptoms at 3 years in 1986. He was diagnosed with a stage III right adrenal neuroblastoma with unfavorable Shimada classification treated with surgical resection. He developed recurrence in his chest and abdomen in 1987, and he received sequential regimens containing doxorubicin, cisplatin, dacarbazine, cyclophosphamide, and etoposide. He was then conditioned with cyclophosphamide and melphalan and received total body irradiation of 1,200 cGy. He underwent matched related donor bone marrow transplant from the fraternal twin brother and achieved remission. He was on cyclosporine and methotrexate for graft-versus-host disease for 2.5 years. A left exophytic renal lesion suspicious for renal cell cancer was identified on surveillance scans. He underwent radical left nephrectomy at 15 years in 1998 and developed chronic kidney disease complicated by gouty arthritis. His creatinine was 1.4-1.8 mg/mL with eGFR in 40 ml/min for a decade before progression. In 2017, he had a symptomatic right thigh schwannoma removed. After an abrupt seizure in 2019, he was diagnosed with an atypical meningioma, WHO grade II, and seizures resolved after surgical resection. During workup for kidney transplantation in 2020, he had multiple incidental exophytic gastric masses on computed tomography (CT), largest measuring 4.7 × 5.5 × 6.1 cm, 1-cm segment three hepatic lesions, a 2.8-cm right adrenal nodule, a 6.4 × 5.8-cm left renal cyst, and a 1.4-cm right thyroid nodule . He had no pulmonary chondromas. Samples from endoscopic ultrasound redemonstrated multiple subepithelial masses in the stomach. Pathology was consistent with GIST with immunohistochemistry staining strongly and diffusely positive CD117 (c-KIT) and DOG1 and negatively for S100 calcium-binding protein. Necrosis was present with one mitotic figure in the 15 high-power field. His GIST sample was tested using the UW-OncoPlex next-generation sequencing 7 test. The University of Washington allowed performing a deep-dive genetic analysis. Given cancer history, he was referred to our clinical cancer genetics service. On physical examination, the height was 177 cm and the weight was 69 kg for a BMI of 23.5 kg/m 2 . He had freckles throughout, no café au lait macules, no head and neck tumors, and no lymphadenopathy, abdomen was diffusely tender, but soft palpation and musculoskeletal and neurologic examination were normal. Serum plasma metanephrines were normal. There were no vestibular schwannomas on previous brain magnetic resonance imaging (MRI). Germline genetic testing was sent on cultured fibroblasts. The UW laboratory obtained specimens from 1987, 1998, 2001, and 2021. GIST was negative for mutations in exons 9, 11, 13, and 17 of KIT and in exons 12 and 18 of PDGFRA . Our patient was diagnosed with familial paraganglioma and pheochromocytoma syndrome (familial PGL/PCC). Tumor profiling and germline genetic testing results for the gene SDHA are summarized in Figure 2 . All three samples and DNA from the cultured fibroblast were run on the same OncoPlex cell. Data were analyzed looking for evidence of mosaicism. Several copy number changes were detected in the GIST without a clear overlap with neuroblastoma from 1987. Neuroblastoma tumor had many additional somatic mutations and copy number changes, with none overlapping with the GIST tumor mutation profile from 2021. Kidney carcinoma had a candidate second somatic hit in a deep intronic region called c.1794=111T>C at 34% variant allele fraction (VAF) and a pathogenic variant in the gene SDHD : c.279C>A (p.Y93*) at 32% VAF. Somatic mutations in NF2 and CDKN1C were also detected in the kidney carcinoma without an overlap with any other tumors sequenced. Consensus in multidisciplinary conference was to start dose-adjusted sunitinib (Sutent) at 25 mg per day for 4 weeks on/2 weeks off schedule over full-dose regorafenib after pharmacy's input given limited knowledge or data for patients with end-stage renal disease. He kept a strict kidney diet, and he tolerated sunitinib well. The dose was increased to 50 mg once per day after 6 months. Patient consented to participate in our repository and registry. Patient had stable to slight regression of disease on repeat CT of abdomen at 6, 9, and 12 months, making him eligible for gastrectomy at 15 months of therapy. A fresh frozen surgical specimen was sent to the laboratory to attempt developing a patient-derived xenograft model. Patient’s first upper extremity arteriovenous (AV) fistula did’ not mature appropriately, and he was scheduled to receive another AV fistula further out from Sutent exposure. After recovery, he was scheduled for screening colonoscopy and found to have three 30-mm tubular adenomas and more than 25 sessile polyps. He will continue to receive colonoscopy every 6 months.
3.955078
0.980469
sec[1]/p[0]
en
0.999998
38885448
https://doi.org/10.1200/PO.23.00455
[ "kidney", "gist", "renal", "diagnosed", "neuroblastoma", "abdomen", "cancer", "three", "genetic", "mutations" ]
[ { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "GB6Z", "title": "Kidney failure, unspecified" }, { "code": "LB30.1", "title": "Renal dysplasia" }, { "code": "NB92.0Y", "title": "Other specified injury of kidney" }, { "code": "LB30.7", "title": "Ectopic or pelvic kidney" }, { "code": "2B5B.Z", "title": "Gastrointestinal stromal tumour of unspecified gastrointestinal sites" }, { "code": "2E87", "title": "Benign gastrointestinal stromal tumour" }, { "code": "2B5B.0", "title": "Gastrointestinal stromal tumour of stomach" }, { "code": "2B5B.1", "title": "Gastrointestinal stromal tumour of small intestine" }, { "code": "2B5B.Y", "title": "Gastrointestinal stromal tumour of other gastrointestinal sites" } ]
=== ICD-11 CODES FOUND === [GB6Z] Kidney failure, unspecified Also known as: Kidney failure, unspecified | nontraumatic kidney injury | renal failure NOS | kidney block | renal impairment NOS [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 [NB92.0Y] Other specified injury of kidney Also known as: Other specified injury of kidney | Injury of kidney without open wound into cavity | Injury of kidney with open wound into cavity | Haematoma of kidney | traumatic perirenal haematoma [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 [2B5B.Z] Gastrointestinal stromal tumour of unspecified gastrointestinal sites Also known as: Gastrointestinal stromal tumour of unspecified gastrointestinal sites | Gastrointestinal stromal tumour, primary site | GIST - [gastrointestinal stromal tumour] [2E87] Benign gastrointestinal stromal tumour Also known as: Benign gastrointestinal stromal tumour | Benign gastrointestinal stromal tumour of stomach | Benign GIST - [gastrointestinal stromal tumour] of stomach | Benign gastrointestinal stromal tumour of duodenum | Benign GIST - [gastrointestinal stromal tumour] of duodenum [2B5B.0] Gastrointestinal stromal tumour of stomach Definition: A gastrointestinal stromal tumour that arises from the stomach. It covers a spectrum of benign to malignant mesenchymal neoplasms and includes most gastric smooth muscle tumours, leiomyoblastomas, and tumours formerly called gastrointestinal autonomic nerve tumours. Also known as: Gastrointestinal stromal tumour of stomach | Malignant GIST - [gastrointestinal stromal tumour] of stomach | Gastrointestinal stromal tumour of cardia of stomach | Gastrointestinal stromal tumour of body of stomach | Gastrointestinal stromal tumour of pyloric antrum of stomach [2B5B.1] Gastrointestinal stromal tumour of small intestine Definition: A gastrointestinal stromal tumour that arises from the small intestine. It usually affects adults over fifty years of age. The majority of cases have spindle cell morphology. The prognosis depends on the tumour size and the mitotic activity. Also known as: Gastrointestinal stromal tumour of small intestine | Malignant GIST - [gastrointestinal stromal tumour] of small intestine | Gastrointestinal stromal tumour of jejunum | Gastrointestinal stromal tumour of ileum | Gastrointestinal stromal tumour of Meckel diverticulum [2B5B.Y] Gastrointestinal stromal tumour of other gastrointestinal sites Also known as: Gastrointestinal stromal tumour of other gastrointestinal sites | Gastrointestinal stromal tumour of other gastrointestinal sites | Gastrointestinal stromal tumour of oesophagus | Gastrointestinal stromal tumour of rectum | Gastrointestinal stromal tumour of colon === GRAPH WALKS === --- Walk 1 --- [GB6Z] Kidney failure, unspecified --PARENT--> [?] Kidney failure Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ... --RELATED_TO--> [?] Congenital renal failure Def: A severe irreversible decline in the ability of kidneys to remove wastes, concentrate urine, and maintain electrolyte balance; blood pressure; and calcium metabolism which existed at, or often before,... --- Walk 2 --- [GB6Z] Kidney failure, unspecified --PARENT--> [?] Kidney failure Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ... --EXCLUDES--> [?] Hypertensive renal disease Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure.... --- Walk 3 --- [LB30.1] Renal dysplasia Def: A condition characterised by abnormal development of one or both kidneys.... --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d... --CHILD--> [?] Autosomal dominant polycystic kidney disease type 1 without tuberous sclerosis Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin1 gene on chromosome 16 (PKD1 gene)... --- Walk 4 --- [LB30.1] Renal dysplasia Def: A condition characterised by abnormal development of one or both kidneys.... --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d... --PARENT--> [?] Hereditary cystic or dysplastic kidney disease, dominant inheritance Def: Cystic or dysplastic renal diseases that are inherited in an autosomal dominant fashion. Usually monogenetic, and can be associated with abnormalities in other organs.... --- Walk 5 --- [NB92.0Y] Other specified injury of kidney --PARENT--> [NB92.0] Injury of kidney --CHILD--> [NB92.01] Contusion of kidney, major --- Walk 6 --- [NB92.0Y] Other specified injury of kidney --PARENT--> [NB92.0] Injury of kidney --CHILD--> [NB92.02] Laceration of kidney, minor
[ "[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --RELATED_TO--> [?] Congenital renal failure\n Def: A severe irreversible decline in the ability of kidneys to remove wastes, concentrate urine, and maintain electrolyte balance; blood pressure; and calcium metabolism which existed at, or often before,...", "[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --EXCLUDES--> [?] Hypertensive renal disease\n Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure....", "[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --CHILD--> [?] Autosomal dominant polycystic kidney disease type 1 without tuberous sclerosis\n Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin1 gene on chromosome 16 (PKD1 gene)...", "[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --PARENT--> [?] Hereditary cystic or dysplastic kidney disease, dominant inheritance\n Def: Cystic or dysplastic renal diseases that are inherited in an autosomal dominant fashion. Usually monogenetic, and can be associated with abnormalities in other organs....", "[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --CHILD--> [NB92.01] Contusion of kidney, major", "[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --CHILD--> [NB92.02] Laceration of kidney, minor" ]
GC2Z&XA6KU8
Disease of kidney, not elsewhere classified
[ { "from_icd11": "GB6Z", "icd10_code": "N19", "icd10_title": "Unspecified kidney failure" }, { "from_icd11": "GB6Z", "icd10_code": "N17-N19", "icd10_title": "" }, { "from_icd11": "GB6Z", "icd10_code": "N17", "icd10_title": "Acute kidney failure" }, { "from_icd11": "LB30.1", "icd10_code": "Q614", "icd10_title": "Renal dysplasia" }, { "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" } ]
N19
Unspecified kidney failure
A 44-year-old woman presented to the gynecology clinic with menorrhagia for six months. Except for the feeling of mild pressure in the lower abdomen, she had no other symptoms. Transvaginal ultrasonography showed no uterine abnormalities , but revealed a right adnexal mass of 8×7cm with both solid and cystic components . No ascites was observed. The serum CA125 level was measured, and turned out low (18 kU/L). An abdominal computed tomography (CT) scan was requested for within two weeks. Five days later, the woman presented to the gynecologic emergency unit with increased abdominal discomfort. Transvaginal ultrasonography demonstrated significantly increased size of the right adnexal mass, which now measured 12×9cm . An abdominal CT scan was made the same day, revealing a right ovarian tumor, as well as a mass in the transverse colon and multiple hypodense lesions in both the right and left lobes of the liver . A diagnosis of metastatic colon cancer was suspected, which was subsequently supported by an increased serum carcinoembryonic antigen (CEA) level of 346 µg/L. Histopathological analysis of a liver biopsy confirmed the diagnosis, revealing classical adenocarcinoma. Immunohistochemical stainings and molecular analysis (using the Idylla TM KRAS Mutation Assay) demonstrated mismatch repair proficiency and a KRAS p.G12V mutation, respectively. Detailed examination of the patient's family history by a clinical geneticist revealed no relatives with colorectal cancer and/or colonic polyposis. Palliative chemotherapy consisting of Capecitabine, Oxaliplatin and Bevacizumab (CapOx-B) was initiated. Oxaliplatin was discontinued after three courses due to toxicity (acute neuropathy: throat discomfort and muscle cramps). CT scans after three courses of CapOx-B and three subsequent courses of Cap-B showed gradual growth of the right ovarian metastasis , whereas the colon tumor and liver metastases had decreased in size after three courses of CapOx-B and stabilized after three courses of Cap-B. Since the abdominal discomfort had also increased, bilateral salpingo-oophorectomy was performed. Notably, Bevacizumab was discontinued several months before surgery and resumed one month after surgery to avoid impaired wound healing. In addition to the right ovarian metastasis , histopathological analysis revealed a microscopic focus of metastatic adenocarcinoma in the left ovary. Next-generation sequencing demonstrated the same KRAS p.G12V mutation in the right ovarian metastasis, as well as inactivating mutations in TP53 (p.R282W) and APC . Chemotherapy was switched to Folinic acid, Fluorouracil, Irinotecan and Bevacizumab (FOLFIRI-B) five months after surgery due to radiological progression of the colon tumor and liver metastases, as well as increasing serum CEA levels . After four courses of FOLFIRI-B, partial response was observed on abdominal CT, and serum CEA levels had significantly decreased . After twelve courses, exploratory laparotomy was performed; however, colectomy and hepatic metastasectomy were not executed because multiple peritoneal metastases were observed. At eighteen months after diagnosis, the patient remains in good clinical condition (WHO performance score 0). Fig 1 Images made during transvaginal ultrasonography at first presentation (A-B), showing a normal uterus without intracavitary abnormalities (A), and a right adnexal mass of 8×7cm (B). Images made during transvaginal ultrasonography at presentation at the gynecologic emergency unit (C-D), showing the enlarged right adnexal mass of 12×9cm with both solid and cystic components (C), and flow on color Doppler imaging (D). Yellow dotted lines indicate measurements. Fig 1 Fig. 2 Coronal section of the contrast-enhanced abdominal CT scan performed at diagnosis (A) with graphic correlation (B), showing a 13×8cm large tumor originating from the right ovary with infiltration of surrounding mesenteric fat, as well as a mass in the distal part of the transverse colon with infiltration of mesocolic fat, and a hypodense liver lesion. The coronal section of the contrast-enhanced abdominal CT scan performed after three courses of CapOx-B and three subsequent courses of Cap-B chemotherapy (C) shows decreased size of the hypodense liver lesion (from 39 to 26mm) and increased size of the right ovarian metastasis (from 13 to 18cm). Gross macroscopic image of the resected right ovarian metastasis (D). Fig 2 Fig. 3 Timeline depicting the course of serum CEA levels during the period of November 2019 to May 2021. Showed are decreasing serum CEA levels during CapOx-B chemotherapy, followed by gradually increasing serum CEA levels during Cap-B chemotherapy, except for an almost 50% drop after bilateral salpingo-oophorectomy. After switch to FOLFIRI-B chemotherapy in October 2020, serum CEA levels quickly decreased again. Fig 3
4.039063
0.976074
sec[1]/p[0]
en
0.999996
34367398
https://doi.org/10.1016/j.radcr.2021.06.072
[ "courses", "serum", "abdominal", "three", "ovarian", "liver", "chemotherapy", "colon", "capox", "metastasis" ]
[ { "code": "LA8Y", "title": "Other specified structural developmental anomaly of heart or great vessels" }, { "code": "8B10.Y", "title": "Other specified transient ischaemic attack" }, { "code": "6A80", "title": "Symptomatic and course presentations for mood episodes in mood disorders" }, { "code": "LA8C.1", "title": "Anomalous aortic origin or course of coronary artery" }, { "code": "8B22.Y", "title": "Other specified cerebrovascular disease" }, { "code": "NE80.3", "title": "Other serum reactions" }, { "code": "5D0Y", "title": "Other specified metabolic disorders" }, { "code": "5B91.0", "title": "Hypercalcaemia" }, { "code": "4A84.Y", "title": "Other specified anaphylaxis" }, { "code": "5C50.F2", "title": "Homocarnosinosis" } ]
=== ICD-11 CODES FOUND === [LA8Y] Other specified structural developmental anomaly of heart or great vessels Also known as: Other specified structural developmental anomaly of heart or great vessels | Congenital anomaly of position or spatial relationships of thoraco-abdominal organs | Usual atrial arrangement | atrial situs solitus | Abnormal atrial arrangement [8B10.Y] Other specified transient ischaemic attack Also known as: Other specified transient ischaemic attack | Vertebrobasilar artery syndrome | vertebrobasilar arterial insufficiency | vertebrobasilar insufficiency | vertebro-basilar artery syndrome, course of resolution unspecified [6A80] Symptomatic and course presentations for mood episodes in mood disorders Definition: 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 disorder, or bipolar type II disorder. These categories indicate the presence of specific, important features of the clinical presentation or of the course, onset, and pattern of mood episodes. These categories are not mutually exclusive, and as many may be added as apply. Also known as: Symptomatic and course presentations for mood episodes in mood disorders [LA8C.1] Anomalous aortic origin or course of coronary artery Definition: A congenital cardiovascular malformation in which the origin and/or course of a coronary artery is abnormal. This is where coronary "anomalies" in the presence of discordant ventriculo-arterial connections should be coded. Also known as: Anomalous aortic origin or course of coronary artery | Anomalous aortic origin of coronary artery with ventriculo-arterial concordance | Anomalous aortic origin of coronary artery | AAOCA - [Anomalous aortic origin of coronary artery] | Right coronary artery from left aortic sinus with ventriculo-arterial concordance [8B22.Y] Other specified cerebrovascular disease Also known as: Other specified cerebrovascular disease | Posterior reversible encephalopathy | Multiple or bilateral precerebral artery syndromes | multiple or bilateral precerebral artery syndromes, course of resolution unspecified | precerebral artery insufficiency NOS [NE80.3] Other serum reactions Also known as: Other serum reactions | Allergic reaction to serum | serum allergy | Complications of vaccination, protein sickness | Protein sickness Excludes: serum hepatitis [5D0Y] Other specified metabolic disorders Also known as: Other specified metabolic disorders | Disorders of plasma-protein metabolism, not elsewhere classified | abnormal protein transport | dysproteinaemia | Absence of albumin in blood [5B91.0] Hypercalcaemia Definition: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused by dehydration secondary to urinary losses of calcium, water and other electrolytes, and to an increase in membrane potential caused by the elevation in extracellular fluid ionized calcium concentration. Patients with moderate to severe hypercalcaemia often complain of nausea and vomiting, symptoms Also known as: Hypercalcaemia | Calcium excess | elevated serum calcium | hypercalcaemic crisis | hypercalcaemic syndrome [4A84.Y] Other specified anaphylaxis Also known as: Other specified anaphylaxis | Latex-induced anaphylaxis | Anaphylaxis due to latex | Latex anaphylaxis | Anaphylactic shock due to serum [5C50.F2] Homocarnosinosis Definition: Homocarnosinosis is a metabolic defect characterised by progressive spastic diplegia, intellectual deficit and retinitis pigmentosa. This extremely rare disorder has been reported in only one family, namely a woman and three of her children. The latter showed but their mother was symptom free. It is therefore uncertain whether there is a relationship between the biochemical defect and the clinical symptoms. Inheritance in the reported family seems to be autosomal dominant. Also known as: Homocarnosinosis | Homocarnosinase deficiency | Serum carnosinase deficiency === GRAPH WALKS === --- Walk 1 --- [LA8Y] Other specified structural developmental anomaly of heart or great vessels --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.... --CHILD--> [LA82] Total mirror imagery Def: A congenital malformation in which there is complete mirror-imaged arrangement of the internal organs along the left-right axis of the body.... --- Walk 2 --- [LA8Y] Other specified structural developmental anomaly of heart or great vessels --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.... --CHILD--> [LA81] Abnormal ventricular relationships Def: A congenital cardiovascular malformation in which the ventricular positions relative to each other or their laterality (sidedness) are abnormal.... --- Walk 3 --- [8B10.Y] Other specified transient ischaemic attack --PARENT--> [8B10] Transient ischaemic attack Def: Transient episode of focal neurological dysfunction caused by focal brain ischemia without acute infarction in the clinically relevant area of the brain or transient monocular visual loss due to retin... --CHILD--> [8B10.Y] Other specified transient ischaemic attack --- Walk 4 --- [8B10.Y] Other specified transient ischaemic attack --PARENT--> [8B10] Transient ischaemic attack Def: Transient episode of focal neurological dysfunction caused by focal brain ischemia without acute infarction in the clinically relevant area of the brain or transient monocular visual loss due to retin... --EXCLUDES--> [?] Neonatal cerebral ischaemia Def: A paediatric condition characterised by insufficient blood flow to the brain of a newborn to meet metabolic demand.... --- Walk 5 --- [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... --RELATED_TO--> [?] Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, without psychotic symptoms Def: A syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, most commonly depressive symptoms. Th... --CHILD--> [?] Postpartum depression without psychotic symptoms --- Walk 6 --- [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... --RELATED_TO--> [?] Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, with psychotic symptoms Def: A syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, including delusions, hallucinations, ... --CHILD--> [?] Postpartum depression with psychotic symptoms
[ "[LA8Y] Other specified structural developmental anomaly of heart or great vessels\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 --CHILD--> [LA82] Total mirror imagery\n Def: A congenital malformation in which there is complete mirror-imaged arrangement of the internal organs along the left-right axis of the body....", "[LA8Y] Other specified structural developmental anomaly of heart or great vessels\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 --CHILD--> [LA81] Abnormal ventricular relationships\n Def: A congenital cardiovascular malformation in which the ventricular positions relative to each other or their laterality (sidedness) are abnormal....", "[8B10.Y] Other specified transient ischaemic attack\n --PARENT--> [8B10] Transient ischaemic attack\n Def: Transient episode of focal neurological dysfunction caused by focal brain ischemia without acute infarction in the clinically relevant area of the brain or transient monocular visual loss due to retin...\n --CHILD--> [8B10.Y] Other specified transient ischaemic attack", "[8B10.Y] Other specified transient ischaemic attack\n --PARENT--> [8B10] Transient ischaemic attack\n Def: Transient episode of focal neurological dysfunction caused by focal brain ischemia without acute infarction in the clinically relevant area of the brain or transient monocular visual loss due to retin...\n --EXCLUDES--> [?] Neonatal cerebral ischaemia\n Def: A paediatric condition characterised by insufficient blood flow to the brain of a newborn to meet metabolic demand....", "[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 --RELATED_TO--> [?] Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, without psychotic symptoms\n Def: A syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, most commonly depressive symptoms. Th...\n --CHILD--> [?] Postpartum depression without psychotic symptoms", "[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 --RELATED_TO--> [?] Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, with psychotic symptoms\n Def: A syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, including delusions, hallucinations, ...\n --CHILD--> [?] Postpartum depression with psychotic symptoms" ]
