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The emergency medical service (EMS) was called by the parents of a 2.5-month-old infant. The parents of a previously healthy infant reported a sudden loss of consciousness and respiratory arrest. The ambulance crew arrived 8 minutes after the initial call and found the infant in cardiac arrest. The parents had started resuscitation according to instructions from the EMS dispatcher over the phone (∼9 minutes). Cardiopulmonary resuscitation was immediately commenced by the EMS physician. After an unsuccessful attempt to insert a peripheral venous catheter, IO access into the left tibial tuberosity was performed to provide vascular access. The heart rate was restored ∼2 minutes after the start of medical resuscitation. The infant was intubated using a nasotracheal tube and brought to the emergency unit and later to the intensive care and resuscitation unit (ICRU) of the Pediatric Department at the University Hospital. Upon admission to the ICRU, the patient was described as being nonreactive, with mydriatic pupils and unmeasurable blood pressure. Inotropic support (initiated at the scene) was continued with a high-dose adrenaline. During admission, a swelling of the left lower limb (the side with inserted IO cannula) was immediately appreciated. Due to the suspected extravasation and extramedullary distribution of catecholamines and crystalloids, identical IO access was established on the lower right limb and the IO needle on the left leg was removed. A central venous catheter was later introduced via the left subclavian vein. Baseline laboratory tests revealed leukocytosis with a left shift, procalcitonin elevation, laboratory signs of severe hepatopathy and coagulopathy. Clinical signs of multiple organ failure were present. After ∼120 minutes, the infant's condition was stabilized, and acute computed tomography scan (CT brain scan + the whole body CT scan) was performed, which revealed extensive thrombosis of the cerebral veins and generalized visceral and limb vasoconstriction. About 3 hours after admission, a vascular surgeon was contacted due to increased edema and livid discoloration of the lower left leg. The vascular surgeon evaluated the limb as a combination of iatrogenic compartment syndrome (due to extravasation of catecholamines and crystalloids) and limb ischemia. He described a hard swelling of the entire lower leg and livid discoloration of almost the entire limb . Urgent fasciotomy of all muscle beds was indicated as the only way to save the limb with two incisions as usual from two skin incisions . The muscles extruded immediately after cutting the fascia. Large areas of inferior and posterior groups of the muscles were grayish and not likely vital. An incision was also made in the dorsal foot area, where marked swelling was also present. The fasciotomy wounds were covered with a lubricated, moist dressing. A dressing change was scheduled at 48 hours post fasciotomy. During these 2 days, the infant remained in very serious condition, and was on permanent circulatory support. An EEG scan revealed a severely abnormal electroencephalogram, with a very depressed background with periodic occurrence of burst suppression EEG pattern. The EEG pattern corresponds to an unfavorable prognosis. Two days later, the dressing on the lower left limb was changed and clearly necrotic tissues were removed. The vitality of most muscles was still very unlikely. In the following period, the patient's condition stabilized, but the cause of circulatory arrest remained unknown and severe consciousness disorder continued. The dressing on the lower left leg was changed every 2 days in the operating room. Full conservative anticoagulation and vasodilation therapy were still indicated. The finding on the limb gradually deteriorated, and the patient developed skin necrosis that was gradually removed along with a part of the muscles. While in comprehensive intensive care, the infant's overall condition and consciousness disorder improved, but the local finding on the left lower limb significantly progressed and resulted in above knee amputation on day 19 after the admission . The amputation stump healed without complications, the overall condition continued to improve, and the infant was discharged to home care on day 51 after the admission. During the hospitalization, no clear explanation was found for the primary cause of the cardiac arrest. No congenital developmental defects and no mitochondrial defects were found. As a result of postischemic brain damage, recurrent epileptic attacks occur. A magnetic resonance imaging scan of the brain performed (1 month after the event) showed clear postischemic changes. The extent of brain tissue damage will be revealed during further development of the infant.
3.949219
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30574447
https://doi.org/10.1055/s-0038-1661407
[ "limb", "scan", "arrest", "minutes", "resuscitation", "brain", "muscles", "dressing", "parents", "consciousness" ]
[ { "code": "ND56.1", "title": "Open wound of unspecified body region" }, { "code": "LB9Z", "title": "Structural developmental anomalies of the skeleton, unspecified" }, { "code": "FB56.6", "title": "Other specified soft tissue disorders" }, { "code": "5B51&XS25", "title": "Severe wasting in infants, children or adolescents" }, { "code": "ND55", "title": "Other injuries of leg, level unspecified" }, { "code": "MB71.Y", "title": "Other specified clinical findings on diagnostic imaging of central nervous system" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "JA66.3", "title": "Abnormal ultrasonic finding on antenatal screening of mother" }, { "code": "PB28", "title": "Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance" }, { "code": "PC98", "title": "Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance" } ]
=== ICD-11 CODES FOUND === [ND56.1] Open wound of unspecified body region Also known as: Open wound of unspecified body region | cut NOS | open wound NOS | penetrating wound NOS | Puncture wound with foreign body unspecified body region Excludes: Traumatic amputations involving multiple body regions | Open wounds involving multiple body regions | traumatic amputation NOS [LB9Z] Structural developmental anomalies of the skeleton, unspecified Also known as: Structural developmental anomalies of the skeleton, unspecified | Abnormal bone development | skeletal anomaly NOS [FB56.6] Other specified soft tissue disorders Also known as: Other specified soft tissue disorders | Fat necrosis | fatty necrosis | Profichet's disease | Sloughing of fascia [ND55] Other injuries of leg, level unspecified Also known as: Other injuries of leg, level unspecified | other injuries of lower limb, level unspecified | Superficial injury of leg, level unspecified | Abrasion of leg, level unspecified | Contusion of leg, level unspecified Excludes: Fracture of leg, level unspecified | Injuries involving multiple body regions [MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system Also known as: Other specified clinical findings on diagnostic imaging of central nervous system | Epidural haemorrhage, localised, no generalised mass effect or midline shift | Epidural haemorrhage, confined to a small region in relation to a fracture | Epidural haemorrhage, size less than 1 x 1 x 1 cm, not in relation to a fracture | Epidural haemorrhage, mass effect or midline shift less than 0.5 cm [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [JA66.3] Abnormal ultrasonic finding on antenatal screening of mother Definition: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother. Also known as: Abnormal ultrasonic finding on antenatal screening of mother | antenatal ultrasound scan abnormal [PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance Also known as: Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance | accidental overdose of other or unspecified drug, medicament or biological substance | accidental poisoning by other or unspecified drug, medicament or biological substance | other or unspecified drug, medicament or biological substance taken in error | accidental drug overdose [PC98] Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance Also known as: Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance | Intentional self-poisoning by and exposure to other or unspecified drug, medicament or biological substance | Intentional overdose of other or unspecified drug, medicament or biological substance | self-administered overdose by drugs | Intentional self-harm by exposure to or harmful effects of systemic antibiotics === GRAPH WALKS === --- Walk 1 --- [ND56.1] Open wound of unspecified body region --EXCLUDES--> [?] Open wounds involving multiple body regions --EXCLUDES--> [?] Traumatic amputations involving multiple body regions --- Walk 2 --- [ND56.1] Open wound of unspecified body region --EXCLUDES--> [?] Open wounds involving multiple body regions --EXCLUDES--> [?] Traumatic amputations involving multiple body regions --- Walk 3 --- [LB9Z] Structural developmental anomalies of the skeleton, unspecified --PARENT--> [?] Structural developmental anomalies of the skeleton Def: A deformation established before birth of an anatomical structure of one or more bones.... --CHILD--> [LB71] Structural developmental anomalies of facial bones Def: Any condition caused by failure of the facial bones to correctly develop during the antenatal period.... --- Walk 4 --- [LB9Z] Structural developmental anomalies of the skeleton, unspecified --PARENT--> [?] Structural developmental anomalies of the skeleton Def: A deformation established before birth of an anatomical structure of one or more bones.... --CHILD--> [LB72] Structural developmental anomalies of shoulder girdle Def: Any condition caused by failure of the shoulder girdle to correctly develop during the antenatal period.... --- Walk 5 --- [FB56.6] Other specified soft tissue disorders --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone.... --EXCLUDES--> [?] Radiculopathy --- Walk 6 --- [FB56.6] Other specified soft tissue disorders --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone.... --EXCLUDES--> [?] Mononeuropathy
[ "[ND56.1] Open wound of unspecified body region\n --EXCLUDES--> [?] Open wounds involving multiple body regions\n --EXCLUDES--> [?] Traumatic amputations involving multiple body regions", "[ND56.1] Open wound of unspecified body region\n --EXCLUDES--> [?] Open wounds involving multiple body regions\n --EXCLUDES--> [?] Traumatic amputations involving multiple body regions", "[LB9Z] Structural developmental anomalies of the skeleton, unspecified\n --PARENT--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....\n --CHILD--> [LB71] Structural developmental anomalies of facial bones\n Def: Any condition caused by failure of the facial bones to correctly develop during the antenatal period....", "[LB9Z] Structural developmental anomalies of the skeleton, unspecified\n --PARENT--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....\n --CHILD--> [LB72] Structural developmental anomalies of shoulder girdle\n Def: Any condition caused by failure of the shoulder girdle to correctly develop during the antenatal period....", "[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --EXCLUDES--> [?] Radiculopathy", "[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --EXCLUDES--> [?] Mononeuropathy" ]
ND56.1
Open wound of unspecified body region
[ { "from_icd11": "ND56.1", "icd10_code": "T141", "icd10_title": "" }, { "from_icd11": "LB9Z", "icd10_code": "Q8789", "icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified" }, { "from_icd11": "LB9Z", "icd10_code": "Q8781", "icd10_title": "Alport syndrome" }, { "from_icd11": "LB9Z", "icd10_code": "Q742", "icd10_title": "Other congenital malformations of lower limb(s), including pelvic girdle" }, { "from_icd11": "LB9Z", "icd10_code": "Q749", "icd10_title": "Unspecified congenital malformation of limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q740", "icd10_title": "Other congenital malformations of upper limb(s), including shoulder girdle" }, { "from_icd11": "LB9Z", "icd10_code": "Q741", "icd10_title": "Congenital malformation of knee" }, { "from_icd11": "LB9Z", "icd10_code": "Q875", "icd10_title": "Other congenital malformation syndromes with other skeletal changes" }, { "from_icd11": "LB9Z", "icd10_code": "Q748", "icd10_title": "Other specified congenital malformations of limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q89", "icd10_title": "Other congenital malformations, not elsewhere classified" }, { "from_icd11": "LB9Z", "icd10_code": "Q65-Q79", "icd10_title": "" }, { "from_icd11": "LB9Z", "icd10_code": "Q73", "icd10_title": "Reduction defects of unspecified limb" }, { "from_icd11": "LB9Z", "icd10_code": "Q730", "icd10_title": "Congenital absence of unspecified limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q731", "icd10_title": "Phocomelia, unspecified limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q74", "icd10_title": "Other congenital malformations of limb(s)" } ]
T141
A 67-year-old woman was referred to the geriatric psychiatric ward complaining of depressed mood, anhedonia, nervousness, brain chirping, fatigue, suicidal ideation, decreased appetite and poor sleep starting 5 months after contracting coronavirus disease 2019. She had intermittent depression for more than 31 years, with one to two episodes per year, each lasting about one month. She had regular outpatient visits and took medicine according to the doctor’s instructions. During this period, there were two severe episodes, one in September 2014 due to a long journey, and the other (this episode) in December 2022 after contracting coronavirus disease 2019. The patient responded well to citalopram, escitalopram (maximum daily dose of 20 mg), and duloxetine (maximum daily dose of 60 mg) while intolerant to venlafaxine, bupropion and trazodone. Her mother was diagnosed with mania. The patient had no history of iron deficiency anaemia, hypothyroidism, or other medical conditions and had no history of any psychoactive substance abuse. No obvious abnormalities were found upon physical or neurologic examination or laboratory tests. She was diagnosed with recurrent depressive disorder and received escitalopram 15 mg/d with no obvious effect over 15 weeks of regular administration, followed by 2 weeks of combined use of duloxetine 60 mg/d as an outpatient therapy, which was less effective. Therefore, we reduced the dose of escitalopram to 10 mg/d and increased the dose of duloxetine to 80 mg/d on admission. Clonazepam at an initial dose of 1.5 mg/d was given to promote sleep. On the morning of the third day, the patient reported itching and creeping sensations deep inside her bilateral shoulders and arms before bedtime, with some remission after moving, which had never happened before. A gradual improvement in mood was reached, but a lack of energy persisted. Thus, escitalopram was discontinued, and duloxetine was increased to 100 mg/d on the sixth day. One week later, the patient exhibited continuous itching and creeping, which caused significant disturbances in sleep at night and drowsiness in the morning. Duloxetine was decreased to 90 mg/d, and clonazepam was concomitantly decreased to 0.5 mg/d for the unrelieved paraesthesia. However, the feeling of creep still held. By clarifying the history, we learned that the patient had a history of intermittent leg soreness since age 41, which increased at rest and decreased after stretching, 3–4 times a week, lasting for half an hour to 4 hours each day, and typically occurred in the evening; however, the patient had never been diagnosed with RLS and had not received specific treatment. The total International Restless Legs Study Group Severity Rating Scale score was 25, indicating severe RLS. None of her first-degree family members reported any previous history of RLS. To consolidate the condition, pramipexole 0.125 mg/d was prescribed to relieve the unpleasant sensations, the dose of duloxetine kept the same. The next morning, the patient reported good sleep without any paraesthesia. She experienced a burning stomach after taking pramipexole, which was relieved by vitamin B6, and this sensation disappeared 3 days later. Polysomnography suggested prolonged sleep latency (34.5 min), poor sleep continuity (27 wake times), deep sleep loss (no N3), low sleep efficiency (80.8%), moderate obstructive sleep apnea hypopnea (apnea hypopnea index = 20.3/hour), multiple transient mentalis myoelectric activities in rapid eye movement sleep, and a periodic leg movement index of 3.6/hour during sleep (Table 1 and 2 ). After five days, an attempt was made to increase the dose of duloxetine to 120 mg/d to improve energy because of insufficient efficacy at a dose of 90 mg/d. Moreover, we stopped pramipexole to determine whether the discomfort worsened. Not surprisingly, she experienced recurrence of unpleasant sensations in her arms. In the next 3 days, the dose of duloxetine was tapered to 30 mg/d, after which the symptoms disappeared. After consultation with the patient, we ultimately prescribed 40 mg/d duloxetine and 0.125 mg/d pramipexole to balance the efficacy and adverse effects . Since the patient had difficulty falling and maintaining asleep, trazodone 25 mg/d and clonazepam 1.0 mg/d were added. When her mood and sleep stabilized, clonazepam was gradually discontinued after discharge. She reported complete remission of depression and RLS. Over the 6 months of follow-up, the patient comes to the outpatient clinic every month and takes medicine regularly. Her mood remained stable, and no RLS or RAS reappeared. Pramipexole was discontinued to prevent long-term treatment-induced worsening of RLS symptoms. The patient is still undergoing regular outpatient visits.
3.894531
0.979492
sec[1]/p[0]
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38730422
https://doi.org/10.1186/s12888-024-05763-7
[ "sleep", "duloxetine", "which", "pramipexole", "mood", "outpatient", "escitalopram", "clonazepam", "regular", "this" ]
[ { "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": "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": "6A8Z", "title": "Mood disorders, unspecified" } ]
=== 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 [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 [6A8Z] Mood disorders, unspecified Also known as: Mood disorders, unspecified | mood disorders, nonorganic or unspecified === 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... --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics --- 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 --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 4 --- [MG41] Sleep disturbance, not elsewhere classified --EXCLUDES--> [?] 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... --PARENT--> [?] ICD Category --- 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.Z] Narcolepsy, unspecified --- 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--> [7A20.1] Narcolepsy, Type 2 Def: Type 2 narcolepsy is a disorder of excessive sleepiness characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep and abnormal manifestations of REM sleep as demonstra...
[ "[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 --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics", "[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 --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....", "[MG41] Sleep disturbance, not elsewhere classified\n --EXCLUDES--> [?] 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 --PARENT--> [?] ICD Category", "[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", "[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--> [7A20.1] Narcolepsy, Type 2\n Def: Type 2 narcolepsy is a disorder of excessive sleepiness characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep and abnormal manifestations of REM sleep as demonstra..." ]
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
The patient, a 31-year-old Caucasian female, was diagnosed with primary EM at the age of 18. She was later diagnosed with exophthalmos and concomitant megalocornea and with bilateral congenital glaucoma resulting in loss and severe impairment of vision at the level of right and left eye, respectively. The symptoms of primary erythromelalgia started at the age of 6 with intermittent painful skin redness and swelling of both her feet and lower parts of the legs. Over time her symptoms increased in frequency and severity often requiring hospitalization. A chronic treatment with NSAIDs and exposure of lower legs to cold compresses were provided resulting in an improvement of symptoms. She was hospitalized once more in October 2008, because the worsening of symptoms evolved into constant erythema and warmth of the lower extremities with associated pain. Her symptoms were aggravated even further by exertion, stress, weight-bearing, and gravity dependency and she spent most time immersing her feet in cold water. She could not wear socks or shoes or cover her feet or legs and she was unresponsive to any of her current medications. Because of severe pain with intense burning to the extremities, the patient was then moved from the Dermatology Unit to our division. Physical examination revealed increased skin temperature to the lower extremities, very strong burning pain, and swollen ankles. There was evidence of chronic immersion injury to the skin on her feet which was thickened, reddened, and macerated with ulcerations. The patient rated her pain as 10/10 on a 0 to 10 scale value (numeric rating scale pain intensity, NRSPI) when lying completely still. She displayed secondary allodynia at the level of the perimalleolar areas and bilateral hyperalgesia at the level of the gastrocnemius and of the instep. As first line of treatment, we started with pregabalin 75 mg twice a day and oxycodone 5 mg twice a day. The drug dosage was then increased in the following weeks up to 150 mg twice a day and 20 mg twice a day for pregabalin and oxycodone, respectively. This therapeutic regimen yielded a considerable improvement of the symptoms such as pain relief (NRSPI score: 3-4), decreased burning sensation to the extremities with need for less cold medications, and regular nocturnal sleep; however, the swelling of lower limbs remained unchanged. The improvement of symptoms lasted until February 2010. In March 2010, the patient was again hospitalized in our unit, since she reported an escalation of pain without apparent triggers. The disabling pain was unresponsive to the therapy; thus, we decided to perform opioid rotation and to replace the anticonvulsant. However, the increase of the drugs yielded heavy side-effects as drowsiness, constipation, and profound asthenia, so we decided in favor of an implantable intrathecal pump drug delivery system. To determine whether the patient will benefit from an implant we performed a proper trial phase. During the trial, the planned drugs were infused through an indwelling catheter that was placed intrathecally. We started with the administration of an anaesthetic at low dose followed by administration of an opioid at low dose 24 hours later. The trial performed with administration of 0.03 mg morphine revealed an improvement of painful symptoms; however, the appearance of intense itching on her face occurred; thus, we decided to use Ziconotide. A fortnight after the test the patient underwent the implant of a spinal port a cache for Ziconotide titration in our unit. The drug was administered through a micropump following a low titration schedule starting from the dosage of 0.3 mcg/ die to the dosage of 1.2 mcg/ die . As a result we observed a clear-cut improvement of the symptoms with pain relief (NRSPI score: 3) and disappearance of allodynia and hyperalgesia. The administration of the anticonvulsant was interrupted and the dosage of opioid, orally administered, was reduced to 5 mg twice a day. At the end of titration the patient was again hospitalized once more in our division to be subjected to the final implant of the intrathecal pump drug delivery system (10 mL Tricumed model/delivering 0.26 mL/daily) with a dosage of 1.8 mcg/ die of Ziconotide. We also observed an unexpected result following administration of Ziconotide: the legs and feet of the patient which at the time of admission were swollen and tumefied dramatically improved after one week . In April 2013, the patient made the pump recharging with a delay of 4 days and came to our observation with her legs and feet swollen along with burning pain. Two days after refill with the usual dosage of Ziconotide the legs were no longer swollen, with no burning pain and with noticeable improvement after one week .
3.943359
0.979004
sec[1]/p[0]
en
0.999998
26609309
https://doi.org/10.1155/2015/592170
[ "pain", "feet", "legs", "improvement", "burning", "twice", "administration", "ziconotide", "extremities", "swollen" ]
[ { "code": "MG3Z", "title": "Pain, unspecified" }, { "code": "8E43.Z", "title": "Pain disorders, unspecified" }, { "code": "MG31.Z", "title": "Acute pain, unspecified" }, { "code": "MG30.Z", "title": "Chronic pain, unspecified" }, { "code": "FB56.2", "title": "Myalgia" }, { "code": "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" } ]
=== ICD-11 CODES FOUND === [MG3Z] Pain, unspecified Also known as: Pain, unspecified | pain observations | pain NOS | generalised pain | generalised pain, NOS [8E43.Z] Pain disorders, unspecified Also known as: Pain disorders, unspecified | Pain disorders [MG31.Z] Acute pain, unspecified Also known as: Acute pain, unspecified | Acute pain [MG30.Z] Chronic pain, unspecified Also known as: Chronic pain, unspecified | Chronic pain [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain [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 === GRAPH WALKS === --- Walk 1 --- [MG3Z] Pain, unspecified --PARENT--> [?] Pain --CHILD--> [MG31] Acute pain Def: Pain with a duration of less than 3 months. This code should be used only when there is no further specification of site.... --- Walk 2 --- [MG3Z] Pain, unspecified --PARENT--> [?] Pain --EXCLUDES--> [?] Mastodynia Def: The symptom of breast pain. This symptom may be classified as cyclic or non-cyclical depending on the clinical patterns.... --- Walk 3 --- [8E43.Z] Pain disorders, unspecified --PARENT--> [8E43] Pain disorders --CHILD--> [8E43.Z] Pain disorders, unspecified --- Walk 4 --- [8E43.Z] Pain disorders, unspecified --PARENT--> [8E43] Pain disorders --EXCLUDES--> [?] Chronic neuropathic pain Def: Chronic neuropathic pain is chronic pain caused by a lesion or disease of the somatosensory nervous system. The pain may be spontaneous or evoked, as an increased response to a painful stimulus (hyper... --- Walk 5 --- [MG31.Z] Acute pain, unspecified --PARENT--> [MG31] Acute pain Def: Pain with a duration of less than 3 months. This code should be used only when there is no further specification of site.... --CHILD--> [MG31.0] Acute pain in the face, not elsewhere classified --- Walk 6 --- [MG31.Z] Acute pain, unspecified --PARENT--> [MG31] Acute pain Def: Pain with a duration of less than 3 months. This code should be used only when there is no further specification of site.... --CHILD--> [MG31.1] Acute headache, not elsewhere classified
[ "[MG3Z] Pain, unspecified\n --PARENT--> [?] Pain\n --CHILD--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....", "[MG3Z] Pain, unspecified\n --PARENT--> [?] Pain\n --EXCLUDES--> [?] Mastodynia\n Def: The symptom of breast pain. This symptom may be classified as cyclic or non-cyclical depending on the clinical patterns....", "[8E43.Z] Pain disorders, unspecified\n --PARENT--> [8E43] Pain disorders\n --CHILD--> [8E43.Z] Pain disorders, unspecified", "[8E43.Z] Pain disorders, unspecified\n --PARENT--> [8E43] Pain disorders\n --EXCLUDES--> [?] Chronic neuropathic pain\n Def: Chronic neuropathic pain is chronic pain caused by a lesion or disease of the somatosensory nervous system. The pain may be spontaneous or evoked, as an increased response to a painful stimulus (hyper...", "[MG31.Z] Acute pain, unspecified\n --PARENT--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....\n --CHILD--> [MG31.0] Acute pain in the face, not elsewhere classified", "[MG31.Z] Acute pain, unspecified\n --PARENT--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....\n --CHILD--> [MG31.1] Acute headache, not elsewhere classified" ]
MG3Z
Pain, unspecified
[ { "from_icd11": "MG3Z", "icd10_code": "R52", "icd10_title": "Pain, unspecified" }, { "from_icd11": "MG3Z", "icd10_code": "R529", "icd10_title": "" }, { "from_icd11": "MG31.Z", "icd10_code": "R520", "icd10_title": "" }, { "from_icd11": "MG30.Z", "icd10_code": "R521", "icd10_title": "" }, { "from_icd11": "MG30.Z", "icd10_code": "R522", "icd10_title": "" }, { "from_icd11": "FB56.2", "icd10_code": "M7918", "icd10_title": "Myalgia, other site" }, { "from_icd11": "FB56.2", "icd10_code": "M7910", "icd10_title": "Myalgia, unspecified site" }, { "from_icd11": "FB56.2", "icd10_code": "M7912", "icd10_title": "Myalgia of auxiliary muscles, head and neck" }, { "from_icd11": "FB56.2", "icd10_code": "M791", "icd10_title": "Myalgia" }, { "from_icd11": "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" } ]
R52
Pain, unspecified
Our patient, a 54-year-old female, had a history of chololithiasis after an ultrasound exam of the abdomen thirty years ago, due to non-specific abdominal pain, which revealed multiple echogenic shadowing stones within the gallbladder. During a recent visit to her personal physician, she was advised to have a magnetic resonance image (MRI) scan in order to evaluate the current state of her reported history of chololithiasis. MRI revealed multiple calculi in the gallbladder as well as within the common bile duct. The patient had a surgical history of right leg amputation due to an accident and was not taking any medication. The diagnosis was followed by ERCP. During this procedure, a guidewire under fluoroscopy was passed into the common bile duct, and contrast was injected, highlighting multiple filling defects (>4). Endoscopic papillary balloon dilation of the common bile duct was performed resulting in the gradual exit of bile duct stones. Subsequently, a plastic stent 10 fr–9 cm was placed in the common bile duct to ensure bile drainage . During the first day of her hospitalization, the patient started complaining of pain radiating to her back. Ultrasound examination of the abdomen revealed a collection of fluid with thickened hyperechoic walls compressing the liver parenchyma. The possibility of a tear of the biliary tree was considered. An abdomen computed tomography (CT) scan revealed a well-circumscribed subcapsular collection (5.7 × 3.5 cm) with an air–fluid level in segment VII of the liver, containing a contrast agent that was previously used in ERCP. It was firstly attributed to an intrahepatic biloma as a complication of the previously performed ERCP. Laboratory workup showed elevated white cell count (13,630 per microliter) and CRP at 231.3 mg/L. However, liver function tests (LFTs) remained within normal levels during the first two days: alanine transaminase(ALT) of 20.0 IU/L, aspartate transaminase (AST) of 32 IU/L, γ -GT of 10.0 IU/L, and bilirubin of 0.39 IU/L. Antibiotic treatment was initiated, Piperacillin/Tazobactam (4 + 0.5) g × 4 and Amikacin 375 mg × 2. Percutaneous drainage of the biloma was scheduled, as it was deemed necessary in order to fully manage this complication. On the third day of admission, a CT exam was repeated, revealing an increase in size of the forenamed subcapsular collection, as well as a rounded water-attenuation fluid collection with an air–fluid level in contact with the previous one. Differential diagnosis included an extension of the already existing collection or a completely different one . Percutaneous drainage of the biloma was performed under ultrasonography guidance. After the injection of 15 cc of lidocaine 1%, the collection was punctured through an intercostal approach with an 18 G Chiba needle. Aspiration of yellow-green fluid confirmed the diagnosis and the correct placement of the needle. An Amplatz superstiff guide wire was then inserted through the needle, and finally, an 8 F pigtail drainage catheter was placed in the collection. Injection of contrast was performed through the pigtail catheter, which opacified the subcapsular collection. Contrast material leak in the peritoneal cavity was not identified . Reduced drainage throughout the next days (ninth to twelfth day of admission), a repetitive CT scan and a magnetic resonance image/magnetic resonance cholangiopancreatography (MRI/MRCP) revealing minimal change in the size of the biloma strengthened the case of two separate bilomas . Percutaneous drainage was once more performed under ultrasound guidance, inserting a second 8 Fr pigtail drainage catheter, which passed through the first biloma and ended inside the second one. Contrast injection indicated no communication between the two bilomas . A sample of the drained fluid was collected, followed by laboratory analysis indicating E. coli infection. Follow-up CT showing both drainage catheters revealed capsular ring enhancement, designating inflammation and abscess formation. However a significant reduction in the size of the bilomas was detected . Over time, the amount of bile drainage decreased. The patient was discharged from the hospital after twenty-two days of hospitalization and came back seven days later in order to remove the two pigtails based on a follow-up CT, which revealed further size reduction of the bilomas and of the two pigtails’ drainage, which stopped. Thirty-eight days later, the patient came back in order to have a cholocystectomy. She had an uncomplicated postoperative course and was discharged from the hospital. Twenty days after her release, she underwent successful ERCP in order to remove the stent that was previously placed in the common bile duct and has been carefully monitored ever since.
3.982422
0.979004
sec[1]/p[0]
en
0.999998
PMC10000511
https://doi.org/10.3390/diagnostics13050831
[ "drainage", "bile", "collection", "duct", "fluid", "which", "order", "common", "contrast", "biloma" ]
[ { "code": "8D64.0Y", "title": "Other specified communicating hydrocephalus" }, { "code": "9A11.Z", "title": "Disorders of lacrimal drainage system, unspecified" }, { "code": "9A11.Y", "title": "Other specified disorders of lacrimal drainage system" }, { "code": "LA86.2Z", "title": "Anomalous pulmonary venous connection, unspecified" }, { "code": "LA14.11", "title": "Agenesis of lacrimal ducts" }, { "code": "DC10.2", "title": "Fistula of gallbladder or bile duct" }, { "code": "DC10.02", "title": "Obstruction of bile duct" }, { "code": "DC13", "title": "Cholangitis" }, { "code": "LB20.2Y", "title": "Other specified structural developmental anomalies of bile ducts" }, { "code": "ME24.35&XA6R80", "title": "Perforation of bile duct" } ]
=== ICD-11 CODES FOUND === [8D64.0Y] Other specified communicating hydrocephalus Also known as: Other specified communicating hydrocephalus | Postinflammatory hydrocephalus | Defective arachnoid villi | Impaired venous drainage | Communicating hydrocephalus due to certain specified causes [9A11.Z] Disorders of lacrimal drainage system, unspecified Also known as: Disorders of lacrimal drainage system, unspecified | Disorders of lacrimal drainage system [9A11.Y] Other specified disorders of lacrimal drainage system Also known as: Other specified disorders of lacrimal drainage system | Infections of lacrimal drainage system | Obstruction of lacrimal drainage system [LA86.2Z] Anomalous pulmonary venous connection, unspecified Also known as: Anomalous pulmonary venous connection, unspecified | Anomalous pulmonary venous connection | anomalous pulmonary venous drainage | APVC - [anomalous pulmonary venous connection] | APVD - [anomalous pulmonary venous drainage] [LA14.11] Agenesis of lacrimal ducts Definition: Isolated congenital alacrima is characterised by deficient lacrimation (ranging from a complete absence of tears to hyposecretion of tears) that is present from birth. Also known as: Agenesis of lacrimal ducts | Congenital alacrimia | absence of lacrimal apparatus | Absence of punctum lacrimale | absence or agenesis of punctum lacrimale Includes: Absence of punctum lacrimale [DC10.2] Fistula of gallbladder or bile duct Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs. Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula [DC10.02] Obstruction of bile duct Also known as: Obstruction of bile duct | extrahepatic biliary obstruction | extrahepatic bile duct obstruction | bile duct obstruction | bile stasis Excludes: with cholelithiasis [DC13] Cholangitis Also known as: Cholangitis | acute cholangiolitis | ascending cholangitis | cholangiolitis | cholangitis NOS Excludes: chronic nonsuppurative destructive cholangitis | cholangitis with cholelithiasis | Primary sclerosing cholangitis [LB20.2Y] Other specified structural developmental anomalies of bile ducts Also known as: Other specified structural developmental anomalies of bile ducts | Anomalous arrangement of pancreatobiliary ducts | Aberrant hepatic duct | Accessory hepatic duct | accessory liver duct === GRAPH WALKS === --- Walk 1 --- [8D64.0Y] Other specified communicating hydrocephalus --PARENT--> [8D64.0] Communicating hydrocephalus Def: Communicating hydrocephalus, also known as non-obstructive hydrocephalus, is a disorder characterised by impaired cerebrospinal fluid reabsorption in the absence of any CSF-flow obstruction between th... --CHILD--> [8D64.00] Increased cerebrospinal fluid production Def: Is a type of communicating hydrocephalus caused by increased CSF production.... --- Walk 2 --- [8D64.0Y] Other specified communicating hydrocephalus --PARENT--> [8D64.0] Communicating hydrocephalus Def: Communicating hydrocephalus, also known as non-obstructive hydrocephalus, is a disorder characterised by impaired cerebrospinal fluid reabsorption in the absence of any CSF-flow obstruction between th... --PARENT--> [8D64] Hydrocephalus Def: Hydrocephalus is an abnormal buildup of cerebrospinal fluid (CSF) deep within the brain. This excess fluid causes the ventricles (cavities) within the brain to widen, putting harmful pressure on the b... --- Walk 3 --- [9A11.Z] Disorders of lacrimal drainage system, unspecified --PARENT--> [9A11] Disorders of lacrimal drainage system --CHILD--> [9A11.2] Dacryocystitis --- Walk 4 --- [9A11.Z] Disorders of lacrimal drainage system, unspecified --PARENT--> [9A11] Disorders of lacrimal drainage system --CHILD--> [9A11.0] Eversion of lacrimal punctum --- Walk 5 --- [9A11.Y] Other specified disorders of lacrimal drainage system --PARENT--> [9A11] Disorders of lacrimal drainage system --CHILD--> [9A11.1] Canaliculitis --- Walk 6 --- [9A11.Y] Other specified disorders of lacrimal drainage system --PARENT--> [9A11] Disorders of lacrimal drainage system --CHILD--> [9A11.0] Eversion of lacrimal punctum
[ "[8D64.0Y] Other specified communicating hydrocephalus\n --PARENT--> [8D64.0] Communicating hydrocephalus\n Def: Communicating hydrocephalus, also known as non-obstructive hydrocephalus, is a disorder characterised by impaired cerebrospinal fluid reabsorption in the absence of any CSF-flow obstruction between th...\n --CHILD--> [8D64.00] Increased cerebrospinal fluid production\n Def: Is a type of communicating hydrocephalus caused by increased CSF production....", "[8D64.0Y] Other specified communicating hydrocephalus\n --PARENT--> [8D64.0] Communicating hydrocephalus\n Def: Communicating hydrocephalus, also known as non-obstructive hydrocephalus, is a disorder characterised by impaired cerebrospinal fluid reabsorption in the absence of any CSF-flow obstruction between th...\n --PARENT--> [8D64] Hydrocephalus\n Def: Hydrocephalus is an abnormal buildup of cerebrospinal fluid (CSF) deep within the brain. This excess fluid causes the ventricles (cavities) within the brain to widen, putting harmful pressure on the b...", "[9A11.Z] Disorders of lacrimal drainage system, unspecified\n --PARENT--> [9A11] Disorders of lacrimal drainage system\n --CHILD--> [9A11.2] Dacryocystitis", "[9A11.Z] Disorders of lacrimal drainage system, unspecified\n --PARENT--> [9A11] Disorders of lacrimal drainage system\n --CHILD--> [9A11.0] Eversion of lacrimal punctum", "[9A11.Y] Other specified disorders of lacrimal drainage system\n --PARENT--> [9A11] Disorders of lacrimal drainage system\n --CHILD--> [9A11.1] Canaliculitis", "[9A11.Y] Other specified disorders of lacrimal drainage system\n --PARENT--> [9A11] Disorders of lacrimal drainage system\n --CHILD--> [9A11.0] Eversion of lacrimal punctum" ]
8D64.0Y
Other specified communicating hydrocephalus
[ { "from_icd11": "9A11.Z", "icd10_code": "H04302", "icd10_title": "Unspecified dacryocystitis of left lacrimal passage" }, { "from_icd11": "9A11.Z", "icd10_code": "H04321", "icd10_title": "Acute dacryocystitis of right lacrimal passage" }, { "from_icd11": "9A11.Z", "icd10_code": "H04301", "icd10_title": "Unspecified dacryocystitis of right lacrimal passage" }, { "from_icd11": "9A11.Z", "icd10_code": "H04561", "icd10_title": "Stenosis of right lacrimal punctum" }, { "from_icd11": "9A11.Z", "icd10_code": "H04329", "icd10_title": "Acute dacryocystitis of unspecified lacrimal passage" }, { "from_icd11": "9A11.Z", "icd10_code": "H04309", "icd10_title": "Unspecified dacryocystitis of unspecified lacrimal passage" }, { "from_icd11": "9A11.Z", "icd10_code": "H04559", "icd10_title": "Acquired stenosis of unspecified nasolacrimal duct" }, { "from_icd11": "9A11.Z", "icd10_code": "H043", "icd10_title": "Acute and unspecified inflammation of lacrimal passages" }, { "from_icd11": "9A11.Z", "icd10_code": "H045", "icd10_title": "Stenosis and insufficiency of lacrimal passages" }, { "from_icd11": "LA86.2Z", "icd10_code": "Q264", "icd10_title": "Anomalous pulmonary venous connection, unspecified" }, { "from_icd11": "LA14.11", "icd10_code": "Q104", "icd10_title": "Absence and agenesis of lacrimal apparatus" }, { "from_icd11": "DC10.2", "icd10_code": "K833", "icd10_title": "Fistula of bile duct" }, { "from_icd11": "DC10.2", "icd10_code": "K823", "icd10_title": "Fistula of gallbladder" }, { "from_icd11": "DC10.02", "icd10_code": "K831", "icd10_title": "Obstruction of bile duct" }, { "from_icd11": "DC13", "icd10_code": "K8309", "icd10_title": "Other cholangitis" } ]
H04302
Unspecified dacryocystitis of left lacrimal passage
A 52-year-old woman with remote history of left facial nerve palsy presented with two days of progressive back pain, lower extremity paresthesias, and urinary incontinence. Her symptoms began three days prior to presentation when she awoke with severe mid-lower back pain extending to her abdomen. She subsequently developed burning paresthesias from her thighs to her toes and urinary incontinence. She presented to our institution on day 3 of symptoms, and her initial examination revealed decreased sensation to pinprick over the bilateral soles, lateral aspects of the feet, and first interspaces, as well as diminished vibratory sense in her great toes. There was trace pyramidal weakness of the left lower extremity and diffuse hyperreflexia without clonus. Ultrasound revealed bladder distension. MRI of the spine showed confluent T2 hyperintensity with patchy gadolinium enhancement in the central cord from T8 to the conus medullaris and thickening and enhancement of multiple lumbosacral nerve roots . Contrasted MRI and MR angiography of the brain were unremarkable. CSF showed mild lymphocytic pleocytosis without hypoglycorrhachia, with serum and CSF studies in Table 1 a. She was treated empirically with intravenous acyclovir, which was discontinued when HSV/VZV studies returned negative. CT chest with contrast showed bilateral hilar and right paratracheal lymphadenopathy. The constellation of hilar lymphadenopathy, longitudinally extensive myeloradiculopathy with MRI enhancement, and mild CSF pleocytosis raised concern for sarcoidosis. Comprehensive ophthalmologic and dermatologic examinations including skin biopsies showed no evidence of sarcoidosis or other inflammatory or infiltrative processes. Endobronchial ultrasound-guided mediastinal lymph node biopsy was performed. Her neurological exam improved throughout her hospitalization, and symptoms had resolved completely by day 13 after symptom onset. At the time of discharge, lymph node pathology results were pending and outpatient follow-up arranged. Fig. 1 MRI characterization of SDAVF. Sagittal ( A ) and axial ( B ) T2-weighted images of the thoracic spine on day 3 reveals longitudinally extensive centromedullary T2 hyperintensity extending from T8 through the conus (A, arrowheads). Axial T1 post contrast image ( C ) at L2 shows diffuse abnormal thickening and hyperenhancement of the cauda equina nerve roots. Follow-up MRI total spine on day 32, which included high resolution sagittal 3D T2-SPACE sequence ( D ), clearly depicts numerous dilated vascular flow voids along the dorsal spinal cord surface (D, arrowheads). These abnormal vessels are not well resolved with the conventional T2 sequence ( E ) acquired as part of the same exam and registered to the same level of the thoracic spine shown in panel D. 3D volume-rendered reformatted image ( F ) from conventional digital subtraction angiogram reveals right T10 shunting AVF (arrowhead) with multiple dilated pial vessels extending craniocaudally along the spinal canal (F, arrows), confirming diagnosis of SDAVF Table 1 Serum and cerebrospinal fluid (CSF) testing on ( a ) initial presentation and ( b ) day 28 after presentation (a) (b) Serum Negative studies: Anti-myelin oligodendrocyte glycoprotein antibody Anti-nuclear antibody Angiotensin converting enzyme Human immunodeficiency virus (HIV) p24 antigen HIV1/2 antibodies Cytomegalovirus PCR/IgG/IgM Epstein Barr virus (EBV) IgM Rapid plasma reagin Quantiferon Gold Lyme antibody Coccidiodes antibodies via immunodiffusion Cryptococcal antigen Negative studies: copper, Vitamin E, folate, cryoglobulins, anti-neutrophilic cytoplasmic antibody, anti-double stranded DNA, anti-cardiolipin antibody, anti-beta-2 glycoprotein, C3/C4, and anti-Ro and anti-La CSF 7 white blood cells × 10 9 /L (WBC) (81% lymphocytes, 16% monocytes, 3% neutrophils), 1 red blood cell × 10 9 /L (RBC) Glucose 48 mg/dL (serum glucose 113 mg/dL) Protein 73 mg/dL (normal: 15–45 mg/dL) Negative studies: CSF bacterial culture Herpes simplex virus (HSV) polymerase chain reaction (PCR) Varicella zoster virus (VZV) PCR VZV IgG Venereal disease research laboratory test 6 WBC × 10 9 /L (75% lymphocytes, 24% monocytes, 1% neutrophils) 1 RBC × 10 9 /L, glucose 87 mg/dL (serum 158 mg/dL) Protein 57 mg/dL No unique oligoclonal bands IgG Index 0.61 (normal range: 0.28–0.66) Negative studies: Cytology (repeated three times) Flow cytometry without evidence of malignancy HSV PCR VZV PCR/IgG/IgM Human T-cell lymphotropic virus antibody EBV PCR Fungal and acid-fast bacillus cultures Coccidioides antibodies via complement fixation and immunodiffusion Cryptococcal antigen Mycoplasma pneumoniae IgG/IgM West Nile virus antibody Anti-aquaporin 4 antibody Metagenomic next-generation sequencing
4.164063
0.961914
sec[1]/p[0]
en
0.999998
PMC9903490
https://doi.org/10.1186/s12883-023-03097-7
[ "anti", "antibody", "virus", "serum", "spine", "nerve", "extending", "without", "enhancement", "antigen" ]
[ { "code": "JA86.Y", "title": "Maternal care for other specified fetal problems" }, { "code": "MB23.1", "title": "Antisocial behaviour" }, { "code": "3B4Z", "title": "Coagulation defects, unspecified" }, { "code": "4A45.Z", "title": "Antiphospholipid syndrome, unspecified" }, { "code": "4A43.Y", "title": "Other specified overlap non-organ specific systemic autoimmune disease" }, { "code": "MA14.14", "title": "Anti-nuclear antibody positive" }, { "code": "MA14.13", "title": "Anti-nuclear antibody negative" }, { "code": "JA86.0", "title": "Maternal care for red cell antibodies" }, { "code": "MA14.1C", "title": "Raised antibody titre" }, { "code": "1D9Z", "title": "Unspecified viral infection of unspecified site" } ]
=== ICD-11 CODES FOUND === [JA86.Y] Maternal care for other specified fetal problems Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS [MB23.1] Antisocial behaviour Definition: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated. Also known as: Antisocial behaviour | Child or adolescent antisocial behaviour [3B4Z] Coagulation defects, unspecified Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality [4A45.Z] Antiphospholipid syndrome, unspecified Also known as: Antiphospholipid syndrome, unspecified | Antiphospholipid syndrome | Hughes syndrome | Anticardiolipin syndrome [4A43.Y] Other specified overlap non-organ specific systemic autoimmune disease Also known as: Other specified overlap non-organ specific systemic autoimmune disease | Antisynthetase syndrome | Reynolds syndrome | Syndromic multisystem autoimmune disease due to ITCH deficiency | Eosinophilia myalgia syndrome [MA14.14] Anti-nuclear antibody positive Also known as: Anti-nuclear antibody positive | ANA - [anti-nuclear antibody] positive [MA14.13] Anti-nuclear antibody negative Also known as: Anti-nuclear antibody negative | ANA - [anti-nuclear antibody] negative [JA86.0] Maternal care for red cell antibodies Definition: Maternal care for rhesus or other isoimmunization Also known as: Maternal care for red cell antibodies | Maternal care for rhesus isoimmunization | Rh factor immunization affecting management of pregnancy | Rh incompatibility | Rh incompatibility with hydrops fetalis [MA14.1C] Raised antibody titre Also known as: Raised antibody titre | antibody titre above reference range | high antibody titre | increased antibody titre Excludes: isoimmunization, in pregnancy affecting fetus or newborn [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 === 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.... --PARENT--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del... --- 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 --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 4 --- [MB23.1] Antisocial behaviour Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated.... --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour --CHILD--> [MB23.2] Avoidance behaviour Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual.... --- Walk 5 --- [3B4Z] Coagulation defects, unspecified --PARENT--> [?] Coagulation defects --CHILD--> [?] 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... --- 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 --PARENT--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems\n Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del...", "[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 --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...", "[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --CHILD--> [MB23.2] Avoidance behaviour\n Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual....", "[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [?] 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...", "[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [?] Congenital or constitutional haemorrhagic condition\n Def: A condition caused by determinants arising during the antenatal period or genetically inherited factors, leading to defects in clotting mechanisms or abnormalities causing structural flaws in the bloo..." ]
JA86.Y
Maternal care for other specified fetal problems
[ { "from_icd11": "JA86.Y", "icd10_code": "O26841 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26843 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26849 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O3680X0 ", "icd10_title": "" }, { "from_icd11": "3B4Z", "icd10_code": "D688", "icd10_title": "Other specified coagulation defects" }, { "from_icd11": "3B4Z", "icd10_code": "D689", "icd10_title": "Coagulation defect, unspecified" }, { "from_icd11": "3B4Z", "icd10_code": "D699", "icd10_title": "Hemorrhagic condition, unspecified" }, { "from_icd11": "3B4Z", "icd10_code": "D698", "icd10_title": "Other specified hemorrhagic conditions" }, { "from_icd11": "3B4Z", "icd10_code": "D65-D69", "icd10_title": "" }, { "from_icd11": "3B4Z", "icd10_code": "D69", "icd10_title": "Purpura and other hemorrhagic conditions" }, { "from_icd11": "4A45.Z", "icd10_code": "D6861", "icd10_title": "Antiphospholipid syndrome" }, { "from_icd11": "4A45.Z", "icd10_code": "D6869", "icd10_title": "Other thrombophilia" }, { "from_icd11": "4A45.Z", "icd10_code": "D6862", "icd10_title": "Lupus anticoagulant syndrome" }, { "from_icd11": "4A45.Z", "icd10_code": "D686", "icd10_title": "Other thrombophilia" }, { "from_icd11": "JA86.0", "icd10_code": "O360930", "icd10_title": "Maternal care for other rhesus isoimmunization, third trimester, not applicable or unspecified" } ]
O26841
The index case was a 32-year-old, gravida 3 para 2, pregnant woman. The patient was initially admitted at 11 weeks of gestation to another hospital because of a back pain and fever. A pyelonephritis diagnosis was made and antibiotic therapy with endovenous cefalexin was started. Back pain and fever were both resolved in few hours. During the hospitalization a routine abdomen scan revealed the presence of solid, hyperechoic material into a distended portal vein. The caliber of the portal vein was found increased and multiple channels were seen. Once the PVT diagnosis was confirmed with Doppler imaging, the patient was referred to a tertiary hospital. She was admitted to our department at 13 weeks and 1 day of gestation, clinically asymptomatic, without signs of hypersplenism or portal cholangiopathy. On the admission the patient was hemodynamically stable with a blood pressure of 100/50 mmHg, pulse rate of 65 bpm, and respiratory rate of 20 breaths/minute. A transabdominal ultrasound revealed a single fetus with CRL of 67 mm, corresponding to 13 weeks of gestation. According to the National Health System Guideline (Istituto Superiore di Sanità (ISS)), a first trimester screening for Down's syndrome was offered and performed with a low risk result. The nuchal translucency was 1.3 mm and the nasal bone was seen with no signs of tricuspid regurgitation and normal wave-a on the ductus venosus. A detailed and focused history taking revealed a gastric sleeve procedure performed the previous year for third degree obesity. Medical history was negative for liver disease. Laboratory investigations revealed a mild normochromic normocytic anaemia (10 mg/dL) and moderate high level of transaminases (AST 81 U/L, ALT 84 U/L) and liver function tests were otherwise unremarkable. Platelets count, prothrombin time, partial thromboplastin time and bleeding time were within the normal range. Thrombotic risk profile was negative for factor V Leiden, prothrombin gene G20210A, hyperhomocysteinemia, antithrombin III deficiency, protein C or S deficiency, and antiphospholipid antibodies. After a gastroenterological consultation the screening for viral and/or autoimmune hepatitis was performed. The autoantibodies (anti-nuclear antibody, anti-smooth muscle antibody, liver/kidney microsomal antibody, anti-soluble liver antigen, and anti-mitochondrial antibody) research was negative. Viral tests were negative for the major hepatotropic viruses (hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E) and for minor ones (herpes simplex, cytomegalovirus, Epstein-Barr virus, or Yellow fever) as well. The abdominal examination revealed a nontender, nondistended abdomen, with no pain and normal bowel sounds, of note a mild splenomegaly was found. No signs of ascites were noted. The severity of liver and other organs involvement was assessed throughout a clinical and laboratory evaluation. Abdominal ultrasound found a hepatomegaly with hypertrophy of the right lobe (anteroposterior diameter 165 mm) with nonhomogeneous hepatic echostructure and portal vein thrombosis with cavernomatous transformation. There were no signs of inflammatory abdominal foci such as appendicitis, diverticulitis, inflammatory bowel diseases, pancreatitis, cholecystitis, hepatic abscesses, and cholangitis. There was no evidence of free ascitic fluid within the abdominal cavity. Color Doppler US confirmed the cavernomatous transformation of the portal venous system in the hilar region of the liver extended to the intrahepatic system. After a discussion with gastroenterology and vascular surgery consultants, an upper digestive endoscopy was arranged and uneventfully performed. The endoscopic evaluation ruled out the presence of esophageal varices. During the hospitalization the patient was started on subcutaneous low-molecular-weight heparins 16.000 units, according to the guidelines for the treatment and prophylaxis of venous thromboembolism . Laboratory tests were performed weekly to monitor the activated partial thromboplastin time (PTT) and the platelets count to rule out heparin-induced thrombocytopenia and to check liver and renal functions. On the admission the patient was on endovenous antibiotic therapy with cefalexin for the pyelonephritis, which was resolved in few days. All the maternal and fetal risks related to the possible development of esophageal varices and/or other collateral circulation, ascites, and hypersplenism were exposed and clearly understood by the patient. The termination of pregnancy was offered according to the Italian law number 194/78 (article 6). A written consent form was obtained from the patient and her partner. At 15 weeks and 1 day of gestation the patient decided to have her pregnancy terminated.
4
0.979492
sec[1]/p[0]
en
0.999998
24392231
https://doi.org/10.1155/2013/396083
[ "liver", "hepatitis", "portal", "gestation", "time", "anti", "antibody", "abdominal", "pain", "fever" ]
[ { "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": "1E50.Z", "title": "Acute viral hepatitis, unspecified" }, { "code": "DB97.2", "title": "Chronic hepatitis, not elsewhere classified" }, { "code": "1E5Z", "title": "Viral hepatitis, unspecified" }, { "code": "1E51.0Z", "title": "Chronic hepatitis B, unspecified" }, { "code": "DB98.3", "title": "Portal vein thrombosis" } ]
=== 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 [1E50.Z] Acute viral hepatitis, unspecified Also known as: Acute viral hepatitis, unspecified | Acute viral hepatitis | acute anicteric hepatitis | Acute hepatitis NOS | acute viral hepatitis non-A non-B NEC [DB97.2] Chronic hepatitis, not elsewhere classified Also known as: Chronic hepatitis, not elsewhere classified | Chronic hepatitis, unspecified | Chronic active hepatitis NEC | Other specified chronic hepatitis | Chronic persistent hepatitis NEC Includes: Chronic hepatitis, unspecified | Other specified chronic hepatitis Excludes: hepatitis (chronic): granulomatous NEC | Drug-induced or toxic liver disease | hepatitis (chronic): viral [1E5Z] Viral hepatitis, unspecified Also known as: Viral hepatitis, unspecified | anicteric hepatitis [1E51.0Z] Chronic hepatitis B, unspecified Also known as: Chronic hepatitis B, unspecified | Chronic hepatitis B | Chronic hepatitis B without delta agent | chronic HBV - [hepatitis B virus] infection | hepatitis B NOS [DB98.3] Portal vein thrombosis Definition: Portal vein thrombosis is a condition where the portal vein and/or its branches are obstructed, mainly by a blood clot or malignant tumour invasion. Also known as: Portal vein thrombosis | Phlebitis of portal vein | deep vein thrombosis of portal vein | portal thrombosis | PVT - [portal vein thrombosis] Includes: Phlebitis of portal vein === GRAPH WALKS === --- Walk 1 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --CHILD--> [DB91] Acute or subacute hepatic failure Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases.... --- Walk 2 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --PARENT--> [13] Diseases of the digestive system --- Walk 3 --- [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 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.... --EXCLUDES--> [?] Fibropolycystic liver disease
[ "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --CHILD--> [DB91] Acute or subacute hepatic failure\n Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases....", "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --PARENT--> [13] Diseases of the digestive system", "[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....", "[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 --EXCLUDES--> [?] Fibropolycystic liver disease" ]
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 55-year-old female patient visited the outpatient clinic after being recommended to undergo a tissue biopsy due to abnormal findings identified during regular breast screening mammograph (MMG) and breast ultrasound (US). The patient had previously undergone regular breast screening with MMG every two years, and no significant findings were observed during that period. She had no previous diagnosed conditions and was not taking any medications. The patient mentioned a family history of her father passing away from pancreatic cancer and her sister undergoing treatment for breast cancer. She started menarche at the age of 15 and is currently not in menopause. After the outpatient visit, an US was performed, revealing an indistinct margin hypoechoic mass measuring 1.5 cm, located 4 cm from the nipple at the 9 o’clock direction of the patient’s right breast . A core needle biopsy was performed on the detected mass, and the histological examination confirmed invasive lobular carcinoma (ILC). The immunohistochemistry staining results were estrogen receptor (ER) positive with an Allred score of 8, progesterone receptor (PR) positive with an Allred score of 8, human epidermal growth factor receptor-2 (HER2) score of 2, indicating equivocal result, and no amplification of HER2 was detected according to fluorescent in situ hybridization (FISH). To assess the staging of the patient before surgery, a breast magnetic resonance imaging (MRI), chest computed tomography (CT), abdominopelvic CT (A-P CT), and a bone scan were performed. The results of the examinations did not reveal any distant metastasis. The breast MRI showed a 2.1 cm x 1.1 cm x 2.2 cm lesion that was confirmed ILC , and a suspicious lymph node measuring 1.7 cm was identified at axillary level I . Additionally, a 0.5 cm low echoic lesion was observed in the 1 o’clock position of the right breast on breast US, and it was decided to remove it concurrently during the breast cancer surgery. Three weeks after the outpatient visit, the patient underwent a right breast lumpectomy and a SLNB. During the surgery, two lymph nodes were harvested for SLNB and they were examined using frozen section biopsy, which confirmed metastasis. As a result, an axillary lymph node dissection was performed for levels I and II of the axillary lymph nodes. The final pathologic report revealed that the breast cancer measured 3cm x 3cm in size ILC. The nuclear grade and histologic grade were both grade 1, indicating a well-differentiated tumor. Lobular carcinoma in situ was extensively present. Lympho-vascular invasion was not identified, and there was no lymph node metastasis among the 15 axillary lymph nodes examined, including the 2 sentinel lymph nodes. The hormone receptor status showed that the ER and PR were positive with an Allred score of 8. However, the HER-2 score was 1, indicating a negative result. The p53 protein was negative, suggesting no abnormalities, and the Ki-67 proliferation index was 10%, indicating a low level of cell proliferation. Interestingly, the final histological examination results differed from the intraoperative frozen section analysis as no evidence of breast cancer metastasis was found in the axillary lymph nodes. Enlarged sentinel lymph nodes were examined for pathologist’s intraoperative consultation. At that time large atypical cells were noted in the sinuses of the sentinel lymph nodes and it was difficult to distinguish metastatic lobular carcinoma from malignant lymphoma. Thus, the final decision for the sentinel lymph nodes was deferred to permanent sections. The lumpectomy specimen of the breast revealed typical microscopic features of invasive lobular carcinoma with associated extensive lobular carcinoma in situ . Immunohistochemically the tumor cells revealed lack of E-cadherin expression and diffuse strong positivity for ER and PR. Therefore, the breast lesion was diagnosed as invasive lobular carcinoma. But the microscopic features of sentinel lymph nodes revealed proliferation of atypical large cells within sinuses . Immunohistochemically the atypical cells were negative for cytokeratin and ER. Thus, the possibility of metastatic carcinoma was excluded. The atypical large cells in the sentinel lymph nodes were positive for CD45, CD30, and MUM1, and negative for ALK, CK-multi (AE1/AE3), ER, CD10, EBV ( in situ hybridization), CD15, EMA, granzyme B, TIA-1, p53, PAX-5, and CD20 (L26). The Ki-67 labeling index was high, and focal positivity was noted for CD3, CD2, CD4, CD5, CD8, CD45RO (UCHL1), and CD43. CD68 positivity was observed in sinusoidal histiocytes, while PR, CK5/6, E-Cadherin, p63, and bcl-2 were non-contributory. These findings led to the final diagnosis of ALK-negative ALCL in the sentinel lymph nodes.
4.003906
0.978516
sec[1]/p[0]
en
0.999993
39610919
https://doi.org/10.3389/fonc.2024.1440126
[ "breast", "lymph", "nodes", "carcinoma", "sentinel", "lobular", "that", "cancer", "score", "axillary" ]
[ { "code": "GB23", "title": "Certain specified disorders of breast" }, { "code": "GB21.Z", "title": "Inflammatory disorders of breast, unspecified" }, { "code": "GB21.Y", "title": "Other specified inflammatory disorders of breast" }, { "code": "QF01.0", "title": "Acquired absence of breast" }, { "code": "GB23.3", "title": "Atrophy of breast" }, { "code": "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" } ]
=== ICD-11 CODES FOUND === [GB23] Certain specified disorders of breast Definition: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere. Also known as: Certain specified disorders of breast | disease of breast | mastopathy [GB21.Z] Inflammatory disorders of breast, unspecified Also known as: Inflammatory disorders of breast, unspecified | Inflammatory disorders of breast | breast inflammation | inflammatory breast disease | mastitis NOS [GB21.Y] Other specified inflammatory disorders of breast Also known as: Other specified inflammatory disorders of breast | Breast antibioma | Infective mastitis | acute infective mastitis | nonpuerperal infective mastitis [QF01.0] Acquired absence of breast Also known as: Acquired absence of breast | absence of breast | mastectomy status | Acquired absence of breast, partial | Acquired absence of breast, total [GB23.3] Atrophy of breast Definition: A condition of the breast, caused by apoptosis of the cells commonly due to prolonged estrogen reduction, diminished cellular proliferation, decreased cellular volume, decreased function, ischaemia, malnutrition, disease, or mutation. This condition is characterised by a partial or complete decrease in size and function of the breast tissue. Also known as: Atrophy of breast | Hypoplasia of breast | hypoplastic breast | mammary hypoplasia [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 === GRAPH WALKS === --- Walk 1 --- [GB23] Certain specified disorders of breast Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.... --CHILD--> [GB23.2] Fat necrosis of breast Def: A condition of the breast, caused by saponification of fat tissue, commonly subsequent to trauma or radiation therapy. This condition is characterised by damage, death, or inflammation of the fat tiss... --PARENT--> [GB23] Certain specified disorders of breast Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.... --- Walk 2 --- [GB23] Certain specified disorders of breast Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.... --CHILD--> [GB23.0] Mammary duct ectasia Def: A condition of the breast, caused by lipid and cellular debris or secretory (such as colostrum) stasis, or a nonspecific duct widening process. This condition is characterised by obstruction and subse... --PARENT--> [GB23] Certain specified disorders of breast Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.... --- Walk 3 --- [GB21.Z] Inflammatory disorders of breast, unspecified --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --CHILD--> [GB21.0] Breast abscess Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ... --- Walk 4 --- [GB21.Z] Inflammatory disorders of breast, unspecified --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --RELATED_TO--> [?] Nonpurulent mastitis associated with childbirth --- Walk 5 --- [GB21.Y] Other specified inflammatory disorders of breast --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --RELATED_TO--> [?] Neonatal infectious mastitis Def: A disease of the breasts in neonates, may be caused by a maternal infection with a bacterial source. This disease is characterised by swelling, erythema, warmth, tenderness, induration of the breast, ... --- Walk 6 --- [GB21.Y] Other specified inflammatory disorders of breast --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --RELATED_TO--> [?] Neonatal infectious mastitis Def: A disease of the breasts in neonates, may be caused by a maternal infection with a bacterial source. This disease is characterised by swelling, erythema, warmth, tenderness, induration of the breast, ...
[ "[GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....\n --CHILD--> [GB23.2] Fat necrosis of breast\n Def: A condition of the breast, caused by saponification of fat tissue, commonly subsequent to trauma or radiation therapy. This condition is characterised by damage, death, or inflammation of the fat tiss...\n --PARENT--> [GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....", "[GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....\n --CHILD--> [GB23.0] Mammary duct ectasia\n Def: A condition of the breast, caused by lipid and cellular debris or secretory (such as colostrum) stasis, or a nonspecific duct widening process. This condition is characterised by obstruction and subse...\n --PARENT--> [GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....", "[GB21.Z] Inflammatory disorders of breast, unspecified\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --CHILD--> [GB21.0] Breast abscess\n Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ...", "[GB21.Z] Inflammatory disorders of breast, unspecified\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --RELATED_TO--> [?] Nonpurulent mastitis associated with childbirth", "[GB21.Y] Other specified inflammatory disorders of breast\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --RELATED_TO--> [?] Neonatal infectious mastitis\n Def: A disease of the breasts in neonates, may be caused by a maternal infection with a bacterial source. This disease is characterised by swelling, erythema, warmth, tenderness, induration of the breast, ...", "[GB21.Y] Other specified inflammatory disorders of breast\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --RELATED_TO--> [?] Neonatal infectious mastitis\n Def: A disease of the breasts in neonates, may be caused by a maternal infection with a bacterial source. This disease is characterised by swelling, erythema, warmth, tenderness, induration of the breast, ..." ]
GB23
Certain specified disorders of breast
[ { "from_icd11": "GB23", "icd10_code": "N6459", "icd10_title": "Other signs and symptoms in breast" }, { "from_icd11": "GB23", "icd10_code": "N6489", "icd10_title": "Other specified disorders of breast" }, { "from_icd11": "GB23", "icd10_code": "N6481", "icd10_title": "Ptosis of breast" }, { "from_icd11": "GB23", "icd10_code": "N6482", "icd10_title": "Hypoplasia of breast" }, { "from_icd11": "GB23", "icd10_code": "N6452", "icd10_title": "Nipple discharge" }, { "from_icd11": "GB23", "icd10_code": "N6451", "icd10_title": "Induration of breast" }, { "from_icd11": "GB23", "icd10_code": "N6453", "icd10_title": "Retraction of nipple" }, { "from_icd11": "GB23", "icd10_code": "N64", "icd10_title": "Other disorders of breast" }, { "from_icd11": "GB23", "icd10_code": "N648", "icd10_title": "Other specified disorders of breast" }, { "from_icd11": "GB23", "icd10_code": "N645", "icd10_title": "Other signs and symptoms in breast" }, { "from_icd11": "GB21.Z", "icd10_code": "N610", "icd10_title": "Mastitis without abscess" }, { "from_icd11": "GB21.Z", "icd10_code": "N611", "icd10_title": "Abscess of the breast and nipple" }, { "from_icd11": "GB21.Z", "icd10_code": "N61", "icd10_title": "Inflammatory disorders of breast" }, { "from_icd11": "QF01.0", "icd10_code": "Z9012", "icd10_title": "Acquired absence of left breast and nipple" }, { "from_icd11": "QF01.0", "icd10_code": "Z9011", "icd10_title": "Acquired absence of right breast and nipple" } ]
N6459
Other signs and symptoms in breast
A 44-year-old white man with a past medical history of viral myocarditis, reduced left ventricular function, and continuous beta-blocker therapy, collapsed on the street. Lay basic life support was initiated in less than 2 minutes by bystanders. Paramedics proceeded with CPR according to the current guidelines with a compression-ventilation ratio of 30:2 after approximately 5 minutes. An electrocardiogram (ECG) showed ventricular fibrillation (VF) as the primary rhythm which was refractory to defibrillations. An emergency physician reached the location 8 minutes after the initial incident. Administration of epinephrine (20 mg total), amiodarone (450 mg total), magnesium-sulfate (2 g), and sodium bicarbonate (100 ml of 8.4 %) via a peripheral venous route and repeated defibrillations at 200 to 360 joules did not restore a viable heart rhythm. An endotracheal tube (ID 8.0 mm) was inserted without complications and ventilation was continued with a resuscitation bag. Subsequently the patient was mechanically ventilated with a mobile respirator in a volume controlled mode (continuous positive pressure ventilation; CPPV) tidal volume 10 ml/kilogram bodyweight, PEEP 5 cmH 2 O, and fraction of inspired oxygen (FiO 2 ) 1.0 at 12 breaths/minute. A second emergency physician (attending) equipped with an automated CPR device (LUCAS 2, Physio-Control, Redmond, USA) and an ultrasound unit was ordered to the site. Capnometry after endotracheal intubation showed a p et CO 2 of 20 to 25 mmHg . Pleural effusion, pulmonary-venous edema, and pneumothorax could be ruled out by lung ultrasound. Cardiac tamponade and burden on the right side of his heart were ruled out by focused cardiac ultrasound. His left ventricle was globally akinetic, his inferior vena cava (IVC) was not distended. CPR was continued using the automated CPR device, providing a constant high quality CPR. The ECG showed intermittent VF and electromechanical dissociation (EMD). Due to his history of myocarditis a rhythmogenic cause of the out-of-hospital cardiac arrest was suggested. The option of empiric thrombolysis for potential myocardial ischemia was abandoned due to lack of evidence of acute myocardial infarction or acute pulmonary embolism, as well as suspected craniocerebral injury after his collapse, since facial and periorbital lacerations were noted. After 80 minutes of CPR persistent EMD was recorded at a rate of 25/minute. The patient had fixed and dilated pupils, p et CO 2 had decreased to less than 10 mmHg, and left ventricular akinesis was unchanged. The team reached the unanimous decision to quit resuscitation efforts. The infusion of catecholamines, mechanical ventilation, and the automated CPR device were stopped. He remained on the ECG monitor according to current practice showing continuous slow EMD. The ventilator was disconnected from the endotracheal tube, the tube remained in situ . Five minutes after withdrawal of all supportive measures audible breathing resumed. A subtle bradycardic pulse was palpable at his carotid artery. QRS-complexes increased in frequency and appeared increasingly narrow. Capnometry showed a spontaneous increase of p et CO 2 to 30 mmHg. Focused cardiac ultrasound showed coordinated ventricular activity with reduced ventricular output. Catecholamine support was restarted; he was ventilated and hypothermia initiated. Shortly after he had a systolic blood pressure of 130 mmHg, a p et CO 2 of 35 mmHg, and a peripheral oxygen saturation of 99 % under FiO 2 0.5. The ECG showed a supraventricular rhythm followed by sinus rhythm. His pupils were round, isocoric, non-dilated, and reactive to light. Fig. 1 Serial end-tidal partial pressure of carbon dioxide readings during cardiopulmonary resuscitation and after return of spontaneous circulation. During automated cardiopulmonary resuscitation end-tidal partial pressure of carbon dioxide values of up to 26 mmHg were recorded. After 60 minutes of cardiopulmonary resuscitation end-tidal partial pressure of carbon dioxide rapidly dropped to values of less than 10 mmHg. White arrow head indicates arrival of emergency physician; black arrow head indicates arrival of emergency medicine attending physician. Time of withdrawal of all supportive measures is indicated by the black arrow . Resumption of monitoring is marked by asterisk . The respective electrocardiogram (ECG)-rhythm is specified in the top lane. The duration of cardiopulmonary resuscitation is marked with the black bar . Return of spontaneous circulation is indicated by the white bar. CPR cardiopulmonary resuscitation, EMD electromechanical dissociation, p et CO 2 end-tidal partial pressure of carbon dioxide, ROSC return of spontaneous circulation, SR sinus rhythm, VF ventricular fibrillation
3.949219
0.972656
sec[1]/p[0]
en
0.999998
27998300
https://doi.org/10.1186/s13256-016-1148-4
[ "resuscitation", "mmhg", "ventricular", "minutes", "rhythm", "pressure", "tidal", "cardiopulmonary", "ventilation", "emergency" ]
[ { "code": "PK81.E", "title": "Cardiopulmonary resuscitation associated with injury or harm in therapeutic use" }, { "code": "LA89.Z", "title": "Functionally univentricular heart, unspecified" }, { "code": "BC45", "title": "Cardiomegaly" }, { "code": "BA41.Z", "title": "Acute myocardial infarction, unspecified" }, { "code": "BC46&XA7XU8", "title": "Ventricular thrombosis" }, { "code": "BD1Z&XT5R", "title": "Acute heart failure" }, { "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" } ]
=== ICD-11 CODES FOUND === [PK81.E] Cardiopulmonary resuscitation associated with injury or harm in therapeutic use Also known as: Cardiopulmonary resuscitation associated with injury or harm in therapeutic use Excludes: Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm [LA89.Z] Functionally univentricular heart, unspecified Also known as: Functionally univentricular heart, unspecified | Functionally univentricular heart | Univentricular cardiopathy | Single ventricle | univentricular heart [BC45] Cardiomegaly Also known as: Cardiomegaly | enlargement of heart | hypertrophic heart | heart hypertrophy | Cardiac hypertrophy Includes: Left ventricular hyperplasia [BA41.Z] Acute myocardial infarction, unspecified Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction [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 === GRAPH WALKS === --- Walk 1 --- [PK81.E] Cardiopulmonary resuscitation associated with injury or harm in therapeutic use --EXCLUDES--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure --- Walk 2 --- [PK81.E] Cardiopulmonary resuscitation associated with injury or harm in therapeutic use --EXCLUDES--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure --- Walk 3 --- [LA89.Z] Functionally univentricular heart, unspecified --PARENT--> [LA89] Functionally univentricular heart Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ... --CHILD--> [LA89.1] Tricuspid atresia Def: A congenital cardiovascular malformation with absence of the tricuspid valvar annulus (connection/junction) or an imperforate tricuspid valve.... --- Walk 4 --- [LA89.Z] Functionally univentricular heart, unspecified --PARENT--> [LA89] Functionally univentricular heart Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ... --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.... --- Walk 5 --- [BC45] Cardiomegaly --PARENT--> [?] Diseases of the myocardium or cardiac chambers Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as... --CHILD--> [BC42] Myocarditis Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an... --- Walk 6 --- [BC45] Cardiomegaly --PARENT--> [?] Diseases of the myocardium or cardiac chambers Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as... --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...
[ "[PK81.E] Cardiopulmonary resuscitation associated with injury or harm in therapeutic use\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure", "[PK81.E] Cardiopulmonary resuscitation associated with injury or harm in therapeutic use\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure", "[LA89.Z] Functionally univentricular heart, unspecified\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\n --CHILD--> [LA89.1] Tricuspid atresia\n Def: A congenital cardiovascular malformation with absence of the tricuspid valvar annulus (connection/junction) or an imperforate tricuspid valve....", "[LA89.Z] Functionally univentricular heart, unspecified\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\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....", "[BC45] Cardiomegaly\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --CHILD--> [BC42] Myocarditis\n Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an...", "[BC45] Cardiomegaly\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --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..." ]
PK81.E
Cardiopulmonary resuscitation associated with injury or harm in therapeutic use
[ { "from_icd11": "LA89.Z", "icd10_code": "Q209", "icd10_title": "Congenital malformation of cardiac chambers and connections, unspecified" }, { "from_icd11": "BC45", "icd10_code": "I517", "icd10_title": "Cardiomegaly" }, { "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" }, { "from_icd11": "BA41.Z", "icd10_code": "I219", "icd10_title": "Acute myocardial infarction, unspecified" }, { "from_icd11": "BA41.Z", "icd10_code": "I21", "icd10_title": "Acute myocardial infarction" } ]
Q209
Congenital malformation of cardiac chambers and connections, unspecified
Anuric AKI persisted after she was transferred to our hospital. In addition to RAO, we suspected contrast-induced nephropathy or cholesterol emboli as a differential diagnosis. However, these were unlikely as she developed AKI before contrast medium was administered and before the intravascular catheter procedure was performed; moreover, there were no signs of peripheral atheroembolism. Her high plasma renin activity (10.7 ng/mL/h, with a plasma aldosterone level of 140 pg/mL), which was tested to determine the cause of hypertension, raised the suspicion that she had a minimally but significantly perfused right kidney. Doppler ultrasonography revealed a renal interlobular artery flow inside the right kidney, indicating that the perfusion of the kidney was sustained, at least at a low level. Renal mercaptoacetyltriglycine (MAG-3) scintigraphy revealed that the right kidney had stained slowly and MAG-3 had not washed out even at 66 min post-injection. The absence of MAG-3 washout meant that the function of the kidney decreased severely, which did not rule out contrast induced AKI, but at least indicated that while renal perfusion was sustained, it was not sufficient to sustain the GFR . Although we initially planned to create an arteriovenous fistula for vascular access for permanent hemodialysis, the results of these renal imaging studies led us to reconsider that the AKI may be reversible if the renal artery was revascularized. However, a second attempt of PTRA was considered challenging, given that the renal artery was almost completely occluded. With no prior experience performing hepatorenal bypass, a transplant surgeon on our team considered kidney AutoTx to be a feasible alternative; therefore, kidney AutoTx was performed on day 25 of hospitalization. The renal artery and vein were anastomosed to the external iliac artery and vein, respectively. Cold and warm ischemia time of the right kidney were 84 and 7 min, respectively. After declamping the external iliac artery, the kidney perfused well, except for the upper one-fifth portion, which appeared to be perfused by an upper polar renal artery. Hence, we decided to anastomose the upper polar renal artery to the inferior epigastric artery; this successfully perfused the upper kidney region. Intraoperatively, the patient started passing urine. For the first 24 h postoperatively, her urine output was 2.2 L, and hemodialysis was discontinued . Her serum creatinine level decreased to 1.02 mg/dL by postoperative day 22, which was almost equivalent to her baseline creatinine level. Her hypertension improved, and the dose of nifedipine was successfully reduced. Her 0-h kidney biopsy during the surgery showed only mild tubular injury and no tubular necrosis. Of 24 glomeruli, 11 showed global glomerular sclerosis, and the remaining 13 exhibited no acute changes. Mild arteriosclerosis with only one cholesterol embolism was observed. Thus, no histological changes were noted that could account for prolonged ischemia leading to anuric AKI . The patient was discharged on day 42 of hospitalization, and her kidney function remained stable for 2 years, with a creatinine level of 1.03 mg/dL. Four months after surgery, a repeat renal MAG-3 scintigraphy showed that the transplanted right kidney at the right iliac fossa stained smoothly, and MAG-3 washed out 15 min after injection, indicating that renal perfusion and glomerular filtration has recovered . Fig. 2 a Renal MAG-3 scintigraphy performed on admission demonstrated slow staining of the right kidney; however, MAG-3 did not wash out even at 66 min after injection, indicating that while renal perfusion was sustained, it was not sufficient to sustain GFR, resulting in anuria. b A repeat renal MAG-3 scintigraphy performed 4 months after surgery demonstrated smooth staining of the transplanted right kidney at the right iliac fossa; additionally, MAG-3 washed out at 15 min after injection, indicating that renal perfusion and glomerular filtration had recovered. MAG-3, Mercaptoacetyltriglycine; GFR, Glomerular filtration rate Fig. 3 The trends for serum creatinine level, urine output, blood pressure, and dose of nifedipine during hospitalization are shown. The patient started passing urine just after kidney autotransplantation, and hemodialysis was discontinued. Furthermore, refractory hypertension was controlled by a lower dose of nifedipine postoperatively. BP, blood pressure; PTRA, Percutaneous transluminal renal artery angioplasty Fig. 4 Light microscopy findings for 0-h kidney biopsy performed during kidney autotransplantation. a There were no glomerular abnormalities. b Mild tubular injury was seen, but there was no tubular necrosis. c Cholesterol embolus was observed in one interlobular artery
4.050781
0.963379
sec[1]/p[2]
en
0.999996
31088385
https://doi.org/10.1186/s12882-019-1353-7
[ "kidney", "renal", "that", "artery", "perfusion", "glomerular", "which", "perfused", "indicating", "scintigraphy" ]
[ { "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": "8A80.Z", "title": "Migraine, unspecified" }, { "code": "QA76", "title": "Medication or substance that is known to be an allergen without injury or harm" }, { "code": "PL13.6", "title": "Medication or substance that is known to be an allergen, as mode of injury or harm" }, { "code": "9C40.A0", "title": "Papilloedema" }, { "code": "PA6Z", "title": "Unintentional fall from unspecified height" } ]
=== ICD-11 CODES FOUND === [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 [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS === GRAPH WALKS === --- Walk 1 --- [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 ... --CHILD--> [GB60] Acute kidney failure Def: An increase in serum creatinine by 0.3 mg/dl or greater within 48 hours; or increase in serum creatinine by 1.5-fold or greater above baseline, which is known or presumed to have occurred within 7 day... --- Walk 3 --- [LB30.1] Renal dysplasia Def: A condition characterised by abnormal development of one or both kidneys.... --PARENT--> [LB30] Structural developmental anomalies of kidneys Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period.... --CHILD--> [LB30.0] Renal agenesis or other reduction defects of kidney Def: A series of conditions resulting in reduced kidney function including a congenital absence of both kidneys... --- Walk 4 --- [LB30.1] Renal dysplasia Def: A condition characterised by abnormal development of one or both kidneys.... --PARENT--> [LB30] Structural developmental anomalies of kidneys Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period.... --CHILD--> [LB30.0] Renal agenesis or other reduction defects of kidney Def: A series of conditions resulting in reduced kidney function including a congenital absence of both kidneys... --- Walk 5 --- [NB92.0Y] Other specified injury of kidney --PARENT--> [NB92.0] Injury of kidney --CHILD--> [NB92.02] Laceration of kidney, minor --- Walk 6 --- [NB92.0Y] Other specified injury of kidney --PARENT--> [NB92.0] Injury of kidney --CHILD--> [NB92.00] Contusion 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 --CHILD--> [GB60] Acute kidney failure\n Def: An increase in serum creatinine by 0.3 mg/dl or greater within 48 hours; or increase in serum creatinine by 1.5-fold or greater above baseline, which is known or presumed to have occurred within 7 day...", "[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --PARENT--> [LB30] Structural developmental anomalies of kidneys\n Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period....\n --CHILD--> [LB30.0] Renal agenesis or other reduction defects of kidney\n Def: A series of conditions resulting in reduced kidney function including a congenital absence of both kidneys...", "[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --PARENT--> [LB30] Structural developmental anomalies of kidneys\n Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period....\n --CHILD--> [LB30.0] Renal agenesis or other reduction defects of kidney\n Def: A series of conditions resulting in reduced kidney function including a congenital absence of both kidneys...", "[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --CHILD--> [NB92.02] Laceration of kidney, minor", "[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --CHILD--> [NB92.00] Contusion 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" }, { "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" } ]
N19
Unspecified kidney failure
A 10-year-old girl presented with a painless reduction in visual acuity in her left eye, incidental finding on the school routine examination. The fundus revealed a unilateral solitary lesion of the RPE with fibrosis and hyperplastic changes at its periphery and thinning in the center. No family or trauma history was noted. The medical and ophthalmic history of the patient were negative. General pediatric physical examination results were normal for all systems. The initial best-corrected visual acuity (BCVA) was 20/20 in the right eye and 20/25 in the left eye. The diopter of both eyes was 0 DS OD and, − 2.0 DS OS. The anterior segment and intraocular pressure were normal. Funduscopic examination of the right eye was unremarkable. A solitary, unilateral, large, scalloped and yellowish-white lesion, with fringe-like margins was observed in the posterior pole and lower middle periphery of the left eye continuous with the optic nerve. Furthermore, we noted the presence of fibrosis and hyperplastic changes in the RPE at the periphery and thinning at the center of the lesion . Infrared fundal (IR) images showed that the fringe-like contour of the lesion was visible, with diffuse hyperreflective signals specifically in the fovea, while with peripheral dark spots, having a typical leopard-spot like appearance . Fundus autofluorescence (FAF) revealed a markedly scalloped lesion containing a hypoautofluorescence area mixed with an isoautofluorescence area . Spectral-domain optical coherence tomography (SD-OCT) revealed certain unique characteristics of the same . The outer segments of photoreceptors presented with an inhomogeneous signal in the fovea, with a weak local signal. The ellipsoid and interdigitation zones were thinner than normal, while the RPE/Bruch’s complex was not flat, with locally visible protrusions. En-face OCT image at the level of the superficial and deep retinal layers appeared normal , the outer retinal layer , and the choroid capillary layer revealed a weak mottled hyperreflective signal; the RPE zone showed a mottled hyperreflective signal with peripheral hyporeflective spots, fringe-like margin lesions . OCTA of the avascular area of the fovea in the superficial, deep, and outer retinal layers appeared to be oval in shape , the choroid capillary layer revealed an increase in the density of the choroidal vasculature in the fovea , the density of the packed honeycomb structure in the central macula increased in OCTA was consistent with the central atrophy yellow-whitish lesion in the fundus photograph ; OCTA image at the level of the RPE zone appeared normal . Based on the clinical examination and characteristic multimodal imaging findings, the patient was diagnosed to have URPED. Fig. 1 In the left eye: a solitary, unilateral, large, scalloped and yellowish-white lesion, with fringe-like margins was observed in the posterior pole and lower middle periphery of the left eye continuous with the optic nerve. Furthermore, we noted the presence of fibrosis and hyperplastic changes in the RPE at the periphery and thinning at the center of the lesion ( a ). IR images showed that the fringe-like contour of the lesion was visible, with diffuse hyperreflective signals specifically in the fovea, while with peripheral dark spots, having a typical leopard-spot like appearance ( b , c ) Fig. 2 FAF revealed a markedly scalloped lesion containing a hypoautofluorescence area mixed with an isoautofluorescence area ( a , b ) Fig. 3 SD-OCT revealed certain unique characteristics of the same. The outer segments of photoreceptors presented with an inhomogeneous signal in the fovea, with a poor local signal. The ellipsoid and interdigitation zones were thinner than normal, while the RPE/Bruch’s complex was not flat, with locally visible protrusions Fig. 4 En-face OCT image at the level of the superficial ( a ) and deep retinal layers ( b ) appeared normal, the outer retinal layer ( c ), and the choroid capillary layer ( d ) revealed a weak mottled hyperreflective signal; the RPE zone showed a mottled hyperreflective signal with peripheral hyporeflective spots, fringe-like margin lesions ( e ) Fig. 5 OCTA of the avascular area of the fovea in the superficial ( a ), deep ( b ), and outer ( c ) retinal layers appeared to be oval in shape, the choroid capillary layer revealed an increase in the density of the choroidal vasculature in the fovea ( d ); OCTA image at the level of the RPE zone appeared normal ( e ) Fig. 6 The density of the packed honeycomb structure in the central macula increased in choroid capillary layer ( a ) was consistent with the central atrophy yellow-whitish lesion in the fundus photograph ( b ), which revealed a thinner RPE for increased density of the choriocapillaris
4.234375
0.949707
sec[1]/p[0]
en
0.999996
32819322
https://doi.org/10.1186/s12886-020-01609-4
[ "lesion", "like", "fovea", "signal", "layer", "fringe", "hyperreflective", "area", "outer", "retinal" ]
[ { "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": "1C62.Z", "title": "Human immunodeficiency virus disease without mention of tuberculosis or malaria, clinical stage unspecified" }, { "code": "1E32", "title": "Influenza, virus not identified" }, { "code": "5C56.0Y", "title": "Other specified sphingolipidosis" }, { "code": "8A44.1", "title": "Adrenoleukodystrophy" }, { "code": "4A01.31", "title": "DNA repair defects other than combined T-cell or B-cell immunodeficiencies" } ]
=== 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 [1C62.Z] Human immunodeficiency virus disease without mention of tuberculosis or malaria, clinical stage unspecified Also known as: Human immunodeficiency virus disease without mention of tuberculosis or malaria, clinical stage unspecified | Human immunodeficiency virus disease without mention of tuberculosis or malaria | human immunodeficiency virus infection | HIV - [human immunodeficiency virus infection] | HIV positive NOS [1E32] Influenza, virus not identified Definition: Any disease of the respiratory system, caused by an unidentified strain of influenza virus. These diseases are characterised by fever, cough, headache, myalgia, arthralgia, or malaise. Transmission is by inhalation of infected respiratory secretions. Also known as: Influenza, virus not identified | flu | Influenza NOS | Viral influenza specific virus not stated to have been identified | Influenza specific virus not stated to have been identified Includes: Influenza specific virus not stated to have been identified | Viral influenza specific virus not stated to have been identified Excludes: Haemophilus influenzae [H. influenzae] meningitis | Haemophilus influenzae [H. influenzae] pneumonia [5C56.0Y] Other specified sphingolipidosis Also known as: Other specified sphingolipidosis | Mucolipidosis type 4 | Sialolipidosis | Gaucher disease | Acid beta-glucosidase deficiency [8A44.1] Adrenoleukodystrophy Definition: X-linked genetic disorder associated with accumulation of very-long-chain fatty acids in the brain and adrenal cortex due to a mutation in the ABCD1 gene causing defects in peroxisomal oxidation. Neurological symptoms can present in childhood or adulthood with almost all patients having concurrent adrenal insufficiency. Also known as: Adrenoleukodystrophy | ALD - [adrenoleukodystrophy] | Addison-Schilder | Adult-onset autosomal dominant leukodystrophy | Autosomal dominant Pelizaeus-Merzbacher disease [4A01.31] DNA repair defects other than combined T-cell or B-cell immunodeficiencies Also known as: DNA repair defects other than combined T-cell or B-cell immunodeficiencies | Nijmegen breakage syndrome | Autosomal recessive nonsyndromal microcephaly with normal intelligence | Immunodeficiency - microcephaly - chromosomal instability | Microcephaly - immunodeficiency - lymphoreticuloma === GRAPH WALKS === --- Walk 1 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Inflammatory arthropathies --- 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.... --RELATED_TO--> [?] Monogenic autoinflammatory syndromes Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies.... --- Walk 4 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system --- 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--> [ME60.0] 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.... --- 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--> [?] 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 --RELATED_TO--> [?] Monogenic autoinflammatory syndromes\n Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies....", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system", "[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....", "[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": "1C62.Z", "icd10_code": "B20", "icd10_title": "Human immunodeficiency virus [HIV] disease" }, { "from_icd11": "1C62.Z", "icd10_code": "B200", "icd10_title": "" }, { "from_icd11": "1C62.Z", "icd10_code": "B201", "icd10_title": "" }, { "from_icd11": "1C62.Z", "icd10_code": "B202", "icd10_title": "" }, { "from_icd11": "1C62.Z", "icd10_code": "B203", "icd10_title": "" }, { "from_icd11": "1C62.Z", "icd10_code": "B207", "icd10_title": "" }, { "from_icd11": "1C62.Z", "icd10_code": "B208", "icd10_title": "" }, { "from_icd11": "1C62.Z", "icd10_code": "B209", "icd10_title": "" }, { "from_icd11": "1C62.Z", "icd10_code": "B21", "icd10_title": "" }, { "from_icd11": "1C62.Z", "icd10_code": "B218", "icd10_title": "" } ]
M00-M25
A 10-year-old girl sustained 80 % TBSA burns during a crib fire as an infant in Columbia. She was abandoned by her biological parents and brought to the United States for treatment where she was adopted by caring foster parents. Prior to treatment at The Mount Sinai Medical Center in NYC, she had undergone 10+ prior surgeries with limited success. On exam, the face was grotesquely deformed characterized by obliteration of facial planes, displacement of the LT ocular adnexae, nasal collapse, and microstomia . On profile, the chin was marked retrusive and the lower lip ectropic with exposure of the lower dentition . Nasal tip and bridge projection was deficient. Multi-stage autogenous reconstruction was initiated with sequential pre-patterned , sculpted MV scapular flaps to the RT and LT hemiface, respectively . Deep facial foundation was restored with insertion of fascial lata slings for suspension of lateral lip commissures in conjunction with each of the scapular flaps . Peri-ocular reconstruction was achieved by re-alignment of the medial canthal tendon by transnasal wire fixation and repositioning of the lateral canthal ligament to the lateral orbital rim. Both upper and lower lids were resurfaced with single sheet grafts to the orbital subunit with single slits opened at the ciliary apertures . Total nasal reconstruction included architectural enhancement of the nasal tip with conchal cartilage grafts and dorsal resurfacing with a patterned, pedicled forehead flap using partial thickness burned skin . The divided pedicle base was “piggy backed” to the lower eyelid for ectropion repair prior to permanent inset. Nostril patency was restored with FTSGs wrapped around nasal stents. Additional refinements included debulking/contouring of the nasal and cheek flaps, SAL, insertion of a Porex chin implant, levator advancement OS, dermal strip grafts for upper lip augmentation, nostril thinning and repositioning, scar revisions, and laser resurfacing. Six months after the final surgery, facial planes have been restored with seams hidden at junction of aesthetic units . Facial components (lips, eyes, nose) are balanced, symmetrical, and complementary. Smile is symmetrical. On profile, nasal, chin, and lip projection are proportional . Fig. 8 Case 2. A 10-year-old girl who suffered 80 % TBSA in crib fire as infant. a Frontal view. Grotesque facial scarring with distortion of facial planes, ocular displacement, nasal collapse, and microstomia. b Profile. Marked chin retrusion and lower lip ectropion from contracting neck scar. Deficient nasal tip and bridge projection. Large patches of scalp alopecia. (Reprinted from Rose EH. Alternative approaches to face transplantation: microsurgical approach. In: Siemienow M (ed) The Know-How of Face Transplantation. London: Springer; 2011 Fig. 9 Case 2. First stage free flap transfer. a Keloid excision LT hemiface. b Design of patterned scapular flap. c Keloid excision RT hemiface. d Design of patterned scapular flap. (Reprinted from Rose EH. Alternative approaches to face transplantation: microsurgical approach. In: Siemienow M (ed) The Know-How of Face Transplantation. London: Springer; 2011) Fig. 10 Case 2. a Insertion of fascia lata sling to lateral lip commissure. b Patterned scapular flap inset into defect. (Reprinted from Rose EH. Alternative approaches to face transplantation: microsurgical approach. In: Siemienow M (ed) The Know-How of Face Transplantation. London: Springer; 2011) Fig. 11 Case 2. Peri-orbital reconstruction. a Pattern of peri-ocular scar excision ( b ) Single sheet resurfacing with FTSG. “Slit” opening for ciliary aperture. Medial canthal ligament re-aligned with transnasal wire through glabella and lateral canthal ligament re-suspended to lateral orbital rim. (Reprinted from Rose EH. Alternative approaches to face transplantation: microsurgical approach. In: Siemienow M (ed) The Know-How of Face Transplantation. London: Springer; 2011 Fig. 12 Case 2. Total nasal reconstruction. a Design of pedicled forehead flap centered on supratrochlear vessels. b Nasal flap inset. Conchal cartilage grafts used for nasal tip definition. (Reprinted from Rose EH. Alternative approaches to face transplantation: microsurgical approach. In: Siemienow M (ed) The Know-How of Face Transplantation. London: Springer; 2011) Fig. 13 Case 2. Six months after last surgery. a Frontal view. Facial contours and planes restored with soft, textured surfaces. Facial components (eyes, lips, nose) in balance and symmetrical. b Profile. Nasal, lip, and chin projection are proportional. (Reprinted from Rose EH. Alternative approaches to face transplantation: microsurgical approach. In: Siemienow M (ed) The Know-How of Face Transplantation. London: Springer; 2011)
4.050781
0.975098
sec[1]/sec[6]/sec[1]/p[0]
en
0.999997
27574662
https://doi.org/10.1186/s41038-015-0014-8
[ "face", "nasal", "transplantation", "facial", "flap", "reprinted", "rose", "alternative", "approaches", "microsurgical" ]
[ { "code": "ED90.1", "title": "Periorificial dermatitis" }, { "code": "8B88.0", "title": "Bell palsy" }, { "code": "LA51", "title": "Facial clefts" }, { "code": "8B88.Z", "title": "Disorders of facial nerve, unspecified" }, { "code": "LA52", "title": "Facial asymmetry" }, { "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" } ]
=== ICD-11 CODES FOUND === [ED90.1] Periorificial dermatitis Definition: Periorificial dermatitis is a term which links two erythematous and papulopustular facial dermatoses that are strongly linked to prolonged potent topical corticosteroid use, namely perioral dermatitis and periocular dermatitis. It is characterised by the development of erythema, papules and pustules in perioral and periocular skin. Also known as: Periorificial dermatitis | Perioral dermatitis | Corticosteroid-induced perioral dermatitis | Periocular dermatitis | Periorificial dermatitis of eyelids [8B88.0] Bell palsy Also known as: Bell palsy | Facial nerve paralysis | Facial nerve palsy | Seventh cranial nerve paralysis | facial palsy [LA51] Facial clefts Definition: Any condition caused by failure of the structures of the face to correctly develop during the antenatal period. These conditions are characterised by a partition in bone, soft tissue, or skin of the face. Also known as: Facial clefts | Craniofacial clefts | Median facial cleft | Tessier number 0-14 and 30 facial cleft | Midline facial cleft Excludes: Frontofacionasal dysostosis | Frontonasal dysplasia [8B88.Z] Disorders of facial nerve, unspecified Also known as: Disorders of facial nerve, unspecified | Disorders of facial nerve | Neuropathy of facial nerve | Disorders of 7th cranial nerve | Disorders of the seventh cranial nerve [LA52] Facial asymmetry Definition: A condition caused by failure of the face to develop symmetrically during the antenatal period. Also known as: Facial asymmetry | Asymmetric face | Hemifacial atrophy | Facial hemiatrophy | Hemifacial hypertrophy [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 === GRAPH WALKS === --- Walk 1 --- [ED90.1] Periorificial dermatitis Def: Periorificial dermatitis is a term which links two erythematous and papulopustular facial dermatoses that are strongly linked to prolonged potent topical corticosteroid use, namely perioral dermatitis... --PARENT--> [ED90] Rosacea and related disorders --CHILD--> [ED90.Y] Other specified rosacea-like disorders --- Walk 2 --- [ED90.1] Periorificial dermatitis Def: Periorificial dermatitis is a term which links two erythematous and papulopustular facial dermatoses that are strongly linked to prolonged potent topical corticosteroid use, namely perioral dermatitis... --PARENT--> [ED90] Rosacea and related disorders --PARENT--> [?] Disorders of the hair follicle Def: This group incorporates disorders of the hair shaft and hair follicular unit including, for example, hirsutism, alopecia, acne and hidradenitis suppurativa.... --- Walk 3 --- [8B88.0] Bell palsy --PARENT--> [8B88] Disorders of facial nerve --CHILD--> [8B88.2] Hemifacial spasm Def: Hemifacial spasm (HFS) is a movement disorder most commonly caused by vascular compression of the VII cranial nerve at its root exit zone from the brainstem. It manifests as involuntary contractions a... --- Walk 4 --- [8B88.0] Bell palsy --PARENT--> [8B88] Disorders of facial nerve --CHILD--> [8B88.2] Hemifacial spasm Def: Hemifacial spasm (HFS) is a movement disorder most commonly caused by vascular compression of the VII cranial nerve at its root exit zone from the brainstem. It manifests as involuntary contractions a... --- Walk 5 --- [LA51] Facial clefts Def: Any condition caused by failure of the structures of the face to correctly develop during the antenatal period. These conditions are characterised by a partition in bone, soft tissue, or skin of the f... --EXCLUDES--> [?] Frontofacionasal dysostosis Def: Fronto-facio-nasal dysostosis is a inherited skeletal disorder characterised by multiple craniofacial anomalies (brachycephaly, blepharophimosis, ptosis, S-shaped palpebral fissures, coloboma, cleft l... --PARENT--> [?] Craniofacial dysostoses Def: Syndromes caused by abnormal development of skull and facial bones. They may present with acrocephaly, exophthalmos, hypertelorism, strabismus, parrot-beaked nose, or hypoplastic maxilla. Non-syndromi... --- Walk 6 --- [LA51] Facial clefts Def: Any condition caused by failure of the structures of the face to correctly develop during the antenatal period. These conditions are characterised by a partition in bone, soft tissue, or skin of the f... --EXCLUDES--> [?] Frontofacionasal dysostosis Def: Fronto-facio-nasal dysostosis is a inherited skeletal disorder characterised by multiple craniofacial anomalies (brachycephaly, blepharophimosis, ptosis, S-shaped palpebral fissures, coloboma, cleft l... --PARENT--> [?] Craniofacial dysostoses Def: Syndromes caused by abnormal development of skull and facial bones. They may present with acrocephaly, exophthalmos, hypertelorism, strabismus, parrot-beaked nose, or hypoplastic maxilla. Non-syndromi...
[ "[ED90.1] Periorificial dermatitis\n Def: Periorificial dermatitis is a term which links two erythematous and papulopustular facial dermatoses that are strongly linked to prolonged potent topical corticosteroid use, namely perioral dermatitis...\n --PARENT--> [ED90] Rosacea and related disorders\n --CHILD--> [ED90.Y] Other specified rosacea-like disorders", "[ED90.1] Periorificial dermatitis\n Def: Periorificial dermatitis is a term which links two erythematous and papulopustular facial dermatoses that are strongly linked to prolonged potent topical corticosteroid use, namely perioral dermatitis...\n --PARENT--> [ED90] Rosacea and related disorders\n --PARENT--> [?] Disorders of the hair follicle\n Def: This group incorporates disorders of the hair shaft and hair follicular unit including, for example, hirsutism, alopecia, acne and hidradenitis suppurativa....", "[8B88.0] Bell palsy\n --PARENT--> [8B88] Disorders of facial nerve\n --CHILD--> [8B88.2] Hemifacial spasm\n Def: Hemifacial spasm (HFS) is a movement disorder most commonly caused by vascular compression of the VII cranial nerve at its root exit zone from the brainstem. It manifests as involuntary contractions a...", "[8B88.0] Bell palsy\n --PARENT--> [8B88] Disorders of facial nerve\n --CHILD--> [8B88.2] Hemifacial spasm\n Def: Hemifacial spasm (HFS) is a movement disorder most commonly caused by vascular compression of the VII cranial nerve at its root exit zone from the brainstem. It manifests as involuntary contractions a...", "[LA51] Facial clefts\n Def: Any condition caused by failure of the structures of the face to correctly develop during the antenatal period. These conditions are characterised by a partition in bone, soft tissue, or skin of the f...\n --EXCLUDES--> [?] Frontofacionasal dysostosis\n Def: Fronto-facio-nasal dysostosis is a inherited skeletal disorder characterised by multiple craniofacial anomalies (brachycephaly, blepharophimosis, ptosis, S-shaped palpebral fissures, coloboma, cleft l...\n --PARENT--> [?] Craniofacial dysostoses\n Def: Syndromes caused by abnormal development of skull and facial bones. They may present with acrocephaly, exophthalmos, hypertelorism, strabismus, parrot-beaked nose, or hypoplastic maxilla. Non-syndromi...", "[LA51] Facial clefts\n Def: Any condition caused by failure of the structures of the face to correctly develop during the antenatal period. These conditions are characterised by a partition in bone, soft tissue, or skin of the f...\n --EXCLUDES--> [?] Frontofacionasal dysostosis\n Def: Fronto-facio-nasal dysostosis is a inherited skeletal disorder characterised by multiple craniofacial anomalies (brachycephaly, blepharophimosis, ptosis, S-shaped palpebral fissures, coloboma, cleft l...\n --PARENT--> [?] Craniofacial dysostoses\n Def: Syndromes caused by abnormal development of skull and facial bones. They may present with acrocephaly, exophthalmos, hypertelorism, strabismus, parrot-beaked nose, or hypoplastic maxilla. Non-syndromi..." ]
ED90.1
Periorificial dermatitis
[ { "from_icd11": "ED90.1", "icd10_code": "L710", "icd10_title": "Perioral dermatitis" }, { "from_icd11": "8B88.0", "icd10_code": "G510", "icd10_title": "Bell's palsy" }, { "from_icd11": "LA51", "icd10_code": "Q361", "icd10_title": "Cleft lip, median" }, { "from_icd11": "8B88.Z", "icd10_code": "G512", "icd10_title": "Melkersson's syndrome" }, { "from_icd11": "8B88.Z", "icd10_code": "G518", "icd10_title": "Other disorders of facial nerve" }, { "from_icd11": "8B88.Z", "icd10_code": "G519", "icd10_title": "Disorder of facial nerve, unspecified" }, { "from_icd11": "8B88.Z", "icd10_code": "G51", "icd10_title": "Facial nerve disorders" }, { "from_icd11": "8B88.Z", "icd10_code": "G511", "icd10_title": "Geniculate ganglionitis" }, { "from_icd11": "8B88.Z", "icd10_code": "G836", "icd10_title": "" }, { "from_icd11": "LA52", "icd10_code": "Q670", "icd10_title": "Congenital facial asymmetry" }, { "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" } ]
L710
Perioral dermatitis
A 29‐year‐old primigravida Japanese woman with no remarkable past medical history was admitted at 25 weeks of gestation due to preterm premature rupture of membranes (pPROM). Bed rest, antibiotic therapy, and tocolysis with intravenous ritodrine and magnesium sulfate administrations were performed. The patient was hospitalized until delivery and was placed on bed rest. At 36 weeks of gestation, emergent CS was performed because inhibiting uterine contractions became difficult despite the administration of tocolytic agents and because the fetus was in the breech position. The surgery was performed without complications, and a healthy neonate was delivered . During surgery, amniotic fluid was clear without any signs of chorioamnionitis. Because the patient was not at a high risk of venous thromboembolism, anticoagulation was not performed during hospitalization and during the perioperative period. The patient remained afebrile, and no sign of infection was observed during the perioperative period. The patient developed an acute onset of epigastric pain 5 days after CS. The pain was temporally relieved by oral administration of H2‐blocker; the patient was discharged on the same day. However, the pain continued after discharge and was exacerbated by dietary intake. On a follow‐up visit 1 week after discharge, she was distressed due to the pain. At presentation, her body weight was 52.0 kg, height was 160.0 cm, and body mass index was 20. 3 kg/m 2 . Her vital signs included body temperature of 37.3°C, blood pressure of 114/69 mmHg, heart rate of 66 beats/min, respiratory rate of 16 breathes/min, and oxygen saturation of 99% with room air. On physical examination, her abdomen was not distended, although abdominal tenderness was observed. There were no indications of jaundice or edema. Blood tests revealed a white blood cell count of 12,670/ μ L , red blood cell count of 448 × 10 4 / μ L (376–500 × 10 4 / μ L), hemoglobin level of 11.8 g/dL (11.3–15.2 g/dL), platelet count of 37.3 × 10 4 / μ L (15–35 × 10 4 / μ L), C‐reactive protein level of 5.09 mg/dL (<0.30 mg/dL), and liver function test results within normal ranges. A coagulation test revealed partial prothrombin time‐internationalized ratio (PT‐INR) of 0.98 (0.85–1.15) and activated partial thromboplastin time (aPTT) of 32.2 sec (26–35 sec). Protein S antigen, protein C antigen, antithrombin III, and activation of factor V levels were within normal ranges. Anticardiolipin (aCL) and aCL beta‐2‐glycoprotein I antibodies showed negative results. These test results ruled out the possibility of underlying hypercoagulative disorders. Abdominal ultrasonography revealed a hyperechoic mass in the intrahepatic PV and superior mesenteric vein (SMV) . Contrast‐enhanced computed tomography (CT) revealed a massive thrombus extending from SMV to intrahepatic PV and splenomegaly . She was diagnosed with acute PVT, and anticoagulation therapy with intravenous unfractionated heparin (UFH) was immediately initiated while maintaining aPTT at 1.5–2.5 times the normal range. Considering intestinal ischemia due to dietary intake, fasting therapy and parenteral nutrition were also initiated. After admission, the patient's pain was gradually relieved and finally disappeared on day 3. Follow‐up contrast‐enhanced CT on day 7 showed resolution of the thrombus in the intrahepatic PV and a decrease in the size of the thrombus in SMV . Dietary ingestion was initiated on the same day. Intravenous UFH was switched to oral warfarin on day 14, and PT‐INR was maintained between 2.0 and 3.0. The patient was discharged on day 30, and warfarin was continued for approximately 8 months because of the residual thrombus in SMV. Follow‐up contrast‐enhanced CT at 8 months after discharge showed the development of collaterals due to SMV occlusion . Although the risk of recurrent PVT and exacerbation of symptoms were high, the patient wanted to bear a second child and became pregnant at 13 months after discharge. Subcutaneous low‐molecular‐weight heparin (LMWH) injection was initiated after the detection of pregnancy at 6 weeks of gestation and continued during pregnancy. PVT was followed‐up using monthly ultrasound evaluations during pregnancy, and no new PVT was observed. Later, the patient was hospitalized because of pPROM at 36 weeks of gestation. Emergent CS was performed, and successful delivery was achieved . LMWH was reinitiated 6 h after the surgery and continued to be used. The patient was discharged at 6 days after CS. Because the patient's previous history of PVT and repeated CS was considered to be risk factors for recurrent PVT, anticoagulation therapy was continued for 6 weeks after CS. No new PVT was observed on ultrasound evaluations 1 year after the discharge.
3.998047
0.976074
sec[1]/p[0]
en
0.999997
29531735
https://doi.org/10.1002/ccr3.1405
[ "because", "pain", "gestation", "blood", "thrombus", "initiated", "intravenous", "risk", "anticoagulation", "discharged" ]
[ { "code": "QC10", "title": "Procedure not carried out because of contraindication" }, { "code": "QB12.0", "title": "Organ transplant candidate" }, { "code": "QC04.5", "title": "Immunization not carried out because of patient refusal" }, { "code": "QC04.Z", "title": "Immunization not carried out for unspecified reason" }, { "code": "QC04.6", "title": "Immunization not carried out because of caregiver refusal" }, { "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 === [QC10] Procedure not carried out because of contraindication Also known as: Procedure not carried out because of contraindication | intervention not carried out because of contraindication | Procedure cancelled due to contraindication [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 [QC04.5] Immunization not carried out because of patient refusal Also known as: Immunization not carried out because of patient refusal [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 [QC04.6] Immunization not carried out because of caregiver refusal Also known as: Immunization not carried out because of caregiver refusal [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 --- [QC10] Procedure not carried out because of contraindication --PARENT--> [?] Interventions not carried out --CHILD--> [QC11] Procedure not carried out because of patient's decision for reasons of belief or group pressure --- Walk 2 --- [QC10] Procedure not carried out because of contraindication --PARENT--> [?] Interventions not carried out --PARENT--> [?] Reasons for contact with the health services --- Walk 3 --- [QB12.0] Organ transplant candidate --PARENT--> [QB12] Waiting period for investigation or treatment other than awaiting admission to adequate facility elsewhere --CHILD--> [QB12.0] Organ transplant candidate --- Walk 4 --- [QB12.0] Organ transplant candidate --PARENT--> [QB12] Waiting period for investigation or treatment other than awaiting admission to adequate facility elsewhere --PARENT--> [?] Factors related to medical facilities or other health care --- Walk 5 --- [QC04.5] Immunization not carried out because of patient refusal --PARENT--> [QC04] Immunization not carried out --CHILD--> [QC04.0] Immunization not carried out due to patient having had the disease --- Walk 6 --- [QC04.5] Immunization not carried out because of patient refusal --PARENT--> [QC04] Immunization not carried out --CHILD--> [QC04.0] Immunization not carried out due to patient having had the disease
[ "[QC10] Procedure not carried out because of contraindication\n --PARENT--> [?] Interventions not carried out\n --CHILD--> [QC11] Procedure not carried out because of patient's decision for reasons of belief or group pressure", "[QC10] Procedure not carried out because of contraindication\n --PARENT--> [?] Interventions not carried out\n --PARENT--> [?] Reasons for contact with the health services", "[QB12.0] Organ transplant candidate\n --PARENT--> [QB12] Waiting period for investigation or treatment other than awaiting admission to adequate facility elsewhere\n --CHILD--> [QB12.0] Organ transplant candidate", "[QB12.0] Organ transplant candidate\n --PARENT--> [QB12] Waiting period for investigation or treatment other than awaiting admission to adequate facility elsewhere\n --PARENT--> [?] Factors related to medical facilities or other health care", "[QC04.5] Immunization not carried out because of patient refusal\n --PARENT--> [QC04] Immunization not carried out\n --CHILD--> [QC04.0] Immunization not carried out due to patient having had the disease", "[QC04.5] Immunization not carried out because of patient refusal\n --PARENT--> [QC04] Immunization not carried out\n --CHILD--> [QC04.0] Immunization not carried out due to patient having had the disease" ]
QC10
Procedure not carried out because of contraindication
[ { "from_icd11": "QC10", "icd10_code": "Z5309", "icd10_title": "Procedure and treatment not carried out because of other contraindication" }, { "from_icd11": "QC10", "icd10_code": "Z530", "icd10_title": "Procedure and treatment not carried out because of contraindication" }, { "from_icd11": "QC04.5", "icd10_code": "Z2821", "icd10_title": "Immunization not carried out because of patient refusal" }, { "from_icd11": "QC04.5", "icd10_code": "Z282", "icd10_title": "Immunization not carried out because of patient decision for other and unspecified reason" }, { "from_icd11": "QC04.Z", "icd10_code": "Z283", "icd10_title": "Underimmunization status" }, { "from_icd11": "QC04.Z", "icd10_code": "Z2803", "icd10_title": "Immunization not carried out because of immune compromised state of patient" }, { "from_icd11": "QC04.Z", "icd10_code": "Z2809", "icd10_title": "Immunization not carried out because of other contraindication" }, { "from_icd11": "QC04.Z", "icd10_code": "Z2802", "icd10_title": "Immunization not carried out because of chronic illness or condition of patient" }, { "from_icd11": "QC04.Z", "icd10_code": "Z2882", "icd10_title": "Immunization not carried out because of caregiver refusal" }, { "from_icd11": "QC04.Z", "icd10_code": "Z2889", "icd10_title": "Immunization not carried out for other reason" }, { "from_icd11": "QC04.Z", "icd10_code": "Z2883", "icd10_title": "Immunization not carried out due to unavailability of vaccine" }, { "from_icd11": "QC04.Z", "icd10_code": "Z2801", "icd10_title": "Immunization not carried out because of acute illness of patient" }, { "from_icd11": "QC04.Z", "icd10_code": "Z2804", "icd10_title": "Immunization not carried out because of patient allergy to vaccine or component" }, { "from_icd11": "QC04.Z", "icd10_code": "Z289", "icd10_title": "Immunization not carried out for unspecified reason" }, { "from_icd11": "QC04.Z", "icd10_code": "Z281", "icd10_title": "Immunization not carried out because of patient decision for reasons of belief or group pressure" } ]
Z5309
Procedure and treatment not carried out because of other contraindication
The patient was a 53-year-old Chinese male employed as a goldminer. He presented to our hospital with complaints of uninduced vision loss, redness, and irritation in the left eye for 4 months, which had aggravated in the past week. He denied any history of systemic disease, ocular trauma, or surgery. Prior to visiting our hospital, he was diagnosed with herpes simplex keratitis (HSK) at a local hospital and received topical antiviral and glucocorticoid therapy. The initial examination revealed a visual acuity of hand motion (HM)/10 cm and an intraocular pressure of 11 mmHg in the left eye. Slit-lamp examination of the left eye showed mixed hyperemia, and a large area of irregular matrix turbidity infiltration and irregular defects of the epithelium were observed in the cornea with a 1.5 mm hypopyon . Confocal microscopy showed a large number of inflammatory cells infiltrating the stroma. Optical coherence tomography (OCT) showed that the corneal stroma was infiltrated and opaque, and a large number of exudates were attached to the endothelium . Corneal scrapings were examined with Gram staining and Potassium hydroxide (KOH) wet film, but the test result was negative. The right eye was normal. The patient was suspected to have HSK combined with bacterial infection and was treated with ganciclovir, gatifloxacin, and tobramycin eye drops. After 3 days of treatment, the patient showed no improvement, and tobramycin and dexamethasone eye drops were administered. After the addition of glucocorticoids, inflammation in the anterior chamber was alleviated, but the corneal lesions continued to expand . To further identify the pathogen, we used a corneal scraper for high-throughput sequencing. The results identified M. haemophilus , with 17,608 sequences with a relative abundance of 97.8%. The patient was diagnosed with M. haemophilus keratitis, received systemic amikacin with a dosage of 750 mg / day, topical 2% amikacin eye drops once per hour, rifampicin eye drops once per hour, and moxifloxacin eye drops 4 times a day, and underwent therapeutic penetrating keratoplasty (TPK). The cornea collected from the operation was analyzed by Ziehl-Neelsen staining, and a large number of mycobacteria were observed . Two months after surgery, the patient’s visual acuity recovered to 0.4 . However, 3 months after the operation, the patient returned to the clinic complaining of redness and swelling in the left eye for nearly 4 days. A slit-lamp examination showed that the corneal graft was transparent, and the corneal epithelial defect at the recipient bed was at the 4 o’clock position. The temporal bulbar conjunctiva was hyperemic and edematous, and white pus was observed locally . A conjunctival M. haemophilus infection was suspected. On the following days, the patient deteriorated rapidly, with caseous necrosis of the conjunctiva that rapidly expanded . Ultrasound biomicroscopy (UBM) revealed conjunctival edema and thickening . Debridement was performed in the area of conjunctival necrosis, and acid-fast staining of the specimens revealed a large number of mycobacteria. Histopathological examination of the infected conjunctival tissue showed granulomatous findings. High-throughput sequencing confirmed M. haemophilus infection (sequence 135,965, relative abundance 99.58%). Systemic examination revealed no infection in other parts of the body, and laboratory results for anti-HIV, VDRL, TPHA, IgG, IgM, IgA, rheumatoid factor, antinuclear antibodies, and Toxoplasma serotry were all negative. The patient received systemic rifampin (600 mg / day), moxifloxacin (400 mg / day), clarithromycin (750 mg / day), and amikacin (750 mg / day) in addition to topical 2% amikacin (once per hour), moxifloxacin (4 times a day), and rifampicin (once per hour). Systemic dose had been maintained at the original dose, topical dose has been changed to once every 2 h after one month of use, and changed to four times a day after three months, and then maintenance treatment. One month later, the patient’s original conjunctival ulcer was repaired, but abscesses in the inferior and temporal subconjunctiva developed, and a nodule appeared on the outer skin of the lower eyelid . After three months of treatment, the conjunctival abscess and skin nodule resolved, and the corneal stroma remained transparent despite the development of a large defect in the conjunctival and corneal epithelia . After 7 months of treatment, the patient’s condition was controlled, the corneal graft was mostly transparent, the visual acuity was 0.3, the conjunctival lesions subsided, and a small scar and mild lower eyelid inversion trichiasis remained . Systemic antibiotic therapy was continued for 10 months, with no relapse one year after discontinuation.