LA8Y
Other specified structural developmental anomaly of heart or great vessels
[ { "from_icd11": "LA8Y", "icd10_code": "Q248 ", "icd10_title": "" }, { "from_icd11": "NE80.3", "icd10_code": "T880XXA", "icd10_title": "Infection following immunization, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8061XA", "icd10_title": "Other serum reaction due to administration of blood and blood products, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8069XA", "icd10_title": "Other serum reaction due to other serum, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8062XA", "icd10_title": "Other serum reaction due to vaccination, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T806", "icd10_title": "Other serum reactions" }, { "from_icd11": "NE80.3", "icd10_code": "T880", "icd10_title": "Infection following immunization" }, { "from_icd11": "5C50.F2", "icd10_code": "E7281", "icd10_title": "Disorders of gamma aminobutyric acid metabolism" }, { "from_icd11": "5C50.F2", "icd10_code": "E728", "icd10_title": "Other specified disorders of amino-acid metabolism" } ]
Q248
While in 2012 Cerami and colleagues reported the first case of acquired NMT following qHPV vaccination and in 2013 Sedarous and Lange reported the first case of NMT with demyelinating CNS lesions , this is the first case where both aspects occur in the same patient. However, the case of Sedarous and Lange was an undefined, probably genetic disease including NMT as a symptom, but likely not of autoimmune origin. The clinical courses of the patients in the aforementioned reports share key aspects with ours, such as well-described NMT symptoms like muscle twitching and cramps, impaired muscle relaxation, and hyperhidrosis. However, a unique clinical feature of our patient was the non-fixed swan neck deformities of the fingers, which is rare in NMT without an underlying rheumatologic disease, of which we did not find any evidence . Pes cavus, on the other hand, has been described in certain genetic syndromes featuring NMT. Accordingly, it would have been interesting to investigate our patient for rare genetic disorders which was unfortunately prevented by her reluctance to further diagnostic measures. Paraclinically, we found neither neuromyotonic discharges in myography nor positive antibodies against CASPR2 and LGI1 in the serum. Of note, their absence does not exclude the diagnosis of acquired NMT, as they are only detected in about 40–50% of cases . However, the most intriguing aspect of this case is the presence of partly active brain lesions and oligoclonal bands (OCBs), which are both typically seen in MS. In this regard, our patient formally fulfilled the 2017 McDonald diagnostic criteria of dissemination in time (presence of Gad-enhancing and -nonenhancing lesions, positive OCBs) and space (periventricular, juxtacortical, and spinal lesions). Even without typical clinical symptoms of MS relapses (e.g., optic neuritis), it is therefore tempting to diagnose our patient with both radiologically isolated syndrome (RIS) and NMT. Even more so, it is conceivable that NMT may mask MS symptoms. Moreover, as a young female, our patient was at a generally higher risk of developing inflammatory CNS disease. On the other hand, in some cases NMT has been reported to manifest itself in the CNS leading to symptoms such as hallucinations, chorea and insomnia, first described by 19th century French physician Augustin Morvan . In addition, the aforementioned case of Sedarous and Lange also featured OCBs in the CSF and periventricular lesions even though there was no evidence of dissemination in time and space . Their patient presented primarily with muscle twitching and cramps, hyperhidrosis, and memory disturbance. Moreover, he experienced bouts of positional vertigo with no clear central correlation. Apart from “poor memory” and the nonspecific vertigo, Sedarous and Lange did not find any clear evidence of CNS dysfunction and attributed the patient’s complaints to peripheral nervous system (PNS) hyperexcitability. In summary, based on her symptoms, our patient does not fall into the category of “classical” Morvan’s syndrome. Finally, vaccines have been described as a possible trigger factor for a small percentage of certain inflammatory autoimmune conditions affecting the CNS and PNS such as acute disseminated encephalomyelitis (ADEM) or Guillain-Barré Syndrome (GBS), respectively. Accordingly, Sutton and colleagues described five cases of clinically isolated syndrome/MS flare-ups following HPV-vaccination. They argued that this may be attributed to the stimulatory effects of HPV virus-like particles on the immune system via “bystander activation” . Even though human papilloma viruses are known for their strict affinity to epithelial cells , it is conceivable that the immunoregulatory signal provided for dendritic cells via IL-6- and TNF-α-secretion may also elicit an inflammatory response in the nervous system . However, it is important to underscore that several studies in both genders have shown no significantly increased risk of autoimmune diseases following HPV-vaccination . NMT per se is a rare disease and it is even rarer occurring after qHPV vaccination. In contrast, based on epidemiological data, inflammatory CNS diseases are comparatively frequent and mostly occur at a young age. Accordingly, there is a certain overlap between this group and people that receive HPV vaccination for the first time. This, in turn, could argue for coincidence rather than causality. Moreover, this fact could be the reason, why a comprehensive overview of case reports with NMT, MS, and patients with similar symptoms following qHPV vaccination is still unavailable. Nonetheless, awareness of rare but severe putative CNS and PNS complications of the qHPV-vaccine can help to better diagnose patients and will certainly help in the future to thoroughly analyze possible confounders in these cases.
4.332031
0.765137
sec[2]/p[0]
en
0.999996
PMC9321055
https://doi.org/10.3390/vaccines10071132
[ "this", "vaccination", "lesions", "even", "that", "qhpv", "sedarous", "lange", "both", "however" ]
[ { "code": "4A01.03", "title": "Transient hypogammaglobulinaemia of infancy" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "QC02.Z", "title": "Need for immunization against certain specified single infectious diseases, unspecified" }, { "code": "QC04.Z", "title": "Immunization not carried out for unspecified reason" }, { "code": "NE80.3", "title": "Other serum reactions" }, { "code": "QC01.8", "title": "Need for immunization against influenza" }, { "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" } ]
=== ICD-11 CODES FOUND === [4A01.03] Transient hypogammaglobulinaemia of infancy Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy] [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 [QC02.Z] Need for immunization against certain specified single infectious diseases, unspecified Also known as: Need for immunization against certain specified single infectious diseases, unspecified | Need for immunization against certain specified single infectious diseases | Need for immunization against unspecified infectious disease | immunization | prophylactic vaccination [QC04.Z] Immunization not carried out for unspecified reason Also known as: Immunization not carried out for unspecified reason | Immunization not carried out | vaccination not done | Immunization not carried out because of contraindication, not otherwise specified [NE80.3] Other serum reactions Also known as: Other serum reactions | Allergic reaction to serum | serum allergy | Complications of vaccination, protein sickness | Protein sickness Excludes: serum hepatitis [QC01.8] Need for immunization against influenza Also known as: Need for immunization against influenza | influenza vaccination | prophylactic vaccination against influenza [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 === GRAPH WALKS === --- Walk 1 --- [4A01.03] Transient hypogammaglobulinaemia of infancy --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 2 --- [4A01.03] Transient hypogammaglobulinaemia of infancy --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 3 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --PARENT--> [?] Harmful effects of substances --CHILD--> [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --- Walk 4 --- [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 ... --- Walk 5 --- [QC02.Z] Need for immunization against certain specified single infectious diseases, unspecified --PARENT--> [QC02] Need for immunization against certain specified single infectious diseases --EXCLUDES--> [?] Immunization not carried out --- Walk 6 --- [QC02.Z] Need for immunization against certain specified single infectious diseases, unspecified --PARENT--> [QC02] Need for immunization against certain specified single infectious diseases --EXCLUDES--> [?] Need for immunization against combinations of infectious diseases
[ "[4A01.03] Transient hypogammaglobulinaemia of infancy\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....", "[4A01.03] Transient hypogammaglobulinaemia of infancy\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 --PARENT--> [?] Harmful effects of substances\n --CHILD--> [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified", "[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 ...", "[QC02.Z] Need for immunization against certain specified single infectious diseases, unspecified\n --PARENT--> [QC02] Need for immunization against certain specified single infectious diseases\n --EXCLUDES--> [?] Immunization not carried out", "[QC02.Z] Need for immunization against certain specified single infectious diseases, unspecified\n --PARENT--> [QC02] Need for immunization against certain specified single infectious diseases\n --EXCLUDES--> [?] Need for immunization against combinations of infectious diseases" ]
4A01.03
Transient hypogammaglobulinaemia of infancy
[ { "from_icd11": "4A01.03", "icd10_code": "D807", "icd10_title": "Transient hypogammaglobulinemia of infancy" }, { "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" }, { "from_icd11": "NE60", "icd10_code": "T50A15A", "icd10_title": "Adverse effect of pertussis vaccine, including combinations with a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50B15A", "icd10_title": "Adverse effect of smallpox vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T416X3A", "icd10_title": "" }, { "from_icd11": "NE60", "icd10_code": "T419X3A", "icd10_title": "" } ]
D807
Transient hypogammaglobulinemia of infancy
A 48-year-old man was referred to our department with multiple liver tumors detected on follow-up computed tomography (CT). He had undergone right upper lobectomy of the lung for AC 2 years previously. The pathological stage of the primary had been T2aN0M0 (stage IB). He was asymptomatic and had no relevant medical history. Contrast-enhanced CT and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) revealed multiple metastases in both lobes of the liver . These tumors were located in segments 2, 3, 5/8 and the right hepatic vein drainage area. Positron emission tomography (PET)-CT showed no extrahepatic tumor manifestations. No lymph node metastases or peritoneal dissemination were identified. The tumor markers carcinoembryonic antigen, pro-gastrin-releasing peptide, and protein induced by vitamin K absence or antagonist-II were all within normal limits. Results of preoperative liver function testing were unremarkable and indocyanine green retention rate at 15 min was 5% (normal). We planned complete resection of the metastases in both lobes of the liver using a two-stage hepatectomy, as CT volumetry of the future liver remnant volume (FLRV) showed 35 % of the total liver volume, which was marginal. During the first-stage, left lateral segmentectomy, partial hepatectomy of segment 5/8 and portal vein embolization of the posterior segmental branches through the ileocolic vein were performed concomitantly . Fibrin glue mixed with iodized oil was used as embolic material. The right lobe of the liver was partly mobilized to allow safe partial hepatectomy of segment 5/8. The Pringle’s maneuver was performed by tightening a rubber tube around the entire hepatoduodenal ligament. Four tumors were identified in the surgical specimen. CT on postoperative day 14 showed FLRV had increased to 45 % of the total liver volume, which was judged to be sufficient. The second-stage surgery was therefore performed 21 days after the first surgery, as resection of the right hepatic vein drainage area (i.e., posterior and dorsal section of the anterior segment) . During the second-stage surgery, adhesion was dissected and cholecystectomy was performed. The right lobe of the liver was then fully mobilized and the short hepatic veins draining into the vena cava were divided between ligation. The hepatoduodenal ligament was encircled and divided into the hepatic artery, portal vein and bile duct. The demarcation line was visualized by clamping the common hepatic artery and right hepatic vein . Hepatic transection was performed under the Pringle’s maneuver. The Glissonean pedicles of the anterior dorsal branches and posterior branch were separately ligated at the root. Finally, the root of the right hepatic vein was transected and the surgical specimen was removed. Eight tumors were identified in the surgical specimen. Histopathologically, all tumors comprised trabecular, palisading, or rosette-like structure with round nuclei of various sizes and eosinophilic granular cytoplasm. Tumor cells stained positive for immunohistochemical markers CD56, synaptophysin, and chromogranin A, with 2 mitoses per 10 high-power fields. The tumors were finally diagnosed as metastatic AC tumors originating from the lung . The patient developed postoperative bile leak, which was treated with endoscopic retrograde biliary drainage and percutaneous bile leakage drainage. He was discharged on postoperative day 82, and has since been followed without any adjuvant therapy. As of the time of writing, 24 months postoperatively, no tumor recurrence has been identified. Fig. 1 Gd-EOB-DTPA-MRI imaging. Gd-EOB-DTPA-MRI demonstrated multiple metastases (11 metastases) in both liver lobes (arrows). (a) arterial phase (b) portal phase (c) equilibrium phase (d) hepatobiliary phase Fig. 1 Fig. 2 Diagram and operative findings. a, b) First operation (a) Diagram showing line of liver resection for the first operation. (b) Portal vein embolization of the posterior segmental branch (arrows). c, d) Second operation (c) Diagram showing line of liver resection for the second operation. (d) Intraoperative image shows the demarcation line appearing after clamping the right hepatic vein. Fig. 2 Fig. 3 Pathological diagnosis. Microscopic examination of the resected liver specimen shows proliferation of atypical cells displaying features characteristic of atypical pulmonary carcinoid. (a) Hematoxylin & eosin staining ×200: The tumor comprises trabecular, palisading and rosette-like structures with round nuclei of various sizes and eosinophilic granular cytoplasm. (b) Immunohistological staining ×200: Immunochemistry of atypical carcinoid positive for synaptophysin. (c) Immunohistological staining ×200: Immunochemistry of atypical carcinoid positive for chromogranin A. Fig. 3
3.996094
0.97168
sec[1]/p[0]
en
0.999997
32492643
https://doi.org/10.1016/j.ijscr.2020.05.043
[ "liver", "hepatic", "vein", "tumors", "stage", "metastases", "tumor", "drainage", "resection", "portal" ]
[ { "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": "BD7Z", "title": "Diseases of veins, unspecified" }, { "code": "MC88", "title": "Prominent veins" }, { "code": "BD7Y", "title": "Other specified diseases of veins" }, { "code": "BD75.Y", "title": "Venous varicosities of other specified sites" }, { "code": "BD73.2Z", "title": "Systemic vein obstruction, 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 [BD7Z] Diseases of veins, unspecified Also known as: Diseases of veins, unspecified [MC88] Prominent veins Also known as: Prominent veins [BD7Y] Other specified diseases of veins Also known as: Other specified diseases of veins [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 [BD73.2Z] Systemic vein obstruction, unspecified Also known as: Systemic vein obstruction, unspecified | Systemic vein obstruction === GRAPH WALKS === --- Walk 1 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --CHILD--> [DB90] Infectious liver disease --- 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 --RELATED_TO--> [?] Hepatic sarcoidosis Def: This is a syndrome involving abnormal collections of chronic inflammatory cells (granulomas) that can form as nodules in multiple organs, of the liver.... --- 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--> [DB99.0] Chronic 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.... --PARENT--> [?] Diseases of liver
[ "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --CHILD--> [DB90] Infectious liver disease", "[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 --RELATED_TO--> [?] Hepatic sarcoidosis\n Def: This is a syndrome involving abnormal collections of chronic inflammatory cells (granulomas) that can form as nodules in multiple organs, of the liver....", "[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--> [DB99.0] Chronic 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 --PARENT--> [?] Diseases of liver" ]
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
A 22‐year‐old Hispanic female patient with a known diagnosis of systemic lupus erythematosus (SLE) presented to the emergency room complaining of headache, chest pain, muscle pain, and joint pain. SLE was diagnosed roughly 2 years prior, crescentic lupus nephritis type IV biopsy confirmed 5 weeks prior to current presentation. On admission, patient’s renal function was at her baseline and did not fluctuate during the hospitalization course: GFR (glomerular filtration rate) 21, BUN (blood urea nitrogen) 93, and creatinine 3.4. Hemoglobin 9.3 and hematocrit 27.6 were also at her baseline and remained stable following week. Home medications for SLE were azathioprine 25 mg PO once daily, hydroxychloroquine 200 mg PO bid, mycophenolate mofetil 1500 mg PO bid, and prednisone 5 mg PO bid. Five days prior to presentation, she began to experience subjective fever, malaise, and arthralgia, myalgia followed by diffuse throbbing headache without visual deficits at that point. There were no seizures or other neurological deficits. On arrival to the Emergency Department, her chief complaint was severe headache and 1 day of right eye blurry vision. Blood pressure was severely elevated at 197/121. Antihypertensive medications Lasix 80 PO BID, Carvedilol 12.5 PO BID, and Isosorbide Mononitrate 30 PO every morning initiated immediately in the Emergency Department. At that time, CT head without contrast showed no acute findings. Lupus flare was suspected, high dose of Prednisone 50 mg PO daily (in contrast to home dose of Prednisone 5 mg PO daily) was started, and home doses of mycophenolate mofetil and hydroxychloroquine were continued since the admission. Clonidine 0.1 mg q6hr was used for treatment only for the first 2 days. Blood pressure remained high 181/99 mm Hg during the day 1 and 188/116 mm Hg during the day 2. The patient was subsequently worked up for chest pain with elevated Troponin I. VQ scan suggested low probability for pulmonary embolism. Soon after, the patient was thought to have myocardial injury and/or demand ischemia in light of SLE‐associated vasculitis, pericarditis, myocarditis, etc On day 2, neurology was consulted for headache and rapid onset right eye blindness. On examination, closing of the right eye demonstrated 20/25 vision in left eye. However, closing of the left eye resulted in severely decreased visual acuity of the right eye to 20/200. On further examination, despite patient was oriented to time, place, person and situtaion, she appeared drowsy and incoherent on open‐ended question, and there was no active hallucination. Cranial nerve examination beside the vision remained intact; pupils were equal and briskly reactive. Motor examination was nonfocal showing strength of 5 out of 5 at that time. There was no bowel and bladder issue. On day 3, three MRI FLAIR (fluid‐attenuated inversion recovery) sequence demonstrated hyperintensity of this patient’s midbrain and thalami sparing the red nuclei . There was no occipital white matter involvement. With adding nifedipine on day 3 of hospitalization, blood pressure decreased to 160/99 of mm Hg. On day 4, patient began to experience lower extremity weakness with motor strength of 4/5 and ataxic gait without any changes in the reflex (she was never hyperreflexic). She has repeatedly refused spinal fluid analysis. Her blood pressure was 155/100 mm Hg by day 5. All her neurological symptoms were self‐limited and began to improve by day 6. Aggressive blood pressure treatment has brought the BP back down to range SBP (systolic blood pressure) 130‐135 mm Hg and DBP (diastolic blood pressure) 70‐80 mm Hg by day 7. Her eventual discharge blood pressure was 123/78 mm Hg. By day 10 of admission (7 days after original study), MRI FLAIR showed near complete resolution of the midbrain hyperintensity when compared to prior imaging . By then, her neurological symptoms had resolved. SLE serum laboratory results demonstrated C3 and C4 levels were low, 34 mg/dL and <5 mg/dL, respectively. ANA was positive; anti‐dsDNA was positive; and dsDNA QN was elevated at 48 IU/mL. Chromatin was positive, and chromatin QN was elevated at >8 AI. B2Glycoprotein 1 IgM and IgG Ab were normal range, 0 and 2, respectively. Anti‐U1 RNP, anti‐Smith, anti‐Jo‐1, centromere Ab, ribosomal P, anti‐Scl‐70, anti‐SS‐A, and anti‐SS‐B were all negative. Resolution of the patient’s symptoms coincided with MRI improvement and blood pressure control before plasma exchange therapy was concluded. On day 9, TPE (Therapeutic Plasma Exchange), which has never used before, was added by treating rheumatologist to manage SLE acute exacerbation. One of the published studies has concluded that despite long‐term treatment with immunosuppressive medications, some patients still progress to complications and TPE was an effective management with successful outcomes. 10
3.902344
0.97998
sec[1]/p[0]
en
0.999997
31360498
https://doi.org/10.1002/ccr3.2245
[ "blood", "pressure", "anti", "headache", "pain", "that", "lupus", "emergency", "remained", "home" ]
[ { "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": "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" }, { "code": "BA2Z", "title": "Hypotension, 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 [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 [BA2Z] Hypotension, unspecified Also known as: Hypotension, unspecified | hypopiesis | low blood pressure | arterial hypotension NOS | decreased blood pressure === 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.... --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--> [MF50.41] Microscopic 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--> [MA12.0] 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--> [?] 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 --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--> [MF50.41] Microscopic 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--> [MA12.0] 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
She was 147.1 cm tall, weighed 47.5 kg, body mass index was 22.0 kg/m 2 , body temperature was 36.6 °C, blood pressure was 105/72 mmHg, and pulse was 72 beats/minute and regular. She showed no mental retardation, and no pigmentation on her skin and oral mucosa. Her cardiopulmonary examination was normal. She had no abnormal abdominal and neurological findings or skeletal abnormalities. Soft NFomas of various sizes were scattered all over her body, and relatively large masses approximately 4 cm in diameter were present on the surface of her right forearm and left upper arm . Her eldest daughter has also been diagnosed as having NF1. She was a caregiver; our patient drank alcohol occasionally but did not smoke tobacco. Her serum levels of inorganic phosphorus (IP), 25(OH)D 3 , and maximum transport of phosphorus in the renal proximal tubules (TmP/GFR) were inappropriately low (Table 1 ). Serum alkaline phosphatase (ALP), intact parathyroid hormone (intact PTH), bone-specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5b (TRACP 5b), and undercarboxylated osteocalcin (ucOC) levels were all elevated. Her serum level of FGF23 was high. The results of total blood cell count and other biochemical parameters were almost within normal limits (Table 1 ). BMD using dual-energy X-ray absorptiometry of the second to fourth lumbar vertebrae (L2–4, total) and left femoral neck were 0.764 g/cm 2 and 0.504 g/cm 2 , with a young adult mean (YAM) of 64% and 54%, respectively. Computed tomography displayed no space occupying lesions other than NFomas on the body surface. Multiple areas of abnormal tracer uptake were seen in her rib on 99 technetium (Tc)-methylene diphosphonate bone (MDPB) scintigraphy. Slight abnormal accumulation of tracers was observed in the NFomas located on the surface of her right forearm and left upper arm on 111 indium-pentetreotide scintigraphy (Octreoscan) . She did not agree with venous sampling because of difficulty in maintaining her supine position for prolonged periods because of systemic pain. Since she strongly desired resection of the NFomas on her right forearm and left upper arm, we respected her wish and excised them in February 2018. Pathology evaluation demonstrated benign NFomas. Unfortunately, there was no improvement in serum IP levels after surgery. Therefore, we administered eldecalcitol (active vitamin D 3 analogue) 0.75 μg per day, which also failed to produce improvement in hypophosphatemia and other abnormal data. Subsequent combination with dibasic calcium phosphate hydrate (3.0 g/day) led to improvement in some of the abnormalities, including hypophosphatemia: IP, 3.1 mg/dL (2.7–4.6); ALP, 209 U/L (106–322); intact PTH, 46 pg/mL (10–65); BAP, 12.4 μg/L (3.8–22.6); and TRACP-5b, 309 mU/dL (120–420) (data not shown). After 6 months, serum calcium, IP, intact PTH, and BAP were 9.1 mg/dL, 3.6 mg/dL, 37 pg/mL, and 14.4 μg/L, respectively, and were stable in the normal range. Furthermore, pain also improved. Fig. 1 Photograph of the patient’s neurofibromas. Two neurofibromas were present: one on the surface of her right forearm ( a ) and one on the surface of her left upper arm ( b ) Table 1 Laboratory findings Inspection Item Reference range Urine analysis Protein (−) Glucose (−) Occult blood (−) Urine biochemistry TmP/GFR 1.77 22–40 Peripheral blood WBC 3270 /μL RBC 409 × 10 4 /μL Hb 11.5 g/dL PLT 24.6 × 10 4 /μL Biochemistry AST 14 IU/L ALT 11 IU/L LDH 168 IU/L ALP 641 IU/L 106–322 γ-GTP 26 IU/L T. Bil 0.95 mg/dL Alb 4.24 g/dL Na 144 mmol/L K 3.4 mmol/L 3.6–4.8 Cl 106 mmol/L Ca 8.8 mg/dL IP 1.9 mg/dL 2.7–4.6 Mg 2.0 mg/dL BUN 12.1 mg/dL Cr 0.51 mg/dL eGFR 90.4 mL/minute/1.73m 2 FBG 97 mg/dL HbA 1c 5.2 % Endocrinology Intact PTH 123 pg/mL 10–65 25(OH)D 3 14.0 ng/mL 20–60 1α25(OH)2D 3 57.2 pg/mL 20–60 FGF23 57.0 pg/mL < 30 BAP 55.1 μg/L 3.8–22.6 TRACP 5b 996 mU/dL 120–420 ucOC 19.0 ng/mL < 4.5 Alb albumin, ALP alkaline phosphatase, ALP alkaline phosphatase, ALT alanine aminotransferase, AST aspartate aminotransferase, BAP bone-specific alkaline phosphatase, BUN blood urea nitrogen, Cr creatinine, eGFR estimated glomerular filtration rate, FBG fasting blood glucose, FGF23 fibroblast growth factor 23, γ-GTP γ-glutamyltransferase, Hb hemoglobin, HbA 1c glycosylated hemoglobin, IP inorganic phosphorus, LDH lactate dehydrogenase, PLT platelets, PTH parathyroid hormone, RBC red blood cells, T . Bil total bilirubin, TmP/GFR maximum transport of phosphate in the renal proximal tubules, TRACP 5b tartrate-resistant acid phosphatase 5b, ucOC undercarboxylated osteocalcin, WBC white blood cells, 1α25(OH)2D3 1α25-dihydroxyvitamin D 3 , 25(OH)D 3 25-hydroxyvitamin D 3 Fig. 2 Octreoscan images. The arrow heads indicate light uptake into neurofibromas located on the surface of her right forearm and left upper arm. Lt . left, Rt . right
4.046875
0.970703
sec[1]/p[1]
en
0.999996
32384911
https://doi.org/10.1186/s13256-020-02381-1
[ "blood", "phosphatase", "surface", "nfomas", "forearm", "serum", "alkaline", "intact", "body", "tracp" ]
[ { "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": "5C64.3", "title": "Disorders of phosphorus metabolism or phosphatases" }, { "code": "MA10.1", "title": "Abnormal levels of other specified serum enzymes" }, { "code": "5C53.02", "title": "Pyruvate dehydrogenase complex deficiency" }, { "code": "5C51.3", "title": "Glycogen storage disease" }, { "code": "5C50.6", "title": "Disorders of serine metabolism" } ]
=== 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 [5C64.3] Disorders of phosphorus metabolism or phosphatases Definition: Any condition caused by errors in phosphorus metabolism, or in phosphatase activity. Also known as: Disorders of phosphorus metabolism or phosphatases | disorders of phosphorus metabolism | Hypophosphatasia | Rathbun syndrome | Congenital hypophosphatasia Includes: Hypophosphatasia Excludes: Adult osteomalacia | Osteoporosis [MA10.1] Abnormal levels of other specified serum enzymes Also known as: Abnormal levels of other specified serum enzymes | Abnormal level of acid phosphatase | abnormal serum level of acid phosphatase | Abnormal level of alkaline phosphatase | abnormal serum level of alkaline phosphatase [5C53.02] Pyruvate dehydrogenase complex deficiency Definition: Pyruvate dehydrogenase deficiency (PDHD) is a rare neurometabolic disorder characterised by a wide range of clinical signs with metabolic and neurological components of varying severity. Manifestations range from often fatal, severe, neonatal to later-onset neurological disorders. Also known as: Pyruvate dehydrogenase complex deficiency | Ataxia with lactic acidosis | PDC - [Pyruvate dehydrogenase complex] deficiency | pyruvate dehydrogenase deficiency | ataxia with lactic acidosis 1 [5C51.3] Glycogen storage disease Definition: The term Glycogen storage disease characterises a group of heterogeneous diseases resulting from defects in the process of glycogen synthesis or breakdown within muscles, liver, and other cell types. Also known as: Glycogen storage disease | Glycogenosis | GSD - [Glycogen storage disease] | glycogen thesaurismosis | diffuse glycogenosis Includes: Glycogen storage disease due to LAMP-2 deficiency | Glycogen storage disease due to glycogen debranching enzyme deficiency | Glycogen storage disease due to muscle glycogen phosphorylase deficiency [5C50.6] Disorders of serine metabolism Also known as: Disorders of serine metabolism | 3-phosphoglycerate dehydrogenase deficiency | 3-phosphoserine phosphatase deficiency | Phosphoserine aminotransferase deficiency | Neurometabolic disorder due to serine deficiency === 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--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or 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.... --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 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--> [MA12.0] Finding of opiate drug 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 --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 --RELATED_TO--> [?] Symptoms, signs or clinical findings of 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 --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....", "[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--> [MA12.0] Finding of opiate drug 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 --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
Our patient is a 2-year-old Middle Eastern boy, weighing 12 kg below fifth centile, height 88 cm at the tenth centile, with bicuspid aortic valve (BAV) coarctation of the aorta, a large inlet ventricular septal defect (VSD) and subaortic membrane with mild left ventricular outflow tract obstruction. He was the product of a consanguineous marriage and there is no history of congenital heart disease in the family. He underwent aortic arch repair and pulmonary artery (PA) banding at 10 days of life. After that he was on regular follow up at our center. He was started on antifailure medication and was referred for complete repair of VSD closure and PA debanding as he was not gaining weight. He was developmentally normal and no other noncardiac comorbidity was identified. The surgery was performed successfully and postoperative transesophageal echocardiography (TEE) showed no residual lesions. On day 5 postoperatively, he developed lethargy, fever, and sternal wound discharge. He had a temperature of 39 °C and tachycardia with heart rate of 140 beats per minute. He showed leukocytosis with a total white blood cell count of 16 × 109/L and raised acute phase reactants. Our patient had methicillin-resistant Staphylococcus aureus (MRSA) growth confirmed by two blood and wound cultures which showed sensitivity to vancomycin and meropenem. He was treated with intravenously administered antibiotics (meropenem and vancomycin). The rest of laboratory parameters including renal, liver, and urine analyses were normal. Repeat blood cultures at 3 weeks of treatment were still positive for MRSA. Rifampicin was added. His follow-up echocardiography at 3-weeks postoperatively, while still on antibiotics, revealed a large pseudoaneurysm arising from the anterior wall of his ascending aorta (AsAo). “Smoky” blood flow into the aneurysm cavity was seen, but no thrombi or vegetation was detected. These findings were confirmed on computed tomography (CT) angiogram, which showed a pseudoaneurysm arising from the anterior wall of the AsAo. The lesion was 4.5 × 4.0 × 3.5 cm in size and had a 10–11 mm neck. It extended to the right and superiorly, causing rightward deviation of his superior vena cava and innominate vein . He was immediately sent to the operating theater. Surface cooling was started early while exposing his right femoral vessels. A 3.5 mm Gore-Tex tube was anastomosed to the side of his proximal right common femoral artery using a 7/0 polypropylene stitch. After heparin was given, a 10 Fr arterial cannula was inserted into the Gore-Tex tube, and was fixed. When his core temperature reached 28 °C, the lower part of his sternum was opened and his right atrium was cannulated with a 24 Fr metal-tip cannula. A cardiopulmonary bypass was started with a full flow of 120 ml/kg, and cooling was continued on bypass until a core temperature of 20 °C was reached. His head was additionally cooled with ice packs. The dissection was then continued. When the upper part of his sternum was reached, the sac of the false aneurysm was opened. His heart was fibrillating at this point. Very low flow was used to improve exposure. A 1 × 1 cm hole at the site of the previous aortic cannulation was found. The edges of the hole and the surrounding tissue appeared infected and friable. Cultures were taken. A cross-clamp was then applied to his AsAo distal to the hole. No cardioplegia was used. A bovine pericardial patch was used to repair the ascending aortic wall. Because of tissue friability, the patch was sutured away from the edges using 7/0 polypropylene mattress continuous stitches. This was further reinforced by an outer 6/0 polypropylene stitch. BioGlue was applied over the patch. After rewarming, the cardiopulmonary bypass was weaned off easily. The femoral arterial line was removed and the Gore-Tex tube was cut short and clipped. The cross-clamp time was 28 minutes, and bypass time was 111 minutes. Fig. 1 Transthoracic echocardiography, suprasternal view, revealing a huge pseudoaneurysm arising from the anterior wall of the ascending aorta. AAO ascending aorta Fig. 2 Computed tomography angiogram (colored) which shows a pseudoaneurysm arising from the anterior wall of the ascending aorta (arrow). Dimensions were 4.5 × 4.0 × 3.5 cm with a 10–11 mm neck. The aneurysm extended to the right and superiorly causing rightward deviation of the superior vena cava and innominate vein. AAo ascending aorta, LA left atrium, RPA right pulmonary artery Fig. 3 Computed tomography angiogram which shows a pseudoaneurysm arising from the anterior wall of the ascending aorta. Dimensions were 4.5 × 4.0 × 3.5 cm with a 10–11 mm neck. The aneurysm extended to the right and superiorly causing rightward deviation of the superior vena cava and innominate vein AAO ascending aorta, LA left atrium, RPA right pulmonary artery
3.923828
0.981445
sec[1]/p[0]
en
0.999996
29661244
https://doi.org/10.1186/s13256-018-1625-z
[ "aorta", "ascending", "wall", "pseudoaneurysm", "arising", "aortic", "artery", "blood", "which", "aneurysm" ]
[ { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "LA8A.3", "title": "Congenital supravalvar aortic stenosis" }, { "code": "BD40.1", "title": "Atherosclerosis of aorta" }, { "code": "BB71.Z", "title": "Aortic valve insufficiency, unspecified" }, { "code": "LA8B.2Y", "title": "Other specified congenital anomaly of aorta or its branches" }, { "code": "8C01.0", "title": "Acute inflammatory demyelinating polyneuropathy" }, { "code": "8A40.Z", "title": "Multiple sclerosis, unspecified" }, { "code": "ND56.4", "title": "Injury of nerve of unspecified body region" }, { "code": "LB0Y", "title": "Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord" }, { "code": "PA82", "title": "Unintentional striking against stationary object" } ]
=== ICD-11 CODES FOUND === [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 [LA8A.3] Congenital supravalvar aortic stenosis Definition: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalvar aortic stenosis' is described as three forms: an hourglass deformity, a fibrous membrane, and a diffuse narrowing of the ascending aorta. Supravalvar aortic stenosis may involve the coronary artery ostia, and the aortic leaflets may be tethered. The coronary arteries can become tortuous and dilate Also known as: Congenital supravalvar aortic stenosis | stenosis of aorta | supravalvular aortic stenosis | stricture of aorta | congenital narrowed aorta Excludes: Congenital aortic valvar stenosis [BD40.1] Atherosclerosis of aorta Also known as: Atherosclerosis of aorta | aorta atheroma | aorta calcification | aorta arteriosclerosis | aortic degeneration [BB71.Z] Aortic valve insufficiency, unspecified Also known as: Aortic valve insufficiency, unspecified | Aortic valve insufficiency | aortic insufficiency | aortic valve incompetency | AI - [aortic incompetence] [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 [8C01.0] Acute inflammatory demyelinating polyneuropathy Definition: Progressive weakness of the limbs over a few days to 28 days, symmetrical deficit, areflexia, absent or mild sensory disturbance, elevated cerebrospinal fluid protein, and slowing of nerve conduction velocities are the cardinal features. The disorder may be preceded by upper respiratory or gastrointestinal infection or immunization 1 to 4 weeks prior to onset of the illness. Bifacial palsy may be present. Also known as: Acute inflammatory demyelinating polyneuropathy | Guillain-Barré syndrome | Guillain Barre syndrome | Acute Inflammatory Demyelinating Polyradiculoneuropathy | acute ascending paralysis Includes: Acute Inflammatory Demyelinating Polyradiculoneuropathy [8A40.Z] Multiple sclerosis, unspecified Also known as: Multiple sclerosis, unspecified | Multiple sclerosis | cerebrospinal sclerosis | disseminated sclerosis | generalised multiple sclerosis [ND56.4] Injury of nerve of unspecified body region Also known as: Injury of nerve of unspecified body region | injuries to nerves, nerve plexuses and roots | injury to nerves, unspecified site | nerve damage NOS | Injury of nerve NOS Excludes: multiple injuries of nerves NOS [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 === GRAPH WALKS === --- Walk 1 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --CHILD--> [BD30] Acute arterial occlusion --- Walk 2 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --CHILD--> [BD50] Aortic aneurysm or dissection Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ... --- Walk 3 --- [LA8A.3] Congenital supravalvar aortic stenosis Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalva... --PARENT--> [LA8A] Congenital anomaly of a ventriculo-arterial valve or adjacent regions Def: A congenital cardiovascular malformation of a ventriculo-arterial valve or its immediate subvalvar and supravalvar regions.... --CHILD--> [LA8A.2] Congenital anomaly of aortic valve Def: A congenital cardiovascular malformation where the aortic valve is abnormal.... --- Walk 4 --- [LA8A.3] Congenital supravalvar aortic stenosis Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalva... --EXCLUDES--> [?] Congenital aortic valvar stenosis Def: A congenital cardiovascular malformation of the aortic valve in which there is narrowing or stricture (obstruction to flow). Additional information: 'Congenital aortic valvar stenosis' arises most co... --EXCLUDES--> [?] Congenital subaortic stenosis --- Walk 5 --- [BD40.1] Atherosclerosis of aorta --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease --EXCLUDES--> [?] Chronic vascular disorders of intestine --- Walk 6 --- [BD40.1] Atherosclerosis of aorta --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease --PARENT--> [?] Chronic arterial occlusive disease
[ "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [BD30] Acute arterial occlusion", "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [BD50] Aortic aneurysm or dissection\n Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ...", "[LA8A.3] Congenital supravalvar aortic stenosis\n Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta.\n\nAdditional information: 'Congenital supravalva...\n --PARENT--> [LA8A] Congenital anomaly of a ventriculo-arterial valve or adjacent regions\n Def: A congenital cardiovascular malformation of a ventriculo-arterial valve or its immediate subvalvar and supravalvar regions....\n --CHILD--> [LA8A.2] Congenital anomaly of aortic valve\n Def: A congenital cardiovascular malformation where the aortic valve is abnormal....", "[LA8A.3] Congenital supravalvar aortic stenosis\n Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta.\n\nAdditional information: 'Congenital supravalva...\n --EXCLUDES--> [?] Congenital aortic valvar stenosis\n Def: A congenital cardiovascular malformation of the aortic valve in which there is narrowing or stricture (obstruction to flow).\n\nAdditional information: 'Congenital aortic valvar stenosis' arises most co...\n --EXCLUDES--> [?] Congenital subaortic stenosis", "[BD40.1] Atherosclerosis of aorta\n --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease\n --EXCLUDES--> [?] Chronic vascular disorders of intestine", "[BD40.1] Atherosclerosis of aorta\n --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease\n --PARENT--> [?] Chronic arterial occlusive disease" ]
BD5Z
Diseases of arteries or arterioles, unspecified
[ { "from_icd11": "BD5Z", "icd10_code": "I7389", "icd10_title": "Other specified peripheral vascular diseases" }, { "from_icd11": "BD5Z", "icd10_code": "I7419", "icd10_title": "Embolism and thrombosis of other parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7411", "icd10_title": "Embolism and thrombosis of thoracic aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7410", "icd10_title": "Embolism and thrombosis of unspecified parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7381", "icd10_title": "Erythromelalgia" }, { "from_icd11": "BD5Z", "icd10_code": "I745", "icd10_title": "Embolism and thrombosis of iliac artery" }, { "from_icd11": "BD5Z", "icd10_code": "I789", "icd10_title": "Disease of capillaries, unspecified" }, { "from_icd11": "BD5Z", "icd10_code": "I748", "icd10_title": "Embolism and thrombosis of other arteries" }, { "from_icd11": "BD5Z", "icd10_code": "I749", "icd10_title": "Embolism and thrombosis of unspecified artery" }, { "from_icd11": "BD5Z", "icd10_code": "I781", "icd10_title": "Nevus, non-neoplastic" }, { "from_icd11": "BD5Z", "icd10_code": "I788", "icd10_title": "Other diseases of capillaries" }, { "from_icd11": "BD5Z", "icd10_code": "I744", "icd10_title": "Embolism and thrombosis of arteries of extremities, unspecified" }, { "from_icd11": "BD5Z", "icd10_code": "I70-I79", "icd10_title": "" }, { "from_icd11": "BD5Z", "icd10_code": "I74", "icd10_title": "Arterial embolism and thrombosis" }, { "from_icd11": "BD5Z", "icd10_code": "I73", "icd10_title": "Other peripheral vascular diseases" } ]
I7389
Other specified peripheral vascular diseases
Several CAS steps need clarification. First, the high-grade, flow-limiting stenosis of the patient was an indication for revascularization despite lack of symptoms. However, the very late presentation after index CAS (4 years) may raise suspicions of plaque atherosclerotic changes, called “neo-atherosclerosis,” which have been shown to play a role in late stent thrombosis or distal embolization in coronary and carotid arteries ( 1 – 3 ). These changes can be better assessed by imaging techniques, such as IVUS and/or optical coherence tomography (OCT), rather than by standard angiography. The initial IVUS run actually confirmed the severe restenosis pattern with a heterogeneous, fragmented plaque. While no specific strategy has been settled on in these cases, the use of brain protection is highly recommended. Since we systematically use distal filters during CISR treatment, one may wonder if proximal protection (i.e., Mo.MA Ultra system) would be a better choice. However, crossing of the stent struts with the Mo. MA distal channel to enter ECA may be difficult or even unsafe. The alternative is to occlude the CCA with a balloon-tipped catheter (or with the Mo.Ma Ultra mono-balloon system) while maintaining the distal filter. The limitation of this approach is the patient widely patent ECA that would maintain a brisk flow to the target ICA, hampering the protective effect of CCA occlusion ( 4 ). Second, target ICA in-stent occlusion after predilation is a rare event. Potential causes include thrombosis, plaque dissection with occlusive flap, or a filter obstructed by embolization of a large amount of debris. While stent thrombosis was excluded by an ACT level >300 s, the site of occlusion (at the proximal stent tract) suggested an occlusive flap. Distal embolization could not be assessed due to the lack of flow. Whatever the cause is, aspiration with a catheter (at least 6F in size) is the first thing to do. The post-aspiration contrast injection was kept long enough to opacify the entire vessel length. A good stent patency was documented with a slow flow and a “minus” defect close to the filter, making distal embolization entrapped into/around the filter basket as the most likely occurrence. Because a further filter aspiration could increase the risk of debris dislodgment, we decided to proceed with DCB inflation. Third, while DCB has been shown to be a valid alternative over POBA or re-stent in CISR ( 5 – 7 ), the limitation is a suboptimal angiographic result requiring “bailout stenting.” Whether a stent placement would have been a better choice for plaque containment in this case is a matter of discussion. However, plaque prolapse has been reported to occur even after CISR re-stenting by OCT ( 2 ). Thus, if required, positioning of a double-layer stent might be the right choice ( 8 ). In this case, both the angiographic and IVUS final assessment showed a wide patent lumen with brisk blood flow and no dissection allowing distal filter remouval (no debris found inside). Fourth, in the case of large-vessel occlusion—such as MCA M1 tract—mechanical thrombectomy is the recommended reperfusion therapy ( 9 ). Unfortunately, no stent retriever was available in our cath lab at that time, and the maneuvers aiming to aspirate/remove the thrombus failed. So, being already in place with the guiding catheter, a third-generation drug-eluting stent (DES) was deployed (as a bailout) with prompt reperfusion and patient neurological improvement. While the use of DES for intracranial atherosclerosis has been reported with good success rates, acceptable complication rates, and minimal ISR rates, no indication exists for periprocedural stroke treatment ( 10 ). Fifth, the smooth, tapering reduction of distal ICA diameter with tiny contrast extravasation suggested a dissection with intramural hematoma-induced lumen compression. This complication was likely due to traumatic arterial wall damage during the passage of the several catheters and the open filter retrieval. Imaging with IVUS confirmed the diagnosis, identified the length of the hematoma allowing us to select the proper stent size and length. Stent post-dilation should be avoided for the risk of hematoma shift outside the stent covered tract. Sixth, Doppler US and CT angiography are the best non-invasive methods to check stent patency over time. The long-term patency of the intracranial DES by CT angiography is greatly hampered by the stent “blooming effect” that makes both MLA and stent diameter determination misleading. Transcranial Doppler is a valuable diagnostic tool that may help in these cases by measuring target vessel PSV MCA velocity that is consistent with <50% restenosis (79 cm/s, <100 cm/s ISR <50%) ( 11 ). Moreover, no different middle cerebral artery vasomotility to physiologic stimuli was shown on both sides.