4.003906
0.97998
sec[1]/p[0]
en
0.999999
36882753
https://doi.org/10.1186/s12879-023-08094-2
[ "corneal", "conjunctival", "systemic", "large", "drops", "topical", "number", "infection", "haemophilus", "amikacin" ]
[ { "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": "9A6Z", "title": "Disorders of conjunctiva, unspecified" }, { "code": "9A60.30", "title": "Ulceration of conjunctiva" }, { "code": "9A61.Z", "title": "Certain specified disorders of conjunctiva, unspecified" }, { "code": "9A61.6", "title": "Conjunctival or subconjunctival degenerations or deposits" }, { "code": "9A61.3", "title": "Conjunctival scars" } ]
=== 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 [9A6Z] Disorders of conjunctiva, unspecified Also known as: Disorders of conjunctiva, unspecified | conjunctival disease NOS | disease of conjunctiva NOS | conjunctiva lesion NOS [9A60.30] Ulceration of conjunctiva Also known as: Ulceration of conjunctiva | conjunctival ulcer [9A61.Z] Certain specified disorders of conjunctiva, unspecified Also known as: Certain specified disorders of conjunctiva, unspecified | Certain specified disorders of conjunctiva | Conjunctival atrophy | Conjunctival emphysema | Conjunctival lymphangiectasis [9A61.6] Conjunctival or subconjunctival degenerations or deposits Definition: These are the conjunctival/subconjunctival accumulation of some materials and gradual deterioration with impairment or loss of function, caused by injury, disease, or aging. Also known as: Conjunctival or subconjunctival degenerations or deposits | Conjunctival concretions | conjunctival concretion | conjunctival calculus | conjunctival calcification Includes: Conjunctival concretions | Conjunctival cysts or argyrosis | Conjunctival pigmentations [9A61.3] Conjunctival scars Definition: These are cicatrices of the mucous membrane that lines the inner surface of the eyelid and the exposed surface of the eyeball that occur due to various reasons such as trauma, infection or allergy. Also known as: Conjunctival scars | conjunctival scarring | scarring of conjunctiva, unspecified eye | conjunctival cicatrix | Conjunctival scars, symblepharon === GRAPH WALKS === --- Walk 1 --- [9A7Z] Disorders of the cornea, unspecified --PARENT--> [?] Disorders of the cornea Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc... --CHILD--> [9A70] Hereditary corneal dystrophies Def: The term corneal dystrophy embraces a heterogeneous group of bilateral genetically determined non-inflammatory corneal diseases that are usually restricted to the cornea. The designation is imprecise ... --- Walk 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--> [9A71] Infectious 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... --CHILD--> [?] Neurotrophic keratopathy --- Walk 4 --- [9A71] Infectious keratitis --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 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--> [9A72] Traumatic keratitis
[ "[9A7Z] Disorders of the cornea, unspecified\n --PARENT--> [?] Disorders of the cornea\n Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc...\n --CHILD--> [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\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--> [9A71] Infectious 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 --CHILD--> [?] Neurotrophic keratopathy", "[9A71] Infectious keratitis\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....", "[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--> [9A72] Traumatic keratitis" ]
9A7Z
Disorders of the cornea, unspecified
[ { "from_icd11": "9A7Z", "icd10_code": "H16203", "icd10_title": "Unspecified keratoconjunctivitis, bilateral" }, { "from_icd11": "9A7Z", "icd10_code": "H16229", "icd10_title": "Keratoconjunctivitis sicca, not specified as Sjogren's, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16231", "icd10_title": "Neurotrophic keratoconjunctivitis, right eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16213", "icd10_title": "Exposure keratoconjunctivitis, bilateral" }, { "from_icd11": "9A7Z", "icd10_code": "H16209", "icd10_title": "Unspecified keratoconjunctivitis, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16221", "icd10_title": "Keratoconjunctivitis sicca, not specified as Sjogren's, right eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16222", "icd10_title": "Keratoconjunctivitis sicca, not specified as Sjogren's, left eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16202", "icd10_title": "Unspecified keratoconjunctivitis, left eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16299", "icd10_title": "Other keratoconjunctivitis, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16292", "icd10_title": "Other keratoconjunctivitis, left eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16219", "icd10_title": "Exposure keratoconjunctivitis, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H169", "icd10_title": "Unspecified keratitis" }, { "from_icd11": "9A7Z", "icd10_code": "H189", "icd10_title": "Unspecified disorder of cornea" }, { "from_icd11": "9A7Z", "icd10_code": "H168", "icd10_title": "Other keratitis" }, { "from_icd11": "9A7Z", "icd10_code": "H162", "icd10_title": "Keratoconjunctivitis" } ]
H16203
Unspecified keratoconjunctivitis, bilateral
We report a case of a 22-year-old Nigerian man of Yoruba ethnicity who presented himself for electrocardiographic screening as a pre-admission medical test. He had a standard 12-lead ECG which revealed uncommon features: inversion of P waves (atrial depolarization) in leads I, aVL and aVR; dominant S waves in leads I, V1 to V6 with reversed R wave progression in chest leads; low voltage QRS axis in V4 to V6; extreme QRS axis; flattened T waves (ventricular repolarization) in V4 to V6 and aVR; and inverted T waves in lead I and aVL . An ECG diagnosis of dextrocardia was made; the differential diagnosis considered was right ventricular hypertrophy. The ECG electrodes were then placed in reverse order (mirror image position) on his body, which produced a normal standard 12-lead ECG pattern of a young adult. This confirmed dextrocardia with mirror image atrial arrangement . On further evaluation, he revealed a 5-year history of recurrent abdominal pain and a 3-week history of catarrh, fever, cough, exercise intolerance and progressive weight loss. There was no history of chest pain, orthopnea, paroxysmal nocturnal dyspnea, palpitation or body swelling. He had no history of contact with someone with a chronic cough. There was a positive history of twins (twice) in his nuclear family. A physical examination revealed a slim young man not in obvious respiratory distress; he was not cyanosed, pale or febrile. He had neither finger clubbing nor pedal edema. A cardiovascular examination showed a pulse rate of 70 beats per minute, blood pressure of 119/62mmHg, visible cardiac impulse at right precordium, apex beat was located at his fifth right intercostal space midclavicular line, and first and second heart sounds were heard. A chest X-ray (posterior anterior view) including upper abdomen showed dextrocardia, with the cardiac apex pointing to the right. His aortic arch was located on the right. His stomach bubble was located below his right hemidiaphragm. His hepatic opacity was located below his left hemidiaphragm. His trachea was slightly deviated to the left. The findings in the lung fields were not remarkable . An abdominopelvic ultrasonography showed that his liver was located on the left side; it measured 14.5cm in span. The liver margin was smooth and the intrahepatic ducts and vascular channels were preserved. The gallbladder was seen in its inferior border. His spleen was located in the right hypochondrium; it was preserved sonographically. His stomach was on the right and his duodenum was located on the left. His two kidneys were seen in the renal beds bilaterally. His abdominal aorta was on the right while his inferior vena cava was located on the left. His urinary bladder was centrally placed and an assessment of situs inversus was made ultrasonographically. Overall, the diagnosis of dextrocardia with situs inversus to exclude Kartagener syndrome was made. Sputum microscopy, culture and sensitivity (MCS), sputum for acid-fast bacilli, chest CT scan and echocardiography were requested. He was placed on a combination of amoxycillin and azithromycin pending the result of his sputum tests. His sputum MCS showed Klebsiella species sensitive to cefuroxime. The sputum acid-fast bacilli test was negative. He was scheduled for echocardiography to determine cardiac structure and function; he was also scheduled for a chest CT. However, he had financial challenges which delayed completion of the investigations. Following completion of the initial antibiotics dosages, he was placed on cefuroxime and he became symptom free within 2 weeks of treatment. Fig. 1 A resting standard 12-lead electrocardiogram of a 22-year-old Nigerian man. He had a heart rate of 73 beats per minute, inversion of P waves in leads I, aVL and aVR, dominant S waves in leads I and V1 to V6, reversed R wave progression in chest leads, low voltage QRS axis in V4 to V6, extreme QRS axis, flattened T waves in V4 to V6 and aVR and inverted T waves in lead I and aVL Fig. 2 A resting standard 12-lead electrocardiogram of a 22-year-old Nigerian man with the electrocardiogram electrodes reversed. The electrocardiogram electrodes were reversed by placing the chest electrodes in a mirror image position on the right side of his chest and reversing the left and right limb leads. All the previous changes were reversed and a normal electrocardiographic pattern of a young adult man occurred Fig. 3 Chest X-ray (posterior anterior view) of a 22-year-old Nigerian man showing dextrocardia, with the cardiac apex pointing to the right. His aortic arch was located on the right. His stomach bubble was located below his right hemidiaphragm. His hepatic opacity was located below his left hemidiaphragm. His trachea was slightly deviated to the left
4.003906
0.980957
sec[1]/p[0]
en
0.999997
26411880
https://doi.org/10.1186/s13256-015-0695-4
[ "located", "chest", "waves", "leads", "lead", "reversed", "dextrocardia", "sputum", "nigerian", "standard" ]
[ { "code": "LD40.0", "title": "Complete trisomy 21" }, { "code": "LD40.1", "title": "Complete trisomy 13" }, { "code": "LD40.2", "title": "Complete trisomy 18" }, { "code": "LD7Y", "title": "Other specified chromosomal anomalies, excluding gene mutations" }, { "code": "LD47.0", "title": "Balanced translocation and insertion in normal individual" }, { "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 === [LD40.0] Complete trisomy 21 Definition: Trisomy 21 is a chromosomal abnormality, characterised by the presence of a third (partial or total) copy of chromosome 21, which clinical manifestations include variable intellectual deficiency, muscular hypotonia and joint laxity, often associated with facial dysmorphism and variable malformations (essentially heart and digestive) and a risk of complications (epilepsy, leukemia, auto-immune and endocrine pathologies, earlier aging and Alzheimer disease. Also known as: Complete trisomy 21 | Down syndrome | Chromosome 21 trisomy | Trisomy 21 syndrome | Trisomy 21 NOS Includes: Down syndrome [LD40.1] Complete trisomy 13 Definition: Trisomy 13 is a chromosomal anomaly caused by the presence of an extra chromosome 13 and is characterised by brain malformations (holoprosencephaly), facial dysmorphism, ocular anomalies, postaxial polydactyly, visceral malformations (cardiopathy) and severe psychomotor retardation. Also known as: Complete trisomy 13 | Patau syndrome | complete trisomy 13 syndrome | d1 trisomy | d1 trisomy syndrome Includes: Patau syndrome [LD40.2] Complete trisomy 18 Definition: Trisomy 18 is a chromosomal abnormality associated with the presence of an extra chromosome 18 and characterised by growth delay, dolichocephaly, a characteristic facies, limb anomalies and visceral malformations. Also known as: Complete trisomy 18 | complete trisomy 18 syndrome | e3 trisomy | trisomy 18 | trisomy 18 syndrome [LD7Y] Other specified chromosomal anomalies, excluding gene mutations Also known as: Other specified chromosomal anomalies, excluding gene mutations | Tetrasomies of the autosomes | Tetrasomy 12p mosaicism | Pallister-Killian syndrome | Tetrasomy 15q [LD47.0] Balanced translocation and insertion in normal individual Definition: A condition caused by translocation of genetic material between chromosomes with no net gain or loss of genetic material, in an individual demonstrating no abnormalities. Confirmation is through observation of a balanced translocation and insertion by genetic testing. Also known as: Balanced translocation and insertion in normal individual | Translocation balanced chromosomes in normal individual | balanced autosomal translocation in normal individual [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 --- [LD40.0] Complete trisomy 21 Def: Trisomy 21 is a chromosomal abnormality, characterised by the presence of a third (partial or total) copy of chromosome 21, which clinical manifestations include variable intellectual deficiency, musc... --PARENT--> [LD40] Complete trisomies of the autosomes Def: Any disease caused by the presence of one extra autosome, for a total of three. Confirmation is through observation of a supernumerary autosome by karyotyping.... --PARENT--> [?] Chromosomal anomalies, excluding gene mutations Def: Any disease caused by alteration of the number or structure of chromosomes.... --- Walk 2 --- [LD40.0] Complete trisomy 21 Def: Trisomy 21 is a chromosomal abnormality, characterised by the presence of a third (partial or total) copy of chromosome 21, which clinical manifestations include variable intellectual deficiency, musc... --RELATED_TO--> [?] Keratoconus in Down syndrome --PARENT--> [?] Keratoconus Def: Keratoconus is a noninflammatory, often bilateral, corneal dystrophy characterised by progressive cone-shaped bulging and thinning of the cornea.... --- Walk 3 --- [LD40.1] Complete trisomy 13 Def: Trisomy 13 is a chromosomal anomaly caused by the presence of an extra chromosome 13 and is characterised by brain malformations (holoprosencephaly), facial dysmorphism, ocular anomalies, postaxial po... --PARENT--> [LD40] Complete trisomies of the autosomes Def: Any disease caused by the presence of one extra autosome, for a total of three. Confirmation is through observation of a supernumerary autosome by karyotyping.... --CHILD--> [LD40.0] Complete trisomy 21 Def: Trisomy 21 is a chromosomal abnormality, characterised by the presence of a third (partial or total) copy of chromosome 21, which clinical manifestations include variable intellectual deficiency, musc... --- Walk 4 --- [LD40.1] Complete trisomy 13 Def: Trisomy 13 is a chromosomal anomaly caused by the presence of an extra chromosome 13 and is characterised by brain malformations (holoprosencephaly), facial dysmorphism, ocular anomalies, postaxial po... --PARENT--> [LD40] Complete trisomies of the autosomes Def: Any disease caused by the presence of one extra autosome, for a total of three. Confirmation is through observation of a supernumerary autosome by karyotyping.... --CHILD--> [LD40.1] Complete trisomy 13 Def: Trisomy 13 is a chromosomal anomaly caused by the presence of an extra chromosome 13 and is characterised by brain malformations (holoprosencephaly), facial dysmorphism, ocular anomalies, postaxial po... --- Walk 5 --- [LD40.2] Complete trisomy 18 Def: Trisomy 18 is a chromosomal abnormality associated with the presence of an extra chromosome 18 and characterised by growth delay, dolichocephaly, a characteristic facies, limb anomalies and visceral m... --PARENT--> [LD40] Complete trisomies of the autosomes Def: Any disease caused by the presence of one extra autosome, for a total of three. Confirmation is through observation of a supernumerary autosome by karyotyping.... --CHILD--> [LD40.2] Complete trisomy 18 Def: Trisomy 18 is a chromosomal abnormality associated with the presence of an extra chromosome 18 and characterised by growth delay, dolichocephaly, a characteristic facies, limb anomalies and visceral m... --- Walk 6 --- [LD40.2] Complete trisomy 18 Def: Trisomy 18 is a chromosomal abnormality associated with the presence of an extra chromosome 18 and characterised by growth delay, dolichocephaly, a characteristic facies, limb anomalies and visceral m... --PARENT--> [LD40] Complete trisomies of the autosomes Def: Any disease caused by the presence of one extra autosome, for a total of three. Confirmation is through observation of a supernumerary autosome by karyotyping.... --CHILD--> [LD40.1] Complete trisomy 13 Def: Trisomy 13 is a chromosomal anomaly caused by the presence of an extra chromosome 13 and is characterised by brain malformations (holoprosencephaly), facial dysmorphism, ocular anomalies, postaxial po...
[ "[LD40.0] Complete trisomy 21\n Def: Trisomy 21 is a chromosomal abnormality, characterised by the presence of a third (partial or total) copy of chromosome 21, which clinical manifestations include variable intellectual deficiency, musc...\n --PARENT--> [LD40] Complete trisomies of the autosomes\n Def: Any disease caused by the presence of one extra autosome, for a total of three. Confirmation is through observation of a supernumerary autosome by karyotyping....\n --PARENT--> [?] Chromosomal anomalies, excluding gene mutations\n Def: Any disease caused by alteration of the number or structure of chromosomes....", "[LD40.0] Complete trisomy 21\n Def: Trisomy 21 is a chromosomal abnormality, characterised by the presence of a third (partial or total) copy of chromosome 21, which clinical manifestations include variable intellectual deficiency, musc...\n --RELATED_TO--> [?] Keratoconus in Down syndrome\n --PARENT--> [?] Keratoconus\n Def: Keratoconus is a noninflammatory, often bilateral, corneal dystrophy characterised by progressive cone-shaped bulging and thinning of the cornea....", "[LD40.1] Complete trisomy 13\n Def: Trisomy 13 is a chromosomal anomaly caused by the presence of an extra chromosome 13 and is characterised by brain malformations (holoprosencephaly), facial dysmorphism, ocular anomalies, postaxial po...\n --PARENT--> [LD40] Complete trisomies of the autosomes\n Def: Any disease caused by the presence of one extra autosome, for a total of three. Confirmation is through observation of a supernumerary autosome by karyotyping....\n --CHILD--> [LD40.0] Complete trisomy 21\n Def: Trisomy 21 is a chromosomal abnormality, characterised by the presence of a third (partial or total) copy of chromosome 21, which clinical manifestations include variable intellectual deficiency, musc...", "[LD40.1] Complete trisomy 13\n Def: Trisomy 13 is a chromosomal anomaly caused by the presence of an extra chromosome 13 and is characterised by brain malformations (holoprosencephaly), facial dysmorphism, ocular anomalies, postaxial po...\n --PARENT--> [LD40] Complete trisomies of the autosomes\n Def: Any disease caused by the presence of one extra autosome, for a total of three. Confirmation is through observation of a supernumerary autosome by karyotyping....\n --CHILD--> [LD40.1] Complete trisomy 13\n Def: Trisomy 13 is a chromosomal anomaly caused by the presence of an extra chromosome 13 and is characterised by brain malformations (holoprosencephaly), facial dysmorphism, ocular anomalies, postaxial po...", "[LD40.2] Complete trisomy 18\n Def: Trisomy 18 is a chromosomal abnormality associated with the presence of an extra chromosome 18 and characterised by growth delay, dolichocephaly, a characteristic facies, limb anomalies and visceral m...\n --PARENT--> [LD40] Complete trisomies of the autosomes\n Def: Any disease caused by the presence of one extra autosome, for a total of three. Confirmation is through observation of a supernumerary autosome by karyotyping....\n --CHILD--> [LD40.2] Complete trisomy 18\n Def: Trisomy 18 is a chromosomal abnormality associated with the presence of an extra chromosome 18 and characterised by growth delay, dolichocephaly, a characteristic facies, limb anomalies and visceral m...", "[LD40.2] Complete trisomy 18\n Def: Trisomy 18 is a chromosomal abnormality associated with the presence of an extra chromosome 18 and characterised by growth delay, dolichocephaly, a characteristic facies, limb anomalies and visceral m...\n --PARENT--> [LD40] Complete trisomies of the autosomes\n Def: Any disease caused by the presence of one extra autosome, for a total of three. Confirmation is through observation of a supernumerary autosome by karyotyping....\n --CHILD--> [LD40.1] Complete trisomy 13\n Def: Trisomy 13 is a chromosomal anomaly caused by the presence of an extra chromosome 13 and is characterised by brain malformations (holoprosencephaly), facial dysmorphism, ocular anomalies, postaxial po..." ]
LD40.0
Complete trisomy 21
[ { "from_icd11": "LD40.0", "icd10_code": "Q909", "icd10_title": "Down syndrome, unspecified" }, { "from_icd11": "LD40.0", "icd10_code": "Q902", "icd10_title": "Trisomy 21, translocation" }, { "from_icd11": "LD40.0", "icd10_code": "Q90", "icd10_title": "Down syndrome" }, { "from_icd11": "LD40.0", "icd10_code": "Q900", "icd10_title": "Trisomy 21, nonmosaicism (meiotic nondisjunction)" }, { "from_icd11": "LD40.0", "icd10_code": "Q901", "icd10_title": "Trisomy 21, mosaicism (mitotic nondisjunction)" }, { "from_icd11": "LD40.1", "icd10_code": "Q917", "icd10_title": "Trisomy 13, unspecified" }, { "from_icd11": "LD40.1", "icd10_code": "Q91", "icd10_title": "Trisomy 18 and Trisomy 13" }, { "from_icd11": "LD40.1", "icd10_code": "Q914", "icd10_title": "Trisomy 13, nonmosaicism (meiotic nondisjunction)" }, { "from_icd11": "LD40.1", "icd10_code": "Q915", "icd10_title": "Trisomy 13, mosaicism (mitotic nondisjunction)" }, { "from_icd11": "LD40.1", "icd10_code": "Q916", "icd10_title": "Trisomy 13, translocation" }, { "from_icd11": "LD40.2", "icd10_code": "Q910", "icd10_title": "Trisomy 18, nonmosaicism (meiotic nondisjunction)" }, { "from_icd11": "LD40.2", "icd10_code": "Q911", "icd10_title": "Trisomy 18, mosaicism (mitotic nondisjunction)" }, { "from_icd11": "LD40.2", "icd10_code": "Q912", "icd10_title": "Trisomy 18, translocation" }, { "from_icd11": "LD40.2", "icd10_code": "Q913", "icd10_title": "Trisomy 18, unspecified" }, { "from_icd11": "LD7Y", "icd10_code": "Q998 ", "icd10_title": "" } ]
Q909
Down syndrome, unspecified
A 64-year-old man was admitted to another hospital because of appetite loss and vomiting. He was diagnosed as having superior mesenteric artery (SMA) syndrome after appropriate investigations. He had been living in social housing because of complications of a cerebral infarction he had had at the age of 57 years. A nasogastric tube was inserted into the third portion of the duodenum beyond the constriction. He was discharged 2 months after admission, his condition having improved. He was subsequently referred to our hospital for gastrostomy because the nasogastric tube had been in place for 3 months. Computed tomography (CT) revealed compression of the third portion of the duodenum between the SMA and aorta . The aorto-mesenteric angle was narrow at 18° and the aorto-mesenteric distance short at 8 mm . His stomach and duodenum were distended, consistent with persistent SMA syndrome. Surgical intervention for SMA syndrome was needed because his condition had not improved. An additional indication for gastrostomy was to provide a route for enteral nutrition because he had dysphagia. After obtaining informed consent, a surgery was planned. His body height was 165.0 cm, his weight 42.0 kg, and his body mass index (BMI) 15.43. His abdomen was soft and not tender. Laboratory tests showed white blood cell count 6.8 × 10 9 /L, red blood cell count 4.84 × 10 12 /L, hemoglobin concentration 14.3 g/dL, total protein concentration 5.6 g/dL, albumin concentration 2.9 g/dL, and cholinesterase concentration 177 U/L. Laparoscopic gastrojejunostomy was performed under general anesthesia. First, a trans-umbilical incision was made and a 12-mm port inserted. After inducing a pneumoperitoneum, 5-mm ports were inserted in the right and left right upper quadrants and 12-mm ports in the right and left lateral abdomen. The omentum was dissected to open the omental bursa. The greater curvature of the stomach was transected with a linear stapler to increase flow to the jejunal bypass . Small incisions were made in the proximal jejunum (30 cm from the Treitz ligament) and posterior wall of the upper body of the stomach (oral side of the stapled line). A 60-mm Endo GIA Tri-Staple™ purple cartridge (Medtronic, Minneapolis, MN, USA) was then inserted into the small incisions in the jejunum and stomach to create a gastrojejunostomy . The common point of entry was closed by a hand-sewn continuous running suture using a 3–0 V-Loc™ (Medtronic), after which a Braun anastomosis was created to prevent afferent loop syndrome . Next, a laparoscopic-assisted percutaneous endoscopic gastrostomy was performed, the gastrostomy being on the oral side of the gastrojejunostomy . The operation time was 156 min and there was little blood loss. Contrast radiography on postoperative day 3 revealed no evidence of leakage or stenosis . Enteral nutrition via the gastrostomy was started and attempts at dysphagia rehabilitation continued. However, his ability to swallow did not improve and he was able to eat only small amounts of food, necessitating enteral nutrition via the gastrostomy. He was discharged from our hospital on the 27th postoperative day. Laboratory tests before discharge showed total protein concentration 5.8 g/dL, albumin concentration 3.0 g/dL and his nutritional condition was slightly improved. We perform the exchange of the gastrostomy every 6 months and there is no evidence of gastric dilatation on the radiographic image. There have since been no problems with the gastrostomy or evidence of recurrence of SMA syndrome. Fig. 1 Abdominal computed tomography findings. a The stomach is dilated because of obstruction of the duodenum. b The third portion of the duodenum is compressed between the SMA and aorta Fig. 2 Computed tomography findings. a Sagittal view. b Axial view. The aorto-mesenteric angle is narrow at 18° and the aorto-mesenteric distance short at 8 mm Fig. 3 Operative findings. a The greater curvature was transected with a liner stapler to increase flow to the jejunal bypass. b A 60-mm Endo GIA Tri-Staple™ purple cartridge (Medtronic, Minneapolis, MN, USA) was inserted into the small incisions in the jejunum and stomach to create a gastrojejunostomy. c A Braun anastomosis was created to prevent afferent loop syndrome. d Laparoscopic-assisted percutaneous endoscopic gastrostomy was also performed, the gastrostomy being located on the oral side of the gastrojejunostomy Fig. 4 Schematic figure of the operation. The greater curvature of the stomach was transected with a linear stapler to increase flow to the jejunal bypass (stomach-partitioning). The gastrostomy was placed on the oral side of the gastrojejunostomy Fig. 5 Contrast radiography findings. There was no evidence of postoperative leakage or stenosis
3.939453
0.972168
sec[1]/p[0]
en
0.999995
36048264
https://doi.org/10.1186/s40792-022-01522-6
[ "gastrostomy", "stomach", "because", "concentration", "gastrojejunostomy", "mesenteric", "duodenum", "aorto", "small", "oral" ]
[ { "code": "QB61.2", "title": "Presence of gastrostomy" }, { "code": "QB62.1", "title": "Attention to gastrostomy" }, { "code": "NE81.3", "title": "Postsurgical leak" }, { "code": "DE12.1", "title": "Gastrostomy malfunction" }, { "code": "EM0Y", "title": "Other specified diseases of the skin" }, { "code": "DA4Z", "title": "Diseases of stomach, unspecified" }, { "code": "DA60.Z", "title": "Gastric ulcer, unspecified" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "LB13.Z", "title": "Structural developmental anomalies of stomach, unspecified" }, { "code": "DA42.73", "title": "Chronic atrophic gastritis of unknown aetiology" } ]
=== ICD-11 CODES FOUND === [QB61.2] Presence of gastrostomy Also known as: Presence of gastrostomy | gastrostomy status [QB62.1] Attention to gastrostomy Also known as: Attention to gastrostomy [NE81.3] Postsurgical leak Also known as: Postsurgical leak | postoperative leak | Postsurgical air leak | postoperative air leak | Postsurgical bile leak Excludes: Malfunction or complication of external stoma of digestive organs | Tracheostomy malfunction [DE12.1] Gastrostomy malfunction Also known as: Gastrostomy malfunction | Haemorrhage from gastrostomy stoma | Infection of gastrostomy stoma [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 [DA4Z] Diseases of stomach, unspecified Also known as: Diseases of stomach, unspecified | disorder of stomach | gastropathy NOS | gastric disease NOS | stomach disease NOS [DA60.Z] Gastric ulcer, unspecified Also known as: Gastric ulcer, unspecified | Gastric ulcer | stomach ulcer | Cushings ulcer | cushing's ulcer of stomach [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [LB13.Z] Structural developmental anomalies of stomach, unspecified Also known as: Structural developmental anomalies of stomach, unspecified | Structural developmental anomalies of stomach | Malformations of stomach [DA42.73] Chronic atrophic gastritis of unknown aetiology Definition: Persistent or recurrent inflammation of the gastric mucosa with atrophy leading to decreased hydrochloric acid concentration in the gastric juice. Atrophic gastritis frequently progresses from chronic gastritis. Also known as: Chronic atrophic gastritis of unknown aetiology | Gastric atrophy | atrophic gastritis | AG - [atrophic gastritis] | CAG - [chronic atrophic gastritis] Includes: Gastric atrophy === GRAPH WALKS === --- Walk 1 --- [QB61.2] Presence of gastrostomy --PARENT--> [QB61] Presence of artificial opening --EXCLUDES--> [?] Attention to artificial openings --- Walk 2 --- [QB61.2] Presence of gastrostomy --PARENT--> [QB61] Presence of artificial opening --CHILD--> [QB61.2] Presence of gastrostomy --- Walk 3 --- [QB62.1] Attention to gastrostomy --PARENT--> [QB62] Attention to artificial openings --EXCLUDES--> [?] Tracheostomy malfunction --- Walk 4 --- [QB62.1] Attention to gastrostomy --PARENT--> [QB62] Attention to artificial openings --EXCLUDES--> [?] Tracheostomy malfunction --- Walk 5 --- [NE81.3] Postsurgical leak --EXCLUDES--> [?] Tracheostomy malfunction --CHILD--> [?] Leak from tracheostomy --- Walk 6 --- [NE81.3] Postsurgical leak --EXCLUDES--> [?] Malfunction or complication of external stoma of digestive organs --CHILD--> [?] Skin problem resulting from external stoma of digestive organs Def: An entity to be used to link a specific skin problem (e.g. psoriasis or parastomal pyoderma gangrenosum) to its proximity to an artificial stoma or fistula from the gastrointestinal tract to the skin ...
[ "[QB61.2] Presence of gastrostomy\n --PARENT--> [QB61] Presence of artificial opening\n --EXCLUDES--> [?] Attention to artificial openings", "[QB61.2] Presence of gastrostomy\n --PARENT--> [QB61] Presence of artificial opening\n --CHILD--> [QB61.2] Presence of gastrostomy", "[QB62.1] Attention to gastrostomy\n --PARENT--> [QB62] Attention to artificial openings\n --EXCLUDES--> [?] Tracheostomy malfunction", "[QB62.1] Attention to gastrostomy\n --PARENT--> [QB62] Attention to artificial openings\n --EXCLUDES--> [?] Tracheostomy malfunction", "[NE81.3] Postsurgical leak\n --EXCLUDES--> [?] Tracheostomy malfunction\n --CHILD--> [?] Leak from tracheostomy", "[NE81.3] Postsurgical leak\n --EXCLUDES--> [?] Malfunction or complication of external stoma of digestive organs\n --CHILD--> [?] Skin problem resulting from external stoma of digestive organs\n Def: An entity to be used to link a specific skin problem (e.g. psoriasis or parastomal pyoderma gangrenosum) to its proximity to an artificial stoma or fistula from the gastrointestinal tract to the skin ..." ]
QB61.2
Presence of gastrostomy
[ { "from_icd11": "QB61.2", "icd10_code": "Z931", "icd10_title": "Gastrostomy status" }, { "from_icd11": "QB62.1", "icd10_code": "Z431", "icd10_title": "Encounter for attention to gastrostomy" }, { "from_icd11": "EM0Y", "icd10_code": "L918", "icd10_title": "Other hypertrophic disorders of the skin" }, { "from_icd11": "EM0Y", "icd10_code": "L988", "icd10_title": "Other specified disorders of the skin and subcutaneous tissue" }, { "from_icd11": "DA60.Z", "icd10_code": "K259", "icd10_title": "Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K255", "icd10_title": "Chronic or unspecified gastric ulcer with perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K254", "icd10_title": "Chronic or unspecified gastric ulcer with hemorrhage" }, { "from_icd11": "DA60.Z", "icd10_code": "K257", "icd10_title": "Chronic gastric ulcer without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K250", "icd10_title": "Acute gastric ulcer with hemorrhage" }, { "from_icd11": "DA60.Z", "icd10_code": "K256", "icd10_title": "Chronic or unspecified gastric ulcer with both hemorrhage and perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K253", "icd10_title": "Acute gastric ulcer without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K252", "icd10_title": "Acute gastric ulcer with both hemorrhage and perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K251", "icd10_title": "Acute gastric ulcer with perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K25", "icd10_title": "Gastric ulcer" }, { "from_icd11": "QF01.Y", "icd10_code": "Z9049", "icd10_title": "Acquired absence of other specified parts of digestive tract" } ]
Z931
Gastrostomy status
From one month after the IPAA, her 24-h stool collection slowly increased to 1.5–2 L. Next, she noticed decreased urine output since April. In early May 2016, she presented to our emergency room with repeated unconsciousness over the course of 10 days. Her vital signs were as follows: blood pressure (BP), 74/50 mmHg; heart rate (HR), 90 bpm; additionally, she exhibited a poor nutritional status (160 cm; 39 kg). On physical examination, active bowel sounds were noticed to occur approximately 7–9 times per minute. Her serum creatinine level was 183 μmol/L, indicating acute kidney injury. Treatment with fluid replacement and noradrenaline maintained her BP at 80–90/50–60 mmHg and gradually normalized her creatinine level. However, her 24-h watery stool collection persisted, and she developed fever and vomiting. While many leukocytes were found in stool collected from the diverted ileostomy, repeated stool cultures and tests for Clostridium difficile toxins were negative. Tests for CMV-DNA, CMV-pp65 and EBV-DNA were performed and were all negative. The patient was not on any medications, including NSAIDs, upon verification. Her treatment with steroids was stopped before the end of April 2015. Empirical treatment with antibiotics, including ceftazidime, metronidazole and oral vancomycin, was administered with no response. Due to her reliance on noradrenaline, relative adrenal insufficiency was suspected, and hydrocortisone was initiated at 50 mg q6 h intravenously. Her stool volume decreased to less than 500 ml per day quickly, by which time the treatment with noradrenaline was successfully stopped. The levels of D-lactate, endotoxin and diamine oxidase indicated that the barrier function of the intestine was compromised and that bacterial translocation may have occurred. Oedematous inflamed mucosa with patchy superficial ulcers was observed in the diverted pouch by pouchoscopy. Although an upper endoscopy and an endoscopy through a stoma revealed a normal gross appearance in the stomach, duodenum and pre-stomal ileum , the histological examination of tissue biopsies of both the duodenum and pre-stomal ileum revealed enteritis, as indicated by moderate villous atrophy, cryptitis, decreased goblet cells, and severe active inflammation with neutrophil infiltration in the lamina propria, as well as negativity for intraepithelial lymphocytosis . From these lines of evidence of histological enteritis presenting in the duodenum, pre-stomal ileum and diverted pouch, we considered pan-enteritis to be present, and we diagnosed the patient with post-colectomy enteritis. The patient was treated with methylprednisolone at 30 mg intravenously once a day with tapering by 5 mg every 7 to 10 days; however, her stool volume from the ileostomy still gradually increased to 3–4 L. After a multidisciplinary team discussion, ileostomy closure was debated as the final rescue treatment and was performed in August 2016. Two months later, her stool volume decreased to less than 1 L per day, and she gained 2.5 kg of weight. Azathioprine at 50 mg/d was prescribed during the tapering of prednisone. Until the last follow-up in March 2018, she performed well, with an increase in body weight to 50 kg, and daily defecation approximately 5–6 times at less than 1 L/day, sometimes with form (Additional file 1 ). Gastroduodenal endoscopy and pouchoscopy were repeated annually and showed normal villi in the descending duodenum and neo-ileum in March 2018 . Gradually, the histology changed, showing recovery of the villous atrophy, cryptitis and inflammation in the lamina propria to normal . Fig. 2 Endoscopic images: a , b at the onset of enteritis; ( c , d ) at the last follow-up in March 2018. a Gastroscopy showing a normal descending duodenum and blunt intestinal villi. b Endoscopy through the loop ileostomy showing the normal appearance of the neo-ileum. c Gastroscopy with indigo carmine staining showing recovery of the villous atrophy. d Pouchoscopy revealing the normal appearance of the neo-ileum in March 2018 Fig. 3 Pathological findings: a - d at the onset of enteritis; ( e - f ) at the last follow-up in March 2018. a , b Pathological images of the duodenum at the onset of enteritis (× 100, × 200): acute and chronic inflammation with some cryptitis, few goblet cells and moderate villous atrophy. c , d Pathological images of the neo-ileum through the ileostomy at the onset of enteritis (× 100, × 200): acute and chronic inflammation with cryptitis, some irregular crypt structures, mild villous atrophy, few goblet cells. e - f Pathological images of the duodenum ( e ) and neo-ileum ( f ) at the last follow-up: recovery of the chronic inflammation, number of goblet cells and villous structures; cryptitis is not observed
4.128906
0.969727
sec[1]/p[1]
en
0.999998
31023233
https://doi.org/10.1186/s12876-019-0974-4
[ "ileum", "enteritis", "stool", "duodenum", "villous", "ileostomy", "atrophy", "cryptitis", "inflammation", "march" ]
[ { "code": "1A40.0&XA0QT6", "title": "Ileum inflammation" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "NB91.71&XA0QT6", "title": "Laceration of ileum" }, { "code": "LB15.1", "title": "Atresia of small intestine" }, { "code": "NB91.7Y&XA0QT6", "title": "Haematoma of ileum" }, { "code": "1A40.Z", "title": "Infectious gastroenteritis or colitis without specification of infectious agent" }, { "code": "1A2Z", "title": "Viral intestinal infections, unspecified" }, { "code": "DD70.Z", "title": "Crohn disease, unspecified site" }, { "code": "1A0Z", "title": "Bacterial intestinal infections, unspecified" }, { "code": "DD3Z", "title": "Ischaemic vascular disorders of intestine, unspecified" } ]
=== ICD-11 CODES FOUND === [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [LB15.1] Atresia of small intestine Definition: Jejunoileal atresias and stenoses are major causes of neonatal intestinal obstruction. Atresia refers to a congenital obstruction with complete occlusion of the intestinal lumen. It accounts for 95% of obstructions. Four types of jejunoileal atresias are described. They can range from having a small area of blockage or web to missing large sections of the intestines. Intestinal atresia is one of the most frequent causes of bowel obstruction in the newborn. The ileal atresia is more common than j Also known as: Atresia of small intestine | Congenital stenosis of small intestine | Congenital absence of small intestine | congenital small intestinal stricture NOS | Multiple-level intestinal atresia Includes: Congenital absence of small intestine | Congenital stenosis of small intestine [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] [1A2Z] Viral intestinal infections, unspecified Also known as: Viral intestinal infections, unspecified | viral and other specified intestinal infections | acute infectious viral gastroenteritis | infantile gastroenteritis virus | infantile viral gastroenteritis [DD70.Z] Crohn disease, unspecified site Also known as: Crohn disease, unspecified site | Crohn disease | Regional enteritis | Crohn disease NOS | Crohns [1A0Z] Bacterial intestinal infections, unspecified Also known as: Bacterial intestinal infections, unspecified | Bacterial enteritis NOS | Bacterial colitis | Phlegmonous colitis [DD3Z] Ischaemic vascular disorders of intestine, unspecified Also known as: Ischaemic vascular disorders of intestine, unspecified | Vascular disorder of intestine, not elsewhere classified | vascular disorder of intestine | vascular bowel disease | ischaemic gut NOS === GRAPH WALKS === --- Walk 1 --- [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 2 --- [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 3 --- [LB15.1] Atresia of small intestine Def: Jejunoileal atresias and stenoses are major causes of neonatal intestinal obstruction. Atresia refers to a congenital obstruction with complete occlusion of the intestinal lumen. It accounts for 95% o... --PARENT--> [LB15] Structural developmental anomalies of small intestine Def: Congenital gross anatomical structural defect of small intestine that results from interference with the normal growth and differentiation of the fetus, which may be inherited genetically, acquired du... --CHILD--> [LB15.1] Atresia of small intestine Def: Jejunoileal atresias and stenoses are major causes of neonatal intestinal obstruction. Atresia refers to a congenital obstruction with complete occlusion of the intestinal lumen. It accounts for 95% o... --- Walk 4 --- [LB15.1] Atresia of small intestine Def: Jejunoileal atresias and stenoses are major causes of neonatal intestinal obstruction. Atresia refers to a congenital obstruction with complete occlusion of the intestinal lumen. It accounts for 95% o... --PARENT--> [LB15] Structural developmental anomalies of small intestine Def: Congenital gross anatomical structural defect of small intestine that results from interference with the normal growth and differentiation of the fetus, which may be inherited genetically, acquired du... --PARENT--> [?] Structural developmental anomalies of the digestive tract Def: Any condition caused by failure of the digestive tract to correctly develop during the antenatal period....
[ "[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...", "[LB15.1] Atresia of small intestine\n Def: Jejunoileal atresias and stenoses are major causes of neonatal intestinal obstruction. Atresia refers to a congenital obstruction with complete occlusion of the intestinal lumen. It accounts for 95% o...\n --PARENT--> [LB15] Structural developmental anomalies of small intestine\n Def: Congenital gross anatomical structural defect of small intestine that results from interference with the normal growth and differentiation of the fetus, which may be inherited genetically, acquired du...\n --CHILD--> [LB15.1] Atresia of small intestine\n Def: Jejunoileal atresias and stenoses are major causes of neonatal intestinal obstruction. Atresia refers to a congenital obstruction with complete occlusion of the intestinal lumen. It accounts for 95% o...", "[LB15.1] Atresia of small intestine\n Def: Jejunoileal atresias and stenoses are major causes of neonatal intestinal obstruction. Atresia refers to a congenital obstruction with complete occlusion of the intestinal lumen. It accounts for 95% o...\n --PARENT--> [LB15] Structural developmental anomalies of small intestine\n Def: Congenital gross anatomical structural defect of small intestine that results from interference with the normal growth and differentiation of the fetus, which may be inherited genetically, acquired du...\n --PARENT--> [?] Structural developmental anomalies of the digestive tract\n Def: Any condition caused by failure of the digestive tract to correctly develop during the antenatal period...." ]
1A40.0&XA0QT6
Ileum inflammation
[ { "from_icd11": "QF01.Y", "icd10_code": "Z9049", "icd10_title": "Acquired absence of other specified parts of digestive tract" }, { "from_icd11": "LB15.1", "icd10_code": "Q411", "icd10_title": "Congenital absence, atresia and stenosis of jejunum" }, { "from_icd11": "LB15.1", "icd10_code": "Q412", "icd10_title": "Congenital absence, atresia and stenosis of ileum" }, { "from_icd11": "1A40.Z", "icd10_code": "A09", "icd10_title": "Infectious gastroenteritis and colitis, unspecified" }, { "from_icd11": "1A40.Z", "icd10_code": "A00-A09", "icd10_title": "" }, { "from_icd11": "1A40.Z", "icd10_code": "A090", "icd10_title": "" }, { "from_icd11": "1A2Z", "icd10_code": "A088", "icd10_title": "Other specified intestinal infections" }, { "from_icd11": "1A2Z", "icd10_code": "A0839", "icd10_title": "Other viral enteritis" }, { "from_icd11": "1A2Z", "icd10_code": "A084", "icd10_title": "Viral intestinal infection, unspecified" }, { "from_icd11": "1A2Z", "icd10_code": "A08", "icd10_title": "Viral and other specified intestinal infections" }, { "from_icd11": "1A2Z", "icd10_code": "A083", "icd10_title": "Other viral enteritis" }, { "from_icd11": "DD70.Z", "icd10_code": "K5090", "icd10_title": "Crohn's disease, unspecified, without complications" }, { "from_icd11": "DD70.Z", "icd10_code": "K50914", "icd10_title": "Crohn's disease, unspecified, with abscess" }, { "from_icd11": "DD70.Z", "icd10_code": "K50913", "icd10_title": "Crohn's disease, unspecified, with fistula" }, { "from_icd11": "DD70.Z", "icd10_code": "K5080", "icd10_title": "Crohn's disease of both small and large intestine without complications" } ]
Z9049
Acquired absence of other specified parts of digestive tract
An 8-year-old female was admitted to the Pediatric Immunology Unit with a clinical history of recurrent upper respiratory infections, pneumonias, and hypogammaglobulinemia. She presented with the first severe infection when she was 6 months old, needing hospitalization in intensive care unit (ICU). At 5 and 7 years old, she had two pneumonias with pleural effusion. On admission, aged 8 years old, physical examination detected weight and height on the 25th percentile. Laboratory exams demonstrated hemoglobin 12.5 g/L, hematocrit 40.1%, white blood cell count 6500 cells/mm 3 , platelets 211,000/mm 3 , and reduced serum levels of IgG 268–497 mg/dL , IgA <6 mg/dL (normal 111–335), and IgM 55–122 mg/dL (normal 59–151). Specific IgG antibodies for measles and rubella were negative despite appropriate immunization. Lymphocyte immunophenotyping showed CD3 + 2085 cells/mm 3 , CD4 + 936 cells/mm 3 , CD8 + 937 cells/mm 3 , CD16 + /56 + 233 cells/mm 3 (normal 73–654), and CD19 + 69 cells/mm 3 (normal 72–520). Further flow cytometry tests showed CD19 + cells ranging from 0 to 4%. Therefore, CVID was diagnosed according to IUIS criteria (decrease of at least two serum immunoglobulin isotypes and negative specific antibody production after vaccination) , and prophylactic antibiotics and intravenous immunoglobulin (IVIG) were started. Antinuclear antibody (ANA) and rheumatoid factor (RF) were negative at that moment. The treatment resulted in the maintenance of IgG ≥600 mg/dL and in a reduced frequency of infectious episodes. However, during the followup, she was hospitalized eight times due to septic shock ( n = 3), pneumonia with pleural effusion ( n = 2), otomastoiditis ( n = 1), acute cytomegalovirus infection ( n = 1), and urinary tract infection ( n = 1). At 12 years old, she developed pancytopenia [hemoglobin 10.2 g/L, hematocrit 34.2%, white blood cell count 3,790/mm ³ (39% neutrophils, 54% lymphocytes, 2% eosinophils, and 5% monocytes), and platelets 108,000/mm ³ ] associated to hepatosplenomegaly. Reticulocyte count was 1.2%, and lactate dehydrogenase (LDH) was 164 mg/dL (normal 117–213). Bone marrow aspiration was performed twice and showed hyperplasia of erythrocyte and hypoplasia of granulocyte series. At that moment, autoantibodies were not detected, such as: ANA, RF, antidouble-stranded DNA (anti-dsDNA), anti-Sm, anti-RNP, anti-Ro, anti-La, anti-P ribosomal, anticardiolipin IgG and IgM, lupus anticoagulant, anti-Scl70, anti-Jo1, anti-insulin, antineutrophil cytoplasmic (ANCA), antiglutamic acid decarboxylase (anti-GAD), antiinsulin, antithyroglobulin, antiperoxidase, antiparietal cell, antiendomysium, antismooth muscle, and anti-liver-kidney microsome antibodies. At the age of 17 years, the patient presented with fever, oral ulcers, alopecia, arthritis of wrists and elbows, headache, and cough and was hospitalized. She developed pleural and large pericardial effusion and was admitted to ICU. Laboratory exams revealed hemoglobin 7.9 g/L, hematocrit 22%, white blood cell count 1,000/mm ³ , platelets 17,000/mm ³ , reticulocyte count 0.32%, proteinuria 3.0 g/day, C3 72 mg/dL (normal 79 152), and C4 4 mg/dL (16–38). Polymerase chain reactions (PCR) for Epstein-Barr virus and blood and urine cultures were negative. The following autoantibodies were observed: ANA (1 : 320, dense fine speckled pattern), anticardiolipin IgM (100 MPL), RF, and lupus anticoagulant. At that moment, she fulfilled the American College of Rheumatology (ACR) criteria for SLE. Additionally, she also had hepatosplenomegaly, aspartate aminotransferase (AST) 58 IU/l (normal 0–20 IU/l), alanine aminotransferase (ALT) 111 IU/l (normal 6–20 IU/L), triglycerides 456 mg/dL (normal <130 mg/dL), ferritin 6034 ng/mL (36–92 ng/mL), and LDH 791 mg/dL. She fulfilled the preliminary criteria for macrophage activation syndrome in pediatric SLE and was treated with intravenous methylprednisolone for three consecutive days and IVIG (2 g/kg/dose) and, after chloroquine (250 mg/day), azathioprine (100 mg/day) and prednisone 40 mg/day. At that moment, bone marrow aspiration evidenced hypoplasia in all cell lineages without neoplastic cells or hemophagocytosis. Renal biopsy showed chronic tubulointerstitial nephritis and focal acute tubular necrosis without glomerular injury and negative immunofluorescence for IgA, IgG, IgM, C1q, C3, and fibrinogen, and liver biopsy showed drug-induced hepatitis without neoplastic cells. Despite treatment, two months later, she died of septic shock secondary to acute pneumonia. Remarkably, the necropsy showed hepatosplenic T-cell lymphoma (HSTL) with diffuse involvement of bone marrow, spleen, liver, and lungs. The lymphoma cells were positive for CD3 immunostaining and negative for CD20 and lysozyme.
4.167969
0.968262
sec[1]/p[0]
en
0.999995
21776287
https://doi.org/10.1155/2011/428703
[ "anti", "cells", "cell", "count", "blood", "that", "moment", "infection", "pleural", "effusion" ]
[ { "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": "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 === [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 [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 --- [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--> [?] Labour or delivery complicated by fetal distress --- 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--> [MB23.1] Antisocial behaviour Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated.... --- 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 --PARENT--> [?] 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 6 --- [3B4Z] Coagulation defects, unspecified --PARENT--> [?] Coagulation defects --PARENT--> [?] 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...
[ "[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--> [?] Labour or delivery complicated by fetal distress", "[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--> [MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....", "[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 --PARENT--> [?] 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...", "[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --PARENT--> [?] 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..." ]
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": "3A51.1", "icd10_code": "D571", "icd10_title": "Sickle-cell disease without crisis" } ]
O26841
A 41-year-old Japanese female office worker with Graves' disease was admitted to our hospital for further examination of hypocalcemia in winter. She had no family history of bone and mineral metabolism disorders and never been drunk. She had a previous history of symptomatic gallstones 8 years before admission, since then, she had restricted intake of fat-rich foods such as meats, oily fish, and milk, for preventing abdominal pain due to gallstones. One year before admission, she visited a local hospital with complaints of palpitation, tremor, and weight loss. She was diagnosed as Graves' disease because of goiter and elevated serum thyroid hormones (free triiodothyronine (FT3) 12.96 pg/mL; normal level, 2.0–3.4 pg/mL, free thyroxin (FT4) 3.44 ng/dL; normal level, 0.9–1.6 ng/dL) and undetectable thyroid stimulating hormone (TSH) (<0.01 μ U/mL; normal level, 0.4–3.8 μ U/mL) with elevated serum TSH receptor antibody (TRAb) (10.7 IU/L; normal level, <1.0 IU/L). At that time, her serum corrected calcium level was normal (8.9 mg/dL; normal level 8.4–10.0 mg/dL). After diagnosis of GD, she was started on treatment with MMI (15 mg once daily) and her hyperthyroidism was gradually corrected. However, about 6 months after treatment with MMI, her thyroid function was severely decreased (FT3 < 0.7 pg/mL, FT4 0.43 ng/dL, TSH 5.81 μ U/mL), and she felt numbness in her hands and lip as well as general fatigue. Therefore, MMI was reduced and levothyroxine sodium hydrate (LT4) was started. However, because her numbness was not completely improved after recovery from hypothyroidism, she visited Sumire Clinic for the treatment of her Graves' disease. At that time, she was diagnosed as severe hypocalcemia (serum corrected calcium level, 6.7 mg/dL) and referred to our hospital. On admission, she was 152.3 cm tall and weighed 39.3 kg, with body mass index of 16.9 kg/m 2 . Her blood pressure was 96/58 mmHg, and her pulse rate was 68 beats/min with regular rhythm. Her thyroid gland was swollen diffusely. Her heart and breathing sounds were clear. The abdomen was flat and soft, and liver and spleen were not palpable. Trousseau and Chvostek signs were positive. Chest X-ray was normal. Electrocardiogram revealed a prolonged QTc interval (0.49 sec; normal level, 0.37–0.44 sec). The laboratory findings were shown in Table 1 . Blood chemistry showed low serum corrected calcium level (7.3 mg/dL) and phosphate level (2.6 mg/dL; normal level, 2.9–4.8 mg/dL), normal magnesium level (2.4 mg/dL; normal level, 1.8–2.4 mg/dL), and elevated alkaline phosphatase level (389 U/L; normal level, 134–359 U/L). There was no renal and liver dysfunction. Urinary calcium excretion ratio was low (0.37%; normal level, 1-2%). Endocrine examinations showed that serum 25(OH)D level was markedly decreased (<5 ng/mL), and intact PTH (iPTH) and 1,25(OH) 2 D levels were elevated (336.5 pg/mL; normal level 10–60 pg/mL and 76 pg/mL; normal level, 20–60 pg/mL, resp.). Thyroid function was almost normal range under treatments of 5 mg/day of MMI and 50 μ g/day of LT4. Markers of bone metabolism showed elevated serum bone alkaline phosphatase level (BAP [56.6 U/L; normal level 13.0–33.9 U/L]) and urinary N-terminal telopeptide of type I collagen level (NTx [100.7 nmolBCE/mmol]). Bone mineral density (BMD) and T-Score in her lumber (L2-4), femoral neck, and distal radius (1/3) regions were all decreased (0.688 g/cm 2 and −2.9 SD, 0.578 g/cm 2 and −1.9 SD, and 0.449 g/cm 2 and −3.4 SD, resp.). From her clinical course and laboratory findings, we diagnosed that her numbness in hands and lip was due to hypocalcemia probably caused by vitamin D deficiency and resolving hyperthyroidism following the treatment with MMI. In addition, we suspected that vitamin D deficiency was mainly due to unbalanced diets restricting fat-rich foods and inadequate exposure to sunlight. Therefore, we started treatment with 3 g/day of calcium lactate hydrate and 0.5 μ g/day of 1 α (OH)D 3 . About 3 months after treatment in spring, cholecystectomy for her gallstones was performed. At that time, her serum 25(OH)D level remained low (7.0 ng/mL) in spite of normalization of serum corrected calcium and iPTH levels (9.2 mg/dL and 52 pg/mL, resp.). After surgery, she completely stopped unbalanced diets restricting fat-rich foods, and the treatment with calcium lactate hydrate and 1 α (OH)D 3 was discontinued. However, serum 25(OH)D level (11.0 ng/mL) failed to improve to the normal range, and serum corrected calcium and iPTH levels were lower and upper limits of normal ranges, respectively (8.7 mg/dL and 58 pg/mL, resp.) in spite of euthyroidism under treatment with 5 mg/day of MMI 6 months after surgery. Therefore, we restarted treatment with 0.75 μ g/day of 1 α (OH)D 3 .
3.988281
0.978516
sec[1]/p[0]
en
0.999998
23710380
https://doi.org/10.1155/2013/512671
[ "serum", "calcium", "that", "corrected", "thyroid", "bone", "resp", "graves", "hypocalcemia", "gallstones" ]
[ { "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" }, { "code": "5B5K.1Z", "title": "Calcium deficiency, unspecified" }, { "code": "5B5K.1Y", "title": "Other specified calcium deficiency" }, { "code": "5C64.5", "title": "Disorders of calcium metabolism" }, { "code": "FB40.Y", "title": "Other specified tenosynovitis" }, { "code": "8A80.Z", "title": "Migraine, unspecified" } ]
=== ICD-11 CODES FOUND === [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 [5B5K.1Z] Calcium deficiency, unspecified Also known as: Calcium deficiency, unspecified | Calcium deficiency | hypocalcaemia NOS | disturbance of calcium absorption | disorder of calcium absorption [5B5K.1Y] Other specified calcium deficiency Also known as: Other specified calcium deficiency | Dietary hypocalcaemia | dietary calcium deficiency [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 [FB40.Y] Other specified tenosynovitis Also known as: Other specified tenosynovitis | Other tenosynovitis or tendinitis | synovitis NOS | Bicipital tendinitis | biceps tendinitis [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine === GRAPH WALKS === --- Walk 1 --- [NE80.3] Other serum reactions --PARENT--> [NE80] Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified --CHILD--> [NE80.2] Rh incompatibility reaction --- Walk 2 --- [NE80.3] Other serum reactions --RELATED_TO--> [?] Anaphylactic shock due to serum --PARENT--> [?] Other serum reactions --- Walk 3 --- [5D0Y] Other specified metabolic disorders --PARENT--> [?] Other metabolic disorders --CHILD--> [5D00] Amyloidosis Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini... --- Walk 4 --- [5D0Y] Other specified metabolic disorders --PARENT--> [?] Other metabolic disorders --CHILD--> [5D0Y] Other specified metabolic disorders --- Walk 5 --- [5B91.0] Hypercalcaemia Def: 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 ... --RELATED_TO--> [?] Myopathy due to hypercalcaemia --PARENT--> [?] Hypercalcaemia Def: 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 ... --- Walk 6 --- [5B91.0] Hypercalcaemia Def: 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 ... --RELATED_TO--> [?] Myopathy due to hypercalcaemia --PARENT--> [?] Hypercalcaemia Def: 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 ...
[ "[NE80.3] Other serum reactions\n --PARENT--> [NE80] Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified\n --CHILD--> [NE80.2] Rh incompatibility reaction", "[NE80.3] Other serum reactions\n --RELATED_TO--> [?] Anaphylactic shock due to serum\n --PARENT--> [?] Other serum reactions", "[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --CHILD--> [5D00] Amyloidosis\n Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...", "[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --CHILD--> [5D0Y] Other specified metabolic disorders", "[5B91.0] Hypercalcaemia\n Def: 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 ...\n --RELATED_TO--> [?] Myopathy due to hypercalcaemia\n --PARENT--> [?] Hypercalcaemia\n Def: 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 ...", "[5B91.0] Hypercalcaemia\n Def: 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 ...\n --RELATED_TO--> [?] Myopathy due to hypercalcaemia\n --PARENT--> [?] Hypercalcaemia\n Def: 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 ..." ]
NE80.3
Other serum reactions
[ { "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" }, { "from_icd11": "5B5K.1Z", "icd10_code": "E58", "icd10_title": "Dietary calcium deficiency" }, { "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": "8A80.Z", "icd10_code": "G43B0", "icd10_title": "Ophthalmoplegic migraine, not intractable" } ]
T880XXA
Infection following immunization, initial encounter
This case report was described in Campania (40◦49′34″N 14◦15′23″E), a region where pig farming was practiced and sporadic evidence of PRV infections was described. Furthermore, it is one of the Italian regions with the biggest number of wild boars and dogs, consequently, many dogs have been trained specifically for wild boar hunting. Two Istrian short-haired hounds (Pupa, a 5-year-old female, and Tigre, a 2-year-old male) from Salerno, a province of Campania (southern Italy), were hospitalized in a private veterinary hospital on December 6, 2019 for fever, neurological signs, incoercible itch, and severe self-made facial lesions. According to the anamnesis, the symptoms began a few days after a hunting trip in the same Italian region. Clinical examination revealed the presence of fever, ataxia, generalized muscular tremors, and self-inflicted erosions of the skin in the region of the head in both animals . Two aliquots of blood (one with anticoagulant and one without) belonging to both animals were centrifuged and stored at -20 °C for future molecular analysis. Complete blood count and blood chemistry (performed using a Procyte Dx Haematology Analyser, IDEXX, US) were comparable between the two animals and showed regenerative and hypochromic anemia, reduced hematocrit, and a marked leukocytosis characterized by neutrophilia and a mild monocytosis (Table 1 ). Despite the conservative therapies (based on fluid therapy and butorphanol), the clinical presentation did not change, and both animals died 48 h from the start of clinical manifestations. Based on the anamnesis and clinical signs of the animals, pseudorabies was suspected as the cause of the death of both animals. One carcass (Pupa, a 5-year-old female) was sent to the Department of Veterinary Medicine and Animal Production of Naples (Naples, Italy) for a definitive etiological diagnosis. Except for the presence of facial lesions, the dead dog was in good nutritional condition and showed no noteworthy abnormalities. The thoracic and abdominal cavities, as well as the viscera, were examined and found to be normal. Examination of the brain, cerebellum, and encephalic trunk revealed hyperemia and congestion . DNA was extracted from several specimens, such as blood, serum, feces, gastric contents, tonsils, brain, brainstem, cerebellum, spleen, lungs, and liver, using DNeasy Blood & Tissue Kits QIAGEN (Qiagen, Germany) following the manufacturer’s instructions. The reliability of each purified and quantified sample was assessed using end-point PCR with GAPDH as the housekeeping gene. Each DNA was used as template in a real-time PCR reaction consisting of a 20-µL reaction volume including 10 µL of 2X SYBR Green (BioRad, US), 20 µM of each primer (forward: 5′-TCTCGGACATGGGCGACT-3′; reverse: 5′-CACGTAGTACAGCAGGCAC-3′), 50 ng DNA, and ddH2O to final volume . Amplification conditions included initial denaturation at 95 °C for 5 min, 40 cycles of 95 °C denaturation for 15 s, 56 °C annealing for 15 s, and 72 °C extension for 15 s. This protocol amplified a conserved region of the gE genes of PRV (92 base pairs) . DNA extracted from PRV Suid herpesvirus 1 strain VR-1362 (ATCC) was used as a positive control and the PCR mix without template DNA represented the negative control. Rabies (however absent in Italy) infection was excluded using an immunofluorescent protocol described in the literature . Table 2 summarizes the positivity and cycle threshold (Ct) values of the different organs and tissues and identified the brainstem as the sample with the lowest Ct value. All samples were further tested with a PCR targeting the partial sequence of gE (493-bp) and commonly used for phylogenetic analysis . Cycling conditions (T100 Thermal Cycler, BioRad, US) and primers were as follows: denaturation at 95 °C for 5 min, 45 cycles of 95 °C for 50 s, 60 °C for 40 s, and 72 °C for 50 s, and final extension at 72 °C for 5 min, forward primer 5′-CCGCGGGCCGTGTTCTTTGT-3′, and reverse primer 5′-CGTGGCCGTTGTGGGTCAT-3′ . The amplified products were run in a 1.2% agarose gel (Certified Molecular Biology Agarose, BioRad, US) and visualized with a UV reader. The brain stem was also the most positive sample in this PCR, therefore the amplification product was purified using a commercial kit (QIAquick PCR Purification Kit, Qiagen, Germany) and sequenced (by an external service, BMR Genomics, Italy) using the Sanger method . Sequence data were analyzed using BLAST to identify similarities with GenBank sequences. Sequencing revealed 100% homology with PRV strains causing outbreaks in France, Belgium and Sicily (clade c) . Phylogenetic analysis was conducted using the maximum likelihood (ML) method in molecular evolutionary genetics software version 10 (MEGA 10) .
4.207031
0.910645
sec[1]/p[0]
en
0.999998
PMC11256590
https://doi.org/10.1186/s12917-024-04189-3
[ "using", "animals", "blood", "region", "italy", "both", "this", "molecular", "brain", "qiagen" ]
[ { "code": "QE11.Z", "title": "Hazardous drug use, unspecified" }, { "code": "6C4Z", "title": "Disorders due to substance use, unspecified" }, { "code": "QE11.3", "title": "Hazardous use of cocaine" }, { "code": "QE11.2", "title": "Hazardous use of sedatives, hypnotics or anxiolytics" }, { "code": "QE11.1", "title": "Hazardous use of cannabis" }, { "code": "ND31", "title": "Open wounds involving multiple body regions" }, { "code": "NE61", "title": "Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified" }, { "code": "CA08.03", "title": "Other allergic rhinitis" }, { "code": "PA75", "title": "Unintentionally bitten by animal" }, { "code": "PG65", "title": "Bitten with undetermined intent by animal" } ]
=== ICD-11 CODES FOUND === [QE11.Z] Hazardous drug use, unspecified Also known as: Hazardous drug use, unspecified | Hazardous drug use | chronic drug use NOS | chronic IV substance use | drug use nos [6C4Z] Disorders due to substance use, unspecified Also known as: Disorders due to substance use, unspecified | Disorders due to substance abuse | drug use disorder | Bad trips due to drugs [QE11.3] Hazardous use of cocaine Definition: A pattern of cocaine use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health professionals. The increased risk may be from the frequency of cocaine use, from the amount used on a given occasion, from risky behaviours associated with cocaine use or the context of use, from a harmful route of administration, or from a combination of these. The risk may be related to short-term eff Also known as: Hazardous use of cocaine | cocaine use | intravenous cocaine use | Hazardous use of crack cocaine | crack cocaine use Excludes: Disorders due to use of cocaine [QE11.2] Hazardous use of sedatives, hypnotics or anxiolytics Definition: A pattern of use of sedatives, hypnotics or anxiolytics that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health professionals. The increased risk may be from the frequency of use of sedatives, hypnotics or anxiolytics, from the amount used on a given occasion, from risky behaviours associated with use of sedatives, hypnotics or anxiolytics or the context of use, from a harmful route Also known as: Hazardous use of sedatives, hypnotics or anxiolytics | Hazardous use of anxiolytics | Hazardous use of hypnotics | hypnotic use | Hazardous use of sedatives Excludes: Disorders due to use of sedatives, hypnotics or anxiolytics [QE11.1] Hazardous use of cannabis Definition: A pattern of cannabis use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health professionals. The increased risk may be from the frequency of cannabis use, from the amount used on a given occasion, from risky behaviours associated with cannabis use or the context of use, from a harmful route of administration, or from a combination of these. The risk may be related to short-term Also known as: Hazardous use of cannabis | marijuana use | cannabis use Excludes: Disorders due to use of cannabis [ND31] Open wounds involving multiple body regions Also known as: Open wounds involving multiple body regions | Open wounds involving head with neck | Open wounds of sites classifiable as open wounds to the head or open wounds of the neck | Nasopharyngeal laceration | Open wounds involving thorax with abdomen, lower back or pelvis Excludes: Traumatic amputations involving multiple body regions [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 [CA08.03] Other allergic rhinitis Definition: This refers to other allergic inflammation of the nasal airways. It occurs when an allergen, such as pollen, dust or animal dander (particles of shed skin and hair) is inhaled by an individual with a sensitized immune system. Also known as: Other allergic rhinitis | Allergy to animal | animal dander allergy | Allergy to dander | Allergy to dandruff [PA75] Unintentionally bitten by animal Also known as: Unintentionally bitten by animal | Unintentionally bitten by insect or bird | pecked by bird | peck by bird | Unintentionally bitten by reptile or amphibian [PG65] Bitten with undetermined intent by animal Also known as: Bitten with undetermined intent by animal | Bitten with undetermined intent by land mammal | Bitten with undetermined intent by marine animal | Bitten with undetermined intent by reptile or amphibian | Bitten with undetermined intent by insect or bird === GRAPH WALKS === --- Walk 1 --- [QE11.Z] Hazardous drug use, unspecified --PARENT--> [QE11] Hazardous drug use Def: A pattern of use of psychoactive substance(s) other than nicotine or alcohol that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent... --CHILD--> [QE11.1] Hazardous use of cannabis Def: A pattern of cannabis use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health pro... --- Walk 2 --- [QE11.Z] Hazardous drug use, unspecified --PARENT--> [QE11] Hazardous drug use Def: A pattern of use of psychoactive substance(s) other than nicotine or alcohol that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent... --CHILD--> [QE11.0] 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... --- Walk 3 --- [6C4Z] Disorders due to substance use, unspecified --PARENT--> [?] Disorders due to substance use Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to... --CHILD--> [6C42] Disorders due to use of synthetic cannabinoids Def: Disorders due to use of synthetic cannabinoids are characterised by the pattern and consequences of synthetic cannabinoid use. Synthetic cannabinoids are synthesized diverse chemical compounds that ar... --- Walk 4 --- [6C4Z] Disorders due to substance use, unspecified --PARENT--> [?] Disorders due to substance use Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to... --RELATED_TO--> [?] Catatonia induced by substances or medications Def: Catatonia induced by substances or medications is a syndrome of primarily psychomotor disturbances, characterized by the co-occurrence of several symptoms of decreased, increased, or abnormal psychomo... --- Walk 5 --- [QE11.3] Hazardous use of cocaine Def: A pattern of cocaine use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health prof... --PARENT--> [QE11] Hazardous drug use Def: A pattern of use of psychoactive substance(s) other than nicotine or alcohol that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent... --EXCLUDES--> [?] Disorders due to substance use Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to... --- Walk 6 --- [QE11.3] Hazardous use of cocaine Def: A pattern of cocaine use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health prof... --PARENT--> [QE11] Hazardous drug use Def: A pattern of use of psychoactive substance(s) other than nicotine or alcohol that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent... --CHILD--> [QE11.2] Hazardous use of sedatives, hypnotics or anxiolytics Def: A pattern of use of sedatives, hypnotics or anxiolytics that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attent...
[ "[QE11.Z] Hazardous drug use, unspecified\n --PARENT--> [QE11] Hazardous drug use\n Def: A pattern of use of psychoactive substance(s) other than nicotine or alcohol that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent...\n --CHILD--> [QE11.1] Hazardous use of cannabis\n Def: A pattern of cannabis use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health pro...", "[QE11.Z] Hazardous drug use, unspecified\n --PARENT--> [QE11] Hazardous drug use\n Def: A pattern of use of psychoactive substance(s) other than nicotine or alcohol that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent...\n --CHILD--> [QE11.0] 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...", "[6C4Z] Disorders due to substance use, unspecified\n --PARENT--> [?] Disorders due to substance use\n Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to...\n --CHILD--> [6C42] Disorders due to use of synthetic cannabinoids\n Def: Disorders due to use of synthetic cannabinoids are characterised by the pattern and consequences of synthetic cannabinoid use. Synthetic cannabinoids are synthesized diverse chemical compounds that ar...", "[6C4Z] Disorders due to substance use, unspecified\n --PARENT--> [?] Disorders due to substance use\n Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to...\n --RELATED_TO--> [?] Catatonia induced by substances or medications\n Def: Catatonia induced by substances or medications is a syndrome of primarily psychomotor disturbances, characterized by the co-occurrence of several symptoms of decreased, increased, or abnormal psychomo...", "[QE11.3] Hazardous use of cocaine\n Def: A pattern of cocaine use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health prof...\n --PARENT--> [QE11] Hazardous drug use\n Def: A pattern of use of psychoactive substance(s) other than nicotine or alcohol that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent...\n --EXCLUDES--> [?] Disorders due to substance use\n Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to...", "[QE11.3] Hazardous use of cocaine\n Def: A pattern of cocaine use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health prof...\n --PARENT--> [QE11] Hazardous drug use\n Def: A pattern of use of psychoactive substance(s) other than nicotine or alcohol that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent...\n --CHILD--> [QE11.2] Hazardous use of sedatives, hypnotics or anxiolytics\n Def: A pattern of use of sedatives, hypnotics or anxiolytics that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attent..." ]
QE11.Z
Hazardous drug use, unspecified
[ { "from_icd11": "QE11.Z", "icd10_code": "Z722", "icd10_title": "" }, { "from_icd11": "6C4Z", "icd10_code": "F1910", "icd10_title": "Other psychoactive substance abuse, uncomplicated" }, { "from_icd11": "6C4Z", "icd10_code": "F1911", "icd10_title": "Other psychoactive substance abuse, in remission" }, { "from_icd11": "6C4Z", "icd10_code": "F19129", "icd10_title": "Other psychoactive substance abuse with intoxication, unspecified" }, { "from_icd11": "6C4Z", "icd10_code": "F19121", "icd10_title": "Other psychoactive substance abuse with intoxication delirium" }, { "from_icd11": "6C4Z", "icd10_code": "F1920", "icd10_title": "Other psychoactive substance dependence, uncomplicated" }, { "from_icd11": "6C4Z", "icd10_code": "F19239", "icd10_title": "Other psychoactive substance dependence with withdrawal, unspecified" }, { "from_icd11": "6C4Z", "icd10_code": "F1914", "icd10_title": "Other psychoactive substance abuse with psychoactive substance-induced mood disorder" }, { "from_icd11": "6C4Z", "icd10_code": "F1921", "icd10_title": "Other psychoactive substance dependence, in remission" }, { "from_icd11": "6C4Z", "icd10_code": "F19221", "icd10_title": "Other psychoactive substance dependence with intoxication delirium" }, { "from_icd11": "6C4Z", "icd10_code": "F19180", "icd10_title": "Other psychoactive substance abuse with psychoactive substance-induced anxiety disorder" }, { "from_icd11": "6C4Z", "icd10_code": "F1924", "icd10_title": "Other psychoactive substance dependence with psychoactive substance-induced mood disorder" }, { "from_icd11": "6C4Z", "icd10_code": "F1917", "icd10_title": "Other psychoactive substance abuse with psychoactive substance-induced persisting dementia" }, { "from_icd11": "6C4Z", "icd10_code": "F19229", "icd10_title": "Other psychoactive substance dependence with intoxication, unspecified" }, { "from_icd11": "6C4Z", "icd10_code": "F1919", "icd10_title": "Other psychoactive substance abuse with unspecified psychoactive substance-induced disorder" } ]
Z722
A previously healthy 7-year-old male patient was admitted to our Pediatric Department, complaining of unremitting fever above 39 °C for 5 days, fatigue, headache, and acute abdominal pain, unresponsive to non-steroidal anti-inflammatory drugs ,and antibiotic treatment with amoxicillin-clavulanate. At admission on physical examination, he presented with bilateral non-exudative conjunctivitis, skin rash on the trunk and upper limbs, and neck rigidity with some sign of meningism. He had had a pauci-symptomatic SARS-CoV-2 infection approximately 4 weeks before, characterized by 2 days of fever, asthenia, and headache. The infection had been ascertained by a positive oronasal swab for SARS-CoV-2. Laboratory findings showed marked elevation of CRP (275 mg/L) and ESR (66 mm/1 th h), but also of ferritin (556 mg/L) and brain natriuretic peptide . Marked lymphopenia (440/mmc) and hypoalbuminemia (23 g/L) were also found at admission. A molecular swab for SARS-CoV-2 was negative. The work-up excluded Epstein Barr virus, cytomegalovirus, parvovirus B19, adenovirus, and HIV infection. The echocardiography performed when he presented to the pediatric emergency unit showed signs of endocarditis (mild aortic and mitral regurgitation) with normal contractility of the myocardium and normal pulmonary pressure (26 mmHg). The abdominal ultrasound showed a thin layer of fluid among the intestinal loops and the chest x-ray showed a homogeneous parenchymal thickening in the left paracardiac basal area with small left basal pleural effusion. In view of his medical history, clinical examination, and blood and instrumental tests, a diagnosis of MIS-C related to COVID-19 infection was made. According to guidelines, IVIG at a dose of 2 g/kg associated with a high dose of metilprednisolone at a dose of 30 mg/kg were started ( Table 1 ). Subcutaneous thromboprophylaxis with low-molecular weight heparin (LMWH) at a dose of 100 UI/kg was also initiated ( Table 1 ). After the third bolus of high-dose corticosteroids, his fever and neurological symptoms persisted, together with a persistent elevation of CRP (135 mg/L). Therefore, intravenous anakinra (a 2 mg/kg/dose every 6 h) was started while intravenous methylprednisolone (1 mg/kg b.i.d.) was continued ( Tables 1 and 2 ), showing a rapid response, with the disappearance of the fever and skin rash and the reduction of CRP (60 mg/L) and pro-BNP (546 pg/ml). After 2 days, he suddenly presented with progressive dyspnea, increased labored breathing, and hypoxia (SatO 2 : 85% in ambient air room), without any other associated symptoms. The delivery of O 2 by humidified high-flow nasal cannula (HFNC) was started with a FiO 2 50%. A chest CT scan was performed, showing multiple basal parenchymal thickening with small basal pleural effusion . An arterial blood gas analysis showed severe hypoxia (PaO 2 , 56 mmHg; PaO 2 /FiO 2 ratio, 170 mmHg). The blood tests showed new slowly increasing inflammatory markers (CRP 113 mg/L, ESR 68 mm/1 th h). Because of the increased work of breathing and persistent altered gas exchange, the patient was transferred to the pediatric intensive care unit (PICU), and then put on invasive mechanical ventilation. Administration of anti-IL-1 was modified and a continuous infusion of high-dose anakinra (12 mg/kg/day) was started ( Tables 1 and 2 ). Echocardiography revealed increased pulmonary pressure (40 mmHg) with normal heart ejection fraction (55%). These results confirmed the hypothesis of ongoing pulmonary vasculitis involving pulmonary arterioles. Therefore, intravenous sildenafil at a dose of 0.15 mg/kg/day was started ( 35 , 36 ) ( Table 1 ), with a progressive reduction of pulmonary pressure (23 mmHg) and resolution of the clinical picture of respiratory failure. After 36 h from the start of the treatment, the patient’s clinical condition as well as laboratory parameters remarkably improved, and he was extubated and again transferred to our department. The treatment was well tolerated and after 3 days the CRP fell in the normal range, sildenafil was stopped, and the biologic treatment was escalated, taking off one dose of anakinra every 3 days, up to discontinuation ( Table 1 ). At discharge, echocardiography revealed signs of previous cardiac involvement with persistent mild mitral regurgitation and total regression of aortic regurgitation, and chest x-ray showed a resolution of parenchymal thickening and pleural effusion. The treatment with LMWH was shifted to oral cardioaspirin at a dose of 5 mg/kg/day (max 100 mg/day) ( Table 1 ). After 2 months of follow-up, the clinical examination was normal, and the blood test and cardiologic assessment with echocardiography also normalized; therefore, the cardioaspirin therapy was stopped.
4.042969
0.975098
sec[1]/p[0]
en
0.999999
PMC9835840
https://doi.org/10.3389/fped.2022.1015617
[ "pulmonary", "mmhg", "fever", "infection", "echocardiography", "basal", "blood", "pediatric", "sars", "regurgitation" ]
[ { "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": "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 === [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 [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 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --CHILD--> [CB40.1] Young syndrome Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections.... --- Walk 2 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality --- Walk 3 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.1] 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--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o... --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Severe acute respiratory syndrome Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.1] Young syndrome\n Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections....", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.1] 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--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii\n Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to..." ]
CB40.Y
Other specified diseases of the respiratory system
[ { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "CA40.Z", "icd10_code": "J189", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J181", "icd10_title": "Lobar pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J188", "icd10_title": "Other pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J168", "icd10_title": "Pneumonia due to other specified infectious organisms" }, { "from_icd11": "CA40.Z", "icd10_code": "J180", "icd10_title": "Bronchopneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J17", "icd10_title": "Pneumonia in diseases classified elsewhere" }, { "from_icd11": "CA40.Z", "icd10_code": "J182", "icd10_title": "Hypostatic pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J16", "icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified" }, { "from_icd11": "CA40.Z", "icd10_code": "J171", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J173", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J178", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J18", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" } ]
Q333
Agenesis of lung
The patient was a Japanese man without a significant family history. He was a smoker and had noticed impairment of his sense of smell following a sinusitis surgery at the age of 20 years. He had no history of medication use. At the age of 49 years, he developed taste disturbance with a lingering salty taste in the mouth and tasted barley tea as salty noodle soup. One year later, he visited a local otolaryngology clinic. He was suspected to have zinc deficiency, and oral zinc supplements were administered. However, his taste disturbance progressed to a sweet taste in addition to the salty taste within the month. At the age of 53 years, a tingling feeling emerged at the tip of the tongue and gradually spread to his entire lips. Despite using an herbal medication and an ointment, these abnormal sensations remained. At the age of 55 years, he showed mild difficulty in swallowing. During the following year, he stopped smoking, but it did not improve his taste disturbance. Subsequently, he developed speech difficulties and muscle wasting of the neck and upper limbs and was referred to our hospital. He presented with mild impairment of the smell sensation. Neither ptosis nor an eye movement disorder was apparent. He showed numbness around the mouth. Touch and pinprick sensations were decreased in the area of the third division of the bilateral trigeminal nerves. Moderate muscle weakness was detected in the orbicularis oculi and oris muscles. Muscle atrophy was noted in the temporal, masseter, and sternocleidomastoid muscles . He had mild dysarthria with remarkable atrophy and fasciculation of the tongue. Corneal and gag reflexes were absent. Severe weakness of the neck extensors caused his head to drop. Further, mild muscle weakness was detected in the left upper limb. Sensory disturbances in the trunk and limbs were not apparent. Bilateral tendon reflexes were normal in the upper limbs and slightly brisk in the lower limbs without pathological reflexes. Neither cerebellar ataxia nor dysautonomia was apparent. Hematological analysis revealed mild elevation of creatinine kinase (392 U/l). Results of complete blood count; electrolytes, including sodium and zinc; vitamin B1 and B12; total cholesterol and triglyceride; blood sugar and HbA1c; liver and renal functions; autoantibodies including anti-SS-A and SS-B, anti-GM1, and GQ1b IgG; and C-reactive protein were normal. Cerebrospinal fluid analysis revealed unremarkable findings. Magnetic resonance imaging (MRI) of the brain was unremarkable. MRI of the spinal cord showed mild cervical spondylosis without spinal cord atrophy. Pulmonary function test showed mild decrement of % vital capacity (76.4%). Results of a nerve conduction study were normal except for reduced F-wave occurrence in the median nerve (30%). In needle electromyography, chronic neurogenic changes with severely decreased number of motor units and high amplitude/long duration motor unit potentials were apparent in the tongue and masseter muscles. Mild chronic neurogenic changes were also observed in the biceps brachii, first dorsal interosseous, quadriceps, and gastrocnemius medialis muscles. Active neurogenic changes, including fasciculation potentials were unapparent in these muscles. In the thoracic paraspinal muscles, fibrillation potentials and positive sharp waves were detected. Regarding the blink reflex, both sides of the R2 components after ipsilateral stimulation were delayed, while the right side of the R2 component after left stimulation was absent . An assessment using the disc test revealed that the patient was unable to discriminate different tastes in the entire tongue. In an electrogustometric study, electrical stimulation of all segments of the tongue failed to induce any type of taste sensation. Laryngoscopy showed no evidence of inflammation and/or masses within the larynx and pharynx. One session of intravenous immunoglobulin (IVIG) therapy (2 g/kg body weight over 5 days) did not improve any of his symptoms and signs. Based on these results, we diagnosed him as having FOSMN with the sole initial symptom of taste disorder. Nine years after the onset of the condition, he developed impaired sensation of touch in the right upper limb and required mechanical ventilation and nutritional support via tube feeding. Subsequent electromyography studies were not performed. Fig. 1 Atrophy of the temporal, masseter, and sternocleidomastoid muscles Fig. 2 Evaluation of the blink reflex. The blink reflex shows impaired brainstem function with delayed or absent R2 responses after ipsilateral and contralateral stimulation. Arrows indicate latency of each response. Normal values (ms): R1 10.5 ± 0.8, ipsilateral R2 (iR2) 30.5 ± 3.4, and contralateral R2 (cR2) 30.5 ± 4.4
3.960938
0.982422
sec[1]/p[0]
en
0.999998
32113480
https://doi.org/10.1186/s12883-020-01639-x
[ "taste", "muscles", "tongue", "muscle", "limbs", "apparent", "atrophy", "stimulation", "without", "disturbance" ]
[ { "code": "MB41.2", "title": "Dysgeusia" }, { "code": "MB41.Z", "title": "Disturbances of smell or taste, unspecified" }, { "code": "MB41.Y", "title": "Other specified disturbances of smell or taste" }, { "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": "DA03.Z", "title": "Diseases of tongue, unspecified" }, { "code": "DA03.0", "title": "Glossitis" } ]
=== ICD-11 CODES FOUND === [MB41.2] Dysgeusia Definition: A disorder characterised by an alteration of the sense of taste Also known as: Dysgeusia | parageusia | loss of taste sense | disturbance of taste | cacogeusia Includes: cacogeusia | ageusia [MB41.Z] Disturbances of smell or taste, unspecified Also known as: Disturbances of smell or taste, unspecified | Disturbances of smell or taste | perversion of sense of smell or taste | disorder of smell or taste [MB41.Y] Other specified disturbances of smell or taste Also known as: Other specified disturbances of smell or taste [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 [DA03.Z] Diseases of tongue, unspecified Also known as: Diseases of tongue, unspecified | Diseases of tongue | disorder of tongue | Glossopathy | unspecified condition of the tongue [DA03.0] Glossitis Definition: Inflammation of the tongue Also known as: Glossitis | inflammation of tongue | tongue inflammation | glazed tongue | Papillitis of tongue Excludes: atrophic glossitis === GRAPH WALKS === --- Walk 1 --- [MB41.2] Dysgeusia Def: A disorder characterised by an alteration of the sense of taste... --PARENT--> [MB41] Disturbances of smell or taste Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste.... --PARENT--> [?] Symptoms or signs involving the nervous system --- Walk 2 --- [MB41.2] Dysgeusia Def: A disorder characterised by an alteration of the sense of taste... --PARENT--> [MB41] Disturbances of smell or taste Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste.... --CHILD--> [MB41.1] Parosmia --- Walk 3 --- [MB41.Z] Disturbances of smell or taste, unspecified --PARENT--> [MB41] Disturbances of smell or taste Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste.... --CHILD--> [MB41.2] Dysgeusia Def: A disorder characterised by an alteration of the sense of taste... --- Walk 4 --- [MB41.Z] Disturbances of smell or taste, unspecified --PARENT--> [MB41] Disturbances of smell or taste Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste.... --PARENT--> [?] Symptoms or signs involving the nervous system --- Walk 5 --- [MB41.Y] Other specified disturbances of smell or taste --PARENT--> [MB41] Disturbances of smell or taste Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste.... --PARENT--> [?] Symptoms or signs involving the nervous system --- Walk 6 --- [MB41.Y] Other specified disturbances of smell or taste --PARENT--> [MB41] Disturbances of smell or taste Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste.... --CHILD--> [MB41.0] Anosmia
[ "[MB41.2] Dysgeusia\n Def: A disorder characterised by an alteration of the sense of taste...\n --PARENT--> [MB41] Disturbances of smell or taste\n Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste....\n --PARENT--> [?] Symptoms or signs involving the nervous system", "[MB41.2] Dysgeusia\n Def: A disorder characterised by an alteration of the sense of taste...\n --PARENT--> [MB41] Disturbances of smell or taste\n Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste....\n --CHILD--> [MB41.1] Parosmia", "[MB41.Z] Disturbances of smell or taste, unspecified\n --PARENT--> [MB41] Disturbances of smell or taste\n Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste....\n --CHILD--> [MB41.2] Dysgeusia\n Def: A disorder characterised by an alteration of the sense of taste...", "[MB41.Z] Disturbances of smell or taste, unspecified\n --PARENT--> [MB41] Disturbances of smell or taste\n Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste....\n --PARENT--> [?] Symptoms or signs involving the nervous system", "[MB41.Y] Other specified disturbances of smell or taste\n --PARENT--> [MB41] Disturbances of smell or taste\n Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste....\n --PARENT--> [?] Symptoms or signs involving the nervous system", "[MB41.Y] Other specified disturbances of smell or taste\n --PARENT--> [MB41] Disturbances of smell or taste\n Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste....\n --CHILD--> [MB41.0] Anosmia" ]
MB41.2
Dysgeusia
[ { "from_icd11": "MB41.2", "icd10_code": "R432", "icd10_title": "Parageusia" }, { "from_icd11": "MB41.Z", "icd10_code": "R439", "icd10_title": "Unspecified disturbances of smell and taste" }, { "from_icd11": "MB41.Z", "icd10_code": "R438", "icd10_title": "Other disturbances of smell and taste" }, { "from_icd11": "MB41.Z", "icd10_code": "R43", "icd10_title": "Disturbances of smell and taste" }, { "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" } ]
R432
Parageusia
KP-PLA can cause extrahepatic metastatic infection, but its secondary SAP has not been reported so far. The patient had no history of biliary tract or pancreatic diseases and drugs taken that may cause pancreatitis, no excessive drinking or overeating before the onset, normal triglyceride level, and negative autoimmune related antibodies. And he have had KP-PLA before the occurrence of pancreatitis, so KP-PLA secondary SAP was considered. By reviewing relevant literature, the potential mechanism of secondary AP of KP-PLA is proposed here: blood infection: Klebsiella pneumoniae was cultured in the drainage fluid and blood of some KP-PLA patients with secondary extrahepatic infection, suggesting that Klebsiella pneumoniae could cause extrahepatic infection through blood transfer. A retrospective study suggested that KP-PLA patients with sepsis were more prone to extrahepatic infection, suggesting that hematogenous infection was a viable route. Biliary tract infection: According to the anatomical structure of liver and pancreas, the intrahepatic and intrahepatic bile ducts eventually converge to the common bile duct and accompany the pancreatic duct to eventually open at the duodenal papilla; part of the common bile duct may converge with the pancreatic duct and open at the duodenal papilla; bacterial infection in the liver may enter the pancreatic tissue through the biliary tract system and lead to AP. Hepatopancreatic fistula and pancreatic portal vein fistula: There have been cases reported in the past that secondary hepatic abscess in patients with chronic pancreatitis is due to the formation of hepatopancreatic fistula, and the formation of pancreatic portal vein fistula can lead to multiple focal hepatic abscess secondary to acute pancreatitis. If hepatic abscess rupture causes hepatopancreatic fistula, bacteria can also infect pancreatic tissue through fistulas and lead to AP. Patients with diabetes are more likely to suffer from Klebsiella pneumoniae infection, and KP-PLA patients with high blood glucose level are more likely to develop extrahepatic metastatic infections. The generally accepted theory is that high glucose levels reduce the adhesion, chemotaxis, phagocytosis of neutrophils, and increase the aggressiveness of Klebsiella pneumoniae. The most common bacterial infection of PLA originates from the biliary tract, and some cryptogenic liver abscesses with unknown infection source were reclassified as enteric after intestinal examination, even were associated with intestinal tumors. Unfortunately, the patient had no intestinal infection symptom when he was admitted to hospital for the first time due to liver abscess, which was classified as cryptogenic liver abscess without complete colonoscopy, thus missing the opportunity for early screening of intestinal tumors. He was diagnosed with colon cancer due to SAP readmitted to hospital, suggesting that liver abscess and extrahepatic metastatic infection were closely related to delayed diagnosis of colon cancer. Colon cancer is one of the cancers with the highest prevalence in the world, its early clinical symptoms are not typical, and most of them are found in the late stage, so the mortality is high. Although there are no guidelines to determine whether PLA patients should be routinely screened for colon cancer, many scholars believe that PLA is closely associated with colon cancer, especially in patients with Klebsiella pneumoniae infection and diabetes. Mohan et al conducted a meta-analysis, which showed that patients with PLA had a much higher incidence of colon cancer than the general population, and over 90% of the pathogenic bacteria were Klebsiella pneumoniae. Therefore, early colon cancer screening for patients with cryptogenic KP-PLA was recommended. It is generally accepted that colon cancer leads to the destruction of intestinal mucosal barrier, and enteric bacteria enter the blood along with the portal vein to cause liver abscess. In addition, the relationship between diabetes and colon cancer is also attracting increasing attention. A large cross-sectional study showed that diabetes mellitus significantly increases the risk of gastrointestinal tumors, especially colorectal cancer. It has been reported that hyperinsulinemia promotes the proliferation of tumor cells by stimulating the IP3-kinase/AKT pathway, apoptosis was inhibited by up-regulation of insulin-like growth factor-2, hyperinsulinemia promote the development of colon cancer by stimulating mutations in the DNA bases of colon cells. A case of brain abscess due to delayed diagnosis of KP-PLA associated with colon cancer was reported in Japan in 2000. This case is the first time KP-PLA associated with colon cancer has been proposed to cause SAP.
4.304688
0.72168
sec[2]/p[0]
en
0.999996
PMC9857361
https://doi.org/10.1097/MD.0000000000032654
[ "infection", "colon", "cancer", "that", "patients", "abscess", "pancreatic", "liver", "extrahepatic", "klebsiella" ]
[ { "code": "1H0Z", "title": "Infection, unspecified" }, { "code": "1G40", "title": "Sepsis without septic shock" }, { "code": "FA10.Z", "title": "Direct infections of joint, unspecified" }, { "code": "1D9Z", "title": "Unspecified viral infection of unspecified site" }, { "code": "1A40.Z", "title": "Infectious gastroenteritis or colitis without specification of infectious agent" }, { "code": "1A40.0&XA03U9", "title": "Colon inflammation" }, { "code": "DB30.Y&XA03U9", "title": "Obstructed colon" }, { "code": "NB91.81", "title": "Laceration of colon" }, { "code": "DD3Z", "title": "Ischaemic vascular disorders of intestine, unspecified" }, { "code": "DB32.2Z&XA03U9", "title": "Colonic dilatation" } ]
=== ICD-11 CODES FOUND === [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] [NB91.81] Laceration of colon Definition: A tear or wound of large intestine. Also known as: Laceration of colon [DD3Z] Ischaemic vascular disorders of intestine, unspecified Also known as: Ischaemic vascular disorders of intestine, unspecified | Vascular disorder of intestine, not elsewhere classified | vascular disorder of intestine | vascular bowel disease | ischaemic gut NOS === GRAPH WALKS === --- Walk 1 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --EXCLUDES--> [?] Infection arising from device, implant or graft, not elsewhere classified --- Walk 2 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --RELATED_TO--> [?] 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 ... --- Walk 3 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Septicaemia --EXCLUDES--> [?] Sepsis with septic shock Def: Septic shock is a subset of sepsis in which circulatory, cellular and metabolic abnormalities are profound enough to substantially increase mortality.... --- Walk 4 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Sepsis of fetus or newborn --CHILD--> [?] Sepsis of fetus or newborn due to streptococcus, group A --- Walk 5 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --EXCLUDES--> [?] Reactive arthropathies Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti... --- Walk 6 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --EXCLUDES--> [?] Reactive arthropathies Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti...
[ "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --EXCLUDES--> [?] Infection arising from device, implant or graft, not elsewhere classified", "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --RELATED_TO--> [?] 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 ...", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Septicaemia\n --EXCLUDES--> [?] Sepsis with septic shock\n Def: Septic shock is a subset of sepsis in which circulatory, cellular and metabolic abnormalities are profound enough to substantially increase mortality....", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Sepsis of fetus or newborn\n --CHILD--> [?] Sepsis of fetus or newborn due to streptococcus, group A", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --EXCLUDES--> [?] Reactive arthropathies\n Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti...", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --EXCLUDES--> [?] Reactive arthropathies\n Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti..." ]
1H0Z
Infection, unspecified
[ { "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" }, { "from_icd11": "1H0Z", "icd10_code": "I", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B90-B94", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B94", "icd10_title": "Sequelae of other and unspecified infectious and parasitic diseases" } ]
B999
Unspecified infectious disease
A 20-year-old Chinese man with no significant medical history was referred for sudden headache with diplopia. His sudden headache started in July 2012 and was aggravated over 3 months by fatigue, recurrent fever, nausea and weight loss, followed by bilateral vision loss and intermittent diplopia. His body temperature was repeatedly elevated, with a maximum temperature of 39.7 °C. His best-corrected visual acuity (BCVA) was 10/20 bilaterally, with a normal intraocular pressure (IOP). He showed ptosis in both eyes, with restricted abduction on the right side. A slit-lamp examination yielded normal results for both the anterior segment and the fundus, with no relative afferent pupillary defect (RAPD). VF testing revealed bitemporal hemianopsia. Laboratory tests showed a white blood cell (WBC) count of 6.26 × 10 9 /L and a neutrophil count of 3.73 × 10 9 /L (59.5%). His renal function was normal, with a creatinine (Cr) and urea level of 61.17 μmol/L and 4.05 mmol/L, respectively. The urine was negative for protein and red blood cells. The urine-specific gravity was normal, while endocrine tests revealed a thyroid-stimulating hormone (TSH) level of 0.04 μIU/mL, an adrenocorticotropic hormone (ACTH) level of 1.70 pg/mL and a testosterone level of < 20.0 pg/mL. Morning cortisol, prolactin (PRL), random blood glucose and glycosylated hemoglobin levels were normal (Table 1 ). Enhanced MRI showed pituitary enlargement with increased T2 signal intensity and heterogeneous enhancement. The sellar mass displayed a suprasellar extension and optic chiasm compression, along with bilateral extension into the cavernous sinus . No abnormalities were found by chest or abdominal computed tomography (CT) or in the levels of tumor markers, C-reactive protein (CRP), antistreptolysin O (ASO) or rheumatoid factor (RF). The immune test results were negative for ANCAs (myeloperoxidase [MPO]-ANCAs, 3.89 RU/mL; proteinase 3 (PR3)-ANCAs, 3.09 RU/mL; reference interval, < 20 RU/mL), as well as antinuclear antibodies (ANAs) and anti-extractable nuclear antigen (ENA) antibodies. The total serum IgG level was 12.30 g/L (7.00–17.00), with an IgA level of 2.01 g/L (0.70–4.00) and an IgM level of 0.35 g/L (0.40–2.30). The patient was suspected to have immune-related pituitaritis. The cerebral spinal fluid (CSF) was then tested. The results indicated a WBC count of 13*10 6 /L and an IgG level of 4.63 mg/dL in the CSF. IgG oligoclonal bands were absent in the serum and CSF, which had no traces of bacteria, such as Staphylococcus aureus and Mycobacterium tuberculosis . A CSF smear showed a mass of lympho-monocytes and macrophages. The patient was then diagnosed with lymphocytic hypophysitis and was treated with IV dexamethasone (20 mg qd) for 3 days, followed by a decreased dosage of dexamethasone (10 mg qd*7 days, 5 mg qd*2 days) and then oral prednisone (60 mg qd). Two months later, the patient’s BCVA recovered to 100/100 bilaterally with a normal VF. His ocular movement was normal, and he reported no diplopia or headache. Additionally, the endocrine hormone levels were within normal limits (Table 1 ). A repeat enhanced MRI showed that the pituitary mass was smaller than before with homogeneous enhancement, and the chiasmal compression had diminished . The patient’s condition remained stable during the following year, with no significant changes observed by MRI. Table 1 Pituitary hormone levels First onset First decrease Recurrence Recurrence (treated) Reference ACTH pg/mL 1.70 NA 46.70 < 5 0–46 TSH, μIU/mL 0.04 0.95 0.67 2.10 0.38–4.34 fT4, ng/dL 0.83 0.92 0.79 1.16 0.81–1.89 FSH, mIU/mL 4.30 8.06 7.49 12.29 1.27–19.26 LH, mIU/mL 0.88 3.27 4.93 6.34 1.24–8.62 E2, pg/mL < 20.00 603.89 ng/dL 3.33 3.08 ng/mL 1.75–7.81 PRL, ng/mL 7.42 19.50 16.39 12.41 2.64–13.13 Morning cortisol, μg/dL 0.30 2.48 10.69 5.95 4.0–22.3 Random blood glucose mmol/L 4.76 4.10 4.52 4.58 3.9–6.1 GH ng/mL NA NA 0.79 0.9 < 2.0 IGF-1 ng/mL NA NA 257 251 116–358 Fig. 1 Magnetic resonance imaging (MRI) scans from the first episode: a Enhanced sagittal T1 sequence: enlarged pituitary fossa with a lesion convex to the suprasellar area. The pituitary stalk was compressed. The size of the lesion was 43*15*17 mm, with a slightly long T1 and long T2 signal mixed with a short T1 signal and a long T2 signal with inhomogeneous enhancement. No obvious bone destruction was detected. b Enhanced coronal T1 sequence: optic chiasm compression with the bilateral cavernous sinus surrounded by the lesion. c Enhanced sagittal T1 sequence: the volume of the lesion was reduced significantly after IV glucocorticoid treatment. d Enhanced coronal T1 sequence: the morphology of the optic chiasm and cavernous sinus returned to normal after IV glucocorticoid administration
4.136719
0.967285
sec[1]/p[0]
en
0.999996
30445952
https://doi.org/10.1186/s12886-018-0966-0
[ "enhanced", "pituitary", "blood", "hormone", "signal", "sequence", "lesion", "headache", "diplopia", "count" ]
[ { "code": "8A04.0", "title": "Enhanced physiological tremor" }, { "code": "8E4A.0", "title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord" }, { "code": "5A61", "title": "Hypofunction or certain other specified disorders of pituitary gland" }, { "code": "5A61.0", "title": "Hypopituitarism" }, { "code": "5A61.Y", "title": "Other specified hypofunction or disorders of pituitary gland" }, { "code": "5D43", "title": "Postprocedural hypopituitarism" }, { "code": "2F9A&XA8J35", "title": "Neoplasms of unknown behaviour of pituitary gland" }, { "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" } ]
=== ICD-11 CODES FOUND === [8A04.0] Enhanced physiological tremor Definition: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc. Also known as: Enhanced physiological tremor [8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Definition: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephalopathy, ataxia, myelopathy, myelitis) nervous system. In the paraneoplastic context, this attack is a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived from a systemic cancer. In the non-paraneoplastic context termed ‘autoimmune’ the etiology rem Also known as: Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord | Paraneoplastic encephalitis | Paraneoplastic encephalitis, neural autoantibody positive | Paraneoplastic encephalitis, neural autoantibody negative | Autoimmune encephalitis [5A61] Hypofunction or certain other specified disorders of pituitary gland Definition: Clinical status with disordered function of the pituitary gland without excessive pituitary hormone production, which is caused by a variety of diseases Also known as: Hypofunction or certain other specified disorders of pituitary gland | disorder of pituitary gland | pituitary disease | pituitary gland disease | pituitary glandular disease Excludes: Postprocedural hypopituitarism | Craniopharyngioma [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 [5A61.Y] Other specified hypofunction or disorders of pituitary gland Also known as: Other specified hypofunction or disorders of pituitary gland | Prolactin deficiency | Isolated prolactin deficiency | Hypothalamic dysfunction, not elsewhere classified | dyspituitarism [5D43] Postprocedural hypopituitarism Definition: This is the postprocedural decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain. If there is decreased secretion of most pituitary hormones, the term panhypopituitarism (pan meaning "all") is used. Also known as: Postprocedural hypopituitarism | iatrogenic pituitary disorder | acquired pituitary gland absence | acquired pituitary glandular absence | iatrogenic postprocedural pituitary disorder [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 === GRAPH WALKS === --- Walk 1 --- [8A04.0] Enhanced physiological tremor Def: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc.... --PARENT--> [8A04] Disorders associated with tremor Def: Tremor is an involuntary oscillation of a body part and is commonly classified according to the behavioural circumstances in which it occurs. Tremor may occur during attempted relaxation (rest tremor)... --PARENT--> [?] Movement disorders Def: This is a group of involuntary movement disorders.... --- Walk 2 --- [8A04.0] Enhanced physiological tremor Def: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc.... --PARENT--> [8A04] Disorders associated with tremor Def: Tremor is an involuntary oscillation of a body part and is commonly classified according to the behavioural circumstances in which it occurs. Tremor may occur during attempted relaxation (rest tremor)... --CHILD--> [8A04.2] Rest tremor Def: Resting tremors happen while the patient is sitting or lying down and relaxed. People who have a resting tremor can usually stop the tremor by deliberately moving the affected body part. It usually oc... --- Walk 3 --- [8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal... --RELATED_TO--> [?] Paraneoplastic retinopathy Def: Paraneoplastic retinopathies result from a targeted attack on the retina due to a tumour immune response initiated by onco-neural antigens derived from systemic cancer. Patients usually present after ... --PARENT--> [?] Retinopathy --- Walk 4 --- [8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal... --RELATED_TO--> [?] Opsoclonus-myoclonus Def: Opsoclonus-myoclonus (OM) is an autoimmune disorder of eye movements characterised by opsoclonus (involuntary unpredictable rapid eye movements [saccades] without inter-saccadic intervals), myoclonus ... --CHILD--> [?] Paraneoplastic opsoclonus myoclonus Def: Paraneoplastic opsoclonus myoclonus (OM) results from a targeted attack on the brainstem as a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived fr... --- Walk 5 --- [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... --PARENT--> [?] Disorders of the pituitary hormone system Def: Clinical status with increased, decreased, or dysregulated secretion of pituitary hormones, which is caused by a variety of tumourous, non-tumourous, and genetic disorders.... --CHILD--> [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... --- Walk 6 --- [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... --EXCLUDES--> [?] Postprocedural hypopituitarism Def: This is the postprocedural decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain. If there is decreased secretion of most pi... --CHILD--> [?] Postirradiation hypopituitarism
[ "[8A04.0] Enhanced physiological tremor\n Def: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc....\n --PARENT--> [8A04] Disorders associated with tremor\n Def: Tremor is an involuntary oscillation of a body part and is commonly classified according to the behavioural circumstances in which it occurs. Tremor may occur during attempted relaxation (rest tremor)...\n --PARENT--> [?] Movement disorders\n Def: This is a group of involuntary movement disorders....", "[8A04.0] Enhanced physiological tremor\n Def: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc....\n --PARENT--> [8A04] Disorders associated with tremor\n Def: Tremor is an involuntary oscillation of a body part and is commonly classified according to the behavioural circumstances in which it occurs. Tremor may occur during attempted relaxation (rest tremor)...\n --CHILD--> [8A04.2] Rest tremor\n Def: Resting tremors happen while the patient is sitting or lying down and relaxed. People who have a resting tremor can usually stop the tremor by deliberately moving the affected body part. It usually oc...", "[8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord\n Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal...\n --RELATED_TO--> [?] Paraneoplastic retinopathy\n Def: Paraneoplastic retinopathies result from a targeted attack on the retina due to a tumour immune response initiated by onco-neural antigens derived from systemic cancer. Patients usually present after ...\n --PARENT--> [?] Retinopathy", "[8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord\n Def: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephal...\n --RELATED_TO--> [?] Opsoclonus-myoclonus\n Def: Opsoclonus-myoclonus (OM) is an autoimmune disorder of eye movements characterised by opsoclonus (involuntary unpredictable rapid eye movements [saccades] without inter-saccadic intervals), myoclonus ...\n --CHILD--> [?] Paraneoplastic opsoclonus myoclonus\n Def: Paraneoplastic opsoclonus myoclonus (OM) results from a targeted attack on the brainstem as a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived fr...", "[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 --PARENT--> [?] Disorders of the pituitary hormone system\n Def: Clinical status with increased, decreased, or dysregulated secretion of pituitary hormones, which is caused by a variety of tumourous, non-tumourous, and genetic disorders....\n --CHILD--> [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...", "[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 --EXCLUDES--> [?] Postprocedural hypopituitarism\n Def: This is the postprocedural decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain. If there is decreased secretion of most pi...\n --CHILD--> [?] Postirradiation hypopituitarism" ]
8A04.0
Enhanced physiological tremor
[ { "from_icd11": "8A04.0", "icd10_code": "G252", "icd10_title": "Other specified forms of tremor" }, { "from_icd11": "8E4A.0", "icd10_code": "G3183", "icd10_title": "Dementia with Lewy bodies" }, { "from_icd11": "8E4A.0", "icd10_code": "G2581", "icd10_title": "Restless legs syndrome" }, { "from_icd11": "8E4A.0", "icd10_code": "G3184", "icd10_title": "Mild cognitive impairment, so stated" }, { "from_icd11": "8E4A.0", "icd10_code": "G9349", "icd10_title": "Other encephalopathy" }, { "from_icd11": "8E4A.0", "icd10_code": "G0481", "icd10_title": "Other encephalitis and encephalomyelitis" }, { "from_icd11": "8E4A.0", "icd10_code": "G9589", "icd10_title": "Other specified diseases of spinal cord" }, { "from_icd11": "8E4A.0", "icd10_code": "G2589", "icd10_title": "Other specified extrapyramidal and movement disorders" }, { "from_icd11": "8E4A.0", "icd10_code": "G3189", "icd10_title": "Other specified degenerative diseases of nervous system" }, { "from_icd11": "8E4A.0", "icd10_code": "G2582", "icd10_title": "Stiff-man syndrome" }, { "from_icd11": "8E4A.0", "icd10_code": "G0489", "icd10_title": "Other myelitis" }, { "from_icd11": "8E4A.0", "icd10_code": "G9581", "icd10_title": "Conus medullaris syndrome" }, { "from_icd11": "8E4A.0", "icd10_code": "G3185", "icd10_title": "Corticobasal degeneration" }, { "from_icd11": "8E4A.0", "icd10_code": "G3181", "icd10_title": "Alpers disease" }, { "from_icd11": "8E4A.0", "icd10_code": "G3182", "icd10_title": "Leigh's disease" } ]
G252
Other specified forms of tremor
A 65-year-old female was referred to our hospital with chest discomfort on effort. On auscultation, a grade III/VI systolic murmur at the 4 th left intercostal space was detected. Her blood pressure was 122/66 mmHg. A chest X-ray showed cardiomegaly (cardiothoracic ratio; 0.55) without pulmonary congestion, and an electrocardiogram showed regular sinus rhythm, poor R wave progression in leads V1 to V4, an inverted T wave, and left ventricular (LV) high voltage (SV1 + RV5 = 6.52 mV). She presented no angiokeratoma on her skin, and had no history of acroparesthesia. A medical interview revealed that her father, one of her younger sisters, and a nephew died suddenly at age 58, 42, and 36, respectively . Another younger sister also presented with LV hypertrophy with outflow obstruction. Transthoracic echocardiography showed diffuse LV hypertrophy with more than 20 mm wall thickness and hyper contraction with LV outflow obstruction. The maximum LV outflow pressure gradient was 87 mmHg, and Valsalva maneuver increased the pressure gradient up to 98 mmHg . Moderate mitral valve regurgitation was detected due to systolic anterior motion of the anterior mitral leaflet. Laboratory data displayed preserved renal function and no proteinuria. Cardiac catheterization revealed a systolic pressure gradient between mid LV and outflow tract by 82 mmHg, and biopsy specimens presented vacuolation of cardiomyocytes, which were stained by periodic acid-Schiff (PAS) stain . Zebra bodies were detected by electron microscopic examination in the cells with vacuolation . Zebra body is a specific finding of Fabry disease, but is also found in other lysosome diseases, such as Niemann-Pick disease, Landing’s disease, Sandhoff’s disease, and mucopolysaccharidosis. The patient had no clinical findings consistent with those diseases. Cationic amphiphilic drugs, including gentamycin, hydroxychloroquine, and amiodarone, are capable of inducing phospholipidosis, leading to deposition of zebra bodies in various cells [ 4 – 6 ], but she had not taken any of these drugs. Although the enzymatic activity of leukocyte GLA was within normal range (62 nmol/mg/h), we initially diagnosed the case with cardiac Fabry disease with the E66Q mutation based on the histological findings. But because the distribution and the density of zebra body were much less than typical cases of Fabry disease, we added the immunostaining against Gb3 in the specimen of LV myocardium. As compared to a case of typical Fabry disease , there was few deposition of Gb3, even in vacuolated cells . We also analyzed plasma levels of Gb3, but it was within normal range (2.8 μg/ml). In contrast, when we analyzed the case for mutations in the disease genes for HCM , it was revealed that the patient carried heterozygous mutations of MYBPC3 and MYH6 (Ser624del). Although both mutations were novel, they were not found in the public sequence databases including dbSNP , 1000 genomes , and Human Genetic Variation database . In addition, the MYBPC3 mutation was predicted to be a disease-causing mutation by three different in silico studies; predicted to be disease-causing by Mutation Taster , probably damaging (score 1.000) by PolyPhen-2 , and damaging (score 0) by SIFT . As for the MYH6 mutation, one amino acid at 624th position in the head domain was deleted, which might be deleterious for the function of α-myosin heavy chain. However, because MYH6 is mainly expressed in the atrial muscles and not in the ventricular muscles in human adult hearts, pathological role of the MYH6 mutation in cardiac hypertrophy in this case might be less significant than the MYBPC3 mutation. From these observations, HOCM was more reasonable to explain the pathophysiology in the case, although the disease modifying effect of the E66Q mutation cannot be ruled out. Fig. 1 Pedigree of the case. The numbers indicate current age or age at death Fig. 2 Echocardiographic findings. a , b Echocardiographic images of para-sternal long axis view of LV showing diffuse cardiac hypertrophy at diastolic ( a ) and systolic ( b ) phases. Systolic anterior motion of anterior mitral leaflet was observed. c Measurement of the pressure gradient between mid-LV and LV outflow tract Fig. 3 Histological findings of left ventricular endomyocardial biopsy. a Vacuolated cardiomyocytes in the left ventricle (hematoxylin and eosin staining). Bar, 50 μm. b PAS stain-positive cardiomyocytes with vacuolation. Bar, 50 μm. c Zebra body in vacuolated cardiomyocytes. d Magnified image of C Fig. 4 Immunostaining of myocardium against Gb3. a Immunostaining of myocardium in typical Fabry disease’s case. Brown staining indicates Gb3 accumulation. Bar, 50 μm. b Immunostaining of myocardium in the present case. Bar, 50 μm
4.257813
0.930664
sec[1]/p[0]
en
0.999997
27160240
https://doi.org/10.1186/s12872-016-0262-y
[ "mutation", "systolic", "pressure", "outflow", "zebra", "fabry", "mmhg", "hypertrophy", "gradient", "cardiac" ]
[ { "code": "GB90.4A", "title": "Nephrogenic diabetes insipidus" }, { "code": "8A02.12", "title": "Dystonia associated with heredodegenerative disorders" }, { "code": "4A01.21", "title": "Immune dysregulation syndromes presenting primarily with autoimmunity" }, { "code": "8C73.Z", "title": "Mitochondrial myopathies, unspecified" }, { "code": "8E02.0", "title": "Genetic Creutzfeldt-Jakob disease" }, { "code": "BA00.2", "title": "Isolated systolic hypertension" }, { "code": "BC60", "title": "Atrial premature depolarization" }, { "code": "BB62.Z", "title": "Mitral valve prolapse, unspecified" }, { "code": "BC70", "title": "Ventricular premature depolarization" }, { "code": "BA00.0", "title": "Combined diastolic and systolic hypertension" } ]
=== ICD-11 CODES FOUND === [GB90.4A] Nephrogenic diabetes insipidus Definition: Nephrogenic diabetes insipidus is a condition in which the kidney tubules respond poorly to pituitary secreted anti-diuretic hormone, resulting in a failure to concentrate the urine, and water loss. Polyuria with dilute urine and polydypsia (excessive thirst) are present. It can be congenital or acquired with many causes. The congenital forms may be attributed to vasopressin receptor or aquaporin-2 defects. They are characterised by polyuria with polydipsia, recurrent bouts of fever, constipatio Also known as: Nephrogenic diabetes insipidus | renal diabetes insipidus | familial nephrogenic diabetes | antidiuretic-hormone-resistant diabetes insipidus | adiuretin-resistant diabetes insipidus Excludes: Central diabetes insipidus [8A02.12] Dystonia associated with heredodegenerative disorders Definition: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen. Also known as: Dystonia associated with heredodegenerative disorders | Dystonia due to autosomal dominant disorders | Rapid-onset dystonia-parkinsonism | Dystonia due to dentatorubropallidoluysian atrophy | Dystonia due to Huntington disease [4A01.21] Immune dysregulation syndromes presenting primarily with autoimmunity Also known as: Immune dysregulation syndromes presenting primarily with autoimmunity | Syndrome with autoimmunity | Immunodeficiency syndromes presenting primarily with autoimmunity | FADD-related immunodeficiency | X-linked immune dysregulation – polyendocrinopathy – enteropathy [8C73.Z] Mitochondrial myopathies, unspecified Also known as: Mitochondrial myopathies, unspecified | Mitochondrial myopathies | Myopathies in mitochondrial disorders [8E02.0] Genetic Creutzfeldt-Jakob disease Definition: A disease of the brain, that is associated with a prion. This disease is characterised by neurological deficits, and is fatal. Confirmation is by pathological examination of the brain. Also known as: Genetic Creutzfeldt-Jakob disease | CJD - [Creutzfeldt-Jakob disease] | Creutzfeldt-Jakob | Creutzfeldt-Jakob disease | JCD - [Jakob-Creutzfeldt disease] [BA00.2] Isolated systolic hypertension Also known as: Isolated systolic hypertension | systolic hypertension | systolic HTN - [hypertension] [BC60] Atrial premature depolarization Definition: Cardiac electrical depolarization arising from the atria, occurring earlier than the expected sinus beat Also known as: Atrial premature depolarization | atrial extrasystoles | ectopic atrial beats | premature atrial contraction | premature atrial beats [BB62.Z] Mitral valve prolapse, unspecified Also known as: Mitral valve prolapse, unspecified | Mitral valve prolapse | systolic click-murmur syndrome | ballooning mitral valve | Barlow syndrome [BC70] Ventricular premature depolarization Definition: Ventricular depolarization occurring earlier than the expected ventricular depolarization initiated by the sinoatrial node or another supraventricular pacemaker. Also known as: Ventricular premature depolarization | premature ventricular complex | premature ventricular contraction | premature ventricular systole | ventricular ectopic beats [BA00.0] Combined diastolic and systolic hypertension Also known as: Combined diastolic and systolic hypertension | diastolic and systolic hypertension | diastolic hypertension with systolic hypertension | diastolic and systolic HTN - [hypertension] === GRAPH WALKS === --- Walk 1 --- [GB90.4A] Nephrogenic diabetes insipidus Def: Nephrogenic diabetes insipidus is a condition in which the kidney tubules respond poorly to pituitary secreted anti-diuretic hormone, resulting in a failure to concentrate the urine, and water loss. P... --PARENT--> [GB90.4] Renal tubular function disorders Def: Disorders primarily due to abnormalities of renal tubular resorption or secretion.... --RELATED_TO--> [?] Nephrogenic syndrome of inappropriate antidiuresis --- Walk 2 --- [GB90.4A] Nephrogenic diabetes insipidus Def: Nephrogenic diabetes insipidus is a condition in which the kidney tubules respond poorly to pituitary secreted anti-diuretic hormone, resulting in a failure to concentrate the urine, and water loss. P... --PARENT--> [GB90.4] Renal tubular function disorders Def: Disorders primarily due to abnormalities of renal tubular resorption or secretion.... --RELATED_TO--> [?] Cystinuria Def: Cystinuria is a renal tubular aminoacid transport disorder characterised by recurrent formation of kidneys cystine stones.... --- Walk 3 --- [8A02.12] Dystonia associated with heredodegenerative disorders Def: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen.... --PARENT--> [8A02.1] Secondary dystonia Def: This is dystonia – a disorder of involuntary muscle contractions – of an acquired nature. Causes include substance toxicity, injury, hypoxia and tumours.... --CHILD--> [8A02.10] Drug-induced dystonia Def: This is dystonia due to medications either as an idiosyncratic side effect or due to overdose of medications.... --- Walk 4 --- [8A02.12] Dystonia associated with heredodegenerative disorders Def: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen.... --PARENT--> [8A02.1] Secondary dystonia Def: This is dystonia – a disorder of involuntary muscle contractions – of an acquired nature. Causes include substance toxicity, injury, hypoxia and tumours.... --CHILD--> [8A02.11] Dystonia-plus Def: This is a group of heterogenous syndromes present with dystonia – a disorder of involuntary muscle contractions – along with other clinical features, but not in tandem with a neurodegenerative disease... --- Walk 5 --- [4A01.21] Immune dysregulation syndromes presenting primarily with autoimmunity --RELATED_TO--> [?] Aicardi-Goutières syndrome Def: Aicardi-Goutières syndrome is an inherited, subacute encephalopathy characterised by the association of basal ganglia calcification, leukodystrophy and cerebrospinal fluid (CSF) lymphocytosis.... --CHILD--> [?] Aicardi-Goutières syndrome type 2 --- Walk 6 --- [4A01.21] Immune dysregulation syndromes presenting primarily with autoimmunity --RELATED_TO--> [?] Autoimmune polyendocrinopathy type 1 Def: Autoimmune polyendocrinopathy type 1, or APECED syndrome, is a genetic disease that manifests in childhood or early adolescence with a combination of chronic mucocutaneous candidiasis, hypoparathyroid... --PARENT--> [?] Immune dysregulation syndromes presenting primarily with autoimmunity
[ "[GB90.4A] Nephrogenic diabetes insipidus\n Def: Nephrogenic diabetes insipidus is a condition in which the kidney tubules respond poorly to pituitary secreted anti-diuretic hormone, resulting in a failure to concentrate the urine, and water loss. P...\n --PARENT--> [GB90.4] Renal tubular function disorders\n Def: Disorders primarily due to abnormalities of renal tubular resorption or secretion....\n --RELATED_TO--> [?] Nephrogenic syndrome of inappropriate antidiuresis", "[GB90.4A] Nephrogenic diabetes insipidus\n Def: Nephrogenic diabetes insipidus is a condition in which the kidney tubules respond poorly to pituitary secreted anti-diuretic hormone, resulting in a failure to concentrate the urine, and water loss. P...\n --PARENT--> [GB90.4] Renal tubular function disorders\n Def: Disorders primarily due to abnormalities of renal tubular resorption or secretion....\n --RELATED_TO--> [?] Cystinuria\n Def: Cystinuria is a renal tubular aminoacid transport disorder characterised by recurrent formation of kidneys cystine stones....", "[8A02.12] Dystonia associated with heredodegenerative disorders\n Def: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen....\n --PARENT--> [8A02.1] Secondary dystonia\n Def: This is dystonia – a disorder of involuntary muscle contractions – of an acquired nature. Causes include substance toxicity, injury, hypoxia and tumours....\n --CHILD--> [8A02.10] Drug-induced dystonia\n Def: This is dystonia due to medications either as an idiosyncratic side effect or due to overdose of medications....", "[8A02.12] Dystonia associated with heredodegenerative disorders\n Def: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen....\n --PARENT--> [8A02.1] Secondary dystonia\n Def: This is dystonia – a disorder of involuntary muscle contractions – of an acquired nature. Causes include substance toxicity, injury, hypoxia and tumours....\n --CHILD--> [8A02.11] Dystonia-plus\n Def: This is a group of heterogenous syndromes present with dystonia – a disorder of involuntary muscle contractions – along with other clinical features, but not in tandem with a neurodegenerative disease...", "[4A01.21] Immune dysregulation syndromes presenting primarily with autoimmunity\n --RELATED_TO--> [?] Aicardi-Goutières syndrome\n Def: Aicardi-Goutières syndrome is an inherited, subacute encephalopathy characterised by the association of basal ganglia calcification, leukodystrophy and cerebrospinal fluid (CSF) lymphocytosis....\n --CHILD--> [?] Aicardi-Goutières syndrome type 2", "[4A01.21] Immune dysregulation syndromes presenting primarily with autoimmunity\n --RELATED_TO--> [?] Autoimmune polyendocrinopathy type 1\n Def: Autoimmune polyendocrinopathy type 1, or APECED syndrome, is a genetic disease that manifests in childhood or early adolescence with a combination of chronic mucocutaneous candidiasis, hypoparathyroid...\n --PARENT--> [?] Immune dysregulation syndromes presenting primarily with autoimmunity" ]
GB90.4A
Nephrogenic diabetes insipidus
[ { "from_icd11": "GB90.4A", "icd10_code": "N251", "icd10_title": "Nephrogenic diabetes insipidus" }, { "from_icd11": "4A01.21", "icd10_code": "D8982", "icd10_title": "Autoimmune lymphoproliferative syndrome [ALPS]" }, { "from_icd11": "4A01.21", "icd10_code": "D89813", "icd10_title": "Graft-versus-host disease, unspecified" }, { "from_icd11": "4A01.21", "icd10_code": "D89810", "icd10_title": "Acute graft-versus-host disease" }, { "from_icd11": "4A01.21", "icd10_code": "D89811", "icd10_title": "Chronic graft-versus-host disease" }, { "from_icd11": "4A01.21", "icd10_code": "D8989", "icd10_title": "Other specified disorders involving the immune mechanism, not elsewhere classified" }, { "from_icd11": "4A01.21", "icd10_code": "D89812", "icd10_title": "Acute on chronic graft-versus-host disease" }, { "from_icd11": "4A01.21", "icd10_code": "D898", "icd10_title": "Other specified disorders involving the immune mechanism, not elsewhere classified" }, { "from_icd11": "8C73.Z", "icd10_code": "G713", "icd10_title": "Mitochondrial myopathy, not elsewhere classified" }, { "from_icd11": "8E02.0", "icd10_code": "A8100", "icd10_title": "Creutzfeldt-Jakob disease, unspecified" }, { "from_icd11": "8E02.0", "icd10_code": "A8109", "icd10_title": "Other Creutzfeldt-Jakob disease" }, { "from_icd11": "8E02.0", "icd10_code": "A810", "icd10_title": "Creutzfeldt-Jakob disease" }, { "from_icd11": "BC60", "icd10_code": "I491", "icd10_title": "Atrial premature depolarization" }, { "from_icd11": "BC60", "icd10_code": "I49", "icd10_title": "Other cardiac arrhythmias" }, { "from_icd11": "BB62.Z", "icd10_code": "I341", "icd10_title": "Nonrheumatic mitral (valve) prolapse" } ]
N251
Nephrogenic diabetes insipidus
The patient, a 72-year-old retired nurse, was in good health with no history of alcohol or tobacco use, chronic lung disease, immune disease, family history, and no complaints of muscle pain or weakness. The patient was admitted to our hospital with symptoms of fever, cough, and shortness of breath. Upon examination (Table 1 ), the patient showed elevated levels of white blood cells and C-reactive protein, and tested negative for SARS-Cov-2 swabs. The patient was diagnosed with community-acquired pneumonia and treated with laroxefin for anti-infection. However, the patient’s dyspnea worsened during treatment. On the third day, the patient required non-invasive ventilator assisted ventilation, and the SARS-Cov-2 swab was tested positive again. The chest CT examination revealed ground glass shadow changes , and the patient was immediately treated with azivudine 5 mg/day for novel coronavirus infection. Azvudine is a small-molecule antiviral drug taken orally, developed independently in China. It is metabolized into active Azvudine triphosphate in cells and specifically targets the RNA-dependent polymerase of the novel coronavirus, effectively blocking or terminating its replication. Additionally, a daily dose of 40 mg of methylprednisolone sodium succinate for injection is administered to reduce alveolar effusion, along with anticoagulant therapy of 4000IU/day of Enoxaparin sodium. However, the patient’s condition continued to worsen. While using a non-invasive ventilator for assistance, the patient’s oxygen concentration remained at 100%, but their oxygen saturation was still only around 70%, and the lowest oxygenation index was only 80. On the 10th day, the patient was moved to the intensive care unit following endotracheal intubation. A re-evaluation of the chest CT scan revealed extensive interstitial fibrosis changes in both lungs . We continued the treatment with methylprednisolone sodium succinate for injection at a dosage of 40 mg/day for its anti-inflammatory effects, enoxaparin sodium at a dosage of 4000IU/day for anticoagulation, along with prone positioning, imipenem and cilastatin sodium for anti-sensitivity combined with voriconazole for anti-infection, and compound sulfamethoxazole for the prevention of pneumocystis infection. To determine the cause, we recommended a lung tissue biopsy to the patient’s family, but they declined. After a thorough physical examination, we discovered that the patient was unable to participate in the muscle strength assessment due to sedation and analgesia, and no rash was observed on the entire body. However, we noticed significant roughness and thickening of the skin on the patient’s fingers, along with evident keratinization changes . At this point, we began to suspect a potential combination of novel coronavirus infection and autoimmune diseases. We conducted auxiliary autoimmune-related tests (Table 2 ), and the results of the patient’s autoimmune antibody spectrum revealed positive antinuclear antibody (ANA) and anti-recombinant RO-52 antibody (+++). Considering the changes in the skin on the patient’s fingers, we have a strong suspicion of dermatomyositis. Therefore, we promptly conducted a myositis-specific antibody spectrum test, which yielded a positive result for anti-PL-12 using the immunoprecipitation method (Table 3 ). As per Solomon et al. , the patient tested positive for anti-PL-12, and the patient’s chest CT scan indicated interstitial lung disease, which is a key criterion. This contributes to a secondary diagnosis, and patients can be diagnosed with AS as outlined above. Subsequently, we continued using methylprednisolone sodium succinate for injection at a dosage of 80 mg per day, cyclophosphamide for injection at a dosage of 0.4 g per day, and Nidanib softgel ethanesulfonate at a dosage of 150 mg twice a day for anti-fibrosis therapy, while reducing the anti-infection regimen. The patient’s oxygenation index improved from day 16 of admission , interstitial fibrosis showed significant improvement based on chest CT review , and the tracheal tube was successfully removed on day 22. At 30 days, the patient only required intermittent nasal catheter oxygen (2 L/min), and we discontinued methylprednisolone sodium succinate, switching to oral prednisone tablets at a dosage of 30 mg per day. The patient was successfully discharged. After discharge, the patient reduced the prednisone dosage by 5 mg per week, and discontinued the prednisone after 6 weeks. A follow-up chest CT showed that the fibrosis in both lungs had been largely absorbed . Finally, we followed up with the patient, who no longer required oxygen therapy, resumed their normal daily activities, and was able to engage in a small amount of physical activity.