4.277344
0.522461
sec[3]/p[1]
en
0.999998
34568455
https://doi.org/10.3389/fcvm.2021.712963
[ "stent", "filter", "flow", "plaque", "while", "that", "embolization", "ivus", "this", "occlusion" ]
[ { "code": "PK93.2", "title": "Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" }, { "code": "QB51.1", "title": "Presence of urogenital implants" }, { "code": "QB51.Y", "title": "Presence of other specified devices other than cardiac or vascular implants" }, { "code": "QB51.3", "title": "Presence of otological or audiological implants" }, { "code": "PL12.3", "title": "Obstruction of device, as mode of injury or harm" }, { "code": "BE1C", "title": "Inferior caval vein obstruction due to foreign body" }, { "code": "PK91.14", "title": "Cardiovascular devices associated with injury or harm, IVC filter" }, { "code": "GA20.50", "title": "Heavy menstrual bleeding" }, { "code": "BA40.Y", "title": "Other specified angina pectoris" }, { "code": "LA8B.Y", "title": "Other specified congenital anomaly of great arteries including arterial duct" } ]
=== ICD-11 CODES FOUND === [PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Also known as: Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Surgical operation with implant of artificial internal gastroenterology or urology device associated with abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure | Surgical operation with gastroenterological or urological bypass or graft associated with abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure | Gastroenterology or urology devices associated with injury or harm, urethral or ureteral stents | Incrustation or calcification of indwelling ureteral stents Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [QB51.1] Presence of urogenital implants Also known as: Presence of urogenital implants | Presence of bladder implant | bladder replaced by other means | replacement of bladder by artificial or mechanical device or prosthesis | Presence of urethral stent [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 [QB51.3] Presence of otological or audiological implants Also known as: Presence of otological or audiological implants | presence of audiological implant | presence of hearing device implant | presence of hearing-aid implant | presence of otological implant [PL12.3] Obstruction of device, as mode of injury or harm Definition: Obstruction associated with prosthetic devices, grafts or implants Also known as: Obstruction of device, as mode of injury or harm | occlusion shunt | blockage of device causing obstruction as mode of injury | blocked tube causing obstruction as mode of injury | occlusion of device causing obstruction as mode of injury Excludes: Obstruction of device without injury or harm [BE1C] Inferior caval vein obstruction due to foreign body Definition: A postnatal pathologic condition of the inferior caval vein (inferior vena cava) in which flow is impeded or blocked by a foreign body. Also known as: Inferior caval vein obstruction due to foreign body | Acquired IVC obstruction due to foreign body | Acquired inferior vena cava obstruction due to foreign body | inferior vena cava obstruction due to blocked vena cava filter [PK91.14] Cardiovascular devices associated with injury or harm, IVC filter Also known as: Cardiovascular devices associated with injury or harm, IVC filter | infection or inflammation of vena cava device Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [GA20.50] Heavy menstrual bleeding Definition: Menstruation with heavy (> 80 ml) volume of monthly blood loss Also known as: Heavy menstrual bleeding | menstruation excessive | Heavy menstrual bleeding caused by bleeding disorders | Excessive menstruation with regular cycle | excessive menses [BA40.Y] Other specified angina pectoris Also known as: Other specified angina pectoris | Atypical angina | Angina of effort | angina pectoris of effort | Coronary slow flow syndrome [LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct Also known as: Other specified congenital anomaly of great arteries including arterial duct | Congenital arterial duct anomaly | Congenital ductus arteriosus anomaly | ductus arteriosus deformity | Ductus arteriosus agenesis === GRAPH WALKS === --- Walk 1 --- [PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm --CHILD--> [?] Functional device failure without injury or harm Def: A device not working or operating correctly, or that has stopped functioning after a period of function, but without documented injury or harm to the patient.... --- Walk 2 --- [PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm --CHILD--> [?] Dislodgement, misconnection or de-attachment of a surgical or medical device without injury or harm Def: A device that has moved out of place, become disconnected, loosened or unstable, but without documented injury or harm.... --- Walk 3 --- [QB51.1] Presence of urogenital implants --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants --CHILD--> [QB51.1] Presence of urogenital implants --- Walk 4 --- [QB51.1] Presence of urogenital implants --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants --PARENT--> [?] Presence of device, implants or grafts --- Walk 5 --- [QB51.Y] Presence of other specified devices other than cardiac or vascular implants --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants --EXCLUDES--> [?] Fitting, adjustment or management of devices --- Walk 6 --- [QB51.Y] Presence of other specified devices other than cardiac or vascular implants --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants --CHILD--> [QB51.2] Presence of intraocular lens
[ "[PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --CHILD--> [?] Functional device failure without injury or harm\n Def: A device not working or operating correctly, or that has stopped functioning after a period of function, but without documented injury or harm to the patient....", "[PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --CHILD--> [?] Dislodgement, misconnection or de-attachment of a surgical or medical device without injury or harm\n Def: A device that has moved out of place, become disconnected, loosened or unstable, but without documented injury or harm....", "[QB51.1] Presence of urogenital implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --CHILD--> [QB51.1] Presence of urogenital implants", "[QB51.1] Presence of urogenital implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --PARENT--> [?] Presence of device, implants or grafts", "[QB51.Y] Presence of other specified devices other than cardiac or vascular implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --EXCLUDES--> [?] Fitting, adjustment or management of devices", "[QB51.Y] Presence of other specified devices other than cardiac or vascular implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --CHILD--> [QB51.2] Presence of intraocular lens" ]
PK93.2
Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices
[ { "from_icd11": "PK93.2", "icd10_code": "T83711A", "icd10_title": "Erosion of implanted vaginal mesh to surrounding organ or tissue, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83718A", "icd10_title": "Erosion of other implanted mesh to organ or tissue, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83728A", "icd10_title": "Exposure of other implanted mesh into organ or tissue, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83719A", "icd10_title": "Erosion of other prosthetic materials to surrounding organ or tissue, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83718S", "icd10_title": "Erosion of other implanted mesh to organ or tissue, sequela" }, { "from_icd11": "PK93.2", "icd10_code": "T83712A", "icd10_title": "Erosion of implanted urethral mesh to surrounding organ or tissue, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83721A", "icd10_title": "Exposure of implanted vaginal mesh into vagina, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T85590A", "icd10_title": "Other mechanical complication of bile duct prosthesis, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83490A", "icd10_title": "Other mechanical complication of implanted penile prosthesis, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T85598A", "icd10_title": "Other mechanical complication of other gastrointestinal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T85528A", "icd10_title": "Displacement of other gastrointestinal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T85520A", "icd10_title": "Displacement of bile duct prosthesis, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83193A", "icd10_title": "Other mechanical complication of other urinary stent, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83123A", "icd10_title": "Displacement of other urinary stents, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83111A", "icd10_title": "Breakdown (mechanical) of implanted urinary sphincter, initial encounter" } ]
T83711A
Erosion of implanted vaginal mesh to surrounding organ or tissue, initial encounter
An 84-year-old woman presented to our hospital with complaints of a 1-week history of abdominal pain and appetite loss. The patient had no history of cough, sputum, fever, chills, weight loss, or night sweats. She had no history of tobacco smoking, tuberculosis or exposure to individuals with tuberculosis. She did not have a history of malignancy, diabetes mellitus, cytotoxic therapy or corticosteroid use. Her family history was unremarkable. Physical examination revealed a heart rate of 90 beats/min, blood pressure of 157/76 mmHg, respiratory rate of 24 breaths/min, temperature of 37.8 °C and oxygen saturation of 98% on room air. Respiratory, cardiac and abdominal examination were unremarkable. Chest radiograph showed multiple small nodules in both lung fields and chest computed tomography (CT) showed diffuse micronodules in random patterns in both lung lobes, cardiomegaly and bilateral pleural effusion . White blood cell count, C-reactive protein and procalcitonin levels were 2800 /μl, 7.50 mg/dl (normal range 0.00–0.10 mg/dl) and 0.373 ng/ml (normal range 0.000–0.046 ng/ml), respectively. Serum carcinoembryonic antigen, carbohydrate antigen 19–9 and soluble IL-2 receptor were elevated at 9.4 ng/ml (normal range 0.0–5.0 ng/ml), 188.4 U/ml (normal range 0.0–37.0 U/ml) and 6163 U/ml (normal range 0–500 U/ml), respectively. Angiotensin-converting enzyme, mycoplasma antibody and blood sugar were within normal ranges. Serum QuantiFERON testing was positive. CD4/8 ratio, CD4 count and CD8 count were 1.73 (normal range 0.6–2.9), 422 /μl and 244 /μl , respectively. IgG, IgA and IgM were 998 mg/dl , 128 mg/dl (normal range 110–410), 59 mg/dl (normal range 46–260), respectively. Testing for human immunodeficiency virus infection was negative. Expectorated sputum smears were negative for bacteria and acid-fast bacilli. Urinary antigen testing (Binax NOW; Binax, Inc., Portland, ME) for Streptococcus pneumoniae and Legionella pneumophila was negative. According to these results, we initially suspected intraabdominal malignancy including malignant lymphoma. However, abdominal CT and magnetic resonance imaging showed no abnormalities. Therefore, we suspected miliary tuberculosis or pulmonary sarcoidosis. Liver, skin and bone marrow biopsies were subsequently performed and showed epithelioid cell granuloma without caseous necrosis. Gastric aspirate smear was positive for acid-fast bacilli and polymerase chain reaction (Loopamp; Eiken Chemical Co., Ltd. Tokyo, Japan) was positive for Mycobacterium tuberculosis . Although these microbiological findings might indicate the presence of non-viable M. tuberculosis , miliary tuberculosis was suspected and antimycobacterial therapy [oral isoniazid (INH) 200 mg/day, rifampicin (RFP) 300 mg/day and ethambutol (EB) 500 mg/day] was initiated on hospital day 12. Gastric aspirate culture was positive for M. tuberculosis after 1 week of culture. After a 2-month treatment course, chest radiograph showed gradual improvement, oral EB was discontinued and the patient was discharged. Although INH and RFP therapy was continued, chest radiograph showed new multiple nodules in the right middle lung field after a 6-month treatment course. Chest CT showed that a right S6 small nodule, presumed to be miliary tuberculosis, had increased and new multiple nodules appeared in the right lower lobe . The patient’s white blood cell count and C-reactive protein at this time were 2400 /μl and 0.09 mg/dl, respectively. Flexible fiberoptic bronchoscopy was subsequently perfomed. Microbiological testing of bronchial lavage fluids did not reveal any bacteria, mycobacteria or fungi. However, cytology showed a small number of Periodic acid-Schiff-positive bodies, suggesting Cryptococcus species . Moreover, serum cryptococcal antigen testing (Serodirect “EIKEN” Cryptococcus; Eiken Chemical Co., Ltd. Tokyo, Japan) was positive (×128). According to these findings, pulmonary cryptococcosis was diagnosed, although the culture was negative. Oral fluconazole (FLCZ; 300 mg/day) was subsequently initiated. After a 6-month treatment course, chest radiograph showed gradual improvement and oral FLCZ was discontinued. The patient received a total of 12 months of antimycobacterial therapy. On follow-up, she has remained asymptomatic with suspect to pulmonary disease, with no recurrence. Fig. 1 Chest radiography on admission showed diffuse micronodules in both lung field Fig. 2 Chest CT on admission showed diffuse micronodules at random pattern in both lung field and a small nodule in the right S6 (white arrow) Fig. 3 Chest CT showed that a right S6 small nodule was increased ( a ) and new multiple nodules appeared in the right lower lobe ( b ) Fig. 4 Cytology of the bronchial lavage showed small amount of body suspicious for Cryptococcus species (Periodic acid-Schiff stain, ×400)
3.984375
0.978027
sec[1]/p[0]
en
0.999997
29338706
https://doi.org/10.1186/s12890-018-0578-8
[ "chest", "tuberculosis", "range", "small", "lung", "respectively", "testing", "blood", "radiograph", "multiple" ]
[ { "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": "1B1Z", "title": "Tuberculosis, unspecified" }, { "code": "1B1Y", "title": "Other specified tuberculosis" }, { "code": "KA61.0", "title": "Congenital tuberculosis" }, { "code": "1B12.40", "title": "Tuberculosis of bones or joints" }, { "code": "1B10.Z", "title": "Respiratory tuberculosis, without mention of bacteriological or histological confirmation" } ]
=== 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 [1B1Z] Tuberculosis, unspecified Also known as: Tuberculosis, unspecified | Infections due to Mycobacterium tuberculosis and Mycobacterium bovis | TB - [tuberculosis] | Tuberculosis infection | TBC - [tuberculosis] [1B1Y] Other specified tuberculosis Also known as: Other specified tuberculosis | Disorders of kidney or ureter in tuberculosis [KA61.0] Congenital tuberculosis Definition: A disease affecting infants, caused by an infection with the bacteria Mycobacterium tuberculosis in utero. Transmission is by vertical transmission. Also known as: Congenital tuberculosis | congenital tuberculous gangrene | congenital tuberculous degeneration | congenital necrotic tuberculosis | congenital tuberculous infection [1B12.40] Tuberculosis of bones or joints Definition: A disease of the bones and joints, caused by an infection with the bacteria Mycobacterium tuberculosis. This disease commonly presents with bone pain, joint inflammation, loss of movement or feeling in the affected bone or joint, and weak bones prone to fracture. Transmission is through haematogenous spread to the bones and joints after inhalation of infected respiratory secretions. Confirmation is by identification of Mycobacterium tuberculosis in biopsy samples of the affected site. Also known as: Tuberculosis of bones or joints | tuberculous cartilage | tuberculosis of bone | tuberculosis of joint | tuberculous bone [1B10.Z] Respiratory tuberculosis, without mention of bacteriological or histological confirmation Also known as: Respiratory tuberculosis, without mention of bacteriological or histological confirmation | Tuberculosis of the respiratory system | respiratory tuberculosis | pulmonary tuberculosis | pulmonary TB === GRAPH WALKS === --- Walk 1 --- [CB7Z] Diseases of the respiratory system, unspecified --PARENT--> [12] Diseases of the respiratory 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 2 --- [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 3 --- [CB27] Pleural effusion Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.... --EXCLUDES--> [?] Chylous effusion Def: A chylothorax (chylous effusion) signifies leakage of chyle from the thoracic duct. A pleural fluid triglyceride concentration of more than 110 mg per decilitre signifies a high likelihood of chylotho... --PARENT--> [?] Other pleural conditions Def: Any other condition effecting the thin serous membrane enveloping the lungs and lining the thoracic cavity... --- Walk 4 --- [CB27] Pleural effusion Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.... --PARENT--> [?] Pleural, diaphragm or mediastinal disorders Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin... --CHILD--> [CB22] Diseases of mediastinum, not elsewhere classified Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora... --- 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... --EXCLUDES--> [?] Primary respiratory tuberculosis without mention of bacteriological or histological confirmation Def: This is a common, and in many cases lethal, infectious disease of the respiratory caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is without mention of ba... --- 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... --EXCLUDES--> [?] Primary respiratory tuberculosis without mention of bacteriological or histological confirmation Def: This is a common, and in many cases lethal, infectious disease of the respiratory caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is without mention of ba...
[ "[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory 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....", "[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....", "[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --EXCLUDES--> [?] Chylous effusion\n Def: A chylothorax (chylous effusion) signifies leakage of chyle from the thoracic duct. A pleural fluid triglyceride concentration of more than 110 mg per decilitre signifies a high likelihood of chylotho...\n --PARENT--> [?] Other pleural conditions\n Def: Any other condition effecting the thin serous membrane enveloping the lungs and lining the thoracic cavity...", "[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --PARENT--> [?] Pleural, diaphragm or mediastinal disorders\n Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin...\n --CHILD--> [CB22] Diseases of mediastinum, not elsewhere classified\n Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora...", "[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 --EXCLUDES--> [?] Primary respiratory tuberculosis without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease of the respiratory caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is without mention of ba...", "[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 --EXCLUDES--> [?] Primary respiratory tuberculosis without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease of the respiratory caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is without mention of ba..." ]
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
A 61-year-old Japanese man presented to the emergency room with hematemesis. He was unconscious due to persistent arterial hypotension. On laboratory examinations, severe anemia was detected (hemoglobin level was 5.0 g/dl). Other laboratory data revealed normal liver, biliary, and pancreatic enzymes. The levels of serum tumor markers, including carcinoembryonic antigen and carbohydrate antigen 19-9, were also within normal limits. Although he had been a habitual alcohol drinker for 40 years, he had no history of pancreatitis or episodes of recurrent abdominal pain. He had presented to another hospital with hematemesis 1 month prior to presenting to our hospital. Abdominal computed tomography (CT) at the previous hospital had revealed a low-density mass of 2.0 cm in size in the pancreatic body with dilatation of the distal main pancreatic duct and a cystic lesion in the pancreatic tail . Further investigation had been planned. Abdominal CT on admission to our hospital demonstrated a low-density mass and a pseudoaneurysm in close contact with the wall of the pseudocyst of the pancreatic tail, compressing the stomach . The pseudoaneurysm had not been detected by abdominal CT performed at the previous hospital 1 month prior. The pancreatic pseudocyst had increased to 3.8 cm in diameter. The patient was resuscitated after being given a blood transfusion. The lesion was diagnosed as a pseudoaneurysm caused by a pancreatic pseudocyst complicating obstructive pancreatitis due to pancreatic cancer. The lesion had ruptured and fistulized into the stomach. Emergency selective angiography was immediately performed. Splenic arteriography revealed that the pseudoaneurysm arose from the left gastroepiploic artery (LGEA) branching from the splenic artery . TAE of the LGEA through the splenic artery was performed. After TAE, complete embolization of the LGEA was confirmed . An upper digestive endoscopy the day after TAE revealed an extrinsic compression of the greater curvature of the gastric body with central erosion that appeared to be the fistula orifice between the stomach and the pancreatic pseudocyst . Bleeding was not observed. Under the diagnosis of pancreatic cancer associated with a ruptured pseudoaneurysm secondary to a pancreatic pseudocyst, elective distal pancreatectomy and splenectomy with regional lymph node dissection combined with partial resection of the stomach was performed 3 weeks after TAE. A firm tumor was located at the body of the pancreas, and the distal pancreas was diffusely hard, which was compatible with pancreatitis caused by obstruction of the main pancreatic duct due to pancreatic cancer. The pancreatic pseudocyst was identified as a firm mass with dense inflammation adhering between the posterior wall of the stomach and the pancreas tail. Macroscopically, the pseudocyst wall consisted of the posterior wall of the stomach and pancreas. The LGEA was located at the wall of the pancreatic pseudocyst. Pathological examination of the tumor tissue revealed a moderately differentiated tubular adenocarcinoma in the pancreatic body with regional lymph node metastasis and the LGEA rupturing into the pancreatic pseudocyst in the pancreatic tail . In the non-cancerous area of the pancreas, sparse periductal lymphocytic infiltrates and well-preserved lobular structures were observed; however, intralobular fibrosis, duct distortions, protein plugs or calculi, which are all suggestive of chronic pancreatitis, were not observed. Fig. 1 Abdominal computed tomography (CT) of the patient. a An initial abdominal CT revealed a low-density mass in the pancreatic body ( arrow ) and a cystic lesion in the pancreatic tail. b One month later, a pseudoaneurysm in close contact with the wall of pancreatic pseudocyst was clearly visualized ( arrow head ) Fig. 2 Angiography before and after embolization. a Splenic arteriography revealed that the pseudoaneurysm arose from the left gastroepiploic artery branching from the splenic artery. b The pseudoaneurysm and the left gastroepiploic artery were successfully embolized using coil embolization Fig. 3 Endoscopic findings. An upper digestive endoscopy the day after trans-arterial embolization revealed an extrinsic compression of the greater curvature in the gastric body with central erosion that appeared to be the fistula orifice between the stomach and the pancreatic pseudocyst Fig. 4 Histopathological findings. a Microscopic evaluation after hematoxylin-eosin staining of the tumor tissue revealed moderately differentiated tubular adenocarcinoma (original magnification, ×13). b Elastic Van Gieson staining revealed an artery penetrating through the wall of the pancreatic pseudocyst (original magnification, ×6). c Elastic Van Gieson staining revealed an artery rupturing into the pancreatic pseudocyst (original magnification, ×6)
3.947266
0.979004
sec[1]/p[0]
en
0.999996
26911459
https://doi.org/10.1186/s12957-016-0812-x
[ "pancreatic", "pseudocyst", "pseudoaneurysm", "artery", "wall", "stomach", "abdominal", "body", "tail", "splenic" ]
[ { "code": "DC3Z", "title": "Diseases of pancreas, unspecified" }, { "code": "DC3Y", "title": "Other specified diseases of pancreas" }, { "code": "LB21.3", "title": "Agenesis-aplasia of pancreas" }, { "code": "LB21.Z", "title": "Structural developmental anomalies of pancreas, unspecified" }, { "code": "DC35.0", "title": "Atrophy of pancreas" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "9B73.2", "title": "Retinal cysts" }, { "code": "DC30.1", "title": "Pseudocyst of pancreas" }, { "code": "3B81.5Z", "title": "Splenic cyst, unspecified" }, { "code": "3B81.50", "title": "Pseudocyst of spleen" } ]
=== ICD-11 CODES FOUND === [DC3Z] Diseases of pancreas, unspecified Also known as: Diseases of pancreas, unspecified [DC3Y] Other specified diseases of pancreas Also known as: Other specified diseases of pancreas | Calculus of pancreas | pancreas calculi | pancreas duct calculus | pancreas duct lithiasis [LB21.3] Agenesis-aplasia of pancreas Definition: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas. Also known as: Agenesis-aplasia of pancreas | Congenital absence of pancreas | Congenital pancreas absence | Congenital pancreatic absence | Absent pancreas [LB21.Z] Structural developmental anomalies of pancreas, unspecified Also known as: Structural developmental anomalies of pancreas, unspecified | Structural developmental anomalies of pancreas | malformations of pancreas | anomalies of pancreas | congenital abnormality of pancreas [DC35.0] Atrophy of pancreas Also known as: Atrophy of pancreas | pancreatic atrophy | pancreas ductal atrophy [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 [9B73.2] Retinal cysts Definition: A retinal cyst is a closed sac, having a distinct membrane and division compared to the nearby tissue in retina that can either be congenital or acquired. Also known as: Retinal cysts | Cyst of ora serrata | Parasitic cyst of retina | Pseudocyst of retina Includes: Cyst of ora serrata | Parasitic cyst of retina Excludes: congenital retinoschisis | Microcystoid degeneration of retina [DC30.1] Pseudocyst of pancreas Also known as: Pseudocyst of pancreas | pancreas pseudocyst | pancreatic pseudocyst | false cyst of pancreas | Pseudocyst of pancreas due to acute pancreatitis [3B81.5Z] Splenic cyst, unspecified Also known as: Splenic cyst, unspecified | Splenic cyst or pseudocyst [3B81.50] Pseudocyst of spleen Definition: A disease caused by determinants arising after birth, during the antenatal period or by genetically inherited factors. This disease is characterised by a noncancerous fluid-filled sac, pseudocysts are like cysts, but lack epithelial or endothelial cells. This disease is often asymptomatic but may present with abdominal pain, nausea and vomiting. Confirmation is through medical imaging. Also known as: Pseudocyst of spleen === GRAPH WALKS === --- Walk 1 --- [DC3Z] Diseases of pancreas, unspecified --PARENT--> [?] Diseases of pancreas Def: This is a group of conditions characterised as being in or associated with the pancreas.... --CHILD--> [DC30] Cystic diseases of the pancreas Def: This is a closed sac, having a distinct membrane and division compared to the nearby tissue, which may contain air, fluids, or semi-solid material, of the pancreas.... --- Walk 2 --- [DC3Z] Diseases of pancreas, unspecified --PARENT--> [?] Diseases of pancreas Def: This is a group of conditions characterised as being in or associated with the pancreas.... --CHILD--> [DC31] Acute pancreatitis Def: Inflammation of the pancreas with sudden onset. Pathological changes range from oedema to necrosis. While mild cases often recover without complications, severe cases have high mortality due to system... --- Walk 3 --- [DC3Y] Other specified diseases of pancreas --PARENT--> [?] Diseases of pancreas Def: This is a group of conditions characterised as being in or associated with the pancreas.... --CHILD--> [DC31] Acute pancreatitis Def: Inflammation of the pancreas with sudden onset. Pathological changes range from oedema to necrosis. While mild cases often recover without complications, severe cases have high mortality due to system... --- Walk 4 --- [DC3Y] Other specified diseases of pancreas --PARENT--> [?] Diseases of pancreas Def: This is a group of conditions characterised as being in or associated with the pancreas.... --CHILD--> [DC32] Chronic pancreatitis --- Walk 5 --- [LB21.3] Agenesis-aplasia of pancreas Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas.... --PARENT--> [LB21] Structural developmental anomalies of pancreas --PARENT--> [?] Structural developmental anomalies of the liver, biliary tract, pancreas or spleen Def: Any condition caused by failure of the liver, biliary tract, pancreas and spleen to correctly develop during the antenatal period.... --- Walk 6 --- [LB21.3] Agenesis-aplasia of pancreas Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas.... --PARENT--> [LB21] Structural developmental anomalies of pancreas --CHILD--> [LB21.2] Accessory pancreas Def: Accessory pancreas is an asymptomatic embryopathy characterised by the presence of pancreatic tissue in other sites of the body such as the splenic pedicle, gonadic pedicles, intestinal mesentery, duo...
[ "[DC3Z] Diseases of pancreas, unspecified\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --CHILD--> [DC30] Cystic diseases of the pancreas\n Def: This is a closed sac, having a distinct membrane and division compared to the nearby tissue, which may contain air, fluids, or semi-solid material, of the pancreas....", "[DC3Z] Diseases of pancreas, unspecified\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --CHILD--> [DC31] Acute pancreatitis\n Def: Inflammation of the pancreas with sudden onset. Pathological changes range from oedema to necrosis. While mild cases often recover without complications, severe cases have high mortality due to system...", "[DC3Y] Other specified diseases of pancreas\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --CHILD--> [DC31] Acute pancreatitis\n Def: Inflammation of the pancreas with sudden onset. Pathological changes range from oedema to necrosis. While mild cases often recover without complications, severe cases have high mortality due to system...", "[DC3Y] Other specified diseases of pancreas\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --CHILD--> [DC32] Chronic pancreatitis", "[LB21.3] Agenesis-aplasia of pancreas\n Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas....\n --PARENT--> [LB21] Structural developmental anomalies of pancreas\n --PARENT--> [?] Structural developmental anomalies of the liver, biliary tract, pancreas or spleen\n Def: Any condition caused by failure of the liver, biliary tract, pancreas and spleen to correctly develop during the antenatal period....", "[LB21.3] Agenesis-aplasia of pancreas\n Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas....\n --PARENT--> [LB21] Structural developmental anomalies of pancreas\n --CHILD--> [LB21.2] Accessory pancreas\n Def: Accessory pancreas is an asymptomatic embryopathy characterised by the presence of pancreatic tissue in other sites of the body such as the splenic pedicle, gonadic pedicles, intestinal mesentery, duo..." ]
DC3Z
Diseases of pancreas, unspecified
[ { "from_icd11": "DC3Z", "icd10_code": "K8681", "icd10_title": "Exocrine pancreatic insufficiency" }, { "from_icd11": "DC3Z", "icd10_code": "K8689", "icd10_title": "Other specified diseases of pancreas" }, { "from_icd11": "DC3Z", "icd10_code": "K869", "icd10_title": "Disease of pancreas, unspecified" }, { "from_icd11": "DC3Z", "icd10_code": "K868", "icd10_title": "Other specified diseases of pancreas" }, { "from_icd11": "DC3Z", "icd10_code": "K87", "icd10_title": "Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere" }, { "from_icd11": "DC3Z", "icd10_code": "K80-K87", "icd10_title": "" }, { "from_icd11": "DC3Z", "icd10_code": "K86", "icd10_title": "Other diseases of pancreas" }, { "from_icd11": "DC3Z", "icd10_code": "K871", "icd10_title": "" }, { "from_icd11": "LB21.Z", "icd10_code": "Q450", "icd10_title": "Agenesis, aplasia and hypoplasia of pancreas" }, { "from_icd11": "LB21.Z", "icd10_code": "Q38-Q45", "icd10_title": "" }, { "from_icd11": "LB21.Z", "icd10_code": "Q45", "icd10_title": "Other congenital malformations of digestive system" }, { "from_icd11": "LB21.Z", "icd10_code": "Q452", "icd10_title": "Congenital pancreatic cyst" }, { "from_icd11": "9B73.2", "icd10_code": "H33109", "icd10_title": "Unspecified retinoschisis, unspecified eye" }, { "from_icd11": "9B73.2", "icd10_code": "H33102", "icd10_title": "Unspecified retinoschisis, left eye" }, { "from_icd11": "9B73.2", "icd10_code": "H33119", "icd10_title": "Cyst of ora serrata, unspecified eye" } ]
K8681
Exocrine pancreatic insufficiency
During the first course of induction chemotherapy, the patient experienced significant neutropenia for 21 days. On day 1, piperacillin sodium and tazobactam sodium were given as empiric antibiotics, and on day 14, micafungin (4 mg/kg daily, intravenously) was added as prophylaxis for antifungal therapy if neutropenia persisted. On day 23, she complained of oral pain. On presentation, her neutrophil count was 0.02 × 10 9 /l with raised C-reactive protein (CRP) of 19.2 mg/l. Due to positive oral secretion cultures for Burkholderia polyphagy, the antibiotic therapy was switched to Tienam. On day 28, she complained of a fever (38.3°C), followed by a cough, dyspnea, and swelling of the face on day 30. Chemotherapy was discontinued. Results of the blood culture, serum galactomannan antigen (GM) test, and 1,3-β-D glucan test (G test) were negative. The patient was positive for rhinovirus in the throat swab and gram-positive coccus in the sputum smear. A blood count indicated that the patient had severe neutropenia (<0.05 × 10 9 /l). Procalcitonin and serum CRP levels were 1.73 ng/ml and 176.3 mg/l, respectively. Chest CT showed a nodular lesion (3.2 cm × 2.8 cm) in the post-basal segment of the left lower lobe with ground glass opacification . The CT scans of the abdomen, as well as the cerebrospinal fluid test, all showed normal results. However, the parents later refused for the patient to undergo head CT examination due to economic reasons. Given the possibility of an opportunistic pathogen infiltrating the fungi prophylaxis and causing pulmonary infection, the antifungal therapy was changed to voriconazole, added with vancomycin. However, the high fever and dyspnea persisted. On day 34, the CRP increased to 301.8 mg/l, and following positive evolution with metagenomic next-generation sequencing (mNGS) (identified by Hugo Biotech, China, free testing) in the genomic DNA of the blood and sputum specimen, Lichtheimia ramosa was detected. Meanwhile, mNGS identified gram-positive streptococcus in the sputum specimen but no pathogenic prokaryotic microorganisms or viruses in the blood specimen. mNGS in cerebrospinal fluid specimens was also performed to determine intracranial IFD, although the results were negative. Because the test results were consistent with the clinical manifestations, we adjusted the antifungal treatment regimen to amphotericin B (amphotericin B liposomes were not available) intravenously (the initial dose was 0.2 mg/kg and increased up to 1.5 mg/kg gradually within 4 days); the therapeutic dose was administered intravenously for 9 weeks. The antibiotic therapy was switched to linezolid combined with Tienam. Meanwhile, the renal function was monitored and found to be normal. She experienced transient hypokalemia (2.33 mmol/l, normal range 3.5–5.5 mmol/l), which was resolved with oral and intravenous potassium supplementation. On day 38, repeated CT showed a larger initial nodular lesion and a new lesion in the upper lobe of the right lung . On day 44, the patient’s temperature was back to normal. On day 52, a repeat CT revealed that the initial nodular lesion had gotten larger (4.7 cm × 24.3 cm) with part consolidation and that the initial regional hazy shadow had disseminated diffusely in the left lung. New regional shadows were seen in the upper lobe of the right lung . Computer tomography angiography (CTA) was conducted and demonstrated no fungal flora in the blood vessels . A multidisciplinary team (MDT) met the recommended surgical treatment for the patient. Meanwhile, posaconazole was added (6 mg/kg oral q6h) combined with amphotericin B. The blood concentration of posaconazole was in the normal range. On day 66, surgical management involved the lower lobe of the left lung and pleura . The yellow and white fungal lesions in the basal segment of the lower lobe of the left lung were observed during surgery. Irregular fungal balls (3.0 cm) and necrosis lesions were observed in the pulmonary alveoli. A microscopic examination revealed tissue necrosis , fungal cenobium in the pulmonary alveoli , and filamentous fungi in the removed pulmonary specimen . It was positive for periodic acid Schiff (PAS) stain and Gomori methenamine silver stain but negative for acid-fast stain. On day 84, the patient started the second induction therapy with cyclophosphamide cytarabine and mercaptopurine. The chemotherapy was completed without the recurrence of the fungal infection. After every 3 months of follow-up, the patient was sequentially treated with posaconazole and was continuously in complete remission. There was no progression of mucormycosis in the chest CT on 6 months after surgery. Brain CT was conducted after active persuasion, and it showed a good image . The clinical course and timeline of the treatment course are summarized in Figure 3 and Table 1 .
4.144531
0.959473
sec[1]/p[1]
en
0.999998
PMC9421258
https://doi.org/10.3389/fonc.2022.949910
[ "blood", "lobe", "lung", "fungal", "oral", "lesion", "pulmonary", "specimen", "course", "chemotherapy" ]
[ { "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": "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 === [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 [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 --- [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.... --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... --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... --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--> [MA12.0] Finding of opiate drug 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 --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 --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 --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 --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--> [MA12.0] Finding of opiate drug 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 71-year-old man with fever and hematuria was admitted to our hospital because of urethral injury during Foley catheter replacement. At admission, physical examination results were as follows: blood pressure, 172/76 mmHg; high-grade fever, 39.0°C; tachycardia, 102 beats/min; and no remarkable cardiac murmur. He had a history of type 2 diabetes requiring insulin and a history of bilateral amputation for gangrene. He developed end-stage kidney failure and underwent hemodialysis twice weekly for 6 months previously. Simultaneously, he was still able to micturate with the aid of an indwelling urinary catheter. Chest radiography revealed cardiomegaly and bilateral pleural effusion. Laboratory test results revealed increased C-reactive protein levels (6.08 mg/dL, normal <0.3 mg/dL). Urine dipstick revealed glucose, blood 3+, protein 3+, and bacteria 3+. Urine microscopy revealed >100 white blood cells and >100 red blood cells/high-power field. Pelvic computed tomography revealed that the balloon of the Foley catheter was observed in the prostatic urethra, suggesting urethral injury . After conducting urine culture and two sets of blood cultures (BCs), intravenous minocycline (200 mg/day) was initiated as an empirical antimicrobial therapy for urinary tract infection (UTI). On day 4, follow-up laboratory test results revealed leukocytosis (16,600/μL) with further increased C-reactive protein levels of 15.9 mg/dL . Transthoracic echocardiography (TTE) revealed MAC involving the posterior mitral annulus, which was significantly more severe than that noted 1 year ago. Notably, an inhomogeneous mobile mass superimposed on the MAC was observed despite the absence of remarkable mitral regurgitation, suggesting vegetations . Brain magnetic resonance imaging revealed multiple cerebral infarctions compatible with systemic embolism . BCs and urine culture collected on admission yielded Klebsiella pneumoniae , which is susceptible to conventional antimicrobials but naturally resistant to ampicillin ( Supplementary Table 1 ). These findings fulfilled the modified Duke criteria for the diagnosis of definite IE: 1 major and 3 minor criteria. Thus, the antimicrobial treatment was switched to intravenous ceftriaxone (4 g/day) for K. pneumoniae IE. However, because the fever continued, multiple separate BCs were performed on day 5 and thereafter. TEE further characterized the vegetations involving the MAC. 2D/3D TEE revealed a growing and prolapsing mass of vegetations originating from the MAC . Nevertheless, intact valve leaflets and no significant mitral regurgitation were observed. The 4D Flexi-slice mode further clarified the morphological details of the MAC. Notably, the MAC where vegetations were attached was located around the P2 segment of the mitral valve (MV) and contained a hypoechoic region in the center, suggesting an annular abscess . In addition, Q-analysis demonstrated that the hypoechoic region showed a low-intensity signal, which was different from both adjacent calcification and normal tissue and indicates a distinct property, supporting this notion . Based on these findings, a tentative diagnosis of IE involving a calcified mitral annular abscess was made. On day 9, cardiac surgery was performed after confirming that the patient had no worsening of neurologic deficits. Visual inspection of the MV revealed a large mass of vegetations superimposed on the calcified posterior annulus of the MV . However, the whole posterior leaflet, except for its basal end, was intact. During removal of vegetations, a small amount of pus was released from the interior of the MAC. Subsequent careful abscess debridement, reconstruction of the posterior atrioventricular groove using a bovine pericardial patch, and subsequent MV replacement with a prosthetic valve (Epic 29 mm, St. Jude Medical) were performed. Both the vegetation tissue and abscess contents were immediately sent for bacterial identification. Multiple separate BCs obtained on day 5 yielded methicillin-resistant Staphylococcus aureus (MRSA). Thus, in addition to ceftriaxone treatment, intravenous vancomycin (0.75 g/2 days) was combined. Finally, gram-positive bacterial infection was confirmed by pathological examination of the resected MV . In addition, both the excised tissue and abscess content yielded MRSA, identical to those from the BCs collected on day 5 ( Supplementary Table 1 ). Thus, the final diagnosis of MRSA IE was made, which fulfilled the modified Duke criteria for a diagnosis of definite IE with 2 major criteria. On day 19, de-escalation of vancomycin monotherapy was performed. Subsequent long-term intravenous vancomycin followed by oral sulfamethoxazole/trimethoprim (800 mg−160 mg/day) was administered. The post-operative course was uneventful, and the patient remained symptom-free during 1-year follow-up.