3.869141
0.979492
sec[1]/p[0]
en
0.999998
38622599
https://doi.org/10.1186/s12890-024-02966-2
[ "anti", "sodium", "infection", "chest", "changes", "methylprednisolone", "succinate", "injection", "oxygen", "fibrosis" ]
[ { "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": "5C72", "title": "Hypo-osmolality or hyponatraemia" }, { "code": "5C71", "title": "Hyperosmolality or hypernatraemia" }, { "code": "5C64.6", "title": "Disorders of sodium metabolism" }, { "code": "5B5K.5", "title": "Sodium chloride deficiency" }, { "code": "5B91.2", "title": "Sodium chloride excess" } ]
=== 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 [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 [5C71] Hyperosmolality or hypernatraemia Definition: Serum sodium concentrations in excess of 145 mmol/L; increased serum concentration of osmotically active particles Also known as: Hyperosmolality or hypernatraemia | Hyperosmolality | hyperosmolality syndrome | nonketotic hyperosmolar syndrome | hyperosmolar syndrome [5C64.6] Disorders of sodium metabolism Also known as: Disorders of sodium metabolism [5B5K.5] Sodium chloride deficiency Definition: Sodium and chloride are usually found together in most foods as sodium chloride, also termed salt. For that reason, the effects of sodium and chloride deficiency are considered together. Deficiency can be caused by poor intake or increased losses (e.g., diuretics increase the urinary excretion of water, sodium, and chloride; in cystic fibrosis the sodium and chloride content of sweat is very high; gastrointestinal losses are associated with diarrhoeal diseases, emesis, ostomy output and other ca Also known as: Sodium chloride deficiency [5B91.2] Sodium chloride excess Definition: The main adverse effect of increased sodium chloride in the diet is increased blood pressure, which is a major risk factor for cardiovascular-renal diseases. However, evidence from a variety of studies, including observational studies and clinical trials, has demonstrated heterogeneity in the blood pressure responses to sodium intake. Those individuals with the greatest reductions in blood pressure in response to decreased sodium intake are termed “salt sensitive”. Also known as: Sodium chloride excess === 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--> [JA86.1] Maternal care for hydrops fetalis --- 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--> [?] Labour or delivery complicated by fetal distress --- 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--> [MB23.1] Antisocial behaviour Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated.... --- Walk 4 --- [MB23.1] Antisocial behaviour Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated.... --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour --CHILD--> [MB23.2] Avoidance behaviour Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual.... --- Walk 5 --- [3B4Z] Coagulation defects, unspecified --PARENT--> [?] Coagulation defects --CHILD--> [?] 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... --- 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--> [JA86.1] Maternal care for hydrops fetalis", "[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --EXCLUDES--> [?] Labour or delivery complicated by fetal distress", "[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--> [MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....", "[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --CHILD--> [MB23.2] Avoidance behaviour\n Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual....", "[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [?] 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...", "[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": "5C72", "icd10_code": "E871", "icd10_title": "Hypo-osmolality and hyponatremia" } ]
O26841
A 67‐year‐old man treated with hemodialysis was evaluated for worsening heart failure with reduced ejection fraction (EF). Eighteen years ago, he experienced an anterior ST‐elevation myocardial infarction (STEMI) treated by percutaneous coronary intervention (PCI) of the proximal left anterior descending (LAD). He was a former smoker and had both diabetes Type 2 and hypercholesterolemia. Ten years ago, he underwent coronary angiography showing progression of coronary artery disease with occlusion of the LAD and the right coronary artery (RCA). Bypass grafting was performed with left internal mammary artery (LIMA) to the LAD and a saphenous vein graft to the RCA. Five years ago, he had a posterolateral STEMI due to a circumflex (CX) occlusion, treated by PCI of the proximal CX and marginal branch. The STEMI was complicated by an acute pulmonary edema and hypotension. The left ventricular (LV) function was severely depressed with an EF 34% and high filling pressures. At that moment, a mild to moderate renal impairment was present with an estimated glomerular filtration rate (eGFR) of 52 ml/min per 1.73 m 2 . Heart failure treatment was optimized, but due to hypotension, only a moderate dose of bisoprolol (5 mg) and ramipril (5 mg) was tolerated. He received both bumetanide and spironolactone. Despite optimal medical therapy, he was several times hospitalized because of decompensated heart failure. An implantable cardioverter‐defibrillator (ICD) was implanted 4 months after the posterolateral STEMI. There was no indication for biventricular pacing because the QRS complex was not enlarged. At that time, the renal function was moderately depressed with an eGFR of 40 ml/min per 1.73 m 2 . Because of NYHA Class 3 heart failure with VO2max of only 9 ml/kg/min on maximal ergospirometry, he was considered but not accepted as a candidate for heart transplantation. Four years ago, he was randomized in the sham controlled CHART‐1 clinical trial investigating intramyocardial stem cell injection. 3 During the study period, there were no hospitalizations for heart failure, and after completion and unblinding, he was informed that he had received active treatment. Two years ago, there was a new series of hospitalizations for heart failure with progressive decline of the renal function. Because of poor diabetic control, he was treated with insulin. Peritoneal dialysis was started 2 years ago but was abandoned because of several episodes of peritonitis. Since 1 year, he is treated with hemodialysis. Despite low blood pressure especially during dialysis, he still received 80 mg of valsartan, 3.75 mg of bisoprolol, and 50 mg of spironolactone. The cardiac function was severely depressed with EF 35% but with chronically high filling pressures, moderate pulmonary hypertension, and moderate functional mitral regurgitation (MR) with effective regurgitant orifice of 23 mm 2 and a regurgitant volume of 27 ml, considered not sufficient for a mitraclip. After a new episode of worsening heart failure 6 months ago, he underwent a new heart catheterization and coronary angiography showing patent grafts and moderate in stent restenosis of the CX with preserved fraction flow reserve (FFR) and no indication for revascularization. There was severe postcapillary pulmonary hypertension (mean pulmonary artery pressure 40 mmHg) and an elevated wedge pressure of 29 mmHg. The heart rate was 62, he was not considered a good candidate for ivabradine. Because there were no other treatment possibilities, we started a treatment with sacubitril/valsartan. The drug was started on a nondialysis day with a blood pressure of 97/56 mmHg. NT‐proBNP at that time was 11 400 pg/mL. He tolerated the starting dose of 24/26 mg sacubitril/valsartan twice a day, also on dialysis days. After 4 weeks at a follow‐up consultation, the blood pressure was 105/60 mmHg, and the dose was increased to 49/51 mg twice a day, both on nondialysis and dialysis days. He described a symptomatic improvement and started again to leave the house for a small walk. The functional class improved from NYHA 3 to NYHA 2. Functional testing with 6‐min walk test was performed before the start of treatment with a walking distance of 300 m. Because of the development of a diabetic foot ulcer, the test could not be repeated. Filling pressures estimated by echocardiography decreased after the initiation of sacubitril/valsartan ( Table 1 ) without changing the intensity of ultrafiltration. There was also a reduction in function mitral insufficiency. Three months after initiation of sacubitril/valsartan, the NT‐proBNP value was reduced to 5,960 pg/ml. Until now, 6 months after the initiation of sacubitril/valsartan, there were no episodes of worsening heart failure.
4.074219
0.970215
sec[1]/p[0]
en
0.999996
31668014
https://doi.org/10.1002/ehf2.12544
[ "heart", "failure", "because", "valsartan", "treated", "coronary", "function", "pressure", "sacubitril", "stemi" ]
[ { "code": "BE2Y", "title": "Other specified diseases of the circulatory system" }, { "code": "BC4Z", "title": "Diseases of the myocardium or cardiac chambers, unspecified" }, { "code": "BD1Z", "title": "Heart failure, unspecified" }, { "code": "LA8Z", "title": "Structural developmental anomaly of heart or great vessels, unspecified" }, { "code": "BA41.Z", "title": "Acute myocardial infarction, unspecified" }, { "code": "DA96.05", "title": "Intestinal failure" }, { "code": "MG4A", "title": "Multi organ failure" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "CB41.2Z", "title": "Respiratory failure, unspecified" }, { "code": "GB6Z", "title": "Kidney failure, unspecified" } ]
=== ICD-11 CODES FOUND === [BE2Y] Other specified diseases of the circulatory system Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart [BC4Z] Diseases of the myocardium or cardiac chambers, unspecified Also known as: Diseases of the myocardium or cardiac chambers, unspecified | Heart disease NOS | cardiac disease NOS [BD1Z] Heart failure, unspecified Also known as: Heart failure, unspecified | myocardial failure | cardiac decompensation | cardiac failure | cardiac failure NOS [LA8Z] Structural developmental anomaly of heart or great vessels, unspecified Also known as: Structural developmental anomaly of heart or great vessels, unspecified | Heart malformations | Cardiac malformations | congenital anomaly of heart | congenital heart disease [BA41.Z] Acute myocardial infarction, unspecified Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction [DA96.05] Intestinal failure Definition: The reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth. Also known as: Intestinal failure [MG4A] Multi organ failure Definition: Failure of function of more than one organ or organ system, not otherwise specified Also known as: Multi organ failure | MODS - [multi organ dysfunction syndrome] | multiple organ failure | multisystem organ failure | multiorgan failure syndrome [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 [CB41.2Z] Respiratory failure, unspecified Also known as: Respiratory failure, unspecified | Respiratory failure, unspecified as acute or chronic | respiration failure | respiratory failure NOS | respiration failed [GB6Z] Kidney failure, unspecified Also known as: Kidney failure, unspecified | nontraumatic kidney injury | renal failure NOS | kidney block | renal impairment NOS === GRAPH WALKS === --- Walk 1 --- [BE2Y] Other specified diseases of the circulatory system --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --RELATED_TO--> [?] Symptoms, signs or clinical findings of the circulatory system --- Walk 2 --- [BE2Y] Other specified diseases of the circulatory system --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --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 3 --- [BC4Z] Diseases of the myocardium or cardiac chambers, unspecified --PARENT--> [?] Diseases of the myocardium or cardiac chambers Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as... --CHILD--> [BC40] Acquired atrial abnormality Def: A postnatal pathological change in form or function of one or both atriums.... --- Walk 4 --- [BC4Z] Diseases of the myocardium or cardiac chambers, unspecified --PARENT--> [?] Diseases of the myocardium or cardiac chambers Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as... --CHILD--> [BC41] Acquired ventricular abnormality Def: A postnatal pathological change in form or function of a ventricle.... --- Walk 5 --- [BD1Z] Heart failure, unspecified --PARENT--> [?] Heart failure --EXCLUDES--> [?] Other complications of obstetric surgery or procedures Def: Any complication caused by or subsequent to obstetric surgery and procedures, and not elsewhere classified.... --- Walk 6 --- [BD1Z] Heart failure, unspecified --PARENT--> [?] Heart failure --CHILD--> [BD10] Congestive heart failure Def: A clinical syndrome characterised by abnormalities of ventricular function and neurohormonal regulation which are accompanied by effort intolerance and fluid retention....
[ "[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of the circulatory system", "[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --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...", "[BC4Z] Diseases of the myocardium or cardiac chambers, unspecified\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --CHILD--> [BC40] Acquired atrial abnormality\n Def: A postnatal pathological change in form or function of one or both atriums....", "[BC4Z] Diseases of the myocardium or cardiac chambers, unspecified\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --CHILD--> [BC41] Acquired ventricular abnormality\n Def: A postnatal pathological change in form or function of a ventricle....", "[BD1Z] Heart failure, unspecified\n --PARENT--> [?] Heart failure\n --EXCLUDES--> [?] Other complications of obstetric surgery or procedures\n Def: Any complication caused by or subsequent to obstetric surgery and procedures, and not elsewhere classified....", "[BD1Z] Heart failure, unspecified\n --PARENT--> [?] Heart failure\n --CHILD--> [BD10] Congestive heart failure\n Def: A clinical syndrome characterised by abnormalities of ventricular function and neurohormonal regulation which are accompanied by effort intolerance and fluid retention...." ]
BE2Y
Other specified diseases of the circulatory system
[ { "from_icd11": "BC4Z", "icd10_code": "I5181", "icd10_title": "Takotsubo syndrome" }, { "from_icd11": "BC4Z", "icd10_code": "I5189", "icd10_title": "Other ill-defined heart diseases" }, { "from_icd11": "BC4Z", "icd10_code": "I519", "icd10_title": "Heart disease, unspecified" }, { "from_icd11": "BC4Z", "icd10_code": "I510", "icd10_title": "Cardiac septal defect, acquired" }, { "from_icd11": "BC4Z", "icd10_code": "I515", "icd10_title": "Myocardial degeneration" }, { "from_icd11": "BC4Z", "icd10_code": "I51", "icd10_title": "Complications and ill-defined descriptions of heart disease" }, { "from_icd11": "BC4Z", "icd10_code": "I516", "icd10_title": "" }, { "from_icd11": "BC4Z", "icd10_code": "I518", "icd10_title": "Other ill-defined heart diseases" }, { "from_icd11": "BD1Z", "icd10_code": "I5023", "icd10_title": "Acute on chronic systolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5030", "icd10_title": "Unspecified diastolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5031", "icd10_title": "Acute diastolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5022", "icd10_title": "Chronic systolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5084", "icd10_title": "End stage heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5020", "icd10_title": "Unspecified systolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5021", "icd10_title": "Acute systolic (congestive) heart failure" } ]
I5181
Takotsubo syndrome
Thyroid hormone plays a crucial role in lipid and energy metabolism. This is why, irrespective of the cause, thyroid hormone can have clinical implications on nearly all organs. The insidious onset and late presentation of symptoms make hypothyroidism difficult to diagnose. Our patient was originally from the Philippines, where the prevalence of hypothyroidism is considered low (8.53%). Iodine deficiency is the most common cause of hypothyroidism globally; however, the Philippines is a repleted country. Compared to autoimmune causes, such as Hashimoto’s in the United States, subclinical hypothyroidism is the most common cause of hypothyroidism in the Philippines, ten times more common in older women than men 9 , 10 , 11 . This patient did not present with the typical signs and symptoms of hypothyroidism, including but not limited to fatigue, depressed mood, inexplicable weight gain, decreased appetite, hair loss, dry skin, periorbital puffiness, constipation, difficulty swallowing, shortness of breath, etc. The patient also denied prior history of head and neck irradiation, personal or family history of autoimmune disorders and/or type 1 diabetes, or past surgical history. He has only taken anti-hypertensive medication (valsartan 25 mg po daily) without any side effects over the years. The patient reported he has always felt healthy and denied knowledge of thyroid diagnosis.A thyroid ultrasound demonstrated a very atrophic thyroid gland with a benign cyst replacing his right thyroid lobe. This is commonly known as atrophic thyroiditis and is considered an extreme form of primary hypothyroidism. Chronic autoimmune thyroiditis (Hashimoto’s) is the most common cause of primary hypothyroidism in iodine-repleted countries. Generally, most cases of Hashimoto’s have diffusely large goiters, which was not observed in this patient. Autoimmune hypothyroidism with small thyroid glands is referred to as Ord’s hypothyroidism.In Hashimoto’s and Ord’s thyroiditis, thyroid volume follows a normal volume distribution. Antibodies to thyroid peroxidase and thyroglobulin are thought to destroy follicles by invasion of the T-lymphocytes. This patient had positive anti-TPOAb and anti-TRAb, further suggesting an autoimmune cause 10 , 12 , 13 , 14 .Both hyper- and hypothyroidism can cause hypertension through different mechanisms. In hyperthyroidism, increased heart rate leads to increased cardiac output. An increased level of T3 increases cardiac contractility as well. The high levels of atrial natriuretic peptide, brain natriuretic peptide, endothelin-1, and adrenomedulin may also contribute to hypertension in hyperthyroidism patients. Hypertension caused by hyperthyroidism increases mortality due to cardiovascular origins by 20% 15 . In hypothyroidism, the heart muscle is weakened and, over time, becomes less efficient. Bradycardia causes decreased ventricular filling and cardiac contractility, leading to low cardiac output. This, in turn, causes increased systemic vascular resistance, leading to hypertension. In hypertension caused by thyroid disorders, anti-hypertensive medications alone may not help control the blood pressure (BP). Decreased metabolic activity of hypothyroidism leads to a decline in peripheral oxygen demand and reduced renin clearance, leading to expansion of blood volume through sodium reabsorption. This mechanism rarely leads to heart failure 15 . This patient’s BP on admission was 155/90, and heart rate (HR) of 66. This high reading also may be secondary to blood loss upon injury. However, the patient admitted he was frequently told by his primary care physician he might need adjunctive anti-hypertensive medication if his BP is not controlled on the current regimen of valsartan 25 mg PO daily. Thyroid hormones increase expression of HMG-CoA reductase enzyme in the liver, leading to increased cholesterol synthesis. Hence, hypothyroidism should lead to decreased hepatic cholesterol synthesis. However, T3-mediated effects on the sterol regulatory element-binding protein-2 (SREBP-2) decreases cell-surface LDL-cholesterol receptors. This in turn, leads to reduced plasma LDL-cholesterol clearance and increased apo-B lipoproteins. These multifactorial and complex mechanism leads to increased total cholesterol, LDL, HDL and TG levels, which ultimately increases risk of non-alcoholic fatty liver disease. Several observational studies have shown levothyroxine treatment may alter lipid metabolism, except the patient with underlying hyperlipidemia 16 . Our patient had high LDL (217), TC (310) and TG (168) on admission. However, he had normal liver function tests and no signs and symptoms of jaundice or other liver pathologies. The patient was started on atorvastatin 20 mg PO daily.
4.34375
0.611328
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0.999996
39967991
https://doi.org/10.15190/d.2024.5
[ "hypothyroidism", "thyroid", "this", "cause", "autoimmune", "anti", "hypertension", "leads", "cholesterol", "common" ]
[ { "code": "5A00.Z", "title": "Hypothyroidism, unspecified" }, { "code": "5A00.0Z", "title": "Congenital hypothyroidism, unspecified" }, { "code": "5A00.2Y", "title": "Other specified acquired hypothyroidism" }, { "code": "5A00.2Z", "title": "Acquired hypothyroidism, unspecified" }, { "code": "5D40.Z", "title": "Postprocedural hypothyroidism, unspecified" }, { "code": "5A03.Z", "title": "Thyroiditis, unspecified" }, { "code": "5A0Z", "title": "Disorders of the thyroid gland or thyroid hormones system, unspecified" }, { "code": "5A03.Y", "title": "Other specified thyroiditis" }, { "code": "5A03.0", "title": "Acute thyroiditis" }, { "code": "4A01.03", "title": "Transient hypogammaglobulinaemia of infancy" } ]
=== ICD-11 CODES FOUND === [5A00.Z] Hypothyroidism, unspecified Also known as: Hypothyroidism, unspecified | Hypothyroidism | Subclinical hypothyroidism [5A00.0Z] Congenital hypothyroidism, unspecified Also known as: Congenital hypothyroidism, unspecified | Congenital hypothyroidism [5A00.2Y] Other specified acquired hypothyroidism Also known as: Other specified acquired hypothyroidism | Primary acquired hypothyroidism | hypothyroidism, primary or NOS | Autoimmune hypothyroidism | Consumptive hypothyroidism [5A00.2Z] Acquired hypothyroidism, unspecified Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea [5D40.Z] Postprocedural hypothyroidism, unspecified Also known as: Postprocedural hypothyroidism, unspecified | Postprocedural hypothyroidism | postoperative hypothyroidism | Postsurgical hypothyroidism | hypothyroidism following thyroidectomy [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 [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 [4A01.03] Transient hypogammaglobulinaemia of infancy Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy] === GRAPH WALKS === --- Walk 1 --- [5A00.Z] Hypothyroidism, unspecified --PARENT--> [5A00] Hypothyroidism --CHILD--> [5A00.0] Congenital hypothyroidism Def: Hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises at birth. Common clinical features include decreased activity and increased sl... --- Walk 2 --- [5A00.Z] Hypothyroidism, unspecified --PARENT--> [5A00] Hypothyroidism --CHILD--> [5A00.1] Iodine-deficiency-related thyroid disorders or allied conditions Def: Any condition caused by aberrant thyroid function due to a deficiency of iodine. Confirmation is by blood test.... --- Walk 3 --- [5A00.0Z] Congenital hypothyroidism, unspecified --PARENT--> [5A00.0] Congenital hypothyroidism Def: Hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises at birth. Common clinical features include decreased activity and increased sl... --RELATED_TO--> [?] Congenital central hypothyroidism --- Walk 4 --- [5A00.0Z] Congenital hypothyroidism, unspecified --PARENT--> [5A00.0] Congenital hypothyroidism Def: Hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises at birth. Common clinical features include decreased activity and increased sl... --CHILD--> [5A00.01] Permanent congenital hypothyroidism without goitre Def: This is a permanent congenital state in which the thyroid gland does not make enough thyroid hormone. This diagnosis is without swelling of the thyroid gland.... --- Walk 5 --- [5A00.2Y] Other specified acquired hypothyroidism --PARENT--> [5A00.2] Acquired hypothyroidism Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth.... --RELATED_TO--> [?] Acquired central hypothyroidism Def: Central Hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, induced by dysfunction of either hypothalamus or pituitary.... --- Walk 6 --- [5A00.2Y] Other specified acquired hypothyroidism --PARENT--> [5A00.2] Acquired hypothyroidism Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth.... --CHILD--> [5A00.21] Myxoedema coma Def: A life-threatening hypothyroid condition with long-standing severe untreated hypothyroidism in whom adaptive mechanisms fail to maintain homeostasis....
[ "[5A00.Z] Hypothyroidism, unspecified\n --PARENT--> [5A00] Hypothyroidism\n --CHILD--> [5A00.0] Congenital hypothyroidism\n Def: Hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises at birth. Common clinical features include decreased activity and increased sl...", "[5A00.Z] Hypothyroidism, unspecified\n --PARENT--> [5A00] Hypothyroidism\n --CHILD--> [5A00.1] Iodine-deficiency-related thyroid disorders or allied conditions\n Def: Any condition caused by aberrant thyroid function due to a deficiency of iodine. Confirmation is by blood test....", "[5A00.0Z] Congenital hypothyroidism, unspecified\n --PARENT--> [5A00.0] Congenital hypothyroidism\n Def: Hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises at birth. Common clinical features include decreased activity and increased sl...\n --RELATED_TO--> [?] Congenital central hypothyroidism", "[5A00.0Z] Congenital hypothyroidism, unspecified\n --PARENT--> [5A00.0] Congenital hypothyroidism\n Def: Hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises at birth. Common clinical features include decreased activity and increased sl...\n --CHILD--> [5A00.01] Permanent congenital hypothyroidism without goitre\n Def: This is a permanent congenital state in which the thyroid gland does not make enough thyroid hormone. This diagnosis is without swelling of the thyroid gland....", "[5A00.2Y] Other specified acquired hypothyroidism\n --PARENT--> [5A00.2] Acquired hypothyroidism\n Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....\n --RELATED_TO--> [?] Acquired central hypothyroidism\n Def: Central Hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, induced by dysfunction of either hypothalamus or pituitary....", "[5A00.2Y] Other specified acquired hypothyroidism\n --PARENT--> [5A00.2] Acquired hypothyroidism\n Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....\n --CHILD--> [5A00.21] Myxoedema coma\n Def: A life-threatening hypothyroid condition with long-standing severe untreated hypothyroidism in whom adaptive mechanisms fail to maintain homeostasis...." ]
5A00.Z
Hypothyroidism, unspecified
[ { "from_icd11": "5A00.Z", "icd10_code": "E039", "icd10_title": "Hypothyroidism, unspecified" }, { "from_icd11": "5A00.Z", "icd10_code": "E038", "icd10_title": "Other specified hypothyroidism" }, { "from_icd11": "5A00.Z", "icd10_code": "E03", "icd10_title": "Other hypothyroidism" }, { "from_icd11": "5A00.2Z", "icd10_code": "E033", "icd10_title": "Postinfectious hypothyroidism" }, { "from_icd11": "5D40.Z", "icd10_code": "E890", "icd10_title": "Postprocedural hypothyroidism" }, { "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": "" } ]
E039
Hypothyroidism, unspecified
Upon initiating the intravitreal injection in the operating room, we measured his blood pressure as 141/69 mmHg (3 October) and 135/70 mmHg (10 October) without blood-pressure-lowering drugs . However, on 12 November, just 2 days after a follow-up visit to our hospital, he complained of a severe headache and walked to the emergency department at Tokyo Takanawa Hospital. He complained of a severe headache on the right back side of his head and visual disturbance of the left visual field with no other systemic neuropathological symptoms. He had no external injury presumed as trauma antecedent and no other apparent causes leading to cerebral hemorrhage. His blood pressure was elevated at 195/108 mmHg, and computed tomography (CT) of the brain revealed the presence of a high-density area (2.5 × 3.0 cm) in the right occipital lobe indicating a subcortical hemorrhage . The patient was treated with an intravenous injection of nicardipine hydrochloride to lower his systemic blood pressure to < 140 mmHg for 2 days. On 13 November, CT showed no enlargement of the high-density area (data not shown). On 15 November, 3 days after the stroke, magnetic resonance imaging (MRI) revealed a peripheral low-intensity zone in the same region and a low-intensity area in the occipital lobe that was consistent with the CT results. Additionally, magnetic resonance (MR) angiography revealed no vascular anomalies or malformation , and T2*-weighted MRI revealed no cerebral microbleeds, thus ruling out cerebral amyloid angiopathy . He was therefore diagnosed with a hypertensive cerebral hemorrhage of the occipital lobe. On 14 November, 2 days after the stroke, the patient began oral treatment with 80 mg/day telmisartan, which was continued for 3 days. Starting 17 November, the telmisartan dose was reduced to 40 mg/day. During this period, his blood pressure was maintained at < 130/80 mmHg, and his symptoms of severe headache disappeared, and visual disturbance of the left visual field was alleviated. Ten days later, he was discharged from Tokyo Takanawa Hospital, and 20 days after discharge he visited our hospital to receive a follow-up ophthalmological examination. Two months after the stroke , visual field tests with Goldmann perimetry at our hospital showed no apparent left homonymous hemianopsia . Follow-up CT and T2*-weighted MRI examinations revealed that the cerebral hemorrhage had been absorbed, and the lesion had decreased in size. One year after the cerebrovascular stroke, the telmisartan was discontinued because his blood pressure had stabilized to a normal level and remained around 110/60 mmHg. Fig. 3 Systolic and diastolic blood pressure ( a ) and plasma vascular endothelial growth factor levels ( b ) of the patient before and after binocular anti-VEGF therapies 1 week apart. More than 2 months after anti-VEGF therapy in both eyes, the plasma VEGF levels fell below the detection limit (< 20 pg/ml). On 12 November 2017, cerebral hemorrhage occurred owing to acute hypertension, and the patient was treated with an intravenous injection of nicardipine hydrochloride for 2 days to lower his blood pressure, which promptly returned to a normal level within the same day. On 14 November, 2 days after the stroke, the patients began oral treatment with 80 mg/day telmisartan, which was continued for 3 days. Starting 17 November, the telmisartan dose was reduced to 40 mg/day and continued for 1 year Fig. 4 Computed tomography (CT) of the brain on 12 November 2017 ( a ) and 14 February 2018 ( c ), and T2*-weighted magnetic resonance imaging (MRI) of the brain on 15 November 2017 ( b ) and 24 July 2018 ( d ). Two different slices were included on each date. High density on the CT ( a yellow arrowhead) and low intensity of the peripheral zone of the lesion on the T2*-weighted MRI ( b yellow arrowhead) revealed cerebral hemorrhage of the right occipital lobe. Three months after the stroke, the high-density area disappeared, and the small low-density area remained on the brain CT ( c yellow arrowhead). The low-intensity lesion decreased in size 8 months later on the brain T2*-weighted MRI ( d yellow arrowheads) Fig. 5 Diffusion-weighted magnetic resonance imaging (MRI) ( a ) and magnetic resonance (MR) angiography ( b ) of the brain on 15 November 2017. Two different slices were included ( a ). Diffusion-weighted MRI revealed the low-intensity area in the same region of the right occipital lobe ( a yellow arrowheads); MR angiography demonstrated no vascular anomalies or malformation. H head, F feet, R right, L left ( b ) Fig. 6 Goldmann perimetry of both eyes on 5 January 2018 (2 months after the cerebral hemorrhage). Goldmann perimetry showed no apparent visual field abnormalities. a left eye, b right eye
3.939453
0.977539
sec[1]/p[3]
en
0.999998
34311786
https://doi.org/10.1186/s13256-021-02983-3
[ "november", "blood", "pressure", "cerebral", "hemorrhage", "weighted", "mmhg", "visual", "brain", "area" ]
[ { "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.... --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--> [MF50.40] 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 --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--> [MF50.40] 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
An 84-year-old male with a left DFA aneurysm was referred to our institute. Eight months prior to this referral, he underwent emergent surgical resection of a ruptured DFA aneurysm (63 mm×55 mm×56 mm) on the left side, wherein another DFA aneurysm (32 mm×31 mm×40 mm) was found on the peripheral side. Nonetheless, only proximal artery ligation of the peripheral lesion was performed at that time for the following reasons: 1) the emergency nature of the surgery, 2) the peripheral lesion was relatively small, with a lower risk of rupture, and 3) the peripheral lesion was located in the deep layer in the thigh. Therefore, the resection was considered highly invasive . The size of the residual aneurysm gradually increased during follow-up after surgery, and he was directed to the radiology department for endovascular treatment. He had a history of graft replacement for an abdominal aortic aneurysm, surgical resection of a right lateral circumflex femoral artery aneurysm, and Alzheimer’s disease with an eight-point score on Hasegawa’s Dementia Scale. Serum biochemical tests showed no obvious abnormalities, except for an elevated serum creatinine level (1.8 mg/dL). No abnormalities were detected on a complete blood count analysis and clotting test. He had no episode, family history, physical findings, or laboratory findings indicating systemic vascular disease or vasculitis. He had taken aspirin, clopidogrel, antihypertensive drugs, and donepezil. Computed tomography (CT) showed a 40 mm×38 mm×52 mm aneurysm in the middle of the left DFA. The proximal artery of this lesion was ligated. Contrast-enhanced CT revealed a contrast effect in the aneurysm that extended to the distal artery. The distal artery branched into multiple small tortuous branches immediately after emerging from the aneurysm, which were continuous with the small collateral vessels from the branches of the left internal iliac artery and reconstructed left DFA . No aneurysms were detected at other sites. Ultrasonography (US) showed that the majority of the aneurysm was thrombolyzed, but blood flow signals were identified in the distal portion of the aneurysm. Vascular surgeons and radiologists discussed whether to treat this aneurysm surgically or endovascularly and decided that the latter was suitable as first-line treatment owing to his numerous comorbidities. The patient and his family consented to this treatment plan. On the basis of the preprocedural imaging findings, we determined that a transcatheter arterial embolization (TAE) with an antegrade or transcollateral approach was not feasible. Additionally, we needed a procedure that could be completed in a short time period as the patient was expected to have difficulty staying in the same position for a long time due to Alzheimer’s disease. Therefore, we planned to perform embolization by directly puncturing the distal orifice of the aneurysm. The patient was placed in a prone position and sedated with continuous dexmedetomidine administration. We first identified the blood flow signals within the aneurysm and distal artery using an ultrasound instrument (Aplio 500, Canon Medical Systems, Otawara, Japan) and a 7.5-MHz linear array probe (PLT-704SBT, Canon Medical Systems) . Then, a 21-G Chiba needle was introduced into the distal orifice of the aneurysm under US guidance , and we carefully injected 1.2 mL of NBCA (B. Braun, Melsungen, Germany)–Lipiodol (Lipiodol Ultra-Fluid; Guerbet, Roissy, France) mixture (1 : 2 ratio) in a stepwise fashion under ultrasound guidance until the color flow signals disappeared. Subsequently, a second puncture and injection of 1.5 mL of the NBCA–Lipiodol mixture (1 : 2 ratio) were performed because a faintly residual blood signal was detected in the aneurysm. After the second injection, the blood signals completely disappeared . A radiograph acquired after this procedure showed the presence of Lipiodol in the distal side of the aneurysm and the proximal part of the distal artery . The procedure was well tolerated by the patient, and it took approximately 40 min to complete. Follow-up US performed on the next day showed no evidence of recanalization in the aneurysm and hematoma. The patient was discharged 2 days after embolization without any complications. No blood signals were detected in the aneurysm on US performed 4 months after embolization. On unenhanced CT performed 16 months after embolization, Lipiodol was still present within the aneurysm and proximal portion of the distal artery. The size of the aneurysm reduced to 37 mm×30 mm×45 mm (preoperative CT, 40 mm×38 mm×52 mm). US performed at nearly the same time revealed no evidence of residual blood flow in the aneurysm, and blood flow in the distal arteries was preserved.
4.035156
0.974121
sec[1]/p[0]
en
0.999999
PMC9816024
https://doi.org/10.3400/avd.cr.22-00043
[ "aneurysm", "artery", "blood", "that", "this", "flow", "signals", "embolization", "lipiodol", "lesion" ]
[ { "code": "BD51.Z", "title": "Aneurysm and dissection of unspecified artery" }, { "code": "BD75.Y", "title": "Venous varicosities of other specified sites" }, { "code": "BA81", "title": "Coronary artery aneurysm" }, { "code": "BB02.1Z", "title": "Aneurysm of pulmonary artery, unspecified" }, { "code": "BD51.4", "title": "Aneurysm or dissection of renal artery" }, { "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 === [BD51.Z] Aneurysm and dissection of unspecified artery Also known as: Aneurysm and dissection of unspecified artery | Arterial aneurysm or dissection, excluding aorta | cirsoid aneurysm NOS | false aneurysm NOS | ruptured aneurysm NOS [BD75.Y] Venous varicosities of other specified sites Also known as: Venous varicosities of other specified sites | Caput medusae | Jugular venous aneurysm | jugular vein aneurysm | Orbital varices [BA81] Coronary artery aneurysm Definition: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times. Also known as: Coronary artery aneurysm | aneurysm of coronary vessels | aneurysmal lesion of coronary artery | arteriovenous aneurysm of coronary vessels | coronary aneurysm Excludes: Congenital coronary arterial aneurysm | Mucocutaneous lymph node syndrome [BB02.1Z] Aneurysm of pulmonary artery, unspecified Also known as: Aneurysm of pulmonary artery, unspecified | Aneurysm of pulmonary artery | pulmonary artery aneurysm | PA - [pulmonary artery aneurysm] | pulmonary aneurysm [BD51.4] Aneurysm or dissection of renal artery Also known as: Aneurysm or dissection of renal artery | aneurysm of renal artery | renal artery aneurysm | renal aneurysm [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 --- [BD51.Z] Aneurysm and dissection of unspecified artery --PARENT--> [BD51] Arterial aneurysm or dissection, excluding aorta --PARENT--> [?] Diseases of arteries or arterioles --- Walk 2 --- [BD51.Z] Aneurysm and dissection of unspecified artery --PARENT--> [BD51] Arterial aneurysm or dissection, excluding aorta --EXCLUDES--> [?] Acute myocardial infarction, without specification of ST elevation Def: This is commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die. This is most commonly due to occlusion (blockage) of a coron... --- Walk 3 --- [BD75.Y] Venous varicosities of other specified sites --PARENT--> [BD75] Venous varicosities of sites other than lower extremity --RELATED_TO--> [?] Gastric varices Def: Abnormally dilated veins developed as portosystemic shunts in the lining of stomach (fundus and/or cardia) in patients with portal hypertension. Once gastric varices develop, they continue to grow, an... --- Walk 4 --- [BD75.Y] Venous varicosities of other specified sites --PARENT--> [BD75] Venous varicosities of sites other than lower extremity --CHILD--> [BD75.0] Sublingual varices Def: Varicose veins on the underside of the tongue... --- Walk 5 --- [BA81] Coronary artery aneurysm Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times.... --EXCLUDES--> [?] Mucocutaneous lymph node syndrome Def: Mucocutaneous lymph node syndrome (Kawasaki disease) is a globally distributed acute vasculitis of young children affecting medium to small calibre arteries and if untreated leads to coronary artery a... --PARENT--> [?] Vasculitis affecting medium or large cutaneous blood vessels Def: A heterogeneous group of disorders characterised by vasculitis centred on medium/large cutaneous blood vessels.... --- Walk 6 --- [BA81] Coronary artery aneurysm Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times.... --CHILD--> [BA81.2] Coronary artery aneurysm without mention of perforation or rupture --PARENT--> [BA81] Coronary artery aneurysm Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times....
[ "[BD51.Z] Aneurysm and dissection of unspecified artery\n --PARENT--> [BD51] Arterial aneurysm or dissection, excluding aorta\n --PARENT--> [?] Diseases of arteries or arterioles", "[BD51.Z] Aneurysm and dissection of unspecified artery\n --PARENT--> [BD51] Arterial aneurysm or dissection, excluding aorta\n --EXCLUDES--> [?] Acute myocardial infarction, without specification of ST elevation\n Def: This is commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die. This is most commonly due to occlusion (blockage) of a coron...", "[BD75.Y] Venous varicosities of other specified sites\n --PARENT--> [BD75] Venous varicosities of sites other than lower extremity\n --RELATED_TO--> [?] Gastric varices\n Def: Abnormally dilated veins developed as portosystemic shunts in the lining of stomach (fundus and/or cardia) in patients with portal hypertension. Once gastric varices develop, they continue to grow, an...", "[BD75.Y] Venous varicosities of other specified sites\n --PARENT--> [BD75] Venous varicosities of sites other than lower extremity\n --CHILD--> [BD75.0] Sublingual varices\n Def: Varicose veins on the underside of the tongue...", "[BA81] Coronary artery aneurysm\n Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times....\n --EXCLUDES--> [?] Mucocutaneous lymph node syndrome\n Def: Mucocutaneous lymph node syndrome (Kawasaki disease) is a globally distributed acute vasculitis of young children affecting medium to small calibre arteries and if untreated leads to coronary artery a...\n --PARENT--> [?] Vasculitis affecting medium or large cutaneous blood vessels\n Def: A heterogeneous group of disorders characterised by vasculitis centred on medium/large cutaneous blood vessels....", "[BA81] Coronary artery aneurysm\n Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times....\n --CHILD--> [BA81.2] Coronary artery aneurysm without mention of perforation or rupture\n --PARENT--> [BA81] Coronary artery aneurysm\n Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times...." ]
BD51.Z
Aneurysm and dissection of unspecified artery
[ { "from_icd11": "BD51.Z", "icd10_code": "I728", "icd10_title": "Aneurysm of other specified arteries" }, { "from_icd11": "BD51.Z", "icd10_code": "I729", "icd10_title": "Aneurysm of unspecified site" }, { "from_icd11": "BD51.Z", "icd10_code": "I72", "icd10_title": "Other aneurysm" }, { "from_icd11": "BA81", "icd10_code": "I2542", "icd10_title": "Coronary artery dissection" }, { "from_icd11": "BA81", "icd10_code": "I2541", "icd10_title": "Coronary artery aneurysm" }, { "from_icd11": "BA81", "icd10_code": "I254", "icd10_title": "Coronary artery aneurysm and dissection" }, { "from_icd11": "BB02.1Z", "icd10_code": "I281", "icd10_title": "Aneurysm of pulmonary artery" }, { "from_icd11": "BD51.4", "icd10_code": "I722", "icd10_title": "Aneurysm of renal artery" }, { "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" } ]
I728
Aneurysm of other specified arteries
An 80-year-old female was admitted to the psychiatric unit for therapeutic adjustment. She had an unremarkable personal and family medical history. Her family referred hypothymia, occasional insomnia, and anxiety after the death of her only son, when she was 78, but she had never attended a psychiatric clinic till three months before admission. During that time she lived alone and took care of herself. At the first visit, she referred anxiety, anhedonia, loneliness, fatigue, and being afraid of living alone. She was diagnosed of adjustment disorder with depressed mood. Despite treatment with different antidepressants, the patient suffered clinical deterioration. At the next psychiatric consultation apathy, loosely structured guilty, hypochondriac, and nihilistic delusions were reported. In addition, she presented reduced speech output and psychomotor retardation with pseudocatatonic postures. At that moment, she was diagnosed of a major depressive episode with catatonia and psychiatric admission for therapeutic restructuring was agreed with her family. Despite different antidepressant and antipsychotic treatments, symptoms worsened and ECT was prescribed. The patient received eight bilateral ECT sessions during the following 25 days. During this period, the patient did not present any sign of improvement. In contrast, she progressively became disoriented, inattentive, perseverative, and her speech turned to be hypophonic, monotonous, with a paucity of content and difficulties in naming and understanding complex orders. She developed rigidity, postural tremor, bradykinesia, gait disturbances, and became wheelchair bound. Due to lack of efficacy, ECT was stopped and a neurological consultation was requested. Myoclonia, ataxia, or pyramidal tract signs were not observed. Considering the differential diagnosis between CJD and epileptic status post-ECT, blood test, cerebrospinal fluid tests, as well as electroencephalogram (ECG) before and after treatment with levetiracetam, and magnetic resonance imaging (MRI) were performed. Bilateral parieto-occipital cortical hyperintensities that affected several gyri, but not basal ganglia or thalamus, were observed in diffusion-weighted imaging (DWI), MRI with diminution of the apparent diffusion coefficient (ADC), and minimal alterations in T2 fluid attenuated inversion recovery (FLAIR) sequences ( Figure 1(a) ). EEG showed slowness and diffuse period sharp wave complexes (PSWC) predominantly in left hemisphere that do not present without variations under antiepileptic treatment. The 14.3.3 protein assay was positive. Biochemical, hematologic alterations, viral, bacterial and parasitic infections, or tumoral processes were ruled out. At that point a diagnosis of CJD was suggested. Due to the neurologic diagnosis, the patient was transferred to the neurologic unit. There, the clinical status deteriorated till a state close to akinetic mutism with no spontaneous speech, no spontaneous movements, inattention, one-word answers to questions, perseverative movements, dysphagia, and incontinency. The family consented genetic study of the prion protein gene ( PRNP ) which detected heterozygosity for methionine/valine at codon 129 and no causative mutations. The patient was discharged to a nursing home 36 days after admission. Surprisingly, at one-month followup, the patient's neurological condition had significantly improved. She was oriented and able to maintain a simple conversation and walk by herself. Nevertheless, cognitive and depressive complains persisted and she referred lacunar amnesia of the previous 6 months. Neurological examination showed symmetric akinetic parkinsonism, reduced fluency, word-finding, difficulties, and ideomotor apraxia. The Minimental state examination score was 21. A new MRI not only confirmed the aforementioned results, but also showed an extension of the abnormalities ( Figure 1(b) ). In contrast, PSWC had disappeared in the EEG. Three months later, cognitive reevaluation could not be reassessed because of fatigue, and eventually the patient could not attend more to consultation due to a slowly progressive cognitive and motor impairment. She died 2 years later, 29 months after the beginning of the episode. Neuropathologic study revealed classical features of CJD with spongiform change, neuronal loss, and gliosis. Large confluent vacuoles were abundant in cortical areas and were surrounded by patchy-perivacuolar PrP res deposits. In addition, frequent unicentric Kuru-type plaques in cerebellar granular layer were observed. Western-blot analysis demonstrated the presence of PrP res type 2. Morphological features were compatible with the mixed MV 2K + C subtype. Concomitant brainstem Lewy-bodies were observed.
4.132813
0.97168
sec[1]/p[0]
en
0.999999
22937408
https://doi.org/10.1155/2011/791275
[ "that", "psychiatric", "family", "referred", "consultation", "speech", "neurological", "cognitive", "unit", "therapeutic" ]
[ { "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": "6E8Z", "title": "Mental, behavioural or neurodevelopmental disorders, unspecified" }, { "code": "QA00.3", "title": "General mental examination" }, { "code": "QC65", "title": "Family history of mental or behavioural disorder" }, { "code": "QA04.6", "title": "General mental examination, requested by authority" }, { "code": "FB83.1Y", "title": "Other specified osteoporosis" } ]
=== ICD-11 CODES FOUND === [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS [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 [QA00.3] General mental examination Also known as: General mental examination | mental health evaluation | general psychiatric examination Excludes: examination requested for medicolegal reasons [QC65] Family history of mental or behavioural disorder Also known as: Family history of mental or behavioural disorder | family history of psychiatric disorder | Family history of intellectual development disorder | Family history of mental retardation | Family history of conditions classifiable as intellectual development disorder [QA04.6] General mental examination, requested by authority Also known as: General mental examination, requested by authority | evaluation of mental health requested by authority | psychiatric examination requested by authority | general psychiatric examination, requested by authority [FB83.1Y] Other specified osteoporosis Also known as: Other specified osteoporosis | Osteoporosis due to eating disorders | Osteoporosis due to anorexia | Osteoporosis due to bulimia | Osteoporosis due to pregnancy or lactation === GRAPH WALKS === --- Walk 1 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --PARENT--> [?] Headache disorders --- Walk 2 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --CHILD--> [8A80.1] Migraine with aura Def: Recurrent attacks, lasting minutes, of unilateral fully-reversible visual, sensory or other central nervous system symptoms that usually develop gradually and are usually followed by headache and asso... --- Walk 3 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm --PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm --- Walk 4 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm --CHILD--> [QA70] Overdose of substance without injury or harm Def: Overdose of a substance occurs when a patient is given more of a prescribed drug or other substance than is intended. Can be the result of inaccurate measurement of drug, including oral administration... --- Walk 5 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --CHILD--> [PL13.1] Underdosing, as mode of injury or harm --- Walk 6 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --PARENT--> [?] Causes of healthcare related harm or injury
[ "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --PARENT--> [?] Headache disorders", "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.1] Migraine with aura\n Def: Recurrent attacks, lasting minutes, of unilateral fully-reversible visual, sensory or other central nervous system symptoms that usually develop gradually and are usually followed by headache and asso...", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm\n --PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm\n --CHILD--> [QA70] Overdose of substance without injury or harm\n Def: Overdose of a substance occurs when a patient is given more of a prescribed drug or other substance than is intended. Can be the result of inaccurate measurement of drug, including oral administration...", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.1] Underdosing, as mode of injury or harm", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --PARENT--> [?] Causes of healthcare related harm or injury" ]
8A80.Z
Migraine, unspecified
[ { "from_icd11": "8A80.Z", "icd10_code": "G43B0", "icd10_title": "Ophthalmoplegic migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43409", "icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A0", "icd10_title": "Cyclical vomiting, in migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D0", "icd10_title": "Abdominal migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43709", "icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A1", "icd10_title": "Cyclical vomiting, in migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43509", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43719", "icd10_title": "Chronic migraine without aura, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43501", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C0", "icd10_title": "Periodic headache syndromes in child or adult, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43401", "icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43419", "icd10_title": "Hemiplegic migraine, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43B1", "icd10_title": "Ophthalmoplegic migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C1", "icd10_title": "Periodic headache syndromes in child or adult, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D1", "icd10_title": "Abdominal migraine, intractable" } ]
G43B0
Ophthalmoplegic migraine, not intractable
This case report describes the detailed neuroadaptive profile of a patient with a de novo 452.4 Kb microdeletion in 1p34.3. He presented with a complex NDD, including severe RD, spelling disorder, speech delay, and ADHD. RD and its comorbidities, such as ADHD, are critical for educational performance, impairing adulthood. It is important to identify the etiology of reading and language disorders and their comorbidities, such as ADHD, to plan intervention strategies. The view that RD is caused largely by genetic factors is now generally accepted although the underlying etiology appears polygenic and multifactorial . The microdeletion revealed in our patient includes the 5’ untranslated region (UTR) and the first 16 of 21 exons of the gene KIAA0319L , possibly leading to its haploinsufficiency. According to the gnomAD , the KIAA0319L gene has a probability of loss-of-function intolerance (pLI) of 0, and thus, heterozygous loss is less likely to be contributing to our patient’s clinical phenotype. However, the hypothesis that KIAA0319L is a candidate gene for RD is supported by suggestive linkage studies . This is reinforced by its homology with another gene, KIAA0319 , already associated to RD . According to an NCBI protein-to-protein blast, both KIAA genes are 61% alike, with only 6% of the coding sequence lying in gaps. KIAA0319L , in adult mice, is expressed in brain regions that in the human brain are crucial for reading performance, supporting its possible involvement in RD . KIAA0319L protein has physical interactions with Nogo Receptor 1 (NgR1), an axon guidance receptor. These two proteins interact predominantly in the cytoplasmic granules of cortical neurons in the human brain cortex. It can be inferred that KIAA0319L protein participates in axon guidance within the cerebral cortex . Embryonic disruption of KIAA0319L , during rat corticogenesis, caused aberrant neuronal migration patterns with periventricular heterotopias . Several reports highlighted how the impaired expression of other RD candidate genes, such as KIAA0319 , DCDC2 , and ROBO1 , resulted in neuronal migration disorders . This leads to hypothesizing the dysregulation of neuronal migration as the underpinning biological mechanism of RD. Observations made from post-mortem histopathological examination of dyslexic brains reporting anatomical abnormalities, such as cortical ectopias, heterotopias, and cortical dysplasia, reinforce the formulation of the hypothesis that RD is a neuronal migration disorder . All these data support a contribution of the disruption of the KIAA0319L gene in the RD of our patient. The identification of KIAA0319L in a group of ADHD-associated genes and pathways suggests that the alteration of transcription, resulting from the deletion of its critical region, could also contribute to the complex NDD of our subject . The NCDN gene encodes neurochondrin (NCDN), a cytoplasmatic neural protein of importance for neural growth, glutamate receptor signaling, and synaptic plasticity. The gnomAD database revealed that the NCDN is predicted to be severely intolerant to haploinsufficiency with a pLI score of 1. Conditional loss of NCDN in mice neural tissue causes depressive-like behaviors, impaired spatial learning, and epileptic seizures . Monoallelic and biallelic variants in NCDN have been reported in six affected individuals with variable degrees of developmental delay (DD), intellectual disability (ID), and epilepsy . Furthermore, heterozygous de novo deletions spanning 1.1 Mb to 3.1 Mb involving NCDN were identified in three individuals with ID and motor and speech delay but not seizures . DD, ID, or epilepsy were absent in our patient who showed impairments in speech, language, and learning, suggesting that NCDN haploinsufficiency was associated to variable clinical features, therefore warranting further investigations for a more precise explanation. TFAP2E is a member of the AP2 family of transcription factors; such proteins bind to and regulate the promoters and enhancers of numerous genes involved in a wide spectrum of physiologic processes during development, cell cycle, and differentiation. PSMB2 encodes a member of the B-type proteasome family, responsible for degradation of short-lived and misfolded cytosolic and nuclear proteins. CLSPN encodes an essential upstream regulator of checkpoint kinase 1 and triggers a checkpoint arrest of the cell cycle in response to replicative stress or DNA damage. This protein is also required for efficient DNA replication during a normal S phase. According to the gnomAD database , TFAP2E , PSMB2 , and CLSPN genes have a pLI score of 0, 0.91, and 0, respectively. No disruption of them has been implicated in the pathogenesis of RD and ADHD.
4.507813
0.650879
sec[4]/p[0]
en
0.999997
36360163
https://doi.org/10.3390/genes13111926
[ "that", "ncdn", "gene", "protein", "adhd", "genes", "this", "neuronal", "migration", "speech" ]
[ { "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": "9A70.Y", "title": "Other specified hereditary corneal dystrophies" }, { "code": "GB81", "title": "Autosomal dominant polycystic kidney disease" }, { "code": "8A02.12", "title": "Dystonia associated with heredodegenerative disorders" }, { "code": "5C50.E0", "title": "Classical organic aciduria" }, { "code": "8E02.0", "title": "Genetic Creutzfeldt-Jakob disease" } ]
=== ICD-11 CODES FOUND === [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS [9A70.Y] Other specified hereditary corneal dystrophies Also known as: Other specified hereditary corneal dystrophies | Epithelial juvenile corneal dystrophy | TGFBI - [transforming growth factor beta-induced] gene | Granular corneal dystrophy | granular-lattice corneal dystrophy Includes: Granular corneal dystrophy [GB81] Autosomal dominant polycystic kidney disease Definition: 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 due to mutations on chromosomes 16 and 4. Non-renal manifestations can include cysts in the liver and less commonly pancreas. Cerebral arterial aneurysms with subarachnoid haemorrhage, and other non-renal vascular abnormalities can also occur. Also known as: Autosomal dominant polycystic kidney disease | adult polycystic kidney disease | Polycystic kidney, adult type | APCKD - [autosomal polycystic kidney disease] | Autosomal dominant polycystic kidney disease type 1 without tuberous sclerosis [8A02.12] Dystonia associated with heredodegenerative disorders Definition: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen. Also known as: Dystonia associated with heredodegenerative disorders | Dystonia due to autosomal dominant disorders | Rapid-onset dystonia-parkinsonism | Dystonia due to dentatorubropallidoluysian atrophy | Dystonia due to Huntington disease [5C50.E0] Classical organic aciduria Definition: This a term used to classify a group of metabolic disorders which disrupt normal amino acid metabolism, particularly branched-chain amino acids, causing a buildup of acids which are usually not present. Also known as: Classical organic aciduria | Methylmalonic aciduria - homocystinuria | Methylmalonic acidaemia - homocystinuria | Methylmalonic aciduria - homocystinuria type cbl C | Methylmalonic acidaemia - homocystinuria type cbl C [8E02.0] Genetic Creutzfeldt-Jakob disease Definition: A disease of the brain, that is associated with a prion. This disease is characterised by neurological deficits, and is fatal. Confirmation is by pathological examination of the brain. Also known as: Genetic Creutzfeldt-Jakob disease | CJD - [Creutzfeldt-Jakob disease] | Creutzfeldt-Jakob | Creutzfeldt-Jakob disease | JCD - [Jakob-Creutzfeldt disease] === GRAPH WALKS === --- Walk 1 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --CHILD--> [8A80.0] Migraine without aura Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu... --- Walk 2 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --CHILD--> [8A80.2] Chronic migraine Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse... --- Walk 3 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 4 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 5 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --PARENT--> [?] Causes of healthcare related harm or injury --- Walk 6 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --PARENT--> [?] Causes of healthcare related harm or injury
[ "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.0] Migraine without aura\n Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu...", "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.2] Chronic migraine\n Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --PARENT--> [?] Causes of healthcare related harm or injury", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --PARENT--> [?] Causes of healthcare related harm or injury" ]
8A80.Z
Migraine, unspecified
[ { "from_icd11": "8A80.Z", "icd10_code": "G43B0", "icd10_title": "Ophthalmoplegic migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43409", "icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A0", "icd10_title": "Cyclical vomiting, in migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D0", "icd10_title": "Abdominal migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43709", "icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A1", "icd10_title": "Cyclical vomiting, in migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43509", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43719", "icd10_title": "Chronic migraine without aura, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43501", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C0", "icd10_title": "Periodic headache syndromes in child or adult, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43401", "icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43419", "icd10_title": "Hemiplegic migraine, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43B1", "icd10_title": "Ophthalmoplegic migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C1", "icd10_title": "Periodic headache syndromes in child or adult, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D1", "icd10_title": "Abdominal migraine, intractable" } ]
G43B0
Ophthalmoplegic migraine, not intractable
A 63-year-old patient was admitted to our department on September 14, 2020, due to an protuberant oesophageal lesion, which was found during a physical examination one week prior. She was in good health in the past and had no apparent medical history. The physical examination showed no positive symptoms. Laboratory tests showed no abnormalities in tumour markers. Upper gastrointestinal endoscopy (OLYMPUS GIF-H290) demonstrated a smooth eminence with a normal oesophageal epithelium in the oesophagus 23 cm away from the incisor . Endoscopic ultrasound (OLYMPUS GF-UE260) indicated that an apparent bell mouth could be seen in the submucosa, which is a sign of the origin of the disease. This suggested that the lesion might be derived from the submucosal layer . Two hypoechoic masses of approximately 1.5*1.5 cm and 1.1*1.0 cm with uniform echoes and clear boundaries could be seen in the mediastinum . Chest CT revealed thickening of the oesophageal wall, and small lymph nodes were seen in the bilateral tracheoesophageal groove with a short diameter of approximately 0.8 cm. Combined with white light endoscopy and endoscopic ultrasound, we thought that the lesion might have originated from the submucosa. Therefore, we did not perform an endoscopic biopsy. After multidisciplinary consultation, endoscopic lesion resection (ESD) was recommended to further define the diagnosis and treatment. On October 14, ESD was performed to completely resect the lesion, and the specimen was sent for examination. The pathological results suggested that heterotypic cells were distributed in nests among proliferative lymphoid tissues in the submucosa. The epithelial layer was intact, and there was no involvement of cancer cells. Cancer cells were visible in the submucosa . The immunohistochemistry results demonstrated staining for cytokeratin (CK5), AE1/AE3 , P40 and P63 , and approximately 80% of the cells were positive for Ki67. Among them, AE1/AE3 positivity was consistent with epithelial carcinoma, while positive staining for CK5, P40 and P63 was in line with squamous cell carcinoma. Furthermore, staining for CD3, CD20, CGA, and Syn was negative, which excluded the possibility of neuroendocrine tumours, lymphoma, etc. These abnormal cells were consistent with poorly differentiated squamous cell carcinoma. Then, the PET scan provided clearer results, revealing 0.5–1.6 cm enlarged lymph nodes in the bilateral tracheoesophageal groove and the right side of the main trachea, with hypermetabolism and an SUVmax of 13.67. This result suggested malignant metastasis of the lymph nodes . The final clinical diagnosis of this patient was submucosal oesophageal squamous cell carcinoma with lymph node metastasis. Then, the patient started chemoradiotherapy. We followed up with the patient regularly. Two months after the start of radiotherapy and chemotherapy, the patient consciously developed nodular masses in the neck. CT examination showed that the enlarged lymph nodes in the bilateral tracheoesophageal groove were significantly reduced. Cervical colour Doppler ultrasound showed that new swollen lymph nodes appeared in the neck, which were considered metastases. The patient continued to receive treatment. At present, nearly 1 year after surgery, chest CT showed that the mediastinal lymph nodes continued to shrink. Neck CT showed no swelling of neck lymph nodes, and there were no obvious abnormalities in tumour markers or abdominal CT. Oesophagography showed that there was no sign of recurrence after surgery. Fig. 1 Upper gastrointestinal endoscopy in our case: a White light endoscopy shows a 1.5*0.6 cm lesion covered by smooth, normal mucosa; b EUS indicates well-defined, slightly heterogeneous, and hypoechoic lesions that might have originated from the submucosal layer; c two hypoechoic masses of approximately 1.5*1.5 cm and 1.1*1.0 cm in the mediastinum, with uniform echoes and clear boundaries, which were considered to be enlarged lymph nodes; d lesion specimen removed by ESD Fig. 2 Histopathological examination: a heterotypic cells could be seen in the submucosa hyperplastic lymphoid tissue, with nest infiltration and growth. The nuclear atypia is obvious, and the nuclear division is easy to see. Its epithelial layer was intact. However, the classification is still unclear; b positive immunohistochemical staining for AE1/AE3, in accordance with epithelial carcinoma; c positive immunohistochemical staining for P40, consistent with squamous cell carcinoma; d positive immunohistochemical staining for P63, in line with squamous cell carcinoma Fig. 3 PET scan images showed a hypermetabolic lesion in the bilateral tracheoesophageal groove with an SUVmax of 13.67, which indicated the metastasis of lymph nodes
4.117188
0.971191
sec[1]/p[0]
en
0.999999
35240995
https://doi.org/10.1186/s12876-022-02169-1
[ "lymph", "that", "nodes", "lesion", "carcinoma", "which", "cells", "staining", "submucosa", "squamous" ]
[ { "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": "8A80.Z", "title": "Migraine, unspecified" }, { "code": "QA76", "title": "Medication or substance that is known to be an allergen without injury or harm" }, { "code": "PL13.6", "title": "Medication or substance that is known to be an allergen, as mode of injury or harm" }, { "code": "9C40.A0", "title": "Papilloedema" }, { "code": "PA6Z", "title": "Unintentional fall from unspecified height" } ]
=== ICD-11 CODES FOUND === [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 [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS === GRAPH WALKS === --- Walk 1 --- [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.... --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 3 --- [BD90.Z] Lymphadenitis, unspecified --PARENT--> [BD90] Lymphadenitis --CHILD--> [BD90.1] Nonspecific mesenteric lymphadenitis --- Walk 4 --- [BD90.Z] Lymphadenitis, unspecified --PARENT--> [BD90] Lymphadenitis --CHILD--> [BD90.1] Nonspecific mesenteric lymphadenitis --- Walk 5 --- [BD90.Y] Other specified lymphadenitis --PARENT--> [BD90] Lymphadenitis --CHILD--> [BD90.1] Nonspecific mesenteric lymphadenitis --- Walk 6 --- [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....
[ "[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 --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....", "[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --CHILD--> [BD90.1] Nonspecific mesenteric lymphadenitis", "[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --CHILD--> [BD90.1] Nonspecific mesenteric lymphadenitis", "[BD90.Y] Other specified lymphadenitis\n --PARENT--> [BD90] Lymphadenitis\n --CHILD--> [BD90.1] Nonspecific mesenteric lymphadenitis", "[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...." ]
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": "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" } ]
I898
Other specified noninfective disorders of lymphatic vessels and lymph nodes
A 4-year-old boy was admitted to our hospital with a history of uncontrolled seizure for nearly 1 year and behavioral change for 2 weeks. The earliest episodes were shown as behavior arrest and blank stare for 5 to 10 s in a frequency of 1–2 times every month. The seizures were infrequent and inconspicuous so they did not cause attention or further treatment at first. 6 months later, changes in semiology and frequency of the seizures were noticed by the parents. They reported one form of episode manifested as behavior arrest during the play or suddenly sit-up during sleep accompanied by a blank stare and drooling with no awareness or responsiveness. Soon after, they found another form of episode manifested as focal tonic–clonic seizures involving the right limbs. Each seizure episode lasted for 30 s to 2 min. He suffered from an increasing frequency of these seizure episodes. He was diagnosed with epilepsy and got started on valproic acid and titrated to a dose of 250 mg twice daily with a weight of 20 Kg. The episodes did not decrease and oxcarbazepine was added. Despite increasing the dose of oxcarbazepine to 450 mg twice daily, he continued to suffer recurrent seizures along with progressive behavioral changes and cognitive impairment for which he was transferred to our hospital for further diagnosis and treatment. On admission, he presented a bad temper of irritability and aggressiveness, showed little interest in toys, and seldom responded to questions. No faciobrachial dystonic seizures were observed. No other abnormal signs were found with a fundamental nervous system examination. Neuropsychological tests revealed global cognitive impairment, especially in memory and executive functions. Before his hospitalization, he had taken the whole exon sequencing test and found no corresponding variation. He also received the tandem mass spectrometry test in blood and gas chromatography mass spectrometry test in urine which ruled out inherited metabolic diseases. EEG showed a slow background activity of 5 ~ 6 Hz and epileptic charges involving bilateral frontal and temporal area, which was more severe in the left hemisphere, as shown in Figure 2 . MRI of brain showed mild atrophy on the cortex of left hemisphere, especially frontal and temporal lobes, as shown in Figure 3 . No abnormal signal was found in bilateral hippocampus. Routine blood test, viral and bacterial tests, blood ammonia, lactate, homocysteine and urine analysis all showed negative results. CSF tests showed white blood cell count of 4 cells per mm 3 . As for the tests of neural antibodies, anti-LGI1-IgG was detected at a titer of 1:100 in serum and 1:1 in CSF. The other tested antibodies against NMDA receptor, AMPAR1, AMPAR2, CASPR2, GABAB receptor and thyroid antigens were all negative. Tomography scan of thorax and abdomen were negative for tumor. Before we received all related results and made the final diagnosis, we added the third ASM—lacosamide with a titration dose of 100 mg twice daily—to control the seizure but got no significant effect. With a corrected diagnosis of anti-LGI1-encephalitis, the boy was treated with intravenous immunoglobulin with a total dose of 2 g/kg over 4 days and intravenous methylprednisolone with a regimen of 15 mg/kg/d for 3 days with a four-day interval and 3 consecutive rounds in total. The seizure episodes were cut down from more than 10 times daily to 1 ~ 2 times daily, and his behavior, memory and language started improving. Yet not all symptoms were completely controlled. We escalated the treatment into rituximab (375 mg/m 2 BSA for 4 weeks) plus monthly intravenous immunoglobulin (2 g/kg/round for 5 months) while oral prednisolone was tapered for 6 months. All the symptoms got alleviated gradually but not completely. During immunotherapy, the behavior change disappeared and cognition improved while the seizures gradually decreased to 2 or 3 times per month. Unfortunately, 5 months after receiving rituximab, the seizures gradually became more and more frequent without obvious signs of encephalopathy. A detailed reevaluation revealed no positive findings. The serum anti-LGI1-IgG became negative and brain MRI did not show further atrophy, as shown in Figure 3 . The B lymphocyte count remained at 0. The addition of oral azathioprine was rejected by the parents who only accepted the adjustment of ASMs. Gradually adjusting the ASMs regimen, his condition is controlled at a relatively stable level. At the most recent follow-up, 41 months after disease onset, he is still taking valproic acid, carbamazepine, lacosamide, and clonazepam, and the seizures occur once or twice daily. He has mild to moderate intellectual disability and is currently in a special education school.
4.117188
0.974609
sec[2]/sec[1]/p[0]
en
0.999996
PMC10169679
https://doi.org/10.3389/fnins.2023.1151430
[ "seizures", "daily", "seizure", "episodes", "shown", "behavior", "times", "twice", "blood", "gradually" ]
[ { "code": "8A68.Z", "title": "Type of seizure, unspecified" }, { "code": "8A6Z", "title": "Epilepsy or seizures, unspecified" }, { "code": "8A63.Y", "title": "Seizure due to other acute cause" }, { "code": "8A67", "title": "Acute repetitive seizures" }, { "code": "8A68.Y", "title": "Other specified type of seizure" }, { "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": "MD11.1", "title": "Asphyxia" }, { "code": "AB31.Z", "title": "Episodic vestibular syndrome, unspecified" } ]
=== ICD-11 CODES FOUND === [8A68.Z] Type of seizure, unspecified Also known as: Type of seizure, unspecified | Types of seizures | uncontrolled seizures | Seizure NOS | fits NOS [8A6Z] Epilepsy or seizures, unspecified Also known as: Epilepsy or seizures, unspecified | Cerebral seizures | Seizure disorder | seizure disorder, so described | epilepsy NOS [8A63.Y] Seizure due to other acute cause Also known as: Seizure due to other acute cause | Seizures due to immune disorders | Seizures due to medications | Toxic syndrome with generalised seizures, drug related | Acute seizures due to central nervous system infections or infestations [8A67] Acute repetitive seizures Definition: Acute repetitive seizures are multiple seizures, with a distinct time of onset, with recovery between each seizure, occurring within 24 hours in adults, or 12 hours in children. Also known as: Acute repetitive seizures | complex partial status epilepticus | Cluster seizures | Serial seizures | Recurrent seizures [8A68.Y] Other specified type of seizure Also known as: Other specified type of seizure | Absence episode | Absence seizure episode | Pseudotetanus | Clonic seizure disorder [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 [MD11.1] Asphyxia Definition: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all the conditions generating impaired or impeded breathing. Also known as: Asphyxia | pathological asphyxia | decreased oxygen supply | oxygen deficiency | positional asphyxia Excludes: asphyxia due to foreign body in respiratory tract | asphyxia due to carbon monoxide | asphyxia due to traumatic [AB31.Z] Episodic vestibular syndrome, unspecified Also known as: Episodic vestibular syndrome, unspecified | Episodic vestibular syndrome === GRAPH WALKS === --- Walk 1 --- [8A68.Z] Type of seizure, unspecified --PARENT--> [8A68] Types of seizures --EXCLUDES--> [?] Neonatal seizures Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn.... --- Walk 2 --- [8A68.Z] Type of seizure, unspecified --PARENT--> [8A68] Types of seizures --CHILD--> [8A68.0] Focal unaware seizure Def: Previously termed “complex partial seizures”, define seizures originating within networks limited to one hemisphere and accompanied by loss of awareness (i.e., knowledge of self or environment).... --- Walk 3 --- [8A6Z] Epilepsy or seizures, unspecified --PARENT--> [?] Epilepsy or seizures Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart.... --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 4 --- [8A6Z] Epilepsy or seizures, unspecified --PARENT--> [?] Epilepsy or seizures Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart.... --CHILD--> [8A62] Epileptic encephalopathies Def: Epilepsies for which no clear etiology can be detected or occurring at the presence of two or more static structural or metabolic conditions increasing the risk for epileptic seizures. The epileptic a... --- Walk 5 --- [8A63.Y] Seizure due to other acute cause --PARENT--> [8A63] Seizure due to acute causes Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult.... --CHILD--> [8A63.Y] Seizure due to other acute cause --- Walk 6 --- [8A63.Y] Seizure due to other acute cause --PARENT--> [8A63] Seizure due to acute causes Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult.... --CHILD--> [8A63.Z] Seizure due to unspecified acute cause
[ "[8A68.Z] Type of seizure, unspecified\n --PARENT--> [8A68] Types of seizures\n --EXCLUDES--> [?] Neonatal seizures\n Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn....", "[8A68.Z] Type of seizure, unspecified\n --PARENT--> [8A68] Types of seizures\n --CHILD--> [8A68.0] Focal unaware seizure\n Def: Previously termed “complex partial seizures”, define seizures originating within networks limited to one hemisphere and accompanied by loss of awareness (i.e., knowledge of self or environment)....", "[8A6Z] Epilepsy or seizures, unspecified\n --PARENT--> [?] Epilepsy or seizures\n Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart....\n --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....", "[8A6Z] Epilepsy or seizures, unspecified\n --PARENT--> [?] Epilepsy or seizures\n Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart....\n --CHILD--> [8A62] Epileptic encephalopathies\n Def: Epilepsies for which no clear etiology can be detected or occurring at the presence of two or more static structural or metabolic conditions increasing the risk for epileptic seizures. The epileptic a...", "[8A63.Y] Seizure due to other acute cause\n --PARENT--> [8A63] Seizure due to acute causes\n Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult....\n --CHILD--> [8A63.Y] Seizure due to other acute cause", "[8A63.Y] Seizure due to other acute cause\n --PARENT--> [8A63] Seizure due to acute causes\n Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult....\n --CHILD--> [8A63.Z] Seizure due to unspecified acute cause" ]
8A68.Z
Type of seizure, unspecified
[ { "from_icd11": "8A68.Z", "icd10_code": "R561", "icd10_title": "Post traumatic seizures" }, { "from_icd11": "8A68.Z", "icd10_code": "R569", "icd10_title": "Unspecified convulsions" }, { "from_icd11": "8A68.Z", "icd10_code": "R56", "icd10_title": "Convulsions, not elsewhere classified" }, { "from_icd11": "8A68.Z", "icd10_code": "R568", "icd10_title": "" }, { "from_icd11": "8A6Z", "icd10_code": "G40A09", "icd10_title": "Absence epileptic syndrome, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40B09", "icd10_title": "Juvenile myoclonic epilepsy, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40B19", "icd10_title": "Juvenile myoclonic epilepsy, intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A19", "icd10_title": "Absence epileptic syndrome, intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A11", "icd10_title": "Absence epileptic syndrome, intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A01", "icd10_title": "Absence epileptic syndrome, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40409", "icd10_title": "Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40802", "icd10_title": "Other epilepsy, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40801", "icd10_title": "Other epilepsy, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40901", "icd10_title": "Epilepsy, unspecified, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G4089", "icd10_title": "Other seizures" } ]
R561
Post traumatic seizures
We report a case of unusual kidney biopsy findings with systemic involvement of AAV in an older patient who had recently been treated for cerebral infarction. AAV with severe interstitial plasma cell infiltration without underlying plasma‐cell proliferative disease or IgG4‐associated disease is very rare. In addition, unlike previous cases, this case presented with the clinical features of active vasculitis, such as serological assessment (ANCA testing), fever, cutaneous lesions, and pulmonary fibrosis. Masuzawa et al described 20 cases of ANCA glomerulonephritis (GN) focusing on plasma cell infiltration. They suggested that plasma cell infiltration in the tubulointerstitium might be associated with an early period of renal inflammation. However, they did not show an association between the plasma cell ratio and the kidney prognosis. 4 Several cases with severe tubulointerstitial injury, as compared to glomerular lesions in ANCA‐GN, have been reported, most of which improved renal function. 5 , 6 , 7 Interestingly, some studies have reported transformation from tubulointerstitial nephritis to crescentic glomerulonephritis in patients with ANCA‐GN. These findings suggest that tubulointerstitial injury in ANCA‐GN, particularly plasma cell infiltration, might be the early, acute lesion. Also, kidney prognosis improves if the disease is found early and treated adequately and quickly. The pathogenesis of AAV is currently not fully understood, but ANCA IgG is considered a major pathogenic factor. 3 , 8 , 9 ANCAs are autoantibodies with epitope specificity against antigens present in the cytoplasm of neutrophils and monocytes. The formation of MPO and PR3‐ANCA might depend on various predisposing factors such as a microbial infection ( Staphylococcus aureus or Escherichia coli infection), genetic factors (PR3‐ANCA with human leukocyte antigen [HLA]‐DP, or MPO‐ANCA with HLA‐DQ), environmental factors (silica), and therapeutic drugs (propylthiouracil). 10 Primed neutrophils activated by MPO, and PR3‐ANCA lead to degranulation, which releases the contents of the cytoplasmic granules into the surrounding tissues. This process also results in the production of reactive oxygen radicals (RORs), and the release of the granular proteins and the RORs cause tissue injury. 11 The degranulated neutrophils ultimately die by apoptosis and necrosis. In addition, activation and degranulation of a large number of neutrophils lead to their accumulation and damage to the vessel wall. Leakage of serum proteins and the formation of fibrin give rise to fibrinoid necrosis. 10 The stimulation of neutrophils by ANCA causes the release of factors that activate complement via an alternative pathway, which could aggravate AAV. 12 A previous study on B‐cell immunity and AAV reported that the B‐cell autoimmune response be facilitated by impaired T‐ and B‐cell regulation and by B‐cell–stimulating factors released by activated neutrophils. 13 Interestingly, our case, diagnosed with AAV and severe interstitial plasma cell infiltration and fibrinoid necrosis of the vessels, supported a previous study 14 regarding the contributions of B cells and plasma cells to ANCA vasculitis. Rituximab has been approved as an AAV therapy, and previous studies have reported that bortezomib inhibits anti‐MPO–mediated necrotizing MPO‐specific plasma cells in the spleen and BM. 14 , 15 The possibility of applying AAV therapies (either rituximab or bortezomib) has been suggested, as there are many plasma cells to target. Our case infers an association between B‐cell immunity and AAV, but we could not prove this speculation. Therefore, further research on the involvement of B‐cell immunity and the process of renal injury resulting from ANCA is needed. Ischemic cerebral infarction caused by AAV is rare and is typically resistant to antiplatelet therapy but tends to recur without proper immunosuppressive therapy. 16 Although stroke in our case was due to an intracranial artery occlusion separate from AAV, AAV can cause neurological manifestations including stroke. Thus, clinicians should consider AAV as cause of acute kidney injury with neurological symptoms. The strength of our study was the unusual histopathological findings of renal involvement of AAV. Based on these results, we deduced various mechanisms of damage to kidney tissue by ANCA. However, the limitation of our study is that we reported only one case, and there was no histopathological confirmation of involvement by other organs in either case. Although we could not obtain the histopathological diagnosis of other organs, we diagnosed this case as AAV by clinical, serological assessment (ANCA testing), and histopathological findings of vascular injury on a renal biopsy.
4.351563
0.89502
sec[2]/p[0]
en
0.999997
33363836
https://doi.org/10.1002/ccr3.3277
[ "anca", "cell", "plasma", "that", "injury", "neutrophils", "kidney", "infiltration", "renal", "factors" ]
[ { "code": "4A44.AZ", "title": "Antineutrophil cytoplasmic antibody-associated vasculitis, 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" }, { "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" } ]
=== ICD-11 CODES FOUND === [4A44.AZ] Antineutrophil cytoplasmic antibody-associated vasculitis, unspecified Also known as: Antineutrophil cytoplasmic antibody-associated vasculitis, unspecified | Antineutrophil cytoplasmic antibody-associated vasculitis | ANCA - [Antineutrophil cytoplasmic antibodies] associated vasculitis | ANCA [Antineutrophil cytoplasmic antibodies] positive vasculitis [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 [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 === GRAPH WALKS === --- Walk 1 --- [4A44.AZ] Antineutrophil cytoplasmic antibody-associated vasculitis, unspecified --PARENT--> [4A44.A] Antineutrophil cytoplasmic antibody-associated vasculitis Def: Necrotizing vasculitis, with few or no immune deposits, predominantly affecting small vessels (i.e., capillaries, venules, arterioles and small arteries), associated with MPO-ANCA or PR3-ANCA. Not all... --CHILD--> [4A44.A0] Microscopic polyangiitis Def: Necrotizing vasculitis, with few or no immune deposits, predominantly affecting small vessels (i.e., capillaries, venules, or arterioles). Necrotizing arteritis involving small and medium sized arteri... --- Walk 2 --- [4A44.AZ] Antineutrophil cytoplasmic antibody-associated vasculitis, unspecified --PARENT--> [4A44.A] Antineutrophil cytoplasmic antibody-associated vasculitis Def: Necrotizing vasculitis, with few or no immune deposits, predominantly affecting small vessels (i.e., capillaries, venules, arterioles and small arteries), associated with MPO-ANCA or PR3-ANCA. Not all... --CHILD--> [4A44.A2] Eosinophilic granulomatosis with polyangiitis Def: Eosinophil-rich and necrotizing granulomatous inflammation often involving the respiratory tract, and necrotizing vasculitis predominantly affecting small to medium-sized vessels, and associated with ... --- Walk 3 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --EXCLUDES--> [?] Clinical findings on antenatal screening of mother Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother.... --- Walk 4 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --CHILD--> [MF92] Chyluria Def: Chyluria, also called chylous urine, is a medical condition involving the presence of chyle in the urine stream, which results in urine appearing milky white.... --- Walk 5 --- [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 6 --- [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...
[ "[4A44.AZ] Antineutrophil cytoplasmic antibody-associated vasculitis, unspecified\n --PARENT--> [4A44.A] Antineutrophil cytoplasmic antibody-associated vasculitis\n Def: Necrotizing vasculitis, with few or no immune deposits, predominantly affecting small vessels (i.e., capillaries, venules, arterioles and small arteries), associated with MPO-ANCA or PR3-ANCA. Not all...\n --CHILD--> [4A44.A0] Microscopic polyangiitis\n Def: Necrotizing vasculitis, with few or no immune deposits, predominantly affecting small vessels (i.e., capillaries, venules, or arterioles). Necrotizing arteritis involving small and medium sized arteri...", "[4A44.AZ] Antineutrophil cytoplasmic antibody-associated vasculitis, unspecified\n --PARENT--> [4A44.A] Antineutrophil cytoplasmic antibody-associated vasculitis\n Def: Necrotizing vasculitis, with few or no immune deposits, predominantly affecting small vessels (i.e., capillaries, venules, arterioles and small arteries), associated with MPO-ANCA or PR3-ANCA. Not all...\n --CHILD--> [4A44.A2] Eosinophilic granulomatosis with polyangiitis\n Def: Eosinophil-rich and necrotizing granulomatous inflammation often involving the respiratory tract, and necrotizing vasculitis predominantly affecting small to medium-sized vessels, and associated with ...", "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....", "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --CHILD--> [MF92] Chyluria\n Def: Chyluria, also called chylous urine, is a medical condition involving the presence of chyle in the urine stream, which results in urine appearing milky white....", "[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..." ]
4A44.AZ
Antineutrophil cytoplasmic antibody-associated vasculitis, unspecified
[ { "from_icd11": "4A44.AZ", "icd10_code": "I776", "icd10_title": "Arteritis, unspecified" }, { "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": "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" } ]
I776
Arteritis, unspecified
Here, we describe a bloodstream infection with P. straminea in an elderly woman that most likely developed from a skin and soft tissue infection . The patient suffered from a range of chronic diseases affecting the skin including allergies, atopic dermatitis, psoriasis, and chronic venous insufficiency, all of which are associated with an increased susceptibility to bacterial, viral, and fungal infections . Other common causes of systemic infection such as pneumonia and urogenital infections were considered unlikely based on clinical examination and a lung X-ray taken at admission in the ED. The cellulitis was, therefore, considered the plausible cause for the symptoms that indicated a systemic infection. The putrid ulceration on the right hand was considered a likely point of entry because P. straminea was isolated from this site as well as from the bloodstream. After the isolation and identification of P. straminea , the antibiotic regimen was changed to ceftazidime, as recommended for the treatment of infection with Pseudomonas spp., followed by a swift and complete recovery of the patient concerning her infection. Follow-up blood cultures remained sterile and were performed to monitor restitution and rule out a biofilm-associated infection (e.g., in the CVC) and to differentiate between CVC infection and soft tissue infection. However, since they were taken during antimicrobial treatment with ceftazidime and no peripheral puncture was possible to compare peripheral and CVC blood culture time to positivity, they have to be interpreted with caution and only in the light of clinical restitution. The Enterococcus isolate was only isolated from the ulcer and was considered not clinically relevant, rather only colonizing the site. The patient fully recovered. Overall, P. straminea was reported from two independent sites. The clinical presentation of the ulcer alongside the therapeutic success of ceftazidime in contrast to clindamycin, which is not effective against Pseudomonas spp., makes an invasive P. straminea infection from a soft tissue focus the likely diagnosis. In contrast, a 16S rDNA sequencing-based analysis sorted P. straminea in a phylogenetic group with environmental Pseudomonas species that have not been reported to cause any infections. The apathogenic nature of P. straminea was underscored by the results from the G. mellonella infection model, a model used to investigate the virulence of bacteria . In that model, we demonstrated the absence of any detrimental effects of injections with P. straminea with respect to the survival of the larvae. Almost all dilutions of P. straminea equaled the germ-free PBS injection in contrast to injections with P. aeruginosa . However, the patient provided susceptibility to a bacterial soft tissue infection with skin barrier dysfunctions caused by her chronic and severe skin diseases and immune system, which should be considered impaired . The immunocompromised condition overall may facilitate the development of septicemia from a wound source. This case demonstrates how unusual bacteria that are considered non-pathogenic may cause serious complications in geriatric patients with chronic dermatologic diseases like atopic dermatitis and psoriasis. The correct identification of such pathogens may sometimes be difficult with standard microbiological techniques, as demonstrated here by the unsatisfying results from the VITEK-System. We, therefore, correlated our identification from clinical routine with a molecular analysis based on 16S rDNA gene sequencing. After PCR and clipping of primer sequences, in a 1426-base-pairs-long DNA fragment, a BLAST search against NCBI GenBank identified a 99.1% identity to P. straminea entries . However, the number of reference genomes in such a rare species is relatively low and the method could still be too imprecise for definite discrimination, especially with respect to related species from the recently proposed P. straminea clade or other Pseudomonas spp. that were described previously to have high similarity with P. straminea . Two candidates from these studies ( Pseudomonas fulva and P. flavescens ) were also among the possible results from the BLAST search. However, the consistent P. straminea score from mass spectrometry with various repetitions from both isolation sites correlated with 16S rDNA sequencing. A recent study confirmed the good performance of MALDI-TOF with updated databases compared to 16S rDNA sequencing with respect to the identification at the species level in environmental Pseudomonas spp. . Overall, the scarce data from environmental pathogens of low clinical importance complicate definite identification, and multiple techniques should be used for identification.
4.324219
0.59668
sec[3]/p[0]
en
0.999997
39195004
https://doi.org/10.3390/idr16040053
[ "straminea", "infection", "that", "considered", "identification", "pseudomonas", "skin", "soft", "tissue", "however" ]
[ { "code": "1H0Z", "title": "Infection, unspecified" }, { "code": "1G40", "title": "Sepsis without septic shock" }, { "code": "FA10.Z", "title": "Direct infections of joint, unspecified" }, { "code": "1D9Z", "title": "Unspecified viral infection of unspecified site" }, { "code": "1A40.Z", "title": "Infectious gastroenteritis or colitis without specification of infectious agent" }, { "code": "8A80.Z", "title": "Migraine, unspecified" }, { "code": "QA76", "title": "Medication or substance that is known to be an allergen without injury or harm" }, { "code": "PL13.6", "title": "Medication or substance that is known to be an allergen, as mode of injury or harm" }, { "code": "9C40.A0", "title": "Papilloedema" }, { "code": "PA6Z", "title": "Unintentional fall from unspecified height" } ]
=== ICD-11 CODES FOUND === [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] [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS === GRAPH WALKS === --- Walk 1 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --RELATED_TO--> [?] Infections of the fetus or newborn --- Walk 2 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --RELATED_TO--> [?] 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 ... --- Walk 3 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --PARENT--> [?] Sepsis --EXCLUDES--> [?] Acute or fulminant melioidosis Def: Acute melioidosis typically presents as an acute pneumonia following inhalation or inoculation of the causative bacterium, Burkholderia pseudomallei. This may progress to fulminant septic shock with m... --- Walk 4 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Septicaemia --EXCLUDES--> [?] Sepsis with septic shock Def: Septic shock is a subset of sepsis in which circulatory, cellular and metabolic abnormalities are profound enough to substantially increase mortality.... --- Walk 5 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --EXCLUDES--> [?] Reactive arthropathies Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti... --- Walk 6 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --EXCLUDES--> [?] Postinfectious arthropathies
[ "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --RELATED_TO--> [?] Infections of the fetus or newborn", "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --RELATED_TO--> [?] 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 ...", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --PARENT--> [?] Sepsis\n --EXCLUDES--> [?] Acute or fulminant melioidosis\n Def: Acute melioidosis typically presents as an acute pneumonia following inhalation or inoculation of the causative bacterium, Burkholderia pseudomallei. This may progress to fulminant septic shock with m...", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Septicaemia\n --EXCLUDES--> [?] Sepsis with septic shock\n Def: Septic shock is a subset of sepsis in which circulatory, cellular and metabolic abnormalities are profound enough to substantially increase mortality....", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --EXCLUDES--> [?] Reactive arthropathies\n Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti...", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --EXCLUDES--> [?] Postinfectious arthropathies" ]
1H0Z
Infection, unspecified
[ { "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" }, { "from_icd11": "1H0Z", "icd10_code": "I", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B90-B94", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B94", "icd10_title": "Sequelae of other and unspecified infectious and parasitic diseases" } ]
B999
Unspecified infectious disease
Severe hypercalcemia was diagnosed as the cause of the clinical signs and iCa levels were measured serially with a blood gas analyzer for monitoring during hypercalcemia treatment. The patient was treated using fluid therapy (0.9% normal saline), furosemide (Dailix, Sinil Pharmaceutical, Republic of Korea), pamidronate (2 mg/kg in 100 ml 0.9% normal saline) for 2 h constant rate infusion (CRI) (Panorin, Hanlim Pharmaceutical, Seoul, Republic of Korea), and sodium bicarbonate 4 mEq/kg slow intravenous (IV) administration (Daewon Pharmaceutical, Seoul, Republic of Korea). Five hours later, systemic hypertension occurred (systemic blood pressure > 200 mmHg), and monitoring was continued using the Doppler method after administering hydralazine 0.5 mg/kg IV (Samjin Pharmaceutical, Seoul, Republic of Korea) and nitroprusside 0.5 µg/kg/min CRI (Nitropress, Pfizer, USA). Intermittent tremors occurred during treatment. On day 1, iCa level decreased to 1.75 mmol/L (reference range, 1.12–1.4 mmol/L) in the morning, and then increased to 2.24 mmol/L in the night; however, as systemic hypertension continued, amlodipine 0.2 mg/kg bid (Myungmoon Pharmaceutical, Seoul, Republic of Korea) was added. As azotemia worsened and hyperphosphatemia developed, aluminum hydroxide 30 mg/kg bid (Gelusam, Samnam Pharmaceutical, Seoul, Republic of Korea), lanthanum carbonate 30 mg/kg bid (Fosrenol, Shire, USA), and sevelamer 30 mg/kg bid (Invela, SK Chemicals, Seoul, Republic of Korea) were started. On day 3, calcitonin 4 IU/kg sc bid was added to reduce the iCa level (1.98 mmol/L, reference range, 1.12–1.4 mmol/L). Nitroprusside treatment was discontinued to prevent cyanide toxicity. On day 7, furosemide was discontinued because azotemia and hyperphosphatemia did not improve. On day 8, after discontinuing furosemide, hypercalcemia slightly worsened, and hence, the calcitonin dose was increased to 6 IU/kg tid (Miacalcic, Novartis). On day 10, hypercalcemia still did not improve, but the patient was discharged at the owner’s request. At discharge, the patient was prescribed oral administration of cyclosporin 5 mg/kg bid, amlodipine 0.4 mg/kg bid, famotidine 1 mg/kg bid, maropitant 1 mg/kg sid (Cerenia, Zoetis, USA), tramadol 4 mg/kg bid (Shinpoong Pharmaceutical, Seoul, Republic of Korea), silymarin 20 mg/kg bid, ursodeoxycholic acid 20 mg/kg bid, Zentonil® 100 mg/dog sid, aluminum hydroxide 30 mg/kg bid, lanthanum carbonate 30 mg/kg bid, and sevelamer 30 mg/kg bid. On day 14, the patient still had partial anorexia and depression, but had normocalcemia and slightly improved calcinosis cutis. However, azotemia worsened and CKD reached IRIS stage 4. The owner still refused critical care and wanted home care using subcutaneous fluid therapy. IMHA did not recur, and hence, the cyclosporin dose was reduced to 2 mg/kg bid. Moreover, as normal blood pressure was maintained, the amlodipine dose was reduced to 0.2 mg/kg bid. The other treatments remained unchanged. On day 20, the patient showed persistent anorexia and lethargy, without other symptoms. Calcinosis cutis had improved more than 5 days before, but hypocalcemia occurred (0.83 mmol/L, reference range, 1.12–1.4 mmol/L). The owner refused any additional treatment but wanted to maintain monitoring. Therefore, calcium supplementation was not initiated. Blood pressure remained normal, and hence, the amlodipine dose was reduced to 0.1 mg/kg bid. On day 27, the clinical signs were similar, and the iCa level (0.85 mmol/L, reference range, 1.12–1.4 mmol/L)was still low. However, azotemia improved slightly and the blood pressure remained normal; hence, amlodipine was discontinued. On day 42, the patient presented with lateral recumbency and labored breathing. Non-regenerative anemia (PCV 26.4%, reference rage 37.1–57%; reticulocyte count 10/µL, reference range 0–60/µL; MCV 60.3 fl., reference range 58.8–71.2 fl.; MCH 20.4 pg, reference range 20.5–24.2 pg; MCHC 33.8 g/dl, reference range 31–36.2 g/dl) due to CKD had aggravated, and azotemia had worsened. The iCa level (0.62 mmol/L, reference range, 1.12–1.4 mmol/L) decreased further, and hence, the jaw tone increased and forelimb stiffness was observed. Although 10% Ca gluconate 1.2–1.5 ml/kg/h CRI (Daihan Pharmaceutical, Seoul, Republic of Korea) was performed, cardiopulmonary arrest occurred. We performed cardiopulmonary resuscitation, and the patient was resuscitated, but vital signs remained unstable, and the mental status remained unclear with no obvious improvement. Finally, euthanasia was performed at the owner’s request. Propofol 0.6 mg/kg iv (Provive 1%, Pharmbio Korea Inc., Republic of Korea) and T 61 ad us. vet. 0.3 ml/kg iv (Korea MSD animal health, Republic of Korea) were used for euthanasia.
3.96875
0.966797
sec[1]/sec[1]/p[0]
en
0.999995
38790012
https://doi.org/10.1186/s12917-024-04030-x
[ "korea", "republic", "mmol", "reference", "range", "pharmaceutical", "seoul", "blood", "amlodipine", "azotemia" ]
[ { "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": "6B22.Z", "title": "Olfactory reference disorder, unspecified" }, { "code": "MB26.03", "title": "Delusion of reference" }, { "code": "6B22.1", "title": "Olfactory reference disorder with poor to absent insight" }, { "code": "4B00.0Z", "title": "Neutropaenia, unspecified" }, { "code": "3B63.1Z", "title": "Acquired thrombocytosis, unspecified" }, { "code": "QA00.6Y", "title": "Other specified examination of eyes or vision" }, { "code": "MA14.1C", "title": "Raised antibody titre" } ]
=== 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 [6B22.Z] Olfactory reference disorder, unspecified Also known as: Olfactory reference disorder, unspecified | Olfactory reference disorder | Delusions of malodour [MB26.03] Delusion of reference Definition: A delusion that events, objects, or other people in the person's immediate environment have a particular and unusual personal significance, usually of a negative or pejorative nature. Also known as: Delusion of reference [6B22.1] Olfactory reference disorder with poor to absent insight Definition: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative explanation for their experience. The lack of insight exhibited by the individual does not vary markedly as a function of anxiety level. Also known as: Olfactory reference disorder with poor to absent insight [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 [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 [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 === 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... --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... --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 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.Y] Other specified persistent proteinuria or albuminuria --- Walk 5 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --CHILD--> [MA18.0Z] Elevated blood glucose level, unspecified --- Walk 6 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --CHILD--> [MA18.0Y] Other specified elevated blood glucose level
[ "[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 --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 --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...", "[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.Y] Other specified persistent proteinuria or albuminuria", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --CHILD--> [MA18.0Z] Elevated blood glucose level, unspecified", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --CHILD--> [MA18.0Y] Other specified elevated blood glucose level" ]
GB42.1
Albuminuria, Grade A3
[ { "from_icd11": "6B22.Z", "icd10_code": "F428", "icd10_title": "Other obsessive-compulsive disorder" }, { "from_icd11": "3B63.1Z", "icd10_code": "D473", "icd10_title": "Essential (hemorrhagic) thrombocythemia" }, { "from_icd11": "MA14.1C", "icd10_code": "R760", "icd10_title": "Raised antibody titer" } ]
F428
Other obsessive-compulsive disorder
A 23-year-old pregnant woman, G2 P1001, was referred to our hospital at 30 + 2 weeks of gestation for detailed ultrasound because of an abnormal mass in the fetal abdomen, suspected to be a gastrointestinal tumor. Her first pregnancy was uneventful, and she gave birth to a term healthy baby weighing 3600 g. The first child was healthy and had normal development. Her current pregnancy course prior to this visit was unremarkable. All basic laboratory tests of antenatal care were within normal limits. At her first antenatal visit, at 20 weeks of gestation, the ultrasound examination performed for fetal anomaly screening revealed no structural abnormalities and normal fetal growth. At 26 weeks of gestation, slightly large-for-date uterine height was suspected by clinical examination. Ultrasound examination showed appropriate fetal size and growth rate. Polyhydramnios with an amniotic fluid index (AFI) of 21 was demonstrated, but no structural abnormality was noted. The follow-up ultrasound scans at 30 weeks of gestation showed progressive polyhydramnios with an AFI of 26 and a solid mass in the fetal abdomen, suspected to be a gastrointestinal tumor. Fetal ultrasound examination at our center demonstrated a live male fetus with appropriate growth, a large left renal tumor, and polyhydramnios with an AFI of 27. The tumor had the following characteristics : located at the left retroperitoneal space of the renal fossa, measured 5.8 × 5.1 × 3.6 cm in diameter, adhered to the left renal parenchyma, solid, rather homogeneous echogenicity similar to that of the renal parenchyma with some areas of low-level echoes, and well-circumscribed and well-demarcated with an echogenic outline, as presented in Figure 1 A. The midline structures, including the great vessels, were displaced to the right side. Color Doppler ultrasound demonstrated strong disorganized vascularization, mainly arising from the left renal artery, as presented in Figure 1 C, and also supported by 3D ultrasound as presented in Figure 1 D. The fetus was in an unstable lie because of polyhydramnios. All other fetal structures, including the left kidney and left adrenal gland, were otherwise normal. No hydropic signs were noted, but hydrocele was clearly demonstrated and probably an early sign of hydrops fetalis. Cardiac function was normal with a myocardial performance index of 0.52 and 0.51 for the left and right sides, respectively. Based on ultrasound findings, the provisional diagnosis was CMN, with differential diagnoses of nephroblastoma (Wilms tumor), rhabdoid tumor, and hamartoma of the kidney. Fetal MRI was not performed since little additional information and no change in management could be expected. A multidisciplinary conference with newborn specialists and pediatric surgeons was held. The plan of management included follow-up ultrasound within 2 weeks to monitor the tumor progression and hydropic signs as well as progressive changes or complications associated with polyhydramnios, fetal surveillance of well-being, and postnatal ultrasound and MRI. At 30 weeks of gestation, the patient had preterm labor. Successful inhibition of preterm labor with nifedipine was achieved, and dexamethasone for promoting lung maturity was given. One week later, at 31 weeks of gestation, the patient developed abdominal discomfort due to polyhydramnios and preterm labor occurred. Amnioreduction was successfully performed. However, labor inhibition failed. External fetal monitoring showed a reassuring fetal status (category 1). Because the fetus was in an unstable (oblique) lie, an emergency cesarean section was performed, leading to the birth of a male newborn weighing 1685 g, with Apgar scores of 8 and 10 at 1 and 5 min, respectively. Neonatal ultrasound and CT scan confirmed the prenatal findings. The baby underwent a left nephrectomy. The findings revealed an enlarged kidney (tumor) with an intact capsule, which measured 10.3 × 7.0 × 7.0 cm. The pathological findings were as follows: Gross pathological findings revealed a 320 g, 10.3 × 7.0 × 7.0 cm left kidney with an attached left ureter and left adrenal gland. The renal capsule was grossly intact. The kidney was bivalved to reveal a large solid mass involving almost the entire kidney. Microscopic pathological examination revealed characteristic findings of congenital mesoblastic nephroma with mixed classic and cellular types. The area of cellular type was corresponding to the gross hemorrhagic area. Tumor necrosis was present. The tumor involved renal sinus soft tissue, perirenal fat, and the pelvicalyceal system. It focally involved part of the adrenal capsule without adrenal parenchymal invasion. All resection margins were free. One hilar lymph node was negative.
4.132813
0.96875
sec[2]/p[0]
en
0.999996
PMC9406745
https://doi.org/10.3390/diagnostics12081951
[ "ultrasound", "fetal", "tumor", "renal", "gestation", "polyhydramnios", "kidney", "well", "adrenal", "labor" ]
[ { "code": "JB07.Z", "title": "Labour or delivery complicated by fetal distress, unspecified" }, { "code": "NE8Y", "title": "Other specified injury or harm arising from surgical or medical care, not elsewhere classified" }, { "code": "JA66.3", "title": "Abnormal ultrasonic finding on antenatal screening of mother" }, { "code": "PK9A.1", "title": "Physical medicine devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices" }, { "code": "QA45.Y", "title": "Other specified antenatal screening" }, { "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" } ]
=== ICD-11 CODES FOUND === [JB07.Z] Labour or delivery complicated by fetal distress, unspecified Also known as: Labour or delivery complicated by fetal distress, unspecified | Labour or delivery complicated by fetal distress | Labour and delivery complicated by fetal stress | fetal distress affecting labour and delivery | Electrocardiographic evidence of fetal distress [NE8Y] Other specified injury or harm arising from surgical or medical care, not elsewhere classified Also known as: Other specified injury or harm arising from surgical or medical care, not elsewhere classified | Other injury or harm from surgical or medical care, not elsewhere classified | Complication of ultrasound therapy | Sequelae of complications of surgical and medical care, not elsewhere classified [JA66.3] Abnormal ultrasonic finding on antenatal screening of mother Definition: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother. Also known as: Abnormal ultrasonic finding on antenatal screening of mother | antenatal ultrasound scan abnormal [PK9A.1] Physical medicine devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices Definition: A physical medicine device was involved in an adverse incident that occurred in a therapeutic (nonsurgical) and rehabilitative task Also known as: Physical medicine devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices | Physical medicine devices associated with adverse incidents, therapeutic ultrasound | Physical medicine devices associated with adverse incidents, chilling or heating units | Physical medicine devices associated with adverse incidents, exercise equipment | Physical medicine devices associated with adverse incidents, massagers [QA45.Y] Other specified antenatal screening Also known as: Other specified antenatal screening | Other antenatal screening based on amniocentesis | antenatal screening using amniocentesis | Antenatal screening for malformations using ultrasound or other physical methods | Antenatal screening for fetal growth retardation using ultrasound or other physical methods [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 === GRAPH WALKS === --- Walk 1 --- [JB07.Z] Labour or delivery complicated by fetal distress, unspecified --PARENT--> [JB07] Labour or delivery complicated by fetal distress --CHILD--> [JB07.1] Labour or delivery complicated by meconium in amniotic fluid Def: A condition characterised by complications during labour and delivery that is caused by meconium in amniotic fluid.... --- Walk 2 --- [JB07.Z] Labour or delivery complicated by fetal distress, unspecified --PARENT--> [JB07] Labour or delivery complicated by fetal distress --CHILD--> [JB07.2] Labour or delivery complicated by biochemical evidence of fetal stress Def: A condition characterised by complications during labour and delivery that is caused by biochemical evidence of fetal distress. Confirmation is by a fetal blood sample from a scalp prick through the o... --- Walk 3 --- [NE8Y] Other specified injury or harm arising from surgical or medical care, not elsewhere classified --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified --EXCLUDES--> [?] Fitting or adjustment of external prosthetic device --- Walk 4 --- [NE8Y] Other specified injury or harm arising from surgical or medical care, not elsewhere classified --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified --RELATED_TO--> [?] Complications of intrauterine procedures, not elsewhere classified Def: A group of conditions characterised as an unfavourable evolution of a condition (complication) due to a health intervention applied inside of the uterus.... --- Walk 5 --- [JA66.3] Abnormal ultrasonic finding on antenatal screening of mother Def: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother.... --PARENT--> [JA66] Clinical findings on antenatal screening of mother Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother.... --CHILD--> [JA66.1] Abnormal biochemical finding on antenatal screening of mother Def: A sign characterised by an abnormality detected by biochemistry during an antenatal screening of the mother.... --- Walk 6 --- [JA66.3] Abnormal ultrasonic finding on antenatal screening of mother Def: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother.... --PARENT--> [JA66] Clinical findings on antenatal screening of mother Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother.... --CHILD--> [JA66.0] Abnormal haematological finding on antenatal screening of mother Def: A sign characterised by an abnormality detected by haematology during an antenatal screening of the mother....
[ "[JB07.Z] Labour or delivery complicated by fetal distress, unspecified\n --PARENT--> [JB07] Labour or delivery complicated by fetal distress\n --CHILD--> [JB07.1] Labour or delivery complicated by meconium in amniotic fluid\n Def: A condition characterised by complications during labour and delivery that is caused by meconium in amniotic fluid....", "[JB07.Z] Labour or delivery complicated by fetal distress, unspecified\n --PARENT--> [JB07] Labour or delivery complicated by fetal distress\n --CHILD--> [JB07.2] Labour or delivery complicated by biochemical evidence of fetal stress\n Def: A condition characterised by complications during labour and delivery that is caused by biochemical evidence of fetal distress. Confirmation is by a fetal blood sample from a scalp prick through the o...", "[NE8Y] Other specified injury or harm arising from surgical or medical care, not elsewhere classified\n --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified\n --EXCLUDES--> [?] Fitting or adjustment of external prosthetic device", "[NE8Y] Other specified injury or harm arising from surgical or medical care, not elsewhere classified\n --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified\n --RELATED_TO--> [?] Complications of intrauterine procedures, not elsewhere classified\n Def: A group of conditions characterised as an unfavourable evolution of a condition (complication) due to a health intervention applied inside of the uterus....", "[JA66.3] Abnormal ultrasonic finding on antenatal screening of mother\n Def: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother....\n --PARENT--> [JA66] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....\n --CHILD--> [JA66.1] Abnormal biochemical finding on antenatal screening of mother\n Def: A sign characterised by an abnormality detected by biochemistry during an antenatal screening of the mother....", "[JA66.3] Abnormal ultrasonic finding on antenatal screening of mother\n Def: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother....\n --PARENT--> [JA66] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....\n --CHILD--> [JA66.0] Abnormal haematological finding on antenatal screening of mother\n Def: A sign characterised by an abnormality detected by haematology during an antenatal screening of the mother...." ]
JB07.Z
Labour or delivery complicated by fetal distress, unspecified
[ { "from_icd11": "JB07.Z", "icd10_code": "O68", "icd10_title": "Labor and delivery complicated by abnormality of fetal acid-base balance" }, { "from_icd11": "JB07.Z", "icd10_code": "O682", "icd10_title": "" }, { "from_icd11": "JB07.Z", "icd10_code": "O688", "icd10_title": "" }, { "from_icd11": "JB07.Z", "icd10_code": "O689", "icd10_title": "" }, { "from_icd11": "JA66.3", "icd10_code": "O283", "icd10_title": "Abnormal ultrasonic finding on antenatal screening of mother" }, { "from_icd11": "JA66.3", "icd10_code": "O283 ", "icd10_title": "" }, { "from_icd11": "PK9A.1", "icd10_code": "Y801", "icd10_title": "Therapeutic (nonsurgical) and rehabilitative physical medicine devices associated with adverse incidents" }, { "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": "" } ]
O68
Labor and delivery complicated by abnormality of fetal acid-base balance
The patient’s daily dose of insulin glargine was increased from 10 to 12 units because of poor glycemic control (X-4 years; HbA1c 7.9%). Nevertheless, he did not obtain good glycemic control in X-3 years (HbA1c 8.2%). His primary physician confirmed negative findings of anti-glutamic acid decarboxylase antibody, C-peptide level of 2.9 ng/mL, and C-peptide index of 1.6. In X-2 years, voglibose 0.2 mg three times daily was added to the present regimen (HbA1c 8.1%). In X year (day 0), he orally received vadadustat 300 mg once daily with a diagnosis of renal anemia (hemoglobin 9.9 g/dL and HbA1c 7.4%). His eGFR was approximately 30 mL/min/1.73 m 2 during the follow-up (Table 1 ). The blood glucose mean (± standard deviation) over the last two weeks (days -14 to -1) was 108 ± 14 mg/dL before breakfast, 122 ± 24 mg/dL before lunch, and 158 ± 39 mg/dL before dinner . The prescribed medications on day 0 were sitagliptin 50 mg once daily, mitiglinide 10 mg three times daily, voglibose 0.2 mg three times daily, insulin glargine injection 12 units once daily, aspirin enteric tablets 100 mg once daily, rosuvastatin 10 mg once daily, esomeprazole 20 mg once daily, furosemide 20 mg once daily, carvedilol 10 mg twice daily, eplerenone 25 mg once daily, perindopril 2 mg once daily, and minodronic acid 50 mg every 4 weeks. There were no significant changes in medication history and lifestyle habits, such as diet and exercise, during treatment with vadadustat. Self-monitoring of blood glucose showed a decreasing tendency on day 18 after the start of vadadustat administration. He developed asymptomatic hypoglycemia on day 23 . The blood glucose level of the concomitant vadadustat period (days 0 to 23) was 94 ± 16 mg/dL before breakfast, 109 ± 20 mg/dL before lunch, and 126 ± 30 mg/dL before dinner . He called his outpatient attending physician and visited the hospital on the same day. This phenomenon was considered to be a result of the drug–drug interaction between sitagliptin and vadadustat via OAT3 inhibition, resulting in an enhanced hypoglycemic effect of sitagliptin and mitiglinide. Table 1 Clinical laboratory data during the treatment of vadadustat Unit Before the initiation of vadadustat (day -49) At the initiation of vadadustat (day 0) At the initiation of daprodustat (day 57) Total protein g/dL 7.2 7.1 7.6 Albumin g/dL 3.9 4.1 4.0 BUN mg/dL 40.4 44.1 43.2 Creatinine mg/dL 1.91 1.79 1.95 eGFR mL/min/1.73m 2 28.0 30.1 27.4 Na meq/L 137 139 136 K meq/L 5.5 5.2 5.8 Cl meq/L 105 105 103 AST U/L 29 26 38 ALT U/L 25 23 38 LDH U/L 214 208 241 γ-GTP U/L 13 12 13 T-Bil mg/dL 0.3 0.4 0.4 Glucose mg/dL 118 130 94 CPK U/L 383 234 262 HDL-c mg/dL 49.2 54.4 48.9 LDL-c mg/dL 53 56 53 HbA1c(NGSP) % 7.4 7.4 7.5 HbF % 1.3 1.3 1.3 White blood cell × 10 3 /μL 6.09 7.34 7.47 Red blood cell × 10 3 /μL 3.26 3.28 3.43 Hemoglobin g/dL 9.8 9.9 10.4 Hematocrit % 30.8 30.8 32.7 MCV fL 94.5 93.9 95.3 MCH pg 30.1 30.2 30.3 MCHC % 31.8 32.1 31.8 Platelet × 10 3 /μL 161 131 152 Abbreviations : BUN blood urea nitrogen, eGFR estimated glomerular filtration rate, Na sodium, K potassium, Cl chloride, AST aspartate aminotransferase, ALT alanine aminotransferase, LDH lactate dehydrogenase, γ-GTP gamma-glutamyl transpeptidase, T-Bil total bilirubin, CPK creatinine phosphokinase, HDL-c high-density lipoprotein-cholesterol, LDL-c low-density lipoprotein-cholesterol, HbA1c (NGSP) hemoglobin A1c (National Glycohemoglobin Standardization Program), HbF fetal hemoglobin, MCV mean corpuscular volume, MCH mean corpuscular hemoglobin, MCHC mean corpuscular hemoglobin concentration Fig. 1 Summary of blood glucose transition and treatment course. The x-axis indicates the number of days and day 0 indicates the day of the initiation of vadadustat. The y-axis indicates fasting blood glucose before breakfast ( a ), before lunch ( b ), and before dinner ( c ). Closed circles show the self-monitoring of blood glucose. Solid lines indicate a blood glucose level of 70 mg/dL, defined as hypoglycemia. On day 23, the patient developed hypoglycemia with a blood glucose level of 67 mg/dL before breakfast. Black, gray, light gray, and white bars represent the period before vadadustat (days -14 to -1), concomitant with vadadustat (days 0 to 23), discontinuation of vadadustat (days 24 to 37), and concomitant with daprodustat (days 57 to 70). Hatched bar represents the period between vadadustat discontinuation and daprodustat initiation (days 38 to 56). Each value represents the blood glucose mean (± standard deviation) during indicated periods. Bars below the graphs represent the administration of hypoglycemic drugs (insulin glargine, mitiglinide, voglibose, sitagliptin, and linagliptin) and HIF-PHD inhibitors (vadadustat and daprodustat)
4.125
0.913086
sec[1]/p[2]
en
0.999996
38072987
https://doi.org/10.1186/s40780-023-00316-8
[ "daily", "vadadustat", "blood", "glucose", "hemoglobin", "mean", "initiation", "breakfast", "sitagliptin", "daprodustat" ]
[ { "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": "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": "5A40.Z", "title": "Intermediate hyperglycaemia, unspecified" }, { "code": "5C61.Y", "title": "Other specified disorders of carbohydrate absorption or transport" } ]
=== 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 [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 [5A40.Z] Intermediate hyperglycaemia, unspecified Also known as: Intermediate hyperglycaemia, unspecified | Intermediate hyperglycaemia | Impaired glucose regulation | prediabetes | latent diabetes [5C61.Y] Other specified disorders of carbohydrate absorption or transport Also known as: Other specified disorders of carbohydrate absorption or transport | Other disorders of intestinal carbohydrate absorption | Glucose malabsorption | Isomaltose malabsorption | Sucrose malabsorption === 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--> [QF21] Difficulty or need for assistance with general life tasks or life management --- 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 --CHILD--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --- 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 --CHILD--> [8A82] Trigeminal autonomic cephalalgias Def: A group of related primary headache disorders essentially characterised by unilateral headache and trigeminal autonomic activation. In most but not all of these disorders, the headache is short-lastin... --- 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--> [?] Preparatory care for dialysis Def: Preparatory care for dialysis may include the assessment, education and counselling of the patient and carer(s) to facilitate psychosocial adjustment, choice of dialysis modality (including site – hom...
[ "[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--> [QF21] Difficulty or need for assistance with general life tasks or life management", "[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 --CHILD--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...", "[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 --CHILD--> [8A82] Trigeminal autonomic cephalalgias\n Def: A group of related primary headache disorders essentially characterised by unilateral headache and trigeminal autonomic activation. In most but not all of these disorders, the headache is short-lastin...", "[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--> [?] Preparatory care for dialysis\n Def: Preparatory care for dialysis may include the assessment, education and counselling of the patient and carer(s) to facilitate psychosocial adjustment, choice of dialysis modality (including site – hom..." ]
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": "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" } ]
Z742
Need for assistance at home and no other household member able to render care
A case presentation of neuroleptic malignant in a young, male patient with known schizophrenia and treated with Olanzapin is reported. This syndrome is well described in the literature, especially with one of its main key symptoms of excessive hyperthermia. Our patient showed the cardinal symptoms of NMS -. Most other possible causes of hyperthermia were ruled out with a negative toxicological screening (except cannabis), normal cerebral CT scan, normal results of liquor analysis, or were all very unlikely in this case (see Table 2 ). Therefore, it was supposed that the patient's ambulant neuroleptic medication was the most possible cause for the NMS. The most important differential diagnoses with their most common triggers are shown in Table 2 . The various common findings of all of them include elevation of body temperature, muscle rigidity with corresponding elevation of serum creatine kinase levels, excessive perspiration, haemodynamic instability and fluctuating awareness. Because of these similar clinical findings, the patient's history with the initial trigger may be extremely helpful in establishing the correct diagnosis. In this case presentation the history of the ambulant neuroleptic drug medication was initially unknown and therefore it was not possible to establish a definitive diagnosis on admission. In contrast to patients with an elevated hypothalamic set point in cytokine induced fever, hyperthermia patients do not respond to or benefit from any antipyretic drug therapy . Since clinical and laboratory findings did not suggest an infectious cause of hyperthermia in our patient, it was decided to cool down the patient with a device especially designed to bring about hypothermia in order to not only achieve rapid, but also controlled, temperature decrease. Arctic Sun 2000 ® is a non-invasive cooling device used primarily on patients after cardiopulmonary resuscitation to induce mild therapeutic hypothermia, according to the International Liaison Committee on Resuscitation (ILCOR) recommendations . The Arctic Sun 2000 ® energy transfer pads cover approximately 40% of the patient's total body surface area and temperature controlled water circulates at a high flow rate inside the pads. The effect achieved by the system is very similar to water immersion and results in highly efficient heat exchange between the patient and the energy transfer pads. Although it has been reported that in some cases with hyperthermia after Olanzapin (Zyprexa®) medication temperature has normalized on its own after a length of time, but from our point of view for a patient with a body temperature higher than 40°C, a conservative treatment was not indicated. We therefore decided to bring the patient's temperature from 42°C to 38.5°C as quickly as possible to avoid damage caused by such a hyperthermic condition . The initial cooling phase from 42°C down to 38.5°C took 120 minutes. To hold the temperature at 38.5°C and to avoid a further temperature decrease, the water temperature inside the energy transfer pads was increased from 10°C to 30°C. With these settings it was possible to stabilize the patient's temperature between 37 to 38°C. No serious side effects, such as cardiac arrhythmia or additional haemodynamic impairment were observed. Furthermore, no serious skin lesions were observed over 48 hours using the Arctic Sun 2000 ® , only a physiological hyperaemia of the covered skin areas with a fast regression within minutes after removing the energy transfer pads from the skin was seen. Other potential methods of quickly lowering body temperature include manual cooling and invasive procedures such as continuous veno-venous haemofiltration (CVVH). During the last few years novel devices originally designed for the delivery of mild therapeutic hypothermia in survivors of cardiac arrest have become available. This case presentation demonstrates that the use of a non-invasive cooling device is safe and efficient in the management of severe hyperthermia and has several advantages compared to other potential methods of temperature management. Invasive cooling by CVVH necessitates the immediate creation of vascular access which would not only pose an additional risk especially in a potentially dehydrated patient but would also account for a certain time delay before the start of cooling therapy. Methods of manual cooling are less reliable because they lack the automated temperature monitoring and feedback regulation and, in addition, manual cooling will probably be much more time consuming with regard to human resources. We therefore believe that in these rare cases of excessive hyperthermia, device-assisted non-invasive cooling should be a treatment of choice wherever available.