4.09375
0.970703
sec[1]/p[0]
en
0.999998
PMC8804532
https://doi.org/10.3389/fmicb.2021.818219
[ "vegetations", "blood", "mitral", "abscess", "urine", "that", "intravenous", "which", "criteria", "fever" ]
[ { "code": "8D8Z", "title": "Disorders of autonomic nervous system, unspecified" }, { "code": "8E20", "title": "Persistent vegetative state" }, { "code": "8E21", "title": "Permanent vegetative state" }, { "code": "BB40", "title": "Acute or subacute infectious endocarditis" }, { "code": "CA0F.Y", "title": "Other specified chronic diseases of tonsils or adenoids" }, { "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 === [8D8Z] Disorders of autonomic nervous system, unspecified Also known as: Disorders of autonomic nervous system, unspecified | Disorder of vegetative system | Disease of autonomic nervous system | disease of sympathetic nervous system | Disorder of parasympathetic nervous system [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 [8E21] Permanent vegetative state Definition: Prognostic term applied to patients in a persistent vegetative state for whom no recovery is expected. Also known as: Permanent vegetative state [BB40] Acute or subacute infectious endocarditis Also known as: Acute or subacute infectious endocarditis | subacute infective endocarditis NOS | infective endocarditis NOS | acute infective endocarditis NOS | infectious endocarditis Excludes: Infectious myocarditis [CA0F.Y] Other specified chronic diseases of tonsils or adenoids Also known as: Other specified chronic diseases of tonsils or adenoids | Chronic tonsillitis | chronic infection of tonsil | Chronic infected tonsil remnant | infected tonsillar remnant [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 --- [8D8Z] Disorders of autonomic nervous system, unspecified --PARENT--> [?] Disorders of autonomic nervous system Def: This is a group of conditions characterised as being in or associated with the autonomic nervous system, the component of the peripheral nervous system that regulates involuntary physiologic processe... --CHILD--> [8D80] Congenital malformations of the autonomic nervous system --- Walk 2 --- [8D8Z] Disorders of autonomic nervous system, unspecified --PARENT--> [?] Disorders of autonomic nervous system Def: This is a group of conditions characterised as being in or associated with the autonomic nervous system, the component of the peripheral nervous system that regulates involuntary physiologic processe... --CHILD--> [8D80] Congenital malformations of the autonomic nervous system --- Walk 3 --- [8E20] Persistent vegetative state Def: 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 injur... --PARENT--> [?] Disorders of consciousness --RELATED_TO--> [?] Delirium Def: Delirium is characterized by a disturbance of attention, orientation, and awareness that develops within a short period of time, typically presenting as significant confusion or global neurocognitive ... --- Walk 4 --- [8E20] Persistent vegetative state Def: 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 injur... --PARENT--> [?] Disorders of consciousness --PARENT--> [08] Diseases of the nervous system Def: This is a group of conditions characterised as being in or associated with the nervous system.... --- Walk 5 --- [8E21] Permanent vegetative state Def: Prognostic term applied to patients in a persistent vegetative state for whom no recovery is expected.... --PARENT--> [?] Disorders of consciousness --CHILD--> [8E22] Minimally conscious state Def: Subacute or chronic state of severely disturbed consciousness in which patients show minimal yet definite signs of consciousness, such as visual pursuit or command following, occurring after a severe ... --- Walk 6 --- [8E21] Permanent vegetative state Def: Prognostic term applied to patients in a persistent vegetative state for whom no recovery is expected.... --PARENT--> [?] Disorders of consciousness --RELATED_TO--> [?] Delirium Def: Delirium is characterized by a disturbance of attention, orientation, and awareness that develops within a short period of time, typically presenting as significant confusion or global neurocognitive ...
[ "[8D8Z] Disorders of autonomic nervous system, unspecified\n --PARENT--> [?] Disorders of autonomic nervous system\n Def: This is a group of conditions characterised as being in or associated with the autonomic nervous system, the \ncomponent of the peripheral nervous system that regulates involuntary physiologic processe...\n --CHILD--> [8D80] Congenital malformations of the autonomic nervous system", "[8D8Z] Disorders of autonomic nervous system, unspecified\n --PARENT--> [?] Disorders of autonomic nervous system\n Def: This is a group of conditions characterised as being in or associated with the autonomic nervous system, the \ncomponent of the peripheral nervous system that regulates involuntary physiologic processe...\n --CHILD--> [8D80] Congenital malformations of the autonomic nervous system", "[8E20] Persistent vegetative state\n Def: 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 injur...\n --PARENT--> [?] Disorders of consciousness\n --RELATED_TO--> [?] Delirium\n Def: Delirium is characterized by a disturbance of attention, orientation, and awareness that develops within a short period of time, typically presenting as significant confusion or global neurocognitive ...", "[8E20] Persistent vegetative state\n Def: 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 injur...\n --PARENT--> [?] Disorders of consciousness\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....", "[8E21] Permanent vegetative state\n Def: Prognostic term applied to patients in a persistent vegetative state for whom no recovery is expected....\n --PARENT--> [?] Disorders of consciousness\n --CHILD--> [8E22] Minimally conscious state\n Def: Subacute or chronic state of severely disturbed consciousness in which patients show minimal yet definite signs of consciousness, such as visual pursuit or command following, occurring after a severe ...", "[8E21] Permanent vegetative state\n Def: Prognostic term applied to patients in a persistent vegetative state for whom no recovery is expected....\n --PARENT--> [?] Disorders of consciousness\n --RELATED_TO--> [?] Delirium\n Def: Delirium is characterized by a disturbance of attention, orientation, and awareness that develops within a short period of time, typically presenting as significant confusion or global neurocognitive ..." ]
8D8Z
Disorders of autonomic nervous system, unspecified
[ { "from_icd11": "8D8Z", "icd10_code": "G903", "icd10_title": "Multi-system degeneration of the autonomic nervous system" }, { "from_icd11": "8D8Z", "icd10_code": "G909", "icd10_title": "Disorder of the autonomic nervous system, unspecified" }, { "from_icd11": "8D8Z", "icd10_code": "G90", "icd10_title": "Disorders of autonomic nervous system" }, { "from_icd11": "8E20", "icd10_code": "R402142", "icd10_title": "Coma scale, eyes open, spontaneous, at arrival to emergency department" }, { "from_icd11": "8E20", "icd10_code": "R402362", "icd10_title": "Coma scale, best motor response, obeys commands, at arrival to emergency department" }, { "from_icd11": "8E20", "icd10_code": "R402252", "icd10_title": "Coma scale, best verbal response, oriented, at arrival to emergency department" }, { "from_icd11": "8E20", "icd10_code": "R402412", "icd10_title": "Glasgow coma scale score 13-15, at arrival to emergency department" }, { "from_icd11": "8E20", "icd10_code": "R4020", "icd10_title": "Unspecified coma" }, { "from_icd11": "8E20", "icd10_code": "R402141", "icd10_title": "Coma scale, eyes open, spontaneous, in the field [EMT or ambulance]" }, { "from_icd11": "8E20", "icd10_code": "R402361", "icd10_title": "Coma scale, best motor response, obeys commands, in the field [EMT or ambulance]" }, { "from_icd11": "8E20", "icd10_code": "R402251", "icd10_title": "Coma scale, best verbal response, oriented, in the field [EMT or ambulance]" }, { "from_icd11": "8E20", "icd10_code": "R402413", "icd10_title": "Glasgow coma scale score 13-15, at hospital admission" }, { "from_icd11": "8E20", "icd10_code": "R402143", "icd10_title": "Coma scale, eyes open, spontaneous, at hospital admission" }, { "from_icd11": "8E20", "icd10_code": "R402243", "icd10_title": "Coma scale, best verbal response, confused conversation, at hospital admission" }, { "from_icd11": "8E20", "icd10_code": "R402363", "icd10_title": "Coma scale, best motor response, obeys commands, at hospital admission" } ]
G903
Multi-system degeneration of the autonomic nervous system
A 33-year-old pregnant woman was born a male newborn by vaginal delivery at 38 weeks of gestation. On the third day, the neonate was referred to the cardiology department due to symptoms of central cyanosis, respiratory distress, and a left parasternal 3/6 systolic ejection murmur. She was three times pregnant, with no complications in either of the prior or current pregnancies. She underwent three previous vaginal deliveries. The medical, allergic, genetic, and psychosocial histories were within normal and she denied the use of tobacco, alcohol, and drugs. The neonate weighed 5000 g and his vital signs had been recorded: blood pressure, 70/55 mmHg; pulse, 110 beats/min; tympanic temperature, 37C; and oxygen saturation, 80 % on room air. Therefore, he was transferred to an incubator for 5 days to improve his general condition and oxygenation, which reached 85 %. Then he was referred for a full cardiac study. Laboratory blood and electrolyte tests were normal. A chest X-ray demonstrated an increased cardiothoracic ratio (CTR). Echocardiography (ECG) showed right axis deviation (RAD) and right ventricular hypertrophy (RVH) . Echocardiography findings were as follows: superior vena cava (SVC) and inferior vena cava (IVC) flow into the right atrium and pulmonary veins flow into the left atrium with atrioventricular concordance and ventricular arterial concordance. Furthermore, the aorta, left aortic arch, left atrium and left ventricle, which measured 9 × 15 mm, were visible. Moderate dilatation of the right atrium and right ventricular (RV), which was accompanied by concentric hypertrophy, was observed. In addition, mild tricuspid valve insufficiency, absent ductus arteriosus, and absent pulmonary valve cusps had a severely stenotic fibrous ring In their place, which measured 9 mm in diameter. Color and spectrum Doppler ultrasound showed that the peak flow velocity through the pulmonary valve annulus increased to 5 m/s and the gradient between the right ventricle and the PA was measured at 95 mmHg . Severe dilatation was noted in the main pulmonary artery with a diameter of 21 mm and also in the dilatation of its branches, with the left pulmonary artery measuring 10 mm in diameter and the right pulmonary artery measuring 11 mm in diameter . The ejection fraction (EF) was 70 %. There was a large membranous ventricular septal defect (VSD) of about 9.5 mm with a bi-directional shunt and a predominance of left to right during systole. The aorta overriding rate was about 50 % of the septal defect The patent foramen ovale (PFO) was 2 mm in diameter, and severe pulmonary insufficiency was noted. The neonate has no other abnormalities besides its heart. The diagnosis for the infant was thus APVS associated with TOF (TOF-type APVS) based on the following evidence: absent pulmonary valve, absent ductus arteriosus, and large membranous VSD. The procedure involved opening the right ventricle, addressing the stenotic pulmonary valve by widening the ventricular outlet with an artificial patch, and closing the interventricular opening with another patch and a stenotic fibrous ring was resected. It's important to note that the decision not to replace the pulmonary valve immediately is based on the consideration that the heart may change in size over time. The right ventricle may not tolerate stenosis but could tolerate insufficiency. Two years later, during his last follow-up, he was still asymptomatic from a cardiac standpoint and had no respiratory symptoms. An ECG was normal. The VSD was tightly closed without any leakage. In addition, there was an absence of the gradient across the pulmonary valve. Fig. 1 An ECG showing right ventricular hypertrophy (RVH) and right axis deviation (RAD). Fig. 1 Fig. 2 An echocardiogram Doppler image of a pulmonary valve showing severe pulmonary regurgitation and severe stenosis with a peak gradient of 95 mmHg (2-A). A parasternal short-axis view adjacent to the sternum, showing an Membranous ventricular septal defect (vsd), severe pulmonary arterial dilation, and a constricted ring in the area of the absent valve(2-B). The parasternal long-axis view, which is adjacent to the sternum, showed the type of defect along with malalignment of the outflow tract (2-C). The echocardiographic Doppler study demonstrates severe pulmonary regurgitation(2-D). The echocardiography shows a dilated pulmonary artery (2-E). The echocardiographic Doppler study demonstrates severe pulmonary stenosis with a maximum pressure gradient (PG max) of 95 mmHg (2-F). The parasternal long-axis in the color Doppler echocardiography reveals the presence of a right-to-left shunt (2-G). The color Doppler echocardiography's parasternal long-axis view reveals a significant defect causing a left-to-right shunt, characterized by a predominant flow from left to right (2-H). Fig. 2
4.160156
0.97168
sec[1]/p[0]
en
0.999994
39053367
https://doi.org/10.1016/j.ijscr.2024.110076
[ "pulmonary", "valve", "ventricular", "axis", "doppler", "parasternal", "which", "echocardiography", "absent", "diameter" ]
[ { "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": "GB61.Z", "title": "Chronic kidney disease, stage unspecified" }, { "code": "BC00", "title": "Multiple valve disease" }, { "code": "BB9Z", "title": "Pulmonary valve disease, unspecified" }, { "code": "BB6Z", "title": "Mitral valve disease, unspecified" }, { "code": "LA8Z", "title": "Structural developmental anomaly of heart or great vessels, 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 [GB61.Z] Chronic kidney disease, stage unspecified Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease [BC00] Multiple valve disease Also known as: Multiple valve disease | Multiple valve disease of unspecified origin | multiple valvular cardiac dysfunction | multivalvular cardiac dysfunction | Disorders of both mitral and aortic valves [BB9Z] Pulmonary valve disease, unspecified Also known as: Pulmonary valve disease, unspecified | rheumatic heart disease of pulmonary valve, unspecified | chronic rheumatic pulmonary valve endocarditis | chronic rheumatic pulmonary valvular endocarditis | rheumatic disease of pulmonary valve [BB6Z] Mitral valve disease, unspecified Also known as: Mitral valve disease, unspecified | noninfective endocarditis of mitral valve | rheumatic heart disease of mitral valve, unspecified | mitral valvulopathy | mitral valve cardiopathy [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 === GRAPH WALKS === --- Walk 1 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --PARENT--> [12] Diseases of the respiratory system --- 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.... --CHILD--> [LA75.2] Congenital hypoplasia of lung --- 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--> [CA40.1] Viral pneumonia Def: A disease of the pulmonary system, caused by an infection with a viral source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhalation... --- 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 ... --CHILD--> [CA40.0] Bacterial pneumonia Def: A disease of the pulmonary system, caused by an infection with a bacterial source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhala...
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --PARENT--> [12] Diseases of the respiratory system", "[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 --CHILD--> [LA75.2] Congenital hypoplasia of lung", "[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--> [CA40.1] Viral pneumonia\n Def: A disease of the pulmonary system, caused by an infection with a viral source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhalation...", "[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--> [CA40.0] Bacterial pneumonia\n Def: A disease of the pulmonary system, caused by an infection with a bacterial source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhala..." ]
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
A middle-aged woman with a history of bipolar disorder with catatonia (last episode two years prior) prescribed bupropion and carbamazepine and no other medical comorbidities presented with altered mental status after being found by bystanders driving in circles in the parking lot of a church she visited regularly. EMS reported that on their arrival, she was fully awake and responsive yet non-verbal. As such, she was transported to the hospital to evaluate for potential cerebrovascular events. In the emergency department (ED), she was found to be hypertensive, tachycardic, mydriatic, diaphoretic, agitated, and tremulous, symptoms that continued for 24 hours of her admission. Laboratory testing was significant for a blood ethanol level of 15 mg/dL and a carbamazepine level of 3.7 µg/mL (with a therapeutic range of 0.5 −4 µg/mL). A urine drug screen was ordered, however, unfortunately never obtained. The medical team suspected that her presentation represented acute benzodiazepine or alcohol withdrawal and decided to admit her to the intensive care unit (ICU) for close monitoring and supportive management. She was placed on the Glasgow Modified Alcohol Withdrawal Score protocol and required a total of 12 mg of lorazepam for tremors and anxiety within a 48-hour period. Upon arrival in the ICU, the patient was also noted to be exhibiting paranoia in regards to taking medications and accepting nursing interventions, and a psychiatry consult was generated. On psychiatric examination, the patient presented as a young-looking 48-year-old woman. She was sitting up in bed, very still and with slow movements. She had no observable physical deformities or disabilities. She was dressed in clean hospital-supplied clothing and appeared well-groomed. She did not exhibit any abnormal involuntary movements. Her behavior was withdrawn and sullen. Her attitude towards the examining psychiatrist was guarded and suspicious. A friend was present at her bedside, whom she frequently looked at for encouragement. She fixated intensely and gazed at the examiner prior to providing an answer. Her speech was fluent, of normal tone, but hesitant with a significant delay and poverty of content. When asked questions, she frequently questioned the examiner's reasoning for asking the questions. Her range of emotional expression was incongruent with her stated mood of "fine" and was constricted to fear. Her thinking was slowed, circumstantial, and perseverative about wanting to speak only to the psychiatrist from another facility who cared for her two years ago during her last catatonic hospitalization. Her thought content, presented as paranoid and suspicious, was centered around attempting to identify the "real" reasons behind the psychiatrist's presence and questioned the safety of the unit and the ability of strangers to walk in. She did not exhibit any observable responses to internal or unseen external stimuli. Her cognition was grossly conversationally normal, with a fair ability to concentrate. Slowly, as she answered questions and the following tableau emerged: the patient had been having nightmares and poor sleep for over a month. She recounted a history of domestic physical, sexual, and psychological trauma with nightmares and insomnia, treated with carbamazepine and bupropion. Given her desire to not depend on medications any longer, she started weaning her bupropion and her carbamazepine, all while starting to take an over-the-counter Valerian Root supplement at a dose of 1,000 mg daily at bedtime, in addition to another over-the-counter supplement named "GABA supplement." When her nightmares returned and started worsening in frequency and intensity, she began doubling the Valerian Root supplement dose in addition to continuing the GABA supplement at the recommended dose. Two or three days prior to admission, she stopped taking her carbamazepine and bupropion, her anxiety peaked, and she presented feeling "not like herself," "anxious," and "excitable." The following morning, she sought to go to church but was hazy in her recollection of what happened next. She recalled feeling "slower" and "anxious" being in the ambulance and volitionally refusing to answer the EMS' questions. She vehemently denied any alcohol use history, corroborated by collateral. It was determined that the patient's presentation was due to GABA overdose from sedative-hypnotic toxicity using agents with unregulated and therefore unpredictable pharmacodynamics. Alcohol withdrawal treatment was stopped, and her carbamazepine was restarted. By the third day of admission, the patient's sensorium cleared, and her treatment team felt comfortable discharging her home. Upon discharge, she presented with a full, reactive but intense affect, and an anxious mood related to the circumstances leading to this hospitalization.
3.855469
0.980469
sec[1]/p[0]
en
0.999997
34659971
https://doi.org/10.7759/cureus.17759
[ "carbamazepine", "supplement", "bupropion", "that", "alcohol", "questions", "withdrawal", "psychiatrist", "nightmares", "over" ]
[ { "code": "PL00", "title": "Drugs, medicaments or biological substances associated with injury or harm in therapeutic use" }, { "code": "LA30.3", "title": "Hyperdontia" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "DA0E.3", "title": "Anomalies of tooth position" }, { "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" }, { "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" } ]
=== ICD-11 CODES FOUND === [PL00] Drugs, medicaments or biological substances associated with injury or harm in therapeutic use Also known as: Drugs, medicaments or biological substances associated with injury or harm in therapeutic use | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics, Penicillins | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics, Cephalosporins or other beta-lactam antibiotics | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics, Chloramphenicol group Excludes: Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm [LA30.3] Hyperdontia Definition: Hyperdontia is the condition of having supernumerary teeth, or teeth which appear in addition to the regular number of teeth. Also known as: Hyperdontia | Supplementary teeth | Supernumerary teeth | supernumerary tooth | supplemental teeth Includes: Supplementary teeth | Supernumerary teeth | distomolar [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 [DA0E.3] Anomalies of tooth position Definition: Dental anomalies are craniofacial abnormalities of form, function, or position of the teeth, bones, and tissues of the jaw and mouth. Anomalies of tooth position can be classified in ectopic, transmigration, transposition, rotation. Also known as: Anomalies of tooth position | Diastema of teeth | abnormal spacing of tooth or teeth | Crowding of tooth or teeth | Distomolar causing crowding Includes: Diastema of teeth [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 [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 === GRAPH WALKS === --- Walk 1 --- [PL00] Drugs, medicaments or biological substances associated with injury or harm in therapeutic use --EXCLUDES--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm --CHILD--> [?] Underdosing without injury or harm Def: Under-dosing occurs when a patient takes less of a medication than is prescribed by the provider or the manufacturer's instructions without documented injury or harm. This can be the result of inaccur... --- Walk 2 --- [PL00] Drugs, medicaments or biological substances associated with injury or harm in therapeutic use --PARENT--> [?] Substances associated with injury or harm in therapeutic use Def: Situations where a substance (drug or medicament) causes harm, in the context of intentional use for therapeutic purposes... --CHILD--> [PL00] Drugs, medicaments or biological substances associated with injury or harm in therapeutic use --- Walk 3 --- [LA30.3] Hyperdontia Def: Hyperdontia is the condition of having supernumerary teeth, or teeth which appear in addition to the regular number of teeth.... --PARENT--> [LA30] Structural developmental anomalies of teeth and periodontal tissues --RELATED_TO--> [?] Disturbances in tooth formation Def: A group of conditions characterised by disturbances in tooth formation.... --- Walk 4 --- [LA30.3] Hyperdontia Def: Hyperdontia is the condition of having supernumerary teeth, or teeth which appear in addition to the regular number of teeth.... --PARENT--> [LA30] Structural developmental anomalies of teeth and periodontal tissues --CHILD--> [LA30.0] Anodontia Def: Anodontia is a genetic disorder commonly defined as the absence of all teeth, affecting both temporary and permanent dentitions, and is extremely rarely encountered in a pure form without any associat... --- Walk 5 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Disorders due to substance use or addictive behaviours Def: Disorders due to substance use and addictive behaviours are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or spe... --CHILD--> [?] Disorders due to addictive behaviours Def: Disorders due to addictive behaviours are recognizable and clinically significant syndromes associated with distress or interference with personal functions that develop as a result of repetitive rewa... --- Walk 6 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Alcohol intoxication Def: Alcohol intoxication is a clinically significant transient condition that develops during or shortly after the consumption of alcohol 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 ...