4.195313
0.949219
sec[2]/p[0]
en
0.999996
19830098
https://doi.org/10.4076/1752-1947-3-6170
[ "temperature", "cooling", "hyperthermia", "possible", "invasive", "pads", "this", "therefore", "that", "body" ]
[ { "code": "MG26", "title": "Fever of other or unknown origin" }, { "code": "NF03.Z", "title": "Unspecified effects of reduced temperature" }, { "code": "ME65.0", "title": "Burning of skin" }, { "code": "NF03.Y", "title": "Other specified effects of reduced temperature" }, { "code": "QD84.Y", "title": "Other specified occupational exposure to risk-factors" }, { "code": "NF01.0", "title": "Heat stroke" }, { "code": "NE86", "title": "Malignant hyperthermia due to anaesthesia" }, { "code": "LD2F.Y", "title": "Other specified syndromes with multiple structural anomalies, without predominant body system involvement" }, { "code": "KD10", "title": "Environmental hyperthermia of newborn" }, { "code": "QA86", "title": "Problem with isolation protocol without injury or harm" } ]
=== ICD-11 CODES FOUND === [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 [NF03.Z] Unspecified effects of reduced temperature Also known as: Unspecified effects of reduced temperature | Other effects of reduced temperature | adverse effect of cold | cold effects | exposure to cold [ME65.0] Burning of skin Definition: A burning sensation in the skin which usually arises without obvious explanation. Also known as: Burning of skin | Burning sensation | Disturbance in temperature sense [NF03.Y] Other specified effects of reduced temperature Also known as: Other specified effects of reduced temperature | Chapping of skin | Exhaustion from cold [QD84.Y] Other specified occupational exposure to risk-factors Also known as: Other specified occupational exposure to risk-factors | Occupational exposure to noise | Occupational exposure to radiation | Occupational exposure to air contaminants other than dust | Occupational exposure to tobacco smoke [NF01.0] Heat stroke Definition: Elevation of core body temperature above 40.6 degrees centigrade due to environmental heat exposure and a failure of thermoregulation. This is a potentially fatal disorder, particularly in infants and children. Also known as: Heat stroke | heat-induced hyperthermia | heat apoplexy | heat pyrexia | heat stress Excludes: Exertional heat stroke [NE86] Malignant hyperthermia due to anaesthesia Definition: A condition caused by hypermetabolism in response to certain anaesthetic drugs. This condition is characterised by hyperthermia, tachycardia, tachypnoea, increased carbon dioxide production, increased oxygen consumption, acidosis, muscle rigidity, and rhabdomyolysis. This condition may be associated with genetic mutation. Also known as: Malignant hyperthermia due to anaesthesia [LD2F.Y] Other specified syndromes with multiple structural anomalies, without predominant body system involvement Also known as: Other specified syndromes with multiple structural anomalies, without predominant body system involvement | Syndromes with multiple structural anomalies of environmental origin | congenital malformation syndromes due to known exogenous causes, not elsewhere classified | Infectious embryofetopathies | Embryofetopathies due to specified maternal conditions [KD10] Environmental hyperthermia of newborn Definition: A paediatric condition characterised by a core body temperature above 37.5 degrees C (99.5 degrees F) in a newborn due to exposure of the newborn to prolonged or extremely high environmental temperature. Also known as: Environmental hyperthermia of newborn | environmentally induced pyrexia | environmentally-induced hyperthermia in newborn | environmentally-induced pyrexia in newborn | environmental fever in newborn [QA86] Problem with isolation protocol without injury or harm Definition: Patient not monitored as frequently as required or ordered; or patient mistakenly or inappropriately put on isolation; or isolation technique broken and contamination possible by patient, health provider, or visitor. No injury or harm resulted. Also known as: Problem with isolation protocol without injury or harm | isolation technique broken and contamination possible without documented injury or harm | patient mistakenly or inappropriately put on isolation without documented injury or harm | Patient not monitored as frequently as required or ordered without documented injury or harm Excludes: Problem associated with isolation protocol === GRAPH WALKS === --- Walk 1 --- [MG26] Fever of other or unknown origin Def: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process.... --EXCLUDES--> [?] Malignant hyperthermia due to anaesthesia Def: A condition caused by hypermetabolism in response to certain anaesthetic drugs. This condition is characterised by hyperthermia, tachycardia, tachypnoea, increased carbon dioxide production, increased... --PARENT--> [?] Other injury or harm from surgical or medical care, not elsewhere classified --- Walk 2 --- [MG26] Fever of other or unknown origin Def: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process.... --PARENT--> [?] General symptoms --RELATED_TO--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --- Walk 3 --- [NF03.Z] Unspecified effects of reduced temperature --PARENT--> [NF03] Other effects of reduced temperature --CHILD--> [NF03.0] Chilblains Def: Chilblains are the result of cold-induced damage principally to the microvasculature of acral skin in susceptible individuals. They are commonest in the winter months in cold, damp climates. They pres... --- Walk 4 --- [NF03.Z] Unspecified effects of reduced temperature --PARENT--> [NF03] Other effects of reduced temperature --CHILD--> [NF03.Y] Other specified effects of reduced temperature --- Walk 5 --- [ME65.0] Burning of skin Def: A burning sensation in the skin which usually arises without obvious explanation.... --PARENT--> [ME65] Disturbances of skin sensation of unspecified aetiology Def: A group of cutaneous symptoms for which it is frequently impossible to identify a precise cause.... --RELATED_TO--> [?] Anaesthesia of skin Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy.... --- Walk 6 --- [ME65.0] Burning of skin Def: A burning sensation in the skin which usually arises without obvious explanation.... --PARENT--> [ME65] Disturbances of skin sensation of unspecified aetiology Def: A group of cutaneous symptoms for which it is frequently impossible to identify a precise cause.... --RELATED_TO--> [?] Anaesthesia of skin Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy....
[ "[MG26] Fever of other or unknown origin\n Def: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process....\n --EXCLUDES--> [?] Malignant hyperthermia due to anaesthesia\n Def: A condition caused by hypermetabolism in response to certain anaesthetic drugs. This condition is characterised by hyperthermia, tachycardia, tachypnoea, increased carbon dioxide production, increased...\n --PARENT--> [?] Other injury or harm from surgical or medical care, not elsewhere classified", "[MG26] Fever of other or unknown origin\n Def: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process....\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....", "[NF03.Z] Unspecified effects of reduced temperature\n --PARENT--> [NF03] Other effects of reduced temperature\n --CHILD--> [NF03.0] Chilblains\n Def: Chilblains are the result of cold-induced damage principally to the microvasculature of acral skin in susceptible individuals. They are commonest in the winter months in cold, damp climates. They pres...", "[NF03.Z] Unspecified effects of reduced temperature\n --PARENT--> [NF03] Other effects of reduced temperature\n --CHILD--> [NF03.Y] Other specified effects of reduced temperature", "[ME65.0] Burning of skin\n Def: A burning sensation in the skin which usually arises without obvious explanation....\n --PARENT--> [ME65] Disturbances of skin sensation of unspecified aetiology\n Def: A group of cutaneous symptoms for which it is frequently impossible to identify a precise cause....\n --RELATED_TO--> [?] Anaesthesia of skin\n Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy....", "[ME65.0] Burning of skin\n Def: A burning sensation in the skin which usually arises without obvious explanation....\n --PARENT--> [ME65] Disturbances of skin sensation of unspecified aetiology\n Def: A group of cutaneous symptoms for which it is frequently impossible to identify a precise cause....\n --RELATED_TO--> [?] Anaesthesia of skin\n Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy...." ]
MG26
Fever of other or unknown origin
[ { "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": "NF03.Z", "icd10_code": "T699XXA", "icd10_title": "Effect of reduced temperature, unspecified, initial encounter" }, { "from_icd11": "NF03.Z", "icd10_code": "T699XXS", "icd10_title": "Effect of reduced temperature, unspecified, sequela" }, { "from_icd11": "NF03.Z", "icd10_code": "T698XXA", "icd10_title": "Other specified effects of reduced temperature, initial encounter" }, { "from_icd11": "NF03.Z", "icd10_code": "T69", "icd10_title": "Other effects of reduced temperature" }, { "from_icd11": "NF03.Z", "icd10_code": "T698", "icd10_title": "Other specified effects of reduced temperature" }, { "from_icd11": "NF03.Z", "icd10_code": "T699", "icd10_title": "Effect of reduced temperature, unspecified" }, { "from_icd11": "NF01.0", "icd10_code": "T670XXA", "icd10_title": "" } ]
R5081
Fever presenting with conditions classified elsewhere
In this case, a healthy adult male with no underlying disease developed meningitis and cranial neuropathy associated with Hunt's syndrome and had to be rehospitalized for brainstem encephalitis. Hunt syndrome is well known to be severe in immunocompromised and elderly patients, but severe cases in immunocompetent adults have rarely been reported . Petersen et al. reported an incidence of 1.6 cases per million of Hunt syndrome-associated meningitis in a large cohort study in Denmark . This underscores the rarity of Hunt syndrome complicating meningitis, especially in healthy individuals. This case highlights that even healthy adult males can experience serious complications. Although occasional cases of Hunt syndrome exacerbated by complications of meningitis or encephalitis have been reported, to our knowledge, there have been no reports of cases requiring rehospitalization due to relapse despite adequate duration of treatment . This case suggests that the generally recommended duration of treatment may be inadequate to cure and relapse in some cases. In cases of Hunt syndrome with fever and multiple cranial neuropathies, it is essential to recognize the potential involvement of the central nervous system, such as meningitis or encephalitis . If such symptoms are present, it is possible that the disease has progressed beyond the typical Hunt syndrome and is affecting the central nervous system. In such cases, invasion of the CNS should be carefully considered and treated accordingly. This case suggests that patients can develop severe CNS complications even in the absence of obvious risk factors such as immunosuppression, underscoring the need for early detection and aggressive management in similar cases. Although no strict guidelines exist for antiviral therapy for Hunt syndrome, the Infectious Diseases Society of America (IDSA) recommends 14 days for VZV encephalitis . The spinal fluid findings became standard after the treatment, and the patient was cured. The treatment was terminated, but the disease relapsed despite standard 14 days of antiviral therapy. Cerebellar symptoms such as dizziness persisted beyond the 14-day treatment period, suggesting that complete recovery may not have been achieved. This suggests the possibility of reactivation of VZV infection in the central nervous system. Therefore, even after completing a standard course of treatment, it is essential to closely monitor clinical symptoms and evaluate whether additional treatment is warranted. Complications involving other cranial neuropathies, such as trigeminal, glossopharyngeal, and vagus nerves, have been reported in Hunt syndrome, and these cases tend to have a poor prognosis . When the patient in this case was first admitted to the hospital, a severe CNS infection, including meningitis, was suspected because of complications involving the trigeminal nerve, glossopharyngeal nerve, vagus nerve, accessory nerves, and hypoglossal nerve. Neuropathy other than the facial and vestibulocochlear nerves improved shortly after treatment, but facial palsy and improved balance function and hearing were not observed. MRI findings on rehospitalization revealed swelling of the entorhinal and facial nerves, suggesting persistent neurological damage due to prolonged inflammation. In the case of facial and vestibulocochlear nerve palsy, microvasculitis affecting nutrient vessels such as the ascending pharyngeal artery is considered a possible mechanism. In this case, VZV vasculitis was suspected, and aspirin was administered acutely to prevent stroke. VZV vasculitis is known to cause granulomatous vasculitis in both large and small cranial vessels, which can lead to stroke. In a retrospective study of patients with VZV meningitis, three of 15 cases reported having a stroke, and in young people and children, one-third of strokes are associated with VZV vasculitis . In this case, aspirin was administered to prevent cerebral infarction, and the medication was discontinued after the acute phase. However, the criteria and duration of aspirin administration in severe cases of Hunt syndrome and VZV vasculitis have not yet been established, and further case accumulation and discussion are needed. In Japan, the varicella vaccine became a routine vaccination for children in 2014, and in 2016, the vaccine was approved for people over 50 years of age to prevent herpes zoster . Shingles can cause a variety of sequelae and, as demonstrated in this case, can significantly impair healthy adults' quality of life (QOL). Therefore, prevention through vaccination has become critical. Furthermore, considering the severity of this 49-year-old case, lowering the target age for herpes zoster vaccination needs to be considered.
4.269531
0.930176
sec[2]/p[0]
en
0.999996
39691149
https://doi.org/10.7759/cureus.73861
[ "this", "cases", "hunt", "meningitis", "that", "complications", "nerve", "vasculitis", "healthy", "encephalitis" ]
[ { "code": "4A01.03", "title": "Transient hypogammaglobulinaemia of infancy" }, { "code": "JB20.Z", "title": "Single spontaneous delivery, unspecified" }, { "code": "QA48.0", "title": "Care or examination immediately after delivery" }, { "code": "8B88.Y", "title": "Other specified disorders of facial nerve" }, { "code": "8A85", "title": "Painful cranial neuropathies or other facial pains" }, { "code": "8A0Y", "title": "Other specified movement disorders" }, { "code": "PA80.1", "title": "Unintentionally struck by projectile from rifle, shotgun or larger firearm" }, { "code": "PG71&XE0Q9", "title": "Struck by projectile from hunting rifle of undetermined intent" }, { "code": "1D01.Z", "title": "Infectious meningitis, unspecified" }, { "code": "1C8E.Z", "title": "Viral meningitis, unspecified" } ]
=== 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] [JB20.Z] Single spontaneous delivery, unspecified Also known as: Single spontaneous delivery, unspecified | Single spontaneous delivery | spontaneous delivery NOS | normal delivery NOS | uncomplicated delivery [QA48.0] Care or examination immediately after delivery Also known as: Care or examination immediately after delivery | care and observation in uncomplicated delivery cases | postpartum care immediately after delivery | postpartum examination immediately after delivery | Postpartum care after hospital delivery Excludes: Complications predominantly related to the puerperium [8B88.Y] Other specified disorders of facial nerve Also known as: Other specified disorders of facial nerve | Geniculate ganglionitis | Ramsay-Hunt syndrome | Ramsay-Hunt disease or syndrome | Hunt neuralgia [8A85] Painful cranial neuropathies or other facial pains Definition: A group of disorders characterised by head and/or facial pain, presenting variably as a neuralgia or as pain of neuropathic or central origin. Also known as: Painful cranial neuropathies or other facial pains | Combined hyperactive dysfunction syndrome of the cranial nerves | Supraorbital neuralgia | Occipital neuralgia | Tolosa-Hunt syndrome [8A0Y] Other specified movement disorders Also known as: Other specified movement disorders | Other movement disorders, not elsewhere classified | chorea NOS | Familial congenital mirror movements | Primary progressive freezing gait [PA80.1] Unintentionally struck by projectile from rifle, shotgun or larger firearm Also known as: Unintentionally struck by projectile from rifle, shotgun or larger firearm | accidental discharge of hunting rifle | accidental discharge of machine gun | accidental discharge of shotgun | accidental shotgun discharge [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 === 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--> [4A01.00] 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 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... --PARENT--> [4A01] Primary immunodeficiencies due to disorders of adaptive immunity --- Walk 3 --- [JB20.Z] Single spontaneous delivery, unspecified --PARENT--> [JB20] Single spontaneous delivery Def: A condition caused by the development of a fetus to the culmination of the pregnancy period. This condition is characterised by spontaneous parturition of a neonate from the uterus.... --CHILD--> [JB20.Y] Single spontaneous delivery with other specified presentation --- Walk 4 --- [JB20.Z] Single spontaneous delivery, unspecified --PARENT--> [JB20] Single spontaneous delivery Def: A condition caused by the development of a fetus to the culmination of the pregnancy period. This condition is characterised by spontaneous parturition of a neonate from the uterus.... --CHILD--> [JB20.0] Spontaneous vertex delivery Def: A condition caused by the development of a fetus to the culmination of the pregnancy period. This condition is characterised by spontaneous parturition of a neonate in vertex position from the uterus.... --- Walk 5 --- [QA48.0] Care or examination immediately after delivery --EXCLUDES--> [?] Complications predominantly related to the puerperium Def: A group of conditions characterised as any adverse evolution (complication) which may arise during the approximately six weeks after delivery during which the uterus returns to the original size (puer... --EXCLUDES--> [?] Obstetrical tetanus Def: A disease caused by an infection with the gram-positive bacteria Clostridium tetani. This disease is characterised by a prolonged contraction of skeletal muscle fibres during pregnancy or within six w... --- Walk 6 --- [QA48.0] Care or examination immediately after delivery --EXCLUDES--> [?] Complications predominantly related to the puerperium Def: A group of conditions characterised as any adverse evolution (complication) which may arise during the approximately six weeks after delivery during which the uterus returns to the original size (puer... --PARENT--> [?] 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 ...
[ "[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...", "[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", "[JB20.Z] Single spontaneous delivery, unspecified\n --PARENT--> [JB20] Single spontaneous delivery\n Def: A condition caused by the development of a fetus to the culmination of the pregnancy period. This condition is characterised by spontaneous parturition of a neonate from the uterus....\n --CHILD--> [JB20.Y] Single spontaneous delivery with other specified presentation", "[JB20.Z] Single spontaneous delivery, unspecified\n --PARENT--> [JB20] Single spontaneous delivery\n Def: A condition caused by the development of a fetus to the culmination of the pregnancy period. This condition is characterised by spontaneous parturition of a neonate from the uterus....\n --CHILD--> [JB20.0] Spontaneous vertex delivery\n Def: A condition caused by the development of a fetus to the culmination of the pregnancy period. This condition is characterised by spontaneous parturition of a neonate in vertex position from the uterus....", "[QA48.0] Care or examination immediately after delivery\n --EXCLUDES--> [?] Complications predominantly related to the puerperium\n Def: A group of conditions characterised as any adverse evolution (complication) which may arise during the approximately six weeks after delivery during which the uterus returns to the original size (puer...\n --EXCLUDES--> [?] Obstetrical tetanus\n Def: A disease caused by an infection with the gram-positive bacteria Clostridium tetani. This disease is characterised by a prolonged contraction of skeletal muscle fibres during pregnancy or within six w...", "[QA48.0] Care or examination immediately after delivery\n --EXCLUDES--> [?] Complications predominantly related to the puerperium\n Def: A group of conditions characterised as any adverse evolution (complication) which may arise during the approximately six weeks after delivery during which the uterus returns to the original size (puer...\n --PARENT--> [?] 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 ..." ]
4A01.03
Transient hypogammaglobulinaemia of infancy
[ { "from_icd11": "4A01.03", "icd10_code": "D807", "icd10_title": "Transient hypogammaglobulinemia of infancy" }, { "from_icd11": "JB20.Z", "icd10_code": "O80", "icd10_title": "Encounter for full-term uncomplicated delivery" }, { "from_icd11": "JB20.Z", "icd10_code": "O808", "icd10_title": "" }, { "from_icd11": "JB20.Z", "icd10_code": "O809", "icd10_title": "" }, { "from_icd11": "QA48.0", "icd10_code": "Z390", "icd10_title": "Encounter for care and examination of mother immediately after delivery" }, { "from_icd11": "8A85", "icd10_code": "G501", "icd10_title": "Atypical facial pain" }, { "from_icd11": "PA80.1", "icd10_code": "W3301XA", "icd10_title": "Accidental discharge of shotgun, initial encounter" }, { "from_icd11": "PA80.1", "icd10_code": "W3302XA", "icd10_title": "Accidental discharge of hunting rifle, initial encounter" }, { "from_icd11": "PA80.1", "icd10_code": "W33", "icd10_title": "Accidental rifle, shotgun and larger firearm discharge and malfunction" }, { "from_icd11": "1D01.Z", "icd10_code": "G02", "icd10_title": "Meningitis in other infectious and parasitic diseases classified elsewhere" }, { "from_icd11": "1D01.Z", "icd10_code": "G028", "icd10_title": "" }, { "from_icd11": "1C8E.Z", "icd10_code": "A879", "icd10_title": "Viral meningitis, unspecified" }, { "from_icd11": "1C8E.Z", "icd10_code": "A878", "icd10_title": "Other viral meningitis" }, { "from_icd11": "1C8E.Z", "icd10_code": "A87", "icd10_title": "Viral meningitis" }, { "from_icd11": "1C8E.Z", "icd10_code": "G020", "icd10_title": "" } ]
D807
Transient hypogammaglobulinemia of infancy
We present a case of a 24-year-old Korean man studying abroad in the USA, who presented to the emergency department with altered sensorium. He had no significant medical history but a history of recreational nitrous oxide inhalation. His use of nitrous oxide escalated from occasional use to a daily intake of 100 balloons over six months. He was admitted to a hospital in the USA for one day due to intermittently confused mentality, gait disturbance and involuntary leg movement. His urine drug level, routine CBC, chemistry, chest X-ray, brain CT scan and electroencephalography all showed normal results, according to his parents’ account. Since he was discharged against medical advice, his medical information could not be retrieved, and his medical records in the USA were entirely based on his parents’ statements. He showed initial improvement with cobalamin supplementation for B 12 deficiency but returned to Korea immediately after discharge. In Korea, his symptoms relapsed several days later, despite no longer abusing N 2 O. He denied using any drugs other than nitrous oxide during the initial evaluation. He had no headache, dizziness, nausea, vomiting, diplopia, dyspnea and chest pain. He exhibited intermittent confusion, altered sensorium, and involuntary leg movements, which appeared more consistent with agitation rather than jerky or myoclonic movements. The neurological examination indicated normal cranial nerve function, as well as intact proximal and distal muscle strength. Sensory perception, including touch, pain, temperature, vibration, and proprioception, was also normal. There was no ataxia observed during the finger-to-nose and heel-to-shin test, and the deep tendon reflexes were normal. His gait appeared grossly normal, despite some difficulty with balance. He scored 22 out of 30 on the Korean version of the mini-mental state examination-2 (K-MMSE-2, license was bought from Inpsyt, Inc., a branch of Hakjisa publisher), displaying impairments in memory, orientation, and attention. Routine laboratory tests were repeated in Korea, along with a chest X-ray and electrocardiogram, all of which showed normal findings. His urine drug levels for acetaminophen, amphetamines, benzodiazepines, zolpidem, and ethanol were negative. Nitrous oxide levels were not measurable in Korea, so results were unknown. However, mildly elevated levels of CRP (16.9 mg/dL; normal < 8 mg/dL) and ESR (70 mm/hr; normal < 15 mm/hr) were noted without a specific focus of inflammation. His coronavirus disease-19 PCR tests were negative. He was positive for LA, while tests for Rheumatoid factor, antinuclear antibody, antineutrophil cytoplasmic antibody, anti-β2-glycoprotein I IgG and IgM and anti-cardiolipin antibody, were negative. His laboratory results demonstrated elevated levels of C3 (206.8 mg/dL; normal 90-180 mg/dL) and C4 (59.83 mg/dL; normal 10-40 mg/dL), which may reflect an underlying inflammatory activity. In addition, protein C (138%; normal 70–130%), protein S (> 150%; normal 62–150%), and antithrombin III (129%; normal 80–120%) were all elevated, supporting a hypercoagulable state while providing evidence against protein C or S deficiency. Nevertheless, d-dimer (3,577 ng/mL; normal < 243ng/mL) and homocysteine (30.12 mmol/L; normal < 15.0 mmol/L) levels were elevated, while vitamin B 12 (695 pg/mL), folate (20.11 ng/mL) and methylmalonic acid levels (2.41 umol/L) were within normal ranges. A spinal tap was performed to assess intracranial pressure and central nervous system inflammation. The results indicated elevated intracranial pressure (260 mm CSF), with normal cell count, protein, glucose, lactate, and adenosine deaminase levels. Further evaluation with electroencephalography was conducted to assess altered sensorium and possible epilepsy, given his involuntary leg movements. The findings demonstrated continuous diffuse theta to delta dominant background slowing. Brain magnetic resonance (MR) imaging provided critical insights, identifying venous sinus thrombosis at the superior sagittal sinus and adjacent cortical veins, along with cortical subarachnoid hemorrhage (SAH) at bilateral frontal sulci . As the diagnostic workup continued, a subsequent chest CT scans unveiled PTE, further indicating a systemic thrombotic process . However, he did not have any symptoms of PTE, except occasional sinus tachycardia up to 130-150 bpm. Echocardiography was performed to assess for right ventricular strain, but no abnormalities were observed. The patient reported no family history of autoimmune or rheumatic diseases. We recommended genetic testing for thrombotic conditions, including methylenetetrahydrofolate reductase (MTHFR) polymorphism; however, the patient declined testing.
3.998047
0.981445
sec[1]/p[0]
en
0.999998
PMC12105173
https://doi.org/10.1186/s12883-025-04237-x
[ "nitrous", "oxide", "chest", "korea", "protein", "altered", "sensorium", "involuntary", "movements", "which" ]
[ { "code": "PB21&XM73B5", "title": "Unintentional exposure to or harmful effects of nitrous oxide" }, { "code": "PC91&XM73B5", "title": "Intentional self-harm by exposure to or harmful effects of nitrous oxide" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "8A45.1", "title": "White matter disorders due to toxicity" }, { "code": "PE81&XM73B5", "title": "Assault by exposure to or harmful effects of nitrous oxide" }, { "code": "CA60.8", "title": "Siderosis" }, { "code": "5C52.0Z", "title": "Inborn errors of fatty acid oxidation or ketone body metabolism, unspecified" }, { "code": "5C53.23", "title": "Mitochondrial protein translation defects" }, { "code": "5C53.2Z", "title": "Disorders of mitochondrial oxidative phosphorylation, unspecified" }, { "code": "4B01.03", "title": "Disorders of neutrophil oxidative metabolism" } ]
=== 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 [8A45.1] White matter disorders due to toxicity Also known as: White matter disorders due to toxicity | White matter disorder due to hexachlorophene toxicity | White matter disorder due to trimethyltin toxicity | White matter disorder due to carbon monoxide toxicity | White matter disorder due to heroin vapour toxicity [CA60.8] Siderosis Definition: Siderosis refers to pneumoconiosis resulting from inhalation of iron from welding fumes or from iron or hematite mine dust. Also known as: Siderosis | arc-welders' disease | arc-welders' lung | arc-welders' nodulation | arc-welders' pneumoconiosis [5C52.0Z] Inborn errors of fatty acid oxidation or ketone body metabolism, unspecified Also known as: Inborn errors of fatty acid oxidation or ketone body metabolism, unspecified | Inborn errors of fatty acid oxidation or ketone body metabolism | Fatty acid oxidation or ketogenesis disorders | disorder of fat oxidation | disorder of fatty acid metabolism [5C53.23] Mitochondrial protein translation defects Definition: This refers to defects in the enzyme that belongs to the family of hydrolases, specifically those acting on acid anhydrides to catalyse transmembrane movement of substances. Also known as: Mitochondrial protein translation defects | Combined oxidative phosphorylation deficiency | Combined mitochondrial respiratory chain complex deficiency | Respiratory chain multiple deficiencies | COXPD - [Combined oxidative phosphorylation deficiency] [5C53.2Z] Disorders of mitochondrial oxidative phosphorylation, unspecified Also known as: Disorders of mitochondrial oxidative phosphorylation, unspecified | Disorders of mitochondrial oxidative phosphorylation | Mitochondrial respiratory chain disorders | OXPHOS - [oxidative phosphorylation] diseases [4B01.03] Disorders of neutrophil oxidative metabolism Also known as: Disorders of neutrophil oxidative metabolism === GRAPH WALKS === --- Walk 1 --- [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 the eye Def: Allergic or hypersensitivity disorders involving the eye includes several clinically different conditions that can be considered as hypersensitivity disorders of the ocular surface. The classification... --- Walk 2 --- [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 substance use Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to... --- Walk 3 --- [8A45.1] White matter disorders due to toxicity --PARENT--> [8A45] Secondary white matter disorders --CHILD--> [8A45.2] White matter disorders due to vascular abnormality or ischemia --- Walk 4 --- [8A45.1] White matter disorders due to toxicity --PARENT--> [8A45] Secondary white matter disorders --CHILD--> [8A45.1] White matter disorders due to toxicity
[ "[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 the eye\n Def: Allergic or hypersensitivity disorders involving the eye includes several clinically different conditions that can be considered as hypersensitivity disorders of the ocular surface. The classification...", "[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 substance use\n Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to...", "[8A45.1] White matter disorders due to toxicity\n --PARENT--> [8A45] Secondary white matter disorders\n --CHILD--> [8A45.2] White matter disorders due to vascular abnormality or ischemia", "[8A45.1] White matter disorders due to toxicity\n --PARENT--> [8A45] Secondary white matter disorders\n --CHILD--> [8A45.1] White matter disorders due to toxicity" ]
PB21&XM73B5
Unintentional exposure to or harmful effects of nitrous oxide
[ { "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
Miss D.C., a right-handed 39 years old medical secretary, underwent a surgery in march 2006 for resecting a vascular tumor (hemangioblastoma) at the level of the medulla oblongata on the right side , which left her with no somatosensory sensations from the right upper limb (arthrokinesthesia and pallesthesia were abolished whereas thermalgesic sensitivity was preserved). The patient was hospitalized for a month after surgery in a rehabilitation clinic where she followed a daily physiotherapy program. After being discharged, she continued physiotherapy twice a week for about 1 year time. Before inclusion, clinical examination with the RASP found somato-sensory impairment located on the palmar side of the right hand for sharp/dull discrimination (two errors out of eight trials), surface pressure touch (four errors out of eight trials), two-point discrimination (absence of two points discrimination with the 5 mm spacing) and proprioception movement of the index (movement felt one out of six trials without direction stated correctly in none of the six trials). No errors were observed on the temperature discrimination and surface localization sub-tests. The patient had a good motor control of her right hand with a score of 62 out of 66 on the upper-extremity test of the Fugl-Meyer assessment . She obtained a score of one out of two on the Hand to lumbar spine sub-test, Shoulder flexion to 90°, elbow at 0°, reflex intensity and dysmetria on the coordination sub-test. Somatosensory Evoked Potentials (SEPs) at 1 year from surgery revealed only peripheral response to the medial nerve stimulation at elbow level. Nine months later the same examination revealed a spinal response (N13), but no subcortical or cortical evoked activity. Her ability to perform visually guided movements allowed us to test the role of proprioception in the update of the body representation for action called Body Schema (BS). BS contains metric body knowledge useful to plan, execute or imagine movements, such as body position in space, size and shape of body parts . Its existence overlaps with the effector representation which existence is postulated by motor control theories . Shadmehr and Krakauer indeed suggested that a key goal of motor control systems is “to form a belief about the state of our body and the world (called state estimation).” As we move and perform actions, the state of our body changes, sensory information reaches the brain and the BS is updated to take them into account. Among those sensory signals, proprioception has always been considered the key source of information to maintain an accurate representation of the body. Here, we tested such hypothesis in the case of tool use. Two are the reasons behind the choice of a tool use paradigm: First, tools use is a very important set of skills that pervade almost every aspect of our life. We use tools to eat, for personal hygiene, to work and even in our leisure time to play sports. As a consequence, impairment in such skills or the inability to acquire them has a strong impact on a patient’s life. Providing an insight on the mechanisms supporting tool use in patients that lack proprioception can have important repercussions on the development of rehabilitation programs and new therapeutic approaches. Second, a large amount of literature supports the idea that the extraordinary human ability to use tools relies on the brain ability to incorporate them into the BS . This means that tool use constitutes a perfect paradigm to study BS plasticity and its rules. Indeed, when actions are performed with tools, specific body parts’ morphology and functionality are drastically modified, which requires a quick and efficient update of the BS to maintain action accuracy. We previously showed that when healthy participants reach and grasp objects using a mechanical grabber that functionally elongates their arm, the brain selectively updates the representation of their arm length to take into account the modification induced by the tool . After using a 40 cm long tool, participants are typically found to act as if their arm was longer than before. In terms of kinematic profile of the movements, post tool-use movements display protracted and reduced peak of wrist acceleration, velocity and deceleration compared to before. Moreover, this pattern has been reported for free-hand pointing movements performed before and after tool-use, but never with the tool. This generalization to untrained movements demonstrates that the origin of the tool-use induced effect is in the lengthening of the arm representation (which would be reflected in changes in any movement performed with that arm) rather than a modification of a specific motor planning for grasping.
4.34375
0.844238
sec[0]/p[0]
en
0.999997
27378879
https://doi.org/10.3389/fnhum.2016.00272
[ "tool", "body", "that", "movements", "representation", "which", "hand", "discrimination", "trials", "proprioception" ]
[ { "code": "PA83.2&XE16F", "title": "Contact with nonpowered hand tool" }, { "code": "PA83.2&XE8T6", "title": "Accidental contact with other powered garden tool" }, { "code": "PH33", "title": "Contact with hot object or liquid with undetermined intent" }, { "code": "PA83.2&XE5WX", "title": "Contact with other powered hand tools and household machinery" }, { "code": "PB13", "title": "Unintentional contact with hot object or liquid" }, { "code": "ND51.Y", "title": "Other specified injuries of spine or trunk, level unspecified" }, { "code": "MG20.Z", "title": "Cachexia, unspecified" }, { "code": "ND56.Z", "title": "Unspecified injury to unspecified part of trunk, limb or body region" }, { "code": "8A22", "title": "Lewy body disease" }, { "code": "ME86.Z", "title": "Problem of unspecified body part" } ]
=== ICD-11 CODES FOUND === [PH33] Contact with hot object or liquid with undetermined intent Also known as: Contact with hot object or liquid with undetermined intent | Contact with hot drinks, food, fat or oil, undetermined intent | Contact with hot cooking oil, undetermined intent | Contact with hot tap water, undetermined intent | contact with other hot fluids, undetermined intent [PB13] Unintentional contact with hot object or liquid Also known as: Unintentional contact with hot object or liquid | Unintentional contact with hot object or liquid, hot drinks, food, fats, or cooking oil | Unintentional contact with hot object or liquid, hot tap water | Unintentional contact with hot object or liquid, hot fluids | Unintentional contact with hot object or liquid, hot household appliances [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 [MG20.Z] Cachexia, unspecified Also known as: Cachexia, unspecified | Cachexia | cachectic | general body deterioration | inanition [ND56.Z] Unspecified injury to unspecified part of trunk, limb or body region Also known as: Unspecified injury to unspecified part of trunk, limb or body region | Injury of unspecified body region | injury NOS | trauma NOS | traumatic injury NOS [8A22] Lewy body disease Definition: Lewy body disease is a neurodegenerative disorder and the second most common form of dementia in the elderly after Alzheimer disease. Lewy bodies are histologically defined as intracytoplasmic eosinophilic neuronal inclusions in the cortex or brainstem. Also known as: Lewy body disease | Lewy body | DLBD - [diffuse Lewy body disease] | diffuse Lewy body disease | CLBD - [cortical Lewy body disease] [ME86.Z] Problem of unspecified body part Also known as: Problem of unspecified body part | Symptom or complaint of a body part === GRAPH WALKS === --- Walk 1 --- [PH33] Contact with hot object or liquid with undetermined intent --PARENT--> [?] Exposure to thermal mechanism with undetermined intent --PARENT--> [?] Undetermined intent --- Walk 2 --- [PH33] Contact with hot object or liquid with undetermined intent --PARENT--> [?] Exposure to thermal mechanism with undetermined intent --CHILD--> [PH31] Exposure to controlled fire with undetermined intent --- Walk 3 --- [PB13] Unintentional contact with hot object or liquid --PARENT--> [?] Unintentional exposure to thermal mechanism --CHILD--> [PB11] Unintentional exposure to controlled fire --- Walk 4 --- [PB13] Unintentional contact with hot object or liquid --PARENT--> [?] Unintentional exposure to thermal mechanism --CHILD--> [PB11] Unintentional exposure to controlled fire
[ "[PH33] Contact with hot object or liquid with undetermined intent\n --PARENT--> [?] Exposure to thermal mechanism with undetermined intent\n --PARENT--> [?] Undetermined intent", "[PH33] Contact with hot object or liquid with undetermined intent\n --PARENT--> [?] Exposure to thermal mechanism with undetermined intent\n --CHILD--> [PH31] Exposure to controlled fire with undetermined intent", "[PB13] Unintentional contact with hot object or liquid\n --PARENT--> [?] Unintentional exposure to thermal mechanism\n --CHILD--> [PB11] Unintentional exposure to controlled fire", "[PB13] Unintentional contact with hot object or liquid\n --PARENT--> [?] Unintentional exposure to thermal mechanism\n --CHILD--> [PB11] Unintentional exposure to controlled fire" ]
PA83.2&XE16F
Contact with nonpowered hand tool
[ { "from_icd11": "PA83.2&XE5WX", "icd10_code": "W294XXA", "icd10_title": "Contact with nail gun, initial encounter" }, { "from_icd11": "PA83.2&XE5WX", "icd10_code": "W294XXD", "icd10_title": "Contact with nail gun, subsequent encounter" }, { "from_icd11": "PA83.2&XE5WX", "icd10_code": "W298XXA", "icd10_title": "Contact with other powered hand tools and household machinery, initial encounter" }, { "from_icd11": "PA83.2&XE5WX", "icd10_code": "W293XXA", "icd10_title": "Contact with powered garden and outdoor hand tools and machinery, initial encounter" }, { "from_icd11": "PA83.2&XE5WX", "icd10_code": "W298XXS", "icd10_title": "Contact with other powered hand tools and household machinery, sequela" }, { "from_icd11": "PA83.2&XE5WX", "icd10_code": "W292XXA", "icd10_title": "Contact with other powered household machinery, initial encounter" }, { "from_icd11": "PA83.2&XE5WX", "icd10_code": "W29", "icd10_title": "Contact with other powered hand tools and household machinery" }, { "from_icd11": "PB13", "icd10_code": "X16XXXA", "icd10_title": "Contact with hot heating appliances, radiators and pipes, initial encounter" }, { "from_icd11": "PB13", "icd10_code": "X101XXA", "icd10_title": "Contact with hot food, initial encounter" }, { "from_icd11": "PB13", "icd10_code": "X100XXA", "icd10_title": "Contact with hot drinks, initial encounter" }, { "from_icd11": "PB13", "icd10_code": "X102XXS", "icd10_title": "Contact with fats and cooking oils, sequela" }, { "from_icd11": "PB13", "icd10_code": "X150XXA", "icd10_title": "Contact with hot stove (kitchen), initial encounter" }, { "from_icd11": "PB13", "icd10_code": "X18XXXA", "icd10_title": "Contact with other hot metals, initial encounter" }, { "from_icd11": "PB13", "icd10_code": "X16XXXD", "icd10_title": "Contact with hot heating appliances, radiators and pipes, subsequent encounter" }, { "from_icd11": "PB13", "icd10_code": "X153XXA", "icd10_title": "Contact with hot saucepan or skillet, initial encounter" } ]
W294XXA
Contact with nail gun, initial encounter
We planned a conversion to central ECLS with direct LV decompression via median sternotomy to manage insufficient pump flow, left ventricular distension, and poor oxygenation. In our institution, the location of the outflow and inflow cannula of the central ECLS system is determined by the presence of right heart failure and pulmonary congestion, according to a standardized protocol . Briefly, an extracorporeal LVAD is established by anastomosing an inflow cannula to the LV apex and an outflow cannula to the ascending aorta, using a cardiopulmonary bypass circuit. The flow rate of the extracorporeal LVAD is measured under an appropriate preload of approximately 10 mmHg of right atrial pressure, and if the flow index is less than 2.4, biventricular support is deemed necessary due to right heart failure. Then, an inflow cannula is anastomosed to the right atrium or right ventricle, and an outflow cannula is anastomosed to the pulmonary artery. When severe pulmonary congestion is present and pulmonary vascular resistance is greater than 3 Wood units, blood flow to the pulmonary artery should be limited to less than 3 L/min to avoid exacerbation of pulmonary congestion. In case of high pulmonary vascular resistance, the serial biventricular VAD system could not provide sufficient blood flow. Therefore, a Y-shaped connector is connected to the outflow cannula so that blood can be delivered to both the pulmonary artery and the ascending aorta. In the present case, an outflow cannula was inserted into the partially clamped ascending aorta. An inflow cannula was inserted through a drainage cuff secured to the apex of the left ventricle. Both inflow and outflow cannulae were connected to a centrifugal pump circuit (BIOFLOAT NCVC; Nipro Corporation, Osaka, Japan) integrated with an artificial lung. The initial pump flow was less than 2.4 L/min/m 2 . TEE revealed a narrowed left ventricular cavity and an enlarged right ventricular cavity, indicating that poor drainage from the left ventricular apex was due to right ventricular failure. In patients with pronounced pulmonary congestion, the implementation of a bi-ventricular assist device (BiVAD) system for right heart support carries the risk of exacerbating pulmonary edema and hemorrhage. Our institution therefore uses a variation of the BiVAD system depicted in Fig. 1 for cases with pulmonary vascular resistance (PVR) exceeding 3.0 Wood units. In this patient, the existing inflow cannula placed in the femoral vein was repurposed as an RA (right atrium) inflow cannula, and a second outflow cannula was positioned in the main pulmonary artery. This system, with the drainage and outflow cannulas connected in a Y formation, enables not only the complete unloading of both ventricles but also the regulation of pulmonary blood flow based on the severity of pulmonary edema. This adjustment led to a stable pump flow, with the centrifugal pump set at 5530 rpm, achieving a total flow rate of 8.0 L/min. Based on empirical evidence, the total flow was divided, directing 3.5 L/min (2.15 L/min/m 2 ) to the pulmonary artery and 4.5 L/min (2.77 L/min/m 2 ) to the ascending aorta. TEE showed a normalized balance between the ventricles, correct orientation of the LV apical drainage cuff, and no suction events. Postoperatively, we managed the patient with deep sedation and mechanical ventilation in the intensive care unit (ICU), aiming to reduce excess extracellular fluid to improve pulmonary congestion and oxygenation. Fig. 1 Central extracorporeal life support system with left ventricular apex vent and pulmonary artery return. A central extracorporeal life support (ECLS) system can be established for patients with severe heart failure due to respiratory failure. The process begins with the introduction of a drainage cannula into the left ventricular apex and connection of the return cannula, which goes to the ascending aorta, to a centrifugal pump circuit equipped with an artificial lung. Given that drainage from the left ventricular apex is often insufficient to maintain total flow in such patients, a peripheral venous cannula is inserted via the femoral vein into the superior vena cava–right atrium (SVC-RA) junction. Subsequently, the cannula is connected to a left ventricular drainage cannula using a Y-connector. To prevent the formation of a left ventricular thrombus, another return cannula is placed into the main pulmonary artery when the drainage volume from the left ventricular apex is exceedingly low. The cannula is connected to the ascending aortic return cannula using a Y-connector. The balance of flow between the two cannulas is controlled by using an adjustable clamp and a separate flow sensor located on one of the outflow tubes
4.253906
0.707031
sec[1]/p[1]
en
0.999997
38597982
https://doi.org/10.1186/s40981-024-00701-8
[ "cannula", "pulmonary", "flow", "ventricular", "outflow", "drainage", "inflow", "system", "apex", "artery" ]
[ { "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": "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" } ]
=== 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 [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 === GRAPH WALKS === --- Walk 1 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --CHILD--> [CB40.1] Young syndrome Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections.... --- 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--> [LA75.0] Accessory lobe of lung Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left... --- Walk 5 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --CHILD--> [CA40.0] 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... --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Severe acute respiratory syndrome Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.1] Young syndrome\n Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections....", "[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--> [LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --CHILD--> [CA40.0] 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...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to..." ]
CB40.Y
Other specified diseases of the respiratory system
[ { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "CA40.Z", "icd10_code": "J189", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J181", "icd10_title": "Lobar pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J188", "icd10_title": "Other pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J168", "icd10_title": "Pneumonia due to other specified infectious organisms" }, { "from_icd11": "CA40.Z", "icd10_code": "J180", "icd10_title": "Bronchopneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J17", "icd10_title": "Pneumonia in diseases classified elsewhere" }, { "from_icd11": "CA40.Z", "icd10_code": "J182", "icd10_title": "Hypostatic pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J16", "icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified" }, { "from_icd11": "CA40.Z", "icd10_code": "J171", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J173", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J178", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J18", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" } ]
Q333
Agenesis of lung
An 88-year-old white woman with a history of vascular dementia and idiopathic pulmonary fibrosis (IPF) presented with a 4.5 cm left-sided level III anterior cervical lymph node . Prior to her onset of dementia and IPF, she was otherwise healthy. Her family history was not relevant for hematologic malignancies or cancer. She denied tobacco smoking. In addition to her neck mass, she developed night sweats and 1.8 kg (4 pound) weight loss. No lymph nodes were detected in her right supraclavicular, axillary, and inguinal regions. Auscultation of her lung bases revealed dry crackles. Hepatomegaly and splenomegaly were not observed. A computed tomography (CT)-guided core needle biopsy was done on September 16, 2014. A core, rather than excisional biopsy was considered given her severe lung disease and inability to tolerate general anesthesia. Tissue examination showed B cells of follicular origin, admixed with high-grade large cells . Flow cytometry showed clonal B cell population (36% of total cellularity) positive for CD10, CD19, and CD20 . Cells were Kappa-restricted associated with < 1% natural killer (NK) cells. Examination of her tumor biopsy showed a CD4:CD8 ratio of 9:1 without aberrant T cell antigen expression. EBV in situ hybridization was not performed. Positron emission tomography (PET-CT) revealed single uptake above the clavicle on the left side with standardized uptake value (SUV) of 4.9 confirming stage 1B disease. Her International Prognostic Index (IPI) was 2 points: low intermediate risk group; age > 60 years, lactate dehydrogenase (LDH) of 599, stage 1, Eastern Cooperative Oncology Group (ECOG) of 0. In addition, given her history of dry coughing and shortness of breath, a chest CT was obtained, which revealed honeycombing, bronchial wall thickening, and subpleural ground glass opacities suggesting interstitial pneumonitis . Her symptoms were controlled with inhaled β-agonists without administration of orally administered or systemic steroids. Her peripheral blood flow cytometry detected increased proportion of cells with cytotoxic potential including human leukocyte antigen-antigen D related (HLA-DR) + T cells (57%, normal 9–36%; absolute count of 884/mm 3 , normal 177–692/mm 3 ) and double positive (DP) CD4/CD8 T cells (4%, normal 0–2%; absolute count of 62 mm 3 , normal 0–50 mm 3 ) . After discussion of treatment options, she opted for best supportive care. Three months later, during a routine follow-up examination, it was noted that the lymph node had completely regressed. Ultrasonographic and clinical remission were documented in October 2016, 25 months after her initial CT-guided biopsy. She died with progressive respiratory insufficiency attributed to IPF without evidence of lymphoma in December 2016. Fig. 1 Initial neck computed tomography for cervical mass and follow-up neck ultrasound. a and b Neck computed tomography showing 4.5 cm level III left-sided neck mass (red arrows). c Neck ultrasound showing resolution of previously observed neck mass. Small non-pathologic appearing nodes with fatty hila were identified (red arrow) Fig. 2 Lymphoma biopsy. 1 Cells are composed predominantly of large lymphocytes two to three times larger than normal background small lymphocytes (Diff-Quik stain, × 100). 2 a–f Flow cytometry, left-sided neck mass: Flow cytometry of the left-sided neck mass shows a CD10 positive kappa light chain-restricted large B cell lymphoma with a background of small T cells and polytypic non-germinal center B cells. a Small T cells ( green , 36% of cellularity) and small CD10 negative B cells ( purple , 10%) with low forward scatter and large CD10 positive B cells ( blue , 39%) with higher forward scatter. b CD5 positive T cells ( green ) and CD5 negative B cells ( purple and blue ). c CD10 positive B cells are larger by forward scatter than the T cells ( green ) and CD10 negative B cells ( purple ). d CD20 and CD10 positive large B cell lymphoma, germinal center type ( blue ) and CD10 negative B cells ( purple ). e CD10 positive B cells ( blue ) show clonal kappa light chain restriction. f CD10 negative B cells ( purple ) show polytypic light chain expression Fig. 3 a Computed tomography demonstrates honeycombing (red arrow) distributed in the left lower lobe. Bronchial thickening is observed in the left lung. b Chest CT revealing subpleural ground glass opacities (red arrow) Fig. 4 a Peripheral blood flow cytometry showing increased double-positive T-cells (DPT) in a patient exhibiting spontaneous remission of diffuse large B-cell lymphoma. b Peripheral blood flow cytometry T cell subtraction associated with increased HLA-DR. DPT and increased HLA-DR expression are linked to T cell activation and potential for cytotoxicity
4.160156
0.96875
sec[1]/p[0]
en
0.999997
30709425
https://doi.org/10.1186/s13256-018-1937-z
[ "cells", "neck", "cell", "large", "flow", "cytometry", "tomography", "biopsy", "lymphoma", "small" ]
[ { "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": "ME86.C", "title": "Symptom or complaint of the neck" }, { "code": "LA6Z", "title": "Structural developmental anomalies of the neck, unspecified" }, { "code": "ME84.0", "title": "Cervical spine pain" }, { "code": "FA71", "title": "Torticollis" }, { "code": "NA23.4Y", "title": "Other specified strain or sprain of cervical spine" } ]
=== 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 [ME86.C] Symptom or complaint of the neck Also known as: Symptom or complaint of the neck | Neck syndrome Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain [LA6Z] Structural developmental anomalies of the neck, unspecified Also known as: Structural developmental anomalies of the neck, unspecified | Malformations of the neck [ME84.0] Cervical spine pain Definition: This is a condition which is usually characterised by pain or discomfort in the neck region and can be caused by numerous spinal problems. It may be a feature of virtually every disorder and disease that occurs above the shoulder blades. Also known as: Cervical spine pain | cervical pain | neck ache | nonspecific pain in the neck region | cervicalgia Includes: cervicalgia Excludes: cervical disc degeneration | Chronic primary cervical pain | Chronic secondary musculoskeletal pain [FA71] Torticollis Also known as: Torticollis | contracture of neck | wry neck | wry neck/torticollis | Intermittent torticollis Excludes: Cervical dystonia | Congenital torticollis | current injury - see injury of spine by body region [NA23.4Y] Other specified strain or sprain of cervical spine Also known as: Other specified strain or sprain of cervical spine | Strain of cervical spine | cervical strain | Strain of cervical anterior longitudinal ligament | Sprain of cervical spine === GRAPH WALKS === --- Walk 1 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --EXCLUDES--> [?] Inborn errors of carbohydrate metabolism --- Walk 2 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --EXCLUDES--> [?] Clinical findings on antenatal screening of mother Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother.... --- Walk 3 --- [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 4 --- [5C56.20] Mucolipidosis --EXCLUDES--> [?] Sialidosis --PARENT--> [?] Oligosaccharidosis --- 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 ... --CHILD--> [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
[ "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of carbohydrate metabolism", "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....", "[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...", "[5C56.20] Mucolipidosis\n --EXCLUDES--> [?] Sialidosis\n --PARENT--> [?] Oligosaccharidosis", "[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 --CHILD--> [3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr..." ]
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": "LA6Z", "icd10_code": "Q680", "icd10_title": "Congenital deformity of sternocleidomastoid muscle" }, { "from_icd11": "LA6Z", "icd10_code": "Q180", "icd10_title": "Sinus, fistula and cyst of branchial cleft" }, { "from_icd11": "LA6Z", "icd10_code": "Q188", "icd10_title": "Other specified congenital malformations of face and neck" }, { "from_icd11": "LA6Z", "icd10_code": "Q10-Q18", "icd10_title": "" }, { "from_icd11": "LA6Z", "icd10_code": "Q182", "icd10_title": "Other branchial cleft malformations" }, { "from_icd11": "ME84.0", "icd10_code": "M542", "icd10_title": "Cervicalgia" }, { "from_icd11": "ME84.0", "icd10_code": "M530", "icd10_title": "Cervicocranial syndrome" }, { "from_icd11": "ME84.0", "icd10_code": "M531", "icd10_title": "Cervicobrachial syndrome" }, { "from_icd11": "FA71", "icd10_code": "M436", "icd10_title": "Torticollis" }, { "from_icd11": "FA71", "icd10_code": "M43", "icd10_title": "Other deforming dorsopathies" } ]
D571
Sickle-cell disease without crisis
A 39-year-old apparently healthy woman complained of fever and productive cough, in March, 2017. Her medical history did not reveal any specific illness, including acquired immune deficiency syndrome, collagen disease, and congenital immunodeficiency. She neither smoked nor consumed alcohol. Three days after onset (clinical day 3), she was admitted to a local general hospital, owing to progressive fever, malaise, and anorexia. On admission, her vital signs were as follows: body temperature, 39.2 °C; blood pressure, 106/64 mmHg; pulse, 80 beats/min with a regular rhythm; SpO 2 , 97% in an air-conditioned room; and respiratory rate, 16 breaths/min. Cyanosis, cardiac murmur, and abnormal breath sounds were absent. The patient’s liver, spleen and lymph nodes were not palpable. Her white blood cell count was 5600/μL, with a shift to the left (81.2% neutrophils). Her aspartate aminotransferase level was 23 IU/L; alanine aminotransferase, 12 IU/L; lactate dehydrogenase, 206 IU/L; and C-reactive protein, 2.4 mg/dL (normal range, 0–0.3 mg/dL). Moreover, the patient’s chest X-ray and chest computed tomography (CT) images revealed subsegmental consolidation in her right lower lobe . After admission, administration of ampicillin/sulbactam (ABPC/SBT), at 6 g/day, was initiated under a clinical diagnosis of severe community-acquired pneumonia. Azithromycin (AZM) was also given at 2 g/day p.o. stat on clinical day 3 . Her indirect hemagglutination titer for MP was negative (1:40) on clinical day 4. After admission (clinical day 7), her fever had not subsided, and the pulmonary lesions had extended to the entire right lower lobe as well as to the left lower lobe . Thus, bronchoalveolar lavage (BAL) and a transbronchial biopsy of the right lower lobe were performed. These examinations revealed nonspecific inflammation with neutrophil infiltration, but no pathogen was identified on pathological or microbiological examination. Contrary to the extremely rapid progression of the pulmonary lesions, her general condition had not significantly deteriorated, which was not compatible with severe bacterial infection. Owing to the unique clinical presentation, organizing pneumonia was considered. Therefore, treatment with prednisolone (PSL) was initiated at 40 mg/day from clinical day 7, and steroid pulse therapy (methylprednisolone 1 g/day) was given on clinical days 10–12. However, neither her symptoms nor her pulmonary lesion improved . Rather, her respiratory failure had worsened significantly, after steroid pulse therapy (clinical day 14), as she required oxygen inhalation at 15 L/min on her motion; therefore, she was transferred to our hospital (Hokkaido University hospital) for further examination and treatment. Considering the existence of lower respiratory tract infection due to any rare pathogens, ABPC/SBT was changed to meropenem (MEPM) on clinical day 14, and levofloxacin (LVFX) and minocycline (MINO) were also initiated concurrently. On admission (clinical day 14), her indirect hemagglutination titer for MP had elevated to 1:2560, which was more than that identified on clinical day 4 at the referring hospital. Moreover, BAL fluid (BALF) examination, which was performed on the day of admission to our hospital, using Ribotest™ Mycoplasma (Asahi Kasei Pharma Corporation, Japan), yielded positive results for the mycoplasma antigen. No other pathogen was identified on microbiological examination of the BALF. Based on these clinical findings, we confirmed our case as severe life-threatening MP pneumonia. Thereafter, we continued empirical antibiotic therapy with LVFX, MINO and MEPM, and corticosteroid therapy with PSL at 40 mg/day. Two days later (clinical day 16), her fever, malaise, and hypoxia had resolved, and her pulmonary lesions had significantly improved . Therefore, we replaced the antibiotics with garenoxacin (GRNX) as monotherapy, at 400 mg/day, and reduced the dosage of PSL from clinical day 18. The patient was discharged on day 24, and administration of GRNX and corticosteroid therapy were continued until clinical day 30 . Subsequently, she had an uneventful recovery with no recurrence of fever or pneumonia. Fig. 1 Chest X-ray image (A, B, C and D) and chest CT image (F, G and H) of the thorax. 10 days before admission to our hospital (clinical day 3), the chest images revealed sub-segmental infiltration in the right lower lobe, which enlarged to bilateral lower lung field from clinical day 7 to 14. After switching the antibiotics, the chest images improved until clinical day 16 Fig. 2 Treatment course. m-PSL: methylprednisolone, PSL: prednisolone, AZM: azithromycin, ABPC/SBT: ampicillin/sulbactam, MEPM: meropenem, LVFX: levofloxacin, MINO: minomycin, GRNX: garenoxacin
3.970703
0.977539
sec[1]/p[0]
en
0.999998
30819124
https://doi.org/10.1186/s12879-019-3846-1
[ "chest", "fever", "lobe", "pneumonia", "pulmonary", "which", "pulse", "respiratory", "abpc", "initiated" ]
[ { "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": "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 === [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 [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 --- [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--> [?] Tuberculosis of the respiratory system Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M.... --CHILD--> [?] Respiratory tuberculosis, confirmed Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough,... --- Walk 4 --- [CB27] Pleural effusion Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.... --EXCLUDES--> [?] Tuberculosis of the respiratory system Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M.... --PARENT--> [?] Tuberculosis Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation... --- 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... --CHILD--> [?] Bronchopleural tuberculosis
[ "[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--> [?] Tuberculosis of the respiratory system\n Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M....\n --CHILD--> [?] Respiratory tuberculosis, confirmed\n Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough,...", "[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --EXCLUDES--> [?] Tuberculosis of the respiratory system\n Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M....\n --PARENT--> [?] Tuberculosis\n Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation...", "[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 --CHILD--> [?] Bronchopleural tuberculosis" ]
CB7Z
Diseases of the respiratory system, unspecified
[ { "from_icd11": "CB7Z", "icd10_code": "J989", "icd10_title": "Respiratory disorder, unspecified" }, { "from_icd11": "CB7Z", "icd10_code": "X", "icd10_title": "" }, { "from_icd11": "CB7Z", "icd10_code": "J09-J18", "icd10_title": "" }, { "from_icd11": "CB27", "icd10_code": "J910", "icd10_title": "Malignant pleural effusion" }, { "from_icd11": "CB27", "icd10_code": "J918", "icd10_title": "Pleural effusion in other conditions classified elsewhere" }, { "from_icd11": "CB27", "icd10_code": "J90", "icd10_title": "Pleural effusion, not elsewhere classified" }, { "from_icd11": "CB27", "icd10_code": "J90-J94", "icd10_title": "" }, { "from_icd11": "CB27", "icd10_code": "J91", "icd10_title": "Pleural effusion in conditions classified elsewhere" }, { "from_icd11": "CA44", "icd10_code": "J869", "icd10_title": "Pyothorax without fistula" }, { "from_icd11": "CA44", "icd10_code": "J860", "icd10_title": "Pyothorax with fistula" }, { "from_icd11": "CA44", "icd10_code": "J85-J86", "icd10_title": "" }, { "from_icd11": "CA44", "icd10_code": "J86", "icd10_title": "Pyothorax" }, { "from_icd11": "MD30.Z", "icd10_code": "R0781", "icd10_title": "Pleurodynia" }, { "from_icd11": "MD30.Z", "icd10_code": "R0782", "icd10_title": "Intercostal pain" }, { "from_icd11": "MD30.Z", "icd10_code": "R079", "icd10_title": "Chest pain, unspecified" } ]
J989
Respiratory disorder, unspecified
A fifty-six-year-old mixed ancestry male patient with end-stage kidney disease due to malignant hypertension was admitted in December 2018 on account of his family’s concerns of a slow decline in functions, confusion, inappropriate behavior, rigors and significant loss of weight and appetite over the past 4 months. He underwent a deceased donor renal transplantation in 2002 with a baseline creatinine of 91 μmol/L (64–104 μmol/L) and eGFR of 58 mL/min/1,73m 2 (> 60 mL/min/1,73m 2 ). His immunosuppressive regime consisted of tacrolimus 2 mg twice daily, prednisone 10 mg once daily, and mycophenolate mofetil (MMF) 500 mg twice daily. He used to work in the South African Police Services previously but has been unemployed for over 10 years, he does not smoke or consume alcohol and does not give a history of gardening or other similar hobbies. The family and environmental history were unremarkable. A review of his medical records revealed a remote history of articular sporotrichosis diagnosed on aspiration of his left wrist joint 2 years prior to his current presentation, for which he received treatment with oral itraconazole 200 mg daily for a total duration of 10 months. On physical examination he had a blood pressure of 135/72 mmHg, heart rate of 96 beats/minute, respiratory rate of 16 per/minute, temperature of 36.4 °C, random blood glucose of 12 mmol/L and, he appeared chronically ill with bilateral temporalis muscle wasting. His extracellular fluid compartment was contracted, and he had chronic non-pitting oedema of the lower limbs. He had symmetrical synovial hypertrophy on the small joints of his hands without evidence of a destructive arthropathy. Importantly, he did not have any stigmata suggestive of cutaneous or lymphocutaneous sporotrichosis. His sensorium was altered with a Glasgow Coma Scale of 12/15 (eyes – 4, motor – 5, verbal – 3), neither meningism nor focal neurological deficits were evident on the motor and sensory examinations. Examination of his fundi revealed no evidence of papilloedema. The rest of his physical examination was unremarkable. His work-up revealed patchy alveolar infiltrates on chest radiography. Computerized tomography of the brain was essentially normal apart from mild global cerebral atrophy and microangiopathic changes. Considering the history, clinical presentation, laboratory findings (Table 1 ) and the high background prevalence of tuberculosis in our population, as well as his immunosuppressed state, we decided to initiate empiric rifampicin sparing oral anti-tuberculous therapy (moxifloxacin 400 mg once daily, isoniazid 300 mg once daily, ethambutol 400 mg once daily, pyridoxine 25 mg once daily and pyrazinamide 1,2 g once daily). The patient’s clinical state continued to deteriorate despite being on anti-tuberculous treatment for more than 4 weeks. The difficulty was distinguishing a slow response to anti-tuberculous therapy in a patient with significant comorbidities from a misdiagnosis. Based on his deteriorating clinical state, previous remote history of articular sporotrichosis, and after reviewing the literature, we entertained the diagnosis of possible meningeal sporotrichosis and subsequently requested investigations specific for sporotrichosis which was confirmed by PCR in February 2019. Based on these results (Table 2 ) we discontinued his anti-tuberculous treatment and MMF and initiated intravenous deoxycholate amphotericin B (AMB-d) (0,75 mg/kg/day – adjusted to eGFR) which was continued for 35 days. Liposomal amphotericin B is prohibitively expensive in our setting, we therefore opted to treat him with AMB-d. Following this intensive phase of daily AMB-d, he showed a slow but favorable response to therapy (Table 3 ) and returned to a level of functioning that allowed independent out-patient living. On discharge, the dosing frequency of AMB-d was decreased to once weekly, given for a total of 4 doses, due to concerns of AMB-d related nephrotoxicity. He was also initiated on oral itraconazole 200 mg twice daily, which he was to continue for the next 12 months followed by 200 mg once daily as life-long prophylaxis. He had been stable and well at the time of this write-up; he unfortunately passed away at home, while asleep 3 months after discharge, an autopsy was declined by the family; the cause of death was presumed to be of cardiovascular nature. Table 1 Clinical and laboratory data ( case 2 ) Red data signifies an abnormal value Spp Species Table 2 Specific laboratory testing for Sporotrichosis ( case 2 ) Red data signifies an abnormal value PCR Polymerase Chain Reaction Table 3 Serial laboratory values depicted in relation to initiation of antifungal therapy ( case 2 ) Neg Negative, CSF Cerebrospinal fluid
3.994141
0.976074
sec[2]/p[0]
en
0.999997
32586384
https://doi.org/10.1186/s13256-020-02385-x
[ "daily", "sporotrichosis", "which", "laboratory", "anti", "tuberculous", "family", "slow", "twice", "oral" ]
[ { "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": "1F2J.Z", "title": "Sporotrichosis, unspecified" }, { "code": "1F2J.Y", "title": "Other specified sporotrichosis" }, { "code": "1F2J.3", "title": "Disseminated sporotrichosis" }, { "code": "1F2J.2", "title": "Pulmonary sporotrichosis" }, { "code": "1F2J.1", "title": "Fixed cutaneous sporotrichosis" }, { "code": "BD50.41", "title": "Abdominal aortic aneurysm with rupture" }, { "code": "EK91", "title": "Dermatoses which may presage cutaneous lymphoma" } ]
=== 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 [1F2J.Z] Sporotrichosis, unspecified Also known as: Sporotrichosis, unspecified | Sporotrichosis [1F2J.Y] Other specified sporotrichosis Also known as: Other specified sporotrichosis | Cutaneous or lymphocutaneous sporotrichosis | Systemic or invasive sporotrichosis | Sporotrichosis arthritis [1F2J.3] Disseminated sporotrichosis Also known as: Disseminated sporotrichosis | generalised sporotrichosis [1F2J.2] Pulmonary sporotrichosis Definition: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. Symptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional complaints of fever, night sweats, weight loss, and fatigue as well as respiratory complaints including dyspnoea, cough, purulent sputum, and haemoptysis. Also known as: Pulmonary sporotrichosis [1F2J.1] Fixed cutaneous sporotrichosis Definition: Cutaneous sporotrichosis which remains localised to the area of inoculation. Also known as: Fixed cutaneous sporotrichosis [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 --- [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--> [QF21] Difficulty or need for assistance with general life tasks or life management --- 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.... --CHILD--> [QF22] Difficulty or need for assistance with communication --- 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 --CHILD--> [8A82] Trigeminal autonomic cephalalgias Def: A group of related primary headache disorders essentially characterised by unilateral headache and trigeminal autonomic activation. In most but not all of these disorders, the headache is short-lastin... --- 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 --CHILD--> [8A81] Tension-type headache Def: A primary and highly prevalent headache disorder, in most cases episodic. Attacks of highly variable frequency and duration are characterised by mild-to-moderate headache without associated symptoms, ... --- 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... --CHILD--> [?] Preparatory care for dialysis Def: Preparatory care for dialysis may include the assessment, education and counselling of the patient and carer(s) to facilitate psychosocial adjustment, choice of dialysis modality (including site – hom... --- 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... --EXCLUDES--> [?] Dependence on renal 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--> [QF21] Difficulty or need for assistance with general life tasks or life management", "[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", "[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 --CHILD--> [8A82] Trigeminal autonomic cephalalgias\n Def: A group of related primary headache disorders essentially characterised by unilateral headache and trigeminal autonomic activation. In most but not all of these disorders, the headache is short-lastin...", "[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 --CHILD--> [8A81] Tension-type headache\n Def: A primary and highly prevalent headache disorder, in most cases episodic. Attacks of highly variable frequency and duration are characterised by mild-to-moderate headache without associated symptoms, ...", "[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--> [?] Preparatory care for dialysis\n Def: Preparatory care for dialysis may include the assessment, education and counselling of the patient and carer(s) to facilitate psychosocial adjustment, choice of dialysis modality (including site – hom...", "[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" ]
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": "1F2J.Z", "icd10_code": "B429", "icd10_title": "Sporotrichosis, unspecified" }, { "from_icd11": "1F2J.Z", "icd10_code": "B42", "icd10_title": "Sporotrichosis" }, { "from_icd11": "1F2J.Z", "icd10_code": "B428", "icd10_title": "Other forms of sporotrichosis" }, { "from_icd11": "1F2J.3", "icd10_code": "B427", "icd10_title": "Disseminated sporotrichosis" }, { "from_icd11": "1F2J.2", "icd10_code": "B420", "icd10_title": "Pulmonary sporotrichosis" }, { "from_icd11": "BD50.41", "icd10_code": "I713", "icd10_title": "Abdominal aortic aneurysm, ruptured" } ]
Z742
Need for assistance at home and no other household member able to render care
However, no history of increased activity, agitation, restlessness, aimless wandering, increased libido, irrational talk, loss of appetite and sleep disturbances as well as hearing voices, social withdrawal, paucity of self-care, violent behavior, gathering of debris, or any abnormal behavior. Past psychiatric history revealed that there was a positive history of psychoactive drug use, specifically, Cannabis , which he used via smoking of dried leaves wrapped in a strip of paper; he began using it at age 16/17 (17 years ago); he was introduced to it by friends and a desire to experiment and rebel; he used drugs independently and with friends; habit was sustained by his allowance and stealing from his parents; drug use continued for a few years and ceased in his early twenties. In his mid-twenties, in 2006 (9 years ago), he became socially withdrawn, left the house for no apparent reason, and began living alone; then he disappeared for 3-4 months (he later admitted he travelled to Niger in a failed bid to emigrate to Europe) and returned home voluntarily, only to begin living in uncompleted buildings and talking irrationally, with history of provoked violent attack on a shopkeeper after being stigmatized as “a mental case.” Subsequently, in 2008, he was admitted to the Neuropsychiatric Hospital, Rumuigbo, and a diagnosis of “Substance Use Disorder” was made; several investigations were done and drugs administered; he was discharged after a month and a fortnight. Follow-up was regular for two months; however, he defaulted because he claimed he was not “mental” and because of the side effects of drugs. There is no history or evidence of a relapse following discharge. In the past medical history, there was no history of hypertension, epilepsy, asthma, diabetes mellitus, sickle cell disease, neurocutaneous disorders, and erectile dysfunction. Family history showed that he is the only male as well as the first of four children in a monogamous setting. However, his mother had 2 children in a later marriage after the divorce of his parents, making a total of 6 children, 3 full sisters and 2 half-sisters. His mother is a middle aged matron with tertiary level of education. His father is deceased, had tertiary level of education, and was a senior civil servant with the Ministry of Agriculture. He was not close to his father and appeared to have had a troubled relationship with him following the divorce of his parents; his father died three years earlier, at age 61, from an unknown medical condition. The personal history revealed that the patient completed his basic education. However, he did not pass the UME with good scores and failed to obtain a university admission, and he was said to be an average student. He enrolled in a part time program, in the National Open University, 2 years earlier, but did not complete the course because of his present illness. Subsequently, he said he has received training as an electrician and construction worker. He claims to be a single father of an 18-year-old boy (with elaborate information about the nonexistent child); however, his mother denies this and he later admitted he told us this so that we would remove his testes since he has a child. Social history showed that, in the past, he occasionally drank alcoholic beverages but has seldom done so for the past seven years. He smoked tobacco in cigarette form occasionally. Patient seldom interacts with people except his family members whom he lives with; he initially said he lives alone but his mother said he lives with her and he admitted this. Psychosexual history as elicited showed that adrenarche was attained at age 14 while onset of nocturnal emissions began at age 17. First sexual activity was with a female partner, experience was pleasurable and exciting, and subsequent experiences have been pleasurable and in almost all cases barrier contraception in the form of male condoms was used. The patient insisted that his sexual orientation and love interest has been strictly heterosexual. He has seldom had any early morning erections over the last 6 years and cannot recall having experienced any nocturnal emissions within the same period. He denies any masturbation as well as orgasm/ejaculation; however, semen for analysis was obtained via masturbation without the use of pornography. In the forensic assessment history, patient has not been convicted for any crime, sentenced to jail, or jumped bail; however, he has been arrested thrice and detained for minor offences such as moving at night during a curfew. Premorbidly, leisure activities included watching football matches; he formed deep ties in relationships, had few friends, and was introverted/quiet. His prevailing mood was happy.
3.498047
0.983398
sec[1]/p[4]
en
0.999998
27478672
https://doi.org/10.1155/2016/8608951
[ "however", "that", "past", "mother", "father", "said", "well", "used", "friends", "drugs" ]
[ { "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": "PL13.8", "title": "Expired or deteriorated medication or substance, as mode of injury or harm" }, { "code": "BA50", "title": "Old myocardial infarction" }, { "code": "8B25.4", "title": "Late effects of stroke not known if ischaemic or haemorrhagic" }, { "code": "QE51.1", "title": "History of spouse or partner violence" }, { "code": "PB36", "title": "Unintentional exposure to or harmful effects of other or unspecified substances chiefly nonmedicinal as to source" } ]
=== ICD-11 CODES FOUND === [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS [PL13.8] Expired or deteriorated medication or substance, as mode of injury or harm Also known as: Expired or deteriorated medication or substance, as mode of injury or harm | drug past expiry date | expired drug | deteriorated drug | drug past due date [BA50] Old myocardial infarction Definition: Past myocardial infarction diagnosed by electrocardiogram (ECG) or other special investigation, but currently presenting no symptoms. Also known as: Old myocardial infarction | past myocardial infarction | healed myocardial infarction | myocardial scar | myocardial scarring Includes: healed myocardial infarction [8B25.4] Late effects of stroke not known if ischaemic or haemorrhagic Definition: Late effects occurring 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episodes. Also known as: Late effects of stroke not known if ischaemic or haemorrhagic | sequelae of stroke, not specified as haemorrhage or infarction | old cerebrovascular accident | old CVA - [cerebrovascular accident] | old stroke [QE51.1] History of spouse or partner violence Definition: Non-accidental acts of physical force, forced or coerced sexual acts, verbal or symbolic acts, or significant caregiving omissions that result in harm to a spouse or intimate partner or that have a reasonable potential for harm. Also known as: History of spouse or partner violence | spouse violence | partner violence | History of spouse or partner violence, physical | partner physical violence [PB36] Unintentional exposure to or harmful effects of other or unspecified substances chiefly nonmedicinal as to source Also known as: Unintentional exposure to or harmful effects of other or unspecified substances chiefly nonmedicinal as to source | Unintentional exposure to or harmful effects of other or unspecified gases, fumes or vapours | Unintentional exposure to or harmful effects of nitrogen oxides | Unintentional exposure to or harmful effects of sulfur dioxide | Unintentional exposure to or harmful effects of formaldehyde === GRAPH WALKS === --- Walk 1 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --CHILD--> [8A80.0] Migraine without aura Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu... --- Walk 2 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --CHILD--> [8A80.2] Chronic migraine Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse... --- Walk 3 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm --PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm --- Walk 4 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 5 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --CHILD--> [PL13.1] Underdosing, as mode of injury or harm --- Walk 6 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --CHILD--> [PL13.2] Drug-related injury or harm in the context of correct administration or dosage, as mode of injury or harm
[ "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.0] Migraine without aura\n Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu...", "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.2] Chronic migraine\n Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm\n --PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.1] Underdosing, as mode of injury or harm", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.2] Drug-related injury or harm in the context of correct administration or dosage, as mode of injury or harm" ]
8A80.Z
Migraine, unspecified
[ { "from_icd11": "8A80.Z", "icd10_code": "G43B0", "icd10_title": "Ophthalmoplegic migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43409", "icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A0", "icd10_title": "Cyclical vomiting, in migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D0", "icd10_title": "Abdominal migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43709", "icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A1", "icd10_title": "Cyclical vomiting, in migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43509", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43719", "icd10_title": "Chronic migraine without aura, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43501", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C0", "icd10_title": "Periodic headache syndromes in child or adult, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43401", "icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43419", "icd10_title": "Hemiplegic migraine, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43B1", "icd10_title": "Ophthalmoplegic migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C1", "icd10_title": "Periodic headache syndromes in child or adult, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D1", "icd10_title": "Abdominal migraine, intractable" } ]
G43B0
Ophthalmoplegic migraine, not intractable
A 70-year-old woman was referred to our hospital for investigation of epigastric discomfort and liver dysfunction. The patient had a history of hypertension and an overactive bladder. Her body mass index (BMI) was 29.3 kg/m 2 , and she had no metabolic diseases, such as diabetes or dyslipidemia. Laboratory data at the time of presentation are shown in Table 1 . CT examination revealed a tumor in a distal bile duct ; however, a tissue specimen could not be collected for diagnosis because of difficulty in approaching the common bile duct. Although the tumor was diagnosed as a cholangiocarcinoma using the rendezvous technique, the patient later developed pancreatitis . After receiving conservative treatment for pancreatitis and regaining her physical strength through rehabilitation, the patient underwent subtotal stomach-preserving pancreaticoduodenectomy. The inflammation around the PV was severe but could be resected without combined resection of the PV. The pathological specimen was a flat infiltrating mass that covered two-thirds of the bile duct lumen and was revealed to be a moderately to poorly differentiated adenocarcinoma, with negative resection margins. Based on the Union for International Cancer Control TNM staging, the pathological diagnosis was T1N1M0, stage IIA. Oral intake was started on the 6th postoperative day. The patient developed a fever on the 12th postoperative day and was found to have an infection from the drain, so antibiotics were administered. In addition, pancrelipase was started on the 19th postoperative day to treat diarrhea symptoms. After that, the postoperative course was stable and the patient was discharged on the 33rd postoperative day. However, the patient presented to the emergency department of our hospital with diarrhea and breathing difficulty on the 59th postoperative day. CT images showed marked fatty liver, ascites, intestinal edema, and PV stenosis . The next day, a PV stent was inserted by the percutaneous transhepatic approach and the PV flow improved . Although arterial bleeding from the liver was observed at the time of puncture, the bleeding spontaneously subsided after compression fixation. The intestinal edema and diarrhea symptoms also improved and the patient was discharged on the 75th postoperative day with oral anticoagulants. At final follow-up 48 months after surgery, there were no signs of MASLD and no problems with the PV flow. Table 1 Results of laboratory investigations First visit Before surgery POD 41 Readmission POD 59 POD 112 2 years after Complete blood count WBC × 10 2 /µl 45.2 62.6 58.3 60.7 38.9 45.6 RBC × 10 4 /µl 464 414 386 405 431 431 Hb g/dl 13.1 11.9 10.6 10.8 11.2 11.2 Plt × 10 4 /µl 23.2 28.7 25.0 26.5 22.1 20.4 Neutr /µl 2600 3500 3790 4200 2570 6390 Lypho /µl 1420 2020 1410 1210 990 2630 Biochemistry T-Bil mg/dl 6.84 1.17 0.44 0.56 0.44 0.36 AST U/L 423 49 43 46 47 30 ALT U/L 924 65 27 26 30 28 LDH U/L 277 196 192 226 153 179 ChE IU/L - - 184 156 237 329 TP g/dl 6.7 6.8 6.4 6.4 6.9 7.2 Alb g/dl 3.7 3.8 3.1 3.0 4.0 4.0 AMY U/L 60 28 – 27 31 67 Lipase U/L 102 63 – 31 21 48 T-CHO mg/dl 182 208 136 134 165 136 TG mg/dl 132 101 72 60 89 48 HDL-C mg/dl 66.0 81.8 54.3 62.8 69.8 52.1 LDL-C mg/dl 90 106.0 60.2 60.4 77.8 71.0 A1c % 5.5 5.5 – 5.4 5.5 6.1 Zn μg/dl – – – 40 – 68 CRP mg/dl 0.91 0.14 1.16 1.17 0.03 0.04 Coagulation PT % 110.5 116.4 – 89.1 95 114.5 WBC white blood cells, RBC red blood cells, Hb hemoglobin, Plt platelets, Neutr neutrophil, Lympho lymphocytes, T-Bil total bilirubin, AST aspartate aminotransferase (GOT), ALT alanine aminotransferase (GPT), LDH lactase dehydrogenase, ChE cholinesterase, TP total protein, Alb albumin, T-CHO total cholesterol, TG triglyceride, HDL-C high-density lipoprotein cholesterol, LDL-C low-density lipoprotein cholesterol, HbA1c hemoglobin A1c, Zn zinc, CRP C-reactive protein, PT prothrombin time Fig. 1 CT images of the tumor and pancreatitis after endoscopic retrograde cholangiopancreatography. a Enhanced tumor (arrowhead) is seen in a distal bile duct. The intrahepatic bile duct is mildly dilated (+). b Extensive inflammation (arrows) is present from the pancreatic head to the mesentery of the transverse colon Fig. 2 CT images on readmission and treatment for PV stenosis. a Liver CT values are decreased overall and there is ascites around the liver and spleen ( * ). b Maximum intensity projection image shows the PV stenosis (arrowhead). c PV stent is inserted via percutaneous transhepatic puncture. d Left: coronal CT image taken at the time of readmission showing ascites throughout and intestinal edema. Right: the same coronal CT view obtained 7 days after intervention shows that the ascites has disappeared and the intestinal edema has improved
4
0.973145
sec[1]/p[0]
en
0.999998
39147944
https://doi.org/10.1007/s12328-024-02027-5
[ "postoperative", "liver", "bile", "duct", "time", "tumor", "ascites", "intestinal", "edema", "pancreatitis" ]
[ { "code": "NE81.0Z", "title": "Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified" }, { "code": "NE81.3", "title": "Postsurgical leak" }, { "code": "QF00", "title": "Acquired absence of limb" }, { "code": "DB30.2", "title": "Adhesions of large intestine with obstruction" }, { "code": "MG30.21", "title": "Chronic postsurgical pain" }, { "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" } ]
=== ICD-11 CODES FOUND === [NE81.0Z] Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified Also known as: Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified | Haemorrhage or haematoma complicating a procedure, not elsewhere classified | postoperative haemorrhage | postoperative bleeding | Haemorrhage at any site resulting from a procedure [NE81.3] Postsurgical leak Also known as: Postsurgical leak | postoperative leak | Postsurgical air leak | postoperative air leak | Postsurgical bile leak Excludes: Malfunction or complication of external stoma of digestive organs | Tracheostomy malfunction [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 [DB30.2] Adhesions of large intestine with obstruction Definition: Large bowel obstruction resulting from intraabdominal adhesion due to laparotomy, trauma, and intraabdominal inflammation such as endometriosis. Also known as: Adhesions of large intestine with obstruction | Postoperative obstruction of the large intestine [MG30.21] Chronic postsurgical pain Definition: Chronic postsurgical pain is chronic pain developing or increasing in intensity after a surgical procedure and persisting beyond the healing process, i.e. at least 3 months after surgery. The pain is either localised to the surgical field, projected to the innervation territory of a nerve situated in this area, or referred to a dermatome (after surgery/injury to deep somatic or visceral tissues). Other causes of pain including infection, malignancy etc. need to be excluded as well as pain contin Also known as: Chronic postsurgical pain | postsurgical pain | chronic postoperative pain | chronic postamputation pain | Chronic pain after spinal surgery Includes: Chronic pain after spinal surgery | Chronic pain after herniotomy | Chronic pain after hysterectomy [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 === GRAPH WALKS === --- Walk 1 --- [NE81.0Z] Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified --PARENT--> [NE81.0] Haemorrhage or haematoma complicating a procedure, not elsewhere classified --CHILD--> [NE81.0Z] Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified --- Walk 2 --- [NE81.0Z] Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified --PARENT--> [NE81.0] Haemorrhage or haematoma complicating a procedure, not elsewhere classified --CHILD--> [NE81.00] Haematoma of surgical wound of skin Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis... --- Walk 3 --- [NE81.3] Postsurgical leak --EXCLUDES--> [?] Tracheostomy malfunction --CHILD--> [?] Leak from tracheostomy --- Walk 4 --- [NE81.3] Postsurgical leak --EXCLUDES--> [?] Tracheostomy malfunction --CHILD--> [?] Infection of tracheostomy stoma --- Walk 5 --- [QF00] Acquired absence of limb --EXCLUDES--> [?] Congenital absence of thigh or lower leg with foot present Def: Any condition caused by the failure of the thigh and lower leg to develop during the antenatal period. These conditions are characterised by direct connection of the foot to the hip.... --CHILD--> [?] Congenital absence of thigh or lower leg with foot present, unilateral --- Walk 6 --- [QF00] Acquired absence of limb --EXCLUDES--> [?] Congenital absence of thigh or lower leg with foot present Def: Any condition caused by the failure of the thigh and lower leg to develop during the antenatal period. These conditions are characterised by direct connection of the foot to the hip.... --CHILD--> [?] Congenital absence of thigh or lower leg with foot present, unilateral
[ "[NE81.0Z] Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified\n --PARENT--> [NE81.0] Haemorrhage or haematoma complicating a procedure, not elsewhere classified\n --CHILD--> [NE81.0Z] Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified", "[NE81.0Z] Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified\n --PARENT--> [NE81.0] Haemorrhage or haematoma complicating a procedure, not elsewhere classified\n --CHILD--> [NE81.00] Haematoma of surgical wound of skin\n Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis...", "[NE81.3] Postsurgical leak\n --EXCLUDES--> [?] Tracheostomy malfunction\n --CHILD--> [?] Leak from tracheostomy", "[NE81.3] Postsurgical leak\n --EXCLUDES--> [?] Tracheostomy malfunction\n --CHILD--> [?] Infection of tracheostomy stoma", "[QF00] Acquired absence of limb\n --EXCLUDES--> [?] Congenital absence of thigh or lower leg with foot present\n Def: Any condition caused by the failure of the thigh and lower leg to develop during the antenatal period. These conditions are characterised by direct connection of the foot to the hip....\n --CHILD--> [?] Congenital absence of thigh or lower leg with foot present, unilateral", "[QF00] Acquired absence of limb\n --EXCLUDES--> [?] Congenital absence of thigh or lower leg with foot present\n Def: Any condition caused by the failure of the thigh and lower leg to develop during the antenatal period. These conditions are characterised by direct connection of the foot to the hip....\n --CHILD--> [?] Congenital absence of thigh or lower leg with foot present, unilateral" ]
NE81.0Z
Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified
[ { "from_icd11": "NE81.0Z", "icd10_code": "T8383XA", "icd10_title": "Hemorrhage due to genitourinary prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "NE81.0Z", "icd10_code": "T82838A", "icd10_title": "Hemorrhage due to vascular prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "NE81.0Z", "icd10_code": "T810", "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" }, { "from_icd11": "QF00", "icd10_code": "Z89512", "icd10_title": "Acquired absence of left leg below knee" } ]
T8383XA
Hemorrhage due to genitourinary prosthetic devices, implants and grafts, initial encounter
A 63-year old man was transferred to our facility with the presumptive diagnosis of endocarditis related to a pacemaker-lead infection. Past medical history included hypertension, coronary artery disease, and noninsulin-dependent diabetes mellitus. A VVI (ventricular ventricular inhibited) pacemaker had been implanted for treatment of sick sinus syndrome 9 years earlier. Six weeks before admission, this device had been removed because of a pocket infection after blunt trauma with dislocation of the device and perforation of the skin. Specimens for microbiologic culture were not obtained at this time. The pacemaker leads were left in place, a gentamicin-containing sponge was applied to the infection site, and a new pacemaker was implanted on the other side of the chest. Four weeks later, the patient sought treatment at the local hospital for a high fever (39.7°C) and chills and a subcutaneous abscess with oxacillin-susceptible S. aureus at the primary insertion site . After surgical drainage, antimicrobial therapy was initiated with intravenous cefuroxime. The remaining pacemaker leads were partially cut but not completely removed. Ten days later, spiking fever and chills unresponsive to the administration of meropenem and vancomycin developed, and the patient was transferred to our medical center for pacemaker ablation. The physical examination did not indicate auscultation abnormalities or stigmata of endocarditis. Laboratory studies were unremarkable except a C-reactive protein (CRP) level of 170 mg/L (normal value < 8 mg/L) and a blood sedimentation rate of 79 mm/h. Multiple blood cultures taken on admission remained negative. Transesophageal echocardiography did not show vegetations or other evidence of endocarditis. On hospital day 6, the new pacemaker was completely removed by percutaneous ablation as were the remaining leads of the old device. Only the tip of the pacemaker lead remained fixed in the myocardium, and surgical removal involving extracorporal circulation was not attempted. The patient’s condition improved rapidly, CRP level returned to normal, and on hospital day 32, the patient was transferred to the local hospital to complete a 6-week course of intravenous vancomycin and rifampin as empirical antistaphylococcal therapy. Before transfer, the daily vancomycin dose had been reduced to 250 mg twice a day after an elevated vancomycin serum level. Eight days later, the patient was readmitted with recurrent high fever. Blood cultures taken on readmission were again negative. After the vancomycin dose was increased to 500 mg every 12 hours, the patient promptly became afebrile. Antimicrobial therapy was discontinued after the patient had completed a 10-week course of vancomycin and rifampin. Three days later, the patient again had spiking fever. After 6 to 48 hours of incubation, four sets of blood cultures obtained on four consecutive days yielded nonpigmented and nonhemolytic staphylococci, initially identified on the basis of a negative tube coagulation test and the API ID 32 Staph system (bioMérieux, Marcy-L’Etoile, France) as coagulase-negative staphylococci, susceptible to oxacillin (MIC 0.5 μg/mL) and vancomycin (MIC 1.0 μg/mL) but resistant to rifampin (MIC >32 μg/mL). However, the colony morphologic findings were suggestive of small colony variants of S. aureus , confirmed by polymerase chain reaction amplification of the nuc and coa genes as well as by determination of the stain’s auxotrophy for hemin. The patient responded promptly to flucloxacillin, 4 g intravenously three times a day. After another 6-week course of parenteral therapy, antimicrobial therapy was discontinued, and the patient was discharged (CRP 7 mg/L, ESR 35 mm/h); he was readmitted after 6 days with chills and high fever. Antimicrobial therapy with intravenous flucloxacillin was resumed and followed by immediate defervescence. Three blood cultures taken on readmission were again positive with S. aureus small colony variants. Clonal identity of all isolates was demonstrated by pulsed-field gel electrophoresis of bacterial DNA (data not shown). A transesophageal echocardiogram showed the residual tip of the pacemaker lead fixed in the myocardial septum without vegetations. The remaining device was finally removed by open-heart surgery with use of cardiopulmonary bypass. Microbiologic culture of the pacemaker electrode performed at a different institution yielded abundant growth of staphylococci that were misidentified as S. warneri, showing the same biochemical profile as the previously isolated bacteria as determined by the ID 32 Staph system. The patient recovered completely and was discharged on the 10th postoperative day after a total hospital course of 7 months.
3.814453
0.978516
sec[0]/p[0]
en
0.999995
14609471
https://doi.org/10.3201/eid0910.030200
[ "pacemaker", "vancomycin", "fever", "blood", "device", "antimicrobial", "cultures", "course", "transferred", "endocarditis" ]
[ { "code": "NE82.11", "title": "Pacemaker syndrome" }, { "code": "NE82.1Y", "title": "Other specified pacemaker or implantable cardioverter defibrillator dysfunction" }, { "code": "QB30.20", "title": "Adjustment or management of cardiac pacemaker" }, { "code": "BC9Y", "title": "Other specified cardiac arrhythmia" }, { "code": "NE82.0Y", "title": "Other specified pacemaker or implantable cardioverter defibrillator complication" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "MG51.20", "title": "Vancomycin resistant Enterococcus" }, { "code": "MG51.01", "title": "Vancomycin resistant Staphylococcus aureus" }, { "code": "MG26", "title": "Fever of other or unknown origin" }, { "code": "1D81.Z", "title": "Infectious mononucleosis, unspecified" } ]
=== ICD-11 CODES FOUND === [NE82.11] Pacemaker syndrome Definition: Cardiovascular signs or symptoms following pacemaker implantation due to suboptimal atrioventricular synchrony, regardless of the pacing mode Also known as: Pacemaker syndrome [NE82.1Y] Other specified pacemaker or implantable cardioverter defibrillator dysfunction Also known as: Other specified pacemaker or implantable cardioverter defibrillator dysfunction | Implantable cardioverter defibrillator high voltage component dysfunction | Inappropriate withholding of implantable cardioverter defibrillator therapy | Implantable cardioverter or defibrillator generator dysfunction | Pacemaker or implantable cardioverter defibrillator output failure [QB30.20] Adjustment or management of cardiac pacemaker Also known as: Adjustment or management of cardiac pacemaker | change of pacemaker | checking of cardiac pacemaker | checking or testing of cardiac pulse generator battery | checking or testing of pulse generator Excludes: Dysfunction or complication of pacemaker, pacemaker lead or implantable cardioverter defibrillator, not elsewhere classified [BC9Y] Other specified cardiac arrhythmia Also known as: Other specified cardiac arrhythmia | Ectopic arrhythmia | ectopic cardiac arrhythmia | ectopic atrial pacemaker | ectopic rhythm NOS [NE82.0Y] Other specified pacemaker or implantable cardioverter defibrillator complication Also known as: Other specified pacemaker or implantable cardioverter defibrillator complication | Pacemaker mediated tachycardia | Infection due to pacemaker or implantable cardioverter defibrillator | Infection due to implantable cardioverter defibrillator | Infection due to pacemaker [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 [MG51.20] Vancomycin resistant Enterococcus Also known as: Vancomycin resistant Enterococcus | VRE - [vancomycin-resistant Enterococcus] [MG51.01] Vancomycin resistant Staphylococcus aureus Also known as: Vancomycin resistant Staphylococcus aureus | VRSA [Vancomycin resistant Staphylococcus aureus] [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 === GRAPH WALKS === --- Walk 1 --- [NE82.11] Pacemaker syndrome Def: Cardiovascular signs or symptoms following pacemaker implantation due to suboptimal atrioventricular synchrony, regardless of the pacing mode... --PARENT--> [NE82.1] Pacemaker or implantable cardioverter defibrillator dysfunction Def: Any abnormality of pacemaker or implantable cardioverter defibrillator (ICD) device function.... --CHILD--> [NE82.11] Pacemaker syndrome Def: Cardiovascular signs or symptoms following pacemaker implantation due to suboptimal atrioventricular synchrony, regardless of the pacing mode... --- Walk 2 --- [NE82.11] Pacemaker syndrome Def: Cardiovascular signs or symptoms following pacemaker implantation due to suboptimal atrioventricular synchrony, regardless of the pacing mode... --PARENT--> [NE82.1] Pacemaker or implantable cardioverter defibrillator dysfunction Def: Any abnormality of pacemaker or implantable cardioverter defibrillator (ICD) device function.... --PARENT--> [NE82] Dysfunction or complication of pacemaker, pacemaker lead or implantable cardioverter defibrillator, not elsewhere classified --- Walk 3 --- [NE82.1Y] Other specified pacemaker or implantable cardioverter defibrillator dysfunction --PARENT--> [NE82.1] Pacemaker or implantable cardioverter defibrillator dysfunction Def: Any abnormality of pacemaker or implantable cardioverter defibrillator (ICD) device function.... --CHILD--> [NE82.11] Pacemaker syndrome Def: Cardiovascular signs or symptoms following pacemaker implantation due to suboptimal atrioventricular synchrony, regardless of the pacing mode... --- Walk 4 --- [NE82.1Y] Other specified pacemaker or implantable cardioverter defibrillator dysfunction --PARENT--> [NE82.1] Pacemaker or implantable cardioverter defibrillator dysfunction Def: Any abnormality of pacemaker or implantable cardioverter defibrillator (ICD) device function.... --CHILD--> [NE82.12] Pacemaker generator dysfunction Def: Pacemaker pulse generator malfunction for any reason except routine battery exhaustion.... --- Walk 5 --- [QB30.20] Adjustment or management of cardiac pacemaker --EXCLUDES--> [?] Dysfunction or complication of pacemaker, pacemaker lead or implantable cardioverter defibrillator, not elsewhere classified --CHILD--> [?] Pacemaker or implantable cardioverter defibrillator complication Def: An event or occurrence related to a pacemaker or an implantable cardioverter defibrillator (ICD) or one of its components that is associated with a healthcare intervention, is a departure from the des... --- Walk 6 --- [QB30.20] Adjustment or management of cardiac pacemaker --EXCLUDES--> [?] Dysfunction or complication of pacemaker, pacemaker lead or implantable cardioverter defibrillator, not elsewhere classified --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...
[ "[NE82.11] Pacemaker syndrome\n Def: Cardiovascular signs or symptoms following pacemaker implantation due to suboptimal atrioventricular synchrony, regardless of the pacing mode...\n --PARENT--> [NE82.1] Pacemaker or implantable cardioverter defibrillator dysfunction\n Def: Any abnormality of pacemaker or implantable cardioverter defibrillator (ICD) device function....\n --CHILD--> [NE82.11] Pacemaker syndrome\n Def: Cardiovascular signs or symptoms following pacemaker implantation due to suboptimal atrioventricular synchrony, regardless of the pacing mode...", "[NE82.11] Pacemaker syndrome\n Def: Cardiovascular signs or symptoms following pacemaker implantation due to suboptimal atrioventricular synchrony, regardless of the pacing mode...\n --PARENT--> [NE82.1] Pacemaker or implantable cardioverter defibrillator dysfunction\n Def: Any abnormality of pacemaker or implantable cardioverter defibrillator (ICD) device function....\n --PARENT--> [NE82] Dysfunction or complication of pacemaker, pacemaker lead or implantable cardioverter defibrillator, not elsewhere classified", "[NE82.1Y] Other specified pacemaker or implantable cardioverter defibrillator dysfunction\n --PARENT--> [NE82.1] Pacemaker or implantable cardioverter defibrillator dysfunction\n Def: Any abnormality of pacemaker or implantable cardioverter defibrillator (ICD) device function....\n --CHILD--> [NE82.11] Pacemaker syndrome\n Def: Cardiovascular signs or symptoms following pacemaker implantation due to suboptimal atrioventricular synchrony, regardless of the pacing mode...", "[NE82.1Y] Other specified pacemaker or implantable cardioverter defibrillator dysfunction\n --PARENT--> [NE82.1] Pacemaker or implantable cardioverter defibrillator dysfunction\n Def: Any abnormality of pacemaker or implantable cardioverter defibrillator (ICD) device function....\n --CHILD--> [NE82.12] Pacemaker generator dysfunction\n Def: Pacemaker pulse generator malfunction for any reason except routine battery exhaustion....", "[QB30.20] Adjustment or management of cardiac pacemaker\n --EXCLUDES--> [?] Dysfunction or complication of pacemaker, pacemaker lead or implantable cardioverter defibrillator, not elsewhere classified\n --CHILD--> [?] Pacemaker or implantable cardioverter defibrillator complication\n Def: An event or occurrence related to a pacemaker or an implantable cardioverter defibrillator (ICD) or one of its components that is associated with a healthcare intervention, is a departure from the des...", "[QB30.20] Adjustment or management of cardiac pacemaker\n --EXCLUDES--> [?] Dysfunction or complication of pacemaker, pacemaker lead or implantable cardioverter defibrillator, not elsewhere classified\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..." ]
NE82.11
Pacemaker syndrome
[ { "from_icd11": "NE82.11", "icd10_code": "T82110A", "icd10_title": "Breakdown (mechanical) of cardiac electrode, initial encounter" }, { "from_icd11": "NE82.11", "icd10_code": "T82120A", "icd10_title": "Displacement of cardiac electrode, initial encounter" }, { "from_icd11": "NE82.11", "icd10_code": "T82190A", "icd10_title": "Other mechanical complication of cardiac electrode, initial encounter" }, { "from_icd11": "NE82.11", "icd10_code": "T82118A", "icd10_title": "Breakdown (mechanical) of other cardiac electronic device, initial encounter" }, { "from_icd11": "NE82.11", "icd10_code": "T82198A", "icd10_title": "Other mechanical complication of other cardiac electronic device, initial encounter" }, { "from_icd11": "NE82.11", "icd10_code": "T82128A", "icd10_title": "Displacement of other cardiac electronic device, initial encounter" }, { "from_icd11": "NE82.11", "icd10_code": "T82191A", "icd10_title": "Other mechanical complication of cardiac pulse generator (battery), initial encounter" }, { "from_icd11": "NE82.11", "icd10_code": "T82119A", "icd10_title": "Breakdown (mechanical) of unspecified cardiac electronic device, initial encounter" }, { "from_icd11": "NE82.11", "icd10_code": "T82111A", "icd10_title": "Breakdown (mechanical) of cardiac pulse generator (battery), initial encounter" }, { "from_icd11": "NE82.11", "icd10_code": "T82199A", "icd10_title": "Other mechanical complication of unspecified cardiac device, initial encounter" }, { "from_icd11": "NE82.11", "icd10_code": "T82121A", "icd10_title": "Displacement of cardiac pulse generator (battery), initial encounter" }, { "from_icd11": "NE82.11", "icd10_code": "T821", "icd10_title": "Mechanical complication of cardiac electronic device" }, { "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" } ]
T82110A
Breakdown (mechanical) of cardiac electrode, initial encounter
A 5-year-old female visited our hospital with a palpable mass in her left upper abdomen for 4 months. She developed abdominal pain 4 months prior to the consultation. However, she did not undergo any treatment until the tumor increased in size, which prompted her visit to our hospital. Her past history, personal history, and family history were unremarkable. Physical examination revealed a mass in the left upper abdomen. The mass measured approximately 9.5 cm × 9.2 cm and had a hard texture. It was fixed and was not tender on palpation. The patient had no abnormal bowel sounds (heard four times per minute). Since the onset of the symptoms, the patient was conscious and oriented, and no remarkable changes were noted in diet, sleep, or urination. However, constipation was noted, with defecation occurring once every three days. She reported no weight loss. Laboratory test results showed normal levels of tumor-associated antigen (0.60 U/mL, normal range = 0.01–37 U/mL), carcinoembryonic antigen (4.69 ng/mL, normal range = 0–5 ng/mL), and alpha fetoprotein (3.58 ng/mL, normal range = 0–10 ng/mL). Abdominal radiography showed obvious accumulation of gases in the colon, but no obvious abnormality was found in the rest of the intestinal tract . Subsequent barium enema revealed adequate filling and development of each segment of the colon under the double contrast of air and barium. Additionally, the colon was complete and clear; no filling defect or abnormal strictures were found. The transverse and sigmoid colon were long, and no obvious stricture was found in the anal canal . Further ultrasonography (US) revealed a round heterogeneous mass of size 11.6 cm × 9.7 cm in the left upper and mid quadrants with well defined margins, heterogeneous echotexture, with punctate echogenic foci, no acoustic shadowing. The mass was close to the superior mesenteric artery, which showed no abnormalities. Doppler revealed multiple foci of vascularity within the mass, which also displayed peripheral vascularity . To further determine the nature of the lesion, the patient underwent abdominal magnetic resonance imaging (MRI). A 11.2 cm × 11.1 cm × 10.8 cm (LR × AP × SI) mass was identified in the left upper quadrant. The mass was globally hypointense on T1 weighted images (T1WI), with some foci of increased signal intensity. On T2 weighted images (T2WI), the mass was mildly heterogeneous, with predominantly high signal and some internal elongated (or linear) hypointense structures. Diffusion weighted images demonstrated a heterogeneous pattern of increased diffusion, more prominent in the periphery, with diffusion restriction on ADC maps. The margin of the lesion was well defined, and a surrounding capsule was noted. There was obvious compression and displacement of the stomach, spleen, and left kidney. The left adrenal gland was not clearly displayed. The head of the pancreas was clearly displayed; however, the tail of the pancreas was not. Multiple dilated and tortuous nutrient arteries were observed in the enhanced scanning arterial phase, multiple foci of enhancement, with flaky appearances were observed in the portal phase, and continuous enhancement was observed in the delayed phase, with obvious enhancement at the edge . The radiologist considered the abdominal mass to be splenic hemangioma or angiosarcoma. Fig. 1 Digital radiography shows obvious accumulation of gases in the colon and no obvious abnormalities in the rest of the intestines Fig. 2 Barium enema shows a complete and clear colonic zone, no filling defect or abnormal stenosis, and a long transverse and sigmoid colon Fig. 3 Grayscale and Doppler ultrasonography show a roundish heterogeneous mass below the spleen in the middle and lower abdomen on the left, with well defined margins, heterogeneous echotexture, with punctate echogenic foci, no acoustic shadowing ( A , B ). Doppler revealed multiple foci of vascularity within the mass, which also displayed peripheral vascularity ( C ) Fig. 4 Magnetic resonance imaging shows the mass was globally hypointense on T1 weighted images, with some foci of increased signal intensity ( A ). Mildly heterogeneous, with predominantly high signal and some internal elongated (or linear) hypointense structures are shown on the T2-weighted images ( B ). Diffusion weighted images demonstrated a heterogeneous pattern of increased diffusion, more prominent in the periphery ( C ). Multiple dilated and tortuous nutrient arteries were observed in the enhanced scanning arterial phase ( D ). Multiple foci of enhancement, with flaky appearances were observed in the portal phase ( E ). In the delayed period, continuous enhancement is seen in the lesions, with obvious enhancement at the edge ( F )
4.019531
0.975586
sec[1]/p[0]
en
0.999997
PMC9701009
https://doi.org/10.1186/s12880-022-00936-w
[ "obvious", "heterogeneous", "foci", "colon", "multiple", "weighted", "enhancement", "diffusion", "phase", "abdominal" ]
[ { "code": "6D50", "title": "Factitious disorder imposed on self" }, { "code": "QB63.Z", "title": "Presence of transplanted organ or tissue, unspecified" }, { "code": "8A61.4Y", "title": "Other specified genetic epileptic syndromes with variable age of onset" }, { "code": "1A40.0&XA03U9", "title": "Colon inflammation" }, { "code": "DB30.Y&XA03U9", "title": "Obstructed colon" }, { "code": "NB91.81", "title": "Laceration of colon" }, { "code": "DD3Z", "title": "Ischaemic vascular disorders of intestine, unspecified" }, { "code": "DB32.2Z&XA03U9", "title": "Colonic dilatation" }, { "code": "6B64", "title": "Dissociative identity disorder" }, { "code": "JA80.Z", "title": "Maternal care related to unspecified multiple gestation" } ]
=== ICD-11 CODES FOUND === [6D50] Factitious disorder imposed on self Definition: Factitious disorder imposed on self is characterised by feigning, falsifying, or inducing medical, psychological, or behavioural signs and symptoms or injury associated with identified deception. If a pre-existing disorder or disease is present, the individual intentionally aggravates existing symptoms or falsifies or induces additional symptoms. The individual seeks treatment or otherwise presents himself or herself as ill, injured, or impaired based on the feigned, falsified, or self-induced s Also known as: Factitious disorder imposed on self | artificial factitious disease | feigned disorder without obvious motivation | factitious disturbance | factitious disorder, not otherwise specified Includes: Münchhausen syndrome Excludes: Excoriation disorder | Malingering [QB63.Z] Presence of transplanted organ or tissue, unspecified Also known as: Presence of transplanted organ or tissue, unspecified | Presence of transplanted organ or tissue | transplanted organ or tissue status | organ or tissue replaced by heterogenous or homogenous transplant | organ transplant [8A61.4Y] Other specified genetic epileptic syndromes with variable age of onset Also known as: Other specified genetic epileptic syndromes with variable age of onset | Autosomal dominant nocturnal frontal lobe epilepsy | Epilepsy with generalised tonic-clonic seizures on awakening | Awakening epilepsy | Epilepsy with GLUT1 deficiency with SLC2A1 mutations [NB91.81] Laceration of colon Definition: A tear or wound of large intestine. Also known as: Laceration of colon [DD3Z] Ischaemic vascular disorders of intestine, unspecified Also known as: Ischaemic vascular disorders of intestine, unspecified | Vascular disorder of intestine, not elsewhere classified | vascular disorder of intestine | vascular bowel disease | ischaemic gut NOS [6B64] Dissociative identity disorder Definition: Dissociative identity disorder is characterised by disruption of identity in which there are two or more distinct personality states (dissociative identities) associated with marked discontinuities in the sense of self and agency. Each personality state includes its own pattern of experiencing, perceiving, conceiving, and relating to self, the body, and the environment. At least two distinct personality states recurrently take executive control of the individual’s consciousness and functioning i Also known as: Dissociative identity disorder | Multiple personality | Multiple personality disorder [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 === GRAPH WALKS === --- Walk 1 --- [6D50] Factitious disorder imposed on self Def: Factitious disorder imposed on self is characterised by feigning, falsifying, or inducing medical, psychological, or behavioural signs and symptoms or injury associated with identified deception. If a... --EXCLUDES--> [?] Excoriation disorder Def: Excoriation disorder is characterised by recurrent picking of one’s own skin leading to skin lesions, accompanied by unsuccessful attempts to decrease or stop the behaviour. The most commonly picked s... --EXCLUDES--> [?] Chronic excoriation of skin Def: A provisional diagnosis for a chronic skin disorder of unknown or uncertain nature characterised by the presence of multiple excoriations. In some cases the excoriation is secondary to intense pruritu... --- Walk 2 --- [6D50] Factitious disorder imposed on self Def: Factitious disorder imposed on self is characterised by feigning, falsifying, or inducing medical, psychological, or behavioural signs and symptoms or injury associated with identified deception. If a... --EXCLUDES--> [?] Malingering Def: Malingering is the feigning, intentional production or significant exaggeration of physical or psychological symptoms, or intentional misattribution of genuine symptoms to an unrelated event or series... --EXCLUDES--> [?] Factitious disorder imposed on self Def: Factitious disorder imposed on self is characterised by feigning, falsifying, or inducing medical, psychological, or behavioural signs and symptoms or injury associated with identified deception. If a... --- Walk 3 --- [QB63.Z] Presence of transplanted organ or tissue, unspecified --PARENT--> [QB63] Presence of transplanted organ or tissue --PARENT--> [?] Surgical or postsurgical states --- Walk 4 --- [QB63.Z] Presence of transplanted organ or tissue, unspecified --PARENT--> [QB63] Presence of transplanted organ or tissue --EXCLUDES--> [?] Presence of bioprosthetic heart valve --- Walk 5 --- [8A61.4Y] Other specified genetic epileptic syndromes with variable age of onset --PARENT--> [8A61.4] Genetic epileptic syndromes with variable age of onset Def: Epilepsies occurring in an otherwise normal child or adult. Seizures may occur spontaneously or may be provoked by external stimuli. Family history of seizures is not uncommon and is frequently report... --CHILD--> [8A61.41] Progressive myoclonic epilepsy --- Walk 6 --- [8A61.4Y] Other specified genetic epileptic syndromes with variable age of onset --PARENT--> [8A61.4] Genetic epileptic syndromes with variable age of onset Def: Epilepsies occurring in an otherwise normal child or adult. Seizures may occur spontaneously or may be provoked by external stimuli. Family history of seizures is not uncommon and is frequently report... --PARENT--> [8A61] Genetic or presumed genetic syndromes primarily expressed as epilepsy Def: The epilepsy is, as best as understood, the direct result of one or more known or presumed genetic defects in which seizures are the core symptom of the disorder....
[ "[6D50] Factitious disorder imposed on self\n Def: Factitious disorder imposed on self is characterised by feigning, falsifying, or inducing medical, psychological, or behavioural signs and symptoms or injury associated with identified deception. If a...\n --EXCLUDES--> [?] Excoriation disorder\n Def: Excoriation disorder is characterised by recurrent picking of one’s own skin leading to skin lesions, accompanied by unsuccessful attempts to decrease or stop the behaviour. The most commonly picked s...\n --EXCLUDES--> [?] Chronic excoriation of skin\n Def: A provisional diagnosis for a chronic skin disorder of unknown or uncertain nature characterised by the presence of multiple excoriations. In some cases the excoriation is secondary to intense pruritu...", "[6D50] Factitious disorder imposed on self\n Def: Factitious disorder imposed on self is characterised by feigning, falsifying, or inducing medical, psychological, or behavioural signs and symptoms or injury associated with identified deception. If a...\n --EXCLUDES--> [?] Malingering\n Def: Malingering is the feigning, intentional production or significant exaggeration of physical or psychological symptoms, or intentional misattribution of genuine symptoms to an unrelated event or series...\n --EXCLUDES--> [?] Factitious disorder imposed on self\n Def: Factitious disorder imposed on self is characterised by feigning, falsifying, or inducing medical, psychological, or behavioural signs and symptoms or injury associated with identified deception. If a...", "[QB63.Z] Presence of transplanted organ or tissue, unspecified\n --PARENT--> [QB63] Presence of transplanted organ or tissue\n --PARENT--> [?] Surgical or postsurgical states", "[QB63.Z] Presence of transplanted organ or tissue, unspecified\n --PARENT--> [QB63] Presence of transplanted organ or tissue\n --EXCLUDES--> [?] Presence of bioprosthetic heart valve", "[8A61.4Y] Other specified genetic epileptic syndromes with variable age of onset\n --PARENT--> [8A61.4] Genetic epileptic syndromes with variable age of onset\n Def: Epilepsies occurring in an otherwise normal child or adult. Seizures may occur spontaneously or may be provoked by external stimuli. Family history of seizures is not uncommon and is frequently report...\n --CHILD--> [8A61.41] Progressive myoclonic epilepsy", "[8A61.4Y] Other specified genetic epileptic syndromes with variable age of onset\n --PARENT--> [8A61.4] Genetic epileptic syndromes with variable age of onset\n Def: Epilepsies occurring in an otherwise normal child or adult. Seizures may occur spontaneously or may be provoked by external stimuli. Family history of seizures is not uncommon and is frequently report...\n --PARENT--> [8A61] Genetic or presumed genetic syndromes primarily expressed as epilepsy\n Def: The epilepsy is, as best as understood, the direct result of one or more known or presumed genetic defects in which seizures are the core symptom of the disorder...." ]
6D50
Factitious disorder imposed on self
[ { "from_icd11": "6D50", "icd10_code": "F6810", "icd10_title": "Factitious disorder imposed on self, unspecified" }, { "from_icd11": "6D50", "icd10_code": "F6812", "icd10_title": "Factitious disorder imposed on self, with predominantly physical signs and symptoms" }, { "from_icd11": "6D50", "icd10_code": "F6811", "icd10_title": "Factitious disorder imposed on self, with predominantly psychological signs and symptoms" }, { "from_icd11": "6D50", "icd10_code": "F681", "icd10_title": "Factitious disorder imposed on self" }, { "from_icd11": "QB63.Z", "icd10_code": "Z9484", "icd10_title": "Stem cells transplant status" }, { "from_icd11": "QB63.Z", "icd10_code": "Z9481", "icd10_title": "Bone marrow transplant status" }, { "from_icd11": "QB63.Z", "icd10_code": "Z9489", "icd10_title": "Other transplanted organ and tissue status" }, { "from_icd11": "QB63.Z", "icd10_code": "Z9483", "icd10_title": "Pancreas transplant status" }, { "from_icd11": "QB63.Z", "icd10_code": "Z9482", "icd10_title": "Intestine transplant status" }, { "from_icd11": "QB63.Z", "icd10_code": "Z949", "icd10_title": "Transplanted organ and tissue status, unspecified" }, { "from_icd11": "QB63.Z", "icd10_code": "Z94", "icd10_title": "Transplanted organ and tissue status" }, { "from_icd11": "QB63.Z", "icd10_code": "Z943", "icd10_title": "Heart and lungs transplant status" }, { "from_icd11": "QB63.Z", "icd10_code": "Z948", "icd10_title": "Other transplanted organ and tissue status" }, { "from_icd11": "DD3Z", "icd10_code": "K559", "icd10_title": "Vascular disorder of intestine, unspecified" }, { "from_icd11": "DD3Z", "icd10_code": "K558", "icd10_title": "Other vascular disorders of intestine" } ]
F6810
Factitious disorder imposed on self, unspecified
A 66-year-old Japanese man was referred to our hospital because of a rectal tumor. He had a history of radical prostatectomy for prostate cancer and transurethral bladder tumor resection. Abdominal computed tomography (CT) showed a tumor of 39 mm in diameter with enlarged lymph nodes in the ileal mesentery and a tumor of 24 mm in diameter in the rectum. Preoperative imaging studies suggested that the tumor in the ileal mesentery could be a low-grade malignant lymphoma, a plasmacytoma, a Castleman disease, an IgG4-related disease, a desmoid tumor, a carcinoid tumor, or a gastrointestinal stromal tumor. We performed laparoscopic low anterior resection for rectal cancer and biopsied an enlarged lymph node in the ileal mesentery to diagnose the tumor. He was diagnosed with rectal cancer with a lymph node metastasis (TNM classification 7th edition, pT3 pN1 cM0, and stage IIIB) and NET (G1) of the ileal mesentery. Although we considered complete resection for the NET (G1) lesion, it was a slow-growing tumor, and the 5-year survival rate of patients with gastrointestinal NET (91.3%) is better than that reported for rectal cancer stage IIIB (78.0%) . Thus, we felt that rectal cancer would determine the patient’s prognosis and decided to follow up the NET (G1) and prioritize adjuvant chemotherapy for the rectal cancer. He received oxaliplatin and capecitabine (XELOX) for 3 months as adjuvant chemotherapy. The NET (G1) lesion of the ileal mesentery had not expanded at follow-up. Three years later, anastomosis recurrence occurred, and we performed abdominoperineal resection of the rectal tumor. At the same time, we again considered resection of the NET lesion, but it had grown to 42 mm and involved both the supra mesenteric artery (SMA) and vein (SMV) and would be very difficult to remove. However, until this point, there were no occlusive bindings of the SMA and SMV. A CT scan that was taken 1 year after the surgery indicated multiple liver metastases and lymph node metastasis of the sacrum. Laboratory tests showed albumin 4.2 g/dl, creatinine 1.36 mg/dl, an international normalized ratio of 0.97, serum bilirubin 0.80 mg/dl, and an indocyanine green retention rate at 15 min of 5.9%. Regarding the tumor markers, serum carcinoembryonic antigen levels were elevated to 15.5 ng/ml. The serum carbohydrate antigen 19-9 and alpha-fetoprotein levels were within the respective normal ranges, and hepatitis B virus surface antigens and hepatitis C virus antibodies were negative. Contrast-enhanced abdominal computed tomography (CT) showed six masses in the right lobe of the liver and segment 3 and a tumor of 47 mm in diameter in the ileal mesentery. The masses in the liver showed ring-like enhancement , and the tumor in the mesentery showed heterogeneous enhancement in the arterial phase . [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) showed increased uptake by the masses in the liver and slight uptake by the tumor in the ileal mesentery . Magnetic resonance imaging (MRI) indicated four other masses in the right lobe of the liver and segment 4 which were not visible on CT and that had no accumulation of [18F]-FDG . All tumors expressed low intensity on T1-weighted MRI, high intensity on T2-weighted MRI, and high intensity on diffusion-weighted images . Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) revealed tumors with low signal intensity in the hepatocellular phase . Fig. 1 Contrast-enhanced computed tomography (CT) and [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) images 1 year after abdominoperineal resection. a Contrast-enhanced CT showed two tumors in segment 5 (arrow and arrowhead) that were enhanced in the arterial phase. b Contrast-enhanced CT showed a 47-mm tumor in the ileal mesentery (arrow) that was enhanced in the arterial phase. c On FDG-PET, accumulation of [18F]-FDG was found in segment 5 (arrow) tumor. d On FDG-PET, only a little accumulation of [18F]-FDG was found in the ileal mesenteric tumor (arrow). e Contrast-enhanced CT showed no tumor in segment 6 that was enhanced in the arterial phase. f On FDG-PET, no accumulation of [18F]-FDG was found in segment 6 Fig. 2 Magnetic resonance imaging (MRI) 1 year after abdominoperineal resection. a The tumor in segment 6 of the liver (arrow) showed low intensity on T1-weighted images. b The tumor in segment 6 of the liver (arrow) showed high intensity on T2-weighted images. c The tumor in segment 6 of the liver (arrow) showed high intensity on diffusion-weighted images. d The tumor in segment 6 of the liver (arrow) showed low signal intensity on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MRI (EOB-MRI)
4.0625
0.97168
sec[1]/p[0]
en
0.999995
32056066
https://doi.org/10.1186/s40792-020-0800-9
[ "tumor", "enhanced", "segment", "ileal", "mesentery", "liver", "that", "intensity", "arrow", "rectal" ]
[ { "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": "8A04.0", "title": "Enhanced physiological tremor" }, { "code": "8E4A.0", "title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord" }, { "code": "ME93.0", "title": "Segmental and somatic dysfunction" }, { "code": "8A06.1", "title": "Segmental myoclonus" }, { "code": "EC23.0", "title": "Non-syndromic genetically-determined hypermelanosis or lentiginosis" } ]
=== 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 [8A04.0] Enhanced physiological tremor Definition: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc. Also known as: Enhanced physiological tremor [8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord Definition: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephalopathy, ataxia, myelopathy, myelitis) nervous system. In the paraneoplastic context, this attack is a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived from a systemic cancer. In the non-paraneoplastic context termed ‘autoimmune’ the etiology rem Also known as: Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord | Paraneoplastic encephalitis | Paraneoplastic encephalitis, neural autoantibody positive | Paraneoplastic encephalitis, neural autoantibody negative | Autoimmune encephalitis [ME93.0] Segmental and somatic dysfunction Also known as: Segmental and somatic dysfunction | segmental dysfunction | somatic dysfunction | Segmental and somatic dysfunction, head region | Segmental and somatic dysfunction, occipitocervical region [8A06.1] Segmental myoclonus Definition: Rhythmic or semi-rhythmic involuntary contractions of muscle groups supplied by one or more contiguous segments of the brainstem and/or spinal cord. Also known as: Segmental myoclonus | Spinal segmental myoclonus | Propriospinal myoclonus [EC23.0] Non-syndromic genetically-determined hypermelanosis or lentiginosis Also known as: Non-syndromic genetically-determined hypermelanosis or lentiginosis | Familial progressive hyperpigmentation | Familial generalised lentiginosis | Inherited patterned lentiginosis | Centrofacial lentiginosis === 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--> [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... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --PARENT--> [?] Symptoms, signs or clinical findings involving the skin --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --EXCLUDES--> [?] Chronic lymphadenitis --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [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 --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --PARENT--> [?] Symptoms, signs or clinical findings involving the skin", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --EXCLUDES--> [?] Chronic lymphadenitis", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
As she developed an unexplained persistent fever during the early days of admission, a thorough diagnostic workup was initiated to identify the underlying cause. Blood cultures were performed, and the results showed the presence of Staphylococcus epidermidis . This finding suggested a possible connection to her burn wound on her arm. She completed a 10-day course of penicillin, but the fever persisted without responding to antipyretics. Additionally, she developed symptoms of compulsive polyphagia (excessive eating), frontal disinhibition with impulsive behavior, such as stealing and hoarding sugar packets from other patients, and the ingestion of non-prescribed medication in excessive amounts, facilitated by a friend who visited her at the hospital. The combination of irritability and mood swings added to the complexity of her presentation, and given these abnormal neurological findings and the changes in her behavior, further investigation and evaluation were needed. Subclinical hyperthyroidism was detected in the laboratory tests, and an ultrasound of the thyroid revealed an enlarged, multinodular thyroid gland. A biopsy of a nodule was performed, which showed a benign follicular nodule. Thiamazole was prescribed for her thyroid condition. Blood and urine cultures were repeated and yielded negative results. Colonoscopy did not reveal any abnormal findings, while endoscopy identified a white plaque lesion in her upper esophagus, which was biopsied and found to be positive for vascular congestion but without dysplasia. Serology and ELISA tests for brucella and blood serology for Coxiella burnetii were negative. Wilson's disease was considered a potential diagnosis due to abnormalities in serum aminotransferases and neuropsychiatric symptoms, but both serum and urinary copper levels were within normal ranges. Acute endocarditis was ruled out based on transthoracic and transesophageal echocardiograms. A CT scan of her chest, abdomen, and pelvis revealed several small lymph nodes in the intercavoaortic and lateroaortic regions, with the largest measuring 16 mm, but no other abnormal findings were observed . Due to her history of a Müllerian tumor, a breast ultrasound was performed and showed no abnormalities, while a mammogram was recommended but not performed due to the patient's lack of cooperation. She also underwent a bone marrow aspiration and biopsy (medulogram and medullary biopsy), which revealed normal cellularity and morphology. Considering her behavioral disinhibition, a brain CT scan was conducted and found to be normal. Subsequently, a brain magnetic resonance imaging (MRI) study showed hyperintense signals on T2-weighted and T2-FLAIR images in the temporal and insular regions , particularly the subinsular tonsils, without restricted diffusion or mass effect. Paraneoplastic and herpetic encephalitis were suggested as possible causes, although herpetic encephalitis was less likely due to the absence of restricted diffusion in the affected regions . Non-specific gliotic foci were also identified in the right anterior frontal subcortical white matter and the right cerebellar hemisphere. Another EEG was performed, showing preserved baseline rhythm with slow activity in the left temporal region for a restricted duration, suggesting a functional deficiency in this region, and a second lumbar puncture was carried out to collect neuronal antibodies such as antineuronal nuclear antibody type 1 (ANNA-1) (anti-Hu), amphiphysin, collapsin response-mediator protein-5 (CRMP-5)-IgG, ANNA-2, and anti-Ma, which also turned out to be negative. Based on the suggestion of the Neurology department, immunoglobulin therapy and corticosteroids were initiated, resulting in a slight improvement in the patient's clinical condition. A follow-up MRI scan one month later showed less prominent hyperintensities in the insular/subinsular and temporomesial regions, which appeared atrophic. A PET-CT scan was requested and revealed multiple hypermetabolic lymph nodes. A fine-needle aspiration (FNA) biopsy of the left cervical lymph node confirmed metastasis by a carcinoma, likely adenocarcinoma, although the immunophenotyping of the lymph node was within normal limits. The immunohistochemical profile using cytokeratins suggested the breast, lung, or gynecological tract as the primary sites. The patient's case was discussed in a multidisciplinary meeting, and it was determined that due to the rapid progression of the disease and the deterioration of the patient's condition, no specific treatment for the neoplasm was recommended. Her neuropsychiatric symptoms worsened, leading to increased dependence on caregivers, and she eventually succumbed to nosocomial pneumonia one year later.
4.074219
0.976074
sec[1]/p[1]
en
0.999996
37667691
https://doi.org/10.7759/cureus.42947
[ "which", "biopsy", "scan", "lymph", "regions", "blood", "suggested", "without", "thyroid", "restricted" ]
[ { "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": "JA85.Y", "title": "Maternal care for other specified fetal abnormality or damage" }, { "code": "KD39.3", "title": "Fetus or newborn affected by complications of fetal surgery" }, { "code": "PK81.5", "title": "Biopsy procedure, not elsewhere classified, associated with injury or harm in therapeutic use" }, { "code": "PK81.4", "title": "Bone marrow aspiration or biopsy associated with injury or harm in therapeutic use" }, { "code": "PK98.0", "title": "Radiological devices associated with injury or harm, diagnostic or monitoring devices" }, { "code": "MB71.Y", "title": "Other specified clinical findings on diagnostic imaging of central nervous system" } ]
=== 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 [JA85.Y] Maternal care for other specified fetal abnormality or damage Also known as: Maternal care for other specified fetal abnormality or damage | Maternal care for damage to fetus from alcohol | suspected damage to fetus from maternal alcohol addiction affecting management of mother | pregnancy management affected by fetal damage from maternal alcohol addiction | maternal care for known or suspected damage to fetus from alcohol [KD39.3] Fetus or newborn affected by complications of fetal surgery Definition: A condition in the fetus due to an unfavourable evolution of a condition (complication) associated with a surgical health intervention applied to the fetus. Also known as: Fetus or newborn affected by complications of fetal surgery | Adverse outcome following fetal skin biopsy [PK81.5] Biopsy procedure, not elsewhere classified, associated with injury or harm in therapeutic use Also known as: Biopsy procedure, not elsewhere classified, associated with injury or harm in therapeutic use | complication during or following biopsy procedure, other than bone marrow Excludes: Bone marrow aspiration or biopsy associated with injury or harm in therapeutic use | Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm [PK81.4] Bone marrow aspiration or biopsy associated with injury or harm in therapeutic use Also known as: Bone marrow aspiration or biopsy associated with injury or harm in therapeutic use | complication during or following bone marrow aspiration or biopsy Excludes: Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm [PK98.0] Radiological devices associated with injury or harm, diagnostic or monitoring devices Also known as: Radiological devices associated with injury or harm, diagnostic or monitoring devices | Radiological devices associated with adverse incidents, malfunction of radiological apparatus | Radiological devices associated with adverse incidents, CT scanner or MRI causing physical injury | Radiological devices associated with adverse incidents, needles used in radiologically-guided biopsies Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system Also known as: Other specified clinical findings on diagnostic imaging of central nervous system | Epidural haemorrhage, localised, no generalised mass effect or midline shift | Epidural haemorrhage, confined to a small region in relation to a fracture | Epidural haemorrhage, size less than 1 x 1 x 1 cm, not in relation to a fracture | Epidural haemorrhage, mass effect or midline shift less than 0.5 cm === 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.... --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--> [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained
[ "[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 --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--> [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained" ]
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": "JA85.Y", "icd10_code": "O358XX0 ", "icd10_title": "" }, { "from_icd11": "JA85.Y", "icd10_code": "O358XX1 ", "icd10_title": "" }, { "from_icd11": "PK98.0", "icd10_code": "Y780", "icd10_title": "Diagnostic and monitoring radiological devices associated with adverse incidents" } ]
I713
Abdominal aortic aneurysm, ruptured
The surgical approach was determined based on the patient's medical history and imaging findings, as discussed in a multidisciplinary treatment (MDT) consultation. Considering the patient's history and imaging manifestations, recurrent thymic carcinoma was suspected, with involvement of the pericardium, bilateral brachiocephalic veins, superior vena cava, and brachiocephalic trunk. The surgery involved vascular replacement, extensive pericardial resection, left brachiocephalic vein‐right atrium bypass, superior vena cava reconstruction, and iodine‐125 radioactive seed implantation for close‐range treatment. Routine anesthesia intubation and sterile draping were performed, and a mid‐sternal incision was made. Intraoperatively, the tumor was observed in the anterior upper mediastinum, slightly to the right, measuring 4.1 × 4.0 × 4.2 cm, solid in consistency, firmly adherent to the surface of the pericardium, and located anterior to the aortic arch. The upper pole of the tumor was positioned between the right brachiocephalic vein and the brachiocephalic trunk, with its right margin closely adjacent to the superior vena cava and its left margin invading the left brachiocephalic vein. The tumor completely encased the initial segment of the brachiocephalic vein, extending posteriorly along the brachiocephalic trunk to the descending aorta. The tumor extended inferiorly to the level of the lower border of the aortic arch, involving the pericardium in this region. The tumor capsule appeared uneven, suggesting possible invasion of the pleura. The tumor also invaded the base of the heart (measuring approximately 5.0 × 4.8 × 5.2 cm). The right pleura was opened, and upon entering the right pleural cavity, it was observed that the right lung was not affected. The left pleura showed localized adhesions and was not entered. During the surgery, the visible primary lesion, the surrounding involved tissues, the invaded pleura, pericardium, superior vena cava, and left brachiocephalic vein were all resected. The artificial blood vessel was anastomosed end‐to‐end with the left brachiocephalic vein and the right atrial end. The left brachiocephalic vein was excised, and the artificial blood vessel was grafted . The tumor was further dissected toward the upper right region, revealing the bilateral superior thymic veins, which were completely freed and resected, along with the branches of multiple thymic veins. The proximal ends were occluded with vascular clips, and the distal ends were divided using an ultrasonic scalpel. The thymus, along with the surrounding tissue, was completely excised. The tumor was then pulled toward the upper right region, ensuring full mobilization of the right phrenic nerve, vagus nerve, and trachea. The relationship between the tumor and the right brachiocephalic vein from its origin to the mid‐segment of the superior vena cava was found to be tight. After careful dissection using scissors, the tumor involving the base of the superior vena cava was partially occluded with a side‐wall vascular clamp, and the tumor and a portion of the vascular wall of the superior vena cava were resected. The tumor tissue was removed, and 5‐0 suture was used for vascular closure. The side wall of the superior vena cava was continuously sutured using the clamps, and superior vena cava reconstruction was performed. lodine‐125 radioactive seeds were implanted in the area of the tumor in the anterior mediastinum. Hemostasis was achieved, and two drainage tubes were placed in the right pleural cavity and the anterior mediastinal region through the bilateral rib arches. The sternum was closed with steel wire sutures, and the chest was closed layer by layer. The operation was completed. The patient received postoperative care, including antibiotic therapy, analgesia, heart rate management, and anticoagulation. The anticoagulation protocol involved a daily subcutaneous injection of 4000 IU enoxaparin sodium, initiated on postoperative Day 1 and continued for 5 days. The follow‐up strategy includes a chest X‐ray at 1 week postoperatively to monitor for pneumothorax and pleural effusion; a chest CT scan with 3D reconstruction at 1 month to evaluate the reconstructed vessels and surgical site; and a repeat CT scan at 6 months to detect any signs of tumor recurrence or metastasis. Of particular note, the patient's chest CT at 1 month revealed significant right‐sided pleural effusion, approximately 60 mm in thickness. The patient was subsequently rehospitalized and underwent a right pleural closed drainage procedure after excluding surgical contraindications, with approximately 850 mL of pale‐yellow pleural fluid drained. The patient was discharged 1 week later in full recovery.
4.078125
0.955566
sec[1]/sec[0]/p[0]
en
0.999998
39853968
https://doi.org/10.1002/cnr2.70089
[ "tumor", "brachiocephalic", "vena", "cava", "vein", "pleural", "vascular", "pericardium", "region", "pleura" ]
[ { "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": "LA8B.24", "title": "Congenital anomaly of aortic arch branch" }, { "code": "LA8B.3", "title": "Tracheo-oesophageal compressive syndrome" }, { "code": "4A44.1", "title": "Aortic arch syndrome" }, { "code": "BD71.1", "title": "Vena caval thrombosis" }, { "code": "NB30.2Z", "title": "Injury of superior vena cava, 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 [LA8B.24] Congenital anomaly of aortic arch branch Definition: A congenital cardiovascular malformation of one or more branches of the aortic arch (innominate, carotid, or subclavian arteries). Also known as: Congenital anomaly of aortic arch branch | Aberrant origin of right subclavian artery | aberrant right subclavian artery syndrome | ARSA - [aberrant right subclavian artery] | ARSCA - [aberrant right subclavian artery] [LA8B.3] Tracheo-oesophageal compressive syndrome Definition: A congenital cardiovascular malformation which causes compression of the trachea and/or the oesophagus. Also known as: Tracheo-oesophageal compressive syndrome | Innominate artery compression syndrome | Innominate artery compression of the trachea | Brachiocephalic artery compression syndrome | Retro-oesophageal origin of aberrant innominate artery [4A44.1] Aortic arch syndrome Definition: Arteritis, often granulomatous, predominantly affecting the aorta and/or its major branches. Onset usually in patients younger than 50. Also known as: Aortic arch syndrome | obliterative aortitis | aortic arch arteritis | subclavian-carotid obstruction syndrome | idiopathic medial aortopathy and arteriopathy [BD71.1] Vena caval thrombosis Definition: Venous thrombosis within the vena cava. Also known as: Vena caval thrombosis [NB30.2Z] Injury of superior vena cava, unspecified Also known as: Injury of superior vena cava, unspecified | Injury of superior vena cava | superior vena cava injury | vena cava injury === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F92] Neoplasms of unknown behaviour of skin --- Walk 3 --- [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--> [?] 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--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --CHILD--> [?] Generalised lymph node enlargement --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [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 --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--> [?] 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--> [?] 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", "[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
The cutaneous manifestation of sarcoidosis is divided into two different types: specific and non-specific . As granulomas are seen on biopsy, the sarcoid skin manifestation will be entitled specific cutaneous sarcoid lesions . In our case, granulomas were detected on breast biopsy. So, the breast abscess of our patient is a specific kind of sarcoid lesion. However, erythema nodosum is recognized as the most common non-specific skin manifestation of sarcoidosis . Hence, it can be said that our case had both specific and non-specific cutaneous sarcoid lesions. To the best of our knowledge, only seven patients with sarcoidosis following IFN-β therapy have been reported in the literature. The initial report by Abdi et al . in 1987 reported the case of a 57-year-old woman with renal cell carcinoma who developed pulmonary sarcoidosis following treatment with IFN-β and vinblastine . Subsequent reports include a case report by Bobbio-Pallavicini et al . in 1995 which discusses a woman diagnosed with multiple myeloma who developed sarcoidosis involving different organs, including liver, bone, and lungs following treatment with IFN-β . Mehta et al ., in 1998, reported the case of a 57-year-old man with MS who developed cutaneous sarcoidosis after being treated with IFN-β for 2 years and 2 months . More recently, in 2005, O'Reilly et al . reported the case of another patient with pulmonary sarcoidosis following weekly treatment with IFN-β . Since that time, three other patients have been reported, all published in 2012. Of these three patients, one was a 39-year-old woman with skin and pulmonary involvement after 3 years of IFN-β treatment, the second one was a 35-year-old man who developed pulmonary sarcoidosis after 6 years of IFN-β treatment, and the third one was a 30-year-old woman with a 5-month history of IFN-β treatment who also had only pulmonary sarcoidosis . The present patient was a 33-year-old Caucasian woman with MS who was treated with IFN-β for 2.5 years and developed both pulmonary and cutaneous sarcoidosis. From a clinical standpoint, in all seven reported patients, IFN-β was discontinued after the discovery of the adverse developments. The first patient was not treated . However, the second patient was treated with corticosteroids, and the third patient recovered following treatment with a combination of hydroxychloroquine, psoralen, and ultraviolet A . One patient improved without any treatment and one was treated with prednisone, hydroxychloroquine, and methotrexate . The final two reported patients were treated with prednisolone and hydroxychloroquine due to the continuity of the signs and complaints, and prednisolone, respectively. In the last patient, prednisolone resulted in complete resolution . Treatment of our patient with a combination of indomethacin and prednisolone caused a significant decrease in the signs and symptoms. A total of eight patients, including the current presented patient, have been reported to have sarcoidosis following treatment with IFN-β, six of which were patients with MS. The average duration of treatment with IFN-β was 28.1 months. In a considerable presentation, the rate of pulmonary and skin involvement in these eight patients was 87.5% and 37.5%, respectively. While IFN-β-induced sarcoidosis may appear to be a separate entity, further research should be conducted to determine factors involved in the occurrence of sarcoidosis following IFN-β treatment. The development of sarcoidosis following treatment with IFN-β seems evident; however, the event may be attributed to its immunomodulatory properties or its effect on the activation of proinflammatory mediators, which can result in the formation of granuloma . The diagnosis of IFN-induced sarcoidosis (IIS) in a patient with MS may be questionable since it is difficult to establish a clear-cut causal relationship. It is well known that sarcoidosis is a great imitator of MS . Therefore, views that the patients presented in this report had from the beginning only sarcoidosis and not MS should be taken into consideration. However, it should be stressed that the available data on the ratio of involved organs in the patients with IIS are different from natural sarcoidosis , so it is most probable that IFN-β, similar to IFN-α, can cause sarcoidosis in patients with MS due to its immunomodulatory properties. Further, it should be noted that the immunopathology of MS may actually contribute to the induction of sarcoidosis in patients undergoing IFN-β treatment. In general, this phenomenon is a form “biologics-induced autoimmune disease”, which has been recently described by Perez-Alvarez et al . and includes diverse autoimmune diseases caused by different biological drugs .
4.210938
0.484863
sec[2]/p[2]
en
0.999996
24330713
https://doi.org/10.1186/1752-1947-7-270
[ "sarcoidosis", "patients", "specific", "that", "pulmonary", "treated", "cutaneous", "different", "sarcoid", "skin" ]
[ { "code": "4B20.Z", "title": "Sarcoidosis, unspecified" }, { "code": "4B20.Y", "title": "Other specified sarcoidosis" }, { "code": "4B20.5", "title": "Cutaneous sarcoidosis" }, { "code": "4B20.4", "title": "Ocular sarcoidosis" }, { "code": "4B20.0", "title": "Sarcoidosis of lung" }, { "code": "PL14.C", "title": "Patient received diagnostic test or treatment intended for another patient" }, { "code": "QB14", "title": "Unavailability or inaccessibility of health care facilities" }, { "code": "PL14.2", "title": "Problem associated with physical transfer of patient" }, { "code": "QB12.0", "title": "Organ transplant candidate" }, { "code": "QA15.1", "title": "Counselling related to sexual behaviour and orientation or sexual relationships of the person" } ]
=== ICD-11 CODES FOUND === [4B20.Z] Sarcoidosis, unspecified Also known as: Sarcoidosis, unspecified | Sarcoidosis | Besnier-Boeck-Schaumann disease | Boeck's disease | Boeck's sarcoid [4B20.Y] Other specified sarcoidosis Also known as: Other specified sarcoidosis | Sarcoidosis of lung with sarcoidosis of lymph nodes | Sarcoidosis of the musculoskeletal system | Sarcoid arthropathy | arthritis secondary to sarcoidosis [4B20.5] Cutaneous sarcoidosis Also known as: Cutaneous sarcoidosis | Sarcoidosis of skin | Acute sarcoidosis with erythema nodosum | Löfgren syndrome | Papular, micropapular or lichenoid sarcoidosis [4B20.4] Ocular sarcoidosis Definition: This is a syndrome involving abnormal collections of chronic inflammatory cells (granulomas) that can form as nodules in multiple organs. Also known as: Ocular sarcoidosis | Sarcoid associated anterior uveitis | Iridocyclitis in sarcoidosis [4B20.0] Sarcoidosis of lung Also known as: Sarcoidosis of lung | lung sarcoid | pulmonary sarcoidosis | sarcoidosis in lung [PL14.C] Patient received diagnostic test or treatment intended for another patient Also known as: Patient received diagnostic test or treatment intended for another patient | wrong patient | incorrect patient Excludes: Procedure undertaken at wrong site or wrong side, as mode of injury or harm [QB14] Unavailability or inaccessibility of health care facilities Also known as: Unavailability or inaccessibility of health care facilities | unavailability of medical facilities | Unavailability of outpatient clinic | Unavailability or inaccessibility of residential aged care service Excludes: bed unavailable [PL14.2] Problem associated with physical transfer of patient Also known as: Problem associated with physical transfer of patient [QB12.0] Organ transplant candidate Also known as: Organ transplant candidate | patient waiting for organ availability | health services provided because of need for organ transplant | organ transplant candidate awaiting organ availability | person on organ transplant waiting list [QA15.1] Counselling related to sexual behaviour and orientation or sexual relationships of the person Also known as: Counselling related to sexual behaviour and orientation or sexual relationships of the person | advice on sexual behaviour or orientation | counselling on sexual behaviour or orientation | promiscuity counselling | patient concerned regarding sexual orientation === GRAPH WALKS === --- Walk 1 --- [4B20.Z] Sarcoidosis, unspecified --PARENT--> [4B20] Sarcoidosis Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual... --CHILD--> [4B20.0] Sarcoidosis of lung --- Walk 2 --- [4B20.Z] Sarcoidosis, unspecified --PARENT--> [4B20] Sarcoidosis Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual... --CHILD--> [4B20.1] Sarcoidosis of lymph nodes Def: Lymphadenopathy is very common in sarcoidosis. Intrathoracic nodes are enlarged in 75 to 90% of all patients; usually this involves the hilar nodes, but the paratracheal nodes are commonly involved. P... --- Walk 3 --- [4B20.Y] Other specified sarcoidosis --PARENT--> [4B20] Sarcoidosis Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual... --CHILD--> [4B20.0] Sarcoidosis of lung --- Walk 4 --- [4B20.Y] Other specified sarcoidosis --PARENT--> [4B20] Sarcoidosis Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual... --CHILD--> [4B20.0] Sarcoidosis of lung --- Walk 5 --- [4B20.5] Cutaneous sarcoidosis --PARENT--> [4B20] Sarcoidosis Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual... --CHILD--> [4B20.2] Sarcoidosis of the digestive system Def: This is a syndrome involving abnormal collections of chronic inflammatory cells (granulomas) that can form as nodules in the digestive system.... --- Walk 6 --- [4B20.5] Cutaneous sarcoidosis --PARENT--> [4B20] Sarcoidosis Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual... --CHILD--> [4B20.2] Sarcoidosis of the digestive system Def: This is a syndrome involving abnormal collections of chronic inflammatory cells (granulomas) that can form as nodules in the digestive system....
[ "[4B20.Z] Sarcoidosis, unspecified\n --PARENT--> [4B20] Sarcoidosis\n Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual...\n --CHILD--> [4B20.0] Sarcoidosis of lung", "[4B20.Z] Sarcoidosis, unspecified\n --PARENT--> [4B20] Sarcoidosis\n Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual...\n --CHILD--> [4B20.1] Sarcoidosis of lymph nodes\n Def: Lymphadenopathy is very common in sarcoidosis. Intrathoracic nodes are enlarged in 75 to 90% of all patients; usually this involves the hilar nodes, but the paratracheal nodes are commonly involved. P...", "[4B20.Y] Other specified sarcoidosis\n --PARENT--> [4B20] Sarcoidosis\n Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual...\n --CHILD--> [4B20.0] Sarcoidosis of lung", "[4B20.Y] Other specified sarcoidosis\n --PARENT--> [4B20] Sarcoidosis\n Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual...\n --CHILD--> [4B20.0] Sarcoidosis of lung", "[4B20.5] Cutaneous sarcoidosis\n --PARENT--> [4B20] Sarcoidosis\n Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual...\n --CHILD--> [4B20.2] Sarcoidosis of the digestive system\n Def: This is a syndrome involving abnormal collections of chronic inflammatory cells (granulomas) that can form as nodules in the digestive system....", "[4B20.5] Cutaneous sarcoidosis\n --PARENT--> [4B20] Sarcoidosis\n Def: Sarcoidosis is a multisystem disorder of unknown cause characterised by the formation of immune granulomas in involved organs. The lung and the lymphatic system are predominantly affected, but virtual...\n --CHILD--> [4B20.2] Sarcoidosis of the digestive system\n Def: This is a syndrome involving abnormal collections of chronic inflammatory cells (granulomas) that can form as nodules in the digestive system...." ]
4B20.Z
Sarcoidosis, unspecified
[ { "from_icd11": "4B20.Z", "icd10_code": "D8689", "icd10_title": "Sarcoidosis of other sites" }, { "from_icd11": "4B20.Z", "icd10_code": "D8685", "icd10_title": "Sarcoid myocarditis" }, { "from_icd11": "4B20.Z", "icd10_code": "D8686", "icd10_title": "Sarcoid arthropathy" }, { "from_icd11": "4B20.Z", "icd10_code": "D8682", "icd10_title": "Multiple cranial nerve palsies in sarcoidosis" }, { "from_icd11": "4B20.Z", "icd10_code": "D8683", "icd10_title": "Sarcoid iridocyclitis" }, { "from_icd11": "4B20.Z", "icd10_code": "D8687", "icd10_title": "Sarcoid myositis" }, { "from_icd11": "4B20.Z", "icd10_code": "D8681", "icd10_title": "Sarcoid meningitis" }, { "from_icd11": "4B20.Z", "icd10_code": "D869", "icd10_title": "Sarcoidosis, unspecified" }, { "from_icd11": "4B20.Z", "icd10_code": "D86", "icd10_title": "Sarcoidosis" }, { "from_icd11": "4B20.Z", "icd10_code": "D868", "icd10_title": "Sarcoidosis of other sites" }, { "from_icd11": "4B20.5", "icd10_code": "D863", "icd10_title": "Sarcoidosis of skin" }, { "from_icd11": "4B20.0", "icd10_code": "D860", "icd10_title": "Sarcoidosis of lung" }, { "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": "" } ]
D8689
Sarcoidosis of other sites
The patient’s vitals were within normal limits, and his physical examinations were benign. The initial laboratory data were only notable for albumin 3.4 g/dL and C-reactive protein 1.83 mg/dL, but the other routine blood cell count and biochemical investigations, including lactate dehydrogenase, were within normal reference ranges (Table 1 ). Repeat CT of abdomen and pelvis with or without contrast in our institution revealed diffuse abnormal thickening of the jejunum and the ileum with enlarged regional lymph nodes at the mesenteries . Repeat gastroscopy and colonoscopy performed in our institution were normal and were the same as the ones at the outside hospital. Subsequent pathological results of the random biopsies from the esophagus to the second portion of duodenum and from the terminal ileum to the rectum showed nothing significant including lymphoid infiltration. However, SBE revealed ceaseless villous atrophy throughout most of his jejunum and ileum without any mass, ulceration or stenosis . Histopathology of the SBE biopsy specimens from the jejunum and the ileum showed loss of villous architecture and significant infiltration of small cells in the lamina propria and the submucosal layers . Interestingly, the biopsy specimens from the distal third portion of duodenum did not show any clear endoscopic findings of villous atrophy using SBE but still consisted of the same lymphocyte infiltrate (data not shown). Microscopy under high power magnification revealed that these infiltrating mononuclear cells had relatively low nuclear grade, and the presence of lymphocytes in the epithelial layer were mostly normal . Immunohistochemistry and flow cytometry (data not shown) showed that majority of such lymphocytes expressed CD3, CD5 and CD7 accompanied by aberrant CD20 expression, but not other B cell or natural killer (NK) cell-markers. In addition, IHC also showed that less than 10% of infiltrating cells expressed Ki-67 . These cells consisted of CD4 + , CD8 − , CD30 − , CD56 − , and Granzyme B − . In situ hybridization did not show Epstein–Barr virus-encoded RNA (data not shown). Additional analysis showed elevated soluble IL-2 receptor 1,470 unit/L, but anti-human T lymphotropic virus 1 antibody (Ab) was not detected (Table 1 ). Fluorodeoxyglucose-positron emission tomography (FDG-PET) detected diffuse small intestinal wall thickening and enlargement of mesenteric lymph nodes, but their maximal standardized uptake values were 1.4 and 2.8, respectively, which are considered as low as physiological uptake . In addition, a bone marrow examination showed no infiltration with atypical lymphocytes. Peripheral T cell lymphoma, not otherwise specified (PTCL-NOS) of the GI tract was originally diagnosed based on the World Health Organization (WHO) Classification of Tumours of Haematopoietic and Lymphoid Tissues at the time , and the findings were considered to be stage II-2 based on the Lugano classification. Fig. 1 CT of pelvis without ( a ) and with contrast ( b ). Arrow and arrowhead point to the thickened wall of small intestine and the swollen lymph nodes, respectively Fig. 2 Endoscopic appearances of jejunum. Observations with normal view ( a ), indigo carmine solution ( b ), narrow band imaging ( c ), and crystal violet staining ( d ) are shown, respectively Table 1 Laboratory data Hematology Biochemistry Serology WBC 7.4 × 10 3 /µL TP 7.0 g/dL HBs Ag Negative Neu 38.6 % Alb 3.4 g/dL HCV Ab Negative Lym 50.2 % BUN 23 mg/dL HTLV1 Ab Negative Mono 8.7 % Cre 1.24 mg/dL Eosino 2.0 % UA 5.9 mg/dL Baso 0.5 % Na 142 mEq/L Aty Lym 0.0 % K 4.7 mEq/L RBC 549 × 10 4 /µL Cl 105 mEq/L Hb 16.4 g/dL Ca 8.7 mg/dL Ht 48.4 % LDH 167 U/L MCV 88.2 fl AST 18 U/L MCH 29.9 pg ALT 30 U/L MCHC 33.9 g/dL γ-GTP 17 U/L Plt 19.5 × 10 4 /µL ALP 225 U/L ESR 63 mm/hr T Bil 0.6 mg/dL TG 88 mg/dL T Cho 140 mg/dL Amy 109 U/L Lip 35 U/L Glu 119 mg/dL HbA1c 5.6 % CRP 1.83 mg/dL CEA 2.8 ng/mL sIL-2R 1470 U/mL Fig. 3 Hematoxylin and eosin (H&E)-stained histological features of SBE biopsy. Formalin-fixed, paraffin-embedded SBE biopsy specimens were sectioned, and then stained with H&E. a Low power view shows the loss of villous architecture and severe infiltration with small cells in the lamina propria and the submucosal layers of jejunum. b High power magnification reveals infiltrating mononuclear cells with mild nuclear grade Fig. 4 Immunophenotypical analysis of the infiltrating cells. Serial sections from Fig. 3 were stained with Abs against either CD3 ( a ), CD5 ( b ), CD7 ( c ), or Ki-67 ( d ), respectively Fig. 5 Whole-body FDG-PET imaging. Abnormal FDG uptake was not detected by PET in the patient’s body, including GI tract and lymph nodes. Arrow points to the enlarged small intestine
4.277344
0.82959
sec[1]/p[1]
en
0.999997
30968266
https://doi.org/10.1007/s12328-019-00971-1
[ "cells", "data", "jejunum", "small", "cell", "ileum", "lymph", "nodes", "infiltration", "villous" ]
[ { "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": "DE11", "title": "Dumping syndrome" }, { "code": "1A40.0&XA8UM1", "title": "Jejunitis" }, { "code": "DA94.0Z", "title": "Primary ulcer of small intestine, unspecified" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "LB15.1", "title": "Atresia of small intestine" } ]
=== ICD-11 CODES FOUND === [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 [DE11] Dumping syndrome Definition: Dumping syndrome is a group of signs and symptoms that develops most often in people who have had surgery to remove all or part of their stomach, or in whom surgically bypassed. It may occur early (during a meal or within 15-30 minutes after a meal with nausea, vomiting, abdominal pain, cramps, diarrhoea, dizziness, and heart palpitations) or late (1 to 3 hours after eating with sweating, weakness, fatigue, dizziness, lightheadedness, heart palpitations, and fainting). Also known as: Dumping syndrome | jejunal syndrome | postgastric surgery syndrome | postgastrectomy syndrome | post cibal syndrome [DA94.0Z] Primary ulcer of small intestine, unspecified Also known as: Primary ulcer of small intestine, unspecified | Primary ulcer of small intestine | acute jejunal ulcer | jejunal peptic ulcer | acute peptic jejunal ulcer [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [LB15.1] Atresia of small intestine Definition: Jejunoileal atresias and stenoses are major causes of neonatal intestinal obstruction. Atresia refers to a congenital obstruction with complete occlusion of the intestinal lumen. It accounts for 95% of obstructions. Four types of jejunoileal atresias are described. They can range from having a small area of blockage or web to missing large sections of the intestines. Intestinal atresia is one of the most frequent causes of bowel obstruction in the newborn. The ileal atresia is more common than j Also known as: Atresia of small intestine | Congenital stenosis of small intestine | Congenital absence of small intestine | congenital small intestinal stricture NOS | Multiple-level intestinal atresia Includes: Congenital absence of small intestine | Congenital stenosis of small intestine === GRAPH WALKS === --- Walk 1 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --EXCLUDES--> [?] Clinical findings on antenatal screening of mother Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother.... --- Walk 2 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --EXCLUDES--> [?] Clinical findings on antenatal screening of mother Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother.... --- 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--> [?] 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 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 ... --CHILD--> [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --- Walk 6 --- [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ... --RELATED_TO--> [?] Other sickle-cell disorders with retinopathy Def: This is an autosomal recessive genetic blood disorder with overdominance, characterised by red blood cells that assume an abnormal, rigid, sickle shape. This diagnosis is due to persistent or acute da...
[ "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....", "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....", "[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...", "[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 --CHILD--> [3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...", "[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --RELATED_TO--> [?] Other sickle-cell disorders with retinopathy\n Def: This is an autosomal recessive genetic blood disorder with overdominance, characterised by red blood cells that assume an abnormal, rigid, sickle shape. This diagnosis is due to persistent or acute da..." ]
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": "DE11", "icd10_code": "K911", "icd10_title": "Postgastric surgery syndromes" }, { "from_icd11": "DA94.0Z", "icd10_code": "K633", "icd10_title": "Ulcer of intestine" }, { "from_icd11": "QF01.Y", "icd10_code": "Z9049", "icd10_title": "Acquired absence of other specified parts of digestive tract" }, { "from_icd11": "LB15.1", "icd10_code": "Q411", "icd10_title": "Congenital absence, atresia and stenosis of jejunum" }, { "from_icd11": "LB15.1", "icd10_code": "Q412", "icd10_title": "Congenital absence, atresia and stenosis of ileum" } ]
D571
Sickle-cell disease without crisis
A 48-year-old man underwent laparoscopic partial liver resection of segment 8 for liver metastasis of rectal cancer. Laparoscopic lower anterior resection was performed in patients with stage T3 rectal cancer. The pathological diagnosis was adenocarcinoma with no lymph node metastasis and the surgical margins of the tumor were negative. Twenty months after surgery, computed tomography revealed a new lesion beneath the diaphragm. Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) revealed a hypointense tumor located just beneath the diaphragm at the liver segment 8 on the hepatobiliary phase . The surgery was performed due to growth in tumor size. The patient was placed in a left hemilateral decubitus position, and five laparoscopic ports were placed as described in Fig. 2 . Pneumoperitoneum was established through the right lateral umbilical 12-mm camera port inserted using the open-entry method. Adhesions from the previous surgery were dissected. Tumor invasion to the diaphragm was detected while the right lobe was mobilized. The invaded area of the diaphragm was encircled using a hanging tape. Liver resection preceded diaphragmatic resection. Due to severe adhesions around the hepatoduodenal ligament and the small extent of resection volume, liver resection was performed without the Pringle maneuver. Liver resection was performed using HARMONIC ACE® (Ethicon Endo-Surgery, Cincinnati, OH, USA) and CUSA® (Clarity Ultrasonic Surgical Aspirator System, Integra LifeSciences Corporation, NR Ireland Limited) while hanging the liver tumor with tape. The inflow of CO 2 into the pleural space after diaphragmatic resection created a poor surgical field due to the development of unsustainable pneumoperitoneum. The liver and diaphragm were held down using two snake retractors to secure the surgical field. The diaphragm defect was repaired with continuous or interrupted sutures placed using LAPRA-TY® (Ethicon Endo-Surgery, Cincinnati, OH, USA) clips and 3–0 Vicryl sutures. Both ends of the string were tied using a LAPRA-TY® clip without ligation. Continuous or interrupted sutures were placed based on the tension of the diaphragm while reducing the pneumoperitoneum pressure from 10 to 6 mmHg, and respiration was temporarily stopped while consulting with the anesthesiologist. The surgery was completed with a 14-French chest tube insertion. The patient had no respiratory or circulatory abnormalities during the surgery. The total operative time was 272 min with a 10-mL blood loss. The image of the surgical method is shown in Fig. 3 . The video of the surgery is available online only (Supporting Information). The postoperative course was uneventful, the chest tube was removed after confirming no air leakage on the first postoperative day, and the patient was discharged 8 days after the surgery. The pathological diagnosis was liver metastasis of rectal cancer invading the diaphragm. The surgical margins of the tumor were negative. The tumor weighed 5 g, including the diaphragm. The excision range of the diaphragm was 34 × 44 mm . Eighteen months after the surgery, no abnormalities were found in the diaphragm regarding respiratory symptoms and imaging findings. Written informed consent was obtained from the patient to publish this video article and any accompanying images presented in this study, and patient anonymity was preserved. Fig. 1 EOB-MRI revealed a hypointensity tumor located just below the diaphragm at liver segment 8 on hepatobiliary phase (arrow). ( a : axial sections, b : coronal sections) Fig. 2 The illustration of the patient and port placement. The patient was placed in the left hemilateral decubitus position. EZ-access was inserted through the right lateral umbilical. Circles represent 12-mm and crosses represent 5-mm ports. 12-mm EZ-access, 12-mm epigastric, 12-mm upper abdominal, 5-mm right subcostal and 5-mm right lateral ports were inserted Fig. 3 Surgical image. a Liver resection using the hanging method prior to diaphragmatic resection. b Diaphragmatic resection while confirming the invading range of the tumor. c Securement the surgical field using two snake retractors. d Repairing the diaphragm with LAPRA-TY® clips. ①Attaching LAPRA-TY® clips to the end of the string. ②Attaching the end of the continuous sutures. ③Adjusted to the tension of the diaphragmatic sutures Fig. 4 a The surgical specimen. The pathological diagnosis was liver metastasis of rectal cancer. The weight of the resected liver including the diaphragm was 5 g. The excision range of the diaphragm was 34 × 44 mm. b The cutting surface of specimen. The tumor had invaded the diaphragm. The surgical margins of the tumor were negative
3.986328
0.972168
sec[1]/p[0]
en
0.999996
34557377
https://doi.org/10.1007/s13691-021-00506-x
[ "diaphragm", "liver", "resection", "tumor", "using", "while", "diaphragmatic", "sutures", "metastasis", "rectal" ]
[ { "code": "CB23", "title": "Disorders of diaphragm" }, { "code": "LB00.1", "title": "Absence of diaphragm" }, { "code": "NB32.Y&XA2JL0", "title": "Laceration of diaphragm" }, { "code": "LB00.Y", "title": "Other specified structural developmental anomalies of diaphragm" }, { "code": "DC51.1&XA2JL0", "title": "Adhesion of diaphragm" }, { "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" } ]
=== ICD-11 CODES FOUND === [CB23] Disorders of diaphragm Definition: This category includes the abnormalities of diaphragmatic position or motion (paralysis, relaxation, and acquired deformity) and the inflammation of the diaphragm, but neoplasms of the diaphragm, congenital malformation of diaphragm, and diaphragmatic hernias are included in other categories. Also known as: Disorders of diaphragm | diaphragmatic disorder | disease of diaphragm | disorder of diaphragm | Acquired diaphragmatic deformity Excludes: Congenital diaphragmatic hernia | Structural developmental anomalies of diaphragm [LB00.1] Absence of diaphragm Also known as: Absence of diaphragm | diaphragm agenesis [LB00.Y] Other specified structural developmental anomalies of diaphragm Also known as: Other specified structural developmental anomalies of diaphragm | Eventration of diaphragm | diaphragm elevation | high diaphragm | Oesophageal hiatus hypertrophy [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 === GRAPH WALKS === --- Walk 1 --- [CB23] Disorders of diaphragm Def: This category includes the abnormalities of diaphragmatic position or motion (paralysis, relaxation, and acquired deformity) and the inflammation of the diaphragm, but neoplasms of the diaphragm, cong... --EXCLUDES--> [?] Congenital diaphragmatic hernia Def: Congenital diaphragmatic hernia is a posterolateral defect of the diaphragm that allows passage of abdominal viscera into the thorax, leading to respiratory insufficiency and persistent pulmonary hype... --PARENT--> [?] Structural developmental anomalies of diaphragm --- Walk 2 --- [CB23] Disorders of diaphragm Def: This category includes the abnormalities of diaphragmatic position or motion (paralysis, relaxation, and acquired deformity) and the inflammation of the diaphragm, but neoplasms of the diaphragm, cong... --EXCLUDES--> [?] Congenital diaphragmatic hernia Def: Congenital diaphragmatic hernia is a posterolateral defect of the diaphragm that allows passage of abdominal viscera into the thorax, leading to respiratory insufficiency and persistent pulmonary hype... --EXCLUDES--> [?] Congenital hiatus hernia Def: Congenital diaphragmatic hernia is an embryopathy which is defined by the absence of development of all or part of the diaphragmatic dome that results in the presence of abdominal viscera in the thora... --- Walk 3 --- [LB00.1] Absence of diaphragm --PARENT--> [LB00] Structural developmental anomalies of diaphragm --CHILD--> [LB00.Y] Other specified structural developmental anomalies of diaphragm --- Walk 4 --- [LB00.1] Absence of diaphragm --PARENT--> [LB00] Structural developmental anomalies of diaphragm --CHILD--> [LB00.Y] Other specified structural developmental anomalies of diaphragm --- Walk 5 --- [LB00.Y] Other specified structural developmental anomalies of diaphragm --PARENT--> [LB00] Structural developmental anomalies of diaphragm --CHILD--> [LB00.Y] Other specified structural developmental anomalies of diaphragm --- Walk 6 --- [LB00.Y] Other specified structural developmental anomalies of diaphragm --PARENT--> [LB00] Structural developmental anomalies of diaphragm --CHILD--> [LB00.0] Congenital diaphragmatic hernia Def: Congenital diaphragmatic hernia is a posterolateral defect of the diaphragm that allows passage of abdominal viscera into the thorax, leading to respiratory insufficiency and persistent pulmonary hype...
[ "[CB23] Disorders of diaphragm\n Def: This category includes the abnormalities of diaphragmatic position or motion (paralysis, relaxation, and acquired deformity) and the inflammation of the diaphragm, but neoplasms of the diaphragm, cong...\n --EXCLUDES--> [?] Congenital diaphragmatic hernia\n Def: Congenital diaphragmatic hernia is a posterolateral defect of the diaphragm that allows passage of abdominal viscera into the thorax, leading to respiratory insufficiency and persistent pulmonary hype...\n --PARENT--> [?] Structural developmental anomalies of diaphragm", "[CB23] Disorders of diaphragm\n Def: This category includes the abnormalities of diaphragmatic position or motion (paralysis, relaxation, and acquired deformity) and the inflammation of the diaphragm, but neoplasms of the diaphragm, cong...\n --EXCLUDES--> [?] Congenital diaphragmatic hernia\n Def: Congenital diaphragmatic hernia is a posterolateral defect of the diaphragm that allows passage of abdominal viscera into the thorax, leading to respiratory insufficiency and persistent pulmonary hype...\n --EXCLUDES--> [?] Congenital hiatus hernia\n Def: Congenital diaphragmatic hernia is an embryopathy which is defined by the absence of development of all or part of the diaphragmatic dome that results in the presence of abdominal viscera in the thora...", "[LB00.1] Absence of diaphragm\n --PARENT--> [LB00] Structural developmental anomalies of diaphragm\n --CHILD--> [LB00.Y] Other specified structural developmental anomalies of diaphragm", "[LB00.1] Absence of diaphragm\n --PARENT--> [LB00] Structural developmental anomalies of diaphragm\n --CHILD--> [LB00.Y] Other specified structural developmental anomalies of diaphragm", "[LB00.Y] Other specified structural developmental anomalies of diaphragm\n --PARENT--> [LB00] Structural developmental anomalies of diaphragm\n --CHILD--> [LB00.Y] Other specified structural developmental anomalies of diaphragm", "[LB00.Y] Other specified structural developmental anomalies of diaphragm\n --PARENT--> [LB00] Structural developmental anomalies of diaphragm\n --CHILD--> [LB00.0] Congenital diaphragmatic hernia\n Def: Congenital diaphragmatic hernia is a posterolateral defect of the diaphragm that allows passage of abdominal viscera into the thorax, leading to respiratory insufficiency and persistent pulmonary hype..." ]
CB23
Disorders of diaphragm
[ { "from_icd11": "CB23", "icd10_code": "J986", "icd10_title": "Disorders of diaphragm" }, { "from_icd11": "LB00.1", "icd10_code": "Q791", "icd10_title": "Other congenital malformations of diaphragm" }, { "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" } ]
J986
Disorders of diaphragm
A 10-year-old male with no significant past medical history presented to an outside emergency department (ED) after he developed lip smacking and mouth twitching followed by a generalized tonic–clonic seizure lasting 5–7 min. Six days prior, he experienced a headache and low-grade fever of 100.3 F and was diagnosed with a viral syndrome by his local physician. While in the ED, he experienced an episode of left lateral gaze and left-hand tensing and was loaded with levetiracetam and transferred to a local PICU. Initial evaluation in the ED revealed a normal head CT and brain MRI. Labs were significant for mildly elevated CRP. CSF studies were normal except for mildly elevated glucose. Infectious workup was negative. Anti-NMDA receptor ab was later found to be negative. EEG was performed showing status epilepticus with focal seizure origination in the right temporoparietooccipital area. He was then sedated with midazolam and intubated. Systemic immunotherapy (SIT) was initiated on day three with intravenous immunoglobulin (IVIG) and IV methylprednisolone (dose and duration in Table 3 ). He remained in SRSE and was placed in a pentobarbital coma. SRSE persisted prompting transfer to a tertiary center for higher level of care. Upon transfer, it was noted that his medications were dosed based on ideal weight, doses were increased, and he achieved burst suppression for a short time. Ketamine was then started as well as additional AEDs (noted below in Table 2 ) to achieve burst suppression. Repeat MRI showed bilateral restricted diffusion of the hippocampus. Pediatric rheumatology was consulted on hospital day 8. Repeat CSF and serum studies were obtained as well as imaging to evaluate for an autoimmune or paraneoplastic process. Paraneoplastic evaluation with CT chest/abdomen/pelvis as well as the testicular ultrasound were negative. CSF studies again showed a normal cell count and protein count. Myelin basic protein was mildly elevated in the CSF; however, the IgG synthesis rate and oligoclonal bands were negative. Serum cytokines showed mild elevations in IL-6 and IL-8 on day 9 of hospitalization after he had received steroids, IVIG, and was started on anakinra. CSF cytokines were sent to Cincinnati Children’s laboratory much later in the hospital course and were normal at that time. Autoantibody studies were grossly negative aside from a positive anti-TPO antibody and anti-thyroglobulin antibody, which both normalized on subsequent testing, suggesting false positivity post-IVIG. He was given a second course of IV methylprednisolone. His autoimmune encephalitis workup resulted with a positive GAD65 antibody in the serum and a mildly positive antibody in the CSF, prompting a five-day course of plasmapheresis. A ketogenic diet was started on hospital day 12; however, ketosis was difficult to achieve. After a lack of improvement in his EEG findings following increased doses of anakinra, tocilizumab (IL-6 receptor antagonist) was started. His serum IL-6 levels were monitored periodically through ARUP and Cincinnati laboratories prior to starting tocilizumab and after its initiation. IL-6 levels rose just prior to starting tocilizumab and remained elevated with monitoring. After his second dose of tocilizumab, there was some improvement in his EEG activity, and pentobarbital was successfully weaned. Seizures returned with an attempted wean of ketamine, and he was given a third dose of tocilizumab. He continued to have breakthrough seizures. He received a third pulse of methylprednisolone on hospital day 48 with no improvement in ability to wean off anesthetic agents. He struggled with rising transaminases, likely due to the large pharmacologic burden from AEDs and antibiotics needed for recurrent infections. His seizure burden increased despite increased doses of ketamine. He was then started on baricitinib (JAKi), and clinical and subclinical seizure activity resolved within 48 h. Cytokine monitoring showed a steady decline in serum IL-6 after starting baricitinib. His baricitinib dose was increased following some breakthrough seizure activity but was then subsequently decreased due to recurrent episodes of pneumonia. He was weaned off ketamine on hospital day 83, at which time he began to have increased alertness and interaction. He was discharged to inpatient rehabilitation and maintained on baricitinib for nearly 12 months. Upon follow up, he remains on several AEDs. He has breakthrough seizures upon weaning AEDs, which eventually resolve without increased therapy. He participates in home schooling and home-based occupational and physical therapies, showing gradual improvements in his motor and cognitive function. He remains in a state of moderate disability.
3.994141
0.977051
sec[2]/sec[0]/sec[0]/p[0]
en
0.999998
PMC12026200
https://doi.org/10.3390/children12040485
[ "seizure", "serum", "tocilizumab", "mildly", "ketamine", "aeds", "antibody", "baricitinib", "anti", "ivig" ]
[ { "code": "8A68.Z", "title": "Type of seizure, unspecified" }, { "code": "8A6Z", "title": "Epilepsy or seizures, unspecified" }, { "code": "8A63.Y", "title": "Seizure due to other acute cause" }, { "code": "8A67", "title": "Acute repetitive seizures" }, { "code": "8A68.Y", "title": "Other specified type of seizure" }, { "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 === [8A68.Z] Type of seizure, unspecified Also known as: Type of seizure, unspecified | Types of seizures | uncontrolled seizures | Seizure NOS | fits NOS [8A6Z] Epilepsy or seizures, unspecified Also known as: Epilepsy or seizures, unspecified | Cerebral seizures | Seizure disorder | seizure disorder, so described | epilepsy NOS [8A63.Y] Seizure due to other acute cause Also known as: Seizure due to other acute cause | Seizures due to immune disorders | Seizures due to medications | Toxic syndrome with generalised seizures, drug related | Acute seizures due to central nervous system infections or infestations [8A67] Acute repetitive seizures Definition: Acute repetitive seizures are multiple seizures, with a distinct time of onset, with recovery between each seizure, occurring within 24 hours in adults, or 12 hours in children. Also known as: Acute repetitive seizures | complex partial status epilepticus | Cluster seizures | Serial seizures | Recurrent seizures [8A68.Y] Other specified type of seizure Also known as: Other specified type of seizure | Absence episode | Absence seizure episode | Pseudotetanus | Clonic seizure disorder [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 --- [8A68.Z] Type of seizure, unspecified --PARENT--> [8A68] Types of seizures --CHILD--> [8A68.0] Focal unaware seizure Def: Previously termed “complex partial seizures”, define seizures originating within networks limited to one hemisphere and accompanied by loss of awareness (i.e., knowledge of self or environment).... --- Walk 2 --- [8A68.Z] Type of seizure, unspecified --PARENT--> [8A68] Types of seizures --CHILD--> [8A68.2] Absence seizures, typical Def: Seizures characterised by sudden onset, interruption of ongoing activities, blank stare, possibly brief upward gaze deviation, unresponsiveness, duration from few seconds to half a minute, and rapid r... --- Walk 3 --- [8A6Z] Epilepsy or seizures, unspecified --PARENT--> [?] Epilepsy or seizures Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart.... --CHILD--> [8A60] Epilepsy due to structural or metabolic conditions or diseases Def: Epilepsy occurring in relation to a distinct other structural or metabolic condition or disease that has been demonstrated to be associated with a substantially increased risk of developing epilepsy.... --- Walk 4 --- [8A6Z] Epilepsy or seizures, unspecified --PARENT--> [?] Epilepsy or seizures Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart.... --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 --- [8A63.Y] Seizure due to other acute cause --PARENT--> [8A63] Seizure due to acute causes Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult.... --CHILD--> [8A63.Z] Seizure due to unspecified acute cause --- Walk 6 --- [8A63.Y] Seizure due to other acute cause --PARENT--> [8A63] Seizure due to acute causes Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult.... --CHILD--> [8A63.0] Febrile seizures Def: Seizures associated with a rise of the body temperature in the absence of intracranial infection, metabolic disturbance, or history of afebrile seizures. They most commonly occur in children between t...
[ "[8A68.Z] Type of seizure, unspecified\n --PARENT--> [8A68] Types of seizures\n --CHILD--> [8A68.0] Focal unaware seizure\n Def: Previously termed “complex partial seizures”, define seizures originating within networks limited to one hemisphere and accompanied by loss of awareness (i.e., knowledge of self or environment)....", "[8A68.Z] Type of seizure, unspecified\n --PARENT--> [8A68] Types of seizures\n --CHILD--> [8A68.2] Absence seizures, typical\n Def: Seizures characterised by sudden onset, interruption of ongoing activities, blank stare, possibly brief upward gaze deviation, unresponsiveness, duration from few seconds to half a minute, and rapid r...", "[8A6Z] Epilepsy or seizures, unspecified\n --PARENT--> [?] Epilepsy or seizures\n Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart....\n --CHILD--> [8A60] Epilepsy due to structural or metabolic conditions or diseases\n Def: Epilepsy occurring in relation to a distinct other structural or metabolic condition or disease that has been demonstrated to be associated with a substantially increased risk of developing epilepsy....", "[8A6Z] Epilepsy or seizures, unspecified\n --PARENT--> [?] Epilepsy or seizures\n Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart....\n --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....", "[8A63.Y] Seizure due to other acute cause\n --PARENT--> [8A63] Seizure due to acute causes\n Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult....\n --CHILD--> [8A63.Z] Seizure due to unspecified acute cause", "[8A63.Y] Seizure due to other acute cause\n --PARENT--> [8A63] Seizure due to acute causes\n Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult....\n --CHILD--> [8A63.0] Febrile seizures\n Def: Seizures associated with a rise of the body temperature in the absence of intracranial infection, metabolic disturbance, or history of afebrile seizures. They most commonly occur in children between t..." ]
8A68.Z
Type of seizure, unspecified
[ { "from_icd11": "8A68.Z", "icd10_code": "R561", "icd10_title": "Post traumatic seizures" }, { "from_icd11": "8A68.Z", "icd10_code": "R569", "icd10_title": "Unspecified convulsions" }, { "from_icd11": "8A68.Z", "icd10_code": "R56", "icd10_title": "Convulsions, not elsewhere classified" }, { "from_icd11": "8A68.Z", "icd10_code": "R568", "icd10_title": "" }, { "from_icd11": "8A6Z", "icd10_code": "G40A09", "icd10_title": "Absence epileptic syndrome, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40B09", "icd10_title": "Juvenile myoclonic epilepsy, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40B19", "icd10_title": "Juvenile myoclonic epilepsy, intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A19", "icd10_title": "Absence epileptic syndrome, intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A11", "icd10_title": "Absence epileptic syndrome, intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A01", "icd10_title": "Absence epileptic syndrome, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40409", "icd10_title": "Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40802", "icd10_title": "Other epilepsy, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40801", "icd10_title": "Other epilepsy, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40901", "icd10_title": "Epilepsy, unspecified, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G4089", "icd10_title": "Other seizures" } ]
R561
Post traumatic seizures
A 63-year-old man with coronary artery disease and old cerebral infarction presented with severe claudication of the right lower limb. The ABI was 0.60 on the right side. Preoperative CT showed total occlusion of the right CIA ostium to CFA, and the CFA was occluded with severe calcification . After confirming the absence of shaggy descending aorta by contrast-enhanced CT, EVT with the TRA was attempted. A 120-cm 6Fr guiding sheath (Destination Slender® guiding sheath; Terumo) was inserted into the left radial artery. Heparin was administered as in Case 1. Control angiography showed a total occlusion of the right just-proximal CIA to distal aspects of the CFA with calcification . First, a 0.014-inch guidewire (Gladius MGES® guidewire; Asahi Intec) and a 150-cm 2.6Fr microcatheter (Caravel® microcatheter; Asahi Intec) with a 130-cm 5Fr support catheter (Glidecath® diagnostic catheter; Terumo) was advanced into the CTO lesion . The guidewire was advanced to the distal EIA but could not be advanced further owing to the calcified occlusion of the CFA; therefore, a retrograde approach was chosen . A 21-G metal needle (Merit Advance® angiography needle; Merit Medical) that was slightly curved was advanced into the distal calcified CFA from the location of the distal lumen . The needle was advanced into the calcified plaque under observation from multiple directions by fluoroscopy. The needle was successfully advanced into the CTO of the distal EIA, as confirmed by DUS . A 0.014-inch guidewire (Halberd® guidewire; Asahi Intec) was inserted from behind the needle and the guidewire was advanced into the CTO lesion (F i g. 3 I). After guidewire externalization by the rendezvous technique in the CTO , a 1.5 × 20-mm balloon (Coyote®; Boston Scientific, USA) and a 4.0 × 40-mm balloon (JADE®; Orbus Neich, Tokyo, Japan) were successfully passed and used to dilate the CFA to the CIA lesion . IVUS showed that the guidewire was able to completely pass through the calcified plaque . A 300-cm 0.014-inch guidewire (Gladius MGES® guidewire; Asahi Intec) was passed in the SFA direction and extended a 6.0 × 40-mm high pressure balloon (SHIDEN HP®; Kaneka) with intravascular hemostasis of the retrograde puncture site . After confirmation of hemostasis of the femoral artery by angiography, a 10.0 × 60-mm stent, a 9.0 × 40-mm stent, and a 8.0 × 100-mm BNS (Misago® stent; Terumo) were deployed for the CIA to the EIA, and a 6.0 × 60-mm drug-coated balloon (Lutonix RX® drug-coated balloon; BARD, AZ, USA) was deployed at the CFA lesion . The final angiography showed good dilation, blood flow, and puncture site hemostasis . The procedural time for EVT was 120 min, the dose of radiation exposure in terms of dose–area product was 17.0 Gycm 2 , and the amount of contrast medium was 150 ml. Postoperative release from bed rest was similar to that in Case 1. The patient’s clinical symptoms were ameliorated, and his ABI improved to 1.07 without RA occlusion. Fig. 3 Case 2. A, B Preprocedural enhanced computed tomography images. C Control angiography showed total occlusion from the proximal aspect of the common iliac artery. D The black arrow shows the 6Fr guiding sheath. The red arrow shows the 5Fr angled support catheter. E The antegrade guidewire was advanced into the distal external iliac artery. The white arrow shows the antegrade wire. F The white arrow shows the antegrade wire. The black arrow shows the 21-G needle. G Image of a 21-G needle created with a double bend. H Duplex ultrasound showed that the retrograde guidewire was inside the vessel. The yellow arrow shows the 21-G needle. The white arrow shows calcified plaque. The red arrow shows the retrograde guidewire. I Bidirectional wiring. The white arrow shows the retrograde guidewire. J The retrograde guidewire was advanced into the antegrade guiding sheath to achieve guidewire externalization. The black arrow shows the antegrade 6Fr guiding sheath. The white arrow shows the retrograde guidewire Fig. 4 Case 2. A Pre-dilation was performed with a small balloon. The black arrow shows the balloon. B An antegrade guidewire was advanced to the superficial femoral artery. The black arrow shows the antegrade guidewire. C A 6.0 × 40-mm high pressure balloon was dilated with intravascular hemostasis of the retrograde puncture site. D Three Misago stents were deployed in the iliac artery, and post-dilation was performed. E A drug-coated balloon was dilated in the common femoral artery. The black arrow shows the drug-coated balloon. F IVUS findings after the guidewire crossing. G IVUS findings after the drug-coated balloon dilation. H, I The final angiography showed good expansion of the iliac to femoral artery, and sufficient antegrade flow
4.003906
0.970215
sec[1]/sec[1]/p[0]
en
0.999998
PMC9590498
https://doi.org/10.1186/s42155-022-00334-x
[ "guidewire", "arrow", "balloon", "advanced", "artery", "retrograde", "needle", "antegrade", "angiography", "black" ]
[ { "code": "BC43.5", "title": "Stress-induced cardiomyopathy" }, { "code": "BB62.Z", "title": "Mitral valve prolapse, unspecified" }, { "code": "PA50.Z&XE3J3", "title": "Balloon accident injuring occupant" }, { "code": "PK91.2Y", "title": "Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" }, { "code": "PK91.13", "title": "Cardiovascular devices associated with injury or harm, intra-aortic balloon pump" }, { "code": "MG2A", "title": "Ageing associated decline in intrinsic capacity" }, { "code": "9B75.03", "title": "Atrophic late-stage age-related macular degeneration" }, { "code": "6D8Z&XS25", "title": "End stage dementia" }, { "code": "9B75.04", "title": "Neovascular late-stage age-related macular degeneration" }, { "code": "BC63.10", "title": "High-grade second degree atrioventricular block" } ]
=== ICD-11 CODES FOUND === [BC43.5] Stress-induced cardiomyopathy Definition: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocardial infarction, but with non-specific electrocardiographic ST elevation and T wave changes, and minimal myocardial enzymatic release, in the absence of coronary stenosis. Also known as: Stress-induced cardiomyopathy | Takotsubo cardiomyopathy | stress cardiomyopathy | broken heart syndrome | apical ballooning syndrome Includes: Takotsubo cardiomyopathy [BB62.Z] Mitral valve prolapse, unspecified Also known as: Mitral valve prolapse, unspecified | Mitral valve prolapse | systolic click-murmur syndrome | ballooning mitral valve | Barlow syndrome [PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Also known as: Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Cardiovascular devices associated with injury or harm, conduits | Mechanical complication of other cardiac and vascular devices and implants | Mechanical complication of artificial heart | Mechanical complication of vascular balloon implant or device [PK91.13] Cardiovascular devices associated with injury or harm, intra-aortic balloon pump Also known as: Cardiovascular devices associated with injury or harm, intra-aortic balloon pump | IABP - [intra-aortic balloon pump] | Mechanical complication of intra-aortic counterpulsation device Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [MG2A] Ageing associated decline in intrinsic capacity Also known as: Ageing associated decline in intrinsic capacity | senescence | senile state | senile dysfunction | senility NOS Includes: senescence without mention of psychosis Excludes: Senile dementia [9B75.03] Atrophic late-stage age-related macular degeneration Also known as: Atrophic late-stage age-related macular degeneration | advanced dry age-related macular degeneration | advanced dry AMD - [age-related macular degeneration] | advanced atrophic age related macular degeneration | Geographic atrophy secondary to age-related macular degeneration without foveal involvement [9B75.04] Neovascular late-stage age-related macular degeneration Also known as: Neovascular late-stage age-related macular degeneration | advanced exudative age-related macular degeneration | advanced exudative AMD - [age-related macular degeneration] | advanced neovascular age related macular degeneration | neovascular age-related macular degeneration [BC63.10] High-grade second degree atrioventricular block Definition: Form of second degree atrioventricular block in which either multiple consecutive P-waves are not conducted or there are transient periods of atrioventricular dissociation Also known as: High-grade second degree atrioventricular block | Advanced heart block === GRAPH WALKS === --- Walk 1 --- [BC43.5] Stress-induced cardiomyopathy Def: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocard... --PARENT--> [BC43] Cardiomyopathy Def: These are myocardial disorders in which the heart muscle is structurally and functionally abnormal, in the absence of coronary artery disease, hypertension, valvular disease and congenital heart disea... --RELATED_TO--> [?] Pacing-induced cardiomyopathy Def: Pacing-induced cardiomyopathy is ventricular dilation, dysfunction (systolic and/or diastolic) and dyskinesia associated with chronic ventricular pacing in the absence of other causes of cardiomyopath... --- Walk 2 --- [BC43.5] Stress-induced cardiomyopathy Def: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocard... --PARENT--> [BC43] Cardiomyopathy Def: These are myocardial disorders in which the heart muscle is structurally and functionally abnormal, in the absence of coronary artery disease, hypertension, valvular disease and congenital heart disea... --CHILD--> [BC43.0] Dilated cardiomyopathy Def: Dilated cardiomyopathy is a myocardial disorder in which there is systolic dysfunction and chamber dilation of one or both ventricles in the absence of a haemodynamic cause that can produce the existe... --- Walk 3 --- [BB62.Z] Mitral valve prolapse, unspecified --PARENT--> [BB62] Mitral valve prolapse --EXCLUDES--> [?] Marfan syndrome Def: Marfan syndrome is a systemic disease of connective tissue characterised by a variable combination of cardiovascular, musculo-skeletal, ophthalmic and pulmonary manifestations. Cardiovascular involvem... --- Walk 4 --- [BB62.Z] Mitral valve prolapse, unspecified --PARENT--> [BB62] Mitral valve prolapse --PARENT--> [?] Mitral valve disease Def: This is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle through the mitral valve i... --- Walk 5 --- [PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices --PARENT--> [PK91.2] Cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Def: A cardiovascular prosthetic or other implant, or cardiovascular material or an accessory device was associated with an adverse incident... --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm --- Walk 6 --- [PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices --PARENT--> [PK91.2] Cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Def: A cardiovascular prosthetic or other implant, or cardiovascular material or an accessory device was associated with an adverse incident... --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
[ "[BC43.5] Stress-induced cardiomyopathy\n Def: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocard...\n --PARENT--> [BC43] Cardiomyopathy\n Def: These are myocardial disorders in which the heart muscle is structurally and functionally abnormal, in the absence of coronary artery disease, hypertension, valvular disease and congenital heart disea...\n --RELATED_TO--> [?] Pacing-induced cardiomyopathy\n Def: Pacing-induced cardiomyopathy is ventricular dilation, dysfunction (systolic and/or diastolic) and dyskinesia associated with chronic ventricular pacing in the absence of other causes of cardiomyopath...", "[BC43.5] Stress-induced cardiomyopathy\n Def: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocard...\n --PARENT--> [BC43] Cardiomyopathy\n Def: These are myocardial disorders in which the heart muscle is structurally and functionally abnormal, in the absence of coronary artery disease, hypertension, valvular disease and congenital heart disea...\n --CHILD--> [BC43.0] Dilated cardiomyopathy\n Def: Dilated cardiomyopathy is a myocardial disorder in which there is systolic dysfunction and chamber dilation of one or both ventricles in the absence of a haemodynamic cause that can produce the existe...", "[BB62.Z] Mitral valve prolapse, unspecified\n --PARENT--> [BB62] Mitral valve prolapse\n --EXCLUDES--> [?] Marfan syndrome\n Def: Marfan syndrome is a systemic disease of connective tissue characterised by a variable combination of cardiovascular, musculo-skeletal, ophthalmic and pulmonary manifestations. Cardiovascular involvem...", "[BB62.Z] Mitral valve prolapse, unspecified\n --PARENT--> [BB62] Mitral valve prolapse\n --PARENT--> [?] Mitral valve disease\n Def: This is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle through the mitral valve i...", "[PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n --PARENT--> [PK91.2] Cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n Def: A cardiovascular prosthetic or other implant, or cardiovascular material or an accessory device was associated with an adverse incident...\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm", "[PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n --PARENT--> [PK91.2] Cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n Def: A cardiovascular prosthetic or other implant, or cardiovascular material or an accessory device was associated with an adverse incident...\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm" ]
BC43.5
Stress-induced cardiomyopathy
[ { "from_icd11": "BB62.Z", "icd10_code": "I341", "icd10_title": "Nonrheumatic mitral (valve) prolapse" }, { "from_icd11": "PA50.Z&XE3J3", "icd10_code": "V960", "icd10_title": "Balloon accident injuring occupant" }, { "from_icd11": "MG2A", "icd10_code": "R54", "icd10_title": "Age-related physical debility" } ]
I341
Nonrheumatic mitral (valve) prolapse
A 62-year-old woman was referred for evaluation and catheter ablation of recurrent paroxysmal narrow-complex tachycardia. Computed tomography revealed coexisting PLSVC with an enlarged CS ostium (29 × 37 mm) . After obtaining written consent from the patient, an electrophysiological study was performed in a lightly sedated fasting state without antiarrhythmic drugs. Electrode catheters were positioned in the right atrium, His bundle, and right ventricular apex and dilated CS. At baseline, the patient exhibited normal AH (94 ms) and HV (36 ms) intervals with a sinus cycle length (CL) of 764 ms . Atrial programmed stimulation revealed dual AV nodal physiology, and clinical tachycardia was reproducibly induced and terminated by right atrial (RA) pacing. The tachycardia CL was 324 ms, and the earliest atrial activation was observed at the His catheter with a septal ventriculoatrial time of −4 ms. The response to ventricular entrainment pacing exhibited a V-A-H-V pattern. His-synchronous premature ventricular contractions were placed repeatedly without advancing the subsequent atrial potentials. Based on the aforementioned findings, we made a diagnosis of typical “slow-fast” AVNRT. SP ablation was performed using a 6-mm-tipped electrode cryoablation catheter (Freezor Xtra; Medtronic, Minneapolis, MN, USA), considering the catheter stability and safety profile. We initiated cryomapping at the posteroinferior aspect of the CS ostium during tachycardia, where SP potential was observed during the sinus rhythm . However, cryomapping at −30 °C for 20 s did not affect the tachycardia. Then, we gradually moved the ablation catheter anteriorly closer to the compact AV node and repeated cryomapping in the same manner. The fourth attempt of cryomapping at the mid-anterior septum , where the AV ratio was 0.36 during the sinus rhythm, terminated the tachycardia in 7 s . Subsequently, cryoablation with a goal temperature of −80 °C for 240 s was initiated during the sinus rhythm. The AV block occurred after 22 s at the tip temperature of −80 °C , and cryoablation was discontinued. The AH conduction returned to normal after 17 s. Cryoablation was applied to the adjacent area with an AV ratio of 0.33 for 240 s during RA pacing, while ensuring a constant AH interval. After a 30-min waiting period, we confirmed the loss of SP conduction, and tachycardia became no longer inducible. The AH interval remained the same as the baseline value . During the 12-month follow-up period, the patient remained free of arrhythmia recurrence without receiving medications. Fig. 1 A) Three-dimensional computed tomography in right and left anterior oblique projections showing PLSVC with an enlarged CS ostium. B) Baseline intracardiac electrocardiogram during the sinus rhythm. C) Intracardiac electrogram during the clinical supraventricular tachycardia. The earliest atrial activation was observed at the His catheter with a septal ventriculoatrial time of −4 ms. His-synchronous premature ventricular contraction did not advance the subsequent atrial potentials. RAO, right anterior oblique; LAO, left anterior oblique; SVC, superior vena cava; IVC, inferior vena cava; RA, right atrium; GCV, great cardiac vein; HRA, high right atrium; His, His bundle; RV, right ventricle; H, His electrogram; PLSVC, persistent left superior vena cava; CS, coronary sinus. Fig. 1 Fig. 2 Intracardiac electrocardiograms and fluoroscopic views of cryoablation sites during sinus rhythm. A) The first cryomapping attempt site. The ABL was positioned at the posteroinferior aspect of the CS ostium with an A/V ratio of 0.05. The slow pathway potential (orange arrow) was observed; however, cryomapping at −30 °C for 20 s did not affect the tachycardia. B) The site of successful ablation. The fourth attempt of cryomapping terminated the tachycardia. ABL was positioned at the mid-anterior septum and with an A/V ratio of 0.36. C) The additional cryoablation site. ABL was positioned at the adjacent area to the site of tachycardia termination (B) with an A/V ratio of 0.33. HRA, high right atrium; His, His bundle; RV, right ventricle; RAO, right anterior oblique; LAO, left anterior oblique; H, His electrogram; ABL, ablation catheter; CS, coronary sinus. Fig. 2 Fig. 3 A) The fourth attempt of cryomapping at the mid-anterior septum terminated the tachycardia in 7 s. B) AV block occurred 22 s after cryoablation that was initiated during sinus rhythm. The AV conduction resumed immediately after ablation was discontinued. C) The AH interval after cryoablation remained the same as at baseline. AV, atrioventricular; HRA, high right atrium; His, His bundle; CS, coronary sinus; RV, right ventricle; ABL, ablation catheter; H, His electrogram. Fig. 3
4.121094
0.964844
sec[0]/sec[0]/p[0]
en
0.999997
34400322
https://doi.org/10.1016/j.ipej.2021.08.002
[ "tachycardia", "sinus", "catheter", "cryoablation", "cryomapping", "ablation", "atrial", "rhythm", "atrium", "oblique" ]
[ { "code": "MC81.0", "title": "Tachycardia, unspecified" }, { "code": "BC71.0Z", "title": "Ventricular tachycardia, unspecified" }, { "code": "MC81.3", "title": "Paroxysmal tachycardia" }, { "code": "BC71.0Y", "title": "Other specified ventricular tachycardia" }, { "code": "BC81.0", "title": "Ectopic atrial tachycardia" }, { "code": "CA0A.Z", "title": "Chronic rhinosinusitis, unspecified" }, { "code": "CA0Y&XA3523", "title": "Nasal sinus obstruction" }, { "code": "CA0J.Y", "title": "Other specified nasal polyp" }, { "code": "LB03.Y", "title": "Other specified structural developmental anomalies of umbilical cord" }, { "code": "DA09.61", "title": "Periapical abscess with sinus" } ]
=== ICD-11 CODES FOUND === [MC81.0] Tachycardia, unspecified Also known as: Tachycardia, unspecified | heart rate fast | rapid heart | Rapid heart beat | increased heart rate [BC71.0Z] Ventricular tachycardia, unspecified Also known as: Ventricular tachycardia, unspecified | Ventricular tachycardia | VT - [ventricular tachycardia] | ventricular tachycardia NOS | paroxysmal ventricular tachycardia [MC81.3] Paroxysmal tachycardia Also known as: Paroxysmal tachycardia | Bouveret-Hoffmann syndrome | Bouveret syndrome | essential paroxysmal tachycardia | paroxysmal tachycardia NOS Excludes: complicating, abortion or ectopic or molar pregnancy [BC71.0Y] Other specified ventricular tachycardia Also known as: Other specified ventricular tachycardia | Monomorphic ventricular tachycardia | Secondary monomorphic ventricular tachycardia associated with diseases classified elsewhere | Left outflow tract ventricular tachycardia | Idiopathic fascicular ventricular tachycardia [BC81.0] Ectopic atrial tachycardia Definition: Ectopic atrial tachycardia originates from a small area (focus) in the atrium and spreading centrifugally. Also known as: Ectopic atrial tachycardia | Focal atrial tachycardia | Ectopic atrial tachycardia, automatic | focal atrial tachycardia, automatic | Ectopic atrial tachycardia, nonautomatic [CA0A.Z] Chronic rhinosinusitis, unspecified Also known as: Chronic rhinosinusitis, unspecified | Chronic rhinosinusitis | Chronic sinusitis | chronic sinusitis NOS | unspecified sinusitis [CA0J.Y] Other specified nasal polyp Also known as: Other specified nasal polyp | Polyp of nasal cavity | Polyp of the nasopharynx | nasopharyngeal polyp | Polyp of adenoid tissue [LB03.Y] Other specified structural developmental anomalies of umbilical cord Also known as: Other specified structural developmental anomalies of umbilical cord | Umbilical cord calcifications | Omphalomesenteric duct remnants or cysts | Vitelline duct remnants and cysts | Persistent omphalomesenteric duct [DA09.61] Periapical abscess with sinus Also known as: Periapical abscess with sinus | Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus | periapical abscess fistula Includes: Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus === GRAPH WALKS === --- Walk 1 --- [MC81.0] Tachycardia, unspecified --PARENT--> [MC81] Abnormalities of heart beat Def: Abnormalities of heart beat is arrhythmia which is any disorder of the heart rate or rhythm. It means that the heart beats too quickly, too slowly or with an irregular pattern.... --CHILD--> [MC81.2] Palpitations --- Walk 2 --- [MC81.0] Tachycardia, unspecified --PARENT--> [MC81] Abnormalities of heart beat Def: Abnormalities of heart beat is arrhythmia which is any disorder of the heart rate or rhythm. It means that the heart beats too quickly, too slowly or with an irregular pattern.... --CHILD--> [MC81.1] Bradycardia, unspecified --- Walk 3 --- [BC71.0Z] Ventricular tachycardia, unspecified --PARENT--> [BC71.0] Ventricular tachycardia Def: Ventricular tachycardia is a cardiac arrhythmia of three or more consecutive complexes in duration emanating from the ventricles at a rate of greater than 120 bpm in adolescents or adults and a rate g... --CHILD--> [BC71.00] Right outflow tract ventricular tachycardia Def: Monomorphic ventricular tachycardia with focal activity originating from the right ventricular outflow tract, having a left bundle branch block (LBBB) morphology and inferior axis.... --- Walk 4 --- [BC71.0Z] Ventricular tachycardia, unspecified --PARENT--> [BC71.0] Ventricular tachycardia Def: Ventricular tachycardia is a cardiac arrhythmia of three or more consecutive complexes in duration emanating from the ventricles at a rate of greater than 120 bpm in adolescents or adults and a rate g... --PARENT--> [BC71] Ventricular tachyarrhythmia Def: Any ventricular rhythm disturbance with a rate faster than the normal age dependent ventricular escape rate.... --- Walk 5 --- [MC81.3] Paroxysmal tachycardia --EXCLUDES--> [?] Complications following abortion, ectopic or molar pregnancy Def: Any complication affecting pregnant females, caused by or subsequent to abortion, ectopic, and molar pregnancy.... --CHILD--> [?] Delayed or excessive haemorrhage following abortion, ectopic or molar pregnancy --- Walk 6 --- [MC81.3] Paroxysmal tachycardia --RELATED_TO--> [?] Re-entry ventricular arrhythmia --PARENT--> [?] Ventricular tachyarrhythmia Def: Any ventricular rhythm disturbance with a rate faster than the normal age dependent ventricular escape rate....
[ "[MC81.0] Tachycardia, unspecified\n --PARENT--> [MC81] Abnormalities of heart beat\n Def: Abnormalities of heart beat is arrhythmia which is any disorder of the heart rate or rhythm. It means that the heart beats too quickly, too slowly or with an irregular pattern....\n --CHILD--> [MC81.2] Palpitations", "[MC81.0] Tachycardia, unspecified\n --PARENT--> [MC81] Abnormalities of heart beat\n Def: Abnormalities of heart beat is arrhythmia which is any disorder of the heart rate or rhythm. It means that the heart beats too quickly, too slowly or with an irregular pattern....\n --CHILD--> [MC81.1] Bradycardia, unspecified", "[BC71.0Z] Ventricular tachycardia, unspecified\n --PARENT--> [BC71.0] Ventricular tachycardia\n Def: Ventricular tachycardia is a cardiac arrhythmia of three or more consecutive complexes in duration emanating from the ventricles at a rate of greater than 120 bpm in adolescents or adults and a rate g...\n --CHILD--> [BC71.00] Right outflow tract ventricular tachycardia\n Def: Monomorphic ventricular tachycardia with focal activity originating from the right ventricular outflow tract, having a left bundle branch block (LBBB) morphology and inferior axis....", "[BC71.0Z] Ventricular tachycardia, unspecified\n --PARENT--> [BC71.0] Ventricular tachycardia\n Def: Ventricular tachycardia is a cardiac arrhythmia of three or more consecutive complexes in duration emanating from the ventricles at a rate of greater than 120 bpm in adolescents or adults and a rate g...\n --PARENT--> [BC71] Ventricular tachyarrhythmia\n Def: Any ventricular rhythm disturbance with a rate faster than the normal age dependent ventricular escape rate....", "[MC81.3] Paroxysmal tachycardia\n --EXCLUDES--> [?] Complications following abortion, ectopic or molar pregnancy\n Def: Any complication affecting pregnant females, caused by or subsequent to abortion, ectopic, and molar pregnancy....\n --CHILD--> [?] Delayed or excessive haemorrhage following abortion, ectopic or molar pregnancy", "[MC81.3] Paroxysmal tachycardia\n --RELATED_TO--> [?] Re-entry ventricular arrhythmia\n --PARENT--> [?] Ventricular tachyarrhythmia\n Def: Any ventricular rhythm disturbance with a rate faster than the normal age dependent ventricular escape rate...." ]
MC81.0
Tachycardia, unspecified
[ { "from_icd11": "MC81.0", "icd10_code": "R000", "icd10_title": "Tachycardia, unspecified" }, { "from_icd11": "BC71.0Z", "icd10_code": "I472", "icd10_title": "Ventricular tachycardia" }, { "from_icd11": "MC81.3", "icd10_code": "I479", "icd10_title": "Paroxysmal tachycardia, unspecified" }, { "from_icd11": "MC81.3", "icd10_code": "I47", "icd10_title": "Paroxysmal tachycardia" }, { "from_icd11": "BC81.0", "icd10_code": "I471", "icd10_title": "Supraventricular tachycardia" }, { "from_icd11": "CA0A.Z", "icd10_code": "J329", "icd10_title": "Chronic sinusitis, unspecified" }, { "from_icd11": "CA0A.Z", "icd10_code": "J324", "icd10_title": "Chronic pansinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J320", "icd10_title": "Chronic maxillary sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J322", "icd10_title": "Chronic ethmoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J323", "icd10_title": "Chronic sphenoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J328", "icd10_title": "Other chronic sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J321", "icd10_title": "Chronic frontal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J30-J39", "icd10_title": "" }, { "from_icd11": "CA0A.Z", "icd10_code": "J32", "icd10_title": "Chronic sinusitis" }, { "from_icd11": "DA09.61", "icd10_code": "K046", "icd10_title": "Periapical abscess with sinus" } ]
R000
Tachycardia, unspecified
A 53-year-old man who had no smoking history was admitted to the first Affiliated Hospital of Zhejiang University (Hangzhou, China) with a mass in the posterior segment of the left lower lobe and complaint of upper right abdominal pain while without any respiratory symptoms. On physical examination, superficial right upper quadrant tenderness was noted. The patient was diagnosed with driver gene-negative pulmonary adenocarcinoma (cT 1c N 3 M 1c , Stage IVB) according to the eighth edition AJCC staging system. The PD-L1 tumour proportion score (TPS) was 50% using PD-L1 IHC 22C3 pharmDx (Dako North America, Inc., Carpinteria, CA, USA). The patient had a history of laparoscopic cholecystectomy due to gallstone and history of cefalexin allergy, and his family history of genetic diseases was negative. His performance score was 1. Initially, the patient received pemetrexed (Hansoh Pharmaceutical, Co., Ltd, Lianyungang, China) plus carboplatin (Corden Pharma Latina SpA, Sermoneta, Italy) for four cycles, followed by two cycles of pemetrexed and bevacizumab (Qilu Pharmaceutical Co., Ltd, Jinan, China). During first-line treatment, the best effect was assessed as partial response (PR), and the progression free survival (PFS) was about six months. Intravenous ibandronic acid (Institute of Pharmacy, Hebei Medical University, Shijiazhuang, China) was given to reduce metastatic bone pain throughout the first-line regular chemotherapy. Whole brain radiotherapy was conducted for thirteen times after the first cycle of first-line treatment. However, after six cycles of first-line chemotherapy, chest CT assessment of the patient demonstrated progressive disease according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) ( 7 ). The re-assessed staging of the patient was classified as rT1 c N 3 M 1c , stage IVB. The patient complained of alleviated upper right abdominal pain without other complaints, and physical examinations demonstrated mild right upper quadrant tenderness with no other alterations. Due to disease progression, he was administered sintilimab (200mg, Q21d, Innovent Biologics, Suzhou, China) in combination of paclitaxel-albumin (Hengrui, Pharmaceutical Co., Ltd, Lianyungang, China) and bevacizumab as second-line therapy. After two cycles of second-line treatment, response to treatment was assessed as PR . Urinalysis results were normal before sintilimab administration. Symptoms with haematuria, pollakiuria and painful micturition developed on the fifth day after the third course of second-line therapy, while no fever was observed. Urinalysis showed red blood cells (RBCs) of 3889.7/µl and white blood cells (WBCs) of 2133.5/µl. Urine culture and serum creatine (sCr) were normal. Urinary bladder ultrasound observed a thickened bladder wall and benign prostatic hyperplasia. Levofloxacin (Daiichi Sankyo (China) Holding Co., Ltd, Beijing, China) was administrated for seven days, which improved symptoms of bloody urine and urinary irritation. These symptoms were originally considered to be the adverse effect of bevacizumab; hence, bevacizumab was immediately discontinued. However, after the fourth cycle of paclitaxel-albumin and sintilimab treatment, similar urinary symptoms and low back pain occurred without fever. Urinalysis showed increased RBCs and WBCs. Urine culture and cytology were both negative. Blood tests showed WBCs of 10100/µl (neutrophils 66.5%, eosinophils 5.5%), C-reactive protein 52.1 mg/L, lactate dehydrogenase 166 U/L, and sCr 299 µmol/L. Urinary ultrasonography showed hydronephrosis and dilated ureter. Cystoscopy revealed diffuse redness of bladder mucosa. A multidisciplinary team (MDT) meeting was organized, and the diagnosis of sintilimab-induced cystitis/ureteritis (Grade 3) was made after exclusion the evidence of urinary infection and metastasis. Methylprednisolone (80mg, 1mg/kg/d, Pfizer Manufacturing Belgium NV, Puurs, Belgium) therapy was performed, and urinary symptoms of the patient was obviously alleviated after two days. The laboratory values were also decreased during corticosteroids treatment . When sCr level was back to normal, computer tomography angiography (CTA)/CT urography (CTU) was conducted and demonstrated ureter dilation and hydroureter. Once urinary symptoms were alleviated, bladder biopsy was performed and confirmed the bladder lymphocyte-dominant inflammation and interstitial tissue hyperplasia . The patient was then switched to maintenance dose of methylprednisolone and tapered gradually, and the urinary symptoms were completely resolved after seventeen days of corticosteroid treatment. The whole steroid treatment was eight weeks. The timeline of treatment course was summarized in Figure 2B .
3.974609
0.974121
sec[1]/p[0]
en
0.999997
35004277
https://doi.org/10.3389/fonc.2021.757069
[ "china", "urinary", "line", "bladder", "pain", "cycles", "bevacizumab", "sintilimab", "without", "pharmaceutical" ]
[ { "code": "1F6B", "title": "Strongyloidiasis" }, { "code": "GB6Z", "title": "Kidney failure, unspecified" }, { "code": "GC04.Z", "title": "Fistula of the genitourinary tract, unspecified" }, { "code": "MF51", "title": "Anuria or oliguria" }, { "code": "GB70.Z", "title": "Calculus of upper urinary tract, unspecified" }, { "code": "GC2Z", "title": "Diseases of the urinary system, unspecified" }, { "code": "FB86.0", "title": "Epiphyseal arrest" }, { "code": "9A78.1", "title": "Corneal pigmentations or deposits" }, { "code": "6D11.5", "title": "Borderline pattern" }, { "code": "EE10.1Y", "title": "Other specified abnormality of nail surface" } ]
=== ICD-11 CODES FOUND === [1F6B] Strongyloidiasis Definition: A disease caused by the parasitic worm Strongyloides. This disease presents with symptoms depending on the site of infection (gastrointestinal tract, pulmonary system, dermis, or systemic), or may be asymptomatic. Transmission is by direct contact through penetration of the skin (generally the feet) with larvae from faecally contaminated soil, or autoinfection of an established infection. Confirmation is by identification of Strongyloides larvae in faecal samples, duodenal fluid samples, sputum, Also known as: Strongyloidiasis | Gastric strongyloides stercoralis | Glomerular disorders in strongyloidiasis | Cutaneous strongyloidiasis | Strongyloidal ground itch Excludes: Trichostrongyliasis [GB6Z] Kidney failure, unspecified Also known as: Kidney failure, unspecified | nontraumatic kidney injury | renal failure NOS | kidney block | renal impairment NOS [GC04.Z] Fistula of the genitourinary tract, unspecified Also known as: Fistula of the genitourinary tract, unspecified | Fistula of the genitourinary tract | persistent urinary fistula | persistent urinary tract fistula | recurrent urinary fistula [MF51] Anuria or oliguria Definition: Anuria means nonpassage of urine, in practice is defined as passage of less than 50 millilitres of urine in a day. Oliguria is the low output of urine. It is clinically classified as an output below 300-500ml/day. Also known as: Anuria or oliguria | Anuria | suppression of urinary secretion | ischuria | Oliguria Excludes: Maternal care for other conditions predominantly related to pregnancy [GB70.Z] Calculus of upper urinary tract, unspecified Also known as: Calculus of upper urinary tract, unspecified | Calculus of upper urinary tract | calculus of urinary tract NOS | urinary calculi | urinary calculus, unspecified [GC2Z] Diseases of the urinary system, unspecified Also known as: Diseases of the urinary system, unspecified | urinary tract disease NOS | Abnormal renal function | kidney dysfunction NOS | kidney hypofunction [FB86.0] Epiphyseal arrest Also known as: Epiphyseal arrest | Harris lines | Atraumatic epiphyseal arrest | Epiphyseal arrest due to hormone disorders | Epiphyseal arrest due to kidney disease [9A78.1] Corneal pigmentations or deposits Also known as: Corneal pigmentations or deposits | Haematocornea | corneal blood staining | keratohaemia | Kayser-Fleischer ring Includes: Haematocornea | Kayser-Fleischer ring | Krukenberg spindle [6D11.5] Borderline pattern Definition: The Borderline pattern specifier may be applied to individuals whose pattern of personality disturbance is characterised by a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, as indicated by many of the following: Frantic efforts to avoid real or imagined abandonment; A pattern of unstable and intense interpersonal relationships; Identity disturbance, manifested in markedly and persistently unstable self-image or sense of self; A t Also known as: Borderline pattern [EE10.1Y] Other specified abnormality of nail surface Also known as: Other specified abnormality of nail surface | Longitudinal ridging of nails | Beaded nails | Trachyonychia | Median nail dystrophy === GRAPH WALKS === --- Walk 1 --- [1F6B] Strongyloidiasis Def: A disease caused by the parasitic worm Strongyloides. This disease presents with symptoms depending on the site of infection (gastrointestinal tract, pulmonary system, dermis, or systemic), or may be ... --EXCLUDES--> [?] Trichostrongyliasis Def: 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... --CHILD--> [?] Trichostrongyliasis due to Trichostrongylus colubriformis --- Walk 2 --- [1F6B] Strongyloidiasis Def: A disease caused by the parasitic worm Strongyloides. This disease presents with symptoms depending on the site of infection (gastrointestinal tract, pulmonary system, dermis, or systemic), or may be ... --EXCLUDES--> [?] Trichostrongyliasis Def: 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... --PARENT--> [?] Diseases due to nematodes --- Walk 3 --- [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--> [?] Renal failure following abortion, ectopic or molar pregnancy --- Walk 4 --- [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 ... --PARENT--> [?] Diseases of the urinary system Def: Any disease characterised by pathological changes to the urinary system.... --- Walk 5 --- [GC04.Z] Fistula of the genitourinary tract, unspecified --PARENT--> [GC04] Fistula of the genitourinary tract Def: Any condition caused by trauma, medical intervention, infection, cancer, or congenital factors. This condition is characterised by the formation of an abnormal passage between any two locations within... --CHILD--> [GC04.2] Ureteral fistula Def: Abnormal passage or communication between the ureter and another body organ or cavity or the body surface.... --- Walk 6 --- [GC04.Z] Fistula of the genitourinary tract, unspecified --PARENT--> [GC04] Fistula of the genitourinary tract Def: Any condition caused by trauma, medical intervention, infection, cancer, or congenital factors. This condition is characterised by the formation of an abnormal passage between any two locations within... --CHILD--> [GC04.2] Ureteral fistula Def: Abnormal passage or communication between the ureter and another body organ or cavity or the body surface....
[ "[1F6B] Strongyloidiasis\n Def: A disease caused by the parasitic worm Strongyloides. This disease presents with symptoms depending on the site of infection (gastrointestinal tract, pulmonary system, dermis, or systemic), or may be ...\n --EXCLUDES--> [?] Trichostrongyliasis\n Def: 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...\n --CHILD--> [?] Trichostrongyliasis due to Trichostrongylus colubriformis", "[1F6B] Strongyloidiasis\n Def: A disease caused by the parasitic worm Strongyloides. This disease presents with symptoms depending on the site of infection (gastrointestinal tract, pulmonary system, dermis, or systemic), or may be ...\n --EXCLUDES--> [?] Trichostrongyliasis\n Def: 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...\n --PARENT--> [?] Diseases due to nematodes", "[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--> [?] Renal failure following abortion, ectopic or molar pregnancy", "[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 --PARENT--> [?] Diseases of the urinary system\n Def: Any disease characterised by pathological changes to the urinary system....", "[GC04.Z] Fistula of the genitourinary tract, unspecified\n --PARENT--> [GC04] Fistula of the genitourinary tract\n Def: Any condition caused by trauma, medical intervention, infection, cancer, or congenital factors. This condition is characterised by the formation of an abnormal passage between any two locations within...\n --CHILD--> [GC04.2] Ureteral fistula\n Def: Abnormal passage or communication between the ureter and another body organ or cavity or the body surface....", "[GC04.Z] Fistula of the genitourinary tract, unspecified\n --PARENT--> [GC04] Fistula of the genitourinary tract\n Def: Any condition caused by trauma, medical intervention, infection, cancer, or congenital factors. This condition is characterised by the formation of an abnormal passage between any two locations within...\n --CHILD--> [GC04.2] Ureteral fistula\n Def: Abnormal passage or communication between the ureter and another body organ or cavity or the body surface...." ]
1F6B
Strongyloidiasis
[ { "from_icd11": "1F6B", "icd10_code": "B789", "icd10_title": "Strongyloidiasis, unspecified" }, { "from_icd11": "1F6B", "icd10_code": "B780", "icd10_title": "Intestinal strongyloidiasis" }, { "from_icd11": "1F6B", "icd10_code": "B78", "icd10_title": "Strongyloidiasis" }, { "from_icd11": "1F6B", "icd10_code": "B781", "icd10_title": "Cutaneous strongyloidiasis" }, { "from_icd11": "1F6B", "icd10_code": "B787", "icd10_title": "Disseminated strongyloidiasis" }, { "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": "GC04.Z", "icd10_code": "N321", "icd10_title": "Vesicointestinal fistula" }, { "from_icd11": "MF51", "icd10_code": "R34", "icd10_title": "Anuria and oliguria" }, { "from_icd11": "GB70.Z", "icd10_code": "N202", "icd10_title": "Calculus of kidney with calculus of ureter" }, { "from_icd11": "GB70.Z", "icd10_code": "N209", "icd10_title": "Urinary calculus, unspecified" }, { "from_icd11": "GB70.Z", "icd10_code": "N20", "icd10_title": "Calculus of kidney and ureter" }, { "from_icd11": "FB86.0", "icd10_code": "M891", "icd10_title": "Physeal arrest" }, { "from_icd11": "9A78.1", "icd10_code": "H18049", "icd10_title": "Kayser-Fleischer ring, unspecified eye" } ]
B789
Strongyloidiasis, unspecified
Physical examination revealed eunuchoid body proportions, short stature, gynecomastia, and poor facial hair growth with generalized jaundice appearance. His neurological examination showed dysarthria, and severe ataxia making his walking impossible without assistance. He had appendicular dysmetria and dysdiadochokinesia, especially in both lower extremities, slightly generalized chorea while talking, hypomimia, mild bradykinesia, slight dystonia in the left hand, brisk deep tendon reflexes in lower extremities. Eye examination showed fragmented pursuit eye movements with slow hypometric saccades, vertical gaze palsy, and square wave jerks in horizontal pursuit (Additional file 1 : Video 1). In the psychiatric examination, he had regressed speech, and looked small compared to his peers, there was no delirium suicide, no homicidal thoughts, and no euthymic perception deviation. His IQ test reported borderline mental capacity (Table 1 ). His Kent EGY intelligence test verbal performance was 85.71. He couldn't get a calculable score from the50 Porteus maze test. Table 1 Summary of the clinical, neuroimaging, and genetic features of Gordon Holmes patients with RNF216 mutations (Adopted from Gonzales- Latapi et al. and Wu et al. Family and Patient (Author) Sex Age of onset (years) Clinical type Clinical feature Pubertal development Imaging findings RNF216 genotype (NM_ 207,111.3) F1-P1 (Margolin DH et al.) M 22 GHS Dysarthria, ataxia, dementia, died at 43 yr No puberty Cerebellar and cerebral atrophy, cerebral WMLs c.2251C > T(p.R751C); c.2251C > T(p.R751C) F1-P2 (Margolin DH et al.) F 20 GHS Personality change, dysarthria, ataxia, dementia, died at 41 yr Normal puberty, secondary amenorrhea Cerebellar and cerebral atrophy, cerebral WMLs c.2251C > T(p.R751C); c.2251C > T(p.R751C) F1-P3 (Margolin DH et al.) M 29 GHS Dysarthria, ataxia and dementia, died at 47 yr Normal puberty, erectile dysfunction Cerebellar and cerebral atrophy, cerebral WMLs c.2251C > T(p.R751C); c.2251C > T(p.R751C) F2-P4 (Margolin DH et al.) M 22 GHS Dysarthria, ataxia, dementia, chorea,gaze-evoked nystagmus, died at 36 yr No puberty Cerebellar atrophy, WMLs surrounding the basal ganglia, hyperintensities in basal ganglia, thalami and midbrain c.615_616delGA(p.E205DfsX15);c.1791 T > A(p.C597X) F3-P5 (Margolin DH et al.) F 27 GHS Ataxia, dysarthria, dementia No puberty Multiple foci of subcortical WMLs, cerebellar atrophy c.721C > T( p.Q241X) F4-P6 (Margolin DH et al.) M 21 GHS Slurred speech, ataxia, mood changes, memory impairment No puberty Cerebellar atrophy, cerebral atrophy, foci of WMLs c.2149C > T(p.R717C) F5-P7 (Alqwaifly M et al.) M 20 GHS Mild ataxia Poor development of puberty Mild cerebellar atrophy, subcortical WMLs c.2061G > A(splicing); c.2061G > A(splicing) F5-P8 (Alqwaifly M et al.) M 24 GHS Ataxia, dementia, dysarthria, broken saccadic eye movement, exaggerated deep tendon reflexes Poor development of puberty Cerebellar atrophy, subcortical WMLs c.2061G > A(splicing); c.2061G > A(splicing) F6-P9 (Mahmood S, et al.) M 22 GHS Limb and gait ataxia, slurred speech, subcortical dementia, chorea, died at 35 yr No puberty Cerebellar atrophy, WMLs in both cerebral hemispheres, grey matter lesions in the thalami, T2 hyperintensities in basal ganglia, thalami, and midbrain c.615_616delG(p.E205fsX15); c.1791 T > A(p.C597X) F7-P10 (Calandra CR et al.) M 28 GHS Ataxia, dysarthria, brisk tendon reflexes, dementia Poor development of puberty Cerebral WMLs, cortical and cerebellar atrophy c.1988C > T(p.P663L); c.1988C > T(p.P663L) F7-P11 (Calandra CR et al.) M 27 GHS Dysarthria, ataxia, brisk reflexes, cognitive impairment Poor development of puberty Cerebral WMLs, cortical and cerebellar atrophy c.1988C > T(p.P663L); c.1988C > T(p.P663L) F8-P12 (Chen et al.) M 33 GHS Dysarthria, ataxia, slurred speech, cognitive impairment Post pubertal infertility Cerebral WMLs, cerebellar atrophy c.1948G > T (p.E650X) F9-P13 (Wu CJ et al.) M 26 GHS Dysarthria, ataxia, cognitive decline No puberty Cerebellar and cerebral atrophy, supratentorial WMLs, involvement of brainstem and thalami c.1549C > T(p.R517X); c.1549C > T(p.R517X) F 10-P14 Çelik et al. M 18 GHS Dysarthria, severe ataxia, appendicular dysmetria, and dysdiadochokinesia, slightly generalized chorea parkinsonizm, slight dystonia, fragmented pursuit eye movements, slow hypometric saccades, vertical gaze palsy, and square wave jerks in horizontal pursuit No puberty Severe cerebellar and vermis atrophy, dilated third and lateral ventricles, slight cerebral cortical atrophy, mesencephalic slight atrophy, and periventricular confluent white matter lesions c.1860_1861dupCT (p.Cys621SerfsTer56) GHS Gordon Holmes Syndrome, WMLs white matter lesions
4.179688
0.598633
sec[1]/sec[0]/p[0]
en
0.999996
37161390
https://doi.org/10.1186/s12920-023-01529-4
[ "atrophy", "ataxia", "cerebellar", "wmls", "puberty", "cerebral", "dysarthria", "dementia", "margolin", "poor" ]
[ { "code": "FB32.Y", "title": "Other specified disorders of muscles" }, { "code": "BE2Y", "title": "Other specified diseases of the circulatory system" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "9C40.BZ", "title": "Optic atrophy, unspecified" }, { "code": "8E7Y", "title": "Other specified diseases of the nervous system" }, { "code": "MB45.0", "title": "Ataxia, unspecified" }, { "code": "8A03.Z", "title": "Ataxic disorders, unspecified" }, { "code": "8A03.0", "title": "Congenital ataxia" }, { "code": "8A03.3Z", "title": "Acquired ataxia, unspecified" }, { "code": "MD11.2", "title": "Ataxic breathing" } ]
=== ICD-11 CODES FOUND === [FB32.Y] Other specified disorders of muscles Also known as: Other specified disorders of muscles | Muscle wasting or atrophy, not elsewhere classified | muscle wasting | muscle wasting disorder | Sarcopenia [BE2Y] Other specified diseases of the circulatory system Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [9C40.BZ] Optic atrophy, unspecified Also known as: Optic atrophy, unspecified | Optic atrophy | optic nerve atrophy | Primary optic atrophy | OA - [optic atrophy] [8E7Y] Other specified diseases of the nervous system Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis [MB45.0] Ataxia, unspecified Also known as: Ataxia, unspecified | ataxia NOS | ataxic | ataxy | dyssynergia [8A03.Z] Ataxic disorders, unspecified Also known as: Ataxic disorders, unspecified | Ataxic disorders [8A03.0] Congenital ataxia Definition: Congenital Ataxia is defined as a lack of coordination due to congenital abnormalities in the cerebellum. It is usually nonprogressive. Also known as: Congenital ataxia | congenital nonprogressive ataxia [8A03.3Z] Acquired ataxia, unspecified Also known as: Acquired ataxia, unspecified | Acquired ataxia [MD11.2] Ataxic breathing Definition: An irregular breathing pattern that usually progresses to complete apnoea. Also known as: Ataxic breathing | Biot's respiration | respiratory ataxia === GRAPH WALKS === --- Walk 1 --- [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--> [FB32.1] Spontaneous rupture of muscle Def: This is a spontaneous tearing or separation of muscle fibres from other muscle fibres and/or tendons in the absence of trauma.... --- Walk 2 --- [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 3 --- [BE2Y] Other specified diseases of the circulatory system --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --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 4 --- [BE2Y] Other specified diseases of the circulatory system --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --EXCLUDES--> [?] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --- 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--> [?] Pulmonary sporotrichosis Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. Symptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...
[ "[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--> [FB32.1] Spontaneous rupture of muscle\n Def: This is a spontaneous tearing or separation of muscle fibres from other muscle fibres and/or tendons in the absence of trauma....", "[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....", "[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --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....", "[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --EXCLUDES--> [?] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....", "[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--> [?] Pulmonary sporotrichosis\n Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. \nSymptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com..." ]
FB32.Y
Other specified disorders of muscles
[ { "from_icd11": "FB32.Y", "icd10_code": "M6281", "icd10_title": "Muscle weakness (generalized)" }, { "from_icd11": "9C40.BZ", "icd10_code": "H47213", "icd10_title": "Primary optic atrophy, bilateral" }, { "from_icd11": "9C40.BZ", "icd10_code": "H47291", "icd10_title": "Other optic atrophy, right eye" }, { "from_icd11": "9C40.BZ", "icd10_code": "H47292", "icd10_title": "Other optic atrophy, left eye" }, { "from_icd11": "9C40.BZ", "icd10_code": "H4720", "icd10_title": "Unspecified optic atrophy" }, { "from_icd11": "9C40.BZ", "icd10_code": "H4722", "icd10_title": "Hereditary optic atrophy" }, { "from_icd11": "9C40.BZ", "icd10_code": "H47239", "icd10_title": "Glaucomatous optic atrophy, unspecified eye" }, { "from_icd11": "9C40.BZ", "icd10_code": "H472", "icd10_title": "Optic atrophy" }, { "from_icd11": "9C40.BZ", "icd10_code": "H48", "icd10_title": "" }, { "from_icd11": "9C40.BZ", "icd10_code": "H480", "icd10_title": "" }, { "from_icd11": "MB45.0", "icd10_code": "R270", "icd10_title": "Ataxia, unspecified" }, { "from_icd11": "8A03.Z", "icd10_code": "G111", "icd10_title": "Early-onset cerebellar ataxia" }, { "from_icd11": "8A03.Z", "icd10_code": "G119", "icd10_title": "Hereditary ataxia, unspecified" }, { "from_icd11": "8A03.Z", "icd10_code": "G118", "icd10_title": "Other hereditary ataxias" }, { "from_icd11": "8A03.Z", "icd10_code": "G113", "icd10_title": "Cerebellar ataxia with defective DNA repair" } ]
M6281
Muscle weakness (generalized)
In fact, the key features of nitrous oxide include reliable analgesia with rapid onset and offset and the possibility of patient self-regulation, as well as effective pain relief and a sedative effect without loss of consciousness, reducing patient anxiety with minimal side effects. Before the first procedure, we evaluated the patient (including pain expert assessment), asked for his or her issues and expectations, obtained informed consent from the patient, the willingness of the family to cooperate, and authorization by the local health authority. Due to the inactivation and depletion of vitamin B12 by N 2 O, its long-term use has been associated with myelopathy, manifested clinically by paraparesis or impaired sensation, and megaloblastic anemia. [ 10 – 12 ] The risk is increased in patients suffering from malnutrition, which is common among EB patients, so we planned a basal control (vitamin B12, serum folate levels and red and white blood cell counts are normal) and periodic follow up (every 2 months) to assess neurologic symptoms and monitoring vitamin B12 levels and blood counts. During the first administration an experienced anesthesiologist was present. For the following, we only required the presence of a doctor with airway management skills and basic life-support certification. A room in the patient's home was set aside for the procedure, professionally cleaned, aerated, and equipped with all emergency devices. Continuous recording of vital signs, including oxygen saturation, was provided using a multi-parameter monitor. The home delivery system consisted of an IntelliFlux (Master Flux Plus, Tecno-Gaz, Italy) equipped with a gas mixer (N 2 O and O 2 ). It includes a pressure-reducing regulator, a backflow one-way demand valve, and a nasal mask, permitting the flow of N 2 O during inspiration only. Exit gas with non-return valves reduces N 2 O emissions in the environment. The nose mask had a perfect hold. The adaptive cushioning and front forks enable perfect, stable positioning, thus preventing any dispersion or leakage of gas, and the central connection contains non-return valves. The “Y” Connection allows the proper flow of gas mixture preventing that the exhaled gases can return to power supply circuit. The small chamber eliminates the risk of CO 2 permanence. The first home administration for conscious sedation was conducted in December 2020. Advanced dressings have a frequency of 3 times per week. The most painful phase is the removal of old dressings and wound cleansing. The gas concentration was set to a N 2 O:O 2 ratio of 30:70 (less than the 50:50 fixed mixture present in the pre-filled cylinders). Conscious sedation and cough reflex are preserved, but a fasting period (2 hours) is observed before the procedure, as a safety precaution, to avoid any risk of vomiting and inhalation, although. During the home sessions, the patient is cooperative, and he gives signals within 2 to 3 minutes. The advanced dressings carried out in a single session that involved half of the body, alternatively the upper body, armpits (45 minutes required), and lower body (30 minutes required). Dressings were performed 48 hours apart. The beneficial effects of conscious sedation are evident. First, dressings were easily completed in a significantly reduced time of 25% to 40% from a duration of 3.5 to 4 hours to a duration–1 to 15 hours. Second, many benefits for the patient have been highlighted: he reports a significant acute-pain reduction, reduction in anticipatory pain and anxiety before the procedure, less medication memory, and less fatigue after the dressing session, which allows him to enjoy and perform multiple activities during the day. The domestic device allows greater flexibility of schedules, allowing less effort for caregivers; therefore, their burden has been significantly reduced in parallel with the reduction in patient suffering. The medium-term benefits are a marked improvement in the bad smell of wounds up to the disappearance of odors and the reduction of the tubes of antibiotic cream applied for local infection (from 1 per month to half a tube per month). His saturation and vital signs remained stable, and there were no episodes of desaturation, tachycardia, or hypotension. We measured pain using the visual analog scale (VAS) with and without conscious sedation with values of 100 mm (10 cm) and 10 mm (1 cm), respectively. In addition, the Numeric Pain Rating Scale (NPRS) values decreased from 10 to 1 during dressing with N 2 O oxide administration. The patient was scheduled to undergo regular follow-up by a pain specialist. The patient received a standard multivitamin supplement daily. He now performs regular daily social activities.