[ "[PL00] Drugs, medicaments or biological substances associated with injury or harm in therapeutic use\n --EXCLUDES--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm\n --CHILD--> [?] Underdosing without injury or harm\n Def: Under-dosing occurs when a patient takes less of a medication than is prescribed by the provider or the manufacturer's instructions without documented injury or harm. This can be the result of inaccur...", "[PL00] Drugs, medicaments or biological substances associated with injury or harm in therapeutic use\n --PARENT--> [?] Substances associated with injury or harm in therapeutic use\n Def: Situations where a substance (drug or medicament) causes harm, in the context of intentional use for therapeutic purposes...\n --CHILD--> [PL00] Drugs, medicaments or biological substances associated with injury or harm in therapeutic use", "[LA30.3] Hyperdontia\n Def: Hyperdontia is the condition of having supernumerary teeth, or teeth which appear in addition to the regular number of teeth....\n --PARENT--> [LA30] Structural developmental anomalies of teeth and periodontal tissues\n --RELATED_TO--> [?] Disturbances in tooth formation\n Def: A group of conditions characterised by disturbances in tooth formation....", "[LA30.3] Hyperdontia\n Def: Hyperdontia is the condition of having supernumerary teeth, or teeth which appear in addition to the regular number of teeth....\n --PARENT--> [LA30] Structural developmental anomalies of teeth and periodontal tissues\n --CHILD--> [LA30.0] Anodontia\n Def: Anodontia is a genetic disorder commonly defined as the absence of all teeth, affecting both temporary and permanent dentitions, and is extremely rarely encountered in a pure form without any associat...", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Disorders due to substance use or addictive behaviours\n Def: Disorders due to substance use and addictive behaviours are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or spe...\n --CHILD--> [?] Disorders due to addictive behaviours\n Def: Disorders due to addictive behaviours are recognizable and clinically significant syndromes associated with distress or interference with personal functions that develop as a result of repetitive rewa...", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Alcohol intoxication\n Def: Alcohol intoxication is a clinically significant transient condition that develops during or shortly after the consumption of alcohol 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 ..." ]
PL00
Drugs, medicaments or biological substances associated with injury or harm in therapeutic use
[ { "from_icd11": "PL00", "icd10_code": "Y40", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y400", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y401", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y402", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y403", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y404", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y405", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y406", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y407", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y408", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y409", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y41", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y410", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y411", "icd10_title": "" }, { "from_icd11": "PL00", "icd10_code": "Y412", "icd10_title": "" } ]
Y40
A 66-year-old man who underwent regular hemodialysis (4 h a day, 3 times a week) for 9 months for end-stage renal disease secondary to IgA nephropathy was hospitalized for living kidney transplantation. He underwent ABO-compatible living kidney transplantation. The kidney donor was his wife; the allograft had three renal arteries that were trimmed and formed into one on the back table, and subsequently, it was anastomosed to the internal iliac artery. Intraoperative Doppler US revealed that the blood flow of each renal artery was adequate, resulting in sufficient blood flow throughout the allograft. Urine output was also observed as soon as blood flow returned. Allograft biopsy an hour after allograft blood flow returned was performed at the lower pole of the allograft, and we confirmed no bleeding from the operative field, including the biopsy site. His introduced immunosuppression regimen included cyclosporin, mycophenolate mofetil, prednisone, and basiliximab. Although urine output was observed postoperatively, serum creatinine level did not decrease. Doppler US showed no evidence of acute rejection, ureteral obstruction, or anastomotic stenosis of renal arteries on postoperative day (POD) 2. Although rejection was considered and steroid pulse therapy was initiated, the allograft function did not improve. On the contrary, urine output decreased, and serum creatinine level increased to 6.0 mg/dL. On POD 6, Doppler US did not show evidence of rejection and anastomotic stenosis, but a region with less blood flow was observed at the upper pole of the allograft, as well as a slight decrease in diastolic flow. During this period, his blood pressure was 145/80 mmHg, and progression of anemia was not observed. On POD 7, surgical exploration was performed and revealed that the blood flow of each renal artery was sufficient, but subcapsular hematoma was detected at the upper pole of the allograft . Capsulotomy was performed, and hematoma with clots was evacuated. Ruptured cyst was observed in the middle of the hematoma, and slight oozing around the cyst was observed . Allograft decompression improved the blood flow at the upper pole of the allograft, and diastolic flow was also improved . Retrospectively, preoperative enhanced computed tomography (CT) of the donor showed a small renal cyst at the upper pole of the allograft , and postoperative unenhanced CT of the recipient showed that the cyst was unclear . At the same time, allograft biopsy was performed, which did not show evidence of rejection and calcineurin inhibitor toxicity, but acute tubular injury was induced by allograft ischemia. After capsulotomy followed by evacuation, urine output increased, and serum creatinine level decreased to 1.7 mg/dL . Fig. 1 Representative images of allograft at the time of surgical exploration. Subcapsular hematoma was confirmed at the upper pole of the allograft. Capsulotomy was performed, and hematoma with clots was observed (red arrow) and subsequently evacuated ( a ). After decompression, the allograft parenchyma expanded and turned bright red (yellow arrow), indicating improvement of blood flow at the upper pole of allograft ( b ) Fig. 2 Representative images of allograft taken by Doppler ultrasonography. Before capsulotomy and evacuation, blood flow of the upper pole of the allograft was slightly poor, and diastolic flow decreased (end-diastolic velocity = 3.7 cm/s, resistive index = 0.67) ( a ). After decompression, allograft blood flow improved (end-diastolic velocity = 10.6 cm/s, resistive index = 0.61) ( b ) Fig. 3 Representative images of allograft obtained by enhanced or unenhanced computed tomography. Preoperative enhanced computed tomography of allograft shows a small renal cyst at the middle to upper pole of the allograft (red arrow: ( a ); axial image, ( b ); coronal image). In the postoperative unenhanced image of the allograft, a small cyst detected before transplantation was unclear (yellow arrow: ( c ); axial image, ( d ); coronal image) Fig. 4 Clinical course of serum creatinine level and urine output, and the regimen of introduced immunosuppression. On postoperative day 6, serum creatinine level was 6.0 mg/dL, and urine output decreased. On postoperative day 7, surgical exploration was performed. After decompression of the allograft, serum creatinine level decreased to 1.7 mg/dL, and urine output increased. The immunosuppression regimen was as follows: cyclosporin, mycophenolate mofetil, prednisone, and basiliximab. At discharge, the doses of each immunosuppressive agent were as follows: 150 mg/day cyclosporin, 1000 mg/day mycophenolate mofetil, and 5 mg/day prednisone. On the day of transplantation and postoperative day 4, 20 mg/day basiliximab was administered. POD = postoperative day; CsA = cyclosporine; MMF = mycophenolate mofetil; PSL = prednisone
4.015625
0.976074
sec[1]/p[0]
en
0.999998
29534686
https://doi.org/10.1186/s12882-018-0860-2
[ "allograft", "flow", "blood", "pole", "renal", "urine", "output", "postoperative", "serum", "creatinine" ]
[ { "code": "NE84", "title": "Failure or rejection of transplanted organs or tissues" }, { "code": "BC01", "title": "Prosthetic valve disease" }, { "code": "BE1A", "title": "Cardiac transplant associated coronary allograft vasculopathy" }, { "code": "GA20.50", "title": "Heavy menstrual bleeding" }, { "code": "BA40.Y", "title": "Other specified angina pectoris" }, { "code": "LA8B.Y", "title": "Other specified congenital anomaly of great arteries including arterial duct" }, { "code": "GC01.0", "title": "Bladder neck obstruction" }, { "code": "DA40.0", "title": "Gastric outlet obstruction" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" } ]
=== ICD-11 CODES FOUND === [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 [BC01] Prosthetic valve disease Also known as: Prosthetic valve disease | homograft prosthetic valve disease | mechanical prosthetic valve disease | allograft prosthetic valve disease | biological prosthetic valve disease [BE1A] Cardiac transplant associated coronary allograft vasculopathy Definition: Coronary artery initimal proliferation following cardiac transplantation, defined based on a combination of visual angiographic vessel descriptors in concert with measures of cardiac allograft function, according to the International Society for Heart and Lung Transplantation. Also known as: Cardiac transplant associated coronary allograft vasculopathy [GA20.50] Heavy menstrual bleeding Definition: Menstruation with heavy (> 80 ml) volume of monthly blood loss Also known as: Heavy menstrual bleeding | menstruation excessive | Heavy menstrual bleeding caused by bleeding disorders | Excessive menstruation with regular cycle | excessive menses [BA40.Y] Other specified angina pectoris Also known as: Other specified angina pectoris | Atypical angina | Angina of effort | angina pectoris of effort | Coronary slow flow syndrome [LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct Also known as: Other specified congenital anomaly of great arteries including arterial duct | Congenital arterial duct anomaly | Congenital ductus arteriosus anomaly | ductus arteriosus deformity | Ductus arteriosus agenesis [GC01.0] Bladder neck obstruction Definition: A condition of the bladder, caused by congenital or acquired abnormalities that impair the muscles that connect the bladder to the urethra. This condition is characterised by obstruction of the bladder neck and constricted opening during urination. This condition may also present with pelvic pain, pollakiuria, incontinence, or incomplete bladder emptying. Confirmation is by video urodynamics to observe the obstruction as the bladder fills and voids. Also known as: Bladder neck obstruction | bladder outlet obstruction | obstruction of bladder neck or vesicourethral orifice | vesicourethral orifice obstruction | BNO - [bladder neck obstruction] Includes: Acquired bladder neck stenosis [DA40.0] Gastric outlet obstruction Definition: Gastric outlet obstruction is a disorder characterised by epigastric abdominal pain and postprandial vomiting due to mechanical obstruction mostly at the level of the pylorus. Also known as: Gastric outlet obstruction | Adult hypertrophic pyloric stenosis | gastric outflow obstruction | hypertrophic pylorus stenosis | hypertrophic pylorus stricture [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 === GRAPH WALKS === --- Walk 1 --- [NE84] Failure or rejection of transplanted organs or tissues --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified --RELATED_TO--> [?] Complications of anaesthesia during labour or delivery Def: Any complication caused by or subsequent to any anaesthetic intervention used during labour and delivery.... --- Walk 2 --- [NE84] Failure or rejection of transplanted organs or tissues --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified --EXCLUDES--> [?] Attention to artificial openings --- Walk 3 --- [BC01] Prosthetic valve disease --RELATED_TO--> [?] Infection or inflammatory reaction of heart valve prosthesis NOS --PARENT--> [?] Infection or inflammatory reaction due to other cardiac and vascular devices, implants and grafts NOS --- Walk 4 --- [BC01] Prosthetic valve disease --RELATED_TO--> [?] Infection or inflammatory reaction of heart valve prosthesis NOS --PARENT--> [?] Prosthetic valve disease --- Walk 5 --- [BE1A] Cardiac transplant associated coronary allograft vasculopathy Def: Coronary artery initimal proliferation following cardiac transplantation, defined based on a combination of visual angiographic vessel descriptors in concert with measures of cardiac allograft functio... --PARENT--> [?] Postprocedural disorders of circulatory system Def: This refers to postprocedural disorders 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 hel... --CHILD--> [BE11] Other functional disturbances following cardiac surgery --- Walk 6 --- [BE1A] Cardiac transplant associated coronary allograft vasculopathy Def: Coronary artery initimal proliferation following cardiac transplantation, defined based on a combination of visual angiographic vessel descriptors in concert with measures of cardiac allograft functio... --PARENT--> [?] Postprocedural disorders of circulatory system Def: This refers to postprocedural disorders 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 hel... --CHILD--> [BE11] Other functional disturbances following cardiac surgery
[ "[NE84] Failure or rejection of transplanted organs or tissues\n --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified\n --RELATED_TO--> [?] Complications of anaesthesia during labour or delivery\n Def: Any complication caused by or subsequent to any anaesthetic intervention used during labour and delivery....", "[NE84] Failure or rejection of transplanted organs or tissues\n --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified\n --EXCLUDES--> [?] Attention to artificial openings", "[BC01] Prosthetic valve disease\n --RELATED_TO--> [?] Infection or inflammatory reaction of heart valve prosthesis NOS\n --PARENT--> [?] Infection or inflammatory reaction due to other cardiac and vascular devices, implants and grafts NOS", "[BC01] Prosthetic valve disease\n --RELATED_TO--> [?] Infection or inflammatory reaction of heart valve prosthesis NOS\n --PARENT--> [?] Prosthetic valve disease", "[BE1A] Cardiac transplant associated coronary allograft vasculopathy\n Def: Coronary artery initimal proliferation following cardiac transplantation, defined based on a combination of visual angiographic vessel descriptors in concert with measures of cardiac allograft functio...\n --PARENT--> [?] Postprocedural disorders of circulatory system\n Def: This refers to postprocedural disorders 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 hel...\n --CHILD--> [BE11] Other functional disturbances following cardiac surgery", "[BE1A] Cardiac transplant associated coronary allograft vasculopathy\n Def: Coronary artery initimal proliferation following cardiac transplantation, defined based on a combination of visual angiographic vessel descriptors in concert with measures of cardiac allograft functio...\n --PARENT--> [?] Postprocedural disorders of circulatory system\n Def: This refers to postprocedural disorders 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 hel...\n --CHILD--> [BE11] Other functional disturbances following cardiac surgery" ]
NE84
Failure or rejection of transplanted organs or tissues
[ { "from_icd11": "NE84", "icd10_code": "T865", "icd10_title": "Complications of stem cell transplant" }, { "from_icd11": "NE84", "icd10_code": "T8649", "icd10_title": "Other complications of liver transplant" }, { "from_icd11": "NE84", "icd10_code": "T86891", "icd10_title": "Other transplanted tissue failure" }, { "from_icd11": "NE84", "icd10_code": "T86890", "icd10_title": "Other transplanted tissue rejection" }, { "from_icd11": "NE84", "icd10_code": "T86822", "icd10_title": "Skin graft (allograft) (autograft) infection" }, { "from_icd11": "NE84", "icd10_code": "T86828", "icd10_title": "Other complications of skin graft (allograft) (autograft)" }, { "from_icd11": "NE84", "icd10_code": "T8641", "icd10_title": "Liver transplant rejection" }, { "from_icd11": "NE84", "icd10_code": "T8642", "icd10_title": "Liver transplant failure" }, { "from_icd11": "NE84", "icd10_code": "T8613", "icd10_title": "Kidney transplant infection" }, { "from_icd11": "NE84", "icd10_code": "T8643", "icd10_title": "Liver transplant infection" }, { "from_icd11": "NE84", "icd10_code": "T86898", "icd10_title": "Other complications of other transplanted tissue" }, { "from_icd11": "NE84", "icd10_code": "T86821", "icd10_title": "Skin graft (allograft) (autograft) failure" }, { "from_icd11": "NE84", "icd10_code": "T8621", "icd10_title": "Heart transplant rejection" }, { "from_icd11": "NE84", "icd10_code": "T8622", "icd10_title": "Heart transplant failure" }, { "from_icd11": "NE84", "icd10_code": "T86892", "icd10_title": "Other transplanted tissue infection" } ]
T865
Complications of stem cell transplant
About two weeks later, however, he required re-admission because of non-compliance with treatment. The symptoms were almost the same as his first hospital admission, albeit milder: a body temperature of 38.2 °C, respiratory rate of 28/min, pulse rate of 112/min, and blood pressure of 95/80 mmHg. An emergency 2DE and STE showed minimal residual pericardial effusion and drop in LVEF (24.0%) with new areas of reduced LS and a GLS of − 10.4% . The white blood cell count was 18.1 × 10 3 /µL with an eosinophilic count of 5.04 × 10 3 /µL (28.0%). High-dose oral prednisolone (60 mg per day) was immediately started. The recovery, however, was slow, and by the 4th day, he became afebrile, and his respiration improved. The left ventricular wall thickness was decreased in his 2DE , and there seemed to be evidence of scar formation in the basal anteroseptal region in his STE . The CMR showed some LGE in the anterior LV wall and evidence of mild mid-myocardial scar formation in the anteroseptal region . After 15 days of admission, he left the hospital in a medically good condition. Six weeks post-discharge, concomitant 2DE, STE, and CMR showed LVEF of 38.0% , GLS of − 12.9% , and evidence of significant improvement in subendocardial edema at different mid and apical LV segments, in addition to subendocardial LGE in the anterior and septal LV walls, consistent with small areas of scar formation . This was, however, in contrast to the STE that did not show any significant reduced LS to raise the possibility of scar formation. Within the next several months, he did well, and seven months after his first admission, while receiving 12.5 mg of prednisolone and with a 0.0% absolute eosinophil count, his LVEF was found to be 48.0% by Simpson’s method and no evidence of significant reduced LS (scar formation) was seen in his STE . These strange and unexpected wax and wanes in his STE were seen once again in his next evaluation , which revealed scar in the base of anterior and posterior walls and reduced LS in the midsegments of the anterolateral wall and base to mid part of the lateral wall . Some degree of recovery in these areas, however, was noted in his last study on 25.04.2020 . A brief timeline of the patient’s clinical presentations and paraclinical findings of both admissions is shown in Table 1 . Fig. 5 A–H Short axis basal, mid, apical and 4-chamber STIR images demonstrating subendocardial and with lesser degree midmyocardial and epicardial edema in different LV walls (mainly the apex) and also in RV walls ( A – E ), which has decreased compared with previous study , indicative of partial improvement. Short axis post contrast views showing subendocardial, midmyocardial and epicardial LGE in anterior, septal and with lesser degree anterolateral LV walls, mainly consistent with residual inflammation and with lesser degree areas of midmyocardial scar formation in anterior and septal walls ( F – H ) Fig. 6 A–F Short axis basal, mid and apical STIR images demonstrating subendocardial edema in different mid and apical walls (mainly in the apex) and also in RV apical region ( A – C ). These have been decreased compared with previous study , suggestive of significant partial improvement. Short axis and 4-chamber post contrast views showing subendocardial LGE in anterior and septal LV walls, consistent with small areas of residual inflammation and scar formation ( D – F ) Table 1 The timeline of the patient’s clinical presentations and paraclinical findings during both admissions and follow-up period Date Day Clinical description Eosinophilia STE (GLS) (%) Bull’s eye (W&W) LVEF by 2DE (%) CMR 18.04.2019 (first admission) 1 Fever, dyspnea, hypotension Significantly positive − 4.1 Reduced LS (all segments) 9.0 23.04.2019 3–5 No more fever, less dyspnea Getting better, None on the 5th day − 8.4 Present 24.0 Acute inflammation (severe LGE) 27.04.2019 9 Doing much better Absent − 12.1 Present 31.0 07.05.2019 19 Doing well Absent − 13.9 Present 38 03.07.2019 76 No symptoms Absent − 17.1 Present 48.0 Treatment non-compliance leading to disease recurrence 18.07.2019 (second admission) 91 Fever, dyspnea Present but less than the first admission − 10.4 Reduced LS mainly in the base, mid and apical regions 24.0 25.07.2019 98 Feeling much better Absent − 14.6 Present 39 Subendocardial and epicardial edema 19.09.2019 153 Doing well Absent − 12.9 Present 38.0 Small areas of residual inflammation and scar formation 20.11.2019 216 No symptoms Absent − 15.8 Present 48.0 21.01.2020 278 No symptoms Absent − 13.2 Present 42.0 25.04.2020 373 No symptoms Absent − 14.6 Present 45.0 CMR cardiac magnetic resonance, GLS global longitudinal strain, LS longitudinal strain, LVEF left ventricular ejection fraction, STE speckle tracking echocardiography, 2DE two-dimensional echocardiography, W&W wax and wanes