4.105469
0.485352
sec[1]/p[5]
en
0.999997
PMC8735711
https://doi.org/10.1097/MD.0000000000028474
[ "pain", "dressings", "home", "conscious", "sedation", "less", "hours", "reduction", "vitamin", "risk" ]
[ { "code": "MG3Z", "title": "Pain, unspecified" }, { "code": "8E43.Z", "title": "Pain disorders, unspecified" }, { "code": "MG31.Z", "title": "Acute pain, unspecified" }, { "code": "MG30.Z", "title": "Chronic pain, unspecified" }, { "code": "FB56.2", "title": "Myalgia" }, { "code": "EH65", "title": "DRESS syndrome" }, { "code": "QB85", "title": "Attention to surgical dressings, drains or sutures" }, { "code": "QF24", "title": "Difficulty or need for assistance with self-care" }, { "code": "QF27", "title": "Difficulty or need for assistance at home and no other household member able to render care" }, { "code": "QE93", "title": "Removal from home in childhood" } ]
=== ICD-11 CODES FOUND === [MG3Z] Pain, unspecified Also known as: Pain, unspecified | pain observations | pain NOS | generalised pain | generalised pain, NOS [8E43.Z] Pain disorders, unspecified Also known as: Pain disorders, unspecified | Pain disorders [MG31.Z] Acute pain, unspecified Also known as: Acute pain, unspecified | Acute pain [MG30.Z] Chronic pain, unspecified Also known as: Chronic pain, unspecified | Chronic pain [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain [EH65] DRESS syndrome Definition: DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a hypersensitivity reaction characterised by a generalised skin rash, fever, eosinophilia, lymphocytosis and visceral involvement (hepatitis, nephritis, pneumonitis, pericarditis and myocarditis) and, in some patients, reactivation of human herpes virus 6. Also known as: DRESS syndrome | Drug-induced hypersensitivity syndrome | DIHS - [drug-induced hypersensitivity syndrome] | Drug rash with eosinophilia and systemic symptoms Includes: Drug-induced hypersensitivity syndrome [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 [QF24] Difficulty or need for assistance with self-care Also known as: Difficulty or need for assistance with self-care | difficulty with self-care | need for assistance with personal care | need for assistance with self-care | Difficulty or need for assistance with dressing [QF27] Difficulty or need for assistance at home and no other household member able to render care Also known as: Difficulty or need for assistance at home and no other household member able to render care | lack of care in home | lack of person able to render necessary care | dependent on care provider and no other household member able to render care | caregiver burn out [QE93] Removal from home in childhood Also known as: Removal from home in childhood | problem of negative life events in childhood of removal from home === GRAPH WALKS === --- Walk 1 --- [MG3Z] Pain, unspecified --PARENT--> [?] Pain --CHILD--> [MG31] Acute pain Def: Pain with a duration of less than 3 months. This code should be used only when there is no further specification of site.... --- Walk 2 --- [MG3Z] Pain, unspecified --PARENT--> [?] Pain --CHILD--> [MG30] Chronic pain Def: Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Chronic pain is pain that persists or recurs for longer t... --- Walk 3 --- [8E43.Z] Pain disorders, unspecified --PARENT--> [8E43] Pain disorders --CHILD--> [8E43.Y] Other specified pain disorders --- Walk 4 --- [8E43.Z] Pain disorders, unspecified --PARENT--> [8E43] Pain disorders --CHILD--> [8E43.0] Neuropathic pain Def: Neuropathic pain is described as electric, burning, or shock like, caused by metabolic, nutritional, infectious, genetic, autoimmune, and/or vasculitic processes. The pain may occur spontaneously, wit... --- Walk 5 --- [MG31.Z] Acute pain, unspecified --PARENT--> [MG31] Acute pain Def: Pain with a duration of less than 3 months. This code should be used only when there is no further specification of site.... --CHILD--> [MG31.0] Acute pain in the face, not elsewhere classified --- Walk 6 --- [MG31.Z] Acute pain, unspecified --PARENT--> [MG31] Acute pain Def: Pain with a duration of less than 3 months. This code should be used only when there is no further specification of site.... --CHILD--> [MG31.1] Acute headache, not elsewhere classified
[ "[MG3Z] Pain, unspecified\n --PARENT--> [?] Pain\n --CHILD--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....", "[MG3Z] Pain, unspecified\n --PARENT--> [?] Pain\n --CHILD--> [MG30] Chronic pain\n Def: Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Chronic pain is pain that persists or recurs for longer t...", "[8E43.Z] Pain disorders, unspecified\n --PARENT--> [8E43] Pain disorders\n --CHILD--> [8E43.Y] Other specified pain disorders", "[8E43.Z] Pain disorders, unspecified\n --PARENT--> [8E43] Pain disorders\n --CHILD--> [8E43.0] Neuropathic pain\n Def: Neuropathic pain is described as electric, burning, or shock like, caused by metabolic, nutritional, infectious, genetic, autoimmune, and/or vasculitic processes. The pain may occur spontaneously, wit...", "[MG31.Z] Acute pain, unspecified\n --PARENT--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....\n --CHILD--> [MG31.0] Acute pain in the face, not elsewhere classified", "[MG31.Z] Acute pain, unspecified\n --PARENT--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....\n --CHILD--> [MG31.1] Acute headache, not elsewhere classified" ]
MG3Z
Pain, unspecified
[ { "from_icd11": "MG3Z", "icd10_code": "R52", "icd10_title": "Pain, unspecified" }, { "from_icd11": "MG3Z", "icd10_code": "R529", "icd10_title": "" }, { "from_icd11": "MG31.Z", "icd10_code": "R520", "icd10_title": "" }, { "from_icd11": "MG30.Z", "icd10_code": "R521", "icd10_title": "" }, { "from_icd11": "MG30.Z", "icd10_code": "R522", "icd10_title": "" }, { "from_icd11": "FB56.2", "icd10_code": "M7918", "icd10_title": "Myalgia, other site" }, { "from_icd11": "FB56.2", "icd10_code": "M7910", "icd10_title": "Myalgia, unspecified site" }, { "from_icd11": "FB56.2", "icd10_code": "M7912", "icd10_title": "Myalgia of auxiliary muscles, head and neck" }, { "from_icd11": "FB56.2", "icd10_code": "M791", "icd10_title": "Myalgia" }, { "from_icd11": "EH65", "icd10_code": "L270", "icd10_title": "Generalized skin eruption due to drugs and medicaments taken internally" }, { "from_icd11": "QB85", "icd10_code": "Z481", "icd10_title": "Encounter for planned postprocedural wound closure" }, { "from_icd11": "QB85", "icd10_code": "Z4821", "icd10_title": "Encounter for aftercare following heart transplant" }, { "from_icd11": "QB85", "icd10_code": "Z483", "icd10_title": "Aftercare following surgery for neoplasm" }, { "from_icd11": "QB85", "icd10_code": "Z4823", "icd10_title": "Encounter for aftercare following liver transplant" }, { "from_icd11": "QB85", "icd10_code": "Z4822", "icd10_title": "Encounter for aftercare following kidney transplant" } ]
R52
Pain, unspecified
A 9-month-old female first came to the Department of Pediatrics, University Hospital Vittorio-Emanuele- Policlinico, Catania, Italy, for clinical checkup. Family history was irrelevant. The mother referred that at the age of 7 months of gestation, fetal ultrasound displayed the presence of a right ovarian cyst. Two weeks later, another ultrasound examination was done and revealed the presence of ascitic fluid with vanishing of the ovarian cyst. She reported normal fetal movements throughout the pregnancy. At the time of gestation, the ages of the little girl’s mother and father were 30 and 36 years old respectively. A programmed caesarean section was carried out with the birth of a female newborn with the following anthropometric measurements: weight 2190 g (3rd percentile), length 47 cm (50th percentile), and occipito-frontal circumference (OFC) 28 cm (< 3rd percentile). Apgar scores were 7 and 9 at 1 and 5 min respectively. The newborn was admitted to local Neonatal Intensive Care Unit (NICU) where she was oxygenated by intubation for four days. She was fed by nasogastric tube due to poor suckling reflex and refusal of alimentation. No signs of ascites were detected on a new abdominal ultrasound. At the age of 2 months and a half, she had an acute respiratory infection with severe respiratory distress, which required endotracheal intubation kept for 2 days. During the first months of life, she showed generalized hypotonia, feeding difficulty, and frequent episodes of vomiting. At 7th month, she had an epileptic seizure manifesting by fixed gaze and head rotation on the right side lasted few minutes and recovered by rectal midazolam. The EEG record was non-informative. Two days later, a new seizure came out with the same characteristic of the previous one and treatment with valproate was started. At 8th month, she was admitted to the Hospital of North Italy and discharged with a diagnosis of axial and segmental hypotonia, epileptic seizures, microcephaly with brain MRI of simplified cortical gyral pattern, and wide corpus callosum hypoplasia. At physical examination, the weight was 6800 g (3rd percentile), length 70 cm (50th), and OFC 38.5 cm (> 4th percentile). She showed minor facial features, microcephaly, developmental delay, generalized hypotonia, and growth retardation. The anterior fontanelle was open 0.5 × 0.5 cm and flat. Tendon reflexes were normally present. She was unable to hold her head up by arm traction maneuver. Routine laboratory analysis, electrolytes, plasma and urinary amino acid, organic acid, urinalysis, thyroid markers, sialo-transferrin, plasma purine, and total cholesterol were within normal limits. TORCH screen, inflammatory markers and otoacoustic emissions screening were normal. On abdominal ultrasound examination, no anomalies were found in the liver, spleen, kidneys, pancreas, or ovaries. ECG and echocardiogram were normal. EEG showed a background disorganization with the presence of rare spike and waves. Treatment with valproate and levetiracetam was continued. The little girl has been serially followed up in ambulatory care. During this period, she had three tonic clonic seizures of short duration, the last one was associated with fever. She presented recurrent stereotyped upper arm waving movements, raising and lowering upper limbs, beating the hands on the tables or other surfaces. The movement anomalies were seen during the day and with less frequency during sleep. At the current age of 2 years old, she has been newly admitted to the Institution. Her anthropometric measurements were weight 12 kg (25th–50th percentile), height 85 cm (50th percentile), and OFC 41.5 cm (< 4th percentile). At clinical examination, she showed minor facial features with notably small head and slightly protruding metopic suture, slanting forehead, short nose with round tip, right epicanthal fold, hypotelorism, down slanting palpebral fissures, small mouth, and dyschromic teeth. At the neurological examination, she showed generalized hypotonia, difficulty in holding her head up, and inability to sit up without support. The anterior fontanelle closed. Patellar reflexes were normally present. Routine laboratory analyses were normal. ECG, echocardiogram, fundus examination, and hearing exploration were also normal. Video-EEG at awake and during sleep showed paroxysmal multifocal spike and waves particularly evident in the bilateral frontal regions . No other seizures were recorded. Physiotherapy and antiepileptic treatment with valproate and levetiracetam were maintained. Fig. 1 a , b EEG of the patient at the age of 2 years. EEG showing the dysregulated background and paroxysmal multifocal spike and waves more evident in the frontal regions
3.957031
0.982422
sec[1]/p[0]
en
0.999996
35804254
https://doi.org/10.1007/s10072-022-06247-w
[ "percentile", "ultrasound", "hypotonia", "head", "presence", "weight", "frontal", "valproate", "seizures", "spike" ]
[ { "code": "5B81.00", "title": "Obesity in children or adolescents" }, { "code": "JB07.Z", "title": "Labour or delivery complicated by fetal distress, unspecified" }, { "code": "NE8Y", "title": "Other specified injury or harm arising from surgical or medical care, not elsewhere classified" }, { "code": "JA66.3", "title": "Abnormal ultrasonic finding on antenatal screening of mother" }, { "code": "PK9A.1", "title": "Physical medicine devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices" }, { "code": "QA45.Y", "title": "Other specified antenatal screening" }, { "code": "KB08.2", "title": "Congenital hypotonia" }, { "code": "9A83", "title": "Flat anterior chamber hypotony of eye" }, { "code": "GC01.4", "title": "Neuromuscular dysfunction of bladder, not elsewhere classified" }, { "code": "5A00.0Y", "title": "Other specified congenital hypothyroidism" } ]
=== ICD-11 CODES FOUND === [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 [JB07.Z] Labour or delivery complicated by fetal distress, unspecified Also known as: Labour or delivery complicated by fetal distress, unspecified | Labour or delivery complicated by fetal distress | Labour and delivery complicated by fetal stress | fetal distress affecting labour and delivery | Electrocardiographic evidence of fetal distress [NE8Y] Other specified injury or harm arising from surgical or medical care, not elsewhere classified Also known as: Other specified injury or harm arising from surgical or medical care, not elsewhere classified | Other injury or harm from surgical or medical care, not elsewhere classified | Complication of ultrasound therapy | Sequelae of complications of surgical and medical care, not elsewhere classified [JA66.3] Abnormal ultrasonic finding on antenatal screening of mother Definition: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother. Also known as: Abnormal ultrasonic finding on antenatal screening of mother | antenatal ultrasound scan abnormal [PK9A.1] Physical medicine devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices Definition: A physical medicine device was involved in an adverse incident that occurred in a therapeutic (nonsurgical) and rehabilitative task Also known as: Physical medicine devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices | Physical medicine devices associated with adverse incidents, therapeutic ultrasound | Physical medicine devices associated with adverse incidents, chilling or heating units | Physical medicine devices associated with adverse incidents, exercise equipment | Physical medicine devices associated with adverse incidents, massagers [QA45.Y] Other specified antenatal screening Also known as: Other specified antenatal screening | Other antenatal screening based on amniocentesis | antenatal screening using amniocentesis | Antenatal screening for malformations using ultrasound or other physical methods | Antenatal screening for fetal growth retardation using ultrasound or other physical methods [KB08.2] Congenital hypotonia Definition: A paediatric condition characterised by abnormally decreased muscle tone that is present at birth in a newborn. Also known as: Congenital hypotonia | floppy baby | floppy baby syndrome | floppy infant | floppy infant syndrome Includes: Nonspecific floppy baby syndrome [9A83] Flat anterior chamber hypotony of eye Also known as: Flat anterior chamber hypotony of eye | Hypotony of eye due to ocular fistula | Hypotony of eye due to other ocular disorders | Primary hypotony of eye | Unspecified hypotony of eye [GC01.4] Neuromuscular dysfunction of bladder, not elsewhere classified Also known as: Neuromuscular dysfunction of bladder, not elsewhere classified | Neurogenic bladder dysfunction NOS | bladder dysfunction | neurogenic bladder NOS | neurogenic dysfunction of the urinary bladder Excludes: Functional urinary incontinence | neurogenic bladder due to cauda equina syndrome | due to spinal cord lesion [5A00.0Y] Other specified congenital hypothyroidism Also known as: Other specified congenital hypothyroidism | Permanent congenital hypothyroidism | Syndromic permanent congenital hypothyroidism | Young-Simpson syndrome | Hypothyroidism - dysmorphism - postaxial polydactyly - intellectual deficit === GRAPH WALKS === --- Walk 1 --- [5B81.00] Obesity in children or adolescents Def: 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-a... --PARENT--> [5B81.0] Obesity due to energy imbalance Def: Obesity is a chronic complex disease defined by excessive adiposity that can impair health. It is in most cases a multifactorial disease due to obesogenic environments, psycho-social factors and genet... --CHILD--> [5B81.00] Obesity in children or adolescents Def: 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-a... --- Walk 2 --- [5B81.00] Obesity in children or adolescents Def: 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-a... --PARENT--> [5B81.0] Obesity due to energy imbalance Def: Obesity is a chronic complex disease defined by excessive adiposity that can impair health. It is in most cases a multifactorial disease due to obesogenic environments, psycho-social factors and genet... --CHILD--> [5B81.00] Obesity in children or adolescents Def: 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-a... --- Walk 3 --- [JB07.Z] Labour or delivery complicated by fetal distress, unspecified --PARENT--> [JB07] Labour or delivery complicated by fetal distress --CHILD--> [JB07.1] Labour or delivery complicated by meconium in amniotic fluid Def: A condition characterised by complications during labour and delivery that is caused by meconium in amniotic fluid.... --- Walk 4 --- [JB07.Z] Labour or delivery complicated by fetal distress, unspecified --PARENT--> [JB07] Labour or delivery complicated by fetal distress --CHILD--> [JB07.1] Labour or delivery complicated by meconium in amniotic fluid Def: A condition characterised by complications during labour and delivery that is caused by meconium in amniotic fluid.... --- Walk 5 --- [NE8Y] Other specified injury or harm arising from surgical or medical care, not elsewhere classified --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified --EXCLUDES--> [?] Fitting or adjustment of external prosthetic device --- Walk 6 --- [NE8Y] Other specified injury or harm arising from surgical or medical care, not elsewhere classified --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified --RELATED_TO--> [?] Complications of anaesthesia during pregnancy
[ "[5B81.00] Obesity in children or adolescents\n Def: 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-a...\n --PARENT--> [5B81.0] Obesity due to energy imbalance\n Def: Obesity is a chronic complex disease defined by excessive adiposity that can impair health. It is in most cases a multifactorial disease due to obesogenic environments, psycho-social factors and genet...\n --CHILD--> [5B81.00] Obesity in children or adolescents\n Def: 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-a...", "[5B81.00] Obesity in children or adolescents\n Def: 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-a...\n --PARENT--> [5B81.0] Obesity due to energy imbalance\n Def: Obesity is a chronic complex disease defined by excessive adiposity that can impair health. It is in most cases a multifactorial disease due to obesogenic environments, psycho-social factors and genet...\n --CHILD--> [5B81.00] Obesity in children or adolescents\n Def: 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-a...", "[JB07.Z] Labour or delivery complicated by fetal distress, unspecified\n --PARENT--> [JB07] Labour or delivery complicated by fetal distress\n --CHILD--> [JB07.1] Labour or delivery complicated by meconium in amniotic fluid\n Def: A condition characterised by complications during labour and delivery that is caused by meconium in amniotic fluid....", "[JB07.Z] Labour or delivery complicated by fetal distress, unspecified\n --PARENT--> [JB07] Labour or delivery complicated by fetal distress\n --CHILD--> [JB07.1] Labour or delivery complicated by meconium in amniotic fluid\n Def: A condition characterised by complications during labour and delivery that is caused by meconium in amniotic fluid....", "[NE8Y] Other specified injury or harm arising from surgical or medical care, not elsewhere classified\n --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified\n --EXCLUDES--> [?] Fitting or adjustment of external prosthetic device", "[NE8Y] Other specified injury or harm arising from surgical or medical care, not elsewhere classified\n --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified\n --RELATED_TO--> [?] Complications of anaesthesia during pregnancy" ]
5B81.00
Obesity in children or adolescents
[ { "from_icd11": "JB07.Z", "icd10_code": "O68", "icd10_title": "Labor and delivery complicated by abnormality of fetal acid-base balance" }, { "from_icd11": "JB07.Z", "icd10_code": "O682", "icd10_title": "" }, { "from_icd11": "JB07.Z", "icd10_code": "O688", "icd10_title": "" }, { "from_icd11": "JB07.Z", "icd10_code": "O689", "icd10_title": "" }, { "from_icd11": "JA66.3", "icd10_code": "O283", "icd10_title": "Abnormal ultrasonic finding on antenatal screening of mother" }, { "from_icd11": "JA66.3", "icd10_code": "O283 ", "icd10_title": "" }, { "from_icd11": "PK9A.1", "icd10_code": "Y801", "icd10_title": "Therapeutic (nonsurgical) and rehabilitative physical medicine devices associated with adverse incidents" }, { "from_icd11": "KB08.2", "icd10_code": "P942", "icd10_title": "Congenital hypotonia" }, { "from_icd11": "9A83", "icd10_code": "H4440", "icd10_title": "Unspecified hypotony of eye" }, { "from_icd11": "9A83", "icd10_code": "H44439", "icd10_title": "Hypotony of eye due to other ocular disorders, unspecified eye" }, { "from_icd11": "9A83", "icd10_code": "H444", "icd10_title": "Hypotony of eye" }, { "from_icd11": "GC01.4", "icd10_code": "N319", "icd10_title": "Neuromuscular dysfunction of bladder, unspecified" }, { "from_icd11": "GC01.4", "icd10_code": "N318", "icd10_title": "Other neuromuscular dysfunction of bladder" }, { "from_icd11": "GC01.4", "icd10_code": "N312", "icd10_title": "Flaccid neuropathic bladder, not elsewhere classified" }, { "from_icd11": "GC01.4", "icd10_code": "N310", "icd10_title": "Uninhibited neuropathic bladder, not elsewhere classified" } ]
O68
Labor and delivery complicated by abnormality of fetal acid-base balance
A 55-year-old post-menopausal woman, affected by second-degree obesity, hypertension, hyperinsulinemia, hypercholesterolemia, hypertriglyceridemia, and sarcopenia, was admitted in May 2021 at the Center of High Specialization for the Care of Obesity, Sapienza University of Rome, Italy. Upon admission, the patient signed an informed consent form in accordance with the General Data Protection Regulation . In March 2021, the patient tested positive for COVID-19 and was hospitalized in a subintensive care unit with bilateral interstitial pneumonia from 2 April2021 until 16 April2021. During hospitalization, heparin, dexamethasone, and a high-flow nasal cannula (HFNC) were administered. On 5 May 2021, the patient tested negative for COVID-19. After discharge, home therapy involved taking pantoprazole 40 mg, olmesartan medoxomil 20 mg, and methylprednisolone 16 mg for three days only, and dexamethasone 4 mg/mL for five days only. This patient was screened from 24 May to 16 July2021, and was prescribed a VLCKD with meal replacements (800 kcal/day) for six weeks, with the following composition of macronutrients as a relative percentage of caloric intake: carbohydrates 28 g (14.6%), olive oil 20 g plus 15 g of lipids from other sources (38.7%), and proteins 85 g (46.7%). She consumed four meal replacements per day (the timings of the main meals were at 8 a.m., 1.00 p.m., 8.00 pm, and mid-afternoon), which contained whey and vegetable proteins derived from soya, green peas, or cereals, and one serving of vegetables with a low glycemic index at lunch and dinner. Supplements of vitamins, minerals and omega-3 fatty acids were provided in accordance with international recommendations . It was also recommended to drink at least 2–2.5 L of water per day. In accordance with the Position Statement of the Italian Society of Endocrinology (SIE) , this patient was closely and periodically monitored through physical examination (anthropometric measurements, blood pressure (BP), heart rate, body composition parameters) and biochemical analyses. Blood tests (blood count, electrolytes, glucose, insulin, lipids, total proteins and albumin, plasma creatinine, blood urea nitrogen and uric acid, alanine transferase, aspartate transaminase, and estimated glomerular filtration rate) were performed before starting the VLCKD and after the 6 weeks of diet therapy with meal replacements. Body weight (BW), height, systolic and diastolic blood pressure, waist circumference (WC), thigh circumference (TC), and hip circumference (HC) were measured at the first visit (T0) and every two weeks thereafter (T2 and T4) until the end of the nutritional protocol (T6). To evaluate muscle mass and strength, a handgrip strength (HG) measurement and a chair stand test (CST) were performed in accordance with the ESWGOP2 report . The HG was measured using a digital dynamometer (Dynx, Akern, Pontassieve, FI, Italy) at T0 and T6 . All measurements were carried out with dominant and non-dominant arms and the highest value was recorded. The CST measured the amount of time needed for a patient to rise five times from a seated position without using arms: sarcopenia is determined if the patient takes more than 15 s, in accordance with the EWGSOP2 report . To assess sarcopenic condition severity, the short physical performance battery (SPPB) was evaluated at the beginning of the protocol, which led to the exclusion of a severe sarcopenic condition (data not shown). Body composition, total body fat mass (FM), and fat-free mass (FFM) were also measured, using multifrequency bioelectrical impedance analysis (BIA, Human Im Touch, DS Medica S.r.l., Milan, Italy) at baseline and at the end of the protocol . The Human Im Touch device records impedance at five frequencies (5, 10, 50, 100, and 250 kHz). During the BIA, patients were lying in a supine position. All measurements were performed on the patient’s right side. The four-surface standard tetra polar electrode technique on the foot and hand was used. Seven days after the beginning of the nutritional protocol, the patient started Interval Training (IT) twice a week. Due to the pandemic, physical exercise sessions were carried out via the Zoom platform with a personal trainer, and each session lasted 30–35 min. The required home-based equipment consisted of a stable chair with a backrest and without armrests, two bottles of water, and a towel. Each session of physical exercise was structured as follows: an initial warm up, which involved breathing exercises and stretching of the posterior chain, a second part based on functional exercises repeated for 30 s with a 15 s pause, a part focusing on proprioception and balance, and finally, a part focused on breathing.
4.078125
0.94873
sec[1]/p[0]
en
0.999997
PMC8950622
https://doi.org/10.3390/healthcare10030573
[ "accordance", "blood", "physical", "body", "measured", "protocol", "italy", "five", "meal", "replacements" ]
[ { "code": "QA47.Z", "title": "Liveborn infants according to place of birth, unspecified" }, { "code": "EE12.1", "title": "Onychomycosis" }, { "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": "MG44.1Z", "title": "Lack of expected normal physiological development, unspecified" }, { "code": "PJ20", "title": "Physical maltreatment" }, { "code": "MB23.0", "title": "Aggressive behaviour" } ]
=== ICD-11 CODES FOUND === [QA47.Z] Liveborn infants according to place of birth, unspecified Also known as: Liveborn infants according to place of birth, unspecified | Liveborn infants according to place of birth [EE12.1] Onychomycosis Definition: Fungal infection of fingernails and/or toenails due most commonly to dermatophytes (tinea unguium) or yeasts, especially Candida species. Also known as: Onychomycosis | Fungal infection of the nails | Onychomycosis classified according to clinical pattern | Superficial white onychomycosis | Distal and lateral subungual onychomycosis Includes: Fungal infection of the nails Excludes: Candidosis of nail or paronychium [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 [MG44.1Z] Lack of expected normal physiological development, unspecified Also known as: Lack of expected normal physiological development, unspecified | Lack of expected normal physiological development | delayed physiological development | unspecified delay in development | development arrest [PJ20] Physical maltreatment Definition: Non-accidental acts of physical force that result, or have reasonable potential to result, in physical harm or that evoke significant fear. The category is applied to the victim of the maltreatment, not the perpetrator. Also known as: Physical maltreatment | physical abuse | Shaken infant syndrome | shaken baby syndrome | Battered baby syndrome [MB23.0] Aggressive behaviour Definition: Actions intended to threaten or hurt another person or to damage property that may be physical, verbal, or symbolic (e.g., acting against the other person's interests). Aggressive behaviour may be appropriate and self-protective, or inappropriate, hostile, and destructive. Also known as: Aggressive behaviour | Violent behaviour | physical violence === GRAPH WALKS === --- Walk 1 --- [QA47.Z] Liveborn infants according to place of birth, unspecified --PARENT--> [QA47] Liveborn infants according to place of birth --CHILD--> [QA47.2] Singleton, unspecified as to place of birth --- Walk 2 --- [QA47.Z] Liveborn infants according to place of birth, unspecified --PARENT--> [QA47] Liveborn infants according to place of birth --PARENT--> [?] Contact with health services for reasons associated with reproduction --- Walk 3 --- [EE12.1] Onychomycosis Def: Fungal infection of fingernails and/or toenails due most commonly to dermatophytes (tinea unguium) or yeasts, especially Candida species.... --RELATED_TO--> [?] Candida onychomycosis Def: This is an infection of the nail plate caused by Candida yeasts. It may be associated with Candida paronychia or may be secondary to nail dystrophy, particularly onycholysis, from other causes. It is ... --PARENT--> [?] Candidosis of nail or paronychium Def: Infection of the nail and/or paronychium (nail fold) with Candida yeasts... --- Walk 4 --- [EE12.1] Onychomycosis Def: Fungal infection of fingernails and/or toenails due most commonly to dermatophytes (tinea unguium) or yeasts, especially Candida species.... --RELATED_TO--> [?] Onychomycosis due to non-dermatophyte mould Def: Fungal nail infection due to organisms other than Candida and dermatophytes. These include Scopulariopsis brevicaulis, Neoscytalidium dimidiatum, Fusarium spp., and Aspergillus spp., which may not res... --PARENT--> [?] Non-dermatophyte superficial dermatomycoses Def: Any condition of the skin and mucous membranes, caused by an infection with fungi other than Candida and dermatophytes.... --- Walk 5 --- [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 6 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics
[ "[QA47.Z] Liveborn infants according to place of birth, unspecified\n --PARENT--> [QA47] Liveborn infants according to place of birth\n --CHILD--> [QA47.2] Singleton, unspecified as to place of birth", "[QA47.Z] Liveborn infants according to place of birth, unspecified\n --PARENT--> [QA47] Liveborn infants according to place of birth\n --PARENT--> [?] Contact with health services for reasons associated with reproduction", "[EE12.1] Onychomycosis\n Def: Fungal infection of fingernails and/or toenails due most commonly to dermatophytes (tinea unguium) or yeasts, especially Candida species....\n --RELATED_TO--> [?] Candida onychomycosis\n Def: This is an infection of the nail plate caused by Candida yeasts. It may be associated with Candida paronychia or may be secondary to nail dystrophy, particularly onycholysis, from other causes. It is ...\n --PARENT--> [?] Candidosis of nail or paronychium\n Def: Infection of the nail and/or paronychium (nail fold) with Candida yeasts...", "[EE12.1] Onychomycosis\n Def: Fungal infection of fingernails and/or toenails due most commonly to dermatophytes (tinea unguium) or yeasts, especially Candida species....\n --RELATED_TO--> [?] Onychomycosis due to non-dermatophyte mould\n Def: Fungal nail infection due to organisms other than Candida and dermatophytes. These include Scopulariopsis brevicaulis, Neoscytalidium dimidiatum, Fusarium spp., and Aspergillus spp., which may not res...\n --PARENT--> [?] Non-dermatophyte superficial dermatomycoses\n Def: Any condition of the skin and mucous membranes, caused by an infection with fungi other than Candida and dermatophytes....", "[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 --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics" ]
QA47.Z
Liveborn infants according to place of birth, unspecified
[ { "from_icd11": "QA47.Z", "icd10_code": "Z38", "icd10_title": "Liveborn infants according to place of birth and type of delivery" }, { "from_icd11": "QA47.Z", "icd10_code": "Z388", "icd10_title": "Other multiple liveborn infant, unspecified as to place of birth" }, { "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" } ]
Z38
Liveborn infants according to place of birth and type of delivery
A 60-year-old male (5′5′′, 73.7 kg) presented for resection of a left acoustic neuroma via a left retromastoid suboccipital craniotomy. His past medical history was significant only for hypertension, which was well controlled with beta-blockade. His physical examination and laboratory workup did not reveal any abnormalities other than decreased hearing and the presence of an acoustic neuroma on imaging studies. He arrived in the operating room with a 20-gauge intravenous catheter in the left hand at heplock. A second 18-gauge peripheral intravenous catheter (IV) was placed in the patient's right hand. After standard monitoring was applied according to recommendations of the American Society of Anesthesiologists, Midazolam 2 milligrams (mg) was administered. General anesthesia was induced with Thiopental 375 mg, Fentanyl 150 micrograms (mcg), Lidocaine 60 mg, and cis -atracurium 10 mg. All intravenous medications for induction were administered via the 18 g intravenous catheter. Anesthesia was maintained with 0.5 MAC Desflurane in Oxygen/Nitrous Oxide 1/1.5 liters per minutes and Remifentanil at 0.15 mcg∗kg −1 ∗min −1 administered via the 20 g IV catheter. It is important to note that throughout the entire procedure the only medication administered through the 20 g IV catheter was the Remifentanil infusion. A neurology team was present to monitor brainstem auditory evoked potentials (BAERs) during resection of the neuroma. Vancomycin 1 gm IV, Mannitol 70 gm IV, Dexamethasone 10 mg IV, and Furosemide 10 mg IV were administered via the 18 g IV over recommended time periods. Approximately 45 minutes after surgical incision, the patient's anesthetic requirements began to rise such that within 2 hours of incision, he required 1 MAC of Desflurane in addition to Nitrous Oxide and Remifentanil in order to maintain homeostasis. At approximately 2.5 hours of operating time, the patient became increasingly tachycardic and was treated with 10 mg of Metoprolol over the next 10 minutes. Train of four (TOF) was continuously monitored throughout the case, and the trend of four (TOF) ratio was noted to be 4/4 at 60 minutes after the initial, and only, dose of cis -atracurium. The patient was allowed to resume spontaneous ventilation 3 hours after induction at which time the tidal volume was 300–400 milliliter (mL), with a respiratory rate of 18-19 breaths per minute. Morphine, 3 mg, IV was administered via the 18 g catheter, while the Remifentanil infusion remained at 0.15 mcg∗kg −1 ∗min −1 . Remifentanil was discontinued 12 minutes after administration of Morphine, as the patient was breathing at a rate of 14–16 breaths per minute and achieving tidal volumes of 400–500 mL. The total surgical time was a little over 3 hours. Surgery was completed 10 minutes after discontinuation of Nitrous Oxide, 15 minutes after Desflurane, 20 minutes after Remifentanil, and 32 minutes after administration of Morphine. When the surgical drapes were taken down, the 20 g IV was noted to be infiltrated, and the patient's hand had become swollen. At this point, it became apparent that the Remifentanil had been infusing subcutaneously for several hours. The presence of adequate circulatory flow to the left arm was confirmed by palpation and Doppler. The patient maintained adequate ventilation and hemodynamic stability but did not exhibit any signs of wakefulness. He did not exhibit any response to painful stimuli. At this time, 0.04 mg of Naloxone was administered intravenously, and the patient began to follow verbal commands. After meeting extubation criteria, 45 minutes after the end of surgery, the trachea was extubated. Extubation criteria used included hemodynamic stability, eye opening, ability to follow commands, strong grip, more than 5-second headlift, swallowing, and purposeful action. The patient was transported to the recovery room with monitors and supplemental nasal cannula oxygen. After his arrival in the recovery room, he required a second dose of Naloxone, as his level of consciousness began to decrease. After this time, he did not exhibit any further signs of sedation. Of note, he did not complain of pain at the surgical site for several hours after being received in the recovery room. The total intraoperative fluids were 1000 mL NS, 150 mL estimated blood loss (EBL), and 2100 mL urine output (UOP). Normothermia to 37 degrees Celsius was maintained throughout the case with the use of warming blankets and fluid warmers. The subcutaneous infiltration in the hand resulted in mild blistering but was treated with warm compresses and resolved over the next 3 days without sequelae. The patient was discharged home and had uneventful postoperative visits with the surgical team.
3.910156
0.971191
sec[0]/p[0]
en
0.999997
22606400
https://doi.org/10.1155/2011/919067
[ "minutes", "remifentanil", "catheter", "time", "hours", "room", "intravenous", "hand", "over", "neuroma" ]
[ { "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": "QB62.Z", "title": "Attention to artificial openings, unspecified" }, { "code": "QB30.5", "title": "Fitting or adjustment of urinary device" }, { "code": "PK93.10", "title": "Gastroenterology or urology devices associated with injury or harm, urinary catheter" }, { "code": "PK90.1", "title": "Anaesthesiology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices" }, { "code": "PK91.2Y", "title": "Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" } ]
=== ICD-11 CODES FOUND === [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 [QB62.Z] Attention to artificial openings, unspecified Also known as: Attention to artificial openings, unspecified | Attention to artificial openings | toilet or cleansing of artificial opening | removal of catheter | passage of sounds or bougies [QB30.5] Fitting or adjustment of urinary device Also known as: Fitting or adjustment of urinary device | change of indwelling catheter | Removal of indwelling urinary catheter | removal of urinary catheter | removal of indwelling catheter [PK93.10] Gastroenterology or urology devices associated with injury or harm, urinary catheter Also known as: Gastroenterology or urology devices associated with injury or harm, urinary catheter | Gastroenterology or urology devices associated with adverse incidents, Foley catheter | Gastroenterology or urology devices associated with adverse incidents, indwelling urinary catheter | Mechanical complication of urinary catheter | Mechanical complication of urinary indwelling catheter Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [PK90.1] Anaesthesiology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices Definition: An anaesthesiology device was involved in an adverse incident that occurred in a therapeutic (nonsurgical) and rehabilitative task Also known as: Anaesthesiology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices | Anaesthesiology devices associated with injury or harm, spinal catheter | Mechanical complication of spinal catheter | Anaesthesiology devices associated with injury or harm, epidural catheter | Anaesthesiology devices associated with injury or harm, endotracheal tube Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Also known as: Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Cardiovascular devices associated with injury or harm, conduits | Mechanical complication of other cardiac and vascular devices and implants | Mechanical complication of artificial heart | Mechanical complication of vascular balloon implant or device === GRAPH WALKS === --- Walk 1 --- [ED5Y] Other specified disorders of epidermal keratinisation --PARENT--> [?] Disorders of epidermal keratinisation Def: This group incorporates dermatoses characterised by scaling (ichthyoses and hyperkeratoses), epidermal thickening (acanthoses and keratodermas), loss of cohesion (acantholytic dermatoses and skin peel... --RELATED_TO--> [?] Hereditary acantholytic dermatoses Def: A group of heritable disorders characterised by epidermal acantholysis and loss of epidermal integrity.... --- Walk 2 --- [ED5Y] Other specified disorders of epidermal keratinisation --PARENT--> [?] Disorders of epidermal keratinisation Def: This group incorporates dermatoses characterised by scaling (ichthyoses and hyperkeratoses), epidermal thickening (acanthoses and keratodermas), loss of cohesion (acantholytic dermatoses and skin peel... --CHILD--> [ED51] Diffuse epidermal hyperkeratosis or acanthosis Def: Conditions characterised by diffuse thickening of the horny and/or spinous layers of the epidermis.... --- Walk 3 --- [KD30.0] Birth depression with 5 minute Apgar score 0-3 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth.... --PARENT--> [KD30] Birth depression Def: A condition characterised by cardiorespiratory and neurological depression in a newborn.... --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.... --- Walk 4 --- [KD30.0] Birth depression with 5 minute Apgar score 0-3 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth.... --PARENT--> [KD30] Birth depression Def: A condition characterised by cardiorespiratory and neurological depression in a newborn.... --CHILD--> [KD30.1] Birth depression with 5 minute Apgar score 4-6 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth.... --- Walk 5 --- [KD30.1] Birth depression with 5 minute Apgar score 4-6 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth.... --PARENT--> [KD30] Birth depression Def: A condition characterised by cardiorespiratory and neurological depression in a newborn.... --CHILD--> [KD30.0] Birth depression with 5 minute Apgar score 0-3 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth.... --- Walk 6 --- [KD30.1] Birth depression with 5 minute Apgar score 4-6 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth.... --PARENT--> [KD30] Birth depression Def: A condition characterised by cardiorespiratory and neurological depression in a newborn.... --CHILD--> [KD30.1] Birth depression with 5 minute Apgar score 4-6 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth....
[ "[ED5Y] Other specified disorders of epidermal keratinisation\n --PARENT--> [?] Disorders of epidermal keratinisation\n Def: This group incorporates dermatoses characterised by scaling (ichthyoses and hyperkeratoses), epidermal thickening (acanthoses and keratodermas), loss of cohesion (acantholytic dermatoses and skin peel...\n --RELATED_TO--> [?] Hereditary acantholytic dermatoses\n Def: A group of heritable disorders characterised by epidermal acantholysis and loss of epidermal integrity....", "[ED5Y] Other specified disorders of epidermal keratinisation\n --PARENT--> [?] Disorders of epidermal keratinisation\n Def: This group incorporates dermatoses characterised by scaling (ichthyoses and hyperkeratoses), epidermal thickening (acanthoses and keratodermas), loss of cohesion (acantholytic dermatoses and skin peel...\n --CHILD--> [ED51] Diffuse epidermal hyperkeratosis or acanthosis\n Def: Conditions characterised by diffuse thickening of the horny and/or spinous layers of the epidermis....", "[KD30.0] Birth depression with 5 minute Apgar score 0-3\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth....\n --PARENT--> [KD30] Birth depression\n Def: A condition characterised by cardiorespiratory and neurological depression in a newborn....\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....", "[KD30.0] Birth depression with 5 minute Apgar score 0-3\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth....\n --PARENT--> [KD30] Birth depression\n Def: A condition characterised by cardiorespiratory and neurological depression in a newborn....\n --CHILD--> [KD30.1] Birth depression with 5 minute Apgar score 4-6\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth....", "[KD30.1] Birth depression with 5 minute Apgar score 4-6\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth....\n --PARENT--> [KD30] Birth depression\n Def: A condition characterised by cardiorespiratory and neurological depression in a newborn....\n --CHILD--> [KD30.0] Birth depression with 5 minute Apgar score 0-3\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth....", "[KD30.1] Birth depression with 5 minute Apgar score 4-6\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth....\n --PARENT--> [KD30] Birth depression\n Def: A condition characterised by cardiorespiratory and neurological depression in a newborn....\n --CHILD--> [KD30.1] Birth depression with 5 minute Apgar score 4-6\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth...." ]
ED5Y
Other specified disorders of epidermal keratinisation
[ { "from_icd11": "KD30.0", "icd10_code": "P210", "icd10_title": "" }, { "from_icd11": "KD30.1", "icd10_code": "P211", "icd10_title": "" }, { "from_icd11": "QB62.Z", "icd10_code": "Z436", "icd10_title": "Encounter for attention to other artificial openings of urinary tract" }, { "from_icd11": "QB62.Z", "icd10_code": "Z434", "icd10_title": "Encounter for attention to other artificial openings of digestive tract" }, { "from_icd11": "QB62.Z", "icd10_code": "Z438", "icd10_title": "Encounter for attention to other artificial openings" }, { "from_icd11": "QB62.Z", "icd10_code": "Z439", "icd10_title": "Encounter for attention to unspecified artificial opening" }, { "from_icd11": "QB62.Z", "icd10_code": "Z43", "icd10_title": "Encounter for attention to artificial openings" }, { "from_icd11": "QB30.5", "icd10_code": "Z466", "icd10_title": "Encounter for fitting and adjustment of urinary device" }, { "from_icd11": "PK93.10", "icd10_code": "T83022A", "icd10_title": "Displacement of nephrostomy catheter, initial encounter" }, { "from_icd11": "PK93.10", "icd10_code": "T83020A", "icd10_title": "Displacement of cystostomy catheter, initial encounter" }, { "from_icd11": "PK93.10", "icd10_code": "T83032A", "icd10_title": "Leakage of nephrostomy catheter, initial encounter" }, { "from_icd11": "PK93.10", "icd10_code": "T83092A", "icd10_title": "Other mechanical complication of nephrostomy catheter, initial encounter" }, { "from_icd11": "PK93.10", "icd10_code": "T83021A", "icd10_title": "Displacement of indwelling urethral catheter, initial encounter" }, { "from_icd11": "PK93.10", "icd10_code": "T83028A", "icd10_title": "Displacement of other urinary catheter, initial encounter" }, { "from_icd11": "PK93.10", "icd10_code": "T83090A", "icd10_title": "Other mechanical complication of cystostomy catheter, initial encounter" } ]
P210
Our patient, a 72-year-old male with a past medical history of polycystic kidney disease, received a liver and kidney transplant from a single donor in January 2006; however, this first kidney immediately failed. He subsequently received a second living-related (i.e. from a living family member) donor kidney in January 2008. His initial anti-rejection medications included tacrolimus (4 mg daily), mycophenolate (2 g daily) and prednisone (10 mg daily). From a transplantation perspective, he tolerated this regimen well. In 2009, however, he developed a small area of cSCC just above his right eyebrow. This was locally excised with clear margins. Cutaneous squamous cell cancer recurred at the same site over the right eye in 2014 and again in 2015. His second recurrence was characterized as well-differentiated cSCC, resected with clear margins but associated with perineural invasion. He received targeted radiation of 5000cg to the surgical site. In Aug 2017, cSCC recurred in the skin along the supraorbital rim, again with perineural invasion. Due to the extent of this recurrence, he received a radical excision with right eye enucleation and radial forearm skin graft to repair the resulting facial skin defect. All margins were reported negative. By this point, the patient’s immunosuppression medications had been modified and included sirolimus (1 mg oral daily), tacrolimus (1 mg oral daily), and prednisone (5 mg oral daily). Following his surgery, the tacrolimus dose was reduced (to 0.5mg every two days), and the sirolimus dose increased (to 2 mg oral daily) in hopes of reducing the risk of developing further cSCC. However, he went on to develop a small cSCC on the right side of the nose; treated with excision and local radiation. He subsequently developed two new lesions in April and May of 2019, both excised with narrow margins. In January 2020 he developed a further two new lesions, one in the skin overlying the right zygoma and a second at the margin of the radial forearm skin graft on the right cheek. Margins were now involved. The area was treated with targeted radiation, taking care to avoid significant radiation field overlap from previous treatments. In February 2020 five new lesions were identified . Pathology now demonstrated poorly differentiated cSCC with lymphovascular invasion and positive margins . At least one of the lesions was felt to be metastatic. Consultation was made for consideration of systemic immunotherapy; however, being a liver and kidney transplant recipient, it was felt that systemic immunosuppression would confer significant risk to failure of both transplants. Intra-lesional immunotherapy was offered as a potentially safer experimental alternative. After careful consideration of the options and associated potential risks and benefits, weekly injections of intra-lesional IL-2 (8M IU total dose per session, divided among multiple lesions and sites of injection) was initiated. Initially, he experienced partial regression in some lesions but clinical progression in others, with developmental of a new submandibular nodule deep to the skin. This subcutaneous nodule was treated intra-lesional injections of IL-2 (bringing the total dose administered to 10M IU per session). Additionally, at this time imiquimod (a topical TLR-7 agonist) was added to all facial lesions, administered as a thin film once daily for five out of seven days per week, by the patient. This was done in the hopes of augmenting an IL-2-mediated anti-tumor immune response. Over the course of the following six weeks, all facial lesions completely clinically responded. In addition, the subcutaneous, submandibular nodule had significantly diminished in size . For a number of reasons, including patient-reported severe pain with injections particularly at the site of the submandibular lesion, ongoing cost of medications, and costs associated with travelling back and forth for weekly treatment, we elected to proceed with excision of the residual submandibular lesion; at the same time, a representative biopsy of the right facial skin was taken as well. The submandibular lesion demonstrated residual high-grade cSCC with necrosis and a pronounced lymphocytic infiltrate but no evidence of nodal tissue . Histological analysis of the right cheek skin revealed no evidence of any residual cSCC . Margins were clear and no lymphovascular invasion or perineural invasion was identified. The area remains disease free 3 months post-treatment . During the course of treatment, liver and kidney function was closely monitored and unaffected by the localized treatment strategy. Overall, he experienced no decline in either (kidney or liver) graft function and had no signs of rejection.
3.9375
0.980957
sec[0]/sec[0]/sec[0]/p[0]
en
0.999995
34122442
https://doi.org/10.3389/fimmu.2021.678028
[ "this", "daily", "cscc", "skin", "lesions", "kidney", "margins", "invasion", "submandibular", "liver" ]
[ { "code": "4A01.03", "title": "Transient hypogammaglobulinaemia of infancy" }, { "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": "ME67", "title": "Skin disorder of uncertain or unspecified nature" }, { "code": "ME66.Y", "title": "Other specified skin changes" }, { "code": "EM0Y", "title": "Other specified diseases of the skin" }, { "code": "ME60.Z", "title": "Skin lesion of unspecified nature" }, { "code": "ME66.1", "title": "Changes in skin texture" }, { "code": "FA5Z", "title": "Arthropathies, unspecified" } ]
=== 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] [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 [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 [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 --- [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 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 --- [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.... --PARENT--> [?] Factors influencing health status --- Walk 4 --- [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--> [QF20] Difficulty or need for assistance with learning --- Walk 5 --- [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 --CHILD--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --- Walk 6 --- [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....
[ "[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...", "[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...", "[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 --PARENT--> [?] Factors influencing health status", "[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--> [QF20] Difficulty or need for assistance with learning", "[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 --CHILD--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...", "[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...." ]
4A01.03
Transient hypogammaglobulinaemia of infancy
[ { "from_icd11": "4A01.03", "icd10_code": "D807", "icd10_title": "Transient hypogammaglobulinemia of infancy" }, { "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": "ME67", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "ME66.Y", "icd10_code": "L578", "icd10_title": "Other skin changes due to chronic exposure to nonionizing radiation" }, { "from_icd11": "EM0Y", "icd10_code": "L918", "icd10_title": "Other hypertrophic disorders of the skin" }, { "from_icd11": "EM0Y", "icd10_code": "L988", "icd10_title": "Other specified disorders of the skin and subcutaneous tissue" }, { "from_icd11": "ME66.1", "icd10_code": "R234", "icd10_title": "Changes in skin texture" } ]
D807
Transient hypogammaglobulinemia of infancy
On physical examination, her vital signs were stable, and her body mass index was 21.8 kg/m 2 (height 156 cm, weight 53 kg). Her bilateral muscle strength was grade 4/5 at neck flexion, 4/5 at shoulder abduction, 4/5 in wrist flexion, 4/5 in hand grip, 2/5 in the proximal hips, and 4/5 in ankle dorsiflexion. She had normal reflexes of the biceps brachii, patella, and ankle. Facial erythema involving the nasolabial folds and an erythematous rash on the upper back and anterior chest wall compatible with V-neck sign and shawl sign were observed. Skin ulcers were seen on the hand knuckles, right elbow and lateral aspect of the right thigh . She had widespread, palpable soft tissue thickening of the bilateral thigh and upper arm with tenderness, which turned out to be calcification. The laboratory results were as follows: white blood cell count, 6440/mm 3 with lymphopenia (lymphocyte 322/mm 3 ); haemoglobin, 9.1 g/dL; platelet, 148,000/mm 3 ; erythrocyte sedimentation rate (ESR), 72 mm/hr.; C-reactive protein (CRP), 0.44 mg/dL; aspartate aminotransferase (AST), 95 (1–40) IU/L; alanine aminotransferase (ALT), 30 (1–40) IU/L; creatine kinase (CK), 128 (20–270) IU/L; lactate dehydrogenase (LDH), 553 (100–225) g/dL; myoglobin, 47.1 (0–106) ng/mL; aldolase, 10.8 (0–7.6) U/L; C3, 83 (83–193) mg/dL; and C4, 19 (15–57) mg/dL. The antinuclear antibody test was positive and showed a homogeneous pattern at a 1:160 dilution, but the anti-dsDNA, anti-Sm, anti-Ro, anti-La, anti-Scl-70, anti-centromere, anti-U1 ribonucleoprotein, anti-phospholipid, and anti-Jo-1 antibody tests were all negative. Magnetic resonance imaging (MRI) of the thigh showed symmetric diffuse muscle signal changes with an enhanced T2 signal and diffuse patchy contrast enhancement involving both the anterior and posterior compartments of the thigh . Her radiographs of shoulders and pelvis showed extensive, plaque-like soft tissue calcification of both hips, thighs and upper arms. Electromyography (EMG) showed fibrillations, positive sharp waves (PSWs), increased amplitudes of motor unit action potential (MUAP) and reduced interference pattern in the biceps. In the EMG of the tibialis and gastrocnemius muscles, fibrillations, PSWs, small and polyphasic MUAPs, and reduced interference pattern were identified. In contrast, the nerve conduction study revealed normal responses. A muscle biopsy of the right vastus lateralis demonstrated many degenerating and regenerating muscle fibers and perifascicular atrophy with moderate infiltration of inflammatory cells in the endomysial and perivascular areas, consistent with dermatomyositis. However, enzyme histochemical analysis showed centrally placed cores in the type I myofibers with nicotinamide adenine dinucleotide dehydrogenase (NADH) and succinate dehydrogenase (SDH) staining, suggesting CCD . Electron microscopy showed both tubuloreticular bodies in the endothelial cells and disorganized myofilaments with scattered short Z-bands and structured central cores in the muscle fibers, findings that suggested a diagnosis of CCD with superimposed dermatomyositis . Computed tomography of the chest and abdomen showed no evidence of interstitial lung disease or malignancy. The echocardiography was normal. The patient had no pathogenic mutations in the genes associated with congenital myopathy, including RYR1, SEPN1, ACTA1, AGRN, BIN1, CFL2, CHAT, CHRNA1, CHRNB1, CHRND, CHRNE, COLQ, DNM2, DOK2, GFPT1, IGHMBP2, KBTBD13, KLHL40, LAMB2, MTM1, MUSK, MYH7, RAPSN, SLC5A7, SMN1, TNNT1, TPM2, TPM3 and TTN , in hybridization capture-based next-generation sequencing. However, she had a heterozygous mutation in the NEB gene of c.8318G > A , which is considered a variant of uncertain significance. Parental genetic testing was negative. Fig. 1 Skin ulcerations on A the elbow and B thigh Fig. 2 Magnetic resonance imaging of the thigh. Coronal images show A increased T2 signal intensity and B normal T1 signal intensity in the pelvis and proximal thigh. C Axial T2-weighted and D gadolinium-enhanced T1-weighted image shows symmetric diffuse muscle edema and inflammation with relative preservation in the left anterior compartment of the thigh Fig. 3 Histological findings in a muscle biopsy specimen obtained from the vastus lateralis. A NADH-tetrazolium reductase stain shows irregularly outlined central cores in the type I myofibers (bar: 200 μm). B ATPase pH 4.3 shows pale central cores in the type I myofibers (bar: 200 μm). Electron microscopy (adenyl acetate and lead citrate stain) shows C a structured central core composed of randomly scattered short Z-bands and fine filaments (arrow) (bar: 5 μm), and D two tubuloreticular bodies (arrows) in the endothelial cells (bar: 500 nm)
4.089844
0.964844
sec[1]/p[1]
en
0.999998
34193198
https://doi.org/10.1186/s12969-021-00598-y
[ "anti", "thigh", "muscle", "signal", "cores", "dehydrogenase", "pattern", "both", "cells", "type" ]
[ { "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": "FA31.8", "title": "Acquired unequal limb length" }, { "code": "NC70.Y", "title": "Other specified superficial injury of hip or thigh" }, { "code": "NC70.2", "title": "Abrasion of thigh" }, { "code": "LB9A.8", "title": "Femoral agenesis or hypoplasia" }, { "code": "NC7Z", "title": "Injuries to the hip or thigh, unspecified" } ]
=== ICD-11 CODES FOUND === [JA86.Y] Maternal care for other specified fetal problems Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS [MB23.1] Antisocial behaviour Definition: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated. Also known as: Antisocial behaviour | Child or adolescent antisocial behaviour [3B4Z] Coagulation defects, unspecified Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality [4A45.Z] Antiphospholipid syndrome, unspecified Also known as: Antiphospholipid syndrome, unspecified | Antiphospholipid syndrome | Hughes syndrome | Anticardiolipin syndrome [4A43.Y] Other specified overlap non-organ specific systemic autoimmune disease Also known as: Other specified overlap non-organ specific systemic autoimmune disease | Antisynthetase syndrome | Reynolds syndrome | Syndromic multisystem autoimmune disease due to ITCH deficiency | Eosinophilia myalgia syndrome [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 [NC70.Y] Other specified superficial injury of hip or thigh Also known as: Other specified superficial injury of hip or thigh | Nonthermal blister of hip or thigh | Nonvenomous insect of hip or thigh | Superficial foreign body in hip or thigh | Splinter in hip or thigh [NC70.2] Abrasion of thigh Also known as: Abrasion of thigh [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 [NC7Z] Injuries to the hip or thigh, unspecified Also known as: Injuries to the hip or thigh, unspecified | Injury of thigh, unspecified | Injury of hip, unspecified === GRAPH WALKS === --- Walk 1 --- [JA86.Y] Maternal care for other specified fetal problems --PARENT--> [JA86] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --EXCLUDES--> [?] Placental transfusion syndromes --- 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--> [?] Labour or delivery complicated by fetal distress --- 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--> [MB23.1] Antisocial behaviour Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated.... --- 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 --PARENT--> [?] 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 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 --EXCLUDES--> [?] Placental transfusion syndromes", "[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --EXCLUDES--> [?] Labour or delivery complicated by fetal distress", "[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--> [MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....", "[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 --PARENT--> [?] 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...", "[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": "FA31.8", "icd10_code": "M21761", "icd10_title": "Unequal limb length (acquired), right tibia" } ]
O26841
Carcamo B. and Francia G. reported a retrospective case series. Six children received metronomic treatment as a palliative cure because they had exhausted all therapeutic alternatives. Patient 1 was a male child diagnosed with metastatic rhabdoid tumor of the left kidney at about 3 years of age. At diagnosis, the metastases were located at the retroperitoneal level, in the lungs and bone marrow, as well as involving the renal vein and the inferior vena cava. The child, after courses of neoadjuvant chemotherapy and radiotherapy, had a progression of the disease in the lung and in bone marrow. At this point, the patient was treated with MC (etoposide 37.5 mg/m 2 /day orally on days 1–21, followed by cyclophosphamide 50 mg/m 2 /day orally on days 22–42, celecoxib 250 mg/m 2 orally twice per day, and valproic acid 15 mg/kg/day divided into two doses): the rhabdoid tumor did not recur, and the pulmonary nodules remained stable. Subsequently, the child died from transplant-related infectious complications without showing, on imaging, signs of recurrent rhabdoid tumor, which therefore responded effectively for 3 years due to treatment. Patient 2 (male) had anaplastic ependymoma from the age of 6. The tumor was partially removed by surgery, and later treated with radiotherapy. After 6 months, there was a relapse in the brain and metastases to the leptomeninges and thoracic spine. Metronomic therapy was therefore initiated with oral etoposide (50 mg/m 2 /day for 21 days) alternating with oral CTX (50 mg/m 2 /day for 21 days), valproic acid, and continuous celecoxib (120 mg/m 2 2 times/day), subsequently modified with sulindac (8 mg/kg/day). The patient had a CR and no evidence of residual disease after 2 years of therapy; he received another 18 months of MC and was lost to follow-up after 8 years of diagnosis and 4 years of metronomic treatment without recurrence. Patient 3 (female) was diagnosed with medulloblastoma at the age of 10 months, and surgically treated in a definitive manner. Upon examination of the ventricular liquor, the presence of microscopic disease was detected; therefore, the girl was treated with chemotherapy and radiotherapy. Six months after the completion of the therapy, she had a microscopic recurrence in the cerebrospinal fluid. She was then given MC and after 5 months she achieved complete remission. After 5 years, the MC was discontinued. Patient 4 (female), age 5, had medulloblastoma localized to the fourth ventricle without desmoplastic or anaplastic features. She was treated with surgical resection, radiotherapy, and vincristine for adjuvant purposes. After 3 months, she had a first relapse, treated with temozolomide, irradiation, and surgical resection on the residual nodule. After another 3 months, a second relapse occurred. She was administered with MC (temozolomide alternating with CTX, celecoxib, and valproic acid), to which the patient partially responded. Ten months after the start of the metronomic treatment, an infiltrative brain tumor formed which led to the patient’s death 2 months later. Patient 5 (male) was diagnosed with metastatic neuroblastoma at age 9 and was treated with neoadjuvant chemotherapy, surgical resection, and finally with radiotherapy and isotretinoin. There was no evidence of residual disease at the end of treatment, but after 6 months there was a relapse treated with MC (etoposide alternating with CTX and continuous sulindac). Due to major hematological toxicities, it was necessary to reduce the dosage of etoposide and CTX, but the patient still showed a partial response at months 5 and 8. At the 11th month of treatment, there was a progression of the disease; thus, sulindac was replaced with celecoxib. After 2 months, the patient died. At 3 years of age, patient 6 (female) was diagnosed with type 2 neurocytoma of the spine. The tumor was treated surgically and later by irradiation, but a residual nodule remained. After 5 months, there was a progression of the disease with an increase in the size of the nodule and the formation of a second lesion; therefore, she received high-dose chemotherapy, developing important hematological toxicity and infectious complications, without obtaining any clinical benefit after 9 cycles. MC was then introduced (temozolomide alternating with CTX, valproic acid, celecoxib, and bevacizumab), and 3 months after the start of treatment there was a reduction in the size of the lesions. The metronomic treatment was gradually discontinued, but 10 months later it was necessary to resume it due to PD. It was possible to interrupt the treatment again, given that a stabilization of the disease was obtained; in the following 4 years of follow-up, the disease remained stable .
4.160156
0.802734
sec[4]/sec[1]/p[0]
en
0.999997
36362482
https://doi.org/10.3390/jcm11216254
[ "treated", "tumor", "metronomic", "radiotherapy", "celecoxib", "diagnosed", "chemotherapy", "etoposide", "valproic", "acid" ]
[ { "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": "QB96", "title": "Contact with health services for radiotherapy session" }, { "code": "EL63", "title": "Radionecrosis of skin due to therapeutic ionizing irradiation" }, { "code": "EL61", "title": "Chronic radiodermatitis following radiotherapy" }, { "code": "PK81.C", "title": "Radiation therapy associated with injury or harm in therapeutic use" }, { "code": "2C3Y", "title": "Other specified malignant neoplasms of skin" } ]
=== 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 [QB96] Contact with health services for radiotherapy session Also known as: Contact with health services for radiotherapy session | admission for radiotherapy [EL63] Radionecrosis of skin due to therapeutic ionizing irradiation Definition: Necrosis and ulceration of skin attributable to radiotherapy Also known as: Radionecrosis of skin due to therapeutic ionizing irradiation | Ulceration of skin due to radiotherapy | Radionecrosis of skin due to radiotherapy [EL61] Chronic radiodermatitis following radiotherapy Definition: The late cutaneous sequelae of the therapeutic use of ionising radiation. It may take five to ten years to develop and is characterised by cutaneous atrophy, fibrosis, dyspigmentation, alopecia and telangiectasia with associated damage to underlying subcutaneous fat. Also known as: Chronic radiodermatitis following radiotherapy | Late radiation reaction | Telangiectasia following radiotherapy | Poikiloderma following radiotherapy | Radiation keratosis following radiotherapy [PK81.C] Radiation therapy associated with injury or harm in therapeutic use Also known as: Radiation therapy associated with injury or harm in therapeutic use | complication during or following radiotherapy | radiotherapy associated with abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure | therapeutic ionizing radiation associated with injury or harm | radiotherapy associated with injury or harm in therapeutic use Excludes: Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm [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 === 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--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Benign symmetrical lipomatosis Def: Benign symmetrical lipomatosis is an uncommon condition characterised by progressive symmetrical accumulation during adult life of adipose mass at the level of the head, neck and upper trunk . The con... --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --CHILD--> [ME62] Acute skin eruption of uncertain or unspecified nature Def: A provisional diagnosis for an acute skin eruption of less than six weeks' duration of unknown, uncertain or unspecified nature.... --- 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--> [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--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Benign symmetrical lipomatosis\n Def: Benign symmetrical lipomatosis is an uncommon condition characterised by progressive symmetrical accumulation during adult life of adipose mass at the level of the head, neck and upper trunk . The con...", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [ME62] Acute skin eruption of uncertain or unspecified nature\n Def: A provisional diagnosis for an acute skin eruption of less than six weeks' duration of unknown, uncertain or unspecified nature....", "[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
The baseline MEP was assessed after a dural incision under TIVA. Thereafter, propofol administration was interrupted and end-tidal sevoflurane concentration was set at 2.5% (Table 1 ). Short-time decrease of bispectral index (BIS) value from 43 to 34 was noted, but it was restored quickly. Five minutes later, a prominent decrease and, subsequently, complete disappearance of MEP responses from both the upper and lower extremities was noted . ECoG showed frequent synchronized high-amplitude repetitive spikes recorded from nearly all 24 leads of the used grid electrode (Unique Medical Co., Ltd., Tokyo, Japan) covering both the frontal (premotor and motor cortex) and temporal (anterior two-thirds of the temporal lobe) convexity . Upon completion of ECoG recordings, anesthesia was changed back to TIVA, and for reduction of sevoflurane concentration, the flow rate of the respirator was set at 10 l/min without changes of FiO 2 . A temporary decrease of BIS value from 42–44 to 23–27 was noted within approximately 15 min after interruption of the sevoflurane inhalation and re-administration of propofol (Table 2 ). In 25 min after return to TIVA, MEP amplitude was about half of those at baseline, and 10 min later, it was restored fully in the upper extremity. Thereafter, anterior temporal lobectomy including lateral and medial temporal lobe structures was attained under appropriate MEP monitoring, which did not demonstrate changes of amplitude or latency . Upon completion of brain resection, propofol administration was stopped again, the end-tidal sevoflurane concentration was set at 2.5%, and 10 min later, control ECoG was recorded. Complete cessation of the previously observed epileptogenic activity from the frontal cortex was noted , which, obviously, indicated effective resection of the epileptic focus; therefore, additional frontal lobectomy was considered unnecessary. Fig. 1 The scheme of anesthesia workflow in the presented case of resective surgery for pharmacoresistant epilepsy characterized by generalized seizures and mental retardation. Starting from the skin incision and until opening of the dura mater, total intravenous anesthesia (TIVA) was provided by means of target-controlled infusions of propofol and remifentanil. The baseline motor evoked potentials (MEP) responses were assessed after dural incision ( A ). It was followed by switching of anesthesia to sevoflurane with its end-tidal concentration of 2.5%. Approximately 5 min later, MEP response had practically disappeared ( B ) and electrocorticography (ECoG) demonstrated frequent synchronized high-amplitude repetitive spikes ( C ) recorded from nearly all leads of the used grid electrode covering both frontal (premotor and motor cortex) and temporal (anterior two-thirds of the temporal lobe) convexity. Within approximately 30 min after return to TIVA, MEP amplitude restored prominently, and did not demonstrate changes of amplitude or latency during subsequent anterior temporal lobectomy ( D ). Thereafter, propofol administration was interrupted again, the end-tidal sevoflurane concentration was changed to 2.5%, and control ECoG showed complete cessation of the previously observed epileptogenic activity from the frontal cortex ( E ), which allowed to avert additional brain resection Table 1 Dynamics of the anesthesia and monitoring parameters during switching from the total intravenous anesthesia to sevoflurane Anesthesia parameters Time from the initiation of switching from TIVA to sevoflurane (min) 0 2 5 10 15 Effect-site concentration of propofol (µg/ml) 2.30 2.03 1.65 1.22 1.03 End-tidal sevoflurane concentration (%) 0 2.1 2.2 2.5 2.5 Effect-site concentration of remifentanil (ng/ml) 7.28 7.25 6.89 6.49 6.32 BIS value 43 34 42 43 44 MEP amplitude (µV): - Left upper extremity (thenar muscles) 100 - 0 0 0 - Left lower extremity (anterior tibial muscle) 165 - 13 0 0 ECoG recording - - Start Recording Finish BIS Bispectral index, ECoG Electrocorticography, MEP Motor evoked potentials, TIVA Total intravenous anesthesia Table 2 Dynamics of the anesthesia and monitoring parameters during switching from sevoflurane to the total intravenous anesthesia Anesthesia parameters Time from the initiation of switching from sevoflurane to TIVA (min) 5 10 15 26 37 Effect-site concentration of propofol (µg/ml) 3.01 2.24 2.26 2.30 2.30 End-tidal sevoflurane concentration (%) 0.14 0.13 0.11 0 0 Effect-site concentration of remifentanil (ng/ml) 6.23 6.18 6.15 6.13 6.12 BIS value 25 23 27 43 46 MEP amplitude (µV): - Left upper extremity (thenar muscles) 0 0 0 62 100 - Left lower extremity (anterior tibial muscle) 0 0 0 74 94 BIS Bispectral index, MEP Motor evoked potentials, TIVA Total intravenous anesthesia
4.210938
0.882813
sec[1]/p[1]
en
0.999997
39297916
https://doi.org/10.1186/s40981-024-00740-1
[ "sevoflurane", "anesthesia", "concentration", "tiva", "amplitude", "propofol", "ecog", "temporal", "tidal", "frontal" ]
[ { "code": "MB40.3", "title": "Anaesthesia of skin" }, { "code": "9A78.6", "title": "Anaesthesia of cornea" }, { "code": "MG30.5Z", "title": "Chronic neuropathic pain, unspecified" }, { "code": "JA67.Z", "title": "Complications of anaesthesia during pregnancy, unspecified" }, { "code": "JB43.Z", "title": "Complications of anaesthesia during the puerperium, unspecified" }, { "code": "8A40.Y", "title": "Other specified multiple sclerosis" }, { "code": "MB21.A", "title": "Poor concentration" }, { "code": "9D42.Y", "title": "Other specified patterns of visual field impairment" }, { "code": "9B75.Y", "title": "Other specified macular disorders" }, { "code": "6B41", "title": "Complex post traumatic stress disorder" } ]
=== ICD-11 CODES FOUND === [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 [9A78.6] Anaesthesia of cornea Definition: This is the condition of having sensation (including the feeling of pain) blocked or temporarily taken away, of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Also known as: Anaesthesia of cornea | corneal anaesthesia [MG30.5Z] Chronic neuropathic pain, unspecified Also known as: Chronic neuropathic pain, unspecified | Chronic neuropathic pain | anaesthesia dolorosa | neuralgia | chronic neurogenic pain (deprecated) [JA67.Z] Complications of anaesthesia during pregnancy, unspecified Also known as: Complications of anaesthesia during pregnancy, unspecified | Complications of anaesthesia during pregnancy [JB43.Z] Complications of anaesthesia during the puerperium, unspecified Also known as: Complications of anaesthesia during the puerperium, unspecified | Complications of anaesthesia during the puerperium [8A40.Y] Other specified multiple sclerosis Also known as: Other specified multiple sclerosis | Certain specified rare variants of multiple sclerosis | Multiple sclerosis, Marburg variant | Myelinoclastic diffuse sclerosis | Schilder disease [MB21.A] Poor concentration Definition: Difficulty focusing attention and sustaining the mental energy necessary to accomplish a task or goal. Also known as: Poor concentration [9D42.Y] Other specified patterns of visual field impairment Also known as: Other specified patterns of visual field impairment | Concentric peripheral loss | Generalised contraction of visual field | Contraction of visual field | Depressed visual field [9B75.Y] Other specified macular disorders Also known as: Other specified macular disorders | Benign concentric annular macular dystrophy | North Carolina macular dystrophy | Occult macular dystrophy | Retinal angiomatous proliferations [6B41] Complex post traumatic stress disorder Definition: Complex post traumatic stress disorder (Complex PTSD) is a disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g. torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). All diagnostic requirements for PTSD are met. In addition, Complex PTSD is characterised by severe and pers Also known as: Complex post traumatic stress disorder | enduring personality change after catastrophic experience | complex PTSD | personality change after disasters | Personality change after concentration camp experiences Excludes: Post traumatic stress disorder | Personality disorder === GRAPH WALKS === --- Walk 1 --- [MB40.3] Anaesthesia of skin Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy.... --PARENT--> [MB40] Sensation disturbance --CHILD--> [MB40.2] Anacusis --- Walk 2 --- [MB40.3] Anaesthesia of skin Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy.... --PARENT--> [MB40] Sensation disturbance --CHILD--> [MB40.0] Asomatognosia --- Walk 3 --- [9A78.6] Anaesthesia of cornea Def: This is the condition of having sensation (including the feeling of pain) blocked or temporarily taken away, of the transparent front part of the eye that covers the iris, pupil, and anterior chamber.... --PARENT--> [9A78] Certain specified disorders of cornea --RELATED_TO--> [?] Ocular laceration without prolapse or loss of intraocular tissue, unilateral --- Walk 4 --- [9A78.6] Anaesthesia of cornea Def: This is the condition of having sensation (including the feeling of pain) blocked or temporarily taken away, of the transparent front part of the eye that covers the iris, pupil, and anterior chamber.... --PARENT--> [9A78] Certain specified disorders of cornea --RELATED_TO--> [?] Injury of conjunctiva or corneal abrasion without mention of foreign body --- Walk 5 --- [MG30.5Z] Chronic neuropathic pain, unspecified --PARENT--> [MG30.5] Chronic neuropathic pain Def: Chronic neuropathic pain is chronic pain caused by a lesion or disease of the somatosensory nervous system. The pain may be spontaneous or evoked, as an increased response to a painful stimulus (hyper... --CHILD--> [MG30.5Y] Other specified chronic neuropathic pain --- Walk 6 --- [MG30.5Z] Chronic neuropathic pain, unspecified --PARENT--> [MG30.5] Chronic neuropathic pain Def: Chronic neuropathic pain is chronic pain caused by a lesion or disease of the somatosensory nervous system. The pain may be spontaneous or evoked, as an increased response to a painful stimulus (hyper... --CHILD--> [MG30.50] Chronic central neuropathic pain Def: Chronic central neuropathic pain is chronic pain caused by a lesion or disease of the central somatosensory nervous system. The pain may be spontaneous or evoked, as an increased response to a painful...
[ "[MB40.3] Anaesthesia of skin\n Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy....\n --PARENT--> [MB40] Sensation disturbance\n --CHILD--> [MB40.2] Anacusis", "[MB40.3] Anaesthesia of skin\n Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy....\n --PARENT--> [MB40] Sensation disturbance\n --CHILD--> [MB40.0] Asomatognosia", "[9A78.6] Anaesthesia of cornea\n Def: This is the condition of having sensation (including the feeling of pain) blocked or temporarily taken away, of the transparent front part of the eye that covers the iris, pupil, and anterior chamber....\n --PARENT--> [9A78] Certain specified disorders of cornea\n --RELATED_TO--> [?] Ocular laceration without prolapse or loss of intraocular tissue, unilateral", "[9A78.6] Anaesthesia of cornea\n Def: This is the condition of having sensation (including the feeling of pain) blocked or temporarily taken away, of the transparent front part of the eye that covers the iris, pupil, and anterior chamber....\n --PARENT--> [9A78] Certain specified disorders of cornea\n --RELATED_TO--> [?] Injury of conjunctiva or corneal abrasion without mention of foreign body", "[MG30.5Z] Chronic neuropathic pain, unspecified\n --PARENT--> [MG30.5] Chronic neuropathic pain\n Def: Chronic neuropathic pain is chronic pain caused by a lesion or disease of the somatosensory nervous system. The pain may be spontaneous or evoked, as an increased response to a painful stimulus (hyper...\n --CHILD--> [MG30.5Y] Other specified chronic neuropathic pain", "[MG30.5Z] Chronic neuropathic pain, unspecified\n --PARENT--> [MG30.5] Chronic neuropathic pain\n Def: Chronic neuropathic pain is chronic pain caused by a lesion or disease of the somatosensory nervous system. The pain may be spontaneous or evoked, as an increased response to a painful stimulus (hyper...\n --CHILD--> [MG30.50] Chronic central neuropathic pain\n Def: Chronic central neuropathic pain is chronic pain caused by a lesion or disease of the central somatosensory nervous system. The pain may be spontaneous or evoked, as an increased response to a painful..." ]
MB40.3
Anaesthesia of skin
[ { "from_icd11": "MB40.3", "icd10_code": "R200", "icd10_title": "Anesthesia of skin" }, { "from_icd11": "MB40.3", "icd10_code": "R201", "icd10_title": "Hypoesthesia of skin" }, { "from_icd11": "JA67.Z", "icd10_code": "O298X1", "icd10_title": "Other complications of anesthesia during pregnancy, first trimester" }, { "from_icd11": "JA67.Z", "icd10_code": "O29", "icd10_title": "Complications of anesthesia during pregnancy" }, { "from_icd11": "JA67.Z", "icd10_code": "O295", "icd10_title": "Other complications of spinal and epidural anesthesia during pregnancy" }, { "from_icd11": "JA67.Z", "icd10_code": "O298", "icd10_title": "Other complications of anesthesia during pregnancy" }, { "from_icd11": "JA67.Z", "icd10_code": "O299", "icd10_title": "Unspecified complication of anesthesia during pregnancy" }, { "from_icd11": "JB43.Z", "icd10_code": "O898", "icd10_title": "Other complications of anesthesia during the puerperium" }, { "from_icd11": "JB43.Z", "icd10_code": "O89", "icd10_title": "Complications of anesthesia during the puerperium" }, { "from_icd11": "JB43.Z", "icd10_code": "O893", "icd10_title": "Toxic reaction to local anesthesia during the puerperium" }, { "from_icd11": "JB43.Z", "icd10_code": "O899", "icd10_title": "Complication of anesthesia during the puerperium, unspecified" }, { "from_icd11": "MB21.A", "icd10_code": "R4189", "icd10_title": "Other symptoms and signs involving cognitive functions and awareness" }, { "from_icd11": "MB21.A", "icd10_code": "R4181", "icd10_title": "Age-related cognitive decline" }, { "from_icd11": "MB21.A", "icd10_code": "R41840", "icd10_title": "Attention and concentration deficit" }, { "from_icd11": "MB21.A", "icd10_code": "R4183", "icd10_title": "Borderline intellectual functioning" } ]
R200
Anesthesia of skin
In the current case report, the patient was first diagnosed with NHL in the fifth month of treatment for lung squamous cell carcinoma according to SEER (Surveillance, Epidemiology, and End Results) recommendation ( 11 ). The patient had multiple metachronous primary tumors. The oncologist chose penpulimab for the treatment of lung cancer. This drug was approved for the first time in China in August 2021. It is a new PD-1 monoclonal antibody that is based on the IgG1 subtype. By binding to PD-1, it activates the immune surveillance and killing effect of T cells on tumors, inhibiting Fcγ receptor binding and Fc-mediated effector function, thereby reducing T cell apoptosis and clearance. Compared with other PD-1 inhibitors, as penpulimab and PD-1 dissociate more slowly, they have higher receptor occupancy and better cell activity and are recommended for Hodgkin’s lymphoma and non-small cell lung cancer ( 12 ). After assessing the patient’s medical condition, oncologists conducted a comprehensive review of the relevant literature and found some new evidence in the results of clinical trials ( 12 , 13 ). The results of these studies indicated that the combination of penpulimab with chemotherapy consistently yielded favorable outcomes across all efficacy measures, significantly mitigating the risk of disease progression and mortality. Subsequently, in October 2021, the oncologist communicated with the patient and started treatment with penpulimab after obtaining informed consent. However, in our patient, lymph node enlargement occurred after five courses of drug treatment, and a lymph node biopsy was performed to diagnose NHL. Penpulimab has been recommended as a second-line treatment for Hodgkin’s lymphoma, but there have been no clinical trials for NHL. The occurrence of lymphoma during the use of a PD-1 inhibitor may be related to the fact that the patient’s lymphoma was a highly invasive NHL as well as to some genetic features such as chromosome 9p24.1 changes and PD-L1 expression. Early studies have found that the effect of PD-1 inhibitors in NHL treatment may not be ideal ( 14 ). The probability of having multiple primary cancers in patients with lung cancer is 21% ( 15 ), and the first metachronous multiple primary cancers of lung cancer rank ninth among metachronous multiple primary cancers, accounting for 3.2% ( 16 ). The cause of lymphoma in this patient may have been related to the following factors: 1) There may be a common carcinogenic mechanism for the development of lymphoma and lung cancer ( 17 ); 2) Tobacco exposure increases the incidence of multiple primary cancers ( 18 ), especially diffuse large B-cell lymphoma ( 19 ); 3) Occupational and environmental pesticide exposure: the patient was a farmer. Several studies have shown that occupational agricultural exposure is associated with a high incidence of NHL ( 20 , 21 ) because exposure to agricultural pesticides increases the risk of diffuse large B-cell lymphoma ( 22 ); 4) Role of chemotherapeutic drugs: chemotherapeutic drugs can cause DNA strand breaks, cell transformation, mutations, and chromosomal aberrations, and can be anticancer and carcinogenic. Several classes of chemotherapeutic agents are associated with treatment-related tumors, including alkylating agents, topoisomerase II inhibitors, and antimetabolites ( 23 ); 5) Immunosuppression: patients experience bone marrow suppression and low immune function after chemotherapy, which diminishes the surveillance and killing effect on cancer cells. Some studies have reported that immunosuppression is the most common risk factor for NHL ( 24 ). Duration of Penpulimab: although the mean elimination half-life of penpulimab is 23.3 d, anti-PD-1 therapy generates polyclonal and memory-adaptive antitumor immunity that can control disease heterogeneity and reset tumor-host immune interactions to cancer rejection ( 25 , 26 ). The Gustave-Roussy Cancer Center in France published the results of a large retrospective study in which 39 patients were forced to discontinue anti-PD-1 drugs early after treatment initiation for less than 2 years for several reasons. Of these patients, 15 experienced disease relapse, with a median time from discontinuation to relapse of 4 months, whereas remission continued in the remaining 24 patients. Comparing the 15 patients who relapsed with the 24 patients who did not relapse revealed that the duration of PD-1/PD-L1 monoclonal antibody was longer before discontinuation in the patients who did not relapse (15.5 months vs. 11 months) ( 27 ). Therefore, anti-PD-1 drugs have a “long tail effect,” which is why lung tumors do not recur immediately after patients stop taking the drugs, but they eventually regrow.
4.296875
0.794434
sec[2]/p[1]
en
0.999994
PMC10323425
https://doi.org/10.3389/fimmu.2023.1114994
[ "patients", "cancer", "that", "lymphoma", "lung", "cell", "penpulimab", "multiple", "drugs", "tumors" ]
[ { "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": "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" } ]
=== 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 [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 === 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 --PARENT--> [?] Mode of injury or harm associated with a surgical or other medical procedure --- Walk 3 --- [QB14] Unavailability or inaccessibility of health care facilities --EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere --CHILD--> [?] Person awaiting admission to acute hospital --- Walk 4 --- [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 5 --- [PL14.2] Problem associated with physical transfer of patient --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes --CHILD--> [PL14.2] Problem associated with physical transfer of patient --- 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 --CHILD--> [PL14.1] Non provision of necessary procedure
[ "[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 --PARENT--> [?] Mode of injury or harm associated with a surgical or other medical procedure", "[QB14] Unavailability or inaccessibility of health care facilities\n --EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere\n --CHILD--> [?] Person awaiting admission to acute hospital", "[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", "[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 --CHILD--> [PL14.2] Problem associated with physical transfer of patient", "[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 --CHILD--> [PL14.1] Non provision of necessary procedure" ]
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": "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" } ]
Z753
Unavailability and inaccessibility of health-care facilities
A 21-year-old primigravida at 37-week gestation presented to the outpatient clinic for a routine obstetrical examination. Her pregnancy course had been uneventful. Her blood pressure at this visit was 184/108. She was asymptomatic except for occasional mild headaches. A urine dipstick showed 3+ proteinuria. Patient was diagnosed with preeclampsia and was admitted to the hospital for emergency induction of labor. She was started on IV magnesium for preeclampsia and labor was induced with oxytocin. She underwent an emergency cesarean section due to fetal decelerations during induction. Subsequently, she delivered a healthy male infant by low transverse C section. Four days after partum, she started spiking high fevers up to 39.5 degrees Celsius and developed tachycardia with heart rate of 140 to 150/min. She was otherwise completely asymptomatic and clinical exam was negative for any localizing signs. Her cesarean section incision looked clean; she had no breast tenderness. Infectious work-up including blood and urine cultures was negative. Her chest X-ray was normal; EKG showed sinus tachycardia. She was empirically started on broad spectrum antibiotics. After 48 hours of IV antibiotics, patient continued to spike high fevers and was still tachycardic. The differential diagnosis of endometritis and septic thrombophlebitis was high on the list even though her abdominal exam was benign. Computerized tomography (CT) scan of the abdomen and pelvis with contrast was ordered to rule out septic thrombophlebitis, which showed a large right retroperitoneal 9.2 cm anteroposterior × 14 cm transverse × 12.5 cm craniocaudal mass with severe right renal hydronephrosis. Due to absence of any fat layer between the kidney and the mass, it was felt to be coming from the lower pole of the right kidney. The mass extended superiorly to the inferior vena cava (IVC) with a possible tumor thrombus in the IVC. The liver was mildly enlarged measuring 19.6 cm with fatty infiltration. The first segment of the sacrum showed a 3 cm × 2.1 cm × 2.6 cm lytic lesion. CT scan of the chest showed 2 pulmonary nodules measuring 7 mm and 11 mm in the left and right lower lobes of the lung, respectively. Due to the above imaging findings, suspicion was high for a stage 4 metastatic cancer arising from the kidney. Renal ultrasound confirmed a large retroperitoneal mass with hydronephrosis. MRI lumbar spine reported an abnormal marrow signal in the S1–S3 segments and an exophytic bony metastatic lesion in the dorsal aspect of S1 causing severe narrowing of the thecal sac. MRI abdomen/pelvis confirmed extension of the retroperitoneal mass into the inferior vena cava (IVC). MRI brain and CT brain were obtained showing calvarial lesions consistent with hemangiomas. A percutaneous CT guided right renal mass biopsy revealed a cellular epithelioid proliferation arranged in nests and composed of round to ovoid cells with hyperchromatic nuclei, inconspicuous nucleoli, and granular amphophilic cytoplasm. Immunohistochemical staining was negative for HMB-45, S100, PAX-8, cytokeratin AE1/AE3, CD117, and DOG-1 but was positive for synaptophysin and chromogranin . The overall morphological and immunohistochemical findings were consistent with a diagnosis of paraganglioma. 24-hour urine testing revealed high levels of urinary nor epinephrine which was 862 mcg/24 hours (normal range 15 to 100 mcg/24 hours) and dopamine which was 902 mcg/24 hours (normal range 52 to 480 mcg/24 hours). Plasma-free metanephrine levels were also elevated at 1690 pg/mL (normal range 18 to 101 pg/mL). The patient continued to remain severely hypertensive after delivery and was started on combined alpha and beta blockade with doxazosin 8 mg daily and propranolol 40 mg twice daily. The patient underwent right sided nephrectomy, removal of the retroperitoneal mass, and resection of the perirenal IVC. Her postoperative course was complicated by severe hypotension and extensive bilateral lower extremity deep venous thromboses in the external iliac and common femoral veins. She required vasopressors for two days and was started on therapeutic anticoagulation with enoxaparin for the DVTs. She was discharged home 2 weeks after her surgery. A metaiodobenzylguanidine (MIBG) whole body scan done later as an outpatient did not demonstrate any focal abnormal uptake. Whole body PET scan showed increased FDG uptake in 3 pulmonary nodules, a large lytic sacral lesion, and a T9 vertebral body lesion all consistent with metastases. The patient underwent gamma knife palliative radiation of the S1 lesion and was started on Zometa for her bony metastases. The tyrosine kinase receptor inhibitor Sunitinib was started to treat her systemic disease.
3.919922
0.981445
sec[1]/p[0]
en
0.999999
26236513
https://doi.org/10.1155/2015/864719
[ "hours", "lesion", "scan", "retroperitoneal", "urine", "section", "which", "large", "renal", "kidney" ]
[ { "code": "LB13.Y", "title": "Other specified structural developmental anomalies of stomach" }, { "code": "DA40.4", "title": "Hourglass stricture and stenosis of stomach" }, { "code": "JB02.4", "title": "Hypertonic, incoordinate, or prolonged uterine contractions" }, { "code": "GC01.Y", "title": "Other specified disorders of bladder" }, { "code": "8B10.Y", "title": "Other specified transient ischaemic attack" }, { "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 === [LB13.Y] Other specified structural developmental anomalies of stomach Also known as: Other specified structural developmental anomalies of stomach | Congenital megalogastria | congenital gastromegaly | congenital enlarged stomach | Congenital displacement of the stomach [DA40.4] Hourglass stricture and stenosis of stomach Definition: This is a structural change of stomach in which one more or less completely divided into two parts, resembling an hourglass in shape, due to often scarring which complicates chronic gastric ulcer. Also known as: Hourglass stricture and stenosis of stomach | hourglass contraction of stomach | hourglass stenosis of stomach | hourglass stricture of stomach | Bilocular stomach [JB02.4] Hypertonic, incoordinate, or prolonged uterine contractions Definition: A condition affecting pregnant females that is idiopathic. This condition is characterised by uterine dysfunction leading to hypertonic, uncoordinated, and prolonged rhythmic activity of the myometrium during labour. Also known as: Hypertonic, incoordinate, or prolonged uterine contractions | Uterine dystocia NOS | Hypertonic uterus dysfunction complicating delivery | hypertonic uterine activity | hypertonic uterine contraction Excludes: dystocia (fetal)(maternal) NOS [GC01.Y] Other specified disorders of bladder Also known as: Other specified disorders of bladder | Non-neurogenic neurogenic bladder | Occult neuropathic bladder | Hinman syndrome | Hinman-Allen syndrome [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 [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 --- [LB13.Y] Other specified structural developmental anomalies of stomach --PARENT--> [LB13] Structural developmental anomalies of stomach Def: Any congenital defect of stomach that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly in t... --CHILD--> [LB13.0] Congenital hypertrophic pyloric stenosis Def: A not uncommon congenital malformation of the stomach of unknown cause in which there is hypertrophy and hyperplasia of the circular muscle of the pylorus. Symptoms of gastric outlet obstruction usual... --- Walk 2 --- [LB13.Y] Other specified structural developmental anomalies of stomach --PARENT--> [LB13] Structural developmental anomalies of stomach Def: Any congenital defect of stomach that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly in t... --CHILD--> [LB13.0] Congenital hypertrophic pyloric stenosis Def: A not uncommon congenital malformation of the stomach of unknown cause in which there is hypertrophy and hyperplasia of the circular muscle of the pylorus. Symptoms of gastric outlet obstruction usual... --- Walk 3 --- [DA40.4] Hourglass stricture and stenosis of stomach Def: This is a structural change of stomach in which one more or less completely divided into two parts, resembling an hourglass in shape, due to often scarring which complicates chronic gastric ulcer.... --PARENT--> [DA40] Acquired anatomical alterations of the stomach Def: This group incorporates gastric disorders principally due to acquired morphological changes of the stomach.... --CHILD--> [DA40.0] Gastric outlet obstruction Def: 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.... --- Walk 4 --- [DA40.4] Hourglass stricture and stenosis of stomach Def: This is a structural change of stomach in which one more or less completely divided into two parts, resembling an hourglass in shape, due to often scarring which complicates chronic gastric ulcer.... --PARENT--> [DA40] Acquired anatomical alterations of the stomach Def: This group incorporates gastric disorders principally due to acquired morphological changes of the stomach.... --PARENT--> [?] Diseases of stomach Def: This is a group of conditions characterised as being in or associated with the stomach.... --- Walk 5 --- [JB02.4] Hypertonic, incoordinate, or prolonged uterine contractions Def: A condition affecting pregnant females that is idiopathic. This condition is characterised by uterine dysfunction leading to hypertonic, uncoordinated, and prolonged rhythmic activity of the myometriu... --EXCLUDES--> [?] Obstructed labour due to other causes Def: Any other condition characterised by the inability of the presenting part of the fetus to progress into the birth canal for any reason.... --CHILD--> [?] Obstructed labour due to unusually large fetus --- Walk 6 --- [JB02.4] Hypertonic, incoordinate, or prolonged uterine contractions Def: A condition affecting pregnant females that is idiopathic. This condition is characterised by uterine dysfunction leading to hypertonic, uncoordinated, and prolonged rhythmic activity of the myometriu... --EXCLUDES--> [?] Obstructed labour due to other causes Def: Any other condition characterised by the inability of the presenting part of the fetus to progress into the birth canal for any reason.... --CHILD--> [?] Obstructed labour due to unusually large fetus
[ "[LB13.Y] Other specified structural developmental anomalies of stomach\n --PARENT--> [LB13] Structural developmental anomalies of stomach\n Def: Any congenital defect of stomach that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly in t...\n --CHILD--> [LB13.0] Congenital hypertrophic pyloric stenosis\n Def: A not uncommon congenital malformation of the stomach of unknown cause in which there is hypertrophy and hyperplasia of the circular muscle of the pylorus. Symptoms of gastric outlet obstruction usual...", "[LB13.Y] Other specified structural developmental anomalies of stomach\n --PARENT--> [LB13] Structural developmental anomalies of stomach\n Def: Any congenital defect of stomach that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly in t...\n --CHILD--> [LB13.0] Congenital hypertrophic pyloric stenosis\n Def: A not uncommon congenital malformation of the stomach of unknown cause in which there is hypertrophy and hyperplasia of the circular muscle of the pylorus. Symptoms of gastric outlet obstruction usual...", "[DA40.4] Hourglass stricture and stenosis of stomach\n Def: This is a structural change of stomach in which one more or less completely divided into two parts, resembling an hourglass in shape, due to often scarring which complicates chronic gastric ulcer....\n --PARENT--> [DA40] Acquired anatomical alterations of the stomach\n Def: This group incorporates gastric disorders principally due to acquired morphological changes of the stomach....\n --CHILD--> [DA40.0] Gastric outlet obstruction\n Def: 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....", "[DA40.4] Hourglass stricture and stenosis of stomach\n Def: This is a structural change of stomach in which one more or less completely divided into two parts, resembling an hourglass in shape, due to often scarring which complicates chronic gastric ulcer....\n --PARENT--> [DA40] Acquired anatomical alterations of the stomach\n Def: This group incorporates gastric disorders principally due to acquired morphological changes of the stomach....\n --PARENT--> [?] Diseases of stomach\n Def: This is a group of conditions characterised as being in or associated with the stomach....", "[JB02.4] Hypertonic, incoordinate, or prolonged uterine contractions\n Def: A condition affecting pregnant females that is idiopathic. This condition is characterised by uterine dysfunction leading to hypertonic, uncoordinated, and prolonged rhythmic activity of the myometriu...\n --EXCLUDES--> [?] Obstructed labour due to other causes\n Def: Any other condition characterised by the inability of the presenting part of the fetus to progress into the birth canal for any reason....\n --CHILD--> [?] Obstructed labour due to unusually large fetus", "[JB02.4] Hypertonic, incoordinate, or prolonged uterine contractions\n Def: A condition affecting pregnant females that is idiopathic. This condition is characterised by uterine dysfunction leading to hypertonic, uncoordinated, and prolonged rhythmic activity of the myometriu...\n --EXCLUDES--> [?] Obstructed labour due to other causes\n Def: Any other condition characterised by the inability of the presenting part of the fetus to progress into the birth canal for any reason....\n --CHILD--> [?] Obstructed labour due to unusually large fetus" ]
LB13.Y
Other specified structural developmental anomalies of stomach
[ { "from_icd11": "DA40.4", "icd10_code": "K312", "icd10_title": "Hourglass stricture and stenosis of stomach" }, { "from_icd11": "JB02.4", "icd10_code": "O624", "icd10_title": "Hypertonic, incoordinate, and prolonged uterine contractions" }, { "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" } ]
K312
Hourglass stricture and stenosis of stomach
A 28-year-old female patient, gravida 1 para 0 without special medical history underwent a series of routine sonographic examinations during the first and second trimesters of the pregnancy. All these examinations before 29 weeks’ gestational age revealed normal fetal growth and no obvious abnormality in the bilateral adnexal area. The patient did not show any typical symptoms and discomfort before 29 weeks’ gestational age, but She complained of occasional mild abdominal pain after the gestational age of 29 weeks. At 29 weeks’ gestational age, routine obstetric ultrasound demonstrated a 9.7 × 8.5 × 6.4 cm complex structure in the left adnexal area. Blood tumor markers including carbohydrate antigen-125 (CA-125) and alpha-fetoprotein (AFP) were in the normal range. At the gestational age of 30 weeks, repeated abdominal ultrasound revealed rapid growth of tumor mass, measuring 25.0 × 15.0 × 13.7 cm. The cyst was found to have a 15.7 × 11.3 × 14.1 cm heterogeneous echogenicity, which was irregular cauliflower-shaped and had strong blood flow. Sonographic examination showed no ascites or pleural effusion . Abdominal magnetic resonance imaging (MRI) revealed a 30 × 17.4 × 18.9 cm cystic and solid mass on the left side of the pelvic cavity, and the solid component was irregular-shaped and cauliflower-shaped appearance . Blood tumor markers were as follows: CA-125 of 43.4 U/mL and AFP of 173.4 ng/mL. We used the international ovarian tumor analysis (IOTA) simple rules to evaluate the mass, and the tumor was classified as malignant according to IOTA simple rules. Maternal–fetal medicine, gynecologic oncology and neonatal intensivist consults were obtained. Due to rapid growth of the masses, and concern for malignancy, an elective cesarean section combined with exploratory laparotomy was recommended after dexamethasone was given to the mother to accelerate fetal lung maturation. She underwent an elective cesarean section at 33 weeks’ gestational age. A female infant was delivered . Intraoperative findings revealed there was a solid and cystic mass measuring 35 × 20 × 15 cm in diameter with smooth surface, arising from the left ovary . The capsule of the tumor mass was intact, and there was no tumor infiltration in the left fallopian tube and the right adnexa. After careful examination of the pelvic and abdominal peritoneum and other organ surfaces (including the omentum, diaphragm, liver, and stomach), no suspicious invasive lesions were found. Gross examination revealed that the tumor was composed of cystic and solid components , and the wall of cystic component was thin and smooth, containing yellowish clear liquid. The tumor mass contained cauliflower-like solid components, measuring 18 × 17 × 15 cm . The intraoperative frozen pathological examination suggested left ovarian immature teratoma. Then, she underwent a left adnexectomy, pelvic mass resection, right ovarian biopsy, bilateral pelvic lymph node dissection, para-aortic lymph node sampling, and omentectomy. Peritoneal washings were also collected and sent for pathological examination. The final histological and immunohistochemical results confirmed the diagnosis of immature left ovarian teratoma (WHO II grade). The tumor was limited to the left ovary without involvement of the left fallopian tube, and no tumor infiltration was found in the omentum, pelvic and paraaortic lymph nodes. Tumor cells were also not observed in peritoneal washings. The tumor was staged as FIGO I C1 (the tumor was limited to the left ovary with surgical spill). After evaluation by oncologists, post-operative chemotherapy was recommended. Therefore, she underwent 4 cycles of BEP chemotherapy regimen. After 18 months of follow-up, there is no sign of tumor recurrence till now. Fig. 1 The ultrasound and MRI images of the tumor. A and B , sonographic examination demonstrated there was a 25.0 × 15.0 × 13.7 cm cyst in the left adnexal area, and the cyst was found to have a 15.7 × 11.3 × 14.1 cm heterogeneous echogenicity, which was irregular cauliflower-shaped and had strong blood flow. p indicate placenta. C and D , Abdominal magnetic resonance imaging (MRI) revealed a 30 × 17.4 × 18.9 cm cystic and solid mass on the left side of the pelvic cavity, and the solid component was irregular-shaped and cauliflower-shaped appearance Fig. 2 A giant immature teratoma of the left ovary. A , After entering the abdomen, there was a huge mass with a smooth surface in the pelvic and abdominal cavity. B , Intraoperative exploration revealed that the mass originated from the left ovary. The black arrow in B points to the uterus after cesarean section. C , Gross examination of the excised specimen showed the tumor mass was cystic and solid
4.007813
0.978516
sec[1]/p[0]
en
0.999998
PMC9237990
https://doi.org/10.1186/s12884-022-04857-y
[ "tumor", "solid", "pelvic", "gestational", "abdominal", "shaped", "cystic", "cauliflower", "ovary", "blood" ]
[ { "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": "2F90.Z", "title": "Neoplasms of unknown behaviour of oral cavity or digestive organs, unspecified site" }, { "code": "2C25.0", "title": "Adenocarcinoma of bronchus or lung" }, { "code": "2C24.0", "title": "Adenocarcinoma of trachea" }, { "code": "BD93.1Y", "title": "Lymphoedema secondary to other specified cause" }, { "code": "CA71.Z", "title": "Pneumonitis due to solids or liquids, 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 [2F90.Z] Neoplasms of unknown behaviour of oral cavity or digestive organs, unspecified site Also known as: Neoplasms of unknown behaviour of oral cavity or digestive organs, unspecified site | Neoplasms of unknown behaviour of oral cavity or digestive organs | abdominal viscera growth | gastrointestinal neoplasm | oral cavity or digestive organ growth [2C25.0] Adenocarcinoma of bronchus or lung Definition: A carcinoma that arises from the lung and is characterised by the presence of malignant glandular epithelial cells. There is a male predilection with a male to female ratio of 2:1. Usually lung adenocarcinoma is asymptomatic and is identified through screening studies or as an incidental radiologic finding. If clinical symptoms are present they include shortness of breath, cough, hemoptysis, chest pain, and fever. Tobacco smoke is a known risk factor. Also known as: Adenocarcinoma of bronchus or lung | primary lung adenocarcinoma | lung adenocarcinoma | bronchiolar adenocarcinoma of unspecified site | Mucinous adenocarcinoma of lung [2C24.0] Adenocarcinoma of trachea Also known as: Adenocarcinoma of trachea | Mucinous adenocarcinoma of trachea | Papillary adenocarcinoma of trachea | Solid carcinoma of trachea | Clear cell adenocarcinoma of trachea [BD93.1Y] Lymphoedema secondary to other specified cause Also known as: Lymphoedema secondary to other specified cause | Lipo-lymphoedema | Lymphoedema due to recurrent infection | Lymphoedema secondary to recurrent infection | Lymphoedema due to chronic inflammation [CA71.Z] Pneumonitis due to solids or liquids, unspecified Also known as: Pneumonitis due to solids or liquids, unspecified | Pneumonitis due to solids or liquids === 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--> [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--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Benign symmetrical lipomatosis Def: Benign symmetrical lipomatosis is an uncommon condition characterised by progressive symmetrical accumulation during adult life of adipose mass at the level of the head, neck and upper trunk . The con... --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] 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--> [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--> [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--> [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--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Benign symmetrical lipomatosis\n Def: Benign symmetrical lipomatosis is an uncommon condition characterised by progressive symmetrical accumulation during adult life of adipose mass at the level of the head, neck and upper trunk . The con...", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] 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--> [2E61] Carcinoma in situ of other or unspecified digestive organs" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
A 73-year-old multiparous woman with no remarkable past medical history visited her local physician with symptoms of low abdominal pain. A left ovarian tumor measuring approximately 15 cm was identified, and she was referred to our hospital for further examination and treatment. Computed tomography (CT) imaging revealed a complex left ovarian tumor comprised of solid and fat components and calcifications with para-aortic and pelvic adenopathy. The blood squamous cell carcinoma antigen (SCC-Ag) level of 11.6 ng/ml was high. Based on these findings, she was suspected of having MCT-SCC. One week after the initial visit, she presented with increasing abdominal pain. Blood tests revealed elevated levels of inflammatory markers (white blood cell [WBC]): 13,100/μl, C-reactive protein (CRP) (16.83 mg/1), and CT imaging revealed that the tumor had shrunk to 10 cm in size with ascites extending into the upper abdomen . The decision was made to proceed an emergency exploratory laparotomy which included total abdominal hysterectomy, bilateral salpingo-oophorectomy, and partial omentectomy. The left ovarian tumor measured 10 cm and had ruptured, and the ensuing ascitic fluid cytology was positive. Intraoperatively, there were multiple unresectable 5 mm peritoneal implants, significant adhesions, and extensive adenopathy resulting in suboptimal debulking. The patient was in poor general condition due to tumor rupture, and maximal effort, including bowel resection, was impossible due to emergency surgery. Postoperatively, pathology revealed poorly differentiated nonkeratinizing SCC consistent with MCT-SCC having p53 overexpression with omental metastasis, conferring stage IIIB ovarian cancer (pT3bNXM0) . Interestingly, there was a synchronous stage IA grade 1 endometrioid adenocarcinoma of the uterus. After surgery, the myChoice CDx (Myriad Genetic Laboratories, Inc., Salt Lake City, United States) test and microsatellite instability (MSI) test (SRL, Tokyo, Japan) were performed using specimens from the nonkeratinizing SCC section of the primary tumor. The GI score of 87 was remarkably high, and there was no BRCA1 / 2 pathogenic mutation. The MSI test was negative. Three weeks after surgery, the patient began intravenous (IV, AUC6) carboplatin and paclitaxel (IV, 175 mg/m 2 ). CT imaging after six courses showed that residual tumors had shrunk by 73 % and blood SCC-Ag levels decreased from 12.8 ng/ml postoperatively to 1.6 ng/ml after one course of chemotherapy, and remained in the normal range thereafter. Since complete resection of the residual tumor was considered feasible, and maximal effort was not possible at the initial surgery, we decided to perform interval debulking surgery (IDS). We performed IDS six months after the first visit. R0 resection was achieved with pelvic and paraortic lymphadenectomy and partial ureteral resection. We did not perform hyperthermic intraperitoneal chemotherapy. The pathology was consistent with metastatic SCC . Since six weeks after IDS, the patient received two additional courses of paclitaxel, carboplatin, and bevacizumab (IV, 15 mg/m 2 ) and was given bevacizumab and olaparib (600 mg/day). Twelve months after IDS, no recurrence has been observed. Fig. 1 Computed tomography (CT) imaging before surgery. A Coronal CT image. A 10-cm-sized pelvic tumor with a solid part is detected (red arrow). Ascites extending to the upper abdomen is also detected (yellow allow). B Axial CT images. The tumor lacks turgidity and is suspected to have ruptured. Fatty components and calcifications are detected within the tumor. Fig. 1 Fig. 2 Histological and immunohistochemical findings. A Macroscopic findings of the primary tumor. The left ovarian tumor has a solid part (red arrow). B Representative images of H&E staining and p53 immunohistochemical staining are shown (200 × magnifications). Most of the tumor is nonkeratinizing squamous cell carcinoma (SCC) and partially low differentiated SCC. Scattered hair follicles are present (red arrow). p53 overexpression in the nonkeratinizing SCC part is confirmed. Fig. 2 Fig. 3 Computed tomography (CT) imaging and histological findings of residual tumors. C T images taken before and after chemotherapy. Red arrows show the change of target lesions (residual ovarian tumor, para-aortic lymoh nodes). B Macroscopic findings of the residual tumor. The yellow arrow indicates the ureter entrapped by the tumor. C, D Representative images of H&E staining of the residual tumor. Nonkeratinizing squamous cell carcinoma (SCC) is detected alongside the primary ovarian tumor ( C ). The chemotherapy-induced hyalinized stroma is widely observed ( D ). E Metastatic SCC is detected in a para-aortic lymph node. Fig. 3
4.058594
0.973145
sec[1]/p[0]
en
0.999995
37216734
https://doi.org/10.1016/j.ijscr.2023.108329
[ "tumor", "ovarian", "residual", "imaging", "nonkeratinizing", "blood", "cell", "resection", "chemotherapy", "arrow" ]
[ { "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": "GA1Z&XA1QK0", "title": "Noninflammatory disorders of ovary" }, { "code": "GA07.Z&XA1QK0", "title": "Inflammation of ovary" }, { "code": "GA30.6", "title": "Premature ovarian failure" }, { "code": "JA01.2", "title": "Ovarian pregnancy" }, { "code": "QF01.10", "title": "Acquired absence of female genital organs" } ]
=== 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 [GA30.6] Premature ovarian failure Definition: Menopause occurring spontaneously before 40 years of age, generally resulting in secondary amenorrhea although some women may exhibit intermittent ovarian function and ovulation, with a minority conceiving and delivering a pregnancy. POF/POI occurs mostly without a known cause, but can be caused by the following conditions: numerical and structural chromosomal abnormalities, Fragile X (FMR1) premutations, autoimmune disorders, radiation therapy, chemotherapy, galactosemia, and other rare enzyme Also known as: Premature ovarian failure | female hypergonadotropic hypogonadism | hypergonadotrophic ovarian failure | primary female hypogonadism | POF - [premature ovarian failure] Excludes: Isolated gonadotropin deficiency | Postprocedural ovarian failure [JA01.2] Ovarian pregnancy Definition: A condition characterised by implantation of the embryo within the ovary during pregnancy. Also known as: Ovarian pregnancy [QF01.10] Acquired absence of female genital organs Also known as: Acquired absence of female genital organs | Acquired absence of cervix | amputation of cervix | Acquired absence of the uterus | acquired uterine absence === 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... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --CHILD--> [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... --- 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.... --CHILD--> [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... --- 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 --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 --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [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...", "[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 --CHILD--> [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...", "[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
On first encounter with the patient in 2007, he reported symptoms of arthritis with varying intensity since 1992. However, till 2003 he did not receive any specific therapy for his symptoms. In 2003 he was diagnosed with RF positive, anti-CCP antibody negative rheumatoid arthritis (RA), which was initially treated with methotrexate (MTX) and prednisolone. However, therapy with MTX was discontinued after a few weeks due to unspecific malaise. In early 2007, the patient was referred to our Department with an acute flare of RA . The acute symptoms were successfully treated with prednisolone. Additional disease modifying anti-rheumatic drug (DMARD) therapy with leflunomide was initiated, which was well tolerated by the patient, except for mild edema of his lower legs. About half a year later, the patient presented again with highly elevated humoral inflammatory parameters and pain on exertion in both hips, knees and ankles with swelling of the latter two as well as several MCP joints. At this time, there were no fever or night sweats, and the patient had gained 10 kg of body weight after his last admission. Again, prednisolone treatment was started (max. 20 mg/d) leading to rapid improvement. In addition, low dose subcutaneous MTX therapy was added to leflunomide. On routine check-up after 6 month, the patient had no joint pain or swelling and no signs of synovitis by ultrasonography. However, humoral inflammatory activity was still high , and the patient described his general condition as "deteriorating" with fever, night sweats and loss of body weight. He additionally complained about paresthesia and pain on pressure in both feet and lower legs. Despite comprehensive diagnostic evaluation including echocardiography, sonography of joints, soft tissue and abdomen, computed-tomography of the thorax, repeated blood cultures, bone marrow aspiration and urine testing, we were not able to identify any infectious or malignant cause for the patients deterioration. Also, values for ANA, ANCA, anti-ds-DNA, complement factors C3 and C4, anti-CCP, and anti-MCV were within the normal range or not detectable, respectively. RF was positive, but has been positive since the diagnosis of RA in 2003. Due to extremely pressure sensitive skin of the lower limbs skin-biopsies were obtained, which revealed an unspecific chronic fibrosing inflammation. Furthermore, a positron emission tomography with fluorodeoxyglucose (FDG-PET) was performed, which demonstrated focal areas of increased glucose uptake on the lower limbs but did not show a typical vasculitis pattern. On a repeated thorough clinical examination, new small (< 5 mm) subcutaneous nodules could be palpated mainly at the inner side of the thighs. However, those lesions could not be detected by ultrasonography. Thus, no biopsy was taken at that time. Treatment with MTX was stopped and replaced by sulfasalazine . Following treatment with high dose prednisolone, the patient's condition improved significantly and CRP levels decreased rapidly . However, one month later the patient presented in deteriorated condition with high inflammatory parameters . He presented with high fever (up to 40°C), lasting for several days, night sweats and increasing painful nodular lesions (3 - 4 cm) at the inner side of the thighs that led to a complete immobilisation of the patient due to pain. On first sight, the lesions appeared as an erythema nodosum, only with less apparent skin discoloration. With regard to the joints, the patient had no complaints and physical examination revealed no signs of synovitis. One of the painful nodules was removed for histological analysis. An MRI-scan of the lower limbs revealed signs of acute fasciitis. After exclusion of any infectious or malignant cause, the patient was again treated with high dose prednisolone (80 mg/d, i.v.). The histology of the nodule revealed a lobular panniculitis, with a mixed cell infiltrate dominated by neutrophils . Together with the clinical findings with a strong systemic inflammatory response without any indication of a flare of the rheumatoid arthritis or underlying infectious or malignant cause, we established the diagnosis of a Pfeifer-Weber-Christian disease (PWCD). Leflunomide and sulfasalazine were therefore replaced by cyclosporine A. The patient responded well to this treatment and temperature as well as inflammatory markers returned back to normal levels rapidly . The patient could be discharged from the hospital. On a routine check-up in the following month the patient presented in very good general condition with no more signs of inflammation. The nodules were still present but clearly reduced in size, and the patient only reported minor pain on pressure.
4.027344
0.976563
sec[1]/p[1]
en
0.999995
20105325
https://doi.org/10.1186/1471-2474-11-18
[ "however", "anti", "prednisolone", "inflammatory", "pain", "which", "well", "arthritis", "treated", "leflunomide" ]
[ { "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": "FA2Z", "title": "Inflammatory arthropathies, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "8C1Z", "title": "Mononeuropathy of unspecified site" }, { "code": "BD90.Z", "title": "Lymphadenitis, unspecified" }, { "code": "FB55.Z", "title": "Enthesopathies, unspecified" } ]
=== ICD-11 CODES FOUND === [JA86.Y] Maternal care for other specified fetal problems Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS [MB23.1] Antisocial behaviour Definition: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated. Also known as: Antisocial behaviour | Child or adolescent antisocial behaviour [3B4Z] Coagulation defects, unspecified Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality [4A45.Z] Antiphospholipid syndrome, unspecified Also known as: Antiphospholipid syndrome, unspecified | Antiphospholipid syndrome | Hughes syndrome | Anticardiolipin syndrome [4A43.Y] Other specified overlap non-organ specific systemic autoimmune disease Also known as: Other specified overlap non-organ specific systemic autoimmune disease | Antisynthetase syndrome | Reynolds syndrome | Syndromic multisystem autoimmune disease due to ITCH deficiency | Eosinophilia myalgia syndrome [FA2Z] Inflammatory arthropathies, unspecified Also known as: Inflammatory arthropathies, unspecified | polyarthritis NOS | inflammatory joint disease NOS | nonpyogenic arthritis NOS | arthritic nodosa [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [8C1Z] Mononeuropathy of unspecified site Also known as: Mononeuropathy of unspecified site | inflammation of nerve NOS | nerve condition NOS | neuritis NOS | nerve disease NOS [BD90.Z] Lymphadenitis, unspecified Also known as: Lymphadenitis, unspecified | Lymphadenitis | adenitis NOS | inflammation of gland | lymphatic gland inflammation [FB55.Z] Enthesopathies, unspecified Also known as: Enthesopathies, unspecified | Certain specified enthesopathies | Enthesopathy of elbow | enthesopathy of elbow region | Adhesive capsulitis not elsewhere classified === GRAPH WALKS === --- Walk 1 --- [JA86.Y] Maternal care for other specified fetal problems --PARENT--> [JA86] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --EXCLUDES--> [?] Labour or delivery complicated by fetal distress --- Walk 2 --- [JA86.Y] Maternal care for other specified fetal problems --PARENT--> [JA86] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --PARENT--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del... --- 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 --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 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--> [3B4Z] Coagulation defects, unspecified --- 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 --EXCLUDES--> [?] Labour or delivery complicated by fetal distress", "[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --PARENT--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems\n Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del...", "[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...", "[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--> [3B4Z] Coagulation defects, unspecified", "[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": "FA2Z", "icd10_code": "M1389", "icd10_title": "Other specified arthritis, multiple sites" } ]
O26841
A 51-years-old female patient was admitted to the department of neurology of our hospital because of progressive numbness in extremities with tingling and weakness for 4 years in April 2021. Her past medical history included a traumatic lumbar fracture in 2019. The neurological physical examination showed slightly decreased muscle strength of the lower extremities, hypoalgesia of the lower extremities, positive pussep sign in the right lower limb, and negative pathological reflexes such as the Babinski reflex. The physical examination showed no hepatosplenomegaly, no superficial lymph node swelling, and no bone pain. The electromyography showed bilateral upper and lower limb neurogenic damage (involving motor fibers, nerve roots, and myelin sheath). The ultrasound revealed pericardial effusion. The laboratory data showed anemia [89 g/L (normal: 115–150 g/L)], a high serum creatinine level [236 umol/L, (normal: 45–84 umol/L)] with proteinuria, high serum globulin [62.5 g/L, (normal: 20–35 g/L)], abnormal erythrocyte sedimentation rate [108 mm/H (normal: 0–20 mm/H)]. The overall autoimmune workup revealed several positive autoantibodies such as antinuclear antibodies, anti-SS-A antibodies, anti-SS-B antibodies, and anti-Ro52 antibodies. The level of prolactin [51.76 ng/mL (normal: 2.74–19.64 ng/mL)] increased significantly. Cerebrospinal fluid tests were normal. Monoclonal gamma globulin identification showed IgA-κ M protein. Among them, the quantitative results from serum protein electrophoresis showed the absolute value of serum M protein was 9.8g/L (normal: 0 g/L). The quantitative results from serum immunofixation electrophoresis showed abnormal levels of IgA [19.10 g/L, (normal: 0.82–4.53 g/L)], IgG [30.9 g/L, (normal: 7.51–15.6 g/L)], IgM [2.3 g/L, (normal: 0.46–3.04g/L)], serum free light chain κ [161.3 mg/L, (normal: 3.30–19.40 mg/L)], serum free light chain λ[155.3 mg/L, (normal: 5.71–26.30 mg/L)], κ/λ[1.039, (normal: 0.26–1.65)] . The level of beta-2 microglobulin [6.76 mg/L (normal: 0.8–2.2 mg/L)] increased significantly. The magnetic resonance imaging of the central nervous system was normal. According to the diagnostic criteria proposed by Dispenzieri in 2003, patients who met 2 major criteria and at least 1 minor criterion could be diagnosed with POEMS syndrome. The patient was transferred to the department of hematology because of a diagnosis of POEMS syndrome. The serum vascular endothelial growth factor (VEGF) was detected, and the level of VEGF was normal. Then bone marrow tests were carried out. Bone marrow biopsy revealed 10% monoclonal plasma cells . The flow cytometric analysis of bone marrow revealed plasma cells with phenotypic abnormalities (CD38+, CD138+, CD229+, ckappa+, BCMA+, clambda-, CD45-, CD19-, CD56-, CD20-, CD13-, FMC33-, CD117-, HLA-DR-) . The patient was diagnosed with multiple myeloma (R-ISS stage III) like POEMS syndrome. To accurately assess the disease, the patient had a PET-CT test. PET-CT showed a hypermetabolic mass in the anterior mediastinum (SUVmax6.1) . We referred the patient to thoracic surgery to further clarify the mediastinal mass. She underwent a mediastinal mass biopsy under video-assisted thoracoscopy. The pathological diagnosis was MALT lymphoma with light chain-restricted plasmacytic differentiation , the immunophenotype of lymphoma cells: CD20 (+, positive control +), CD19 (+), CD22 (+), CD79a (+), PAX-5 (+), PAX8 (+), BCL2 (+), MNDA (+), CD21 and CD35 (a little +, FDC networks +), CD3 (-), CD5 (-), CD43 (-), CD10 (-), BCL6 (-), IgD (-), CD1a (-), TDT (-), CD117 (-, positive control+), P53 (partial+, wild-type), Ki-67 LI (about 5%); the immunophenotype of plasma cells: MUM1 (+), κ (+), λ (a little +, monoclonal); EBER CISH(-, positive control +); IgM (-). No mutation of exon 5 of MYD88 was detected. The patient was eventually diagnosed with MALT lymphoma and MM like POEMS syndrome. In May 2021, the patient received 1 course of combination therapy (rituximab 375 mg/m 2 , day 1; bortezomib 1.3 mg/m 2 , day 1, 4, 8, 11; dexamethasone 20 mg, day 1, 2, 4, 5, 8, 9, 11, 12). The peripheral neuritis was significantly improved. Bone marrow biopsy and flow cytometric analysis showed no monoclonal plasma cells. The results from serum protein electrophoresis showed the absolute value of serum M protein was 1.5 g/L. The patient completed additional 4 courses of combination therapy (rituximab; bortezomib; dexamethasone). PET-CT showed there was no hypermetabolic tumor in the anterior mediastinum. Bone marrow biopsy and flow cytometric analysis showed negative minimal residual disease of monoclonal plasma cells. The patient continued to receive lenalidomide maintenance (25 mg day 1–21,28 days/a cycle).
4.15625
0.956055
sec[1]/p[0]
en
0.999997
PMC9875955
https://doi.org/10.1097/MD.0000000000032801
[ "serum", "bone", "cells", "monoclonal", "protein", "marrow", "plasma", "antibodies", "poems", "biopsy" ]
[ { "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" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" } ]
=== ICD-11 CODES FOUND === [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 [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias === GRAPH WALKS === --- Walk 1 --- [NE80.3] Other serum reactions --RELATED_TO--> [?] Anaphylactic shock due to serum --PARENT--> [?] Anaphylaxis Def: Anaphylaxis is a severe, life-threatening systemic hypersensitivity reaction characterised by being rapid in onset with potentially life-threatening airway, breathing, or circulatory problems and is u... --- Walk 2 --- [NE80.3] Other serum reactions --RELATED_TO--> [?] Serum sickness vasculitis Def: An acute vasculitic illness typified by fever, arthralgia and urticarial vasculitis resulting from an immune complex-mediated (type III) immune reaction to foreign protein. Historically this was large... --PARENT--> [?] Vasculitis associated with probable aetiology Def: Vasculitis that is associated with a probable specific etiology. The name (diagnosis) should have a prefix term specifying the association (e.g. hydralazine-associated microscopic polyangiitis, hepati... --- Walk 3 --- [5D0Y] Other specified metabolic disorders --PARENT--> [?] Other metabolic disorders --CHILD--> [5D0Y] Other specified metabolic disorders --- Walk 4 --- [5D0Y] Other specified metabolic disorders --PARENT--> [?] Other metabolic disorders --CHILD--> [5D00] Amyloidosis Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini... --- Walk 5 --- [5B91.0] Hypercalcaemia Def: 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 ... --RELATED_TO--> [?] Myopathy due to hypercalcaemia --PARENT--> [?] Hypercalcaemia Def: 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 ... --- Walk 6 --- [5B91.0] Hypercalcaemia Def: 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 ... --PARENT--> [5B91] Mineral excesses --CHILD--> [5B91.1] Zinc excess Def: Adverse effects associated with chronic intake of supplemental zinc include suppression of immune response, decrease in high-density lipoprotein (HDL) cholesterol and reduced copper status. Acute adve...
[ "[NE80.3] Other serum reactions\n --RELATED_TO--> [?] Anaphylactic shock due to serum\n --PARENT--> [?] Anaphylaxis\n Def: Anaphylaxis is a severe, life-threatening systemic hypersensitivity reaction characterised by being rapid in onset with potentially life-threatening airway, breathing, or circulatory problems and is u...", "[NE80.3] Other serum reactions\n --RELATED_TO--> [?] Serum sickness vasculitis\n Def: An acute vasculitic illness typified by fever, arthralgia and urticarial vasculitis resulting from an immune complex-mediated (type III) immune reaction to foreign protein. Historically this was large...\n --PARENT--> [?] Vasculitis associated with probable aetiology\n Def: Vasculitis that is associated with a probable specific etiology. The name (diagnosis) should have a prefix term specifying the association (e.g. hydralazine-associated microscopic polyangiitis, hepati...", "[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --CHILD--> [5D0Y] Other specified metabolic disorders", "[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --CHILD--> [5D00] Amyloidosis\n Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...", "[5B91.0] Hypercalcaemia\n Def: 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 ...\n --RELATED_TO--> [?] Myopathy due to hypercalcaemia\n --PARENT--> [?] Hypercalcaemia\n Def: 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 ...", "[5B91.0] Hypercalcaemia\n Def: 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 ...\n --PARENT--> [5B91] Mineral excesses\n --CHILD--> [5B91.1] Zinc excess\n Def: Adverse effects associated with chronic intake of supplemental zinc include suppression of immune response, decrease in high-density lipoprotein (HDL) cholesterol and reduced copper status. Acute adve..." ]
NE80.3
Other serum reactions
[ { "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" }, { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" } ]
T880XXA
Infection following immunization, initial encounter
A 68 year old male smoking for 30 pack-year was admitted to the hospital on December 5, 2018 due to "left lung shadow was found for 4 months, and cough with left subcostal pain for 2 months". After admission, chest enhanced CT showed that there was a leaf like solid density increase shadow in the lower left lung with obvious enhancement, and the left lower lobe bronchus was partially occluded . Tracheoscopy showed that there were nodular processes at the opening of the basal segment of the left lower lobe, with smooth surface and complete mucosa . Local bleeding was seen on the surface of the node at the opening of the basal segment of the left lower lobe touched by the biopsy forceps, with the amount of 100 ml. After immediate intratracheal injection of hemocoagulase 2 IU, adrenaline 1 IU and intravenous drip of pituitrin 6 IU, the bleeding gradually decreased. The next day, only a small amount of dark red blood filaments were found in the sputum. The bronchial artery CTA showed that the anterior wall of the thoracic aorta sent out the left and right bronchial arteries from the level of the 5th and 6th thoracic vertebrae respectively. The branches of the left bronchial artery were tortuous and dilated . However, two days later, the patient coughed violently at night and had massive hemoptysis. The total amount of hemoptysis was about 500 ml within half an hour. After hemostasis with hemocoagulase 2 IU and pituitrin 12 IU, the amount of hemoptysis gradually decreased. After consultation with the thoracic surgeon, it was decided that because of the large amount of bleeding and the clear cause of the disease, the possibility of massive bleeding again after medical treatment was large, the emergency left lower lobe resection was performed immediately. The operation chosen to enter the chest cavity through the posterolateral incision of the left chest. Extensive adhesion was found in the chest cavity, which was carefully separated by ultrasonic knife The exploration found that the left lower lobe of the lung was consolidated and could not be re-expanded. The left lower pulmonary vein was thin. There were tortuous and thickened arterial vessels on the surface of the left main bronchus and the lower lobe bronchus. The abnormal vessels originated from the aortic arch , and were cut off at the root of the vessels with linear cut stapler. First, cut off the lower lobe pulmonary vein with linear cut stapler, fully expose the lower lobe bronchus, and cut off with linear cut stapler. Continue to dissociate the lower lobe pulmonary artery and cut it with linear cut stapler. Cut along the gap between the upper and lower lobes with linear cut stapler, and remove the surgical specimen. The procedure went smoothly, approximately 400 ml of blood was lost, and no transfusion was given. The operation lasted three and a half hours. The patient was discharged after 1 week in hospital. Postoperative pathology: alveolar atrophy in the "lower lobe of left lung", bronchiole dilatation and bleeding, muscular vascular wall uneven thickness, congestion, interstitial fibrous tissue hyperplasia, chronic inflammatory cell infiltration; One lymph node in "Group 5", seven lymph nodes under "carina" showed reactive hyperplasia, and "bronchial artery in mediastinum" showed thick walled vessels with uneven wall thickness. No new acute hemoptysis was observed after discharge, and the patient was still being followed up at the time of writing this report. Fig. 1 Chest computed tomography plain scan: left lower lobe bronchus partially occluded, left lower lobe consolidation Fig. 2 Bronchoscopy showed no pulsatile, smooth nodular on the surface of the basal segment of the left lower lobe. The mucosa was intact with mild congestion. Local hemorrhage was seen on the surface of the nodule by biopsy forceps. As shown in the figure, the abnormal blood vessel have been marked with arrows Fig. 3, 4 Computed tomography angiophy of bronchial artery (coronary plane): tortuous and dilated branches of left bronchial artery Fig. 5 Computed tomography angiophy of bronchial artery (sagittal plane): tortuous and dilated branches of left bronchial artery Fig.6, 7 Computed tomography angiophy of bronchial artery (cross section): the left bronchial artery branches are tortuous and dilated, the volume of the left lower lobe of the lung shrinks, and the lung tissue consolidation shows soft tissue density shadow Fig. 8, 9 Computed tomography angiophy of bronchial artery (iterarive reconstruction): tortuous and dilated branches of left bronchial artery Fig. 10 Surgical specimen: black arrow indicates abnormal twisted and thickened esophageal nutrient vessels and bronchial arteries from the descending aorta
3.912109
0.980469
sec[1]/p[0]
en
0.999995
37370170
https://doi.org/10.1186/s13019-023-02279-1
[ "lobe", "bronchial", "artery", "lung", "tortuous", "chest", "that", "bronchus", "surface", "bleeding" ]
[ { "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" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA74.Y", "title": "Other specified structural developmental anomalies of bronchi" }, { "code": "LA74.Z", "title": "Structural developmental anomalies of bronchi, unspecified" }, { "code": "CA44", "title": "Pyothorax" }, { "code": "NB32.41", "title": "Minor laceration of bronchus" } ]
=== ICD-11 CODES FOUND === [CB40.2] Pulmonary collapse Also known as: Pulmonary collapse | Atelectasis | lung collapse | pulmonary atelectasis | pulmonary collapse with atelectasis Includes: Atelectasis Excludes: Primary atelectasis of newborn | tuberculous atelectasis, not confirmed | tuberculous atelectasis, confirmed [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 [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 [LA74.Y] Other specified structural developmental anomalies of bronchi Also known as: Other specified structural developmental anomalies of bronchi | Congenital absence of bronchus | Agenesis of bronchus | Absence of bronchus | Congenital bronchogenic cysts [LA74.Z] Structural developmental anomalies of bronchi, unspecified Also known as: Structural developmental anomalies of bronchi, unspecified | Structural developmental anomalies of bronchi | Malformations of bronchi | malformation of bronchus NOS | bronchi deformity [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 [NB32.41] Minor laceration of bronchus Also known as: Minor laceration of bronchus | laceration of bronchus less than 1 cm | laceration of bronchus NOS Includes: laceration of bronchus less than 1 cm | laceration of bronchus NOS === GRAPH WALKS === --- Walk 1 --- [CB40.2] Pulmonary collapse --EXCLUDES--> [?] Respiratory tuberculosis, confirmed Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough,... --CHILD--> [?] Tuberculosis of lung, confirmed by culture only Def: This is a common, and in many cases lethal, infectious disease of the lung caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is confirmed by culture only.... --- Walk 2 --- [CB40.2] Pulmonary collapse --EXCLUDES--> [?] Respiratory tuberculosis, confirmed Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough,... --CHILD--> [?] Tuberculosis of lung, confirmed histologically Def: This is a common, and in many cases lethal, infectious disease of the lung caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is confirmed histologically.... --- Walk 3 --- [LA75.0] Accessory lobe of lung Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left... --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 --- [LA75.0] Accessory lobe of lung Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left... --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 5 --- [MD41] Clinical findings on diagnostic imaging of lung Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us... --PARENT--> [?] Clinical findings in the respiratory system --CHILD--> [MD40] Clinical findings in specimens from respiratory organs and thorax --- Walk 6 --- [MD41] Clinical findings on diagnostic imaging of lung Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us... --PARENT--> [?] Clinical findings in the respiratory system --CHILD--> [MD41] Clinical findings on diagnostic imaging of lung Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...
[ "[CB40.2] Pulmonary collapse\n --EXCLUDES--> [?] Respiratory tuberculosis, confirmed\n Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough,...\n --CHILD--> [?] Tuberculosis of lung, confirmed by culture only\n Def: This is a common, and in many cases lethal, infectious disease of the lung caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is confirmed by culture only....", "[CB40.2] Pulmonary collapse\n --EXCLUDES--> [?] Respiratory tuberculosis, confirmed\n Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough,...\n --CHILD--> [?] Tuberculosis of lung, confirmed histologically\n Def: This is a common, and in many cases lethal, infectious disease of the lung caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is confirmed histologically....", "[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...\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", "[LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...\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....", "[MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...\n --PARENT--> [?] Clinical findings in the respiratory system\n --CHILD--> [MD40] Clinical findings in specimens from respiratory organs and thorax", "[MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...\n --PARENT--> [?] Clinical findings in the respiratory system\n --CHILD--> [MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us..." ]
CB40.2
Pulmonary collapse
[ { "from_icd11": "CB40.2", "icd10_code": "J9811", "icd10_title": "Atelectasis" }, { "from_icd11": "CB40.2", "icd10_code": "J9819", "icd10_title": "Other pulmonary collapse" }, { "from_icd11": "CB40.2", "icd10_code": "J981", "icd10_title": "Pulmonary collapse" }, { "from_icd11": "LA75.0", "icd10_code": "Q331", "icd10_title": "Accessory lobe of lung" }, { "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": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "JA8A.1", "icd10_code": "O43123", "icd10_title": "Velamentous insertion of umbilical cord, third trimester" }, { "from_icd11": "JA8A.1", "icd10_code": "O43193", "icd10_title": "Other malformation of placenta, third trimester" }, { "from_icd11": "JA8A.1", "icd10_code": "O43122", "icd10_title": "Velamentous insertion of umbilical cord, second trimester" }, { "from_icd11": "JA8A.1", "icd10_code": "O43113", "icd10_title": "Circumvallate placenta, third trimester" }, { "from_icd11": "JA8A.1", "icd10_code": "O43192", "icd10_title": "Other malformation of placenta, second trimester" }, { "from_icd11": "JA8A.1", "icd10_code": "O43103", "icd10_title": "Malformation of placenta, unspecified, third trimester" }, { "from_icd11": "JA8A.1", "icd10_code": "O43101", "icd10_title": "Malformation of placenta, unspecified, first trimester" }, { "from_icd11": "JA8A.1", "icd10_code": "O43102", "icd10_title": "Malformation of placenta, unspecified, second trimester" } ]
J9811
Atelectasis
A 76-year-old Caucasian man with a history of type 2 diabetes, chronic kidney disease (CKD) stage 3A, essential hypertension, hypothyroidism, antiphospholipid antibody syndrome, prior cerebellar strokes, and prostate cancer (Gleason 10) with widespread metastasis to the bone presented with non-oliguric severe AKI 3 weeks after receiving simultaneous therapy with denosumab (120 mg subcutaneous injection once) and abiraterone (1 g per day orally). The patient had failed prior antineoplastic therapy with leuprolide acetate, bicalutamide, and nilutamide. On admission, his serum creatinine (SCr) was elevated at 5.7 mg/dL from a baseline of 1.2 mg/dL . His active outpatient medications consisted of rosuvastatin (40 mg daily), benazepril, metoprolol tartrate, metformin, warfarin, low-dose prednisone (started concomitantly with abiraterone), and levothyroxine. The patient had been on statin therapy for more than 1 year and the dose had not been recently modified. The patient denied prior episodes of myopathies, rhabdomyolysis, or AKI. His physical exam was unremarkable. Further blood work showed hyperkalemia, mild metabolic acidosis, hypocalcemia, mild transaminemia (predominantly AST), and creatine kinase (CK) of 44,476 IU/L (Table 2 ). Urine studies revealed dipstick proteinuria (100 mg/dL), large dipstick blood, only a few normomorphic erythrocytes, and negative culture. All serologic work-up (ANA, PR3- and MPO-ANCA, anti-GBM antibodies, ENA panel, C3, C4, RF) and viral studies (HBV, HCV, CMV, EBV, Influenza A/B, Parainfluenza, Adenovirus, RSV) were negative or normal. Thyroid function tests were normal. Kidney sonogram and Doppler studies were negative for hydronephrosis and renal vein thrombosis, respectively. On admission, abiraterone therapy was discontinued and no further doses of denosumab were administered. Subsequently, the patient underwent kidney biopsy that was consistent with severe acute tubular injury with presence of myoglobin casts, confirming the diagnosis of rhabdomyolysis-induced AKI . The patient responded well to intravenous isotonic fluids and discontinuation of denosumab, abiraterone, and rosuvastatin. CK levels normalized by day 25 of hospitalization and the SCr at the time of hospital discharge was 3.1 mg/dL . After hospital discharge, the patient resumed all prior medications, including rosuvastatin, except for denosumab and abiraterone. His successive antineoplastic therapy consisted of enzalutamide. Kidney function returned to baseline 12 months after discharge and he had no recurrent episodes of rhabdomyolysis. Fig. 1 Time-related serum creatinine (SCr) and creatine kinase (CK) changes in relation to denosumab and abiraterone exposure (D −21), hospital admission (D1), and hospital discharge (D45). Gray arrow = denosumab 120 mg subcutaneous injection (single shot) and abiraterone started at 1 g orally per day. Black arrow = admission to the hospital, abiraterone stopped. Blue arrow = hospital discharge Table 2 Urinary and blood biochemical profiles at baseline, time of hospital admission, and at the time of peak creatine kinase (CK) Baseline (before admission) At the time of admission At the time of peak CK Blood studies Sodium, mmol/L 135[135–145] 137 134 (L) Potassium, mmol/L 4.6 [3.6–5.0] 6.2 (H) 3.7 Phosphorus, mg/dL 2.9 [2.4–4.5] 2.4 2.5 Calcium, mg/dL 10 [8.4–10.2] 8.6 (L) 5.7 (L) Ionized calcium, mg/dL -- [4.5–5.3] -- 3.4 (L) Bicarbonate, mmol/L 29 [22–31] 21 (L) 13 (L) Aspartate aminotransferase, U/L 29 [10–50] 354 (H) 1423 (H) Alanine aminotransferase, U/L 19 [10–50] 125 (H) 330 (H) Creatine kinase, IU/L -- [39–308] 44,476 (H) 105,120 (H) Lactate dehydrogenase, U/L -- [135–225] 943 (H) 1135 (H) Creatinine, mg/dL 1.2 [0.67–1.17] 5.7 (H) 5.2 (H) eGFR, mL/min/1.73 m 2a 59 10 (L) 11 (L) Urine studies pH -- [5.0–6.0] 6 6 Dipstick blood -- [negative] Large Large Dipstick protein, mg/dL -- [negative] 100 100 Specific gravity -- [1.008–1.030] 1.018 1.013 Red blood cells/HPF -- [0–3/HPF] 15 35 White blood cells/HPF -- [0–5/HPF] <1 5 Squamous epithelial cells/HPF -- [0–5/HPF] 10 <1 Leukocyte esterase -- [negative] Negative Negative [] = laboratory reference values; (H) = above laboratory reference value; (L) = below laboratory reference value; --= not measured; a eGFR = estimated glomerular filtration rate by MDRD study equation Fig. 2 Kidney biopsy light microscopy. a Hematoxylin & eosin (X200) showing dark pink, filamentous tubular casts (yellow arrow); b ) Jones’ silver stain (X400) showing dark pink, coarsely granular and filamentous tubular casts (yellow arrow) Fig. 3 Kidney biopsy light microscopy showing tubular casts staining positively for myoglobin by immunohistochemistry (anti-myoglobin) (yellow arrow), (X400)
4.003906
0.976563
sec[1]/p[0]
en
0.999997
26220655
https://doi.org/10.1186/s12882-015-0113-6
[ "abiraterone", "blood", "kidney", "denosumab", "time", "arrow", "baseline", "creatine", "kinase", "dipstick" ]
[ { "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": "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 === [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 [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 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ... --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --CHILD--> [?] Coagulation defects, purpura or other haemorrhagic or related conditions Def: A condition caused by determinants arising during the antenatal period, after birth or by genetically inherited factors, leading to coagulation defects. This condition is characterised by increased br... --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC... --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.1] Finding of cocaine in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.0] Finding of opiate drug in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Coagulation defects, purpura or other haemorrhagic or related conditions\n Def: A condition caused by determinants arising during the antenatal period, after birth or by genetically inherited factors, leading to coagulation defects. This condition is characterised by increased br...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] 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
normal liver and renal function, normal electrolytes, negative hepatitis serology, normal autoimmune liver antibodies and negative for 9 tumor markers (male). ECG showed normal electrocardiographic changes. Ultrasonography showed splenomegaly. Enhanced CT of the whole abdomen showed varices of the lower oesophagogastric fundus; multiple intra-abdominal lymph nodes were calcified, with the larger lymph nodes located in the hepatic hilar region and compressing the main portal vein; and the spleen was enlarged . No significant abnormalities were found on cranial and chest CT. Medication was given on admission to stop the bleeding, but there was no improvement. The morning of the next day, there was recurrent vomiting of blood, heavy bleeding and a significant drop in hemoglobin. Digital subtraction angiography (DSA) was then given and intraoperative arteriography showed no significant abnormalities; venography showed severe stenosis of the junction of left and right branches of the portal vein, with a stenosis of approximately 80%. A small amount of portal blood entered the liver through the stenotic portion and most of it flowed backwards into the splenic vein. Multiple side branches of the splenic and superior mesenteric veins formed and flowed into the gastro-Esophagus fundic plexus, and contrast spillage was seen in the fundic plexus . Then, an appropriate amount of tissue glue and embolization coil was injected into the above-mentioned side branches for embolization, and portal vein stenting was performed at the portal vein stenosis . The portal vein pressure below the stenotic segment was measured with a glass manometer at 34 cm H2O prior to embolisation. A combined whole abdomen enhanced CT and DSA angiogram showed lymph node calcification in the hepatic hilar region compressing the portal trunk, the same location as the DSA angiogram showed for the portal stenosis, so portal stenosis and portal hypertension were considered to be due to lymph node calcification compression. The night of the next day, the patient continued to vomit blood postoperatively. Emergency gastroscopy showed varices in the lower esophagus with multiple red signs; active bleeding was seen and was treated with local sclerotherapy with polidocanol under gastroscopy. However, there was still active hemorrhage after treatment, so laparoscopic splenectomy with perisoph-agogastric devascularization was performed in the early morning of the third day. Intraoperatively, there were multiple caseous nodules in the greater omentum and abdominal wall, and approximately 3 × 5 cm caseous nodules in the left abdominal wall. The greater omentum was clearly adherent to the abdominal wall and the liver and spleen, and the gastrointestinal tract was clearly dilated with dark red bloody material. There were no obvious cirrhotic changes in the liver, the spleen was markedly enlarged and the lower esophagus and perigastric fundus veins were markedly stagnant and dilated. The spleen and the caseous nodule in the left upper abdomen were excised and sent for pathological examination.Intraoperative diagnosis: EVB, hemorrhagic shock, abdominal tuberculosis and portal vein stenosis. Postoperative pathological examination of the spleen was consistent with chronic hematopoietic splenomegaly; the caseous mass of the abdominal wall showed a cystic wall-like structure microscopically, a large amount of necrotic material within the cyst, and vascular proliferation within the cystic wall with lymphocytic histiocytic infiltration . Because of the intraoperative diagnosis of abdominal tuberculosis, postoperative culture of sputum acid-fast bacilli, ascites antacid cultures and tuberculosis DNA (sputum) tests were negative and combined with pathological examination suggested that calcification of the abdominal lymph nodes was not related to tuberculosis. Postoperatively, the patient's vital signs were stable, no significant drop in hemoglobin, no bleeding symptoms, bleeding stopped and he was discharged with symptomatic supportive treatment. Follow-up after discharge was good, with no complaints of bleeding . Fig. 1 CT axial and coronal views: A and B Esophagogastric fundic varices with multiple lymph node calcifications in the abdominal cavity compressing the portal vein causing portal stenosis Fig. 2 DSA shows severe stenosis of the right and left branches of the portal vein, consistent with the CT showing the site of compression of the lesion Fig. 3 After portal vein stenting and PTVE embolization treatment Fig. 4 Caseous like mass in the abdominal wall with pathological findings (HE, × 400) and no tuberculosis component microscopically Fig. 5 Time node flow chart of treatment measures implementation
4.003906
0.975098
sec[1]/p[2]
en
0.999996
PMC9107723
https://doi.org/10.1186/s12876-022-02322-w
[ "portal", "abdominal", "vein", "stenosis", "wall", "lymph", "bleeding", "liver", "multiple", "spleen" ]
[ { "code": "DB98.3", "title": "Portal vein thrombosis" }, { "code": "DB98.7Z", "title": "Portal hypertension, unspecified" }, { "code": "NB90.4Y&XA1E17", "title": "Portal venous laceration" }, { "code": "LA90.21", "title": "Congenital portosystemic shunt" }, { "code": "DB98.7Y", "title": "Other specified portal hypertension" }, { "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 === [DB98.3] Portal vein thrombosis Definition: Portal vein thrombosis is a condition where the portal vein and/or its branches are obstructed, mainly by a blood clot or malignant tumour invasion. Also known as: Portal vein thrombosis | Phlebitis of portal vein | deep vein thrombosis of portal vein | portal thrombosis | PVT - [portal vein thrombosis] Includes: Phlebitis of portal vein [DB98.7Z] Portal hypertension, unspecified Also known as: Portal hypertension, unspecified | Portal hypertension | PHT - [portal hypertension] | Portal HTN [LA90.21] Congenital portosystemic shunt Also known as: Congenital portosystemic shunt | anomalous pulmonary venous drainage to hepatic veins | anomaly of portal vein connection | portal vein deformity | portal vein anomaly [DB98.7Y] Other specified portal hypertension Also known as: Other specified portal hypertension | Banti syndrome | Banti spleen | fibrocongestive splenomegaly | congestive splenomegaly [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 --- [DB98.3] Portal vein thrombosis Def: Portal vein thrombosis is a condition where the portal vein and/or its branches are obstructed, mainly by a blood clot or malignant tumour invasion.... --PARENT--> [DB98] Vascular disorders of the liver Def: Vascular disorders of the liver are conditions where the hepatic blood flow is deranged due to damage, malformation and obstruction of hepatic artery, portal vein and hepatic vein.... --RELATED_TO--> [?] Inborn malformations of the vascular system of the liver Def: Inborn malformations include porto-systemic shunts and arterio-portal shunts.... --- Walk 2 --- [DB98.3] Portal vein thrombosis Def: Portal vein thrombosis is a condition where the portal vein and/or its branches are obstructed, mainly by a blood clot or malignant tumour invasion.... --PARENT--> [DB98] Vascular disorders of the liver Def: Vascular disorders of the liver are conditions where the hepatic blood flow is deranged due to damage, malformation and obstruction of hepatic artery, portal vein and hepatic vein.... --RELATED_TO--> [?] Hereditary haemorrhagic telangiectasia Def: Rendu-Osler-Weber disease, also called hereditary haemorrhagic telangiectasia (HHT), is a genetic disorder of angiogenesis leading to arteriovenous dilatations: cutaneo-mucosal haemorrhagic telangiect... --- Walk 3 --- [DB98.7Z] Portal hypertension, unspecified --PARENT--> [DB98.7] Portal hypertension Def: Portal hypertension is abnormal increase of portal vein pressure, which induces development of collateral vessels of portal vein including oesophageal and cardiac varices. It also contributes to devel... --CHILD--> [DB98.70] Idiopathic portal hypertension --- Walk 4 --- [DB98.7Z] Portal hypertension, unspecified --PARENT--> [DB98.7] Portal hypertension Def: Portal hypertension is abnormal increase of portal vein pressure, which induces development of collateral vessels of portal vein including oesophageal and cardiac varices. It also contributes to devel... --CHILD--> [DB98.70] Idiopathic portal hypertension --- Walk 5 --- [LA90.21] Congenital portosystemic shunt --PARENT--> [LA90.2] Peripheral venous malformations --RELATED_TO--> [?] Blue rubber bleb naevus syndrome Def: Blue rubber bleb nevus (BRBNS) is a rare vascular malformation disorder with cutaneous and visceral lesions frequently associated with serious, potentially fatal bleeding and anaemia. Multifocal venou... --- Walk 6 --- [LA90.21] Congenital portosystemic shunt --PARENT--> [LA90.2] Peripheral venous malformations --RELATED_TO--> [?] Blue rubber bleb naevus syndrome Def: Blue rubber bleb nevus (BRBNS) is a rare vascular malformation disorder with cutaneous and visceral lesions frequently associated with serious, potentially fatal bleeding and anaemia. Multifocal venou...
[ "[DB98.3] Portal vein thrombosis\n Def: Portal vein thrombosis is a condition where the portal vein and/or its branches are obstructed, mainly by a blood clot or malignant tumour invasion....\n --PARENT--> [DB98] Vascular disorders of the liver\n Def: Vascular disorders of the liver are conditions where the hepatic blood flow is deranged due to damage, malformation and obstruction of hepatic artery, portal vein and hepatic vein....\n --RELATED_TO--> [?] Inborn malformations of the vascular system of the liver\n Def: Inborn malformations include porto-systemic shunts and arterio-portal shunts....", "[DB98.3] Portal vein thrombosis\n Def: Portal vein thrombosis is a condition where the portal vein and/or its branches are obstructed, mainly by a blood clot or malignant tumour invasion....\n --PARENT--> [DB98] Vascular disorders of the liver\n Def: Vascular disorders of the liver are conditions where the hepatic blood flow is deranged due to damage, malformation and obstruction of hepatic artery, portal vein and hepatic vein....\n --RELATED_TO--> [?] Hereditary haemorrhagic telangiectasia\n Def: Rendu-Osler-Weber disease, also called hereditary haemorrhagic telangiectasia (HHT), is a genetic disorder of angiogenesis leading to arteriovenous dilatations: cutaneo-mucosal haemorrhagic telangiect...", "[DB98.7Z] Portal hypertension, unspecified\n --PARENT--> [DB98.7] Portal hypertension\n Def: Portal hypertension is abnormal increase of portal vein pressure, which induces development of collateral vessels of portal vein including oesophageal and cardiac varices. It also contributes to devel...\n --CHILD--> [DB98.70] Idiopathic portal hypertension", "[DB98.7Z] Portal hypertension, unspecified\n --PARENT--> [DB98.7] Portal hypertension\n Def: Portal hypertension is abnormal increase of portal vein pressure, which induces development of collateral vessels of portal vein including oesophageal and cardiac varices. It also contributes to devel...\n --CHILD--> [DB98.70] Idiopathic portal hypertension", "[LA90.21] Congenital portosystemic shunt\n --PARENT--> [LA90.2] Peripheral venous malformations\n --RELATED_TO--> [?] Blue rubber bleb naevus syndrome\n Def: Blue rubber bleb nevus (BRBNS) is a rare vascular malformation disorder with cutaneous and visceral lesions frequently associated with serious, potentially fatal bleeding and anaemia. Multifocal venou...", "[LA90.21] Congenital portosystemic shunt\n --PARENT--> [LA90.2] Peripheral venous malformations\n --RELATED_TO--> [?] Blue rubber bleb naevus syndrome\n Def: Blue rubber bleb nevus (BRBNS) is a rare vascular malformation disorder with cutaneous and visceral lesions frequently associated with serious, potentially fatal bleeding and anaemia. Multifocal venou..." ]
DB98.3
Portal vein thrombosis
[ { "from_icd11": "DB98.3", "icd10_code": "I81", "icd10_title": "Portal vein thrombosis" }, { "from_icd11": "DB98.7Z", "icd10_code": "K766", "icd10_title": "Portal hypertension" }, { "from_icd11": "LA90.21", "icd10_code": "Q265", "icd10_title": "Anomalous portal venous connection" }, { "from_icd11": "MD81.3", "icd10_code": "R100", "icd10_title": "Acute abdomen" }, { "from_icd11": "JA01.0", "icd10_code": "O0000", "icd10_title": "Abdominal pregnancy without intrauterine pregnancy" }, { "from_icd11": "JA01.0", "icd10_code": "O000", "icd10_title": "Abdominal pregnancy" }, { "from_icd11": "ME04.Z", "icd10_code": "R180", "icd10_title": "Malignant ascites" }, { "from_icd11": "ME04.Z", "icd10_code": "R18", "icd10_title": "Ascites" } ]
I81
Portal vein thrombosis
A 61-year-old man underwent resection of a part of his tongue due to tongue cancer and was admitted to our hospital for hepatocellular carcinoma with about 5 cm diameter of tumor at the liver segment IV. Computed tomography (CT) showed that the tumor was enhanced during the arterial phase and washed out during the portal phase, and the tumor pressed the right anterior branch to the main branch of Glisson and the middle hepatic vein; hence, the diagnosis of hepatocellular carcinoma was made . The indocyanine green retention rate at 15 min was 21.8%. Child-Pugh score was A. The patient tested negative for hepatitis B surface antigen and hepatitis C virus antibody. He had a history of excessive consumption of alcohol, and alcoholic liver damage was considered as a possibility. Partial hepatectomy with segments IV + V and cholecystectomy with cystic duct-tube drainage were performed. Intraoperative findings indicated that the anterior branch of bile duct was exposed at the resected area, and some small bile ducts were ligated. On POD 1 following hepatectomy, bile leakage developed from the drain placed in the foramen of Winslow. CT showed fluid collection in the cavity between the liver and fistula to drain. Cholangiography via the endoscopic bile duct enhancement showed no communication between the common bile duct and abdominal cavity. Drip infusion cholangiography (DIC)-CT revealed the bile duct of the peripheral side. We maintained simple drainage to reduce the cavity. On POD 19, this patient had fever and CT revealed that the fluid collection has increased . Percutaneous drainage to the cavity near the liver cut surface was performed. Cholangiography via the c-tube did not show the anterior branch of the bile duct. Fistulogram from the drainage tube at the abdominal cavity showed the bile duct at segments V and VIII . We diagnosed the bile leakage from the isolated bile duct of segments V and VIII. Further management was needed to control the persistent biliary leak of 200–250 mL/day. Liver function was evaluated again. The indocyanine green retention rate at 15 min was 27.7%. LHL15 was 0.575. Liver volume of segments V and VIII was 260 mL, and remnant liver volume was 1272 mL, which were calculated using the 3D image analysis system (SYNAPSE VINCENT; Fuji Photo Film Co., Ltd.). Functional remnant liver volume (FRLV) was calculated based on the liver volume using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MRI for 20 min . FRLV after liver resection of segments V and VIII was 2176 mL. Even if the function becomes extinct by PTPE to segment V and VIII, remnant liver volume was sufficient. We considered that bile leakage could not be cured with either PTPE or bile duct ablation alone, because of the large volume of bile leakage more than 200 mL per day. The therapeutic strategy involved combination therapy of PTPE and bile duct ablation. First, percutaneous transhepatic cholangiography drainage (PTCD) tube was inserted to the bile duct of segment V. PTPE with coil embolization was performed to the part of the portal vein of segments V and VIII by puncturing the part of the portal vein of segment V. The liver volume of segments V and VIII was decreased from 260 to 123 mL after PTPE. After the PTPE, bile leakage decreased to about 50 mL/day. We confirmed that cholangiography via the PTCD tube showed the bile duct at segments V and VIII. For bile duct ablation, 1.2 mL pure ethanol was injected from the PTCD tube. Over 1.2 mL of ethanol leaked into the abdominal cavity. After ethanol injection, the PTCD tubes were clamped for 5 min. Then, another bile duct ablation with 2.0 mL of pure ethanol was performed 1 week after of the first procedure. After bile duct ablation, bile leakage has decreased from 50 to 10 mL/day gradually. The patient left the hospital, and he was rehospitalized and reinjected with 2.0 mL of pure ethanol for three times. The drainage tube and bile duct tube were removed on POD 139 . The clinical course is summarized in figure. Complications with combination treatment of PTPE and bile duct ablation were not noted. Fig. 1 Preoperative abdominal computed tomography showed a 50 × 48 mm hepatic mass that pressed the anterior Glisson Fig. 2 On postoperative day 19, abdominal computed tomography showed the fluid at the liver cut surface ( a ). Cholangiography via the c-tube did not detect the anterior branch of the bile duct (arrows) and does not communicate with the abdominal cavity ( b ) Fig. 3 Clinical course of bile duct leakage and drainage amount. The number shows the times of bile duct ablation. PTCD: percutaneous transhepatic cholangiography drainage. PTPE: percutaneous transhepatic portal embolization
4.1875
0.949707
sec[1]/p[0]
en
0.999996
29915920
https://doi.org/10.1186/s40792-018-0463-y
[ "bile", "duct", "liver", "tube", "segments", "drainage", "viii", "ptpe", "leakage", "cavity" ]
[ { "code": "DC10.2", "title": "Fistula of gallbladder or bile duct" }, { "code": "DC10.02", "title": "Obstruction of bile duct" }, { "code": "DC13", "title": "Cholangitis" }, { "code": "LB20.2Y", "title": "Other specified structural developmental anomalies of bile ducts" }, { "code": "ME24.35&XA6R80", "title": "Perforation of bile duct" }, { "code": "DC10.00", "title": "Obstruction of cystic duct" }, { "code": "LB20.23", "title": "Structural developmental anomalies of cystic duct" }, { "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" } ]
=== ICD-11 CODES FOUND === [DC10.2] Fistula of gallbladder or bile duct Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs. Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula [DC10.02] Obstruction of bile duct Also known as: Obstruction of bile duct | extrahepatic biliary obstruction | extrahepatic bile duct obstruction | bile duct obstruction | bile stasis Excludes: with cholelithiasis [DC13] Cholangitis Also known as: Cholangitis | acute cholangiolitis | ascending cholangitis | cholangiolitis | cholangitis NOS Excludes: chronic nonsuppurative destructive cholangitis | cholangitis with cholelithiasis | Primary sclerosing cholangitis [LB20.2Y] Other specified structural developmental anomalies of bile ducts Also known as: Other specified structural developmental anomalies of bile ducts | Anomalous arrangement of pancreatobiliary ducts | Aberrant hepatic duct | Accessory hepatic duct | accessory liver duct [DC10.00] Obstruction of cystic duct Also known as: Obstruction of cystic duct | cystic duct obstruction | cystic ductal obstruction | obstructed cystic duct | Acquired cystic duct atresia [LB20.23] Structural developmental anomalies of cystic duct Also known as: Structural developmental anomalies of cystic duct | congenital deformity of cystic duct | cystic duct anomaly | cystic duct deformity | cystic duct distortion [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 === GRAPH WALKS === --- Walk 1 --- [DC10.2] Fistula of gallbladder or bile duct Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs.... --PARENT--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile.... --EXCLUDES--> [?] Structural developmental anomalies of gallbladder or bile ducts --- Walk 2 --- [DC10.2] Fistula of gallbladder or bile duct Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs.... --PARENT--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile.... --CHILD--> [DC10.2] Fistula of gallbladder or bile duct Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs.... --- Walk 3 --- [DC10.02] Obstruction of bile duct --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --CHILD--> [?] Calculus of gallbladder or cystic duct with other cholecystitis Def: Stones in gallbladder or cystic duct present with inflammation of the gall bladder wall and cystic duct.... --- Walk 4 --- [DC10.02] Obstruction of bile duct --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --- Walk 5 --- [DC13] Cholangitis --EXCLUDES--> [?] Calculus of bile duct with cholangitis Def: Stones in bile duct present with inflammation of bile duct.... --CHILD--> [?] Calculus of bile duct with other cholangitis Def: This is an infection of the bile duct (cholangitis), usually caused by bacteria ascending from its junction with the duodenum (first part of the small intestine).... --- Walk 6 --- [DC13] Cholangitis --EXCLUDES--> [?] Primary biliary cholangitis Def: Primary biliary cholangitis is characterised by progressive destruction and disappearance of the intralobular bile duct epithelial cells leading to cholestasis (high alkaline phosphatase and GGT {gamm... --PARENT--> [?] Autoimmune liver disease Def: Autoimmune liver diseases are generally forms of chronic liver disease in which the etiology is unclear but autoimmune mechanisms are evident or postulated for the development of the disease. The prim...
[ "[DC10.2] Fistula of gallbladder or bile duct\n Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs....\n --PARENT--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts\n Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile....\n --EXCLUDES--> [?] Structural developmental anomalies of gallbladder or bile ducts", "[DC10.2] Fistula of gallbladder or bile duct\n Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs....\n --PARENT--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts\n Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile....\n --CHILD--> [DC10.2] Fistula of gallbladder or bile duct\n Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs....", "[DC10.02] Obstruction of bile duct\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...\n --CHILD--> [?] Calculus of gallbladder or cystic duct with other cholecystitis\n Def: Stones in gallbladder or cystic duct present with inflammation of the gall bladder wall and cystic duct....", "[DC10.02] Obstruction of bile duct\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...", "[DC13] Cholangitis\n --EXCLUDES--> [?] Calculus of bile duct with cholangitis\n Def: Stones in bile duct present with inflammation of bile duct....\n --CHILD--> [?] Calculus of bile duct with other cholangitis\n Def: This is an infection of the bile duct (cholangitis), usually caused by bacteria ascending from its junction with the duodenum (first part of the small intestine)....", "[DC13] Cholangitis\n --EXCLUDES--> [?] Primary biliary cholangitis\n Def: Primary biliary cholangitis is characterised by progressive destruction and disappearance of the intralobular bile duct epithelial cells leading to cholestasis (high alkaline phosphatase and GGT {gamm...\n --PARENT--> [?] Autoimmune liver disease\n Def: Autoimmune liver diseases are generally forms of chronic liver disease in which the etiology is unclear but autoimmune mechanisms are evident or postulated for the development of the disease. The prim..." ]
DC10.2
Fistula of gallbladder or bile duct
[ { "from_icd11": "DC10.2", "icd10_code": "K833", "icd10_title": "Fistula of bile duct" }, { "from_icd11": "DC10.2", "icd10_code": "K823", "icd10_title": "Fistula of gallbladder" }, { "from_icd11": "DC10.02", "icd10_code": "K831", "icd10_title": "Obstruction of bile duct" }, { "from_icd11": "DC13", "icd10_code": "K8309", "icd10_title": "Other cholangitis" }, { "from_icd11": "DC13", "icd10_code": "K8301", "icd10_title": "Primary sclerosing cholangitis" }, { "from_icd11": "DC13", "icd10_code": "K830", "icd10_title": "Cholangitis" }, { "from_icd11": "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" } ]
K833
Fistula of bile duct
A 28-year-old female patient presented to our clinic for progressive decrease in vision, first the right eye and later the left eye, for the past year. Her medical history was unremarkable in terms of systemic disease. She reported going to another center one year earlier for reduced vision where she was diagnosed with VKH and treated 3 times with high-dose corticosteroid and finally with an injection in her right eye. At time of presentation, the patient was using oral methylprednisolone 16 mg/day, oral cyclosporine 150 mg/day, and oral azathioprine 75 mg/day. Physically, she exhibited cushingoid appearance and complained of excessive weight gain and hair growth on the body. On examination, her visual acuity was light perception with projection in the right eye and 0.6 in the left eye. Anterior segment examination of both eyes was normal except for white accumulations consistent with corticosteroid in the inferior subconjunctival region of the right eye. Intraocular pressure measurement was 13 mmHg in the right and 15 mmHg in the left eye with dorzolamide hydrochloride-timolol maleate twice daily. Fundoscopic examination revealed no cells in the vitreous and exudative retinal detachment from the inferior quadrants to the superotemporal arcade in the right eye. In the left eye, there were no cells in the vitreous, while exudative retinal detachment was observed in the inferior periphery and subretinal fibrin accumulation was noted at the superotemporal and inferotemporal arcades and nasal to the optic disc . Ultrasonographic imaging (USG) was compatible with exudative retinal detachment in the right and left eyes . Fluorescein angiography (FA) and indocyanine green angiography (ICGA) in the right eye revealed hypofluorescence in the region corresponding to the exudative retina detachment, as well as early hyperfluorescence increasing in later phases at the peripheral superotemporal arcade surrounded by multiple localized hypofluorescent foci. In the left eye, FA and ICGA revealed early hyperfluorescence increasing in later phases in the macula, superior and inferior temporal arcades, and nasal of the optic nerve . Enhanced depth imaging-optical coherence tomography (EDI-OCT) revealed subretinal fluid and a hyperreflective band located subretinally in the section taken at the peripheral superotemporal arcade in the right eye; in the left eye, EDI-OCT showed subretinal fluid on the section passing through the macula, and subretinal hyperreflective material with a hyporeflective field and irregularity in retinal pigment epithelium (RPE) in the section taken at the level of the superotemporal arcade . Subfoveal choroidal thickness in the left eye was determined as 591 µm on EDI-OCT . Neurologic and otorhinolaryngologic examinations were normal; however, dermatologic examination revealed findings consistent with hirsutism. Based on the results of ophthalmologic examination and auxiliary imaging techniques, the patient was diagnosed with bullous type CSCR exacerbated by corticosteroid therapy. After consultation with endocrinologists, the patient was diagnosed with Cushing’s syndrome associated with systemic corticosteroid use, and gradual methylprednisolone tapering was recommended. Therapy with cyclosporine and azathioprine was discontinued. The subconjunctival corticosteroid particles were removed from the patient’s right eye. After consultation with endocrinology and obtaining the patient’s consent, treatment was initiated with oral mineralocorticoid receptor antagonist eplerenone 25 mg twice daily. Low fluence photodynamic therapy (PDT) (25 J/cm 2 , 300 mW/cm 2 ) was applied to areas of leakage seen on FA and ICGA in the macula and superotemporal arcade in the left eye due to the potential threat to the macula. Focal laser photocoagulation was applied to areas of leakage in the left nasal and inferotemporal arcades. Exudative detachment was reduced in the right eye and had completely regressed in the left eye at 1-month follow-up. At month 4, visual acuity was counting fingers from 1 meter in the right eye and had improved to 0.7 in the left eye. Anterior segment examination was normal in both eyes. Fundus examination in the right eye revealed regression of the exudative detachment to the inferotemporal arcade and the presence of subretinal fibrosis at the peripheral superotemporal arcade; in the left eye, subretinal fibrosis was observed at the inferior and superior temporal arcades . EDI-OCT examination revealed subretinal fluid in the right and left maculas, and subfoveal choroidal thickness was 537 µm in the right eye and 335 µm in the left eye . The patient was lost to follow-up after the fourth month because she moved to another country.
4.089844
0.976074
sec[1]/p[0]
en
0.999996
28845331
https://doi.org/10.4274/tjo.38039
[ "superotemporal", "arcade", "subretinal", "exudative", "detachment", "corticosteroid", "oral", "retinal", "arcades", "macula" ]
[ { "code": "QB51.Y", "title": "Presence of other specified devices other than cardiac or vascular implants" }, { "code": "9B65.0", "title": "Noninfectious posterior uveitis" }, { "code": "9B78.5", "title": "Retinal haemorrhage" }, { "code": "9B75.04", "title": "Neovascular late-stage age-related macular degeneration" }, { "code": "9B78.30", "title": "Reticular pseudodrusen" }, { "code": "DA96.02", "title": "Malabsorption or intolerance of specific nutrients" }, { "code": "AA8Z", "title": "Nonsuppurative otitis media, unspecified" }, { "code": "9B73.Y", "title": "Other specified retinal detachments or breaks" }, { "code": "ME62.5", "title": "Acute exudative skin eruption" }, { "code": "ND56.3", "title": "Dislocation or strain or sprain of unspecified body region" } ]
=== ICD-11 CODES FOUND === [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 [9B65.0] Noninfectious posterior uveitis Also known as: Noninfectious posterior uveitis | noninfectious choroiditis | Posterior uveitis due to Vogt Koyanagi Harada syndrome | Sympathetic Ophthalmia | sympathetic ophthalmitis [9B78.5] Retinal haemorrhage Also known as: Retinal haemorrhage | intraretinal haemorrhage | retinal haemorrhage, unspecified eye | retinal haemorrhages | preretinal haemorrhage Excludes: Traumatic retinal haemorrhage [9B75.04] Neovascular late-stage age-related macular degeneration Also known as: Neovascular late-stage age-related macular degeneration | advanced exudative age-related macular degeneration | advanced exudative AMD - [age-related macular degeneration] | advanced neovascular age related macular degeneration | neovascular age-related macular degeneration [9B78.30] Reticular pseudodrusen Definition: Histologically located above the retinal pigment epithelium, this finding is often associated with other retinal disease. Also known as: Reticular pseudodrusen | RPD - [reticular pseudodrusen] | SDD - [subretinal drusenoid deposits] [DA96.02] Malabsorption or intolerance of specific nutrients Definition: Food intolerance is a term used for difficulty in digesting a food due to various physiological responses associated with a particular food, or compound found. Food intolerance should not be mistaken for food allergy, which is primarily involving the immune reaction against the food. Also known as: Malabsorption or intolerance of specific nutrients | Carbohydrate intolerance other than lactose | disorder of carbohydrate absorption | Malabsorption due to intolerance to carbohydrate | carbohydrate intolerance [AA8Z] Nonsuppurative otitis media, unspecified Also known as: Nonsuppurative otitis media, unspecified | otitis media with effusion | nonsuppurative otitis media, not specified as acute or chronic | mucoid otitis media | secretory otitis media [9B73.Y] Other specified retinal detachments or breaks Also known as: Other specified retinal detachments or breaks | Exudative retinal detachments | Tractional retinal detachments | Traction detachment of retina without breaks | traction detachment of retina, unspecified eye [ME62.5] Acute exudative skin eruption Definition: A provisional diagnosis for a skin eruption of unknown or uncertain nature which arises abruptly and in which exudation and crusting are prominent features. Common causes are infected eczema, acute allergic contact dermatitis and impetigo. Also known as: Acute exudative skin eruption [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 === GRAPH WALKS === --- Walk 1 --- [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 2 --- [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 3 --- [9B65.0] Noninfectious posterior uveitis --PARENT--> [9B65] Posterior uveitis --CHILD--> [9B65.1] Infectious posterior uveitis --- Walk 4 --- [9B65.0] Noninfectious posterior uveitis --RELATED_TO--> [?] Ocular Behçet disease --PARENT--> [?] Noninfectious posterior uveitis --- Walk 5 --- [9B78.5] Retinal haemorrhage --EXCLUDES--> [?] Traumatic retinal haemorrhage --PARENT--> [?] Injury of eye or orbit --- Walk 6 --- [9B78.5] Retinal haemorrhage --EXCLUDES--> [?] Traumatic retinal haemorrhage --PARENT--> [?] Injury of eye or orbit
[ "[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 --EXCLUDES--> [?] Fitting, adjustment or management of devices", "[9B65.0] Noninfectious posterior uveitis\n --PARENT--> [9B65] Posterior uveitis\n --CHILD--> [9B65.1] Infectious posterior uveitis", "[9B65.0] Noninfectious posterior uveitis\n --RELATED_TO--> [?] Ocular Behçet disease\n --PARENT--> [?] Noninfectious posterior uveitis", "[9B78.5] Retinal haemorrhage\n --EXCLUDES--> [?] Traumatic retinal haemorrhage\n --PARENT--> [?] Injury of eye or orbit", "[9B78.5] Retinal haemorrhage\n --EXCLUDES--> [?] Traumatic retinal haemorrhage\n --PARENT--> [?] Injury of eye or orbit" ]
QB51.Y
Presence of other specified devices other than cardiac or vascular implants
[ { "from_icd11": "9B78.5", "icd10_code": "H3560", "icd10_title": "Retinal hemorrhage, unspecified eye" }, { "from_icd11": "9B78.5", "icd10_code": "H3563", "icd10_title": "Retinal hemorrhage, bilateral" }, { "from_icd11": "9B78.5", "icd10_code": "H3562", "icd10_title": "Retinal hemorrhage, left eye" }, { "from_icd11": "9B78.5", "icd10_code": "H3561", "icd10_title": "Retinal hemorrhage, right eye" }, { "from_icd11": "9B78.5", "icd10_code": "H356", "icd10_title": "Retinal hemorrhage" }, { "from_icd11": "DA96.02", "icd10_code": "K9049", "icd10_title": "Malabsorption due to intolerance, not elsewhere classified" }, { "from_icd11": "DA96.02", "icd10_code": "K9041", "icd10_title": "Non-celiac gluten sensitivity" }, { "from_icd11": "DA96.02", "icd10_code": "K904", "icd10_title": "Other malabsorption due to intolerance" }, { "from_icd11": "AA8Z", "icd10_code": "H6592", "icd10_title": "Unspecified nonsuppurative otitis media, left ear" }, { "from_icd11": "AA8Z", "icd10_code": "H65413", "icd10_title": "Chronic allergic otitis media, bilateral" }, { "from_icd11": "AA8Z", "icd10_code": "H6590", "icd10_title": "Unspecified nonsuppurative otitis media, unspecified ear" }, { "from_icd11": "AA8Z", "icd10_code": "H6593", "icd10_title": "Unspecified nonsuppurative otitis media, bilateral" }, { "from_icd11": "AA8Z", "icd10_code": "H65499", "icd10_title": "Other chronic nonsuppurative otitis media, unspecified ear" }, { "from_icd11": "AA8Z", "icd10_code": "H65", "icd10_title": "Nonsuppurative otitis media" }, { "from_icd11": "AA8Z", "icd10_code": "H654", "icd10_title": "Other chronic nonsuppurative otitis media" } ]
H3560
Retinal hemorrhage, unspecified eye
Diagnostic endomyocardial biopsy (EMB) was performed on day 8. Photomicrograph revealed moderate myocyte hypertrophy with moderate interstitial fibrosis and a few interstitial inflammatory infiltrates without associated myocyte necrosis . The counts of CD3 + T-lymphocytes and CD68 + macrophages were 2.2 and 23.9 cells/mm 2 , respectively; this corresponded to 6.2 leucocytes/mm 2 , including up to 4 monocytes/mm 2 , which did not fulfill the proposed immunohistochemical criteria for myocarditis (≥ 14 leucocytes/mm 2 , including up to 4 monocytes/mm 2 and CD3 + T-lymphocytes ≥ 7 cells/mm 2 ) by World Heart Federation and European Society of Cardiology. Furthermore, late gadolinium-enhanced cardiac magnetic resonance imaging showed no abnormalities, indicating the absence of myocardial necrosis, supporting this notion. Fig. 3 Endomyocardial biopsy of the left ventricle. Photomicrograph showing moderate to severe endocardial thickening, interstitial and perivascular fibrosis, and focal interstitial edema (scale bar: 100 µm) ( a ). High-power view with hematoxylin–eosin stain showing moderate hypertrophy of myocytes with no remarkable myocyte loss (scale bar: 50 µm) ( b ). Some CD3 + T - lymphocytes can be observed (scale bar: 100 µm) ( c ). CD68 + macrophages can be observed sporadically in the interstitial fibrosis area (scale bar: 100 µm) ( d ) In addition, a workup for the unexplained tachycardia was performed. We performed thyroid function tests using stored blood samples obtained on admission day 1 through day 7 (Table 2 ). Strikingly, thyroid studies using pre-amiodarone treatment sera on admission demonstrated undetectable thyroid-stimulating hormone (TSH) levels (reference: 0.35–4.94 mIU/L), and markedly elevated free T3 and T4 (> 30 pg/mL, reference: 1.71–3.71 pg/mL; 3.81 ng/dL, reference: 0.7–1.48 ng/dL, respectively), strongly suggesting thyrotoxicosis. Table 1 Timeline Timeline 14 days prior to presentation The patient experienced diarrhoea and nausea 10 days prior to presentation She began to feel dyspnoea on effort 4 days prior to presentation She experienced worsening dyspnoea and a nonproductive cough on deep breathing On emergent presentation 6:40:00 PM She presented with worsening dyspnoea at the emergency department. Electrocardiogram showed MAT. Echocardiography revealed left ventricular dilatation and severe hypokinesis; the patient was diagnosed with dilated cardiomyopathy 6:44:00 PM She was treated for MAT with intravenous administration of adenosine triphosphate, verapamil, and landiolol, as well as multiple cardioversions, which were ineffective 8:12:00 PM She rapidly progressed to cardiogenic shock and respiratory decompensation, which required intubation and inotropic support 9:35:00 PM Emergent coronary angiography was unremarkable. An IABP was inserted 11:59:00 PM Amiodarone was started for refractory MAT Day 3 IABP and administration of amiodarone successfully suppressed the recurrence of MAT Day 5 She was weaned from the vasoactive agents, and anti-failure therapy was carefully induced Day 7 She was weaned off IABP Day 8 Endomyocardial biopsy was performed A workup for the unexplained tachycardia led to the correct diagnosis of thyroid storm Day 11 Extubation and cardiac rehabilitation Day 31 Thiamazole was induced Day 38 Follow-up echocardiography demonstrated significant improvements in left ventricular systolic function and reverse remodelling Day 40 Discharged to home Regular follow-up She received treatment at our outpatient clinic to establish clinical euthyroidism Day 131 Total thyroidectomy was performed; thyroid pathology was consistent with Graves' disease 6-month follow-up 48-month follow-up Full recovery of the LVSD was observed She remained clinically stable MAT: Multifocal atrial tachycardia, IABP: Intra-aortic balloon pump, LVSD: Left ventricular systolic dysfunction Table 2 Trend of thyroid function tests Laboratory findings Results Reference value Thyroid function On admission* Day 3* Day 5* Day 7* Day 10 TSH < 0.01 mIU/L** < 0.01 mIU/L < 0.01 mIU/L < 0.01 mIU/L < 0.01 mIU/L 0.35–4.94 mIU/L fT3 > 30 pg/mL** > 30 pg/mL 27.61 pg/mL 6.25 pg/mL 3.83 pg/mL 1.71–3.71 pg/mL fT4 3.81 ng/dL** 3.32 ng/dL 2.66 ng/dL 1.81 ng/dL 1.38 ng/dL 0.7–1.48 ng/dL TgAb 531 IU/mL 0–28 IU/mL TPOAb 45 IU/mL 0–16 IU/mL TRAb 11.5 IU/L 0–2.0 IU/L TSAb 651% 0–120% TSH: Thyroid-stimulating hormone, fT3: Free triiodothyronine, fT4: Free thyroxine, TgAb: Anti-thyroglobulin antibody, TPOAb: Anti-thyroid peroxidase antibody, TRAb: TSH receptor antibody, TSAb: Thyroid-stimulating antibody *Data were retrospectively measured using stored blood samples obtained on admission Day 1 through Day 7 **Data using pre-amiodarone treatment sera
4.152344
0.886719
sec[1]/p[1]
en
0.999997
33663404
https://doi.org/10.1186/s12872-021-01935-5
[ "thyroid", "interstitial", "scale", "function", "using", "amiodarone", "reference", "iabp", "antibody", "endomyocardial" ]
[ { "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": "JA01.Y", "title": "Other specified ectopic pregnancy" }, { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "9A7Y", "title": "Other specified disorders of the cornea" }, { "code": "CB0Z", "title": "Respiratory diseases principally affecting the lung interstitium, unspecified" }, { "code": "CB03.4", "title": "Idiopathic pulmonary fibrosis" } ]
=== 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 [JA01.Y] Other specified ectopic pregnancy Also known as: Other specified ectopic pregnancy | Cornual gestation or pregnancy | cornual gestation | cornual pregnancy | Cervical pregnancy [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 [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 [CB0Z] Respiratory diseases principally affecting the lung interstitium, unspecified Also known as: Respiratory diseases principally affecting the lung interstitium, unspecified | interstitial lung disease NOS | diffuse parenchymal lung diseases [CB03.4] Idiopathic pulmonary fibrosis Definition: Idiopathic pulmonary fibrosis (IPF) is defined as a specific form of chronic, progressive fibrosing interstitial pneumonia (pneumonitis) of unknown cause, occurring primarily in older adults, limited to the lungs, and associated with the histopathologic and/or radiologic pattern of UIP. The definition of IPF requires the exclusion of other forms of interstitial pneumonia (pneumonitis) including other idiopathic interstitial pneumonias (pneumonitis) and Interstitial Lung Disease (ILD) associated Also known as: Idiopathic pulmonary fibrosis | interstitial pulmonary fibrosis | IPF - [Idiopathic pulmonary fibrosis] | idiopathic lung fibrosis | fibrosing lung disease === 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--> [?] Acquired hypothyroidism Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth.... --- Walk 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--> [5A03.0] Acute thyroiditis Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial.... --- Walk 3 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --PARENT--> [?] Endocrine diseases --- Walk 4 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --PARENT--> [?] Endocrine diseases --- Walk 5 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.0] Acute thyroiditis Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial.... --- Walk 6 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.1] Subacute thyroiditis Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection....
[ "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Acquired hypothyroidism\n Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....", "[5A03.Z] Thyroiditis, unspecified\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....", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --PARENT--> [?] Endocrine diseases", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --PARENT--> [?] Endocrine diseases", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.0] Acute thyroiditis\n Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial....", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.1] Subacute thyroiditis\n Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection...." ]
5A03.Z
Thyroiditis, unspecified
[ { "from_icd11": "5A03.Z", "icd10_code": "E069", "icd10_title": "Thyroiditis, unspecified" }, { "from_icd11": "5A03.Z", "icd10_code": "E064", "icd10_title": "Drug-induced thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E065", "icd10_title": "Other chronic thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E06", "icd10_title": "Thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E062", "icd10_title": "Chronic thyroiditis with transient thyrotoxicosis" }, { "from_icd11": "5A0Z", "icd10_code": "E0781", "icd10_title": "Sick-euthyroid syndrome" }, { "from_icd11": "5A0Z", "icd10_code": "E0789", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E079", "icd10_title": "Disorder of thyroid, unspecified" }, { "from_icd11": "5A0Z", "icd10_code": "E034", "icd10_title": "Atrophy of thyroid (acquired)" }, { "from_icd11": "5A0Z", "icd10_code": "E00-E07", "icd10_title": "" }, { "from_icd11": "5A0Z", "icd10_code": "E07", "icd10_title": "Other disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E078", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E35", "icd10_title": "Disorders of endocrine glands in diseases classified elsewhere" }, { "from_icd11": "5A00.2Z", "icd10_code": "E033", "icd10_title": "Postinfectious hypothyroidism" }, { "from_icd11": "5A03.0", "icd10_code": "E060", "icd10_title": "Acute thyroiditis" } ]
E069
Thyroiditis, unspecified
A 19-year-old healthy female presented with an abrupt deterioration of left eye vision of 1-day duration. For 10 days prior to presentation, she was suffering from dry cough; 5 days later she had intermittent fever up to 41°C with shaking chills. There was a history of contact with a cat, but she denied being scratched. On admission, physical and neurologic examinations were unremarkable. Ophthalmologic assessment disclosed visual acuity of 4/4 in the right eye and 4/60 in the left eye. She had normal anterior segments and intraocular pressures. A left afferent pupillary defect was noted. Funduscopy of the right eye showed a small white optic disk lesion in its temporal aspect with a deep retinal white lesion along the superonasal arcade . The left optic disk had blurred margins with bigger white lesions in its nasal and temporal aspects with an associated localized vitreous opacity on its surface . There was marked macular edema and two deep retinal white lesions along the superotemporal arcade and inferonasal to the optic disk. Optical coherence tomography (OCT) revealed intraretinal fluid in the right papillomacular bundle and left exudative macular detachment . Visual field examination showed right nasal step and superonasal arcuate defect while there was enlargement of the left blind spot with nasal step . Work-up revealed mild anemia with hemoglobin of 11.7 g% and leukocytosis of 14,800 (lymphocytes, 31%). Kidney and liver functions were within normal limits except for a slightly elevated lactate dehydrogenase at 768 (normal range, 300–620 u/l). She had elevated erythrocyte sedimentation rate (ESR) (90 mm/h) and C-reactive protein (5.3 mg%; normal range, less than 1). Chest X-ray did not reveal any pathological findings, and CT scan and MRI of the head and brain showed mild thickening of the optic nerves bilaterally and hyperintense foci in the flair sequences in the intraocular aspects of the optic nerves, respectively. Cerebrospinal fluid cytology was normal. Serological tests were negative for HIV, syphilis, Brucella , Coxiella burnetti , toxoplasma, and toxocara. Serological tests for B. henselae revealed positive IgM titer at 75 units (negative, below 40) and IgG titer at 94 units (negative, below 60). Treatment was started with a combination of Doxycycline (100 mg twice daily) and Rifampicin (300 mg twice daily); in addition she received oral steroids at 1 mg/kg/day. Over the ensuing 3 days, she felt better, there was no fever, and visual acuity in the left eye improved to 4/24. Fundoscopy disclosed few hard exudates in the right papillomacular bundle and a left macular star while optic disk lesions were smaller bilaterally. OCT revealed marked resolution of bilateral macular edema. Four days following institution of therapy, she complained of a central defect in the left visual field. Visual acuity was counting fingers at 1 m in the left eye while it was unchanged in the right eye. Funduscopy did not reveal any new findings. Visual fields however revealed a left central scotoma . Treatment with oral steroids was changed to intravenous Methylprednisolone (500 mg/day) for three consecutive days with a tapering regimen of oral steroids thereafter. There was prompt response with improvement in visual acuity and visual fields. Two weeks following the treatment, VA was 4/16 (left eye; LE). In addition, hemoglobin was 13.8 g% with a normal LDH at 366 u/l, WBC count was 11,900 (lymphocytes 15.4%), ESR was 28 mm/h, and CRP was less than 0.5. Treatment was discontinued after 10 weeks. After a 5-month follow-up period, vision was 4/4 in RE and 4/5 in LE. Visual fields were normal in RE but a small nasal step persisted in LE. Funduscopy was normal in the right eye but few small hard exudates were still seen in the left eye. Fig. 1 Color fundus photograph of the right eye showing a small white optic disk lesion in its temporal aspect with a deep retinal white lesion along the superonasal arcade ( left ). Color fundus photograph of the left eye showing blurred optic disk margins with white lesions in its nasal and temporal aspects with an associated localized vitreous opacity on its surface. Marked macular edema is also seen with a deep retinal white lesion along the superotemporal arcade ( right ) Fig. 2 OCT showing intraretinal fluid in the right papillomacular bundle ( upper ) and left exudative macular detachment ( lower ) Fig. 3 Visual field tests (24–2) showing enlargement of the left blind spot with nasal step on presentation ( upper ). Left central scotoma with inferotemporal extension was demonstrated few days later ( middle ). Total resolution of the central scotoma and improvement of the nasal step was noted 14 days later ( lower )
4.042969
0.978027
sec[1]/p[0]
en
0.999996
22057809
https://doi.org/10.1007/s12348-011-0046-6
[ "visual", "white", "optic", "nasal", "disk", "macular", "lesion", "step", "acuity", "small" ]
[ { "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": "EF5Y", "title": "Other specified dermatoses attributable to hyperviscosity or microvascular occlusion" }, { "code": "JB41.1", "title": "Deep phlebothrombosis in the puerperium" }, { "code": "EB60.Y", "title": "Lichen sclerosus of other specified sites" }, { "code": "MC80.00", "title": "White coat hypertension" }, { "code": "1F2D.2", "title": "White piedra" } ]
=== 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 [EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion Also known as: Other specified dermatoses attributable to hyperviscosity or microvascular occlusion | Cutaneous microvascular occlusion by platelet plugs | Cutaneous microvascular disturbances due to myeloproliferative disorder-associated platelet plugs | Cutaneous microvascular disturbances due to paroxysmal nocturnal haemoglobinuria-associated platelet plugs | Cutaneous microvascular occlusion by emboli [JB41.1] Deep phlebothrombosis in the puerperium Also known as: Deep phlebothrombosis in the puerperium | postnatal deep vein thrombosis | postpartum deep phlebothrombosis | postpartum deep-vein thrombosis | DVT - [deep venous thrombosis] postnatal [EB60.Y] Lichen sclerosus of other specified sites Also known as: Lichen sclerosus of other specified sites | Extragenital lichen sclerosus | Guttate lichen sclerosus | White spot disease | Guttate scleroderma [MC80.00] White coat hypertension Definition: Persistently elevated office blood pressure readings with persistently normal out-of-the-office readings. Also known as: White coat hypertension | white coat syndrome [1F2D.2] White piedra Definition: A disease of the hair shaft, caused by an infection with the fungi Trichosporon beigelii. This disease is characterised by irregular, soft, white, or light brown nodules which adhere to the hair follicle. Transmission is by direct contact with contaminated soil or water, or by airborne transmission. Confirmation is by identification of Trichosporon beigelii in a hair follicle sample. Also known as: White piedra | Trichosporosis nodosa Includes: Trichosporosis nodosa === 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.... --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ... --- Walk 2 --- [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.... --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 --- [MC1Y] Other specified symptoms or signs involving the visual system --PARENT--> [?] Symptoms or signs involving the visual system --CHILD--> [MC10] Eye appearance abnormal --- Walk 4 --- [MC1Y] Other specified symptoms or signs involving the visual system --PARENT--> [?] Symptoms or signs involving the visual system --RELATED_TO--> [?] Fear of eye disease --- 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--> [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.... --- 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 --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 ...", "[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 --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....", "[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", "[MC1Y] Other specified symptoms or signs involving the visual system\n --PARENT--> [?] Symptoms or signs involving the visual system\n --RELATED_TO--> [?] Fear of eye disease", "[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....", "[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
An 80-year-old Arabian female presented to our hospital with a 2–month history of swelling over the right eyebrow, pain, proptosis of the right eye and diplopia . Physical examination revealed a 2 cm ill-defined painful mass over the right eyebrow. The patient complains of double vision looking to the left. Computed tomography (CT) of the right orbit demonstrated an ill-defined, homogeneous, contrast-enhancing mass attached to the medial rectus. As a space-occupying orbital lesion, a lymphoma or a sarcoma was suspected. As a result, a biopsy was performed. On microscopic examination, the tumour was composed of interlacing bundles of spindle cells with anisokaryosis and hyperchromatic nuclei . Some mitotic figures were observed. Immunohistochemical study was not possible because neoplastic material has been exhausted. The conclusion was malignant spindle cells tumour, most consistently to sarcoma or sarcomatoid carcinoma. No lymph node or distant metastases were found. Subsequently, total exenteration of the right orbit was performed under general anaesthesia. Dilute adrenaline was injected to lessen bleeding generally abundant in this type of excision. Periosteum was incised right around the orbital rim and separated from the bone passing back towards the orbital apex. The eyeball, eyelids, appendages of the eye and periosteum were removed. Surgical specimen was addressed for pathological examination. At gross examination, the tumour appeared ill-defined, whitish and firm. It measured 4/2.5/1.5 cm. It was attached to the sclera without infiltration into eyeball. It infiltrated the upper eyelid . Microscopic examination revealed spindle cells forming disorganized fascicles. They have an irregular nucleus with vesicular chromatin and an eosinophilic cytoplasm. The mitotic index was 18 per 10 high-power fields. Adipose tissue and striated muscle infiltration was observed . Immunohistochemical panel used for initial work up of this high grade spindle cell neoplasm was desmin, smooth muscle actin (SMA), pancytokeratin AE1/AE3, epithelial membrane antigen (EMA), S100 protein and CD34. This panel served to rule out first leiomyosarcoma, rhabdomyosarcoma, sarcomatoid carcinoma and spindle cell melanoma. It revealed diffuse positive staining for pancytokeratin AE1/AE3, EMA and SMA and focal positivity for S100 protein . The lesion was immunonegative for desmin and CD34 . As pancytokeratin AE1/AE3, EMA, SMA and S100 protein staining was positive, we completed by second panel. It showed h-cladesmon, Melan-A and HMB-45 negative staining. These pathological and immunohistochemical findings suggested the diagnoses of myoepithelioma, epithelial myoepithelial carcinoma and myoepithelial carcinoma. Myoepithelioma was excluded because the tumour borders were infiltrative. Epithelial myoepithelial carcinoma is by definition composed of a biphasic arrangement of inner luminal ductal cells and outer myoepitheliaI cells. However, the tumour did not show bi-layered duct-like structures. The most appropriate diagnosis was myoepithelial carcinoma. The tumour was extending to upper and posterior surgical margins. Radiotherapy was then indicated. The patient was lost to follow-up until she developed local tumour progression 3 months after removal. The patient was again lost to follow-up and therefore did not receive any other treatment in our hospital. Fig. 1 Case report timeline Fig. 2 Histological aspect of the lesion in biopsy: a The tumour is composed of interlacing bundles of spindle cells (H&E × 100). b The neoplastic cells show anisokaryosis and hyperchromatic nuclei (H&E × 400) Fig. 3 Gross features of the exenterated orbital contents: Cut surface shows ill-defined, whitish and firm tumour. It is attached to the sclera without infiltration into eyeball. It infiltrates the upper eyelid. The tumour is extending to the surgical margins Fig. 4 Histological aspect of the tumour after orbital exenteration: a Neoplastic spindle cells are arranged in disorganized fascicules (H&E × 100). b The tumour is attached to the sclera without infiltration (H&E × 40). c Infiltration into adipose tissue and striated muscle is observed (H&E × 40). d High-power view shows the obvious cytologic atypia and several mitoses of the neoplastic cells (H&E × 400) Fig. 5 Immunohistochemical profile of the tumour after orbital exenteration: The tumor cells express pancytokeratin AE1/AE3 a , EMA b , SMA ( c ) and express focally S100 protein ( d ) Fig. 6 Immunohistochemical profile of the tumour after orbital exenteration: The tumor cells are negative for desmin ( a ) (infiltrated skeletal muscle fibers are staining with desmin) and CD34 ( b ) (vessel endothelial cells are staining with CD34)
4.140625
0.969727
sec[1]/p[0]
en
0.999999
30123086
https://doi.org/10.1186/s12907-018-0073-4
[ "tumour", "cells", "orbital", "spindle", "carcinoma", "immunohistochemical", "infiltration", "staining", "defined", "attached" ]
[ { "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": "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 === [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 [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 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --PARENT--> [02] Neoplasms Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair.... --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] 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... --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--> [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 --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] 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 --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--> [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
The patient, a 26-year-old Caucasian woman was referred by the oral and maxillofacial surgeon for orthodontic treatment in order to prepare for orthognathic surgery, with the aim of correcting the changes in growth of the maxillae. During the anamnesis, the patient reported that at about two years of age, her mother took her to the doctor, since she frequently suffered from a blocked nose, however, the pediatrician attributed the problem to allergic episodes. Only at the age of five, when extrusion of the left eyeball was noted, were CT scans requested, resulting in the diagnosis of MAS. After the examination was performed, the cause of the complaint of a blocked nose was confirmed to be airway obstruction due to the disease. Moreover, the patient reported that she had menarche at 11 years of age. During adolescence and early adulthood, scintigraphy examinations were requested to assess progression of the condition. The first scintigraphy exam was performed at age 16. This showed abnormal hyperuptake in the areas of the skull, mandible, distal portion of the right humerus, proximal portion of the right ulna, posterior portions of the right and left costal arches, and proximal portion of the left femur . At 22 years of age, she repeated the examination, in which no new areas of anomalous hyperuptake were observed. There was only a slight increase in the intensity of the radiopharmaceutical concentration in the topography of the skull . At 26 years of age, the examination was performed again and no changes were found when compared with the examination performed at age 22, demonstrating stability of the process . When the patient was still at the stage of adolescence, maxillofacial surgeon performed some procedures to correct the abnormalities the patient presented, as follows: 1 craniofacial surgery for decompression of the optic nerve and 4 nose surgeries for unobstructing the airways, the latter surgery was performed at 19 years of age. It is worth emphasizing that the patient has been followed up by an endocrinologist, otorhinolaryngologist, neurologist and orthopedist since she was 5 years old. In the extraoral clinical examination, it was noted that the patient had facial asymmetry and an exacerbated bone development in the maxilla when compared with the mandible. In addition, she reported some pain in the region of the maxillary arch. The patient also reported that she had a single café au lait stain in the region of her back . On intraoral examination, a more evident increase in volume was observed in the maxillary arch, affecting the maxillary bone . In view of the clinical findings, patient’s reports, and her medical history, a CT scan was requested to assess the patient’s bone pattern. Cone-beam computed tomography was performed with the CS 9600-3D device (CarestreamDental, Atlanta, USA), parameters of 120 kV, 8 mA, 150 um Voxel and 16.0 cm x 17.0 cm FOV. The digital images were stored in the KDIS system - Kodak Dental Imaging Software (Carestream Health Inc., New York, USA) in the original format (DICOM). In the tomographic reconstructions, an expansive lesion was observed, going in all directions with varying degrees of bone density (numerous bone trabeculae irregularly arranged with hypodense areas - ground glass appearance), affecting the following bones: Frontal, Ethmoid, Temporal, Zygomatic, Sphenoid, Lower Nasal, Maxillary and Mandibular Bone . With specific regard to the maxilla, the lesion affected the frontal, zygomatic, palatine and alveolar processes, maxillary tuberosity, in addition to the body regions of the maxilla, with a total aplasia of both maxillary sinuses and consequent total obliteration of the ostiomeatal units . In the mandible, the lesion involved the entire region of the symphysis, mandibular body on both sides, retromolar trigone, angle and ascending rami, with displacement of the mandibular canals bilaterally and of the mental foramina to the superior region. There was also a large multilocular hypodense area in the region of the body of the mandible, angle and inferior portion of the ascending ramus of the mandible on the right side, suggestive of an area of fibrous connective tissue. Relative to the airways, the exam showed a constriction in the patient’s pharyngeal region, adjacent to the posterior-inferior portion of the soft palate, suggesting a possible retrusion of soft tissue. In view of the foregoing description, with the results of the up-to-date tomography and scintigraphy exams confirming the stability of disease progression, by taking the necessary precautions and being aware of the limitations of the treatment imposed by bone, it will be possible to continue with the orthodontic treatment.
3.988281
0.978516
sec[1]/p[0]
en
0.999998
PMC10062463
https://doi.org/10.4317/jced.60161
[ "bone", "region", "maxillary", "that", "mandible", "portion", "nose", "requested", "scintigraphy", "areas" ]
[ { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" }, { "code": "ND56.0", "title": "Superficial injury of unspecified body region" }, { "code": "ND56.Z", "title": "Unspecified injury to unspecified part of trunk, limb or body region" }, { "code": "CA44", "title": "Pyothorax" }, { "code": "FB3Z", "title": "Disorders of muscles, unspecified" }, { "code": "ND56.8", "title": "Traumatic amputation of unspecified body region" } ]
=== ICD-11 CODES FOUND === [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias [ND56.0] Superficial injury of unspecified body region Also known as: Superficial injury of unspecified body region | superficial injury of limb NOS | Superficial injury NOS | scratch NOS | Cutaneous wounds, injuries or scars Excludes: multiple superficial injuries NOS [ND56.Z] Unspecified injury to unspecified part of trunk, limb or body region Also known as: Unspecified injury to unspecified part of trunk, limb or body region | Injury of unspecified body region | injury NOS | trauma NOS | traumatic injury NOS [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 [FB3Z] Disorders of muscles, unspecified Also known as: Disorders of muscles, unspecified | disorder of muscle, unspecified | muscle disease | muscular disease | muscular disorder [ND56.8] Traumatic amputation of unspecified body region Also known as: Traumatic amputation of unspecified body region | avulsion NOS | Traumatic amputation NOS | traumatic avulsion NOS | traumatic extremity loss Excludes: multiple: crushing injuries NOS | multiple traumatic amputations NOS === GRAPH WALKS === --- Walk 1 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system --- Walk 2 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system --- Walk 3 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --CHILD--> [FB84.2] Subacute osteomyelitis --- Walk 4 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --EXCLUDES--> [?] Inflammatory conditions of jaws --- Walk 5 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopetrosis Def: Osteopetrosis ('marble bone disease') is a descriptive term that refers to a group of rare, heritable disorders of the skeleton characterised by increased bone density on radiographs. Osteopetrotic co... --- Walk 6 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopenia
[ "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --CHILD--> [FB84.2] Subacute osteomyelitis", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --EXCLUDES--> [?] Inflammatory conditions of jaws", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopetrosis\n Def: Osteopetrosis ('marble bone disease') is a descriptive term that refers to a group of rare, heritable disorders of the skeleton characterised by increased bone density on radiographs. Osteopetrotic co...", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopenia" ]
FC0Z
Diseases of the musculoskeletal system or connective tissue, unspecified
[ { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X6", "icd10_title": "Other osteomyelitis, lower leg" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X9", "icd10_title": "Other osteomyelitis, unspecified sites" }, { "from_icd11": "FB84.Z", "icd10_code": "M8668", "icd10_title": "Other chronic osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M86662", "icd10_title": "Other chronic osteomyelitis, left tibia and fibula" }, { "from_icd11": "FB84.Z", "icd10_code": "M86151", "icd10_title": "Other acute osteomyelitis, right femur" }, { "from_icd11": "FB84.Z", "icd10_code": "M86141", "icd10_title": "Other acute osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M86641", "icd10_title": "Other chronic osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M8669", "icd10_title": "Other chronic osteomyelitis, multiple sites" } ]
XIII
The procedure was performed electively with the patient under general anesthesia. TEE-guided transseptal puncture was performed with radiofrequency ablation. A balloon-tipped catheter was floated across the mitral valve and into the aorta. An Astato wire (Asahi Intecc Medical) was passed through the catheter, snared, and externalized via a left femoral artery sheath. A “flying V” configuration was formed using the Astato wire insulated by 2 guiding catheters. The sheath tips were positioned in the center of the mitral valve orifice to act as a pivot for centerline laceration. The catheters were then withdrawn to electrosurgically lacerate the AMVL from tip to base with the annuloplasty ring as the backstop to prevent injury to the aortomitral junction . Successful laceration of the AMVL was confirmed on TEE . After removal of the catheters and externalized wire, the mitral valve was re-crossed with a Safari wire and septotomy was performed with a 14-mm balloon. The Baylis sheath was then replaced with a 16-F E-sheath, following which a reverse-mounted 29-mm Sapien S3 was deployed (under rapid burst pacing) using a 30/70 distribution to reduce the risk of LVOT obstruction, 10 cc overfilled, and post-dilated . An excellent position was achieved with no LVOT obstruction or significant central MR . The patient was discharged, but he was readmitted with significant hemolytic anemia (Hb 62 g/dL, bilirubin 86 μmol/L). Repeated CT and TEE found moderate MR due to an intra-ring paravalvular jet . There was no central MR. Consequently, after more discussion with the heart team, a further procedure was performed to address the residual MR. Transfemoral transseptal crossing was performed, the leak between the annuloplasty ring and THV was traversed, and an 8-mm Amplatzer vascular plug 4 (Abbott Cardiovascular) was deployed . The THV was then crossed with 2 Safari wires and kissing balloon dilatation was performed (20 mm and 18 mm Cristal) to modify the circular THV into the elliptical shape of the annuloplasty ring, without forcing circularization of the annuloplasty ring, producing an excellent final result with only trivial residual MR . Figure 2 Fluoroscopic Images of the LAMPOON Procedure (A) Initially a transmitral wire is crossed into the left ventricle and snared from a transaortic catheter and then externalized. The 2 insulating guiding catheters are then withdrawn to expose a section of wire, (B) which is positioned in the center of the leaflet to be lacerated. (C and D) The wire is electrified and withdrawn by drawing back the transmitral and transaortic catheters simultaneously. (E) Illustration of the LAMPOON procedure. LA = left atrium; LAO = left anterior oblique; PA = postero-anterior; RAO = right anterior oblique. Figure 3 Anterior Mitral Valve Leaflet Laceration Before (A and C) and after (B and D) modification. (A) The “flying V” configuration of catheters and wire. (B) The impact of leaflet laceration with significant worsening of mitral regurgitation on color Doppler. (C and D) The appearances on 3-dimensional transesophageal echocardiography before (C) and after (D) leaflet laceration. Figure 4 Fluoroscopic Images of the Implantation of the Transcatheter Heart Valve The mitral annuloplasty ring is traversed by 2 wires (A), and atrial septostomy is performed with a 14-mm balloon (B). The balloon-expanding THV was deployed under rapid burst pacing (C) and post-dilatated with 4 cc overfill (D). LV = left ventricle. Figure 5 2-Dimensional Transesophageal Echocardiography The positioning of the transcatheter heart valve (THV) in relation to the left ventricular outflow tract (LVOT) with minimal transvalvular regurgitation (A) and a continuous-wave Doppler through the LVOT demonstrating no significant gradient (B). LA = left atrium. Figure 6 Paravalvular (Intra-Ring) Leak Between the THV and the Annuloplasty Ring (A and B) Transesophageal echocardiography and (C and D) computed tomography. PVL = paravalvular leak. Figure 7 Closure of the Paravalvular Leak Closure of the paravalvular leak by (A and B) traversing the defect with a wire and (C) implantation of a vascular plug. (D) The final result on transesophageal echocardiography with color Doppler is shown, demonstrating no significant leak. LA = left atrium. Figure 8 The Effect of Kissing Balloon Dilatation on THV Appearance Appearance of the transcatheter heart valve before (A, C, E) and after (B, D, F) kissing balloon dilatation in the angiographic (A and B) and 3-dimensional transesophageal echocardiography views (C to F) with (E and F) and without (C and D) color Doppler. (D and F) A significantly more elliptical shape compared with the more circularized appearance seen in C and E.
4.042969
0.937988
sec[3]/p[1]
en
0.999997
40250940
https://doi.org/10.1016/j.jaccas.2025.103279
[ "wire", "ring", "balloon", "valve", "mitral", "catheters", "annuloplasty", "leak", "laceration", "paravalvular" ]
[ { "code": "QB84", "title": "Follow-up care involving removal of fracture plate or other internal fixation device" }, { "code": "9B71.1&XS5S", "title": "Hypertensive Retinopathy, Stage 2, focal arteriolar narrowing, marked generalised arteriolar narrowing, arteriovenous nicking, opacity, “copper wiring” of arteriolar wall, or a combination of these signs" }, { "code": "LA8B.Y", "title": "Other specified congenital anomaly of great arteries including arterial duct" }, { "code": "JB02.4", "title": "Hypertonic, incoordinate, or prolonged uterine contractions" }, { "code": "LD26.5", "title": "Constriction rings" }, { "code": "DA20.0", "title": "Oesophageal obstruction" }, { "code": "MC41", "title": "Tinnitus" }, { "code": "BC43.5", "title": "Stress-induced cardiomyopathy" }, { "code": "BB62.Z", "title": "Mitral valve prolapse, unspecified" }, { "code": "PA50.Z&XE3J3", "title": "Balloon accident injuring occupant" } ]
=== ICD-11 CODES FOUND === [QB84] Follow-up care involving removal of fracture plate or other internal fixation device Also known as: Follow-up care involving removal of fracture plate or other internal fixation device | Change of internal fixation device | change of fixation device | change of Kirschner wire | Checking of internal fixation device Excludes: removal of external fixation device [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 [JB02.4] Hypertonic, incoordinate, or prolonged uterine contractions Definition: A condition affecting pregnant females that is idiopathic. This condition is characterised by uterine dysfunction leading to hypertonic, uncoordinated, and prolonged rhythmic activity of the myometrium during labour. Also known as: Hypertonic, incoordinate, or prolonged uterine contractions | Uterine dystocia NOS | Hypertonic uterus dysfunction complicating delivery | hypertonic uterine activity | hypertonic uterine contraction Excludes: dystocia (fetal)(maternal) NOS [LD26.5] Constriction rings Definition: A condition caused by entangling of fibrous bands of the amniotic sac around a developing fetus. This condition may present with circular indentation around a digit or limb, swelling, restriction of the lymphatic or venous flow, limb development defects, or in utero amputation. Also known as: Constriction rings | Amniotic band syndrome | Constriction ring syndrome | Congenital amputation [DA20.0] Oesophageal obstruction Definition: Hindrance of the passage of luminal contents in the oesophagus. Obstruction of oesophagus can be partial or complete, and caused by intrinsic or extrinsic factors. Also known as: Oesophageal obstruction | obstruction of oesophagus | oesophageal narrowing | obstructed oesophagus | Stricture of oesophagus Excludes: Congenital stenosis or stricture of oesophagus | Anatomical alteration due to gastro-oesophageal reflux disease | Neoplasms of the oesophagus [MC41] Tinnitus Definition: A nonspecific symptom of hearing disorder characterised by the sensation of buzzing, ringing, clicking, pulsations, and other noises in the ear in the absence of appropriate corresponding external stimuli and in the absence of what the examiner can hear with a stethoscope. Also known as: Tinnitus | noises in ear | observation of tinnitus | ringing in ear | tinnitus aurium [BC43.5] Stress-induced cardiomyopathy Definition: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocardial infarction, but with non-specific electrocardiographic ST elevation and T wave changes, and minimal myocardial enzymatic release, in the absence of coronary stenosis. Also known as: Stress-induced cardiomyopathy | Takotsubo cardiomyopathy | stress cardiomyopathy | broken heart syndrome | apical ballooning syndrome Includes: Takotsubo cardiomyopathy [BB62.Z] Mitral valve prolapse, unspecified Also known as: Mitral valve prolapse, unspecified | Mitral valve prolapse | systolic click-murmur syndrome | ballooning mitral valve | Barlow syndrome === GRAPH WALKS === --- Walk 1 --- [QB84] Follow-up care involving removal of fracture plate or other internal fixation device --EXCLUDES--> [?] Follow-up care involving removal of external fixation device --PARENT--> [?] Contact with health services for specific surgical interventions --- Walk 2 --- [QB84] Follow-up care involving removal of fracture plate or other internal fixation device --EXCLUDES--> [?] Follow-up care involving removal of external fixation device --PARENT--> [?] Contact with health services for specific surgical interventions --- Walk 3 --- [LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct --PARENT--> [LA8B] Congenital anomaly of great arteries including arterial duct Def: A congenital cardiovascular malformation of the great arteries (aorta, pulmonary trunk [main pulmonary artery], branch pulmonary arteries) or the arterial duct (ductus arteriosus).... --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.... --- Walk 4 --- [LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct --PARENT--> [LA8B] Congenital anomaly of great arteries including arterial duct Def: A congenital cardiovascular malformation of the great arteries (aorta, pulmonary trunk [main pulmonary artery], branch pulmonary arteries) or the arterial duct (ductus arteriosus).... --CHILD--> [LA8B.0] Congenital aortopulmonary window Def: A congenital cardiovascular malformation in which there is side-to-side continuity of the lumens of the ascending aorta and pulmonary trunk in association with separate aortic and pulmonary valves or ... --- Walk 5 --- [JB02.4] Hypertonic, incoordinate, or prolonged uterine contractions Def: A condition affecting pregnant females that is idiopathic. This condition is characterised by uterine dysfunction leading to hypertonic, uncoordinated, and prolonged rhythmic activity of the myometriu... --EXCLUDES--> [?] Obstructed labour due to other causes Def: Any other condition characterised by the inability of the presenting part of the fetus to progress into the birth canal for any reason.... --CHILD--> [?] Obstructed labour due to locked twins --- Walk 6 --- [JB02.4] Hypertonic, incoordinate, or prolonged uterine contractions Def: A condition affecting pregnant females that is idiopathic. This condition is characterised by uterine dysfunction leading to hypertonic, uncoordinated, and prolonged rhythmic activity of the myometriu... --PARENT--> [JB02] Abnormalities of forces of labour Def: Any condition affecting pregnant females, characterised by an anomaly or dysfunction to the tissues or processes associated with the natural progression of labour. These conditions may lead to further... --CHILD--> [JB02.0] Primary uterine inertia Def: A condition affecting pregnant females characterised by insufficiently strong or inappropriately coordinated rhythmic activity of the myometrium during labour to efface and dilate the cervix....
[ "[QB84] Follow-up care involving removal of fracture plate or other internal fixation device\n --EXCLUDES--> [?] Follow-up care involving removal of external fixation device\n --PARENT--> [?] Contact with health services for specific surgical interventions", "[QB84] Follow-up care involving removal of fracture plate or other internal fixation device\n --EXCLUDES--> [?] Follow-up care involving removal of external fixation device\n --PARENT--> [?] Contact with health services for specific surgical interventions", "[LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct\n --PARENT--> [LA8B] Congenital anomaly of great arteries including arterial duct\n Def: A congenital cardiovascular malformation of the great arteries (aorta, pulmonary trunk [main pulmonary artery], branch pulmonary arteries) or the arterial duct (ductus arteriosus)....\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....", "[LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct\n --PARENT--> [LA8B] Congenital anomaly of great arteries including arterial duct\n Def: A congenital cardiovascular malformation of the great arteries (aorta, pulmonary trunk [main pulmonary artery], branch pulmonary arteries) or the arterial duct (ductus arteriosus)....\n --CHILD--> [LA8B.0] Congenital aortopulmonary window\n Def: A congenital cardiovascular malformation in which there is side-to-side continuity of the lumens of the ascending aorta and pulmonary trunk in association with separate aortic and pulmonary valves or ...", "[JB02.4] Hypertonic, incoordinate, or prolonged uterine contractions\n Def: A condition affecting pregnant females that is idiopathic. This condition is characterised by uterine dysfunction leading to hypertonic, uncoordinated, and prolonged rhythmic activity of the myometriu...\n --EXCLUDES--> [?] Obstructed labour due to other causes\n Def: Any other condition characterised by the inability of the presenting part of the fetus to progress into the birth canal for any reason....\n --CHILD--> [?] Obstructed labour due to locked twins", "[JB02.4] Hypertonic, incoordinate, or prolonged uterine contractions\n Def: A condition affecting pregnant females that is idiopathic. This condition is characterised by uterine dysfunction leading to hypertonic, uncoordinated, and prolonged rhythmic activity of the myometriu...\n --PARENT--> [JB02] Abnormalities of forces of labour\n Def: Any condition affecting pregnant females, characterised by an anomaly or dysfunction to the tissues or processes associated with the natural progression of labour. These conditions may lead to further...\n --CHILD--> [JB02.0] Primary uterine inertia\n Def: A condition affecting pregnant females characterised by insufficiently strong or inappropriately coordinated rhythmic activity of the myometrium during labour to efface and dilate the cervix...." ]
QB84
Follow-up care involving removal of fracture plate or other internal fixation device
[ { "from_icd11": "QB84", "icd10_code": "Z4733", "icd10_title": "Aftercare following explantation of knee joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z4732", "icd10_title": "Aftercare following explantation of hip joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z472", "icd10_title": "Encounter for removal of internal fixation device" }, { "from_icd11": "QB84", "icd10_code": "Z471", "icd10_title": "Aftercare following joint replacement surgery" }, { "from_icd11": "QB84", "icd10_code": "Z4731", "icd10_title": "Aftercare following explantation of shoulder joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z4781", "icd10_title": "Encounter for orthopedic aftercare following surgical amputation" }, { "from_icd11": "QB84", "icd10_code": "Z4789", "icd10_title": "Encounter for other orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z47", "icd10_title": "Orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z470", "icd10_title": "" }, { "from_icd11": "QB84", "icd10_code": "Z478", "icd10_title": "Encounter for other orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z479", "icd10_title": "" }, { "from_icd11": "JB02.4", "icd10_code": "O624", "icd10_title": "Hypertonic, incoordinate, and prolonged uterine contractions" }, { "from_icd11": "DA20.0", "icd10_code": "K222", "icd10_title": "Esophageal obstruction" }, { "from_icd11": "MC41", "icd10_code": "H9312", "icd10_title": "Tinnitus, left ear" }, { "from_icd11": "MC41", "icd10_code": "H9311", "icd10_title": "Tinnitus, right ear" } ]
Z4733
Aftercare following explantation of knee joint prosthesis
A 34‐year‐old woman presented to our hospital with a mass in her right breast, which she noticed after giving birth to her second child. Breast cancer was diagnosed via core needle biopsy. The tumor was classified as invasive ductal carcinoma, estrogen receptor (ER) positive, progesterone receptor (PgR) positive, and HER2 positive. The patient's family history was as follows: her maternal grandmother suffered from stomach cancer in her seventies, her mother suffered from gallbladder cancer in her fifties, and her maternal aunt suffered from stomach cancer in her thirties. The timeline of the treatment course is shown in Figure 1 . The patient received eight courses of docetaxel–pertuzumab–trastuzumab therapy (75 mg/m 2 docetaxel on Day 1, 420 mg/kg pertuzumab on Day 1, and 6 mg/kg trastuzumab on Day 1 every 3 weeks). Subsequently, right total mastectomy and axillary lymph node dissection were performed. The main pathological findings were a residual tumor diameter measuring 53 mm, a number of residual lymph node metastases found in four of 18 nodes, ER and PgR positivity, HER2 negativity, and a histological response to preoperative therapy of grade 1a. Postoperatively, the patient received chemotherapy and endocrine therapy (pertuzumab–trastuzumab, tamoxifen, and a luteinizing hormone‐releasing hormone agonist). Magnetic resonance imaging revealed liver metastases. After three courses of trastuzumab emtansine (3.6 mg/kg every 3 weeks), the metastatic lesions had progressed. Subsequently, adriamycin and cyclophosphamide (AC) therapy (60 mg/m 2 adriamycin on Day 1 and 600 mg/m 2 cyclophosphamide on Day 1 every 3 weeks) was administered. Considering cardiotoxicity, AC therapy was completed after 11 courses (total adriamycin dose: 495 mg/m 2 ). Thereafter, lapatinib plus capecitabin therapy was administered. After 20 months, the metastatic tumors showed progression . BRCA genetic testing (BRACAnalysis® [Myriad Genetics]) was conducted using the patient's blood sample as the germline sample, and a pathogenic variant was detected. The variant using hg19 as the reference genome was BRCA2 : c.9139C>T . Considering her age, the BRCA test should have been done earlier, but considering the timing of insurance coverage in our country, it was decided at this time. As the results of immunostaining of the surgical specimen were negative for HER2, olaparib (600 mg/kg daily) was administered. The tumor size reduced after olaparib administration ; however, progression of liver metastases was noted after 12 months of olaparib administration . Repeated biopsy of the liver metastasis revealed an ER‐positive, PgR‐positive, and HER2‐negative tumor. Abemaciclib (150 mg twice daily) plus fulvestrant (500 mg every 4 weeks) therapy was administered. After 8 months, metastatic lesions progressed. Considering the possibility that HER2‐positive cells were dominant, trastuzumab deruxtecan (5.4 mg/kg every 3 weeks) was administered. After 4 months, metastatic lesions progressed. The HER2 status was not confirmed, but we decided to use drugs that had not been previously used; therefore, bevacizumab (10 mg/kg on Days 1 and 15 every 4 weeks) plus paclitaxel therapy (90 mg/m 2 on Days 1, 8, and 15 every 4 weeks) was administered. Cancer genomic profiling (FoundationOne® Liquid CDx) was performed during bevacizumab plus paclitaxel therapy. The sample at the time of surgery was >3 years old, and the amount of specimen at the time of liver biopsy was insufficient; therefore, liquid biopsy was performed. Figure 2D shows computed tomography images of liver metastasis when cancer genomic profiling testing was performed. The variants detected were BRCA2 c.9139C>T and BRCA2 c.9139_9141delinsTAC mutations, with 48.9% and 0.37% allele frequencies, respectively . The other variants that were detected were as follows: DNMT3A c.2183G>A (p.G728D) with 0.6% allele frequency, LTK c.548C>T (p.S183F) with 45.2% allele frequency, LTK c.2120G>A (p.W707Ter) with 48.4% allele frequency, MSH2 c.2197G>A (p.A733T) with 48.0% allele frequency, RB1 c.2455C>G (p.L819V) with 46.0% allele frequency, SPOP c.931C>T (p.L311F) with 46.0% allele frequency, and MYC rearrangement . After 9 months of bevacizumab plus paclitaxel therapy, metastatic lesions progressed. After that, we decided to use drugs that had not been used previously; therefore, eribulin was sequentially administered (1.1 mg/m 2 on Days 1 and 8 every 3 weeks). However, after 3 months, metastatic lesions progressed; thus, irinotecan (100 mg/m 2 on Days 1, 8, and 15 every 5 weeks) was administered. After one course, the patient's general condition deteriorated, and the policy of best supportive care was adopted; 4 months later, the patient died.
4.039063
0.975098
sec[1]/p[0]
en
0.999995
PMC10290195
https://doi.org/10.1002/ccr3.7537
[ "every", "allele", "cancer", "metastatic", "frequency", "trastuzumab", "liver", "lesions", "progressed", "plus" ]
[ { "code": "5A00.03", "title": "Transient congenital hypothyroidism" }, { "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": "5C64.5", "title": "Disorders of calcium metabolism" }, { "code": "2E03", "title": "Malignant neoplasm metastasis in bone or bone marrow" }, { "code": "2D70", "title": "Malignant neoplasm metastasis in lung" }, { "code": "MF50.0", "title": "Frequent micturition" } ]
=== ICD-11 CODES FOUND === [5A00.03] Transient congenital hypothyroidism Definition: Transient congenital hypothyroidism is defined as transient thyroid dysfunction with mildly elevated thyroid-stimulating hormone (TSH) and low thyroxine (FT4) levels which return to normal either very promptly and spontaneously, or after several months of thyroxine therapy. The disorder is due to a variety of causes including iodine deficiency or exposure to iodine-containing compounds, transplacental passage of blocking maternal antibodies, and dyshormonogenesis. Also known as: Transient congenital hypothyroidism | Transient congenital hypothyroidism due to monoallelic or biallelic mutations of dual oxidase 2 mutation | Transient congenital hypothyroidism due to heterozygous mutations of monoallelic or biallelic mutations of DUOX2 mutation | Transient congenital hypothyroidism due to maternal intake of antithyroid drugs | Transient congenital hypothyroidism due to maternal iodine deficiency or excess Excludes: Transitory congenital goitre with normal function [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 [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 [2E03] Malignant neoplasm metastasis in bone or bone marrow Definition: The spread of a malignant neoplasm from a primary site to the skeletal system. The majority of metastatic neoplasms to the bone are carcinomas. Also known as: Malignant neoplasm metastasis in bone or bone marrow | bone metastasis | bony metastasis | osseous metastasis | secondary cancer of bone [2D70] Malignant neoplasm metastasis in lung Also known as: Malignant neoplasm metastasis in lung | metastasis in lung | pulmonary metastasis | secondary cancer in lung | secondary malignant tumour in lung Excludes: Malignant neoplasms of bronchus or lung [MF50.0] Frequent micturition Definition: Needing to urinate more often than normal. Also known as: Frequent micturition | Urinary frequency | Frequency of micturition NOS | Frequent urination | Micturition frequency Excludes: Pollakiuria === GRAPH WALKS === --- Walk 1 --- [5A00.03] Transient congenital hypothyroidism Def: Transient congenital hypothyroidism is defined as transient thyroid dysfunction with mildly elevated thyroid-stimulating hormone (TSH) and low thyroxine (FT4) levels which return to normal either very... --EXCLUDES--> [?] Neonatal goitre, not elsewhere classified Def: A paediatric condition characterised by swelling of the thyroid gland of a newborn with associated swelling of the neck or larynx that is not classified elsewhere.... --PARENT--> [?] Transitory neonatal disorders of thyroid function Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with the thyroid.... --- Walk 2 --- [5A00.03] Transient congenital hypothyroidism Def: Transient congenital hypothyroidism is defined as transient thyroid dysfunction with mildly elevated thyroid-stimulating hormone (TSH) and low thyroxine (FT4) levels which return to normal either very... --PARENT--> [5A00.0] Congenital hypothyroidism Def: Hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises at birth. Common clinical features include decreased activity and increased sl... --CHILD--> [5A00.00] Permanent congenital hypothyroidism with diffuse goitre Def: A condition caused by a partial or complete loss of thyroid function due to failure of the thyroid to correctly develop during the antenatal period. This condition is characterised by a swollen, smoot... --- Walk 3 --- [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 4 --- [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 5 --- [2C0Z] Malignant neoplasms of intestine, unspecified --PARENT--> [?] Malignant neoplasms of intestine --CHILD--> [?] Malignant neoplasms of large intestine --- Walk 6 --- [2C0Z] Malignant neoplasms of intestine, unspecified --PARENT--> [?] Malignant neoplasms of intestine --PARENT--> [?] Malignant neoplasms of digestive organs Def: A primary malignant neoplasm involving any part of the gastrointestinal system....
[ "[5A00.03] Transient congenital hypothyroidism\n Def: Transient congenital hypothyroidism is defined as transient thyroid dysfunction with mildly elevated thyroid-stimulating hormone (TSH) and low thyroxine (FT4) levels which return to normal either very...\n --EXCLUDES--> [?] Neonatal goitre, not elsewhere classified\n Def: A paediatric condition characterised by swelling of the thyroid gland of a newborn with associated swelling of the neck or larynx that is not classified elsewhere....\n --PARENT--> [?] Transitory neonatal disorders of thyroid function\n Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with the thyroid....", "[5A00.03] Transient congenital hypothyroidism\n Def: Transient congenital hypothyroidism is defined as transient thyroid dysfunction with mildly elevated thyroid-stimulating hormone (TSH) and low thyroxine (FT4) levels which return to normal either very...\n --PARENT--> [5A00.0] Congenital hypothyroidism\n Def: Hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises at birth. Common clinical features include decreased activity and increased sl...\n --CHILD--> [5A00.00] Permanent congenital hypothyroidism with diffuse goitre\n Def: A condition caused by a partial or complete loss of thyroid function due to failure of the thyroid to correctly develop during the antenatal period. This condition is characterised by a swollen, smoot...", "[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 --CHILD--> [?] Malignant neoplasms of large intestine", "[2C0Z] Malignant neoplasms of intestine, unspecified\n --PARENT--> [?] Malignant neoplasms of intestine\n --PARENT--> [?] Malignant neoplasms of digestive organs\n Def: A primary malignant neoplasm involving any part of the gastrointestinal system...." ]
5A00.03
Transient congenital hypothyroidism
[ { "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
Date Relevant Patient Data December 3, 2017 (day 1/admission date) Patient admitted with: Severe headaches; Convulsions; Difficulty swallowing; Polyuria; Polydipsia; Tachycardia; Positive Kernig’s; Right upper quadrant (RUQ) tenderness; Diagnosed with bacterial meningitis in a diabetic; with differentials of cerebral malaria, brain abscess; Labs 1. FBS: 19.1 mmol/l Daily FBS 2. PITC: non-reactive; 3. LP for CSF analysis: biochemistry, microscopy, India ink, ZN staining. 4. ESR: 87 mm/hr.; 5. BS for MPS: 20 parasites per 200 wbcs; 6. FHG, UECs, CT scan: patient did not do these because of lack of funds; 7. Urinalysis: ph = 7.0; glucose +++; blood ++; SG 1.010; ketones nil; deposit: nothing seen. 8. Abdominal ultrasound: normal abdominal scan, no renal or splenic abscess. Treatment: 1. Diazepam 10 mg PRN 2. Artesunate: 180 mg at 0, 12 and 24 h; 3. Ceftriaxone 2 g BD for 10 days; 4. Paracetamol 1 g tid 5. Metformin 500 mg bd 6. Dentogel cream apply QID on the oral lesions for 5 days. 7. IV fluids 4 l of normal saline in 24 h Day 2 Patient had four convulsions last night. Another which was partial occurs during the round. On examination: left sided paresis noted. All vitals including heart rate were now normal. Results: 1. CSF: turbid; 60 cells/mm 3 ; Pandy test negative; India ink positive; gram stain: no organism isolated; ZN negative; VDRL: negative. 2. FBS = 17.4 mmol/l; 3. I.V phenytoin 100 mg BD 4. Fluconazole 1200 mg od for 2 weeks, then 400 mg od for 10 weeks; then 200 mg od for 6 months. 5. Daily FBS; do UECs, FHG, CT scan of the head, TSH 6. Continue with ceftriaxone, metformin, PCM, dentogel, and artesunate, 7. Monitor for seizure occurrence and chart Day 3 Reports improvement with no seizures reported; patient is now able to feed, has mild headaches. FBS not reported; Vitals normal (BP = 112/72 mmHg, pulse 97 bpm, SPO2 = 94%); Neck is soft and Kernig’s negative. Plan: continue with fluconazole, ceftriaxone, phenytoin, paracetamol, aremether-lumefantrine Day 4–6 Reports some neck pains and headaches; On examination, patient is in fair general condition, vitals are normal; Neck is soft and Kernig’s negative; FBS oscillates between 13 and 14 mmol/l; Plan: continue with medication, do nutritional counseling because of diabetes; Day 7 Patient complaints of frontal headache, itchiness on areas that had strapping used to secure IV lines, and gluteal itchiness FBS = 13.7 mmol/l; Patient is once again sick looking, with normal vitals (BP = 116/79 mmHg; SPO 2 = 95%; pulse = 85) Neck is stiff and tongue lesions are still present on the edge of the tongue; Pruritic pustules on the areas with strapping, buttock has no eruptions; Plan: 1. I.M diclofenac 75 mg PRN; 2. hydrocortisone cream to apply bd; 3. soluble insulin 5 IU tid; 4. continue antimeningitics and phenytoin; 5. do daily pre-dinner RBS and FBS. Day 8 Patient still complaining of severe headache despite administration of three doses of diclofenac; the tongue ulcer is still painful and she is still itching; Patient is sick looking but with normal vitals; She still has the stiff neck, rashes and the tongue ulcers; Plan: 1. 4mls of clear CSF tapped and sent for microscopy: India ink positive; 2. Continue with the medication from the previous day. Day 9 The headaches have improved and her vitals are normal; FBS = 20.9 mmol/l; Plan: 1. stop the insulin; 2. increase metformin to 1 g bd; 3. continue with other medication. Day 10–13 Patient reports improvement and her vitals are normal. RBS ranged between 8.0 and 13.1 mmol/l. Plan: 1. continue with management as per treatment sheet i.e. ceftriaxone, fluconazole, metformin, glibenclamide, hydrocortisone cream and dentogel. 2. Do serial CSF tapping if headaches are persistent. Day 14 Patient has no complaints today. FBS = 8 mmol/l. Plan: 1. Allow home on metformin 750 mg bd; 2. Fluconazole 800 mg od for two weeks then 400 mg for 10 weeks; 3. Dentogel, hydrocortisone cream, and omeprazole. 4. To come again on 12th January 2018. 1st clinic visit Patient is doing well except for a flare up of her allergic rhino-sinusitis. Blood sugar was 5.8 mmol/l and a repeat lumber puncture was negative on India ink test. The need for dietary prudence and drug adherence was emphasized. She was then given fluconazole 800 mg od and asked to continue with metformin 750 mg bd, cetirizine 10 mg prn, omeprazole 20 mg bd and hydrocortisone. 2nd clinic visit Patient diagnosed with pneumonia; RBS = 8.2 mmol/l; BS for MPS was negative; CSF for India ink was negative for Cryptococcus; Plan: -septrin 960 mg bd for one week; -paracetamol 1 g tid for 5 days; -omeprazole 20 mg 1 h before supper for a month; -fluconazole 800 mg od for a month; -metformin 500 mg bd for a month;
3.574219
0.981934
sec[1]/sec[1]/p[0]
en
0.999998
30606110
https://doi.org/10.1186/s12879-018-3625-4
[ "mmol", "continue", "plan", "metformin", "vitals", "fluconazole", "headaches", "india", "neck", "still" ]
[ { "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": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB80.Y", "title": "Other specified disorders of bone density or structure" }, { "code": "QF2B", "title": "Need for continuous supervision" }, { "code": "6A21.2Z", "title": "Schizoaffective disorder, continuous, unspecified" }, { "code": "8C71.4", "title": "Neuromyotonia" }, { "code": "QB9Y", "title": "Other specified contact with health services for nonsurgical interventions not involving devices" }, { "code": "QF10", "title": "Limited function or disability of body organ or system" } ]
=== 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 [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 [FB80.Y] Other specified disorders of bone density or structure Also known as: Other specified disorders of bone density or structure | Bone dysplasia | Inherited bone dysplasia | Acquired bone dysplasia | Drug-induced bone dysplasia [QF2B] Need for continuous supervision Also known as: Need for continuous supervision Excludes: Difficulty or need for assistance at home and no other household member able to render care [6A21.2Z] Schizoaffective disorder, continuous, unspecified Also known as: Schizoaffective disorder, continuous, unspecified | Schizoaffective disorder, continuous [8C71.4] Neuromyotonia Definition: Neuromyotonia or Isaac's syndrome is an immune-mediated peripheral nerve disorder characterised by continuous muscle fibre activity at rest resulting in muscle stiffness, cramps, myokymia, and pseudomyotonia. Also known as: Neuromyotonia | Isaacs neuromyotonia | Isaacs syndrome | Isaacs-Mertens syndrome | continuous muscle fibre activity [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 [QF10] Limited function or disability of body organ or system Also known as: Limited function or disability of body organ or system | disability of body organ or system | limited function of body organ or system | Limited function or disability of blood or blood forming organs | Limited function of blood or blood forming organs Excludes: Difficulty or need for assistance with activities === 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--> [?] 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... --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 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 --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--> [?] 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 --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 --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 --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": "FB80.Z", "icd10_code": "M8458XA", "icd10_title": "Pathological fracture in neoplastic disease, other specified site, initial encounter for fracture" }, { "from_icd11": "FB80.Z", "icd10_code": "M84552A", "icd10_title": "Pathological fracture in neoplastic disease, left femur, initial encounter for fracture" }, { "from_icd11": "FB80.Z", "icd10_code": "M8468XA", "icd10_title": "Pathological fracture in other disease, other site, initial encounter for fracture" }, { "from_icd11": "FB80.Z", "icd10_code": "M84652K", "icd10_title": "Pathological fracture in other disease, left femur, subsequent encounter for fracture with nonunion" }, { "from_icd11": "FB80.Z", "icd10_code": "M84522A", "icd10_title": "Pathological fracture in neoplastic disease, left humerus, initial encounter for fracture" }, { "from_icd11": "FB80.Z", "icd10_code": "M8450XA", "icd10_title": "Pathological fracture in neoplastic disease, unspecified site, initial encounter for fracture" }, { "from_icd11": "FB80.Z", "icd10_code": "M84559D", "icd10_title": "Pathological fracture in neoplastic disease, hip, unspecified, subsequent encounter for fracture with routine healing" }, { "from_icd11": "FB80.Z", "icd10_code": "M84521D", "icd10_title": "Pathological fracture in neoplastic disease, right humerus, subsequent encounter for fracture with routine healing" }, { "from_icd11": "FB80.Z", "icd10_code": "M84559A", "icd10_title": "Pathological fracture in neoplastic disease, hip, unspecified, initial encounter for fracture" }, { "from_icd11": "FB80.Z", "icd10_code": "M84659A", "icd10_title": "Pathological fracture in other disease, hip, unspecified, initial encounter for fracture" }, { "from_icd11": "FB80.Z", "icd10_code": "M84521A", "icd10_title": "Pathological fracture in neoplastic disease, right humerus, initial encounter for fracture" }, { "from_icd11": "FB80.Z", "icd10_code": "M84550A", "icd10_title": "Pathological fracture in neoplastic disease, pelvis, initial encounter for fracture" }, { "from_icd11": "FB80.Z", "icd10_code": "M84511A", "icd10_title": "Pathological fracture in neoplastic disease, right shoulder, initial encounter for fracture" }, { "from_icd11": "FB80.Z", "icd10_code": "M8458XD", "icd10_title": "Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing" }, { "from_icd11": "FB80.Z", "icd10_code": "M84551A", "icd10_title": "Pathological fracture in neoplastic disease, right femur, initial encounter for fracture" } ]
M8458XA
Pathological fracture in neoplastic disease, other specified site, initial encounter for fracture
Patient 1 is a 6-month-old boy who was born term with a birth weight of 3.3 kg via urgent C-section due to maternal bleeding. Prenatal course was otherwise unremarkable. Due to severe hypoxemic respiratory failure at birth, he was treated with intubation, high frequency ventilation, supplemental oxygen (FiO2 = 1.00), iNO, and surfactant administration. Echocardiogram showed right to left ductal shunt consistent with severe PH. Intravenous epoprostenol, sildenafil and milrinone were started in addition to iNO. He underwent cardiac catheterization at 1.5 months of age. Hemodynamic evaluation showed an indexed pulmonary vascular resistance (PVRi) of 15.5 WU*m2 (iNO, oxygen and sildenafil) which decreased to 10.2 WU*m2 with acute uptitration of epoprostenol. Chest CT scan was significant for enlarged pulmonary arteries, patent ductus arteriosus and nonspecific findings suggestive of interstitial lung disease including interlobular septal thickening and ground-glass opacity without pulmonary nodules. He subsequently underwent lung biopsy which demonstrated alveolar simplification with interstitial widening, muscularization of small and medium sized pulmonary arteries and interstitial cells suggestive of pulmonary interstitial glycogenosis but no evidence of alveolar capillary dysplasia. Whole exome sequencing showed a pathogenic 17q23 microdeletion, which encompasses the PH associated TBX4 gene. He was then transferred to our institution at ∼2 months of age for further care. His PAH therapy was titrated to combination therapy with sildenafil, bosentan, intravenous treprostinil, and iNO. His treatment also included an intravenous steroid burst followed by daily inhaled steroids with a modest clinical response but persistent severe pulmonary hypertension by echocardiogram. Over the subsequent 2 months, he continued to manifest hemodynamic instability and post-ductal hypoxemia suggestive of suprasystemic PH. At 4 months of age sildenafil was discontinued due to the lack of a clear clinical response as well as parental concerns regarding the use of this drug. He also developed significant transaminitis prompting cessation of bosentan at 5.5 months of age. He subsequently underwent a second cardiac catheterization at 6 months of age to evaluate his response to ongoing therapy, which showed improvement from his previous catheterization but still severe disease, with a mean pulmonary arterial pressure (mPAP) of 38 mmHg [systemic mean arterial pressure (sMAP) of 49 mmHg], and PVRi of 5.91 WU*m2 (iNO + oxygen + treprostinil). His Qp:Qs improved with increasing doses of iNO and treprostinil . Due to hypotension after the catheterization, his treprostinil dose was maintained at 50 ng/kg/min and iNO increased to 60 ppm delivered via noninvasive ventilation. He failed multiple attempts to wean his iNO dose below 60 ppm, as evidenced by right to left ductal shunting on echocardiogram and significant pre- and post-ductal saturation gradients during attempted weans. Because of inability to even slowly wean from this high dose of iNO, the decision was made to start riociguat as additional targeted PAH therapy. Riociguat was initiated at 0.05 mg once daily (0.006 mg/kg/dose), and slowly increased to 0.5 mg/dose thrice daily. He had hypotension without signs of inadequate perfusion after the third dose of riociguat but responded well to saline bolus. Apart from this event, the titration was well tolerated and his hypoxemic events became less frequent. Riociguat was gradually increased to 2 mg/dose TID with iNO weaned and eventually discontinued 7 weeks after riociguat initiation . He had no other reported side effects from riociguat during the titration period. During riociguat uptitration, he was able to wean from noninvasive positive pressure ventilation to nasal cannula. Repeat echocardiogram off iNO showed improved ventricular septal flattening and a greater degree of left to right shunting across the PDA, suggesting improved pulmonary vascular resistance. He was discharged home on subcutaneous treprostinil 37 ng/kg/min, riociguat 2 mg TID, and supplemental oxygen. Repeat echocardiogram 2 months later showed continuous low velocity left to right flow in his patent ductus arteriosus, moderate septal flattening and preserved biventricular systolic function. With improved growth and activity level, and no parental report of intolerance to medications after 4 months on this combination therapy, riociguat was increased to 2.5 mg TID at 13 months of age (body weight 9.4 kg). At latest outpatient follow up, he was 21 months old, World Health Organization functional class II with persistent sub-systemic pulmonary hypertension by echocardiogram, and preserved growth.
4.019531
0.977051
sec[1]/p[0]
en
0.999998
PMC9751701
https://doi.org/10.3389/fped.2022.1014922
[ "pulmonary", "riociguat", "echocardiogram", "treprostinil", "oxygen", "ductal", "sildenafil", "catheterization", "which", "interstitial" ]
[ { "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": "MC90", "title": "Clinical findings on diagnostic imaging of heart or coronary circulation" }, { "code": "MD11.1", "title": "Asphyxia" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "3A51.7", "title": "High affinity haemoglobin" }, { "code": "NF05", "title": "Asphyxiation" } ]
=== 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 [MC90] Clinical findings on diagnostic imaging of heart or coronary circulation Also known as: Clinical findings on diagnostic imaging of heart or coronary circulation | abnormal diagnostic imaging of heart | abnormal diagnostic imaging of coronary circulation | abnormal echocardiogram | abnormal findings on diagnostic imaging of heart and coronary circulation Excludes: Long QT syndrome [MD11.1] Asphyxia Definition: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all the conditions generating impaired or impeded breathing. Also known as: Asphyxia | pathological asphyxia | decreased oxygen supply | oxygen deficiency | positional asphyxia Excludes: asphyxia due to foreign body in respiratory tract | asphyxia due to carbon monoxide | asphyxia due to traumatic [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 [3A51.7] High affinity haemoglobin Definition: A disease caused by determinants arising after birth, in the antenatal period or by genetically inherited factors leading to high oxygen affinity haemoglobin. This disease is characterised by abnormalities in the globin chains that alter the affinity of the haemoglobin molecule for oxygen, affecting the normal loading of oxygen in the lungs and delivery of oxygen to the tissues. Also known as: High affinity haemoglobin | Haemoglobins with abnormal oxygen affinity [NF05] Asphyxiation Also known as: Asphyxiation | suffocation NOS | traumatic asphyxia | positional asphyxiation | asphyxia (ligature) Excludes: Respiratory distress of newborn | Adult acute respiratory distress syndrome | asphyxia from carbon monoxide === GRAPH WALKS === --- Walk 1 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --CHILD--> [CB40.1] Young syndrome Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections.... --- Walk 2 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality --- Walk 3 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --PARENT--> [?] Structural developmental anomalies of the respiratory system --- 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 ... --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o... --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --CHILD--> [CA40.2] Fungal pneumonia
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.1] Young syndrome\n Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections....", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies 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--> [LA75.2] 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 --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii\n Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --CHILD--> [CA40.2] Fungal pneumonia" ]
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 31‐year‐old, gravida 4, para 1, woman was referred to our institute due to suspected fetal Pierre Robin sequence, at 34 + 6 weeks of gestation. A difficult intubation was anticipated, and the possibility of achieving surgical airway in an EXIT procedure was planned. The woman, which is known to have a bicornuate uterus, had previously undergone a cesarean section during her first labor due to breech presentation at 39 weeks of gestation. The child was born weighing 2710 g with micrognathia and cleft palate, not requiring an EXIT procedure. She also underwent two spontaneous abortions at 8 weeks of gestation. A prenatal magnetic resonance imaging (MRI) at 32 + 2 weeks of gestation and an ultrasound (US) demonstrated severe micrognathia. Fetal echocardiography and genetic consultation were normal. Amniocentesis was not performed due to maternal refusal. At 35 + 2 weeks of gestation, a two‐dimensional US was repeated and a three‐dimensional US was performed to evaluate in more detail the fetal anatomy and growth. US showed polyhydramnios, dropped tongue, posterior pharynx, and retrognathia‐micrognathia. No palate was observed. While the delivery was planned to 37 weeks of gestation (for fetal lung maturity), 7 at 35 + 3 weeks of gestation, the patient started feeling regular uterine contractions, and it seemed as she was going into spontaneous labor. Contraction stress test was negative, US showed breech presentation, and the blood pressure and pulse were within normal ranges. After a multidisciplinary discussion, the decision was made to deliver through a cesarean section with preparation for a possible EXIT procedure. Members of the team (including fetomaternal medicine/obstetricians, otolaryngologist, neonatologists, anesthesiologist, pediatric anesthesiologist, pediatric pulmonologist, midwifery, and neonatal intensive care unit nursing) were gathered to prepare for the delivery and perform an EXIT procedure to secure an airway if necessary. Due to breech presentation, bicornuate uterus (pregnancy in the left uterus), placental location (fundal posterior), low uterine segment dehiscence, and umbilical cord entanglement around the fetus neck (two complete loops), a classic EXIT procedure could not be performed. The plan was that after the delivery of the breech presentation newborn, the placenta would be left attached supplying oxygen to the newborn. Uterine muscle relaxants will be given to provide maximum time of placental oxygenation to the newborn to allow the otolaryngologist to secure temporary newborn airway. After pulsation will not be felt in the umbilical cord, it would be transected, and later, definitive airway will be established. Through a cesarean section, the baby which was not crying nor breathing spontaneously was delivered and put at a sterile table at the mother's right side with the umbilical cord intact utilizing a modified EXIT procedure. The total maternal blood loss did not exceed 1000 mL, and there were no signs of maternal hemodynamic compromise during the procedure or maternal postoperative decrease in hemoglobin values. A live 2975 g female infant with Apgar scores of 6 and 6 at 1 and 5 minutes, respectively, was born (appearance—2, pulse—2, grimace—1, activity—1, respiration—0). Not being able to breathe spontaneously, the baby demonstrated signs of upper airway obstruction. Initially, the team waited for signs of spontaneous breathing before any intervention; however, the neonate did not seem to be able to breathe on her own. Only then, when it was clear that airway support is essential for saving the baby's life, attempts for direct laryngoscopy were undergone. After two failed direct laryngoscopy attempts by the pediatric anesthesiologist, another attempt was made by the otolaryngologist, and since a direct clear vision of the larynx could not be achieved due to the severe micrognathia, a decision to perform a tracheotomy to ventilate and secure the neonate airway was made. A laryngeal mask was inserted, and then, a tracheotomy was performed. Blood gases from the umbilical cord showed pH level of 7.3. Birthweight was 2975 g. The neonate was transferred to the neonatal intensive care unit, was ventilated through a 3.0 neonatal Shiley tracheostomy tube, and was stable . Cardiac echocardiography, abdominal US, and brain US were normal. The neonate was successfully disconnected from the ventilator 4 days after delivery and started breathing spontaneously . Long‐term airway management was planned, including distraction osteogenesis to attempt an improvement of airway dynamics, as well as cleft palate repair. 7 At the age of 2 years, the toddler is healthy and achieved all the developmental milestones on time.
3.890625
0.975586
sec[1]/p[0]
en
0.999996
30455887
https://doi.org/10.1002/ccr3.1799
[ "airway", "gestation", "exit", "fetal", "breech", "micrognathia", "maternal", "delivery", "umbilical", "cord" ]
[ { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "CA22.Z", "title": "Chronic obstructive pulmonary disease, unspecified" }, { "code": "7A41", "title": "Obstructive sleep apnoea" }, { "code": "CB60", "title": "Tracheostomy malfunction" }, { "code": "MD2Z", "title": "Haemorrhage from respiratory passages, unspecified" }, { "code": "JA61.Y", "title": "Other specified venous complications in pregnancy" }, { "code": "JA8E", "title": "Maternal care related to prolonged pregnancy" }, { "code": "JA01.Y", "title": "Other specified ectopic pregnancy" }, { "code": "JA61.Z", "title": "Venous complications in pregnancy, unspecified" }, { "code": "JA82.5", "title": "Maternal care for multiple gestation with malpresentation of one fetus or more" } ]
=== 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 [CA22.Z] Chronic obstructive pulmonary disease, unspecified Also known as: Chronic obstructive pulmonary disease, unspecified | Chronic obstructive pulmonary disease | COPD - [chronic obstructive pulmonary disease] | COAD - [chronic obstructive airways disease] | COLD - [chronic obstructive lung disease] [7A41] Obstructive sleep apnoea Definition: Obstructive sleep apnoea is characterised by repetitive episodes of apnoea or hypopnea that are caused by upper airway obstruction occurring during sleep. These events often result in reductions in blood oxygen saturation and are usually terminated by brief arousals from sleep. Excessive sleepiness is a major presenting complaint in many but not all cases. Reports of insomnia, poor sleep quality, and fatigue are also common. Upper airway resistance syndrome shares the same pathophysiology and sh Also known as: Obstructive sleep apnoea | obstructive sleep apnoea syndrome | obstructive sleep apnoea, adult | OSA - [obstructive sleep apnoea] | obstructive sleep apnoea, paediatric Excludes: Obstructive neonatal apnoea [CB60] Tracheostomy malfunction Also known as: Tracheostomy malfunction | tracheostomy dysfunction | status of malfunctioning tracheostomy | functional disturbance of tracheostomy | tracheostomy complications [MD2Z] Haemorrhage from respiratory passages, unspecified Also known as: Haemorrhage from respiratory passages, unspecified | haemorrhage from respiratory tract | respiratory system haemorrhage | airway haemorrhage NOS [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 [JA8E] Maternal care related to prolonged pregnancy Definition: Pregnancy that has exceeded a duration of 42 weeks from the last menstrual period. Also known as: Maternal care related to prolonged pregnancy | post-term pregnancy | pregnancy beyond 42 weeks of gestation | prolonged gestation | postmature pregnancy Includes: Post-term [JA01.Y] Other specified ectopic pregnancy Also known as: Other specified ectopic pregnancy | Cornual gestation or pregnancy | cornual gestation | cornual pregnancy | Cervical pregnancy [JA61.Z] Venous complications in pregnancy, unspecified Also known as: Venous complications in pregnancy, unspecified | Venous complications in pregnancy | Gestational phlebopathy, NOS [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 === 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 --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 --- [CA22.Z] Chronic obstructive pulmonary disease, unspecified --PARENT--> [CA22] Chronic obstructive pulmonary disease Def: Chronic Obstructive Pulmonary disease (COPD), a common preventable and treatable disease, is characterised by persistent airflow limitation that is usually progressive and associated with an enhanced ... --CHILD--> [CA22.1] Certain specified chronic obstructive pulmonary disease --- Walk 4 --- [CA22.Z] Chronic obstructive pulmonary disease, unspecified --PARENT--> [CA22] Chronic obstructive pulmonary disease Def: Chronic Obstructive Pulmonary disease (COPD), a common preventable and treatable disease, is characterised by persistent airflow limitation that is usually progressive and associated with an enhanced ... --CHILD--> [CA22.Z] Chronic obstructive pulmonary disease, unspecified --- Walk 5 --- [7A41] Obstructive sleep apnoea Def: Obstructive sleep apnoea is characterised by repetitive episodes of apnoea or hypopnea that are caused by upper airway obstruction occurring during sleep. These events often result in reductions in bl... --EXCLUDES--> [?] Obstructive neonatal apnoea Def: 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 characte... --PARENT--> [?] Apnoea of newborn Def: Any condition characterised by suspension of external breathing in a newborn (premature or term) which is not classified elsewhere... --- Walk 6 --- [7A41] Obstructive sleep apnoea Def: Obstructive sleep apnoea is characterised by repetitive episodes of apnoea or hypopnea that are caused by upper airway obstruction occurring during sleep. These events often result in reductions in bl... --EXCLUDES--> [?] Obstructive neonatal apnoea Def: 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 characte... --PARENT--> [?] Apnoea of newborn Def: Any condition characterised by suspension of external breathing in a newborn (premature or term) which is not classified elsewhere...