4.070313
0.970703
sec[1]/p[5]
en
0.999995
36698163
https://doi.org/10.1186/s44156-022-00013-6
[ "present", "scar", "formation", "walls", "absent", "subendocardial", "areas", "apical", "lvef", "however" ]
[ { "code": "JA82.2", "title": "Maternal care for transverse or oblique lie" }, { "code": "JA82.1", "title": "Maternal care for breech presentation" }, { "code": "JA82.Z", "title": "Maternal care for malpresentation of fetus, unspecified" }, { "code": "JA82.6", "title": "Maternal care for compound presentation" }, { "code": "JA82.5", "title": "Maternal care for multiple gestation with malpresentation of one fetus or more" }, { "code": "EH94", "title": "Scar of skin, not elsewhere classified" }, { "code": "FB32.Y", "title": "Other specified disorders of muscles" }, { "code": "EE60.1", "title": "Hypertrophic scar" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "9A77.Y", "title": "Other specified corneal scars or opacities" } ]
=== ICD-11 CODES FOUND === [JA82.2] Maternal care for transverse or oblique lie Also known as: Maternal care for transverse or oblique lie | Maternal care for oblique presentation | Maternal care for prolapse of arm or hand | Maternal care for transverse presentation of fetus | transverse presentation [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 [JA82.Z] Maternal care for malpresentation of fetus, unspecified Also known as: Maternal care for malpresentation of fetus, unspecified | Maternal care for malpresentation of fetus | abnormal fetal presentation | malpresentation of fetus | fetal malpresentation [JA82.6] Maternal care for compound presentation Also known as: Maternal care for compound presentation | compound presentation of fetus [JA82.5] Maternal care for multiple gestation with malpresentation of one fetus or more Also known as: Maternal care for multiple gestation with malpresentation of one fetus or more | abnormal presentation in multiple gestation [EH94] Scar of skin, not elsewhere classified Also known as: Scar of skin, not elsewhere classified | adherent scar of skin | cicatrix NOS | scar NOS | disfigurement due to scar [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 [EE60.1] Hypertrophic scar Definition: Hypertrophic scars result from the production of excessive amounts of collagen in the dermis during connective tissue repair following inflammation, injury or surgery. In contrast to keloid scars, they do not expand beyond the boundary of the initial injury or inflammation and may undergo spontaneous resolution. Also known as: Hypertrophic scar | hypertrophic scarring [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 [9A77.Y] Other specified corneal scars or opacities Also known as: Other specified corneal scars or opacities | Corneal infiltrate or haze | Surgically-induced corneal haze | Argentous corneal deposits | Corneal deposits in metabolic disorders === GRAPH WALKS === --- Walk 1 --- [JA82.2] Maternal care for transverse or oblique lie --PARENT--> [JA82] Maternal care for malpresentation of fetus Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal.... --EXCLUDES--> [?] Obstructed labour due to malposition or malpresentation of fetus Def: A condition affecting pregnant females, caused by the abnormal position of fetal head or the abnormal presentation of the fetus away from the fetal head in vertex.... --- Walk 2 --- [JA82.2] Maternal care for transverse or oblique lie --PARENT--> [JA82] Maternal care for malpresentation of fetus Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal.... --EXCLUDES--> [?] Obstructed labour due to malposition or malpresentation of fetus Def: A condition affecting pregnant females, caused by the abnormal position of fetal head or the abnormal presentation of the fetus away from the fetal head in vertex.... --- Walk 3 --- [JA82.1] Maternal care for breech presentation --PARENT--> [JA82] Maternal care for malpresentation of fetus Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal.... --CHILD--> [JA82.2] Maternal care for transverse or oblique lie --- Walk 4 --- [JA82.1] Maternal care for breech presentation --PARENT--> [JA82] Maternal care for malpresentation of fetus Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal.... --CHILD--> [JA82.1] Maternal care for breech presentation --- Walk 5 --- [JA82.Z] Maternal care for malpresentation of fetus, unspecified --PARENT--> [JA82] Maternal care for malpresentation of fetus Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal.... --EXCLUDES--> [?] Obstructed labour due to malposition or malpresentation of fetus Def: A condition affecting pregnant females, caused by the abnormal position of fetal head or the abnormal presentation of the fetus away from the fetal head in vertex.... --- Walk 6 --- [JA82.Z] Maternal care for malpresentation of fetus, unspecified --PARENT--> [JA82] Maternal care for malpresentation of fetus Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal.... --CHILD--> [JA82.1] Maternal care for breech presentation
[ "[JA82.2] Maternal care for transverse or oblique lie\n --PARENT--> [JA82] Maternal care for malpresentation of fetus\n Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal....\n --EXCLUDES--> [?] Obstructed labour due to malposition or malpresentation of fetus\n Def: A condition affecting pregnant females, caused by the abnormal position of fetal head or the abnormal presentation of the fetus away from the fetal head in vertex....", "[JA82.2] Maternal care for transverse or oblique lie\n --PARENT--> [JA82] Maternal care for malpresentation of fetus\n Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal....\n --EXCLUDES--> [?] Obstructed labour due to malposition or malpresentation of fetus\n Def: A condition affecting pregnant females, caused by the abnormal position of fetal head or the abnormal presentation of the fetus away from the fetal head in vertex....", "[JA82.1] Maternal care for breech presentation\n --PARENT--> [JA82] Maternal care for malpresentation of fetus\n Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal....\n --CHILD--> [JA82.2] Maternal care for transverse or oblique lie", "[JA82.1] Maternal care for breech presentation\n --PARENT--> [JA82] Maternal care for malpresentation of fetus\n Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal....\n --CHILD--> [JA82.1] Maternal care for breech presentation", "[JA82.Z] Maternal care for malpresentation of fetus, unspecified\n --PARENT--> [JA82] Maternal care for malpresentation of fetus\n Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal....\n --EXCLUDES--> [?] Obstructed labour due to malposition or malpresentation of fetus\n Def: A condition affecting pregnant females, caused by the abnormal position of fetal head or the abnormal presentation of the fetus away from the fetal head in vertex....", "[JA82.Z] Maternal care for malpresentation of fetus, unspecified\n --PARENT--> [JA82] Maternal care for malpresentation of fetus\n Def: Care provided for the pregnant female for incorrect position or orientation of the fetus at near term or during labour, determined by its relation to the spine of the mother and the birth canal....\n --CHILD--> [JA82.1] Maternal care for breech presentation" ]
JA82.2
Maternal care for transverse or oblique lie
[ { "from_icd11": "JA82.2", "icd10_code": "O322XX2", "icd10_title": "Maternal care for transverse and oblique lie, fetus 2" }, { "from_icd11": "JA82.2", "icd10_code": "O322XX0", "icd10_title": "Maternal care for transverse and oblique lie, not applicable or unspecified" }, { "from_icd11": "JA82.2", "icd10_code": "O322XX1", "icd10_title": "Maternal care for transverse and oblique lie, fetus 1" }, { "from_icd11": "JA82.2", "icd10_code": "O322", "icd10_title": "Maternal care for transverse and oblique lie" }, { "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" }, { "from_icd11": "JA82.1", "icd10_code": "O321XX3", "icd10_title": "Maternal care for breech presentation, fetus 3" }, { "from_icd11": "JA82.1", "icd10_code": "O321XX0", "icd10_title": "Maternal care for breech presentation, not applicable or unspecified" }, { "from_icd11": "JA82.1", "icd10_code": "O321", "icd10_title": "Maternal care for breech presentation" }, { "from_icd11": "JA82.Z", "icd10_code": "O328XX1", "icd10_title": "Maternal care for other malpresentation of fetus, fetus 1" }, { "from_icd11": "JA82.Z", "icd10_code": "O328XX0", "icd10_title": "Maternal care for other malpresentation of fetus, not applicable or unspecified" }, { "from_icd11": "JA82.Z", "icd10_code": "O328XX2", "icd10_title": "Maternal care for other malpresentation of fetus, fetus 2" }, { "from_icd11": "JA82.Z", "icd10_code": "O329XX0", "icd10_title": "Maternal care for malpresentation of fetus, unspecified, not applicable or unspecified" }, { "from_icd11": "JA82.Z", "icd10_code": "O328XX3", "icd10_title": "Maternal care for other malpresentation of fetus, fetus 3" }, { "from_icd11": "JA82.Z", "icd10_code": "O32", "icd10_title": "Maternal care for malpresentation of fetus" } ]
O322XX2
Maternal care for transverse and oblique lie, fetus 2
A 63 year-old male farmer with a history of a tick bite presented with a sudden onset of fever on May 28, 2014, with a temperature of 38.6 °C, accompanied by rash, nausea, anorexia, fatigue, enlarged lymph node, and general body aches. He presented to the emergency department of The First Affiliated Hospital of China Medical University (CMU) on June 4. Routine blood tests showed leukocytosis with peripheral blood plasmacytosis (white blood cell [WBC] count, 24.46 × 10 9 /L; proplasmacytes, 5%; mature plasma cells, 18%) and thrombocytopenia (platelets[PLT], 75 × 10 9 /L). Cytological examination of the bone marrow demonstrated plasmacytosis. With a preliminary diagnosis of MM, he was admitted to the Department of Hematology of CMU on June 6. Physical examination revealed palpable swollen lymph nodes in the submandibular and bilateral axillary regions, accompanied with dispersed red papules on chest and abdomen. Laboratory tests upon admission showed thrombocytopenia, increased alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) levels, prolonged prothrombin time (PT) and activated partial thromboplastin time (APTT). Immunofixation by electrophoresis revealed a polyclonal pattern with increased amounts of immunoglobulin (IgA, IgG, and IgM) and immunoglobulin light chains. Proteinuria was observed but Bence Jones proteinuria was negative. Because of abnormal bone marrow cytology, X-ray of skull, thoracic and lumbar vertebrae, and pelvis was performed, with normal findings. ELISA and RT-PCR were performed to detect SFTSV-specific IgM/IgG and SFTSV RNA as previously described . And the IgM antibody and RNA to SFTSV were positive. Bone marrow cytology showed plasmacytosis, with plasma cells accounting for 29.2% of all nucleated cells, including proplasmacytes (6.8%) and mature plasma cells (22.4%) . However, flow cytometric immunophenotyping (FCI) of bone marrow revealed that the increased plasma cells were not monoclonal . The patient was administered doxycycline, human immunoglobulins, plasma transfusion and other supporting treatments, and was improved. Finally, a diagnosis of reactive plasmacytosis associated with SFTS was reached. The clinical and laboratory findings are summarized in Table 1 . Fig. 1 Representative images of bone marrow cytology(Wright and Giemsa stain) showing plasmacytosis. a For case 1, ( b and c ) for case 2 at different time points Fig. 2 Representative scatter plots of bone marrow flow cytometric immunophenotyping. ( a - c ) For case 1, the incresed plasma cells were polyclonal (CD19 + CD38 + CD138 + cKappa+cLambda+) ( d - f ) for case 2, the incresed plasma cells were abnormal monoclonal (CD19 + CD38 + CD138 + cKappa-cLambda+) ( g - i ) for case 2, the incresed plasma cells disappear and were polyclonal (CD19 + CD38 + CD138 + cKappa+cLambda+) Table 1 Clinical findings and laboratory data of the two patients with SFTS who presented with reactive plasmacytosis Gender/age,y M/63 F/42 Occupation farmer farmer Onset to admission, d 8 7 Tick bite history + + Fever + + Gastrointestinal symptoms a + + Lymphadenopathy + + Rash + + Fatigue + _ hemorrhage b _ + Apathy _ + WBC (3.5–9.5 a 10~ 9/L) 24.46 2.58 RBC(M: 4.3–5.8 a 10~ 12/L, F: 3.8–5.1 a 10~ 12/L) 3.86 4.03 PLT(125–350 a 10~ 9/L) 75 25 PT(11.0–13.7 s) 16.9 17.5 Fg(2.00–4.00 g/L) 2.9 1.82 APTT(31.5–43.5 s) 68.3 90.0 Proteinuria 1+ microscale AMY(28–100 U/L) 30 230 LPS(13–60 U/L) 27 194 ALT(13–69 U/L) 37 727 AST(15–46 U/L) 28 2940 ALP(38–126 U/L) 244 120 LDH(135–225 U/L) 794(313–618 U/L) 2690 CK(39–308 U/L) 21 1086 Immunofixation electrophoresis polyclonal IgG polyclonal IgG IgA(0.82–4.53 g/L) 2.64 2.43 IgG(7.51–15.6 g/L) 17.2 28.5 IgM(0.46–3.04 g/L) 28.1 0.76 Antibody IgM, RNA of SFTSV + + Bone marrow cytology Plasma cells accounting for 29.2%: naïve (6.8%) and mature (22.4%) ones. Plasma cells accounting for 50.4%: naïve (39.6%) and mature (10.8%); normal mature plasma cells accounting for 2.2%, no naive plasma cells. Flow cytometric immunophenotyping(FCI) Plasma cells of normal phenotype accounting for 20%, mainly expressing CD38, CD 138, CD19; partly expressing CD 200, cKappa, and cLambda, not expressed CD20, Kappa, Lambda, CD25, CD35, CD22, FMC7, CD103, CD10, CD5, IgM, CD23, CD117, and CD56. Plasma cells of abnormal phenotype accounting for 44.7%, mainly expressing CD38, CD 138, CD19, and cLambda; not expressing CD7, CD117, CD33, CD10, CD34, CD28, CD56, CD25, CD11c, CD5, FMC7, CD22, TdT, CD200, CD20, Kappa, Lambda, and cKappa. Plasma cells of normal phenotype accounting for 1.1%, mainly expressing CD38, CD138, CD19, partly expressing cKappa and cLambda. outcome Recoverd Recoverd c a Nausea, vomiting, anorexia, or abdominal discomfort b Multiple skin petechiae or ecchymosis c This patient was diagnosed with angioimmunoblastic T-cell lymphoma 8 months later and died eventually
4.183594
0.949707
sec[1]/sec[0]/p[0]
en
0.999996
30348099
https://doi.org/10.1186/s12879-018-3431-z
[ "plasma", "cells", "bone", "marrow", "accounting", "plasmacytosis", "ckappa", "clambda", "expressing", "mature" ]
[ { "code": "2A83.2", "title": "Solitary plasmacytoma" }, { "code": "2A83.Z", "title": "Plasma cell neoplasm, unspecified" }, { "code": "5D0Y", "title": "Other specified metabolic disorders" }, { "code": "2A83.Y", "title": "Other specified plasma cell neoplasms" }, { "code": "2A83.4", "title": "Plasma cell leukaemia" }, { "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 === [2A83.2] Solitary plasmacytoma Definition: A single focus of clonal (malignant) plasma cells either in the bone or in another anatomic site without peripheral blood involvement. Also known as: Solitary plasmacytoma | solitary plasmacytoma without mention of remission | solitary myeloma | localised malignant plasma cell tumour NOS | plasmacytoma NOS Includes: solitary myeloma [2A83.Z] Plasma cell neoplasm, unspecified Also known as: Plasma cell neoplasm, unspecified | Plasma cell neoplasms | plasma cell tumours | plasma cells dyscrasia | plasma cell neoplasm NOS [5D0Y] Other specified metabolic disorders Also known as: Other specified metabolic disorders | Disorders of plasma-protein metabolism, not elsewhere classified | abnormal protein transport | dysproteinaemia | Absence of albumin in blood [2A83.Y] Other specified plasma cell neoplasms Also known as: Other specified plasma cell neoplasms | POEMS syndrome | Osteosclerotic myeloma | Peripheral neuropathy - organomegaly - endocrinopathy - monoclonal plasma cell disorder - skin changes [2A83.4] Plasma cell leukaemia Definition: An aggressive plasma cell neoplasm. It is characterised by the presence of neoplastic plasma cells in the peripheral blood (PB). The neoplastic plasma cells comprise more than 20% of the white cells in the PB or the number of clonal plasma cells in the PB exceeds 2x10⁹/L. Also known as: Plasma cell leukaemia | plasma cell leukaemia, NOS | leukemic plasma cell | plasma cell leukaemia without mention of remission | plasmacytic leukaemia [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 --- [2A83.2] Solitary plasmacytoma Def: A single focus of clonal (malignant) plasma cells either in the bone or in another anatomic site without peripheral blood involvement.... --PARENT--> [2A83] Plasma cell neoplasms Def: Plasma cell neoplasms are a group of disorders characterized by the monoclonal expansion of terminally differentiated B cells (plasma cells) that produce monoclonal immunoglobulins, known as M protein... --CHILD--> [2A83.0] Monoclonal gammopathy of undetermined significance --- Walk 2 --- [2A83.2] Solitary plasmacytoma Def: A single focus of clonal (malignant) plasma cells either in the bone or in another anatomic site without peripheral blood involvement.... --PARENT--> [2A83] Plasma cell neoplasms Def: Plasma cell neoplasms are a group of disorders characterized by the monoclonal expansion of terminally differentiated B cells (plasma cells) that produce monoclonal immunoglobulins, known as M protein... --CHILD--> [2A83.0] Monoclonal gammopathy of undetermined significance --- Walk 3 --- [2A83.Z] Plasma cell neoplasm, unspecified --PARENT--> [2A83] Plasma cell neoplasms Def: Plasma cell neoplasms are a group of disorders characterized by the monoclonal expansion of terminally differentiated B cells (plasma cells) that produce monoclonal immunoglobulins, known as M protein... --CHILD--> [2A83.1] Plasma cell myeloma Def: A bone marrow-based plasma cell neoplasm usually characterised by presence of a serum monoclonal protein and/or urinary light chains. ”CRAB” criteria (calcium elevation (hypercalcaemia), renal failure... --- Walk 4 --- [2A83.Z] Plasma cell neoplasm, unspecified --PARENT--> [2A83] Plasma cell neoplasms Def: Plasma cell neoplasms are a group of disorders characterized by the monoclonal expansion of terminally differentiated B cells (plasma cells) that produce monoclonal immunoglobulins, known as M protein... --CHILD--> [2A83.2] Solitary plasmacytoma Def: A single focus of clonal (malignant) plasma cells either in the bone or in another anatomic site without peripheral blood involvement.... --- Walk 5 --- [5D0Y] Other specified metabolic disorders --PARENT--> [?] Other metabolic disorders --PARENT--> [?] Metabolic disorders --- Walk 6 --- [5D0Y] Other specified metabolic disorders --PARENT--> [?] Other metabolic disorders --PARENT--> [?] Metabolic disorders
[ "[2A83.2] Solitary plasmacytoma\n Def: A single focus of clonal (malignant) plasma cells either in the bone or in another anatomic site without peripheral blood involvement....\n --PARENT--> [2A83] Plasma cell neoplasms\n Def: Plasma cell neoplasms are a group of disorders characterized by the monoclonal expansion of terminally differentiated B cells (plasma cells) that produce monoclonal immunoglobulins, known as M protein...\n --CHILD--> [2A83.0] Monoclonal gammopathy of undetermined significance", "[2A83.2] Solitary plasmacytoma\n Def: A single focus of clonal (malignant) plasma cells either in the bone or in another anatomic site without peripheral blood involvement....\n --PARENT--> [2A83] Plasma cell neoplasms\n Def: Plasma cell neoplasms are a group of disorders characterized by the monoclonal expansion of terminally differentiated B cells (plasma cells) that produce monoclonal immunoglobulins, known as M protein...\n --CHILD--> [2A83.0] Monoclonal gammopathy of undetermined significance", "[2A83.Z] Plasma cell neoplasm, unspecified\n --PARENT--> [2A83] Plasma cell neoplasms\n Def: Plasma cell neoplasms are a group of disorders characterized by the monoclonal expansion of terminally differentiated B cells (plasma cells) that produce monoclonal immunoglobulins, known as M protein...\n --CHILD--> [2A83.1] Plasma cell myeloma\n Def: A bone marrow-based plasma cell neoplasm usually characterised by presence of a serum monoclonal protein and/or urinary light chains. ”CRAB” criteria (calcium elevation (hypercalcaemia), renal failure...", "[2A83.Z] Plasma cell neoplasm, unspecified\n --PARENT--> [2A83] Plasma cell neoplasms\n Def: Plasma cell neoplasms are a group of disorders characterized by the monoclonal expansion of terminally differentiated B cells (plasma cells) that produce monoclonal immunoglobulins, known as M protein...\n --CHILD--> [2A83.2] Solitary plasmacytoma\n Def: A single focus of clonal (malignant) plasma cells either in the bone or in another anatomic site without peripheral blood involvement....", "[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --PARENT--> [?] Metabolic disorders", "[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --PARENT--> [?] Metabolic disorders" ]
2A83.2
Solitary plasmacytoma
[ { "from_icd11": "2A83.2", "icd10_code": "C9030", "icd10_title": "Solitary plasmacytoma not having achieved remission" }, { "from_icd11": "2A83.2", "icd10_code": "C9032", "icd10_title": "Solitary plasmacytoma in relapse" }, { "from_icd11": "2A83.2", "icd10_code": "C9031", "icd10_title": "Solitary plasmacytoma in remission" }, { "from_icd11": "2A83.2", "icd10_code": "C903", "icd10_title": "Solitary plasmacytoma" }, { "from_icd11": "2A83.Z", "icd10_code": "C90", "icd10_title": "Multiple myeloma and malignant plasma cell neoplasms" }, { "from_icd11": "2A83.4", "icd10_code": "C9010", "icd10_title": "Plasma cell leukemia not having achieved remission" }, { "from_icd11": "2A83.4", "icd10_code": "C9012", "icd10_title": "Plasma cell leukemia in relapse" }, { "from_icd11": "2A83.4", "icd10_code": "C9011", "icd10_title": "Plasma cell leukemia in remission" }, { "from_icd11": "2A83.4", "icd10_code": "C901", "icd10_title": "Plasma cell leukemia" }, { "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]" } ]
C9030
Solitary plasmacytoma not having achieved remission