[ "[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 --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...", "[CA22.Z] Chronic obstructive pulmonary disease, unspecified\n --PARENT--> [CA22] Chronic obstructive pulmonary disease\n Def: Chronic Obstructive Pulmonary disease (COPD), a common preventable and treatable disease, is characterised by persistent airflow limitation that is usually progressive and associated with an enhanced ...\n --CHILD--> [CA22.1] Certain specified chronic obstructive pulmonary disease", "[CA22.Z] Chronic obstructive pulmonary disease, unspecified\n --PARENT--> [CA22] Chronic obstructive pulmonary disease\n Def: Chronic Obstructive Pulmonary disease (COPD), a common preventable and treatable disease, is characterised by persistent airflow limitation that is usually progressive and associated with an enhanced ...\n --CHILD--> [CA22.Z] Chronic obstructive pulmonary disease, unspecified", "[7A41] Obstructive sleep apnoea\n Def: Obstructive sleep apnoea is characterised by repetitive episodes of apnoea or hypopnea that are caused by upper airway obstruction occurring during sleep. These events often result in reductions in bl...\n --EXCLUDES--> [?] Obstructive neonatal apnoea\n Def: 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 characte...\n --PARENT--> [?] Apnoea of newborn\n Def: Any condition characterised by suspension of external breathing in a newborn (premature or term) which is not classified elsewhere...", "[7A41] Obstructive sleep apnoea\n Def: Obstructive sleep apnoea is characterised by repetitive episodes of apnoea or hypopnea that are caused by upper airway obstruction occurring during sleep. These events often result in reductions in bl...\n --EXCLUDES--> [?] Obstructive neonatal apnoea\n Def: 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 characte...\n --PARENT--> [?] Apnoea of newborn\n Def: Any condition characterised by suspension of external breathing in a newborn (premature or term) which is not classified elsewhere..." ]
CB40.Y
Other specified diseases of the respiratory system
[ { "from_icd11": "CA22.Z", "icd10_code": "J449", "icd10_title": "Chronic obstructive pulmonary disease, unspecified" }, { "from_icd11": "CA22.Z", "icd10_code": "J440", "icd10_title": "Chronic obstructive pulmonary disease with (acute) lower respiratory infection" }, { "from_icd11": "CA22.Z", "icd10_code": "J44", "icd10_title": "Other chronic obstructive pulmonary disease" }, { "from_icd11": "CA22.Z", "icd10_code": "J448", "icd10_title": "" }, { "from_icd11": "7A41", "icd10_code": "G4733", "icd10_title": "Obstructive sleep apnea (adult) (pediatric)" }, { "from_icd11": "7A41", "icd10_code": "G4730", "icd10_title": "Sleep apnea, unspecified" }, { "from_icd11": "CB60", "icd10_code": "J9503", "icd10_title": "Malfunction of tracheostomy stoma" }, { "from_icd11": "CB60", "icd10_code": "J9501", "icd10_title": "Hemorrhage from tracheostomy stoma" }, { "from_icd11": "CB60", "icd10_code": "J9502", "icd10_title": "Infection of tracheostomy stoma" }, { "from_icd11": "CB60", "icd10_code": "J9509", "icd10_title": "Other tracheostomy complication" }, { "from_icd11": "CB60", "icd10_code": "J9504", "icd10_title": "Tracheo-esophageal fistula following tracheostomy" }, { "from_icd11": "CB60", "icd10_code": "J950", "icd10_title": "Tracheostomy complications" }, { "from_icd11": "MD2Z", "icd10_code": "R049", "icd10_title": "Hemorrhage from respiratory passages, unspecified" }, { "from_icd11": "MD2Z", "icd10_code": "R04", "icd10_title": "Hemorrhage from respiratory passages" }, { "from_icd11": "JA8E", "icd10_code": "O480", "icd10_title": "Post-term pregnancy" } ]
J449
Chronic obstructive pulmonary disease, unspecified
A 78 year-old man with a left arm pain which had been worsening for 4 months was admitted in March 2008 to the orthopedic department. Physical examination revealed the presence of a large humeral mass and concomitant axillary lymphadenopathy. Computed tomography (CT) showed a pathological tissue in the humerus diaphysis infiltrating the muscle and dubious involvement of locoregional lymph nodes . Positron emission tomography (PET) confirmed the presence of bone disease while the locoregional lymph nodes were not fluorodeoxyglucose (FDG) avid, suggesting a reactive lymphadenopathy. Biopsy of the humerus revealed the presence of a DLBCL. In immunohistochemistry, the neoplastic tissue was cluster of differentiation (CD) number 20 positive, CD79alfa +, CD 10+, CD3-, CD5-, CD23+, BCL2-, BCL6+ with a Ki67 of 30%. According to the algorithm by , it was sub-classified as germinal center B-cell–like DLBCL. Successive bone marrow trephine biopsy excluded the presence of bone marrow involvement. In accordance with the WHO classification for “Tumours of Soft Tissue and Bone”, this patient was affected by a primary bone lymphoma . Because of muscle involvement per continuitatem a stage IV EA bulky was assigned. Due to age and stage, the International Prognostic Index (IPI) was 2. The patient was in a good clinical condition (performance status of 0) and echocardiography revealed a normal left cardiac function with an ejection fraction of 70%. Therefore we administered in first line 6 cycles of rituximab, cyclophosphomide, doxorubicin, vincristine and prednisone (R-CHOP). Because CT scan showed only a partial remission (PR) and pain persisted, 90Y-ibritumomab tiuxetan (90Y-IT) consolidation was administered on the basis of the positive experience published by . Also in our case the radioimmuneconiugate was able to induce a PET-confirmed complete response (CR). One year later he suffered a painful, local, histological-proven relapse . Due to the advanced age (79 years), poor performance status at the time of relapse and his ineligibility to ASCT, the patient underwent bimonthly administration of Rituximab for two years in order to spare as much toxicity as possible. After 2 months the patient’s general conditions improved and after 18 months he achieved a second CR. Since at this time the disease was confined to the bone without invasion of the surrounding structures, bisphosphonates were administered concomitantly. However, six months later, a second local relapse occurred, which (as with the previous ones) was proved by CT-PET . Again no other tissues apart from the bone were involved so the patient underwent radiotherapy (RT) without any systemic treatment obtaining a CR. Only four months later he presented a painful mass in the left arm with bone and muscle involvement. Ultrasonography showed a patchy and hypoechoic area of 45x35 mm in the left biceps and X-ray revealed an osteolytic area of the humerus diaphysis. The suspicion of relapse was proven by biopsy and PET as well as by bone marrow trephine biopsy which excluded other disease localizations. Due to the lack of other treatment options, he finally underwent Bendamustine 90 mg/m 2 days 1–2 q28 plus Rituximab 375 mg/m 2 every 28 days for 6 cycles. Because of the advanced age, pegfilgrastim and antibiotic prophylaxis were administered to prevent neutropenia and infectious complications. The treatment was well tolerated. Reversible hematologic toxicity, mainly consisting of grade 2 neutropenia, occurred after the fourth cycle. Non extra-hematologic toxicities were registered with the exception of moderate fatigue. After the first cycle local pain regressed, after the second the mass was no longer palpable and after the fourth a PET-CT was carried out which confirmed CR so the remaining two cycles were administered. This result was quite unexpected since the patient had been heavily pretreated and the third relapse occurred only four months after RT. Moreover, the patient remained in CR for 12 months until he suffered the fourth relapse. Figure 1 Computed tomography (CT) and Positron emission tomography (PET) images at the time of diagnosis. Panel A : CT scan showing the pathological tissue of the mid-diaphysis of the left humerus infiltrating the adjacent biceps brachii muscle for a longitudinal extent of 10.5 cm and axial dimensions of up to 5.5 cm. Several lymph nodes placed in the supraclavicular (1 cm), subclavian (2 cm) and in the axilla (19 mm). Panel B : PET image at the diagnosis with FDG uptake restricted to the primary mass, sparing locoregional lymph nodes. Figure 2 PET image after second (Panel A), third (Panel B) and fourth relapse (Panel C) as well as after BR treatment (Panel D).
4.050781
0.974121
sec[1]/p[0]
en
0.999997
25045615
https://doi.org/10.1186/2193-1801-3-342
[ "bone", "relapse", "panel", "which", "presence", "tomography", "tissue", "humerus", "muscle", "involvement" ]
[ { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" }, { "code": "FB82.3", "title": "Relapsing polychondritis" }, { "code": "1C1J.Z", "title": "Relapsing fever, unspecified" }, { "code": "8A40.0", "title": "Relapsing-remitting multiple sclerosis" }, { "code": "1C1J.0", "title": "Tick-borne relapsing fever" }, { "code": "1C1J.1", "title": "Louse-borne relapsing fever" } ]
=== ICD-11 CODES FOUND === [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias [FB82.3] Relapsing polychondritis Definition: Relapsing polychondritis is a multisystem inflammatory disease of unknown aetiology affecting the cartilage. The disease is characterised by intermittent or fluctuant inflammatory manifestations due to inflammation of the cartilaginous structures, resulting in tissue damage and tissue destruction. Chondritis of auricular, nasal, tracheal cartilage predominates in this disease, suggesting response to tissue-specific antigens such as collagen II and cartilage matrix protein (matrillin-1). In about Also known as: Relapsing polychondritis [1C1J.Z] Relapsing fever, unspecified Also known as: Relapsing fever, unspecified | Relapsing fever | febris recurrens | novy febris recurrens | novy relapsing fever [8A40.0] Relapsing-remitting multiple sclerosis Definition: Clearly defined disease relapses with full recovery or with sequelae and residual deficit upon recovery. The periods between disease relapses are characterised by a lack of disease progression. Also known as: Relapsing-remitting multiple sclerosis [1C1J.0] Tick-borne relapsing fever Definition: A disease caused by an infection with the bacteria Borrelia. This disease is characterised by repeated episodes of fever, with the febrile episode lasting for approximately 3 days, followed by the afebrile state of approximately 7 days. Transmission is through the bite of an infected soft tick (from the genus Ornithodoros). Confirmation is by identification of spirochete bacteria from a blood smear, bone marrow, or cerebrospinal fluid. Also known as: Tick-borne relapsing fever | Relapsing fever due to any Borrelia species other than Borrelia recurrentis | African tick-borne fever Includes: Relapsing fever due to any Borrelia species other than Borrelia recurrentis [1C1J.1] Louse-borne relapsing fever Definition: A spirochaetal infection caused by the human to human transmission of Borrelia recurrentis by the human body louse. Epidemics are associated with poor living conditions as may result from famine or war. Episodic fever may progress to severe jaundice, haemorrhage, confusion and death. Confirmation is by identification of Borrelia in blood films. Also known as: Louse-borne relapsing fever | Relapsing fever due to Borrelia recurrentis Includes: Relapsing fever due to Borrelia recurrentis === GRAPH WALKS === --- Walk 1 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Nonorgan specific systemic autoimmune disorders --- Walk 2 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --EXCLUDES--> [?] 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 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --EXCLUDES--> [?] Infection of vertebra Def: A condition of the vertebrae, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition commonly presents with fever, chills, headache, weight loss, or may be asympto... --- Walk 4 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --CHILD--> [FB84.2] Subacute osteomyelitis --- Walk 5 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopenia --- Walk 6 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --PARENT--> [?] Osteopathies or chondropathies
[ "[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 ...", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --EXCLUDES--> [?] Infection of vertebra\n Def: A condition of the vertebrae, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition commonly presents with fever, chills, headache, weight loss, or may be asympto...", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --CHILD--> [FB84.2] Subacute osteomyelitis", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopenia", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --PARENT--> [?] Osteopathies or chondropathies" ]
FC0Z
Diseases of the musculoskeletal system or connective tissue, unspecified
[ { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X6", "icd10_title": "Other osteomyelitis, lower leg" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X9", "icd10_title": "Other osteomyelitis, unspecified sites" }, { "from_icd11": "FB84.Z", "icd10_code": "M8668", "icd10_title": "Other chronic osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M86662", "icd10_title": "Other chronic osteomyelitis, left tibia and fibula" }, { "from_icd11": "FB84.Z", "icd10_code": "M86151", "icd10_title": "Other acute osteomyelitis, right femur" }, { "from_icd11": "FB84.Z", "icd10_code": "M86141", "icd10_title": "Other acute osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M86641", "icd10_title": "Other chronic osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M8669", "icd10_title": "Other chronic osteomyelitis, multiple sites" } ]
XIII
Retrorectal tumors are rare, with a reported incidence of 1 per 40 thousand hospitalizations . Two-thirds of them are cystic developmental lesions, which are classified into dermoid cysts, epidermoid cysts, teratomas, and enteric cysts. The latter include cystic rectal duplication and tailgut cysts, also called retrorectal cystic hamartomas . Currently, it is hypothesized that the etiology of tailgut cysts is linked to aberrant embryonic development, while the precise incidence in the general population remains unknown , by reason of absence of specific clinical symptoms, asymptomatic course in up to 50% of the cases , and heterogeneity of the cases presented. Although there is one reported case of nonsurgical treatment, where a tailgut cyst was confirmed with endoscopic ultrasound-guided fine-needle aspiration , along with a few instances of laparoscopic and TEM resections, the majority of cases are treated with open surgical approaches . This is most likely due to the fact that the surgical approach is determined by size , and the larger the cyst is, the less space remains between the rectum and sacrum. In such a case, miniinvasive approaches become more complicated and preference is given to open surgery, considering that the complete resection of the lesion to prevent its recurrence is recommended. Moreover, it was shown by Hjermstad et al. that the average maximal diameter of tailgut cysts is larger (4.6 cm) in symptomatic patients than in asymptomatic ones (3.2 cm). Chereau et al. report a mean size of 5.4 cm with no correlation between size and symptoms of retrorectal tumors, though with a significant correlation between their size and malignancy, but only 28/47 tumors in the study were tailgut cysts. Other studies show the average diameter 4.1 cm with the largest being 15 cm . Meanwhile, endoscopic resection may be performed for subepithelial lesions less than 20 mm in size, with no mention of extraluminal lesions, in accordance with European guidelines , and for lesions less than 40 mm in size, following American guidelines . To our best knowledge, this is the first reported case of endoscopic resection of tailgut cyst. We decided to treat the lesion endoscopically, due to its relatively small size, clear boundaries, location, that was adjacent to the rectal wall, and absence of large vessels around. Because of its extramural location, the mucosal bulge was not evident as seen in intramural lesions, making it challenging to determine the optimal location for the initial incision. Maintaining the dissection plane throughout the entire procedure was achievable, and no adverse events occurred during the procedure. On the other hand, the abovementioned size limits should be respected because it would be risky and technically demanding to work with a gastro- or colonoscope in a tight space with a cystic lesion larger than 4 cm. But for the small-sized retrorectal formations, endoscopic approach may be preferable, given its miniinvasiveness, since only the rectal wall and connective tissue need to be dissected to reach the lesion. Both transperineal and transabdominal surgical approaches seem to be associated with much greater tissue injuries, involving skin, muscles, vessels, and potentially pelvic or perineal nerves . TEM shares similarities with the minimally invasive and well-visualized endoscopic approach we employed. It does not present drawbacks associated with open surgery and could be utilized for excising benign or carefully selected malignant retrorectal tumors with favorable outcomes and minimal complications [ 15 – 17 ]. However, documentation of TEM specifically for retrorectal tumors in the literature is sparse, and its availability among specialized medical facilities worldwide is limited. The presented REER technique employed bears resemblance to the submucosal tunneling endoscopic resection (STER) method, with the primary distinction being the necessity to separate the tumor from retrorectal fat rather than submucosal connective tissue. Endoscopists proficient in STER procedures should encounter no significant challenges in performing this procedure. Although we did not encounter any complications, it is essential to consider potential intraprocedural complications, such as major bleeding, the need for surgical conversion, or gas-related complications, given the nature of the technique employed and the anatomical region involved. The omission of endoscopic cases in literature can presumably be explained by the rarity of retrorectal tumors and their relatively large average size. We believe, that for small (<40 mm) lesions in retrorectal space, endoscopic resection could be considered as one of the treatment options.
4.332031
0.807617
sec[2]/p[0]
en
0.999997
38939693
https://doi.org/10.1155/2024/5538439
[ "retrorectal", "endoscopic", "cysts", "tumors", "lesions", "tailgut", "that", "resection", "cystic", "cases" ]
[ { "code": "DB36.1", "title": "Rectal abscess" }, { "code": "DA25.3Y/PK80.32", "title": "Oesophageal ulcer due to endoscopic procedures" }, { "code": "DA42.8Z/PK80.32", "title": "Gastritis due to endoscopic procedures" }, { "code": "DA51.5Y/PK80.32", "title": "Duodenitis due to endoscopic procedures" }, { "code": "PL11.4", "title": "Failure of sterile precautions, as mode of injury or harm" }, { "code": "PK80.92", "title": "Vascular procedure associated with injury or harm, endoscopic approach" }, { "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" } ]
=== ICD-11 CODES FOUND === [DB36.1] Rectal abscess Definition: A condition of the rectum, caused by an infection with a bacterial, viral, or fungal source. This condition is characterised by a focal accumulation of purulent material in the rectal area. Also known as: Rectal abscess | rectal boil | rectum abscess | pararectal abscess | periproctic abscess [PL11.4] Failure of sterile precautions, as mode of injury or harm Definition: An infection occurred because standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient. Also known as: Failure of sterile precautions, as mode of injury or harm | failure of sterile precautions during intervention | contamination as mode of injury or harm | failure to take proper precautions | Failure of sterile precautions during surgical and medical care Excludes: Failure of sterile precautions without injury or harm [PK80.92] Vascular procedure associated with injury or harm, endoscopic approach Also known as: Vascular procedure associated with injury or harm, endoscopic approach Excludes: Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm [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 === GRAPH WALKS === --- Walk 1 --- [DB36.1] Rectal abscess Def: A condition of the rectum, caused by an infection with a bacterial, viral, or fungal source. This condition is characterised by a focal accumulation of purulent material in the rectal area.... --PARENT--> [DB36] Certain infections of the large intestine --CHILD--> [DB36.0] Colonic abscess Def: A condition of the colon, caused by an infection with a bacterial, viral, or fungal source. This condition is characterised by focal accumulation of purulent material in colonic tissue. This disease m... --- Walk 2 --- [DB36.1] Rectal abscess Def: A condition of the rectum, caused by an infection with a bacterial, viral, or fungal source. This condition is characterised by a focal accumulation of purulent material in the rectal area.... --PARENT--> [DB36] Certain infections of the large intestine --CHILD--> [DB36.0] Colonic abscess Def: A condition of the colon, caused by an infection with a bacterial, viral, or fungal source. This condition is characterised by focal accumulation of purulent material in colonic tissue. This disease m... --- Walk 3 --- [PL11.4] Failure of sterile precautions, as mode of injury or harm Def: An infection occurred because standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient.... --EXCLUDES--> [?] Failure of sterile precautions without injury or harm Def: Standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient, without documented injury or harm.... --EXCLUDES--> [?] Failure of sterile precautions, as mode of injury or harm Def: An infection occurred because standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient.... --- Walk 4 --- [PL11.4] Failure of sterile precautions, as mode of injury or harm Def: An infection occurred because standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient.... --EXCLUDES--> [?] Failure of sterile precautions without injury or harm Def: Standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient, without documented injury or harm.... --EXCLUDES--> [?] Failure of sterile precautions, as mode of injury or harm Def: An infection occurred because standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient....
[ "[DB36.1] Rectal abscess\n Def: A condition of the rectum, caused by an infection with a bacterial, viral, or fungal source. This condition is characterised by a focal accumulation of purulent material in the rectal area....\n --PARENT--> [DB36] Certain infections of the large intestine\n --CHILD--> [DB36.0] Colonic abscess\n Def: A condition of the colon, caused by an infection with a bacterial, viral, or fungal source. This condition is characterised by focal accumulation of purulent material in colonic tissue. This disease m...", "[DB36.1] Rectal abscess\n Def: A condition of the rectum, caused by an infection with a bacterial, viral, or fungal source. This condition is characterised by a focal accumulation of purulent material in the rectal area....\n --PARENT--> [DB36] Certain infections of the large intestine\n --CHILD--> [DB36.0] Colonic abscess\n Def: A condition of the colon, caused by an infection with a bacterial, viral, or fungal source. This condition is characterised by focal accumulation of purulent material in colonic tissue. This disease m...", "[PL11.4] Failure of sterile precautions, as mode of injury or harm\n Def: An infection occurred because standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient....\n --EXCLUDES--> [?] Failure of sterile precautions without injury or harm\n Def: Standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient, without documented injury or harm....\n --EXCLUDES--> [?] Failure of sterile precautions, as mode of injury or harm\n Def: An infection occurred because standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient....", "[PL11.4] Failure of sterile precautions, as mode of injury or harm\n Def: An infection occurred because standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient....\n --EXCLUDES--> [?] Failure of sterile precautions without injury or harm\n Def: Standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient, without documented injury or harm....\n --EXCLUDES--> [?] Failure of sterile precautions, as mode of injury or harm\n Def: An infection occurred because standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient...." ]
DB36.1
Rectal abscess
[ { "from_icd11": "DB36.1", "icd10_code": "K611", "icd10_title": "Rectal abscess" }, { "from_icd11": "PL11.4", "icd10_code": "Y62", "icd10_title": "Failure of sterile precautions during surgical and medical care" }, { "from_icd11": "PL11.4", "icd10_code": "Y620", "icd10_title": "Failure of sterile precautions during surgical operation" }, { "from_icd11": "PL11.4", "icd10_code": "Y621", "icd10_title": "Failure of sterile precautions during infusion or transfusion" }, { "from_icd11": "PL11.4", "icd10_code": "Y622", "icd10_title": "Failure of sterile precautions during kidney dialysis and other perfusion" }, { "from_icd11": "PL11.4", "icd10_code": "Y623", "icd10_title": "Failure of sterile precautions during injection or immunization" }, { "from_icd11": "PL11.4", "icd10_code": "Y624", "icd10_title": "Failure of sterile precautions during endoscopic examination" }, { "from_icd11": "PL11.4", "icd10_code": "Y625", "icd10_title": "Failure of sterile precautions during heart catheterization" }, { "from_icd11": "PL11.4", "icd10_code": "Y626", "icd10_title": "Failure of sterile precautions during aspiration, puncture and other catheterization" }, { "from_icd11": "PL11.4", "icd10_code": "Y628", "icd10_title": "Failure of sterile precautions during other surgical and medical care" }, { "from_icd11": "PL11.4", "icd10_code": "Y629", "icd10_title": "Failure of sterile precautions during unspecified surgical and medical care" }, { "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" } ]
K611
Rectal abscess
A 53-year-old male was candidated for mitral valve replacement due to severe calcified mitral stenosis with a left ventricular ejection fraction of about 55%. History was negative for other chronic diseases. In coronary angiography and right-heart catheterization, moderate stenosis was reported in the mid-portion of the left anterior descending artery, with no need for intervention. The pulmonary artery pressure was 60/35 mm Hg. During the operation, anesthesia was maintained with an infusion of atracurium, midazolam, and remifentanil as well as with an inhalation of isoflurane. Isoflurane was not used during CPB. After establishing CPB, the patient was cooled down to 30 ˚C. The mitral valve was replaced with a CarboMedics valve (No. 29). The patient had a systolic pressure > 100 mm Hg at the end of CPB; however, due to subsequent hypotension, an epinephrine infusion was started. He was transferred to the ICU in hypotensive status with transient premature ventricular contractions while receiving epinephrine. The patient was extubated after 7 hours while he had compensated metabolic acidosis. He was conscious on the first morning after surgery and was out of bed without abnormal physical finding. He gradually developed tachypnea and suffered severe pulmonary edema in the afternoon. His heart rate increased to 150 bpm with atrial fibrillation rhythm and hypotension. He developed metabolic acidosis with a decreased urine output. Transthoracic echocardiography revealed preserved left and right ventricular functions. The peak and mean transprosthetic mitral valve gradients were 38.4 mm Hg and 15.8 mm Hg, respectively, without paravalvular leakage. Fluoroscopy demonstrated normal mechanical valve function, and the measured gradient was thought to be related to tachycardia. In postoperative electrocardiogram (ECG), T-wave inversion was detected in leads II and III and AVF without ST-segment elevation. Due to severe respiratory distress and impaired consciousness, the patient was intubated on the first postoperative night. Atracurium was administered during intubation. In spite of receiving high-dose inotrope and fluids, the patient was hypotensive and anuric with severe metabolic acidosis and low PO 2 . The patient’s chest was opened in the ICU to rule out cardiac tamponade, which was negative with good ventricular contraction in a hyperkinetic status. On the second postoperative morning, the patient showed severe metabolic acidosis with hypotension, anuria, and 40.5 ˚C fever (axillary). The patient was transferred to the operating room in pre-arrest state. Anesthesia was maintained by the infusion of atracurium, midazolam, and remifentanil and CBP was established immediately. After the beginning of CPB, transesophageal echocardiography was done and revealed a suspected mass at the ventricular side of the mechanical mitral valve. The contraction of the left and right ventricles was reduced significantly. With suspected mechanical mitral valve malfunction, aortic cross-clamp and cardiac arrest were performed, body temperature was reduced to 28 ˚C, and the mechanical mitral valve was exposed. The function of the mechanical valve was normal, and there was about 10% to 15% paravalvular leakage. The exploration of the mentioned suspected mass became possible by removing the prosthetic valve: There were no abnormal findings inside the left ventricle. The vein graft was anastomosed to the left anterior descending artery due to moderate stenosis, and the mechanical valve was replaced for a second time. During CPB, the patient showed severe metabolic acidosis with lactate > 15 mmol/lit not eliminated by CPB. An intra-aortic balloon pump was inserted, and CPB was ended with high-dose epinephrine. The patient was transferred to the ICU with an open sternum and severe hypotension. In spite of ventilation with high FiO 2 , PO 2 was low. Due to anuria and severe acidosis at the end of the reoperation day, continuous venovenous dialysis was initiated. Hypocalcemia developed on the second postoperative day continued during the following days. Peritoneal dialysis was performed at the end of the third postoperative day without any improvement in the patient’s condition. Sedation was discontinued on the third postoperative day owing to deep coma status. Because of jaw spasm, the mouth suction was difficult. Creatine phosphokinase (CPK) enzyme and creatine phosphokinase-MB (CPK-MB) enzyme were measured 43500 U and 12100 U, respectively, with hypoglycemic crisis on days 3, 4, and 5 after the operation. Despite severe hypotension, the extremities were warm with palpable pedal pulses. The patient died after 5 days due to multi-organ failure ( Table 3 and Table 4 ).
3.871094
0.978027
sec[1]/p[7]
en
0.999997
29576786
N/A
[ "valve", "mitral", "acidosis", "mechanical", "postoperative", "ventricular", "hypotension", "metabolic", "without", "stenosis" ]
[ { "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": "BB60.Z", "title": "Mitral valve stenosis, unspecified" }, { "code": "LA89.2", "title": "Mitral atresia" }, { "code": "LA87.11", "title": "Congenital mitral valvar stenosis" }, { "code": "LA87.10", "title": "Congenital mitral regurgitation" }, { "code": "5C73.Z", "title": "Acidosis, unspecified" } ]
=== ICD-11 CODES FOUND === [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 [BB60.Z] Mitral valve stenosis, unspecified Also known as: Mitral valve stenosis, unspecified | Mitral valve stenosis | MS - [mitral stenosis] | mitral stenosis | mitral valvular stricture [LA89.2] Mitral atresia Definition: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve. Also known as: Mitral atresia | Mitral atresia with absent atrioventricular connection | absent left atrioventricular connection or junction | absent left atrioventricular connection in laevocardia | mitral atresia with absent valvar annulus [LA87.11] Congenital mitral valvar stenosis Definition: A congenital cardiovascular malformation of the mitral valve in which there is narrowing or stricture of the valvar orifice (obstruction to flow). Also known as: Congenital mitral valvar stenosis | Duroziez disease | congenital mitral stenosis | congenital stenosis of mitral valve | congenital mitral valve stricture [LA87.10] Congenital mitral regurgitation Definition: A congenital cardiovascular finding in which there is backward flow through the mitral valve. Also known as: Congenital mitral regurgitation | congenital insufficiency of mitral valve | congenital mitral insufficiency | congenital mitral valve incompetence | congenital mitral valve insufficiency [5C73.Z] Acidosis, unspecified Also known as: Acidosis, unspecified | Acidosis | acidosis NOS | metabolic acidaemia | lactic acidosis === GRAPH WALKS === --- Walk 1 --- [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... --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 2 --- [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--> [GB61.0] Chronic kidney disease, stage 1 Def: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²)... --- Walk 3 --- [BC00] Multiple valve disease --PARENT--> [?] Heart valve diseases --EXCLUDES--> [?] Atypical truncal valve Def: A congenital cardiovascular malformation in which the truncal valve does not have the usual morphological or functional attributes at birth.... --- Walk 4 --- [BC00] Multiple valve disease --PARENT--> [?] Heart valve diseases --EXCLUDES--> [?] Acute rheumatic fever Def: A disease of the connective tissue, caused by an infection with the gram-positive bacteria Streptococcus pyogenes (the disease may also affect the heart, joints, central nervous system, subcutaneous t... --- Walk 5 --- [BB9Z] Pulmonary valve disease, unspecified --PARENT--> [?] Pulmonary valve disease --RELATED_TO--> [?] Traumatic injury to pulmonary valve --- Walk 6 --- [BB9Z] Pulmonary valve disease, unspecified --PARENT--> [?] Pulmonary valve disease --CHILD--> [BB90] Pulmonary valve stenosis Def: Pulmonary valve stenosis is an obstruction at the level of pulmonary valve which impedes the outflow of blood from right ventricle to pulmonary artery....
[ "[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 --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....", "[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--> [GB61.0] Chronic kidney disease, stage 1\n Def: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²)...", "[BC00] Multiple valve disease\n --PARENT--> [?] Heart valve diseases\n --EXCLUDES--> [?] Atypical truncal valve\n Def: A congenital cardiovascular malformation in which the truncal valve does not have the usual morphological or functional attributes at birth....", "[BC00] Multiple valve disease\n --PARENT--> [?] Heart valve diseases\n --EXCLUDES--> [?] Acute rheumatic fever\n Def: A disease of the connective tissue, caused by an infection with the gram-positive bacteria Streptococcus pyogenes (the disease may also affect the heart, joints, central nervous system, subcutaneous t...", "[BB9Z] Pulmonary valve disease, unspecified\n --PARENT--> [?] Pulmonary valve disease\n --RELATED_TO--> [?] Traumatic injury to pulmonary valve", "[BB9Z] Pulmonary valve disease, unspecified\n --PARENT--> [?] Pulmonary valve disease\n --CHILD--> [BB90] Pulmonary valve stenosis\n Def: Pulmonary valve stenosis is an obstruction at the level of pulmonary valve which impedes the outflow of blood from right ventricle to pulmonary artery...." ]
GB61.Z
Chronic kidney disease, stage unspecified
[ { "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" }, { "from_icd11": "BC00", "icd10_code": "I34", "icd10_title": "Nonrheumatic mitral valve disorders" }, { "from_icd11": "BC00", "icd10_code": "I35", "icd10_title": "Nonrheumatic aortic valve disorders" }, { "from_icd11": "BC00", "icd10_code": "I36", "icd10_title": "Nonrheumatic tricuspid valve disorders" } ]
N183
Chronic kidney disease, stage 3 (moderate)
Radial neck fractures in children fall under a spectrum of injuries that should be addressed using an algorithm of progressive intervention: from closed manipulation to percutaneous fixation to open attempts, with the aim being to gain the best acceptable reduction . The present report describes a case of an impacted, displaced, and minimally angulated radial neck fracture in a 6-year-old child, treated by reduction and fixation with K-wire under-elbow arthroscopy after an unsuccessful manipulation attempt. Restoration of radial neck angulation and alignment is essential to reestablish the normal biomechanics and stability of the elbow. The standard for minimally angulated (< 30-degree) fractures in young patients is simple immobilization, which often results in excellent outcomes for most patients. However, many classifications do not consider the impaction of the fracture and the displacement in the coronal plane of the proximal radial epiphysis. Indications for the treatment of radial neck fractures should consider several factors: fracture location, degree of displacement, associated injuries, skeletal maturity, and time elapsed since the injury. The amount of angulation is still considered the primary criterion in the decision for a conservative or surgical treatment of fracture management. Kim et al. reported that an angulation < 30 degrees can be treated by simple immobilization and casting, an angulation of 30–60 degrees by closed reduction and fixation or by open reduction if the closed reduction fails, and an angulation ≥ 60 degrees by open reduction . The age of the patient and the degree of skeletal maturity are also critical when defining the treatment indication; for example, older children with radial neck fractures show worse outcomes than younger children. Métaizeau et al. reported that an angulation of 20–30 degrees in young children may be remodeled in time, but even an angulation of 10–15 degrees in children over 12 years old cannot be remodeled . Similarly, Bernstein et al . reported that remodeling is possible in angulations of 60 degrees in children up to 6 years of age, but angulations > 30 degrees cannot be corrected in children older than 12 years . However, the management of pediatric radial neck fractures, especially of those with an angulation of > 30 degrees or a displacement > 3 mm, is still controversial. For this reason, the treatment of choice for pediatric radial neck fractures is yet to be established . These fractures can be challenging to reduce, and this is the reason why many surgical options have been described, including indirect reduction and fixation techniques under fluoroscopic assistance, such as percutaneous pinning and the elastic stable intramedullary nailing (ESIN) technique or direct technique by open reduction with or without internal fixation and suturing of the annular ligament, more common in the past but still used for unsuccessful indirect reduction. The ESIN technique, better known as the Métaizeau technique, is a minimally invasive surgery performed with a single nail contoured and bent at the tip, approximately 30–45 degrees, to catch the displaced proximal epiphysis, whereas the rest of the nail is prebent with a gentle curve of 20 degrees to obtain a three-point fixation. Under image intensifier guidance, the nail is introduced proximally to the distal radial epiphysis, advanced proximally with gentle rotational movements until it reaches the fracture, and then rotated until the fracture is reduced . The percutaneous pinning technique consists of a K-wire inserted percutaneously from the proximal to distal radial neck fracture site, which is used as a lever, and the radial neck fracture is reduced under image intensifier guidance . After reduction, the K-wire is advanced toward the ulnar side to impact the opposite cortex. The stability of reduction and forearm rotation is checked under fluoroscopic control. In two studies comparing the Métaizeau technique and percutaneous pinning , the authors found no statistical superiority of one technique over the other in terms of clinical outcome and radiological alignment. Direct visualization of the joint surface requires open surgery to obtain the best reduction, but it is widely reported that open reduction by articular exposure leads to worse medium-term and long-term functional outcomes . The open surgical approach is achieved by using the Kocher approach between the anconeus and the extensor carpi ulnaris; the radial head is gently repositioned and the interposed capsular or ligamentous structures that blocked reduction are removed. If the head fragment is unstable, fixation using Kirschner wire or Steinmann pins is necessary.
4.285156
0.857422
sec[2]/p[0]
en
0.999997
32580779
https://doi.org/10.1186/s13256-020-02390-0
[ "reduction", "radial", "degrees", "neck", "fracture", "angulation", "fractures", "children", "fixation", "open" ]
[ { "code": "GC79", "title": "Disorders of breast reduction" }, { "code": "LB9A.Z", "title": "Reduction defects of lower limb, unspecified" }, { "code": "LB99.Z", "title": "Reduction defects of upper limb, unspecified" }, { "code": "LB9Z", "title": "Structural developmental anomalies of the skeleton, unspecified" }, { "code": "LB9A.Y", "title": "Other specified reduction defects of lower limb" }, { "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 === [GC79] Disorders of breast reduction Also known as: Disorders of breast reduction [LB9A.Z] Reduction defects of lower limb, unspecified Also known as: Reduction defects of lower limb, unspecified | Reduction defects of lower limb | lower extremities underdeveloped [LB99.Z] Reduction defects of upper limb, unspecified Also known as: Reduction defects of upper limb, unspecified | Reduction defects of upper limb [LB9Z] Structural developmental anomalies of the skeleton, unspecified Also known as: Structural developmental anomalies of the skeleton, unspecified | Abnormal bone development | skeletal anomaly NOS [LB9A.Y] Other specified reduction defects of lower limb Also known as: Other specified reduction defects of lower limb [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 --- [GC79] Disorders of breast reduction --PARENT--> [?] Postprocedural disorders of genitourinary system Def: Any disorder caused by or subsequent to any intervention of the genitourinary system.... --EXCLUDES--> [?] Irradiation cystitis Def: Acute or chronic inflammatory tissue changes in the urinary bladder caused by ionizing radiation; called also radiocystitis.... --- Walk 2 --- [GC79] Disorders of breast reduction --PARENT--> [?] Postprocedural disorders of genitourinary system Def: Any disorder caused by or subsequent to any intervention of the genitourinary system.... --CHILD--> [GC70] Postoperative adhesions of vagina Def: A condition caused by or subsequent to any vaginal surgery or intervention. This condition is characterised by fibrous bands of scar tissue between the intravaginal tissues (intravaginal adhesions). T... --- Walk 3 --- [LB9A.Z] Reduction defects of lower limb, unspecified --PARENT--> [LB9A] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB9A.1] Tibial hemimelia Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula.... --- Walk 4 --- [LB9A.Z] Reduction defects of lower limb, unspecified --PARENT--> [LB9A] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB9A.1] Tibial hemimelia Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula.... --- Walk 5 --- [LB99.Z] Reduction defects of upper limb, unspecified --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 6 --- [LB99.Z] Reduction defects of upper limb, unspecified --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....
[ "[GC79] Disorders of breast reduction\n --PARENT--> [?] Postprocedural disorders of genitourinary system\n Def: Any disorder caused by or subsequent to any intervention of the genitourinary system....\n --EXCLUDES--> [?] Irradiation cystitis\n Def: Acute or chronic inflammatory tissue changes in the urinary bladder caused by ionizing radiation; called also radiocystitis....", "[GC79] Disorders of breast reduction\n --PARENT--> [?] Postprocedural disorders of genitourinary system\n Def: Any disorder caused by or subsequent to any intervention of the genitourinary system....\n --CHILD--> [GC70] Postoperative adhesions of vagina\n Def: A condition caused by or subsequent to any vaginal surgery or intervention. This condition is characterised by fibrous bands of scar tissue between the intravaginal tissues (intravaginal adhesions). T...", "[LB9A.Z] Reduction defects of lower limb, unspecified\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.Z] Reduction defects of lower limb, unspecified\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....", "[LB99.Z] Reduction defects of upper limb, unspecified\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.Z] Reduction defects of upper limb, unspecified\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...." ]
GC79
Disorders of breast reduction
[ { "from_icd11": "LB9A.Z", "icd10_code": "Q7292", "icd10_title": "Unspecified reduction defect of left lower limb" }, { "from_icd11": "LB9A.Z", "icd10_code": "Q72891", "icd10_title": "Other reduction defects of right lower limb" }, { "from_icd11": "LB9A.Z", "icd10_code": "Q72899", "icd10_title": "Other reduction defects of unspecified lower limb" }, { "from_icd11": "LB9A.Z", "icd10_code": "Q72", "icd10_title": "Reduction defects of lower limb" }, { "from_icd11": "LB9A.Z", "icd10_code": "Q728", "icd10_title": "Other reduction defects of lower limb" }, { "from_icd11": "LB9A.Z", "icd10_code": "Q729", "icd10_title": "Unspecified reduction defect of lower limb" }, { "from_icd11": "LB99.Z", "icd10_code": "Q71892", "icd10_title": "Other reduction defects of left upper limb" }, { "from_icd11": "LB99.Z", "icd10_code": "Q71899", "icd10_title": "Other reduction defects of unspecified upper limb" }, { "from_icd11": "LB99.Z", "icd10_code": "Q7192", "icd10_title": "Unspecified reduction defect of left upper limb" }, { "from_icd11": "LB99.Z", "icd10_code": "Q71", "icd10_title": "Reduction defects of upper limb" }, { "from_icd11": "LB99.Z", "icd10_code": "Q718", "icd10_title": "Other reduction defects of upper limb" }, { "from_icd11": "LB99.Z", "icd10_code": "Q719", "icd10_title": "Unspecified reduction defect of upper limb" }, { "from_icd11": "LB9Z", "icd10_code": "Q8789", "icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified" }, { "from_icd11": "LB9Z", "icd10_code": "Q8781", "icd10_title": "Alport syndrome" }, { "from_icd11": "LB9Z", "icd10_code": "Q742", "icd10_title": "Other congenital malformations of lower limb(s), including pelvic girdle" } ]
Q7292
Unspecified reduction defect of left lower limb
The patient under discussion is a young woman with increasing dyspnea and anemia in the 7th week of pregnancy. Anemia is a common condition in pregnancy and is defined as a hemoglobin level <11 g/dL in the first trimester and below 10.5 g/dL in the second and third trimester [ 1 – 3 ]. It affects up to 40% of pregnant women worldwide and nearly one third in the USA . It is a risk factor associated with antepartum, intrapartum and postpartum maternal morbidity, and perinatal morbidity and mortality with adverse effects arising proportionally to the severity of anemia . The topic of anemia in pregnancy is complex and there is a wide variety of potential underlying etiologies that should be considered (Table 1 ). However, physiologic anemia (dilutional) and iron deficiency are the two most common causes of anemia in pregnant women. Physiologic anemia is due to an increase in plasma volume by 10–15% at weeks 6–12 of gestation with a further rapid expansion by weeks 30–34, and plateauing or slightly decreasing toward term. All of this occurs despite an adequate increase in red blood cell mass. At term, the total plasma volume of 4700–5200 mL is about 30–50% above that in non-pregnant women, while the increase in red cell mass is only about 10–30% . This physiologic fall in hemoglobin concentration across pregnancy is often quoted as 5 g/L, but it was found to be as high as 8 g/L in some studies . Insufficient supply of iron and micronutrients, such as folate, vitamins B 12 , B 6 and copper due to inappropriate intake, hyperemesis gravidarum or malabsorption may also contribute to an imbalance between availability and increased nutrient requirements for fetal red blood cell production and fetoplacental growth, and consequently result in anemia. Iron deficiency is the most common cause of anemia worldwide and affects about one in three pregnant women . Laboratory data of the discussed patient showed significantly reduced levels of all iron status parameters (serum iron, transferrin saturation and ferritin) and confirmed the diagnosis of iron deficiency. However, this condition has been known for many years in this patient and could not be improved by regular oral iron supplementation. Assessment of iron status is sometimes challenging. Thus, the markedly reduced transferrin levels observed in the discussed patient may hint at malnutrition, protein deficiency, zinc deficiency, chronic liver injury or conditions, such as acute phase reactions, chronic disease or hereditary hypotransferrinemia . Iron deficiency may be due to increased loss (gastrointestinal or urogenital bleeding, epistaxis, blood donation, hemoglobinuria caused by intravascular hemolysis), malnutrition, malabsorption, relative iron deficiency during therapy with erythropoietin, infection with Helicobacter pylori , or increased physiologic needs. Microcytic anemia may further be caused by chronic inflammation with a subsequent increase in hepcidin , which is an acute phase protein and hormone, and as such is a key regulator of systemic iron balance . It inhibits iron entry into the plasma compartment from the three main sources of iron, i.e. dietary absorption in the duodenum, the release of recycled iron from macrophages and the release of stored iron from hepatocytes . Less frequently, microcytic hypochromic anemia may be sideroblastic (hereditary or acquired due to deficiencies in vitamin B 6 or copper, or due to lead poisoning) and in rare cases it may be caused by thalassemia, sickle cell disease, or it may present as inherited atypical form of microcytic anemia. In the presence of fragmentocytes, microcytic hypochromic anemia may be artificial, i.e. resulting from hyponatremia. Table 1 Causes of different forms of anemia in adults. (Adapted from ) Reticulocyte count Microcytic MCV <80 fL Normocytic MCV 80–100 fL Macrocytic MCV >100 fL Low or normal Iron deficiency Anemia of chronic disease/inflammation Sideroblastic anemia Copper deficiency Vitamin B 6 deficiency Zinc deficiency Bleeding (acute) Iron deficiency (early) Anemia of chronic disease/inflammation Bone marrow suppression (cancer, aplastic anemia, infection) Chronic renal insufficiency Hypothyroidism Hypopituitarism Excess alcohol Vitamin B 12 or folate deficiency Excess alcohol Myelodysplastic syndrome Liver disease Hypothyroidism HIV infection Medications that interfere with nuclear maturation Increased Thalassemia Hemolysis Bleeding (with bone marrow recovery) Hemolysis Bone marrow recovery (e.g. after infection, vitamin B 12 or folate replacement and/or iron replacement) Hemolysis Bone marrow recovery (e.g. after infection, vitamin B 12 or folate replacement and/or iron replacement) MCV mean corpuscular volume
4.394531
0.606445
sec[1]/sec[0]/p[0]
en
0.999995
32468113
https://doi.org/10.1007/s00508-020-01679-w
[ "iron", "anemia", "deficiency", "infection", "microcytic", "vitamin", "pregnancy", "pregnant", "women", "physiologic" ]
[ { "code": "5B5K.0", "title": "Iron deficiency" }, { "code": "ED62.0", "title": "Haemosiderin pigmentation of skin" }, { "code": "5C64.1Z", "title": "Disorders of iron metabolism, unspecified" }, { "code": "5C64.1Y", "title": "Other specified disorders of iron metabolism" }, { "code": "CA60.8", "title": "Siderosis" }, { "code": "3A9Z", "title": "Anaemias or other erythrocyte disorders, unspecified" }, { "code": "KA8Y", "title": "Other specified haemorrhagic or haematological disorders of fetus or newborn" }, { "code": "3A70.11", "title": "Aplastic anaemia due to other external agents" }, { "code": "JB64.0", "title": "Anaemia complicating pregnancy, childbirth or the puerperium" }, { "code": "3A70.Z", "title": "Aplastic anaemia, unspecified" } ]
=== ICD-11 CODES FOUND === [5B5K.0] Iron deficiency Definition: Iron deficiency is a state in which there is insufficient iron to maintain the normal physiological function of blood, brain and muscles. It can exist in the absence of anaemia if it has not lasted long enough or if it has not been severe enough to cause the haemoglobin concentration to fall below the threshold for the specific sex and age group. Iron deficiency is the most common nutritional deficiency. Also known as: Iron deficiency | Fe deficiency | Intellectual developmental disorder due to iron deficiency | Iron depletion without anaemia Excludes: Iron deficiency anaemia [ED62.0] Haemosiderin pigmentation of skin Definition: Dermal haemosiderin deposition causes a yellowish-brown or bronze discolouration of the skin. The deposition may be focal as seen following repeated extravasation of red blood cells (e.g. in association with venous hypertension or chronic vasculitis) or from generalised iron overload (e.g. haemochromatosis). Haemosiderin may stimulate melanogenesis and thus the colour is due to variable proportions of haemosiderin and melanin. Also known as: Haemosiderin pigmentation of skin | Iron pigmentation | iron pigmentation disorder | Lower limb haemosiderosis | hypostatic haemosiderosis [5C64.1Z] Disorders of iron metabolism, unspecified Also known as: Disorders of iron metabolism, unspecified | Disorders of iron metabolism | iron storage disease | iron storage disorder [5C64.1Y] Other specified disorders of iron metabolism Also known as: Other specified disorders of iron metabolism | Haemochromatosis | diabetic hemochromatosis | familial hemochromatosis | hemochromatosis NOS [CA60.8] Siderosis Definition: Siderosis refers to pneumoconiosis resulting from inhalation of iron from welding fumes or from iron or hematite mine dust. Also known as: Siderosis | arc-welders' disease | arc-welders' lung | arc-welders' nodulation | arc-welders' pneumoconiosis [3A9Z] Anaemias or other erythrocyte disorders, unspecified Also known as: Anaemias or other erythrocyte disorders, unspecified | anaemia NOS | anaemic condition NOS | primary anaemia NOS | multifactorial anaemia NOS [KA8Y] Other specified haemorrhagic or haematological disorders of fetus or newborn Also known as: Other specified haemorrhagic or haematological disorders of fetus or newborn | Kasabach-Merritt syndrome | Blood dyscrasia of fetus or newborn | Other congenital anaemias, not elsewhere classified | newborn anaemia NOS [3A70.11] Aplastic anaemia due to other external agents Also known as: Aplastic anaemia due to other external agents | toxic anaemia | toxic aplastic anaemia | aplastic anaemia due to toxic cause [JB64.0] Anaemia complicating pregnancy, childbirth or the puerperium Definition: A condition of the circulatory system affecting pregnant females, characterised by a haemoglobin level below 11 grams per decilitre that complicates pregnancy, childbirth, or the puerperium. Also known as: Anaemia complicating pregnancy, childbirth or the puerperium | anaemia in mother complicating pregnancy, childbirth or puerperium | Anaemia of or complicating pregnancy | Anaemia of the puerperium | puerperal anaemia [3A70.Z] Aplastic anaemia, unspecified Also known as: Aplastic anaemia, unspecified | Aplastic anaemia | erythroid aplasia | AA - [aplastic anaemia] | haematopoietic aplasia === GRAPH WALKS === --- Walk 1 --- [5B5K.0] Iron deficiency Def: Iron deficiency is a state in which there is insufficient iron to maintain the normal physiological function of blood, brain and muscles. It can exist in the absence of anaemia if it has not lasted lo... --RELATED_TO--> [?] Acquired iron deficiency anaemia due to decreased absorption --CHILD--> [?] Acquired iron deficiency anaemia due to gastrectomy Def: Gastrectomy can be due to gastric cancer or gastric bypass for obesity (this form of surgery bypasses the duodenum, the major site of intestinal iron absorption). As a result, iron deficiency can occu... --- Walk 2 --- [5B5K.0] Iron deficiency Def: Iron deficiency is a state in which there is insufficient iron to maintain the normal physiological function of blood, brain and muscles. It can exist in the absence of anaemia if it has not lasted lo... --RELATED_TO--> [?] Acquired iron deficiency anaemia due to decreased absorption --CHILD--> [?] Acquired iron deficiency anaemia due to coeliac disease Def: Coeliac disease causes malabsorption of iron and, as a consequence, iron deficiency anaemia, especially in young patients.... --- Walk 3 --- [ED62.0] Haemosiderin pigmentation of skin Def: Dermal haemosiderin deposition causes a yellowish-brown or bronze discolouration of the skin. The deposition may be focal as seen following repeated extravasation of red blood cells (e.g. in associati... --RELATED_TO--> [?] Hereditary haemochromatosis Def: This is a hereditary disease characterised by excessive intestinal absorption of dietary iron resulting in a pathological increase in total body iron stores.... --PARENT--> [?] Liver diseases due to disorders of mineral metabolism Def: This is a liver disease due to a disorder of the organic compound required by an organism as a vital nutrient in limited amounts.... --- Walk 4 --- [ED62.0] Haemosiderin pigmentation of skin Def: Dermal haemosiderin deposition causes a yellowish-brown or bronze discolouration of the skin. The deposition may be focal as seen following repeated extravasation of red blood cells (e.g. in associati... --RELATED_TO--> [?] Hereditary haemochromatosis Def: This is a hereditary disease characterised by excessive intestinal absorption of dietary iron resulting in a pathological increase in total body iron stores.... --EXCLUDES--> [?] Neonatal haemochromatosis Def: Neonatal hemochromatosis is an iron storage disorder of unknown etiology present at birth, and characterised by the association of severe hepatocellular failure with hyperbilirubinemia, signs of haemo... --- Walk 5 --- [5C64.1Z] Disorders of iron metabolism, unspecified --PARENT--> [5C64.1] Disorders of iron metabolism Def: This refers to any disorders of the set of chemical reactions maintaining human homeostasis of iron. The control of this necessary but potentially toxic substance is an important part of many aspects ... --CHILD--> [5C64.1Z] Disorders of iron metabolism, unspecified --- Walk 6 --- [5C64.1Z] Disorders of iron metabolism, unspecified --PARENT--> [5C64.1] Disorders of iron metabolism Def: This refers to any disorders of the set of chemical reactions maintaining human homeostasis of iron. The control of this necessary but potentially toxic substance is an important part of many aspects ... --CHILD--> [5C64.10] Iron overload diseases Def: Iron overload is the accumulation of excess iron in body tissues. Iron overload usually occurs as a result of a genetic predisposition to absorb and store iron in excess amounts, the most common form ...
[ "[5B5K.0] Iron deficiency\n Def: Iron deficiency is a state in which there is insufficient iron to maintain the normal physiological function of blood, brain and muscles. It can exist in the absence of anaemia if it has not lasted lo...\n --RELATED_TO--> [?] Acquired iron deficiency anaemia due to decreased absorption\n --CHILD--> [?] Acquired iron deficiency anaemia due to gastrectomy\n Def: Gastrectomy can be due to gastric cancer or gastric bypass for obesity (this form of surgery bypasses the duodenum, the major site of intestinal iron absorption). As a result, iron deficiency can occu...", "[5B5K.0] Iron deficiency\n Def: Iron deficiency is a state in which there is insufficient iron to maintain the normal physiological function of blood, brain and muscles. It can exist in the absence of anaemia if it has not lasted lo...\n --RELATED_TO--> [?] Acquired iron deficiency anaemia due to decreased absorption\n --CHILD--> [?] Acquired iron deficiency anaemia due to coeliac disease\n Def: Coeliac disease causes malabsorption of iron and, as a consequence, iron deficiency anaemia, especially in young patients....", "[ED62.0] Haemosiderin pigmentation of skin\n Def: Dermal haemosiderin deposition causes a yellowish-brown or bronze discolouration of the skin. The deposition may be focal as seen following repeated extravasation of red blood cells (e.g. in associati...\n --RELATED_TO--> [?] Hereditary haemochromatosis\n Def: This is a hereditary disease characterised by excessive intestinal absorption of dietary iron resulting in a pathological increase in total body iron stores....\n --PARENT--> [?] Liver diseases due to disorders of mineral metabolism\n Def: This is a liver disease due to a disorder of the organic compound required by an organism as a vital nutrient in limited amounts....", "[ED62.0] Haemosiderin pigmentation of skin\n Def: Dermal haemosiderin deposition causes a yellowish-brown or bronze discolouration of the skin. The deposition may be focal as seen following repeated extravasation of red blood cells (e.g. in associati...\n --RELATED_TO--> [?] Hereditary haemochromatosis\n Def: This is a hereditary disease characterised by excessive intestinal absorption of dietary iron resulting in a pathological increase in total body iron stores....\n --EXCLUDES--> [?] Neonatal haemochromatosis\n Def: Neonatal hemochromatosis is an iron storage disorder of unknown etiology present at birth, and characterised by the association of severe hepatocellular failure with hyperbilirubinemia, signs of haemo...", "[5C64.1Z] Disorders of iron metabolism, unspecified\n --PARENT--> [5C64.1] Disorders of iron metabolism\n Def: This refers to any disorders of the set of chemical reactions maintaining human homeostasis of iron. The control of this necessary but potentially toxic substance is an important part of many aspects ...\n --CHILD--> [5C64.1Z] Disorders of iron metabolism, unspecified", "[5C64.1Z] Disorders of iron metabolism, unspecified\n --PARENT--> [5C64.1] Disorders of iron metabolism\n Def: This refers to any disorders of the set of chemical reactions maintaining human homeostasis of iron. The control of this necessary but potentially toxic substance is an important part of many aspects ...\n --CHILD--> [5C64.10] Iron overload diseases\n Def: Iron overload is the accumulation of excess iron in body tissues. Iron overload usually occurs as a result of a genetic predisposition to absorb and store iron in excess amounts, the most common form ..." ]
5B5K.0
Iron deficiency
[ { "from_icd11": "5B5K.0", "icd10_code": "E611", "icd10_title": "Iron deficiency" }, { "from_icd11": "5C64.1Z", "icd10_code": "E83110", "icd10_title": "Hereditary hemochromatosis" }, { "from_icd11": "5C64.1Z", "icd10_code": "E83119", "icd10_title": "Hemochromatosis, unspecified" }, { "from_icd11": "5C64.1Z", "icd10_code": "E83111", "icd10_title": "Hemochromatosis due to repeated red blood cell transfusions" }, { "from_icd11": "5C64.1Z", "icd10_code": "E8310", "icd10_title": "Disorder of iron metabolism, unspecified" }, { "from_icd11": "5C64.1Z", "icd10_code": "E8319", "icd10_title": "Other disorders of iron metabolism" }, { "from_icd11": "5C64.1Z", "icd10_code": "E83118", "icd10_title": "Other hemochromatosis" }, { "from_icd11": "5C64.1Z", "icd10_code": "E831", "icd10_title": "Disorders of iron metabolism" }, { "from_icd11": "CA60.8", "icd10_code": "J634", "icd10_title": "Siderosis" }, { "from_icd11": "3A9Z", "icd10_code": "D6489", "icd10_title": "Other specified anemias" }, { "from_icd11": "3A9Z", "icd10_code": "D6481", "icd10_title": "Anemia due to antineoplastic chemotherapy" }, { "from_icd11": "3A9Z", "icd10_code": "D6101", "icd10_title": "Constitutional (pure) red blood cell aplasia" }, { "from_icd11": "3A9Z", "icd10_code": "D6109", "icd10_title": "Other constitutional aplastic anemia" }, { "from_icd11": "3A9Z", "icd10_code": "D649", "icd10_title": "Anemia, unspecified" }, { "from_icd11": "3A9Z", "icd10_code": "D748", "icd10_title": "Other methemoglobinemias" } ]
E611
Iron deficiency
The patient was taken to the operative suite and anesthetized on the gurney in supine position. Flexible cystoscopy was then performed and the operative side ureteral orifice was cannulated with a 0.035 inch Sensor Wire (Boston Scientific, Boston, MA), advanced up the ureter to the renal pelvis. The cystoscope was withdrawn and removed from the patient leaving the wire in place. The cystoscope was then brought back into the bladder adjacent to the wire. The ureter was then sequentially dilated over the wire utilizing a 5F open-end ureteral catheter (Boston Scientific) followed by an 8F to 10F coaxial dilator. Leaving the 10F sheath in place, a second wire was advanced up the ureter to serve as a safety wire. A Zebra Wire (Boston Scientific) served as the safety wire, preferred because it is a different color scheme and more radiolucent than the sensor wire preventing confusion with antegrade working wires. Continued sequential ureteral dilation was performed with the 11F inner portion of the access sheath. An 11/13 Navigator (Boston Scientific) ureteral access sheath (UAS) was then easily placed under cystoscopic visualization and without the need for fluoroscopy. CT scan was previously reviewed to ensure no ureteral stones. Cystoscopic-guided UAS placement would be aborted if resistance is felt and alternatively, fluoroscopy guidance or ureteroscopy would be employed. A urethral catheter was then placed into the bladder over wire adjacent to the UAS to provide both ureteral access and bladder drainage . 4 Patient was then transferred from the gurney to the operating table positioned prone on an Allen Advance “Jackson Spinal” Table (Allen Medical, Acton, MA), surgical table equipped with a Allen Bow Frame (Allen Medical). Scout fluoroscopy images are obtained followed by retrograde pyelography. A marking pen was used to create a skin template of the renal anatomy and surrounding structures drawing the ribs, kidney stones, renal collecting system, and pleura (location previously determined with careful review of the CT scan) . Retrograde ureterorenoscopy was performed to evaluate the stones and identify preferred caliceal access for stone treatment. Air bubbles and C-arm rotations help to identify posterior calices. A 12.5 cm 18-gauge needle (Boston Scientific) was used in obtaining access and subsequently cannulated with a 0.035 in Sensor Wire positioned into the renal collecting system. Skin incision was made with 11-blade scalpel. Sequential dilation of the tract was then performed with an 8F to 10F coaxial dilator (Boston Scientific). A second Sensor Wire is placed to serve as a safety. A 30F 12 cm NephroMax balloon with 30F/34F 17 cm clear renal sheath (Boston Scientific) was used to dilate the tract and maintain renal access during the procedure. All percutaneous maneuvers in achieving access, including needle and wire entry and tract dilation, were visualized endoscopically to provide an additional layer of safety and precision during these critical steps. Renoscopy and ureteroscopy were performed with a standard rigid nephroscope and flexible ureteroscope (Karl Storz, Tuttingen, Germany). Lithoclast (Boston Scientific) device and Perc-NCircle (Cook Medical, Bloomington, IN) stone retrieval device were employed in extracting stones. In addition to the stones visualized on CT, another two stones (2 and 3 mm) were identified endoscopically and extracted. Final endoscopic evaluation of the kidney was performed with a combination of antegrade and retrograde flexible scope renoscopy. Final ureteroscopy was performed as the ureteroscope and UAS were withdrawn in tandem. At this point, the urethral catheter was clamped to permit slight bladder dilation and the ureteroscope was positioned within the bladder, visualizing the operative side ureteral orifice. Ureteral stent was then deployed over wire appropriately positioned, coiled within the bladder, and renal pelvis visualized both endoscopically and radiographically. A dissolvable hemostatic plug was advanced down the renal access sheath into the renal access tract before removal of the access sheath. 5 Multilevel (11th and 12th) intercostal anesthetic nerve blocks are performed using 0.5% Marcaine. Incision was closed with 2–0 Vicryl followed by 3–0 Monocryl and skin glue. Anesthetic was reversed and patient was transported to the postoperative recovery area. Acetaminophen 1000 mg and ketorolac 30 mg were both given intravenous before leaving the operative suite. Total time in odds ratio was 1 hours and 57 minutes. Total fluoroscopy time was 42 seconds. Renal access time was one minute. Fifty milliliters blood loss was recorded. Patient was subsequently discharged home in <90 minutes.
3.919922
0.904785
sec[1]/sec[0]/p[0]
en
0.999997
29503872
https://doi.org/10.1089/cren.2017.0136
[ "wire", "access", "renal", "boston", "ureteral", "scientific", "bladder", "sheath", "stones", "sensor" ]
[ { "code": "QB84", "title": "Follow-up care involving removal of fracture plate or other internal fixation device" }, { "code": "9B71.1&XS5S", "title": "Hypertensive Retinopathy, Stage 2, focal arteriolar narrowing, marked generalised arteriolar narrowing, arteriovenous nicking, opacity, “copper wiring” of arteriolar wall, or a combination of these signs" }, { "code": "QD70.6", "title": "Problems associated with inadequate access to electricity" }, { "code": "QB30.3", "title": "Adjustment or management of vascular access device" }, { "code": "QB50.Y", "title": "Presence of other specified cardiac or vascular implants or grafts" }, { "code": "NE81.2Y", "title": "Other specified surgical site infection" }, { "code": "QB30.Y", "title": "Fitting, adjustment or management of other specified implanted devices" }, { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "GB6Z", "title": "Kidney failure, unspecified" }, { "code": "LB30.1", "title": "Renal dysplasia" } ]
=== ICD-11 CODES FOUND === [QB84] Follow-up care involving removal of fracture plate or other internal fixation device Also known as: Follow-up care involving removal of fracture plate or other internal fixation device | Change of internal fixation device | change of fixation device | change of Kirschner wire | Checking of internal fixation device Excludes: removal of external fixation device [QD70.6] Problems associated with inadequate access to electricity Definition: Inadequate power that may restrict healthy living. Also known as: Problems associated with inadequate access to electricity [QB30.3] Adjustment or management of vascular access device Also known as: Adjustment or management of vascular access device [QB50.Y] Presence of other specified cardiac or vascular implants or grafts Also known as: Presence of other specified cardiac or vascular implants or grafts | Presence of artificial heart | Presence of intravascular prosthesis, not elsewhere classified | Status following peripheral angioplasty NOS | Presence of vascular implant or access port device [NE81.2Y] Other specified surgical site infection Also known as: Other specified surgical site infection | Local complication at access site of cardiac catheterisation | Postprocedural abscess | Postprocedural stitch abscess [QB30.Y] Fitting, adjustment or management of other specified implanted devices Also known as: Fitting, adjustment or management of other specified implanted devices | Fitting or adjustment of ileostomy or other intestinal appliances | fitting of ileostomy device | Fitting or adjustment of colostomy | fitting of colostomy belt [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 === GRAPH WALKS === --- Walk 1 --- [QB84] Follow-up care involving removal of fracture plate or other internal fixation device --EXCLUDES--> [?] Follow-up care involving removal of external fixation device --PARENT--> [?] Contact with health services for specific surgical interventions --- Walk 2 --- [QB84] Follow-up care involving removal of fracture plate or other internal fixation device --EXCLUDES--> [?] Follow-up care involving removal of external fixation device --PARENT--> [?] Contact with health services for specific surgical interventions --- Walk 3 --- [QD70.6] Problems associated with inadequate access to electricity Def: Inadequate power that may restrict healthy living.... --PARENT--> [QD70] Problems associated with the natural environment or human-made changes to the environment --EXCLUDES--> [?] Occupational exposure to risk-factors --- Walk 4 --- [QD70.6] Problems associated with inadequate access to electricity Def: Inadequate power that may restrict healthy living.... --PARENT--> [QD70] Problems associated with the natural environment or human-made changes to the environment --CHILD--> [QD70.0] Problems associated with exposure to noise --- Walk 5 --- [QB30.3] Adjustment or management of vascular access device --PARENT--> [QB30] Adjustment or management of implanted devices --CHILD--> [QB30.0] Adjustment or management of implanted hearing device --- Walk 6 --- [QB30.3] Adjustment or management of vascular access device --PARENT--> [QB30] Adjustment or management of implanted devices --CHILD--> [QB30.1] Adjustment or management of infusion pump
[ "[QB84] Follow-up care involving removal of fracture plate or other internal fixation device\n --EXCLUDES--> [?] Follow-up care involving removal of external fixation device\n --PARENT--> [?] Contact with health services for specific surgical interventions", "[QB84] Follow-up care involving removal of fracture plate or other internal fixation device\n --EXCLUDES--> [?] Follow-up care involving removal of external fixation device\n --PARENT--> [?] Contact with health services for specific surgical interventions", "[QD70.6] Problems associated with inadequate access to electricity\n Def: Inadequate power that may restrict healthy living....\n --PARENT--> [QD70] Problems associated with the natural environment or human-made changes to the environment\n --EXCLUDES--> [?] Occupational exposure to risk-factors", "[QD70.6] Problems associated with inadequate access to electricity\n Def: Inadequate power that may restrict healthy living....\n --PARENT--> [QD70] Problems associated with the natural environment or human-made changes to the environment\n --CHILD--> [QD70.0] Problems associated with exposure to noise", "[QB30.3] Adjustment or management of vascular access device\n --PARENT--> [QB30] Adjustment or management of implanted devices\n --CHILD--> [QB30.0] Adjustment or management of implanted hearing device", "[QB30.3] Adjustment or management of vascular access device\n --PARENT--> [QB30] Adjustment or management of implanted devices\n --CHILD--> [QB30.1] Adjustment or management of infusion pump" ]
QB84
Follow-up care involving removal of fracture plate or other internal fixation device
[ { "from_icd11": "QB84", "icd10_code": "Z4733", "icd10_title": "Aftercare following explantation of knee joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z4732", "icd10_title": "Aftercare following explantation of hip joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z472", "icd10_title": "Encounter for removal of internal fixation device" }, { "from_icd11": "QB84", "icd10_code": "Z471", "icd10_title": "Aftercare following joint replacement surgery" }, { "from_icd11": "QB84", "icd10_code": "Z4731", "icd10_title": "Aftercare following explantation of shoulder joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z4781", "icd10_title": "Encounter for orthopedic aftercare following surgical amputation" }, { "from_icd11": "QB84", "icd10_code": "Z4789", "icd10_title": "Encounter for other orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z47", "icd10_title": "Orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z470", "icd10_title": "" }, { "from_icd11": "QB84", "icd10_code": "Z478", "icd10_title": "Encounter for other orthopedic aftercare" }, { "from_icd11": "QB84", "icd10_code": "Z479", "icd10_title": "" }, { "from_icd11": "QB30.3", "icd10_code": "Z452", "icd10_title": "Encounter for adjustment and management of vascular access device" }, { "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" } ]
Z4733
Aftercare following explantation of knee joint prosthesis
Resulting actual examples of IPM-TDM reports from the implementation of this concept, always provided digitally with the name of the IPM reviewer and the telephone number for very rare requests, reflect the real-world clinical environment of a TDM value to be considered for graft and patient safety from the very beginning. The intention is to report the IPM-TDM findings as concisely as possible. Patient 10 days post-HSCT , “CsA trough level in the upper therapeutic range of the acute HSCT phase. Fluconazole, amlodipine, and carvedilol increase the level. In particular, fluconazole reduces fentanyl degradation with an urgent need for fentanyl re-evaluation, especially in the case of withdrawal of metamizole as current cytochrome P450 isozyme 3A4 (CYP3A4)-inducer. Metamizole also lowers CsA levels. Cave: Coxib in the PRN medication is considered critical in combination with CsA, risk of additive nephrotoxicity. In addition, always keep in mind the myelosuppressive potential of mirtazapine in the context of HSCT. Increased risk of bleeding with duloxetine, cave with current thrombocytopenia. Manifest hypomagnesemia under CsA. Wolf, tel. no.” Patient 4 days post-HSCT , “Incorrect dose information? Exclude sampling error. TAC trough level inadequately increased and above therapeutic range of the acute HSCT phase with risks for kidneys (see declining e GFR) and infections. Voriconazole increases TAC-level, as do yesterday’s red blood cell transfusions. Aprepitant starting tomorrow will increase CsA exposure further. Cave: Enhanced exposure of loperamide under tacrolimus and voriconazole (cumulative risk of long QTc). Especially critical with currently manifest hypomagnesemia. Wolf, tel. no.” Patient 10 years after lung transplantation hospitalized in the orthopedic department for operative intervention , “TAC trough level in the therapeutic range of long-term therapy under concomitant inhibitors of metabolism itraconazole and amlodipine and on the other side the CYP3A4 inducer metamizole. Cave: If metamizole is discontinued, TAC levels will rise, requiring close monitoring and timely dose adjustment. Maintain serum potassium (K) and magnesium (Mg) high normal with current cumulative risk of QTc elongation. The actual TAC target range depends on the primary clinical problem, (CMV diagnostics?—PCR? and/or CD4/CD8-ratio inversed?) and the course of the graft. Avoid combination of coxib and TAC with risk of cumulative nephrotoxicity. Wolf, tel. no.” Patient 6 months post-HSCT , “CsA trough level despite low dosage inadequate and again within a therapeutic range of an acute therapy phase with risk of infections and nephrotoxicity. Exclude sampling error. Current target range always according to foreground clinical risk and HSCT course as well as further immunosuppression. The acute discrete liver dysfunction, depending on varying extent, leads to impaired metabolism of CsA, among others. Furthermore, ponatinib increases CsA exposure and requires dose adjustment of CsA and follow-up as well as monitoring of liver function. Additional findings: Differential diagnosis CMV? Previous folic acid deficiency now compensated? Wolf, tel. no.” Patient 3 years after kidney transplantation , “TAC level delayed by 2 h below measurable range at minimum daily dose and single dose. However, transient cortisone bridging has been introduced. Current TAC target range depends on the acute priority clinical problem. Lercanidipine increases TAC exposure. Recent manifestations of hyponatraemia, folic acid deficiency, hypogammaglobulinemia (potential ADR of MMF). Intermittent serum Mg monitoring is recommended. Very critical is the combination of 40 mg simvastatin with lercanidipine, which leads to a considerably higher statin exposure with renal risks, obviously used in long-term therapy with CKD of the kidney transplant. Wolf, tel. no.” Patient 8 weeks after HSCT , “CsA trough level in the therapeutic range of a post-acute phase of HSCT. Voriconazole increases the CsA exposure. Current target range according to frontline clinic (CMV?) and HSCT course. Reversal of CD4/CD8 ratio inversion (besides PCR) after virustatic therapy? Manifest hypogammaglobulinemia after MMF as a potential ADR? Probenecid is contraindicated in patients with eGFR < 50 mL/min/1.73 m 2 and critical in pre-existing hematopoietic disorders (see SmPC). Renal insufficiency [creatinine clearance ≤ 55 mL/min or ≥2+ proteinuria (>100 mg/dL)] is a contraindication to the use of cidofovir (see SmPC). Manifest hypomagnesemia, critical with current cumulative long-QTc risk from voriconazole, levofloxacin, etc. Maintain high normal serum K and Mg in this high-risk constellation if unavoidable. Wolf, tel. no.”
4.15625
0.605957
sec[1]/sec[1]/p[0]
en
0.999997
37765269
https://doi.org/10.3390/pharmaceutics15092300
[ "hsct", "range", "risk", "current", "wolf", "exposure", "trough", "therapeutic", "critical", "phase" ]
[ { "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": "QC4Y", "title": "Personal history of other specified health problems" }, { "code": "QA43.Z", "title": "Supervision of high-risk pregnancy, unspecified" }, { "code": "QA43.Y", "title": "Other specified supervision of high-risk pregnancy" }, { "code": "QD84.Z", "title": "Occupational exposure to risk-factors, unspecified" }, { "code": "MB26.A", "title": "Suicidal ideation" } ]
=== 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 [QC4Y] Personal history of other specified health problems Also known as: Personal history of other specified health problems | Personal history of diseases of the circulatory system | history of disease or disorder of circulatory system | personal history of conditions classifiable as diseases of the circulatory system | Personal history of diseases of the respiratory system [QA43.Z] Supervision of high-risk pregnancy, unspecified Also known as: Supervision of high-risk pregnancy, unspecified | Supervision of high-risk pregnancy [QA43.Y] Other specified supervision of high-risk pregnancy Also known as: Other specified supervision of high-risk pregnancy | Supervision of pregnancy with grand multiparity | pregnancy management affected by grand multiparity | multiparity affecting management of pregnancy, labour and delivery | pregnancy supervision for multiparity [QD84.Z] Occupational exposure to risk-factors, unspecified Also known as: Occupational exposure to risk-factors, unspecified | Occupational exposure to risk-factors | problem with occupational physical environment [MB26.A] Suicidal ideation Definition: Thoughts, ideas, or ruminations about the possibility of ending one's life, ranging from thinking that one would be better off dead to formulation of elaborate plans. Also known as: Suicidal ideation | suicidal tendency | suicidal tendencies | suicidal ideation tendencies | suicide risk Excludes: Suicide attempt | Personal history of self-harm === GRAPH WALKS === --- Walk 1 --- [QA00.6Y] Other specified examination of eyes or vision --PARENT--> [QA00.6] Examination of eyes or vision --CHILD--> [QA00.62] No vision impairment --- 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 --RELATED_TO--> [?] Transient neonatal neutropaenia Def: Neonatal neutropaenia can be due to underproduction of the marrow (e.g. hypoxemia due to placental insufficiency, congenital viral disease) or excessive utilization of white blood cells (bacterial sep... --- Walk 4 --- [4B00.0Z] Neutropaenia, unspecified --PARENT--> [4B00.0] Neutropenia --PARENT--> [4B00] Disorders of neutrophil number --- 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... --CHILD--> [3B63.1Z] Acquired thrombocytosis, unspecified --- 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--> [3B63.10] Secondary thrombocytosis
[ "[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --CHILD--> [QA00.62] No vision impairment", "[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 --RELATED_TO--> [?] Transient neonatal neutropaenia\n Def: Neonatal neutropaenia can be due to underproduction of the marrow (e.g. hypoxemia due to placental insufficiency, congenital viral disease) or excessive utilization of white blood cells (bacterial sep...", "[4B00.0Z] Neutropaenia, unspecified\n --PARENT--> [4B00.0] Neutropenia\n --PARENT--> [4B00] Disorders of neutrophil number", "[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--> [3B63.1Z] Acquired thrombocytosis, 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 --CHILD--> [3B63.10] Secondary 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": "QC4Y", "icd10_code": "Z86718", "icd10_title": "Personal history of other venous thrombosis and embolism" }, { "from_icd11": "QC4Y", "icd10_code": "Z9181", "icd10_title": "History of falling" }, { "from_icd11": "QA43.Z", "icd10_code": "Z35", "icd10_title": "" }, { "from_icd11": "QA43.Z", "icd10_code": "Z354", "icd10_title": "" }, { "from_icd11": "QA43.Z", "icd10_code": "Z358", "icd10_title": "" }, { "from_icd11": "QA43.Z", "icd10_code": "Z359", "icd10_title": "" }, { "from_icd11": "QA43.Z", "icd10_code": "O0990 ", "icd10_title": "" }, { "from_icd11": "QA43.Z", "icd10_code": "O0993 ", "icd10_title": "" }, { "from_icd11": "QA43.Y", "icd10_code": "O09521 ", "icd10_title": "" }, { "from_icd11": "QA43.Y", "icd10_code": "O09522 ", "icd10_title": "" }, { "from_icd11": "QA43.Y", "icd10_code": "O09523 ", "icd10_title": "" }, { "from_icd11": "QA43.Y", "icd10_code": "O09529 ", "icd10_title": "" }, { "from_icd11": "QA43.Y", "icd10_code": "O09899 ", "icd10_title": "" } ]
D473
Essential (hemorrhagic) thrombocythemia
A 57-year-old female with history of myocardial infarction and need for cardiac catheterization with stent placement requiring clopidogrel for many years, as well as a history of hypertension requiring lisinopril, was evaluated by her gynecologist for ongoing pelvic pain. She had no personal history of rheumatologic disorders, including systemic sclerosis. She had no family history of cancers. She underwent a pelvic ultrasound which showed bilateral complex ovarian cysts. She was slated for a laparoscopic bilateral salpingo-oophorectomy (BSO), and clopidogrel was stopped 2 weeks prior to surgery. Pre-operative CA-125 level was normal, as was her complete blood count, hepatic, and renal function. Upon laparoscopy, there was found to be enlargement of the right ovary with excrescences, grossly suspicious for malignancy, thus requiring exploratory laparotomy. Frozen section of the right ovary described a borderline tumor, and a hysterectomy was then performed in addition to the BSO. Estimated blood loss was 350 cc. The final pathology confirmed a serous Borderline tumor without microinvasion or evidence of invasive carcinoma in either ovary . Postoperatively the patient was given thromboembolism prophylaxis with heparin 5000 U subcutaneously every 8 hours. She developed fevers to 101 degrees F for 2 days without an obvious source of infection; blood and urine cultures were negative, and chest x-ray was unremarkable, with the exception of atelectasis. Empiric antibiotics however, were added. Neurologic examination was unremarkable and the patient was lucid without evidence of mental status changes. Creatinine levels rose to 2.0 mg/dL, thought due to hypovolemia, and intravenous fluids were increased. A CBC showed decrease in the platelet count to 110 K/ul (ref 142–424) on post-operative day (POD)#2, and to 63 K/ul on POD #3, when the patient was evaluated by a hematologist. The hemoglobin (Hgb) level was 8.1 g/dL (ref 12.2–16.2), prothrombin time (PT) 13.1 seconds (ref 11.7–14.7 sec), fibrinogen 550 mg/dL (ref 188–421 mg/dL), lactate dehydrogenase (LDH) 2764 U/L (ref 313–618 U/L), haptoglobin level <7 mg/dL (ref 42–312 mg/dL), and evaluation of the red cells by peripheral blood smear with 1–2 shistocytes per high-powered field (HPF) . D-dimer level (fibrin-degradation split products) was 2.68 ug/ml (ref 0.0–0.42 ug/ml). Cr 1.0 mg/dL (ref <1.2 mg/dL), which was improved from 2.0 mg/dL with the addition of further IV fluids on POD#4. The patient then developed worsening blood pressure, requiring antihypertensives including clonidine, and experienced chest pain with swelling in her legs; workup including CT angiogram and an ultrasound of the lower extremities with Doppler negative for thromboembolism. Heparin was stopped and an interim diagnosis of heparin-induced thrombocytopenia (HIT) was considered; a prophylactic argatroban infusion was given while HIT studies were pending and was continued empirically for 5 days. On POD#4, platelets were 67 K/uL, Hgb 8.1 g/dL, LDH 2964 U/L, with 3–5 shistocytes per HPF , with D-dimer (FDP) level 2.25 ug/ml She was neurologically intact and lucid. The patient was placed on prednisone and platelets improved to 83 K/uL on POD#5 with hemoglobin 7.7 g/dL requiring red cell transfusion, LDH 1694 U/L, fibrinogen 556 mg/dL, with liver function testing normal. HIT ELISA was negative as was heparin-induced platelet aggregation assay, and there was no evidence LAC. Factor VIII levels were followed, showing normal levels with no evidence of inhibitor, ristocetin cofactor activity was normal, and ADAMTS13 level. Creatinine level was then stable. The patient was observed on prednisone and treated empirically for fevers. On POD #6, the platelet count rose to 106 K/uL, hemoglobin to 7.9 g/dL, requiring additional red cell transfusion, LDH stable at 1610 U/L, with examination of the peripheral blood smear showing persistently 4–5 shistocytes per HPF, and creatinine level of 1.2 mg/dL. On POD#7, hgb level 9.7 g/dL, platelets 177 K/ul, LDH 1618 U/L, Cr 1.2 mg/dL, fibrinogen 301 mg/dL. On POD#8, the platelet count rose to 222 K/ul, hemoglobin to 10.2 g/dL, LDH 979 U/L, peripheral smear with 3–4 shistocytes per HPF, and stabilized for the rest of the hospitalization. The differential diagnosis included microangiopathic hemolytic anemia (MAHA) associated with thrombotic thrombocytopenic purpura (TTP)/hemolytic-uremic syndrome (HUS), systemic inflammatory response syndrome (SIRS), antiphospholipid antibody syndrome, a compensated disseminated intravascular coagulation (DIC), and /or hypertension-associated MAHA. In looking for specific trigger, we also asked the question as to whether MAHA has been triggered by ovarian tumors.
3.992188
0.977539
sec[0]/p[0]
en
0.999997
22708045
https://doi.org/10.4084/MJHID.2012.030
[ "requiring", "blood", "count", "evidence", "heparin", "platelet", "hemoglobin", "shistocytes", "including", "ovary" ]
[ { "code": "BC01/BB9Z", "title": "Pulmonary prosthetic valve failure requiring replacement" }, { "code": "BC01/BB6Z", "title": "Mitral prosthetic valve failure requiring replacement" }, { "code": "BC01/BB8Z", "title": "Tricuspid prosthetic valve failure requiring replacement" }, { "code": "5A11", "title": "Type 2 diabetes mellitus" }, { "code": "BC01/BB7Z", "title": "Aortic prosthetic valve failure requiring replacement" }, { "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 === [5A11] Type 2 diabetes mellitus Definition: Diabetes mellitus type 2 (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) is a metabolic disorder that is characterised by high blood glucose in the context of insulin resistance and relative insulin deficiency. Also known as: Type 2 diabetes mellitus | adult onset diabetes | maturity onset diabetes | nonketotic diabetes | type 2 diabetes Includes: non-insulin-dependent diabetes of the young Excludes: Diabetes mellitus in pregnancy | Diabetes mellitus, other specified type | Idiopathic Type 1 diabetes mellitus [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 --- [5A11] Type 2 diabetes mellitus Def: Diabetes mellitus type 2 (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) is a metabolic disorder that is characterised by high blood glucose in the context of insulin... --EXCLUDES--> [?] Diabetes mellitus, other specified type Def: Diabetes mellitus which cannot be classified as either Type 1 or Type 2 diabetes mellitus.... --CHILD--> [?] Diabetes mellitus due to diseases of the exocrine pancreas Def: Other specified diabetes mellitus due to diseases of the exocrine pancreas is a form of diabetes which is caused by any process that diffusely injures the pancreas. Acquired processes include pancreat... --- Walk 2 --- [5A11] Type 2 diabetes mellitus Def: Diabetes mellitus type 2 (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) is a metabolic disorder that is characterised by high blood glucose in the context of insulin... --EXCLUDES--> [?] Idiopathic Type 1 diabetes mellitus Def: Some forms of type 1 diabetes mellitus have no known aetiologies. These patients have permanent insulinopenia and are prone to ketoacidosis, but have no evidence of β-cell autoimmunity. Although only ... --CHILD--> [?] Fulminant type 1 diabetes mellitus
[ "[5A11] Type 2 diabetes mellitus\n Def: Diabetes mellitus type 2 (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) is a metabolic disorder that is characterised by high blood glucose in the context of insulin...\n --EXCLUDES--> [?] Diabetes mellitus, other specified type\n Def: Diabetes mellitus which cannot be classified as either Type 1 or Type 2 diabetes mellitus....\n --CHILD--> [?] Diabetes mellitus due to diseases of the exocrine pancreas\n Def: Other specified diabetes mellitus due to diseases of the exocrine pancreas is a form of diabetes which is caused by any process that diffusely injures the pancreas. Acquired processes include pancreat...", "[5A11] Type 2 diabetes mellitus\n Def: Diabetes mellitus type 2 (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) is a metabolic disorder that is characterised by high blood glucose in the context of insulin...\n --EXCLUDES--> [?] Idiopathic Type 1 diabetes mellitus\n Def: Some forms of type 1 diabetes mellitus have no known aetiologies. These patients have permanent insulinopenia and are prone to ketoacidosis, but have no evidence of β-cell autoimmunity. Although only ...\n --CHILD--> [?] Fulminant type 1 diabetes mellitus" ]
BC01/BB9Z
Pulmonary prosthetic valve failure requiring replacement
[ { "from_icd11": "5A11", "icd10_code": "E11319", "icd10_title": "Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema" }, { "from_icd11": "5A11", "icd10_code": "E1151", "icd10_title": "Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene" }, { "from_icd11": "5A11", "icd10_code": "E1121", "icd10_title": "Type 2 diabetes mellitus with diabetic nephropathy" }, { "from_icd11": "5A11", "icd10_code": "E1110", "icd10_title": "Type 2 diabetes mellitus with ketoacidosis without coma" }, { "from_icd11": "5A11", "icd10_code": "E11621", "icd10_title": "Type 2 diabetes mellitus with foot ulcer" }, { "from_icd11": "5A11", "icd10_code": "E1142", "icd10_title": "Type 2 diabetes mellitus with diabetic polyneuropathy" }, { "from_icd11": "5A11", "icd10_code": "E1165", "icd10_title": "Type 2 diabetes mellitus with hyperglycemia" }, { "from_icd11": "5A11", "icd10_code": "E1169", "icd10_title": "Type 2 diabetes mellitus with other specified complication" }, { "from_icd11": "5A11", "icd10_code": "E1152", "icd10_title": "Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene" }, { "from_icd11": "5A11", "icd10_code": "E1140", "icd10_title": "Type 2 diabetes mellitus with diabetic neuropathy, unspecified" }, { "from_icd11": "5A11", "icd10_code": "E1143", "icd10_title": "Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy" }, { "from_icd11": "5A11", "icd10_code": "E11649", "icd10_title": "Type 2 diabetes mellitus with hypoglycemia without coma" }, { "from_icd11": "5A11", "icd10_code": "E113393", "icd10_title": "Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral" }, { "from_icd11": "5A11", "icd10_code": "E1136", "icd10_title": "Type 2 diabetes mellitus with diabetic cataract" }, { "from_icd11": "5A11", "icd10_code": "E11628", "icd10_title": "Type 2 diabetes mellitus with other skin complications" } ]
E11319
Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema
A 52-year-old female patient presented with epigastric pain and persistent colic in the left abdominal region. The patient had a history of invasive adenocarcinoma in the right upper lobe of the lung, for which she underwent right upper lobe resection and received adjuvant chemotherapy with pemetrexed and carboplatin eight years prior to admission. Genetic testing revealed the presence of an epidermal growth factor receptor (EGFR) exon 21 mutation, resulting in a 3.5-year administration of maintenance therapy with erlotinib-targeted drugs. However, a recurrence of the tumor was detected by positron emission tomography-computed tomography (PET-CT) scans, necessitating a right lobectomy followed by postoperative chemotherapy with pemetrexed and nedaplatin. Postoperative genetic analysis identified EGFR exon 21 L858R mutation and EGFR exon 20 T790M mutation. Subsequently, the patient underwent two years of oral osimertinib-targeted therapy following the completion of chemotherapy. Nonetheless, in April 2020, disease progression was identified based on elevated carcinoembryonic antigen (CEA) levels observed during a reexamination. Consequently, the patient’s treatment was switched to anrotinib, albeit discontinued after only one month due to the occurrence of adverse effects. As a result, oral osimertinib was reintroduced as the choice of therapy, yet CEA levels remained persistently elevated during subsequent evaluations. In July 2020, a combination therapy comprising osimertinib and bevacizumab was administered, resulting in a significant reduction in CEA levels. However, after a duration of four months, the administration of bevacizumab was terminated due to drug-induced liver injury, and the patient continued with maintenance therapy utilizing oral osimertinib alone. Unfortunately, CEA monitoring in January 2021 unveiled a subsequent increase, prompting an escalation in the osimertinib dosage. In April 2021, CEA levels persistently rose without any signs of improvement, leading to the decision to switch to almonertinib as the oral drug. During a physical examination in December 2021, the patient was diagnosed with cervical lymphadenopathy, confirmed by needle biopsy to be metastatic carcinoma, while whole-body bone imaging showed no irregularities. Consequently, the oral drug was switched to Afatinib. However, this medication had to be discontinued a week later due to intolerable side effects, including oral mucositis, weight loss, and diarrhea. Moreover, additional genetic testing revealed the presence of TP53, MET, ROS1, and ALK mutations ( Table 1 ), indicating the existence of additional drug resistance gene mutations. In January 2022, computed tomography (CT) scans revealed further enlargement of the cervical lymph nodes. The patient was hospitalized for a comprehensive treatment approach consisting of chemotherapy using pemetrexed and carboplatin, alongside targeted therapy employing bevacizumab. In addition, supraclavicular radiotherapy was administered as part of the therapeutic regimen. Regrettably, after two cycles of chemotherapy, bone metastases were detected, indicating disease progression. Thus, the therapy regimen was modified to include abraxane and bevacizumab . During hospitalization for chemotherapy, an enhanced CT scan of the upper abdomen showed patchy low-density shadows in the head of the pancreas, measuring approximately 19 mm × 17 mm . The degree of enhancement observed during the scan was lower than that of normal pancreatic tissue, and the nature of the shadows remained undetermined. One month later, the patient underwent a CT scan due to abdominal pain, which revealed patchy low-density shadows in the pancreatic head area with indistinct borders . These findings were suggestive of acute pancreatitis. Further enzymatic screening confirmed the presence of pancreatitis, with elevated levels of amylase (969.10 U/L; normal range: 30-110 U/L) and lipase . Tumor marker analysis indicated elevated levels of pro-gastrin releasing-peptide (pro-GRP) (173.69 pg/mL; normal range: 0-63 pg/mL) and CEA (39.60 ng/mL; normal range: 0-5 ng/mL). Magnetic resonance imaging (MRI) indicated mildly enhancing masses measuring approximately 20 mm × 13 mm and 13 mm × 10 mm in the neck and uncinate process of the pancreas, respectively, along with encapsulated effusion in the pancreatic head . Furthermore, an ultrasound-guided gastroscopy was performed for cytopathology examination, revealing a small cell carcinoma lesion in the pancreatic head that tested positive for CK, CD56, Ki67, Syn, and TTF-1 . Based on the patient’s clinical history and pathological findings, metastatic tumors originating from the lung were highly suspected.
4.074219
0.971191
sec[1]/p[0]
en
0.999998
PMC10835274
https://doi.org/10.3389/fonc.2024.1274034
[ "chemotherapy", "oral", "osimertinib", "bevacizumab", "drug", "head", "pancreatic", "pemetrexed", "genetic", "presence" ]
[ { "code": "QB97", "title": "Contact with health services for chemotherapy session for neoplasm" }, { "code": "QC05.Y", "title": "Other specified prophylactic measures" }, { "code": "QB9Y", "title": "Other specified contact with health services for nonsurgical interventions not involving devices" }, { "code": "3B64.1Y", "title": "Other specified acquired thrombocytopenia" }, { "code": "QC48.Y", "title": "Other specified personal history of medical treatment" }, { "code": "MD11.8Z", "title": "Mouth breathing, unspecified" }, { "code": "DA01.00", "title": "Oral leukoplakia" }, { "code": "DA01.10", "title": "Oral aphthae or aphtha-like ulceration" }, { "code": "MD80.1", "title": "Symptom or complaint of the mouth, tongue or lip" }, { "code": "DA01.1Y", "title": "Other specified noninfectious erosive or ulcerative disorders of oral mucosa" } ]
=== ICD-11 CODES FOUND === [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 [MD11.8Z] Mouth breathing, unspecified Also known as: Mouth breathing, unspecified | Mouth breathing | breathing orally | mouth respiration [DA01.00] Oral leukoplakia Definition: Leukoplakia is a condition where areas of keratosis appear as adherent white patches on the mucous membranes of the oral cavity. Leukoplakia may affect other gastrointestinal tract mucosal sites, or mucosal surfaces of the urinary tract and genitals. Also known as: Oral leukoplakia | Leukoplakia of gingiva | leukoplakia of oral epithelium | leucoplakia of oral mucosa | leukokeratosis of oral mucosa Includes: Leukoplakia of gingiva Excludes: Hairy leukoplakia [DA01.10] Oral aphthae or aphtha-like ulceration Definition: This is a frequent small, shallow, painful ulceration in the oral mucosa. Recurrent oral ulceration that clinically resembles recurrent aphthous stomatitis but presents atypically, including commencement after adolescence, with fever, with a strong family history, or failing to resolve with age. Also known as: Oral aphthae or aphtha-like ulceration | Recurrent aphthous stomatitis | Recurrent oral aphthae | Major recurrent aphthous stomatitis | major aphthous stomatitis [MD80.1] Symptom or complaint of the mouth, tongue or lip Also known as: Symptom or complaint of the mouth, tongue or lip | Mouth swelling | mouth oedema | swollen mouth | Lip swelling [DA01.1Y] Other specified noninfectious erosive or ulcerative disorders of oral mucosa Also known as: Other specified noninfectious erosive or ulcerative disorders of oral mucosa | Oral ulceration due to immunobullous disease | Oral mucosal involvement by immunobullous disorder classified elsewhere | Oral ulceration due to physical injury | Mechanical oral ulceration === GRAPH WALKS === --- Walk 1 --- [QB97] Contact with health services for chemotherapy session for neoplasm --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB90] Contact with health services for ear piercing --- Walk 2 --- [QB97] Contact with health services for chemotherapy session for neoplasm --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB92] Contact with health services for issue of repeat prescription --- Walk 3 --- [QC05.Y] Other specified prophylactic measures --PARENT--> [QC05] Need for certain specified other prophylactic measures --CHILD--> [QC05.1] Prophylactic immunotherapy --- Walk 4 --- [QC05.Y] Other specified prophylactic measures --PARENT--> [QC05] Need for certain specified other prophylactic measures --CHILD--> [QC05.1] Prophylactic immunotherapy --- Walk 5 --- [QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --PARENT--> [?] Reasons for contact with the health services --- Walk 6 --- [QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB92] Contact with health services for issue of repeat prescription
[ "[QB97] Contact with health services for chemotherapy session for neoplasm\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB90] Contact with health services for ear piercing", "[QB97] Contact with health services for chemotherapy session for neoplasm\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB92] Contact with health services for issue of repeat prescription", "[QC05.Y] Other specified prophylactic measures\n --PARENT--> [QC05] Need for certain specified other prophylactic measures\n --CHILD--> [QC05.1] Prophylactic immunotherapy", "[QC05.Y] Other specified prophylactic measures\n --PARENT--> [QC05] Need for certain specified other prophylactic measures\n --CHILD--> [QC05.1] Prophylactic immunotherapy", "[QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --PARENT--> [?] Reasons for contact with the health services", "[QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB92] Contact with health services for issue of repeat prescription" ]
QB97
Contact with health services for chemotherapy session for neoplasm
[ { "from_icd11": "QB97", "icd10_code": "Z5111", "icd10_title": "Encounter for antineoplastic chemotherapy" }, { "from_icd11": "QB97", "icd10_code": "Z5112", "icd10_title": "Encounter for antineoplastic immunotherapy" }, { "from_icd11": "QB97", "icd10_code": "Z511", "icd10_title": "Encounter for antineoplastic chemotherapy and immunotherapy" }, { "from_icd11": "QB97", "icd10_code": "Z51", "icd10_title": "Encounter for other aftercare and medical care" }, { "from_icd11": "QB9Y", "icd10_code": "Z5181", "icd10_title": "Encounter for therapeutic drug level monitoring" }, { "from_icd11": "QC48.Y", "icd10_code": "Z794", "icd10_title": "Long term (current) use of insulin" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7902", "icd10_title": "Long term (current) use of antithrombotics/antiplatelets" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7982", "icd10_title": "Long term (current) use of aspirin" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7984", "icd10_title": "Long term (current) use of oral hypoglycemic drugs" }, { "from_icd11": "QC48.Y", "icd10_code": "Z79899", "icd10_title": "Other long term (current) drug therapy" }, { "from_icd11": "MD11.8Z", "icd10_code": "R065", "icd10_title": "Mouth breathing" }, { "from_icd11": "DA01.00", "icd10_code": "K1329", "icd10_title": "Other disturbances of oral epithelium, including tongue" }, { "from_icd11": "DA01.00", "icd10_code": "K1321", "icd10_title": "Leukoplakia of oral mucosa, including tongue" }, { "from_icd11": "DA01.00", "icd10_code": "K132", "icd10_title": "Leukoplakia and other disturbances of oral epithelium, including tongue" }, { "from_icd11": "DA01.10", "icd10_code": "K120", "icd10_title": "Recurrent oral aphthae" } ]
Z5111
Encounter for antineoplastic chemotherapy
The megaoesophagus was thought to be a result of the chronic gastric pathology. Surgical correction of the gastric pathology was determined to be the most critical step, despite the anaesthetic risk associated with mild unilateral aspiration pneumonia. A gastroscopy performed prior to surgery was done under general anaesthesia after premedication with intravenous diazepam at 0.3 mg/kg (Pax 5 mg/mL, Pharmacare Limited, Sandton, South Africa) and induction with intravenous propofol at 4 mg/kg (propofol 20 mg/mL, Fresenius Kabi, Midrand, South Africa) to effect. Anaesthesia was maintained with isoflurane (Isofor, Safeline Pharmaceuticals, Roodepoort, South Africa). Difficulty was experienced passing the endoscope through what appeared to be a twisted lower oesophageal sphincter. Upon entering the stomach, it was found that the pyloric antrum was positioned on the left side of the patient, not in its normal position on the right. Mucosal biopsies, taken for histopathology, confirmed a Helicobacter infection. After gastroscopy, the patient was moved to theatre, placed on positive pressure ventilation and a 100 mm Veress needle (Veress pneumoperitoneum needle, Karl Storz Veterinary Endoscopy, Goleta, United States [US]) was used to access the peritoneal cavity. The peritoneal cavity was insufflated with CO 2 to an intra-abdominal pressure of 13 mmHg using an insufflator (pressure-regulating mechanical insufflator, Karl Storz Veterinary Endoscopy). The Veress needle was removed and, using the same site, a 6 mm standard trocar and cannula was placed. A 5 mm, 0 degree, 29 cm laparoscopic telescope (Hopkins II telescope, Karl Storz Veterinary Endoscopy) was introduced through the cannula into the peritoneal cavity. After inspection of the peritoneal cavity, an 11 mm standard trocar and cannula was placed under direct laparoscopic visualisation on the right side of the patient, 40 mm caudal to the last rib and 40 mm lateral to the rectus abdominis muscle . Laparoscopic examination of the cranial peritoneal cavity revealed the greater omentum wrapped over the greater curvature of the partially dilated stomach from right to left. The pyloric antrum and duodenum were not seen in their normal position in the right quadrant. The splenic edge was visualised between the liver and the stomach at this location . On viewing the left cranial peritoneal cavity, a clear fold between the abnormally positioned pyloric antrum and the gastric corpus and fundus was visualised . An estimated 180 degree clockwise gastric rotation was confirmed. Non-traumatic forceps (Clickline Babcock Forceps, Karl Storz Veterinary Endoscopy) were used to grasp the pyloric antrum and overlying omentum. With careful traction towards the right lateral abdomen, repetitive attempts resulted in repositioning the pyloric antrum . The normal anatomic positions of the pyloric antrum, duodenum, gastric corpus and fundus, as well as adjacent spleen were confirmed after the repositioning . A routine laparoscopic-assisted incisional gastropexy (LAIG) was performed . The dog was hospitalised for four days post-operatively whilst being treated with intravenous crystalloids at 1.5 times maintenance (Ringers, Adcock Ingram Critical Care, Johannesburg, South Africa), intravenous metoclopramide (Clopamon 5 mg/mL, Pharmacare, Woodmead, South Africa) constant rate of infusion at 1 mg/kg/24 hours and subcutaneous maropitant (Cerenia 10 mg/mL, Zoetis, Sandton, South Africa) at 1 mg/kg once a day. As Helicobacter infection was diagnosed on the gastric biopsies it was treated with metronidazole (ADCO-Metronidazole 400 mg, Adcock Ingram Limited, Midrand, South Africa) at 10 mg/kg PO bid, amoxicillin (Betamox 500 mg, Ranbaxy Pharmaceuticals, Roodepoort, South Africa) at 20 mg/kg PO bid and omeprazole (Losec MUPS 40 mg, AstraZeneca Pharmaceuticals, Bryanston, South Africa) at 1 mg/kg PO bid . The vomiting and regurgitation resolved and the megaoesophagus was managed by feeding the patient soft food from an elevated position. The patient was kept in an upright position for 10 min post-feeding. After four days the owner insisted that the dog should be discharged as she could manage the partially resolved aspiration pneumonia on an outpatient basis. Oral antibiotics and gastroprotectants were dispensed and the owner was shown how to feed the dog appropriately. Twenty-four hours after discharge the dog was presented to our after-hours clinic with tachycardia, tachypnoea, pyrexia and abnormal lung sounds. The patient deteriorated with clinical signs related to pneumonia, but the owner declined further diagnostics and treatment and opted for humane euthanasia of the patient. A necropsy examination was declined.
4.089844
0.935059
sec[3]/p[0]
en
0.999997
30456979
https://doi.org/10.4102/jsava.v89i0.1713
[ "south", "africa", "gastric", "pyloric", "antrum", "peritoneal", "cavity", "intravenous", "position", "karl" ]
[ { "code": "1F53.Z", "title": "Chagas disease, unspecified" }, { "code": "1F2E.Z", "title": "Paracoccidioidomycosis, unspecified" }, { "code": "1D2Z", "title": "Dengue fever, unspecified" }, { "code": "8A03.1Y", "title": "Other specified hereditary ataxia" }, { "code": "1D21", "title": "Dengue with warning signs" }, { "code": "1F66.0", "title": "Loiasis" }, { "code": "5C64.10", "title": "Iron overload diseases" }, { "code": "DA4Z", "title": "Diseases of stomach, unspecified" }, { "code": "DA60.Z", "title": "Gastric ulcer, unspecified" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" } ]
=== ICD-11 CODES FOUND === [1F53.Z] Chagas disease, unspecified Also known as: Chagas disease, unspecified | Chagas disease | American trypanosomiasis | infection due to Trypanosoma cruzi | South American trypanosomiasis [1F2E.Z] Paracoccidioidomycosis, unspecified Also known as: Paracoccidioidomycosis, unspecified | Paracoccidioidomycosis | Brazilian blastomycosis | Lutz disease | Brazilian blastomycotic [1D2Z] Dengue fever, unspecified Also known as: Dengue fever, unspecified | breakbone fever | classical dengue | classical dengue fever | dandy fever [8A03.1Y] Other specified hereditary ataxia Also known as: Other specified hereditary ataxia | Autosomal recessive ataxia | Autosomal recessive spastic ataxia of Charlevoix-Saguenay | Ataxia due to Marinesco-Sjögren syndrome | Autosomal recessive ataxias due to POLG mutations [1D21] Dengue with warning signs Definition: Clinical warning signs are: abdominal pain or tenderness, mucosal bleeding, lethargy and/or restlessness, rapid decrease in platelet count, increase in haematocrit. Other signs can include: persistent vomiting, visible fluid accumulation, liver enlargement more than 2 cm. Also known as: Dengue with warning signs | Bangkok haemorrhagic fever | Singapore haemorrhagic fever | Thailand haemorrhagic fever | Southeast Asia haemorrhagic fever [1F66.0] Loiasis Definition: A disease caused by an infection with the parasitic worm Loa loa. This disease is characterised by Calabar swellings found anywhere on the body (commonly found near joints). This disease may also present with generalised itching, muscle pain, joint pain, fatigue or may be asymptomatic. Transmission is through the bite of an infected fly (genus Chrysops). Confirmation is by identification of adult Loa loa in the skin or eye, Loa loa microfilariae in a blood sample obtained in the day (1000 - 1400 Also known as: Loiasis | Eye worm disease of Africa | Loa loa infestation | African eyeworm disease | Calabar swelling Includes: Eye worm disease of Africa | Loa loa infestation | Calabar swelling [5C64.10] Iron overload diseases Definition: Iron overload is the accumulation of excess iron in body tissues. Iron overload usually occurs as a result of a genetic predisposition to absorb and store iron in excess amounts, the most common form of which is hereditary hemochromatosis. Iron overload can also occur as a complication of other hematologic disorders that require chronic transfusion therapy, repeated injections of parenteral iron, or excessive iron ingestion. Excessive iron stores usually accumulate in the reticuloendothelial tis Also known as: Iron overload diseases | idiopathic haemosiderosis | hemosiderosis | Hereditary haemochromatosis | HFE-related hereditary haemochromatosis, Type 1 [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 === GRAPH WALKS === --- Walk 1 --- [1F53.Z] Chagas disease, unspecified --PARENT--> [1F53] Chagas disease Def: A disease caused by an infection with the protozoan parasite Trypanosoma cruzi. This disease is characterised by fever, headache, lymphadenopathy, pallor, muscle pain, dyspnoea, swelling, or abdominal... --CHILD--> [1F53.3] Chagas disease with digestive system involvement Def: A disease caused by an infection with the protozoan parasite Trypanosoma cruzi. This disease is characterised by severe malaise or digestive system involvement (such as megaoesophagus or megacolon). T... --- Walk 2 --- [1F53.Z] Chagas disease, unspecified --PARENT--> [1F53] Chagas disease Def: A disease caused by an infection with the protozoan parasite Trypanosoma cruzi. This disease is characterised by fever, headache, lymphadenopathy, pallor, muscle pain, dyspnoea, swelling, or abdominal... --CHILD--> [1F53.2] Chronic Chagas disease with heart involvement Def: A disease caused by a chronic infection with the protozoan parasite Trypanosoma cruzi. This disease commonly presents with severe malaise or cardiac involvement (such as cardiomyopathy, cardiac failur... --- Walk 3 --- [1F2E.Z] Paracoccidioidomycosis, unspecified --PARENT--> [1F2E] Paracoccidioidomycosis Def: A disease caused by an infection with the fungi Paracoccidioides brasiliensis. This disease commonly presents with fever, toxaemia, weight loss, adenopathy, hepatosplenomegaly, anaemia, or eosinophili... --CHILD--> [1F2E.Y] Other specified paracoccidioidomycosis --- Walk 4 --- [1F2E.Z] Paracoccidioidomycosis, unspecified --PARENT--> [1F2E] Paracoccidioidomycosis Def: A disease caused by an infection with the fungi Paracoccidioides brasiliensis. This disease commonly presents with fever, toxaemia, weight loss, adenopathy, hepatosplenomegaly, anaemia, or eosinophili... --PARENT--> [?] Mycoses --- Walk 5 --- [1D2Z] Dengue fever, unspecified --PARENT--> [?] Dengue Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti... --CHILD--> [1D22] Severe dengue Def: Clinical signs include: 1. Severe plasma leakage leading to shock (dengue shock syndrome - DSS) and/or fluid accumulation with respiratory distress; 2. severe bleeding as evaluated by clinician, 3. se... --- Walk 6 --- [1D2Z] Dengue fever, unspecified --PARENT--> [?] Dengue Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti... --CHILD--> [1D20] Dengue without warning signs
[ "[1F53.Z] Chagas disease, unspecified\n --PARENT--> [1F53] Chagas disease\n Def: A disease caused by an infection with the protozoan parasite Trypanosoma cruzi. This disease is characterised by fever, headache, lymphadenopathy, pallor, muscle pain, dyspnoea, swelling, or abdominal...\n --CHILD--> [1F53.3] Chagas disease with digestive system involvement\n Def: A disease caused by an infection with the protozoan parasite Trypanosoma cruzi. This disease is characterised by severe malaise or digestive system involvement (such as megaoesophagus or megacolon). T...", "[1F53.Z] Chagas disease, unspecified\n --PARENT--> [1F53] Chagas disease\n Def: A disease caused by an infection with the protozoan parasite Trypanosoma cruzi. This disease is characterised by fever, headache, lymphadenopathy, pallor, muscle pain, dyspnoea, swelling, or abdominal...\n --CHILD--> [1F53.2] Chronic Chagas disease with heart involvement\n Def: A disease caused by a chronic infection with the protozoan parasite Trypanosoma cruzi. This disease commonly presents with severe malaise or cardiac involvement (such as cardiomyopathy, cardiac failur...", "[1F2E.Z] Paracoccidioidomycosis, unspecified\n --PARENT--> [1F2E] Paracoccidioidomycosis\n Def: A disease caused by an infection with the fungi Paracoccidioides brasiliensis. This disease commonly presents with fever, toxaemia, weight loss, adenopathy, hepatosplenomegaly, anaemia, or eosinophili...\n --CHILD--> [1F2E.Y] Other specified paracoccidioidomycosis", "[1F2E.Z] Paracoccidioidomycosis, unspecified\n --PARENT--> [1F2E] Paracoccidioidomycosis\n Def: A disease caused by an infection with the fungi Paracoccidioides brasiliensis. This disease commonly presents with fever, toxaemia, weight loss, adenopathy, hepatosplenomegaly, anaemia, or eosinophili...\n --PARENT--> [?] Mycoses", "[1D2Z] Dengue fever, unspecified\n --PARENT--> [?] Dengue\n Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti...\n --CHILD--> [1D22] Severe dengue\n Def: Clinical signs include: 1. Severe plasma leakage leading to shock (dengue shock syndrome - DSS) and/or fluid accumulation with respiratory distress; 2. severe bleeding as evaluated by clinician, 3. se...", "[1D2Z] Dengue fever, unspecified\n --PARENT--> [?] Dengue\n Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti...\n --CHILD--> [1D20] Dengue without warning signs" ]
1F53.Z
Chagas disease, unspecified
[ { "from_icd11": "1F53.Z", "icd10_code": "B570", "icd10_title": "Acute Chagas' disease with heart involvement" }, { "from_icd11": "1F53.Z", "icd10_code": "B57", "icd10_title": "Chagas' disease" }, { "from_icd11": "1F53.Z", "icd10_code": "B574", "icd10_title": "Chagas' disease (chronic) with nervous system involvement" }, { "from_icd11": "1F53.Z", "icd10_code": "B575", "icd10_title": "Chagas' disease (chronic) with other organ involvement" }, { "from_icd11": "1F2E.Z", "icd10_code": "B419", "icd10_title": "Paracoccidioidomycosis, unspecified" }, { "from_icd11": "1F2E.Z", "icd10_code": "B41", "icd10_title": "Paracoccidioidomycosis" }, { "from_icd11": "1F2E.Z", "icd10_code": "B418", "icd10_title": "Other forms of paracoccidioidomycosis" }, { "from_icd11": "1D2Z", "icd10_code": "A97", "icd10_title": "" }, { "from_icd11": "1D2Z", "icd10_code": "A979", "icd10_title": "" }, { "from_icd11": "1D21", "icd10_code": "A971", "icd10_title": "" }, { "from_icd11": "1F66.0", "icd10_code": "B743", "icd10_title": "Loiasis" }, { "from_icd11": "5C64.10", "icd10_code": "E83110", "icd10_title": "Hereditary hemochromatosis" }, { "from_icd11": "5C64.10", "icd10_code": "E83119", "icd10_title": "Hemochromatosis, unspecified" }, { "from_icd11": "5C64.10", "icd10_code": "E83111", "icd10_title": "Hemochromatosis due to repeated red blood cell transfusions" }, { "from_icd11": "5C64.10", "icd10_code": "E8310", "icd10_title": "Disorder of iron metabolism, unspecified" } ]
B570
Acute Chagas' disease with heart involvement
A 50-year-old male, modified Rankin scale (mRS) 0, presented with the acute onset of aphasia, right-sided facial droop, and right hemiplegia, with a National Institute of Health Stroke Scale (NIHSS) of 23. A computed tomography angiography (CTA) of the head and neck demonstrated a left cervical ICA dissection and an intracranial carotid “T” type of occlusion. A CT perfusion (CTP) indicated a large mismatch between the small core (infarct) and the penumbra (viable tissue at risk). The patient was not a candidate for the recombinant tissue plasminogen activator (rtPA), as the time of his stroke/symptom onset was unknown. He was thus referred to our service for endovascular treatment of his anterior circulation ELVO. The procedure was carried out under general anesthesia since the patient was agitated. In anticipation of the potential need for emergency extracranial carotid artery stenting, the patient was loaded with 600 mg of aspirin through an orogastric tube. Once the diagnostic angiogram had confirmed an occlusive dissection of the left cervical ICA, a Precise Pro RX 7x40 mm stent (Cordis, Miami, FL) was placed. Reestablishment of antegrade flow through the cervical left ICA then demonstrated an occlusion of the ipsilateral supraclinoid ICA just distal to the takeoff of the ophthalmic artery and extending up to the distal left M1 . As described in a recently proposed scheme to classify the tortuosity of the ICA, the cavernous carotid artery of this patient was a type IB (mild tortuosity) with open configuration/angles of the anterior and posterior genu, with the subcategory determined by the posterior genu angle, which, in his case, was equal to 90 degrees . For this particular case, we used an 8 Fr FlowGate (Stryker Neurovascular, Fremont, CA) BGC positioned distal to the recently placed carotid stent, the Arc™ support catheter (Medtronic, Irvine, CA) as the intracranial intermediate AC, and a Marksman™ microcatheter (eV3, Irvine, CA), which was navigated over a Synchro-2 microwire (Stryker Neurovascular, Fremont, CA) beyond the occluded left M1. For the first thrombectomy pass, a Trevo® XP ProVue 6 x 25 mm Retriever (Stryker Neurovascular, Fremont, CA) was deployed spanning from the distal left M1 segment down to the distal supraclinoid ICA. After the first thrombectomy pass, follow-up DSA runs demonstrated persistent occlusion of the most distal supraclinoid left ICA and ipsilateral M1 segment. A second thrombectomy pass was then performed, with the stent retriever spanning a proximal M2 branch down to the proximal M1 segment . Follow-up DSA runs showed recanalization of the left supraclinoid ICA and left M1. There was also complete patency of the left anterior cerebral artery (ACA). However, there was residual occlusion of the superior left M2 branch. A third thrombectomy pass was performed using a similar technique, this time with the Trevo® Pro 18 microcatheter (Stryker Neurovascular, Fremont, CA). The Trevo® Pro 18 microcatheter was then navigated slightly more distally, this time into the proximal superior division of the left M2 branch. A Trevo® XP ProVue 4 x 20 mm (Stryker Neurovascular, Fremont, CA) stent-retriever was then delivered across the occluded segment. Follow-up angiograms demonstrated complete patency of the left supraclinoid ICA, ACA, M1, and M2 branches. As the left M1 was recanalized, residual occlusion of the left anterior temporal artery was noted. Using a Trevo® XP ProVue 3 x 30 mm stent-retriever (Stryker Neurovascular, Fremont, CA), two additional thrombectomy passes of the left anterior temporal artery occlusion were performed. In each of these thrombectomy attempts, the Arc™ catheter was again navigated against the proximal aspect of the clot, this time, situated near the ostium of the left anterior temporal artery. It is unclear why recanalization of the left anterior temporal artery was unsuccessful. No further recanalization attempts were made as some retrograde filling of the vessel territory via leptomeningeal collaterals existed. Final DSA runs demonstrated thrombolysis in cerebral infarction (TICI) 2B flow through the left anterior cerebral circulation, with a cutoff of the left anterior temporal artery . The procedure was then concluded, and the patient was extubated and transferred to the neurointensive care unit. By postoperative day (POD) 2, the patient had made significant improvement with an NIHSS of 8, with some mixed aphasia, and 4/5 strength in his right hemibody. At POD 30, the patient had only mild dysarthria and some word finding difficulty, near-normal motor strength, and had been discharged from physical therapy and occupational therapy but was still undergoing speech therapy.
4.058594
0.963867
sec[1]/sec[0]/p[0]
en
0.999996
27382525
https://doi.org/10.7759/cureus.617
[ "artery", "occlusion", "stryker", "neurovascular", "fremont", "thrombectomy", "stent", "supraclinoid", "this", "trevo" ]
[ { "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": "BE2Y", "title": "Other specified diseases of the circulatory system" }, { "code": "DB30.Y", "title": "Other specified obstruction of large intestine" }, { "code": "DA0C.Y", "title": "Other specified periodontal disease" }, { "code": "BA41.Z", "title": "Acute myocardial infarction, unspecified" }, { "code": "GA16.Y", "title": "Other specified acquired abnormalities of uterus, except cervix" } ]
=== 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 [BE2Y] Other specified diseases of the circulatory system Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart [DB30.Y] Other specified obstruction of large intestine Also known as: Other specified obstruction of large intestine | Obstruction of large intestine due to compression or stenosis | Acute bowel obstruction, not elsewhere classified | Subacute bowel obstruction, not elsewhere classified | subacute intestinal obstruction NOS [DA0C.Y] Other specified periodontal disease Also known as: Other specified periodontal disease | Chronic periodontitis | Adult periodontitis | adult-onset periodontitis | chronic pericementitis [BA41.Z] Acute myocardial infarction, unspecified Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction [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 === GRAPH WALKS === --- Walk 1 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --CHILD--> [?] Chronic arterial occlusive disease --- Walk 2 --- [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 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--> [?] Pathological fracture --- Walk 6 --- [BD52.3] Rupture of artery --PARENT--> [BD52] Certain specified disorders of arteries or arterioles --EXCLUDES--> [?] Leukocytoclastic vasculitis Def: Leukocytoclastic vasculitis (hypersensitivity vasculitis; hypersensitivity angiitis) is a histopathological term commonly used to denote a small-vessel vasculitis. It may be localised to the skin or m...
[ "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [?] Chronic arterial occlusive disease", "[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....", "[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--> [?] Pathological fracture", "[BD52.3] Rupture of artery\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles\n --EXCLUDES--> [?] Leukocytoclastic vasculitis\n Def: Leukocytoclastic vasculitis (hypersensitivity vasculitis; hypersensitivity angiitis) is a histopathological term commonly used to denote a small-vessel vasculitis. It may be localised to the skin or m..." ]
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